A recent study confirms the role of guilt and the need to resolve meaning-of-life issues in those attempting to move beyond PTSD:
Combat veterans commonly report guilt and depression following stressful military experiences. More depressed veterans often report higher levels of posttraumatic stress disorder (PTSD; Dohrenwend et al., 2006). Guilt also appears to be a distress-related response, potentially increasing both avoidant coping and PTSD (Henning & Frueh, 1997; Street, Gibson, & Holohan, 2005), potentially worsening prognosis and treatment response (Kubany et al., 1995; Owens, Chard, & Cox, 2008). Understanding the multiple inﬂuences on PTSD is a pressing priority, particularly with current military deployments.
Cognitive restructuring models of coping (e.g., Park & Ai, 2006) may explain why PTSD develops in some trauma survivors and not others. Posttraumatic stress disorder is believed to result when a traumatic event shatters core beliefs that enable people to establish meaning in life (Janoff-Bulman, 1992). If people cannot cognitively restructure traumatic events, regain meaning in life, and rebuild core beliefs, depression and guilt may develop. ...
Veterans of various service eras (N =174) completed an Internet survey about combat exposure, posttraumatic stress disorder (PTSD) symptoms, depression, guilt, and meaning in life. Results of a hierarchical regression indicated that younger age; higher levels of combat exposure, depression, and guilt; and lower meaning in life predicted greater PTSD severity. The interaction between meaning in life and depression also was significant, with a stronger inverse relation between meaning and PTSD at lower levels of depression. Meaning in life may be an important treatment concern for veterans with PTSD symptoms, particularly at higher levels of functioning.
Source: "Posttraumatic stress disorder, guilt, depression, and meaning in life among military veterans," Journal of Traumatic Stress, Volume 22 Issue 6, Pages 654-657
In educational interest, article(s) quoted from extensively.