In the first scientific study of its kind, the National Center for Veterans Studies (NCVS) is investigating the relationship of shame, guilt and trauma among active duty military and how these variables affect Soldiers' suicide risks.

"Guilt and shame are important psychological contributors to suicide risks," said Dr. Craig Bryan, a principal researcher and the associate director of NCVS. "It's particularly relevant to military populations, which is why this research is so important."

The anonymous study consists of more than 40 active duty personnel who are currently receiving mental healthcare treatment in military clinics. Researchers hope to have 200 participants for the study, which is in its first year, by 2013.

"Most people think guilt and shame are interchangeable," said Bryan. "But guilt is feeling bad about something you've done, while shame is feeling bad about who you are - that you're a terrible person. The correlation with moral injury happens when you do things that violate your sense of right and wrong - it disrupts your sense of how the world should work and makes you feel bad about yourself."

Bryan, a cognitive behavioral psychologist and the suicide prevention manager at Lackland Air Force Base in Texas, is also an Operation Iraqi Freedom veteran. While in theater in 2009 as director of the traumatic brain injury clinic, he said troops suffering from combat-related injuries described high levels of shame, guilt and "moral injury."

Bryan said Soldiers who witnessed death and war's aftermath were more likely to become depressed and feel isolated. "Displacement occurs when they return home and begin thinking about what they've done," he said. "What happened in the ‘normal' settings of war begins to settle in, and that leads to moral injury."

The study's preliminary results indicate that higher levels of shame, guilt and moral injuries are examples of indirect links that correlate to suicide risks.

However, "Soldiers can change their perspective and be less self-critical," said Bryan. "Once they accept that the rules are different in combat, we can target that sense of shame and guilt and help them forgive themselves. That's important, because something else can trigger these feelings in the future if it's not addressed now."

NCVS is an advocate for veteran healthcare, and hopes the study will help influence policymakers, increase funding and educate and train physicians, the military and the public about veteran-related issues.  

If you or someone you know needs help, call the national crisis hotline at 1-800-273-TALK (8255).