Although guilt is not one of the 'core' symptoms of post-traumatic stress disorder (PTSD) it often goes hand-in-hand with it. There can be guilt at surviving a trauma while others did not and a feeling of responsibility for not preventing the event in the first place. People can also feel guilty about how they behaved during and after the trauma and about how they deal with its consequences. Guilt has been found to be prevalent in about a third of children experiencing acute or non-abusive trauma such as floods, fires and car accidents and among children exposed to recurring trauma or child abuse nearly 60% felt guilt. A study of 87 Californian children between the ages of 5 and 16, all of whom had been exposed to interpersonal violence, found that guilt over things done and not done was highly associated with the severity of the child's PTSD. Feelings of unreality and separation anxiety were also significantly related to PTSD symptoms.
Kletter, Hilit, Weems, Carl F. and Carrion, Victor G. - Guilt and posttraumatic stress symptoms in child victims of interpersonal violence Clinical Child Psychology and Psychiatry January 2009, 14(1), 71-83
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