Selfhood under stress: Network differences in trauma-related disorders and self-conscious emotions

Background Disturbances in self-organization (DSO), self-conscious emotions such as shame and guilt, and internalizing symptoms are increasingly recognized as fundamental components of trauma-related psychopathology. However, little is known about how these domains interrelate across individuals with different levels of clinical need. This exploratory study used network analysis to examine the structure of PTSD, DSO, shame, guilt, anxiety, and depression in clinical and non-clinical groups. Methods A community sample and an out-patient clinical sample completed the International Trauma Questionnaire (ITQ), the Personal Feelings Questionnaire-2 (PFQ-2), the GAD-7, and the PHQ-9. Regularized partial correlation networks were estimated separately for the two groups. Centrality, bridge strength, and community detection indices were compared to identify convergent and divergent patterns. Results Across both groups, DSO emerged as a central and extensively connected node, indicating a core role of self-related disturbances in the broader network architecture. Anxiety and depression formed a coherent internalizing cluster, while guilt showed a stable association with depressive symptoms in both networks. Distinct patterns also emerged: in the clinical group, stronger edges linked shame, DSO, and depression, whereas guilt displayed a clearer connection with PTSD and anxiety-related nodes. These differences suggest greater embedding of self-conscious emotions within psychopathological processes under conditions of elevated distress. Conclusions Findings highlight the pivotal role of self-organization difficulties within trauma-related psychopathology and reveal both shared and group-specific pathways linking shame, guilt, and internalizing symptoms. These results underscore the relevance of considering self-related disturbances not only in PTSD-focused formulations but also across broader clinical constellations. Implications for future research and therapeutic approaches are discussed.