Guilt as a mediator between depressive symptoms and subjective age: A 17-year longitudinal study of Israeli ex-prisoners of war

This longitudinal study assesses the trajectories of depressive symptoms and subjective age and the mediating role of guilt in the association between them. Two groups of aging Israeli combat veterans (M age = 57), 128 ex-prisoners of war (ex-POWs), and 106 comparable combat veterans (controls), were assessed at 3 times: 18 (Time 1 [T1]), 30 (Time 2 [T2]), and 35 (Time 3 [T3]) years after the war. They filled out self-report questionnaires on depression, guilt, and subjective age. Results revealed that significantly more ex-POWs had chronic or delayed clinical levels of depressive symptoms than did controls and that chronic and delayed depressive symptoms were associated with a higher subjective age at T3. Furthermore, the path between depressive symptoms at T1 for predicting subjective age at T3 was fully explained by levels of guilt-distress at T2. Although the mediation effect was found in both study groups, it was significantly stronger among ex-POWs than among controls. These findings suggest that not only is depression a long-term sequela of traumatic stress, it is also a risk factor for psychological aging among war veterans. Furthermore, guilt-distress appears to play an important role in advancing subjective age, especially among ex-POWs.