Genuine regret follows guilt ultimately (4)
I believe the answer is:
true
'genuine' is the definition.
(associated in meaning)
'regret follows guilt ultimately' is the wordplay.
'regret' becomes 'rue' (to rue something is to regret it).
'follows' says to put letters next to each other.
'ultimately' says to take the final letters.
The final letter of 'guilt' is 't'.
'rue' after 't' is 'TRUE'.
(Other definitions for true that I've seen before include "Factually accurate" , "Straight or loyal" , "Real; loyal" , "In accordance with facts" , "Agreeing with fact or reality" .)