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Mendes AL, Coimbra M, Canavarro MC, Ferreira C. How do early affiliative memories explain body image shame? A 12-month longitudinal study in adolescent girls. Appetite 2024; 200:107576. [PMID: 38908406 DOI: 10.1016/j.appet.2024.107576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/23/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE This study aimed to explain adolescent girls' body image shame across a 12- month longitudinal design, and its relationship with early parental memories of warmth and safeness and fear of receiving compassion from others. DESIGN AND METHODS Participants included 231 adolescent girls, who completed self-report measures at three different periods: baseline (W1), 6-month follow-up (W2), and 12-month follow-up (W3). Descriptive and correlational analyses were performed, and differences between participants at the different waves were explored through repeated measures ANOVA. A cross-lagged panel model tested the mediational effect of fears of receiving compassion on the association between early affiliative memories (W1) and body image shame (W3). RESULTS ANOVA results found significant differences throughout time in memories of warmth and safeness (tending to diminish) and in body image shame (tending to rise). Correlation analysis revealed that all variables were significantly associated in the expected directions, across the three waves. Finally, path analysis revealed that early affiliative parental memories (in W1) had a direct effect on body image shame (in W3), through the fear of receiving compassion from others (in W2), accounting for 85% of body image shame's variance (W3). CONCLUSIONS These findings indicate that the lack of early affiliative memories often leads to the development of defensive mechanisms such as fears of receiving compassion from others which in turn can foster isolation and distant relationships, enhancing feelings of inferiority and inadequacy, which in female adolescents can emerge centered on body image - body image shame. This study further highlights the importance of prevention and intervention strategies based on compassion to specifically target fears of receiving compassion from others, in adolescent girls dealing with feelings of inferiority and shame regarding their body.
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Affiliation(s)
- Ana Laura Mendes
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Portugal.
| | - Maria Coimbra
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Portugal
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Portugal
| | - Cláudia Ferreira
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Portugal
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2
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Lawrence D, Bagshaw R, Stubbings D, Watt A. The Maintenance Model of Restrictive Practices: A Trauma-Informed, Integrated Model to Explain Repeated Use of Restrictive Practices in Mental Health Care Settings. Issues Ment Health Nurs 2024:1-16. [PMID: 39023511 DOI: 10.1080/01612840.2024.2369594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Nurses are at the forefront of care in mental health services but their role is conflicted; they carry the most responsibility for care and also for restrictive practices. The harmful effects of restrictive practices for mental health patients are well documented, have attracted negative media attention, public concern, and criticism directed specifically at nursing staff. The need to reduce restrictive practices has been highlighted by patients, carer groups, legislators, policy makers, academics, and mental health service providers. Policies and best practice guidelines have resulted, but restrictive practices remain a global problem. This theory paper proposes that inertia is partly due to the absence of a coherent model that explains the initiation and maintenance of restrictive practice in inpatient mental health settings. The conceptual development and synthesis of the model and its practical implications are discussed.
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Affiliation(s)
- Daniel Lawrence
- Priory Group, Priory Healthcare, Monmouthshire, UK
- Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
| | - Ruth Bagshaw
- Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
| | - Daniel Stubbings
- Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
| | - Andrew Watt
- Department of Applied Psychology, Cardiff Metropolitan University, Cardiff, UK
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3
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Carvalho SA, Carvalho F, Fonseca L, Santos G, Castilho P. Beyond the Centrality of Shame: How Self-Concealment and Fear of Receiving Compassion From Others Impact Psychological Suffering in Transgender Adults. JOURNAL OF HOMOSEXUALITY 2024; 71:1373-1391. [PMID: 36043899 DOI: 10.1080/00918369.2022.2114398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Shame-based social interactions are a minority social stressor commonly experienced by transgender individuals. However, few studies have explored the centrality of shame experiences in transgender identity and mental health. Also, the ability to receive care and soothing support may be influenced by intrapersonal shame- and fear-related factors, which may hinder openness, and support and care seeking, thus contributing to psychological distress. This study aims to examine the relationship between central shame experiences, fear of receiving compassion from others, self-concealment, and psychological distress (depression, anxiety, and stress symptoms) in a sample of Portuguese transgender adults. Following a cross-sectional design, data from a convenience sample of 70 self-identified transgender individuals undergoing gender-affirming medical interventions (GAMIs) were analyzed, using SPSS PROCESS, to determine whether the relationship between central shame experiences and psychological suffering occurred indirectly through fear of receiving compassion from others, and self-concealment. Results suggest that fear of receiving compassion from others, but not self-concealment, was the underlying factor between central shame experiences, and depression and anxiety. Results suggest that the centrality of shame experiences and stress symptomatology associate sequentially through fear of compassion and, in turn, through self-concealment. Clinical implications for mental health interventions with transgender individuals undergoing GAMI are discussed.
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Affiliation(s)
- Sérgio A Carvalho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, School of Psychology and Life Sciences (EPCV), Lusófona University, Lisbon, Portugal
| | - Frederica Carvalho
- Faculty of Medicine, Institute of Psychological Medicine (IPM), University of Coimbra, Coimbra, Portugal
| | - Lígia Fonseca
- CHUC, Centro de Responsabilidade Integrada de Psiquiatria (CRIP), Coimbra University Hospital, Coimbra, Portugal
| | - Graça Santos
- CHUC, Centro de Responsabilidade Integrada de Psiquiatria (CRIP), Coimbra University Hospital, Coimbra, Portugal
| | - Paula Castilho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
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Vermeulen M, Gandhi A, Van Den Eede F, Raes F, Krans J. Event centrality in social anxiety disorder and major depressive disorder. Memory 2024; 32:528-539. [PMID: 38662790 DOI: 10.1080/09658211.2024.2341706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 04/03/2024] [Indexed: 07/24/2024]
Abstract
Event centrality is defined by the extent to which a memory of an event has become central to an individual's identity and life story. Previous research predominantly focused on the link between event centrality and trauma-related symptomatology. Nevertheless, it can be argued that the perception of (adverse) events as central to one's self is not exclusive to Posttraumatic Stress Disorder (PTSD). Other disorders where adverse events are linked to the onset of symptoms might also be related to event centrality. This study examined the relevance of event centrality for Social Anxiety Disorder (SAD) and for Major Depressive Disorder (MDD) separately. Moreover, we examined which cognitive and emotion regulation variables (i.e., trait anxiety, rumination, worry, intrusions and avoidance, and posttraumatic cognitions) mediated these relationships. No significant correlation was found between event centrality and social anxiety. However, a significant positive correlation was found between event centrality and depression. In a combined group, this relation was mediated by all cognitive and emotion regulation variables except for worry.
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Affiliation(s)
- Mirjam Vermeulen
- Behavior, Health, and Psychopathology, KU Leuven, Leuven, Belgium
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Amarendra Gandhi
- Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Filip Van Den Eede
- Department of Psychiatry, Antwerp University Hospital, Edegem (Antwerp), Belgium
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Filip Raes
- Behavior, Health, and Psychopathology, KU Leuven, Leuven, Belgium
| | - Julie Krans
- Behavior, Health, and Psychopathology, KU Leuven, Leuven, Belgium
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
- Pro Persona Overwaal Centre for Anxiety, OCD, and PTSD, Nijmegen, the Netherlands
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Zhang R, Chen J, Zhang C, Xu W. Longitudinal association of mindfulness with aggression and non-suicidal self-injury in adolescence: The mediating role of shame-proneness. Aggress Behav 2024; 50:e22121. [PMID: 37909325 DOI: 10.1002/ab.22121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
The aim of the current study was to investigate the longitudinal association of facets of mindfulness with aggression and non-suicidal self-injury (NSSI) among adolescents and to explore whether shame-proneness can mediate the longitudinal association. The present longitudinal study investigated the associations between mindfulness, aggression, and NSSI in a sample of 706 Chinese adolescents (M = 15.33; SD = 1.34; 50.20% girls). Five facet mindfulness questionnaire was completed at baseline and middle school students' shame scale was completed at 6-month follow-up. The Chinese version of Buss-Perry aggression questionnaire and adolescents' self-harm scale were completed at both baseline and 6-month follow-up. Shame-proneness significantly mediated the longitudinal association between (a) describing and aggression (-0.107, 95% CI: [-0.151 to -0.067]), and NSSI (-0.041, 95% CI: [-0.069 to -0.019]). (b) Acting with awareness and aggression (-0.094, 95% CI: [-0.139 to -0.061]), and NSSI (-0.036, 95% CI: [-0.062 to -0.016]). (c) Nonjudging and aggression (-0.062, 95% CI: [-0.107 to -0.024]) and NSSI (-0.024, 95% CI: [-0.047 to -0.008]). Describing, acting with awareness, and nonjudging were predictive factors of aggression and self-injury in adolescents, and shame-proneness played a crucial role in the negative longitudinal association between them. Findings from the current study may offer some implications in the domains of clinical practice and education to improve mental health and further ameliorate the misbehavior among adolescents.
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Affiliation(s)
- Ruotong Zhang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jing Chen
- Institute of Psychology, Chinese Academic of Sciences, Beijing, China
| | - Chunyang Zhang
- China Academy of Civil Aviation Science and Technology, Beijing, China
| | - Wei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
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Chau AKC, So SHW, Barkus E. The role of loneliness and negative schemas in the moment-to-moment dynamics between social anxiety and paranoia. Sci Rep 2023; 13:20775. [PMID: 38008774 PMCID: PMC10679161 DOI: 10.1038/s41598-023-47912-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023] Open
Abstract
Social anxiety and paranoia often co-occur and exacerbate each other. While loneliness and negative schemas contribute to the development of social anxiety and paranoia separately, their role in the development of the two symptoms co-occurring is rarely considered longitudinally. This study examined the moment-to-moment relationship between social anxiety and paranoia, as well as the effects of loneliness and negative schemas on both experiences individually and coincidingly. A total of 134 non-clinical young adults completed experience sampling assessments of momentary social anxiety, paranoia, and loneliness ten times per day for six consecutive days. Participants' negative-self and -other schemas were assessed with the Brief Core Schema Scale. Dynamic structural equation modelling revealed a bidirectional relationship between social anxiety and paranoia across moments. Loneliness preceded increases in both symptoms in the next moment. Higher negative-self schema was associated with a stronger link from paranoia to social anxiety; whereas higher negative-other schema was associated with a stronger link from social anxiety to paranoia. Our findings support the reciprocal relationship between social anxiety and paranoia. While loneliness contributes to the development of social anxiety and paranoia, negative self and other schemas appear to modify the relationships between the two symptoms.
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Affiliation(s)
- Anson Kai Chun Chau
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, New Territories, 3/F Wong Foo Yuan Building, Hong Kong, People's Republic of China
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, People's Republic of China
| | - Suzanne Ho-Wai So
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, New Territories, 3/F Wong Foo Yuan Building, Hong Kong, People's Republic of China.
| | - Emma Barkus
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, UK
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Samson I, Nyberg J, Lindström E, Schalling E. "I Just Want People to Think I'm Normal": An Interview Study of Young Swedish Women With Covert Stuttering. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2192-2210. [PMID: 37595785 DOI: 10.1044/2023_ajslp-22-00354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
PURPOSE Research indicates that there is a tendency for females who stutter, more often than males, to use coping strategies that involve covering their stutter, for example, by avoiding situations that require verbal participation. The aim of the study is to increase knowledge about how covert stuttering develops and its impact on self-image and quality of life for women who stutter. METHOD Eleven young women who stutter covertly were interviewed, and data were subjected to qualitative content analysis. Background information was obtained from the self-report instruments measuring the impact of stuttering on different aspects of life (Overall Assessment of the Speaker's Experiences of Stuttering) and degree of perceived social anxiety (Liebowitz Social Anxiety Scale, Self-Report). RESULTS Three main themes were identified: (a) managing stuttering, (b) personal aspects, and (c) stuttering as a phenomenon. Shame and a desire to fit in emerged as distinct motives for covering stuttering. The women described that stuttering controlled both life choices and everyday life. Development of self-image had been strongly negatively affected, resulting in social anxiety. The women expressed a particular vulnerability of being a woman who stutters, due to societal norms of female behavior and a lack of female role models who stutter. CONCLUSIONS The choice of coping strategy was motivated by a desire to "be normal." As a result, stuttering had come to dominate life and affect self-image and life choices. The study highlights the importance for clinicians to be alert to and aware of the fact that the experiences of women who stutter can lead them to develop coping strategies that have far-reaching negative consequences.
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Affiliation(s)
- Ineke Samson
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Danderyd Hospital, Stockholm, Sweden
| | - Jill Nyberg
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Elisabeth Lindström
- Logopedics, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turkku, Finland
| | - Ellika Schalling
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Sciences/Speech-Language Pathology, Uppsala University, Sweden
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Farahani H, Azadfallah P, Watson P, Qaderi K, Pasha A, Dirmina F, Esrafilian F, Koulaie B, Fayazi N, Sepehrnia N, Esfandiary A, Abbasi FN, Rashidi K. Predicting the Social-Emotional Competence Based on Childhood Trauma, Internalized Shame, Disability/Shame Scheme, Cognitive Flexibility, Distress Tolerance and Alexithymia in an Iranian Sample Using Bayesian Regression. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:351-363. [PMID: 37234828 PMCID: PMC10205962 DOI: 10.1007/s40653-022-00501-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 05/28/2023]
Abstract
The purpose of this study was to predict Social Emotional Competence based on childhood trauma, internalized shame, disability/shame scheme, cognitive flexibility, distress tolerance, and alexithymia in an Iranian sample using Bayesian regression. The participants in this research were a sample of 326 (85.3% female and 14.7% male) people living in Tehran in 2021 who were selected by convenience sampling through online platforms. The survey assessments included demographic characteristics (age and gender), presence of childhood trauma, social-emotional competence, internalized shame, the Toronto Alexithymia scales, Young's measure of disability/shame together with measures of cognitive flexibility and distress tolerance. The results from Bayesian regression and Bayesian Model Averaging (BMA) indicated that internalized shame, cognitive flexibility and distress tolerance can be predictive of Social Emotional Competence. These results suggested that Social Emotional Competence can be explained by some important personality factors.
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Echoes of shame: a comparison of the characteristics and psychological sequelae of recalled shame experiences across the voice hearing continuum. Behav Cogn Psychother 2023; 51:61-73. [PMID: 36285429 DOI: 10.1017/s1352465822000418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Voice hearing occurs across a number of psychiatric diagnoses and appears to be present on a continuum within the general population. Previous research has highlighted the potential role of past experiences of shame in proneness to voice hearing in the general population. AIMS This study aimed to extend this past research and compare people with distressing voices, people with voices but no distress, and a non-voice hearing control group, on various dimensions of shame and shame memory characteristics. METHOD In a cross-sectional, online study 39 distressed voice hearers, 31 non-distressed voice hearers and 50 non-voice hearers undertook a shame memory priming task in which they were prompted to recall a memory of a shaming experience from their past. They then completed questionnaires assessing the characteristics of the recalled shame event and the psychological sequalae of this event (i.e. intrusions, hyperarousal, avoidance, the centrality of shame memories, external shame, and self-criticism). RESULTS The majority of recalled shame memories involved experiences such as interpersonal criticism or experiences of being devalued. Univariate analyses found no significant differences between the three groups with regard to the shame events that were recalled, but the distressed voice hearer group reported significantly more hyperarousal, intrusions, self-criticism, and external shame in relation to their experience. CONCLUSIONS The findings suggest that voice hearers recall similar types of shame experiences to non-voice hearers, but that problematic psychological sequelae of these shame experiences (in the form of intrusive memories, hyperarousal, external shame, and self-criticism) may specifically contribute to distressing voice hearing.
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10
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Swee MB, Klein K, Murray S, Heimberg RG. A Brief Self-Compassionate Letter-Writing Intervention for Individuals with High Shame. Mindfulness (N Y) 2023; 14:854-867. [PMID: 37090852 PMCID: PMC9992917 DOI: 10.1007/s12671-023-02097-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 04/25/2023]
Abstract
Objectives Over the last decade, the mental health of undergraduate students has been of increasing concern and the prevalence of psychological disorders among this population has reached an unprecedented high. Compassion-based interventions have been used to treat shame and self-criticism, both of which are common experiences among undergraduate students and transdiagnostic vulnerability factors for an array of psychological disorders. This randomized controlled study examined the utility of a brief online self-compassionate letter-writing intervention for undergraduate students with high shame. Method Participants were 68 undergraduates who scored in the upper quartile on shame. Individuals were randomly assigned to a 16-day self-compassionate letter-writing intervention (n = 29) or a waitlist control group (n = 39). Participants completed baseline, post-assessment, and one-month follow-up measures. Results Participants who practiced self-compassionate letter writing evidenced medium-to-large reductions in global shame, external shame, self-criticism, and general anxiety at post-assessment, and gains were sustained at follow-up. Additionally, there were trend-level effects for increases in self-compassion and decreases in depression for those who participated in the intervention. Conclusions This study examined the efficacy of self-compassionate letter-writing as a stand-alone intervention for undergraduate students with high shame. This brief, easily accessible, and self-administered practice may be beneficial for a host of internalizing symptoms in this population and may support university counseling centers as they navigate high demand for mental health services.
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Affiliation(s)
| | - Keith Klein
- Southern Illinois University Carbondale, Carbondale, USA
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11
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Duarte C, Ferreira C. Body image shame in men: confirmatory factor analysis and psychometric properties of the Body Image Shame Scale. Eat Weight Disord 2022; 27:2377-2385. [PMID: 35171494 DOI: 10.1007/s40519-022-01373-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 01/21/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Body image shame plays a key role in disordered eating symptoms and psychological adjustment. Nonetheless, research has been mainly focussed on women. The Body Image Shame Scale (BISS) was previously developed and tested in a nonclinical sample of women. This study examines the BISS in a sample of men comprising students and community participants. METHODS Participants were 420 men, who completed the BISS and self-report measures of shame, self-criticism, body weight and shape concerns, and psychopathological symptoms. RESULTS The previously identified structure of the BISS, with an external and internal dimension, fitted the data well. All items presented high reliability. The BISS total score and its subscales in men present high construct reliability, and convergent and discriminant validity. Correlation analyses indicated that BISS and its subscales in men present positive associations with general shame and self-criticism, body weight and shape concerns, and with indices of poorer psychological adjustment. CONCLUSION Findings supported that the BISS is a reliable measure to assess body shame in men. LEVEL OF EVIDENCE III: Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- C Duarte
- School of Education, Language and Psychology, York St. John University, York, UK.
- Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
| | - C Ferreira
- Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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González-Rodríguez A, Seeman MV. Differences between delusional disorder and schizophrenia: A mini narrative review. World J Psychiatry 2022; 12:683-692. [PMID: 35663297 PMCID: PMC9150033 DOI: 10.5498/wjp.v12.i5.683] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/23/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
Psychotic syndromes are divided into affective and non-affective forms. Even among the non-affective forms, substantial differences exist. The aim of this relatively brief review is to synthesize what is known about the differences between two non-affective psychoses, schizophrenia and delusional disorder (DD), with respect to clinical, epidemiological, sociodemographic, and treatment response characteristics. A PubMed literature search revealed the following: in schizophrenia, hallucinations, negative symptoms and cognitive symptoms are prominent. They are rare in DD. Compared to schizophrenia patients, individuals with DD maintain relatively good function, and their delusions are believable; many are beliefs that are widely held in the general population. Treatments are generally similar in these two forms of psychosis, with the exception that antidepressants are used more frequently in DD and, for acute treatment, effective antipsychotic doses are lower in DD than in schizophrenia. It is with the hope that the contrasts between these two conditions will aid in the provision of safe and effective treatment for both that this review has been conducted.
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Affiliation(s)
- Alexandre González-Rodríguez
- Department of Mental Health, Mutua Terrassa University Hospital, University of Barcelona, Barcelona 08280, Spain
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto M5P 3L6, Ontario, Canada
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13
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Gaziel-Guttman M, Anaki D, Mashal N. Social Anxiety and Shame Among Young Adults with Autism Spectrum Disorder Compared to Typical Adults. J Autism Dev Disord 2022; 53:2490-2498. [PMID: 35394242 DOI: 10.1007/s10803-022-05526-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 11/26/2022]
Abstract
Social anxiety (SA) is common among young adults with autism spectrum disorder (ASD). While shame feelings predict SA among typical adults, the relationship between shame and SA in ASD remains unclear. The current study compared the relationship between SA and shame in ASD. SA, shame, and autistic self-assessment questionnaires were administered to 33 young adults with ASD (28 M/5F) and 38 typical young adults (32 M/6F, Mage = 24 years, range = 20-28 in both groups). Results showed higher SA levels in ASD than typical adults, but lower levels of shame characteristics in the former than in the latter group. Moreover, a significant moderation model showed that some aspects of shame were related to SA only in the typical group but not in ASD.
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Affiliation(s)
- Meyrav Gaziel-Guttman
- School of Education, Bar-Ilan University, Max & Anna Webb St, 5290002, Ramat-Gan, Israel
| | - David Anaki
- Department of Psychology, Bar-Ilan University, Max & Anna Webb St, 5290002, Ramat-Gan, Israel.
| | - Nira Mashal
- School of Education, Bar-Ilan University, Max & Anna Webb St, 5290002, Ramat-Gan, Israel.
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14
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Vermeulen M, Smits D, Claes L, Gandhi A, Raes F, Krans J. The Dutch 20 Item Centrality of Event Scale. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2022. [DOI: 10.1027/1015-5759/a000704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Event centrality is defined as the extent to which a memory of a traumatic event forms a reference point for people’s identity and attribution of meaning to other experiences in their life. Event centrality is typically measured with the Centrality of Event Scale (CES; Berntsen & Rubin, 2006 ). The present study’s first aim was to investigate the underlying factor structure and construct validity of the Dutch 20-item CES (CES-20) in undergraduates ( N = 1,091). The second aim was to test whether the CES-20 could prospectively predict posttraumatic stress disorder (PTSD) symptoms four months later. The data supported a one-factor structure of the CES with a high internal consistency (α = .95), which is not in line with the theoretical model of event centrality but aligns with previous empirical research. Furthermore, high construct validity was evidenced by positive and significant relations between the CES and PTSD symptoms, depressive symptoms, DSM-5 trauma A criterion, and the number of experienced negative life events. Event centrality was not a significant predictor of PTSD symptoms four months later when controlling for PTSD symptoms at time 1, which questions the prospective relation between event centrality and later PTSD symptoms for those events.
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Affiliation(s)
| | - Dirk Smits
- Behavior, Health and Psychopathology, KU Leuven, Belgium
- Odisee, University of Applied Sciences, Brussels, Belgium
| | - Laurence Claes
- Behavior, Health and Psychopathology, KU Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Belgium
| | - Amarendra Gandhi
- L-BioStat, Department of Public Health and Primary Care, KU Leuven, Belgium
- Knowledge Center, SD Worx, Antwerp, Belgium
| | - Filip Raes
- Behavior, Health and Psychopathology, KU Leuven, Belgium
| | - Julie Krans
- Behavior, Health and Psychopathology, KU Leuven, Belgium
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands
- Pro Persona Overwaal Centre for Anxiety, OCD and PTSD, Nijmegen, The Netherlands
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15
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ASMARI Y, DOLATSHAHI B, POURSHARIFI H, BARAHMAND U. "Early Negative Memories, Humiliation and Defectiveness/Shame Schema: An Emotion-Focused Therapeutic Approach to Social Anxiety". JOURNAL OF EVIDENCE-BASED PSYCHOTHERAPIES 2022. [DOI: 10.24193/jebp.2022.1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
"Introduction: Recently emotion-focused therapy has developed as an additional approach and considers the role of primary emotions such as shame in the formation and persistence of SAD. Objectives: The purpose of this study was to investigate the theoretical model of emotion-focused therapy for SAD by considering the role of early negative memories, humiliation and the mediating role of self-defectiveness/shame schema in the etiology of SAD. Method: This cross-sectional descriptive study recruited a sample of 105 students, 44 males (41.9%) 61 females (58.1%), diagnosed with SAD by psychologists from Shahid Beheshti University Counseling Center. Participants ranging in age from 18 to 34 with a mean age of 23.1 years (SD=3.5) completed the Social Phobia Inventory, Humiliation Inventory, Early Life Experiences Scale, Defectiveness /Shame Schema subscale of the Young Schema Questionnaire-Short Form. Results: Data were analyzed using SmartPLS-SEM. The results showed that early childhood experiences and humiliation significantly predict SAD. Also, the indirect effects of the independent variables through defectiveness/shame schema on SAD were significant. Conclusions: Consistent with the assumptions of the emotion-focused approach to SAD, these results confirm that early life experiences and humiliation with the development of shame schemes play an important role in the etiology of SAD and must be considered for therapy to be effective. The results of this study suggest that the components of the emotion-focused model can have therapeutic value as targets of intervention in randomized clinical trials."
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16
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Cunha M, Silva P, Ferreira C, Galhardo A. Measuring Shame in Adolescents: Validation Studies of the External and Internal Shame Scale in a Community Sample. CHILD & YOUTH CARE FORUM 2021. [DOI: 10.1007/s10566-021-09607-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Swee MB, Hudson CC, Heimberg RG. Examining the relationship between shame and social anxiety disorder: A systematic review. Clin Psychol Rev 2021; 90:102088. [PMID: 34598054 DOI: 10.1016/j.cpr.2021.102088] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/21/2021] [Accepted: 09/17/2021] [Indexed: 11/28/2022]
Abstract
This paper is the first systematic review of the literature on the relationship between shame and social anxiety (SA). We reviewed a total of 60 peer-reviewed empirical articles that met criteria for inclusion. We begin by summarizing literature investigating the empirical association between shame and SA and review literature on whether this association is impacted by cultural or diagnostic differences. Next, we briefly describe the updated version of Rapee and Heimberg's (1997) cognitive-behavioral model of social anxiety disorder (SAD; Heimberg, Brozovich, & Rapee, 2014) and propose how shame may interact with five processes described therein: environmental experiences, observations/images of the self, perceived negative evaluation by others, post-event cognitive processes, and behavioral manifestations of SA. We review the current literature on shame and SA as it relates to each of these domains. Thereafter, we discuss existing research on the role of shame in the treatment of SAD and the implications of the research discussed in this review. Finally, we conclude with a discussion of some key limitations in the existing literature and areas for future research.
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Affiliation(s)
- Michaela B Swee
- Department of Psychology, Temple University, 1701 North 13(th) Street, Philadelphia, PA 19122, United States.
| | - Chloe C Hudson
- Department of Psychology, Queen's University, 62 Arch Street, Humphrey Hall, Kingston, ON K7L 3N6, Canada.
| | - Richard G Heimberg
- Department of Psychology, Temple University, 1701 North 13(th) Street, Philadelphia, PA 19122, United States.
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18
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Luoma J, Lear MK. MDMA-Assisted Therapy as a Means to Alter Affective, Cognitive, Behavioral, and Neurological Systems Underlying Social Dysfunction in Social Anxiety Disorder. Front Psychiatry 2021; 12:733893. [PMID: 34646176 PMCID: PMC8502812 DOI: 10.3389/fpsyt.2021.733893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Social anxiety disorder (SAD) is a prevalent and often debilitating psychiatric disorder that can assume a chronic course even when treated. Despite the identification of evidence-based pharmacological and behavioral treatments for SAD, much room for improved outcomes exists and 3,4-methylenedioxymethamphetamine (MDMA) has been proposed as a promising adjunctive treatment to psychological interventions for disorders characterized by social dysfunction. A small randomized, placebo-controlled trial of MDMA-assisted therapy (MDMA-AT) for social anxiety in autistic adults offered encouraging results, but more research is sorely needed to explore the potential for MDMA-AT in treating SAD. This review aims to stimulate future study by summarizing research on disruptions in neurological, perceptual, receptive, and expressive systems regulating social behavior in SAD and proposing how MDMA-AT may alter these systems across four domains. First, we review research highlighting the roles of social anhedonia and reduced social reward sensitivity in maintaining SAD, with specific attention to the reduction in positive affect in social situations, infrequent social approach behaviors, and related social skills deficits. We posit that MDMA-AT may enhance motivation to connect with others and alter perceptions of social reward for an extended period following administration, thereby potentiating extinction processes, and increasing the reinforcement value of social interactions. Second, we review evidence for the central role of heightened social evaluative threat perception in the development and maintenance of SAD and consider how MDMA-AT may enhance experiences of affiliation and safety when interacting with others. Third, we consider the influence of shame and the rigid application of shame regulation strategies as important intrapersonal processes maintaining SAD and propose the generation of self-transcendent emotions during MDMA sessions as a mechanism of shame reduction that may result in corrective emotional experiences and boost memory reconsolidation. Finally, we review research on the role of dysfunctional interpersonal behaviors in SAD that interfere with social functioning and, in particular, the development and maintenance of close and secure relationships. We discuss the hypothesized role of MDMA-AT in improving social skills to elicit positive interpersonal responses from others, creating a greater sense of belonging, acceptance, and social efficacy.
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Affiliation(s)
- Jason Luoma
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
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19
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Mendes AL, Canavarro MC, Ferreira C. Affiliative interactions and body and eating-related difficulties in adolescent girls: The effects of fears of compassion and feelings of social safeness. Appetite 2021; 168:105715. [PMID: 34582885 DOI: 10.1016/j.appet.2021.105715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 11/15/2022]
Abstract
The need to examine the associations between emotion regulation and mental health and well-being among adolescents is increasingly recognized. Adolescence is a critical time characterized by increased vulnerability towards emotional struggles and difficulties, especially related with body image and eating behaviours. Thus, it seems particularly important to analyse the processes and mechanisms underlying the relationships between several risk factors (such as the lack of early affiliative memories) and body and eating-related difficulties, in this specific developmental phase. The current study intended to examine whether early affiliative memories are significantly associated with body and eating-related difficulties (i.e., body image shame and eating psychopathology severity), and whether this association is mediated by lower feelings of social safeness and increased levels of fears of receiving compassion from others. This cross-sectional study was conducted with 231 adolescent girls from the community, aged between 12 and 18, who completed self-report measures. Data were examined through descriptive and correlational statistics, and the adequacy of the model was performed via path analysis. Path analysis results revealed that fears of receiving compassion from others and low feelings of social safeness mediated the relationship between early affiliative memories and body and eating-related difficulties. The path model accounted for the variances in the following way: 27% of feelings of social safeness; 23% of fears of receiving compassion from others; 28% of body-image shame; and 54% of eating psychopathology severity, revealing a very good fit. These findings emphasize the relevance of assessing and working on potential processes underlying the adoption of disordered body and eating attitudes and behaviours, not only but especially in female adolescents with scarce recall of early affiliative experiences with close ones.
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Affiliation(s)
- Ana Laura Mendes
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Portugal.
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Portugal
| | - Cláudia Ferreira
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Portugal
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20
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Matos M, Galhardo A, Moura-Ramos M, Steindl SR, Bortolon C, Hiramatsu Y, Baumann T, Yiu RXQ, Ferreira C. Measuring shame across five countries: dimensionality and measurement invariance of the external and internal shame scale. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02019-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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O'Loghlen E, Grant S, Galligan R. Shame and binge eating pathology: A systematic review. Clin Psychol Psychother 2021; 29:147-163. [PMID: 34010473 DOI: 10.1002/cpp.2615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Shame is broadly implicated in the development and maintenance of eating pathology. However, the relationship between shame and binge eating symptoms specifically is less clear. This review aimed to clarify what types of shame are associated with binge eating symptoms and the antecedents and maintenance factors in these relationships. METHOD A systematic search for quantitative and qualitative empirical studies was conducted to identify evidence of the relationship between shame and binge eating symptoms. Altogether, 270 articles were identified and screened for eligibility in the review. RESULTS Results of the relevant empirical studies (n = 31) identified several types of shame associated with binge eating pathology: (i) internal shame, (ii) external shame, (iii) body shame and (iv) binge eating-related shame, as well as several mechanisms and pathways through which shame was associated with binge eating symptoms. DISCUSSION Drawing from the research findings, this review presents an original, integrated model of the cyclical shame-binge eating relationship. Clinical interventions that might break this cycle are discussed, as well as methodological weaknesses which limit causal inferences and important areas of future research.
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Affiliation(s)
- Elyse O'Loghlen
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Sharon Grant
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Roslyn Galligan
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
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22
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Rescripting Social Trauma: A Pilot Study Investigating Imagery Rescripting as an Adjunct to Cognitive Behaviour Therapy for Social Anxiety Disorder. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10221-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Childhood maltreatment and adulthood proneness to shame and guilt: The mediating role of maladaptive schemas. MOTIVATION AND EMOTION 2021. [DOI: 10.1007/s11031-021-09866-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Aunjitsakul W, McGuire N, McLeod HJ, Gumley A. Candidate Factors Maintaining Social Anxiety in the Context of Psychotic Experiences: A Systematic Review. Schizophr Bull 2021; 47:1218-1242. [PMID: 33778868 PMCID: PMC8379542 DOI: 10.1093/schbul/sbab026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Social anxiety is common in psychosis and associated with impaired functioning, poorer quality of life, and higher symptom severity. This study systematically reviewed factors maintaining social anxiety in people with attenuated, transient, or persistent psychotic experiences. Other correlates of social anxiety were also examined. MEDLINE, Embase, CENTRAL, and PsycINFO were searched for relevant literature up to October 19, 2020. Forty-eight articles were eligible for narrative synthesis: 38 cross-sectional studies, 8 prospective studies, 1 uncontrolled trial, and 1 qualitative study. From 12060 participants, the majority was general population (n = 8771), followed by psychosis samples (n = 2532) and those at high risk of psychosis (n = 757). The methodological quality and risk of bias were assessed using the Mixed Methods Appraisal Tool. Ninety percent of studies were rated as high to very-high quality. Poorer quality studies typically failed to adequately control for confounds and provided insufficient information on the measurement validity and reliability. Prominent psychological factors maintaining social anxiety included self-perceptions of stigma and shame. Common correlates of social anxiety included poorer functioning and lower quality of life. In conclusion, stigma and shame could be targeted as a causal mechanism in future interventional studies. The integration of findings from this review lead us to propose a new theoretical model to guide future intervention research.
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Affiliation(s)
- Warut Aunjitsakul
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand,Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK,To whom correspondence should be addressed; Glasgow Institute of Health and Wellbeing, Glasgow Mental Health Research Facility, University of Glasgow, Fleming Pavilion, West of Scotland Science Park (Todd Campus), Glasgow, G20 0XA, UK; tel: 0141-330-4852, e-mail:
| | - Nicola McGuire
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Hamish J McLeod
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Andrew Gumley
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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25
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Bortolon C, Brand RM, Altman R, Matos M. Beyond trauma: the contribution of characteristics of shame memories, shame, and self-criticism to voice-hearing proneness. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01438-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Perceived self-society moral discrepancies concerning fairness predict depression and paranoid ideation. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-018-0034-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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27
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Heriot-Maitland C, Wykes T, Peters E. Trauma and Social Pathways to Psychosis, and Where the Two Paths Meet. Front Psychiatry 2021; 12:804971. [PMID: 35082703 PMCID: PMC8785245 DOI: 10.3389/fpsyt.2021.804971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/17/2021] [Indexed: 12/17/2022] Open
Abstract
The pathways from trauma-via dissociation-to psychosis have been thoroughly tested and evidenced, but what has received less attention has been the social pathways-via dissociation-to psychosis. Often social factors are more commonly linked to other influences, e.g., to appraisals and the creation of negative schema in cognitive models, or to unsupportive caregiving experiences where there is high "expressed emotion." However, evidence is now emerging that negative social rank experiences, such as being excluded or shamed, may themselves have dissociative properties, which poses intriguing questions as to how trauma pathways and social pathways might interact. This article reviews the state of knowledge in trauma and social pathways to psychosis and then considers the potential mechanisms and the relationships between them, specifically (i) dissociation, (ii) attachment, and (iii) social rank. Recommendations are suggested for future modeling and testing of three-way interactions (dissociation × attachment × social rank) in the pathway from trauma to psychosis.
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Affiliation(s)
- Charles Heriot-Maitland
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.,Institute of Health and Wellbeing, Mental Health Research Facility, University of Glasgow, Glasgow, United Kingdom
| | - Til Wykes
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Emmanuelle Peters
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
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28
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Martins MJ, Castilho P, Santos V, Gumley A. Schizophrenia: An Exploration of an Acceptance, Mindfulness, and Compassion‐based Group Intervention. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Maria João Martins
- Faculty of Psychology, University of Coimbra,
- Community Mental Health Team, Baixo Vouga Hospital Centre,
| | | | - Vitor Santos
- Community Mental Health Team, Baixo Vouga Hospital Centre,
| | - Andrew Gumley
- Institute of Health and Wellbeing, University of Glasgow,
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29
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Castilho P, Pinto AM, Viegas R, Carvalho S, Madeira N, Martins MJ. External Shame as a Mediator between Paranoia and Social Safeness in Psychosis. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Paula Castilho
- Cognitive‐Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Ana Margarida Pinto
- Cognitive‐Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
- Psychological Medicine Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal,
| | - Ricardo Viegas
- Cognitive‐Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Sérgio Carvalho
- Cognitive‐Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Nuno Madeira
- Psychological Medicine Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal,
- Psychiatry Department, Coimbra Hospital and University Centre, Coimbra, Portugal,
| | - Maria João Martins
- Cognitive‐Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
- Psychological Medicine Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal,
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30
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Biermann M, Bohus M, Gilbert P, Vonderlin R, Cornelisse S, Osen B, Graser J, Brüne M, Ebert A, Lyssenko L, Kleindienst N. Psychometric properties of the German version of the fears of compassion scales. Clin Psychol Psychother 2020; 28:137-149. [PMID: 32783286 DOI: 10.1002/cpp.2496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/03/2020] [Accepted: 08/09/2020] [Indexed: 01/07/2023]
Abstract
The cultivation of compassion is associated with beneficial effects on physical and psychological health, satisfaction with life and social relationships. However, some individuals, especially those high in psychopathological symptoms or those with particular disorders such as borderline personality disorder (BPD) may demonstrate pronounced fears of engagement in compassionate experiences or behaviours. Furthermore, fears of compassion have been found to impede progress in psychotherapy. The 38-item fears of compassion scales (FCS) is a self-report questionnaire for measuring trait levels of fears of compassion (a) one receives from others (FCFO), (b) one feels towards others (FCTO) and (c) one feels for oneself (self-compassion; FSC). The FCS is an internationally used instrument of proven validity and reliability in both clinical and nonclinical samples. In the present study, a German translation of the FCS including its three subscales was provided, and the psychometric properties were examined in 430 participants from four different samples: (a) a sample from the general population; (b) a mixed sample of psychiatric residential and outpatients; (c) a clinical sample of residential and outpatients with a primary diagnosis of BPD and (d) a sample of healthy control participants. Internal consistencies were excellent for the German version of the FSC and acceptable to excellent for its subscales. Correlations with established measures of mental health demonstrate its validity. Additionally, the German FCS discriminates significantly between individuals from the general population and patients, thus supporting its specificity. The German FCS is suitable to detect potential obstacles in cultivating compassion in psychotherapeutic treatments and beyond.
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Affiliation(s)
- Miriam Biermann
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Mannheim, Germany
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Mannheim, Germany.,McLean Hospital Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Gilbert
- School of Sciences, University of Derby, Derby, UK
| | - Ruben Vonderlin
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Mannheim, Germany
| | - Sven Cornelisse
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Mannheim, Germany
| | - Bernhard Osen
- Clinical for Psychosomatic & Psychotherapy, Schön Clinic Bad Bramstedt, Bad Bramstedt, Germany
| | - Johannes Graser
- Faculty of Health, Department of Psychology and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Martin Brüne
- Clinic for Psychiatry, Psychotherapy and Preventive Medecine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Andreas Ebert
- Clinic for Psychiatry, Psychotherapy and Preventive Medecine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Lisa Lyssenko
- Department of Public Health and Health Education, University of Education, Freiburg, Freiburg im Breisgau, Germany
| | - Nikolaus Kleindienst
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Mannheim, Germany
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31
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Khoramnia S, Bavafa A, Jaberghaderi N, Parvizifard A, Foroughi A, Ahmadi M, Amiri S. The effectiveness of acceptance and commitment therapy for social anxiety disorder: a randomized clinical trial. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:30-38. [PMID: 32321083 DOI: 10.1590/2237-6089-2019-0003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 06/04/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Acceptance and commitment therapy has been used to treat anxiety disorders recently. The purpose of this study was to investigate the effectiveness of acceptance and commitment therapy for psychological symptoms in students with social anxiety disorder, including difficulty in emotion regulation, psychological flexibility based on experiential avoidance, self-compassion, and external shame. METHODS This study was a semi-experimental clinical trial. Twenty four students with social anxiety disorder were randomly divided into two groups after initial evaluations: an experimental group (12 subjects) and a control group (12 subjects). The experimental group received 12 treatment sessions based on a protocol of acceptance and commitment therapy for anxiety disorders, and the control group was put on a waiting list. Self-Compassion (SCS), Difficulty in Emotion Regulation (DERS), External Shame (ESS), Social Anxiety (SPIN), and Acceptance and Action (AAQ-II) questionnaires were used to assess participants. Data were analyzed using SPSS. RESULTS Acceptance and commitment therapy was shown to be effective at the post-test and follow up stages for reducing external shame, social anxiety, and difficulty in emotion regulation and its components, and for increasing psychological flexibility and self-compassion (p < 0.05). The largest effect size of treatment was for increase of psychological flexibility and the lowest efficacy was for the components "difficulty in impulse control" and "limited access to emotional strategies" at the post-test and follow-up stages, respectively. CONCLUSION Acceptance and commitment therapy may be an appropriate psychological intervention for reducing the symptoms of students with social anxiety disorder and helping them to improve psychological flexibility. Emotion and related problems can be identified as one of the main targets of this treatment. CLINICAL TRIAL REGISTRATION Iranian Registry of Clinical Trials, IRCT20180421039369N1.
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Affiliation(s)
- Samad Khoramnia
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Bavafa
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Aliakbar Parvizifard
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Aliakbar Foroughi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mojtaba Ahmadi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Amiri
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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32
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Hiramatsu Y, Asano K, Kotera Y, Sensui T, Endo A, Shimizu E, Basran J, Goss K. Development of the Japanese version of the Other As Shamer Scale using item response theory. BMC Res Notes 2020; 13:200. [PMID: 32248832 PMCID: PMC7133010 DOI: 10.1186/s13104-020-05027-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/17/2020] [Indexed: 11/25/2022] Open
Abstract
Objective External shame reflects a person’s anxiety that he or she might be rejected by others. The Other as Shamer Scale (OAS) is a scale for assessing external shame. The Japanese version of the OAS was developed, and its reliability and validity were examined using Item Response Theory (IRT). Results A survey was conducted with university students (N = 199). Exploratory factor analysis of the results indicated a significantly high factor loading on the first factor, which was identical to the original version of the scale as well as high internal consistency. Moreover, the results confirmed that each item had adequate discrimination and information levels, suggesting that external shame could be discriminated against with high accuracy for a wide range of relatively low and relatively high external shame groups. These results suggest that the OAS could be used to screen external shame as a stress factor and to assess intervention effects.
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Affiliation(s)
- Yoichi Hiramatsu
- Research Center for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. .,The Japanese Centre for Compassionate Mind Reserch and Training, Tokyo, Japan. .,Komachi Clinical Psychology Office, 2-11-1, Minamisaiwai, Nisi-ku, Yokohama-MSBldg, Yokohama, Kanagawa, 220-0005, Japan.
| | - Kenichi Asano
- The Japanese Centre for Compassionate Mind Reserch and Training, Tokyo, Japan.,Department of Psychological Counseling, Faculty of psychology, Mejiro University, 4-31-1 Nakaochiai, Shinjyuku-ku, Tokyo, 161-0032, Japan
| | - Yasuhiro Kotera
- Human Sciences Research Centre, University of Darby, Kedleston Road, Derby, DE22 1GB, UK
| | - Toshihiko Sensui
- Department of Psychology, Faculty of Human Studies, Saitamagakuen University, 1510, Kizoro, Kawaguchi, Saitama, 333-0831, Japan
| | - Ayumu Endo
- Department of Psychology, Faculty of Letters, Komazawa University, 1-23-1, Komazawa, Setagaya-ku, Tokyo, 154-8525, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,Department of Cognitive Behavioral Physiology, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Jaskaran Basran
- Centre for Compassion Research and Training,College of Health and Social Care Research Centre, University of Derby, Derby, DE22 1GB, UK.,The Compassionate Mind Foundation, Office 29, Riverside Chambers, Full Street, Derby, DE1 3AF, UK
| | - Ken Goss
- Coventry & Warwickshire Partnership Trust, Coventry Eating Disorder Service, Swanswell Point, Stoney Stanton Road, Coventry, CV1 4FS, UK
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Ferreira C, Moura-Ramos M, Matos M, Galhardo A. A new measure to assess external and internal shame: development, factor structure and psychometric properties of the External and Internal Shame Scale. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00709-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Vermeulen M, Smits D, Boelen PA, Claes L, Raes F, Krans J. The Dutch Version of the Centrality of Event Scale (CES). EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2020. [DOI: 10.1027/1015-5759/a000517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract. Event centrality is defined as the extent to which the memory of a traumatic event forms a reference point for personal identity and the attribution of meaning to other experiences in a person’s life. The current study investigated the psychometric properties of the Dutch translation of the Centrality of Event Scale (CES; Berntsen & Rubin, 2006 ) and its relation with symptoms of Posttraumatic Stress Disorder (PTSD), depression, exposure to traumatic events as defined by DSM-5 trauma criterion A, and negative life events in a student sample ( N = 967). An underlying structure of one factor was found. This factor structure was replicated in two additional independent samples. High internal consistency was found for a 6-item CES. CES scores were positively related to symptoms of PTSD and depression, to the DSM-5 trauma criterion A, and the number of negative life events. The CES made a unique contribution to the explained variance in PTSD symptoms when controlling for depression. However, CES scores were unrelated to depression when controlling for PTSD symptoms, suggesting that event centrality might be more typically related to PTSD, and less to depression.
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Affiliation(s)
| | - Dirk Smits
- Behavior, Health and Psychopathology, KU Leuven, Belgium
- Odisee, University of Applied Sciences, Brussels, Belgium
| | - Paul A. Boelen
- Department of Clinical Psychology, Utrecht University, The Netherlands
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - Laurence Claes
- Behavior, Health and Psychopathology, KU Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Belgium
| | - Filip Raes
- Behavior, Health and Psychopathology, KU Leuven, Belgium
| | - Julie Krans
- Behavior, Health and Psychopathology, KU Leuven, Belgium
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35
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Carden LJ, Saini P, Seddon C, Watkins M, Taylor PJ. Shame and the psychosis continuum: A systematic review of the literature. Psychol Psychother 2020; 93:160-186. [PMID: 30426672 DOI: 10.1111/papt.12204] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 09/07/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Shame is increasingly implicated in the development and maintenance of several psychological problems including psychosis. The aim of the current paper was to review the research literature concerning the relationship between shame and the psychosis continuum, examining the nature and direction of this relationship. METHOD Systematic searches of databases PsycINFO, Medline, Scopus, and Web of Science (from the earliest available database date until November 2016) were undertaken to identify papers that examined the relationship between shame and psychosis or psychotic experiences. RESULTS A total of 20 eligible papers were identified. Risk of bias assessment identified methodological shortcomings across the research in relation to small, unrepresentative samples and failure to control for confounding variables. Narrative synthesis suggested positive associations between shame and paranoia (n = 10, r = .29-.62), shame and psychosis (n = 1, r = .40), and shame and affiliation with voices (n = 1, β = .26), and suggested that shame was greater in those with psychosis compared to controls (n = 4, d = 0.76-1.16). CONCLUSIONS Overall, several studies provide partial support for the theory that shame is an important factor in relation to psychotic experiences in both clinical and non-clinical populations, particularly paranoia. However, the predominance of cross-sectional designs prevents any conclusions being drawn concerning the temporal nature of associations. Additional research is necessary to further delineate the role of shame in relation to specific psychotic experiences such as voice-hearing. Longitudinal research is particularly needed to help establish the directionality and temporal aspects of effects. PRACTITIONER POINTS Research indicates moderate-to-strong positive associations between shame and psychotic experiences in the existing literature. The results provide preliminary evidence that shame may play a role in relation to psychosis and, more specifically, paranoia. Findings should be interpreted with caution due to many disparities across the studies reviewed and methodological shortcomings (e.g., small sample sizes). It is not currently possible to determine causality or direction of effect due to the cross-sectional design of all existing studies.
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Affiliation(s)
- Louise J Carden
- Single Point of Access, Mersey Care NHS Trust, Liverpool, UK
| | - Pooja Saini
- NIHR CLAHRC NWC, Institute of Psychology, Health & Society, University of Liverpool, UK.,School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK
| | - Claire Seddon
- Liverpool Early Intervention Service, Mersey Care NHS Trust, Liverpool, UK
| | - Megan Watkins
- NIHR CLAHRC NWC, Institute of Psychology, Health & Society, University of Liverpool, UK
| | - Peter James Taylor
- Division of Psychology & Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, UK
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Abstract
PURPOSE OF REVIEW Studies on the relations between shame and anxiety and obsessive-compulsive and related disorders (OCRDs) are reviewed, with a focus on recent work. RECENT FINDINGS Medium-sized positive correlations have been consistently found across anxiety disorders and OCRDs, suggesting that this relation is transdiagnostic. Most studies focused on shame-proneness and found similar relations across multiple types (e.g. internal, external) and domains (e.g. bodily, characterological, behavioural) of shame, with little variation between clinical and non-clinical populations and different age categories. However, most studies are cross-sectional and correlational and by separately studying clinical and non-clinical populations, they do not give a unitary dimensional view of the relation between shame and symptoms. Emerging findings suggest that shame may be a marker of the response to treatment in these disorders, and its relation with symptoms may be bidirectional. The consistent but medium-sized associations between shame and symptoms of anxiety and OCRDs warrant the future search for mediators and moderators.
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Affiliation(s)
- Aurora Szentágotai-Tătar
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania. .,The Institute for Research, Development and Innovation in Applied Natural Sciences, Babeş-Bolyai University, Cluj-Napoca, Romania.
| | - Diana-Mirela Nechita
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.,International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Andrei C Miu
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania.,Cognitive Neuroscience Laboratory, Babeș-Bolyai University, Cluj-Napoca, Romania
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Wong GHY. Social anxiety within a network of mild delusional ideations, negative symptoms and insight in outpatients with early psychosis: A psychopathological path analysis. ANXIETY STRESS AND COPING 2020; 33:342-354. [DOI: 10.1080/10615806.2020.1723007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Gloria Hoi-Yan Wong
- Department of Social Work and Social Administration and Department of Psychiatry, The University of Hong Kong, Hong Kong
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38
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Simpson J, Helliwell B, Varese F, Powell P. Self-disgust mediates the relationship between childhood adversities and psychosis. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2020; 59:260-275. [PMID: 32011749 DOI: 10.1111/bjc.12245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/07/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Traumatic events in childhood have been implicated in the development of psychosis, but given that trauma is not in itself sufficient to cause psychosis, researchers have started to investigate other psychological constructs potentially involved in explaining this relationship. Given that self-disgust as a transdiagnostic construct plays a role in the development/maintenance of a range of mental health difficulties, the objective of this study was to investigate whether self-disgust mediates the relationship between childhood trauma and psychosis. METHOD A cross-sectional quantitative study design was used. Seventy-eight participants (Mage = 37.64 years, SDage = 11.57 years; 77% women; 88% White Caucasian) who reported experiencing clinical levels of psychosis were recruited using social media. The participants completed online survey measures of childhood trauma, self-disgust, experiences of psychosis, self-esteem, and external shame. The data were analysed using correlation and mediation analyses. RESULTS Significant indirect effects of childhood trauma on both positive (β = .17, BC 95% CI [0.06, 0.30]) and negative symptoms (β = .26, BC 95% CI [0.14, 0.40]) of psychosis via self-disgust were observed. These effects remained despite the inclusion of self-esteem and external shame as control variables in the mediation models. CONCLUSION This study is the first to show a mediating role for self-disgust in the relationship between childhood trauma and later psychosis. Although the findings should be considered preliminary until strengthened by further research, they nevertheless provide corroboration of the potential utility of self-disgust as a transdiagnostic construct not only from a theoretical perspective, but also from its potential to inform formulation and interventions. PRACTITIONER POINTS When assessing individuals with psychosis, especially those with a trauma history explore experiences and feelings related to the construct of self-disgust. Such experiences are likely to centre on feelings of repulsion towards the self/need for distance and might also manifest in the content of their psychotic experiences. Individuals with significant levels or experiences of self-disgust are likely to need specific interventions to address these; while interventions seeking to improve positive aspects of their identity might well be useful, they are unlikely to address the specific maladaptive elements of self-disgust. While self-disgust-focused interventions have not been widely researched, limited current evidence suggests cognitive restructuring and affirmation techniques might be useful.
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Affiliation(s)
- Jane Simpson
- Division of Health Research, Lancaster University, UK
| | - Ben Helliwell
- Division of Health Research, Lancaster University, UK
| | - Filippo Varese
- Division of Psychology and Mental Health, University of Manchester, UK.,Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Philip Powell
- School of Health and Related Research, University of Sheffield, UK.,Department of Economics, University of Sheffield, UK
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Kotera Y, Adhikari P, Sheffield D. Mental health of UK hospitality workers: shame, self-criticism and self-reassurance. SERVICE INDUSTRIES JOURNAL 2020. [DOI: 10.1080/02642069.2020.1713111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yasuhiro Kotera
- Centre for Human Sciences Research, University of Derby, Derby, UK
| | - Prateek Adhikari
- Centre for Human Sciences Research, University of Derby, Derby, UK
| | - David Sheffield
- Centre for Human Sciences Research, University of Derby, Derby, UK
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40
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Martins MJ, Macedo A, Carvalho CB, Pereira AT, Castilho P. Are shame and self‐criticism the path to the pervasive effect of social stress reactivity on social functioning in psychosis? Clin Psychol Psychother 2019; 27:52-60. [DOI: 10.1002/cpp.2406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 09/04/2019] [Accepted: 10/01/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Maria João Martins
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences University of Coimbra Coimbra Portugal
- Department of Psychological Medicine, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - António Macedo
- Department of Psychological Medicine, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Célia Barreto Carvalho
- Department of Psychology, Faculty of Human and Social Sciences University of Azores Portugal
| | - Ana Telma Pereira
- Department of Psychological Medicine, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Paula Castilho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences University of Coimbra Coimbra Portugal
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41
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Cheok F, Proeve M. The Role of Perspective Taking and Alexithymia in Associations Between Shame, Guilt, and Social Anxiety. J Cogn Psychother 2019; 33:286-300. [PMID: 32746392 DOI: 10.1891/0889-8391.33.4.286] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The present study expanded previous research concerning relationships between shame, guilt, and social anxiety by examining both internal and external shame and exploring the role of two cognitive constructs relating to emotion regulation, perspective taking, and alexithymia. Findings were consistent with the literature regarding positive associations between shame and social anxiety and no relationship between guilt and social anxiety. Perspective taking was positively related to guilt, while alexithymia was positively related to both shame types. Social anxiety was predicted by shame-proneness, external shame, and alexithymia. There were also small indirect effects for both types of shame on social anxiety through alexithymia. Further replication of relationships between shame, alexithymia, and social anxiety is needed. Alexithymia, with and without concurrent shame, has implications for therapeutic interventions for social anxiety as it may represent a barrier to implementing conventional therapies.
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Affiliation(s)
- Frida Cheok
- School of Psychology, University of Adelaide, South Australia, Australia
| | - Michael Proeve
- School of Psychology, University of Adelaide, South Australia, Australia
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42
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Gilboa‐Schechtman E, Keshet H, Peschard V, Azoulay R. Self and identity in social anxiety disorder. J Pers 2019; 88:106-121. [DOI: 10.1111/jopy.12455] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/26/2018] [Accepted: 01/14/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Eva Gilboa‐Schechtman
- Department of Psychology and the Gonda Brain Science Center Bar‐Ilan University Ramat‐Gan Israel
| | - Hadar Keshet
- Department of Psychology and the Gonda Brain Science Center Bar‐Ilan University Ramat‐Gan Israel
| | - Virginie Peschard
- Department of Psychology and the Gonda Brain Science Center Bar‐Ilan University Ramat‐Gan Israel
| | - Roy Azoulay
- Department of Psychology and the Gonda Brain Science Center Bar‐Ilan University Ramat‐Gan Israel
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43
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Ferreira C, Dias B, Oliveira S. Behind women's body image-focused shame: Exploring the role of fears of compassion and self-criticism. Eat Behav 2019; 32:12-17. [PMID: 30471481 DOI: 10.1016/j.eatbeh.2018.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 11/02/2018] [Accepted: 11/06/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE Recent studies seem to support that being open to compassion from self and others is key for psychological and social well-being. In particular, findings indicated that fears of affiliative emotions are associated with negative affect and difficulties in threat regulation. The current study examined a path model which tested the direct and indirect effect of fears of compassion on both externalized and internalized body image-related shame, and the potential mediator role of self-criticism on these relationships. METHODS In this study participated 651 Portuguese women, aged between 18 and 55, from the general population who completed a set of self-report measures of fears of compassion, self-criticism, and body image-related shame. RESULTS The tested model accounted for 53% of externalized and 45% of internalized body image shame's variance and revealed an excellent fit. Findings corroborated the plausibility of the hypothesized model suggesting that fears of self-compassion and receiving compassion from others are positively associated with body image shame, and that self-criticism is a significant mediator of these associations, even when controlling for the effects of age and BMI. CONCLUSIONS These findings highlight the relevance of addressing fears of compassion and critical forms of self-relating in the understanding and management of body image-related difficulties. This study seems to have important clinical implications by suggesting the pertinence of the cultivation of compassionate abilities and attitudes, as adaptive self-regulatory strategies to target body image difficulties.
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Affiliation(s)
- Cláudia Ferreira
- CINEICC - Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
| | - Bernardo Dias
- CINEICC - Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Sara Oliveira
- CINEICC - Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
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44
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Kotera Y, Gilbert P, Asano K, Ishimura I, Sheffield D. Self‐criticism and self‐reassurance as mediators between mental health attitudes and symptoms: Attitudes toward mental health problems in Japanese workers. ASIAN JOURNAL OF SOCIAL PSYCHOLOGY 2018. [DOI: 10.1111/ajsp.12355] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Yasuhiro Kotera
- Human Sciences Research Centre University of Derby Derby United Kingdom
| | - Paul Gilbert
- Human Sciences Research Centre University of Derby Derby United Kingdom
| | - Kenichi Asano
- Department of Psychological Counseling Mejiro University Tokyo Japan
| | - Ikuo Ishimura
- Department of Clinical Psychology Tokyo Seitoku University Tokyo Japan
| | - David Sheffield
- Human Sciences Research Centre University of Derby Derby United Kingdom
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45
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Savulich G, Jeanes H, Rossides N, Kaur S, Zacharia A, Robbins TW, Sahakian BJ. Moral Emotions and Social Economic Games in Paranoia. Front Psychiatry 2018; 9:615. [PMID: 30524323 PMCID: PMC6258735 DOI: 10.3389/fpsyt.2018.00615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 11/01/2018] [Indexed: 11/13/2022] Open
Abstract
Impaired social cognitive processes are putative psychological mechanisms implicated in the formation and maintenance of paranoid beliefs. Paranoia denotes unfounded fears about the hostile intentions of others and is prevalent in a significant proportion of the general population. We investigated social cognition in healthy participants selectively recruited to have a broad occurrence of paranoid thinking (n = 89). Participants completed a novel computerized task of moral emotions and two social economic exchange games (Prisoner's Dilemma, Ultimatum Game) from the EMOTICOM neuropsychological test battery. Regression analyses revealed that delusional ideation predicted shameful feelings when the victim of deliberate harm by another person. Cooperative behavior on the Prisoner's Dilemma was greatest when the participant and opponent contributed equally to joint earnings. Participants demonstrated significantly more punishment behavior when contributions were unequal and stole more from the opponent using a suspicious strategy of gameplay. In addition, paranoid thinking was positively associated with more stealing from the cooperative opponent. On the Ultimatum Game, participants accepted significantly more unequal offers when the opponent contributed more and sensitivity to fairness was greatest when the participant contributed more. These data demonstrate that delusional ideation predicts a maladaptive emotional response to interpersonal harm and that paranoid thinking may lead to reduced cooperation toward mutual reward. The effects of paranoia on moral emotions and pro-social behavior at more severe levels of persecutory thinking warrant further investigation.
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Affiliation(s)
- George Savulich
- Department of Psychiatry, University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Hannah Jeanes
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Nicole Rossides
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Sahaj Kaur
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Alice Zacharia
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W. Robbins
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Barbara J. Sahakian
- Department of Psychiatry, University of Cambridge, School of Clinical Medicine, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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46
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Steindl SR, Matos M, Creed AK. Early shame and safeness memories, and later depressive symptoms and safe affect: The mediating role of self-compassion. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-9990-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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47
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Tonna M, Paglia F, Ottoni R, Ossola P, De Panfilis C, Marchesi C. Delusional disorder: The role of personality and emotions on delusional ideation. Compr Psychiatry 2018; 85:78-83. [PMID: 30005180 DOI: 10.1016/j.comppsych.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/26/2018] [Accepted: 07/03/2018] [Indexed: 11/26/2022] Open
Abstract
The relationship between personality and Delusional Disorder in still debated. The present study aimed to evaluate the role of personality features and emotional dispositions on the proneness to delusional beliefs, through the lens of a dimensional approach. 91 outpatients were administered the Structured Interview for DSM-IV Personality Disorders, the Pathological Narcissism Inventory, the Positive and Negative Affect Schedule and the Peters et al. Delusions Inventory. Delusion proneness was positively related to the "Hiding the Self" domain of narcissistic vulnerability and to paranoid traits and negatively related to "Positive Affect". Paranoid traits and "Hiding the Self" significantly interacted in influencing delusion ideation. These data suggest that proneness to delusion depends, at least in part, on a complex interplay between specific emotional and paranoid dispositions within personality.
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Affiliation(s)
- Matteo Tonna
- Department of Mental Health, Local Health Service, Parma, Italy.
| | - Francesca Paglia
- Department of Neuroscience, Psychiatric Unit, University of Parma, Italy
| | - Rebecca Ottoni
- Department of Neuroscience, Psychiatric Unit, University of Parma, Italy
| | - Paolo Ossola
- Department of Neuroscience, Psychiatric Unit, University of Parma, Italy
| | - Chiara De Panfilis
- Department of Neuroscience, Psychiatric Unit, University of Parma, Italy; Department of Mental Health, Local Health Service, Parma, Italy
| | - Carlo Marchesi
- Department of Neuroscience, Psychiatric Unit, University of Parma, Italy; Department of Mental Health, Local Health Service, Parma, Italy
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48
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Cândea DM, Szentagotai-Tătar A. Shame-proneness, guilt-proneness and anxiety symptoms: A meta-analysis. J Anxiety Disord 2018; 58:78-106. [PMID: 30075356 DOI: 10.1016/j.janxdis.2018.07.005] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 11/28/2022]
Abstract
There is a growing body of investigations showing that shame and guilt are important features of various psychological problems including anxiety disorders. This study quantitatively summarized the magnitude of the associations of shame and guilt with anxiety symptoms. We looked both at the associations with broader categories of anxiety symptoms (i.e., undifferentiated anxiety symptoms, trait and state anxiety), but also with symptoms specific to individual anxiety disorders. In most cases, shame was more strongly associated with anxiety symptoms (in general medium effect sizes) than guilt (in general small effect sizes). When controlling for the shared variance of shame and guilt, in most cases only shame remained significantly associated with anxiety symptoms. Moderation analyses testing for the effect of subtype of shame/guilt, type of measurement, clinical status, age and gender were conducted. Two types of guilt seem to be equally maladaptive as shame, generalized guilt (involving a free-floating guilt separated from specific contexts) and contextual-maladaptive guilt (involving an inappropriate or exaggerated feeling of responsibility). External shame (perceived negative evaluations of others) seems to be more strongly associated with social anxiety symptoms than internal shame (negative self-evaluations). Results for other moderators and implications are discussed in light of the existing theoretical and empirical data.
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Affiliation(s)
- Diana-Mirela Cândea
- Evidence-Based Assessment and Psychological Interventions Doctoral School, Babeş-Bolyai University, 37 Republicii Street 400015, Cluj-Napoca, Romania; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, 37 Republicii Street 400015, Cluj-Napoca, Romania
| | - Aurora Szentagotai-Tătar
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, 37 Republicii Street 400015, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, 37 Republicii Street, 400015, Cluj-Napoca, Romania.
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49
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Gehrt TB, Berntsen D, Hoyle RH, Rubin DC. Psychological and clinical correlates of the Centrality of Event Scale: A systematic review. Clin Psychol Rev 2018; 65:57-80. [PMID: 30138786 DOI: 10.1016/j.cpr.2018.07.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 07/25/2018] [Accepted: 07/29/2018] [Indexed: 10/28/2022]
Abstract
The Centrality of Event Scale (CES) was introduced to examine the extent to which a traumatic or stressful event is perceived as central to an individual's identity and life story, and how this relates to Posttraumatic Stress Disorder (PTSD) symptoms. In addition, the CES has been examined in relation to a range of other conditions and dispositions. We present a systematic review of the correlates of the CES. Results from 92 publications resulted in 25 measurement categories in the six theoretical domains of trauma, negative affect and distress, autobiographical memory, personality, positive affect, and gender. The mean weighted correlations of the 25 measurement categories ranged from -.17 to .55, with standard errors from .01 to .02, allowing us to distinguish empirically among effects. Consistent with the theoretical motivation for the CES and predictions predating the review, the CES correlated positively with a range of measures, correlating most highly with measures related to trauma, PTSD, grief, and autobiographical memory. The findings show that the CES probes aspects of autobiographical memory of broad relevance to clinical disorders, and with specific implications for theories of PTSD.
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Affiliation(s)
- Tine B Gehrt
- Center on Autobiographical Memory Research, Aarhus University, Denmark.
| | - Dorthe Berntsen
- Center on Autobiographical Memory Research, Aarhus University, Denmark
| | - Rick H Hoyle
- Department of Psychology and Neuroscience, Duke University, United States
| | - David C Rubin
- Center on Autobiographical Memory Research, Aarhus University, Denmark; Department of Psychology and Neuroscience, Duke University, United States
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Matos M, Duarte J, Pinto-Gouveia J. The Origins of Fears of Compassion: Shame and Lack of Safeness Memories, Fears of Compassion and Psychopathology. THE JOURNAL OF PSYCHOLOGY 2018; 151:804-819. [PMID: 29166226 DOI: 10.1080/00223980.2017.1393380] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Empirical and clinical research suggests that some individuals find self-generating compassion and receiving compassion from others difficult and aversive. However, it is unclear how these fears of compassion are linked to early experiences and to psychopathological symptoms. This study explores the relationship between shame traumatic memories, centrality of shame memories, early memories of warmth and safeness, fears of compassion, and depression, anxiety and paranoid symptoms. Participants were 302 individuals from the general community population, who completed self-report measures of fears of compassion, shame memories, early affiliative memories, and psychopathology. Shame traumatic and central memories were positively associated with fears of compassion for self, for others and from others, whereas early memories of warmth and safeness were negatively related to such fears. Path analyses revealed that fears of compassion for self and of receiving compassion from others mediated the effects of shame traumatic memory, centrality of shame memory and early memories of warmth and safeness on depressive, anxious and paranoid symptoms. These findings have implications for therapeutic interventions as these fears, as well as the negative shame-based emotional memories fuelling them, may need to be addressed in therapy to assist patients in self-generating and receiving compassion.
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