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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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Levinstein Y, Zerach G, Levi-Belz Y, Bonanno GA. Trajectories of moral injury and their associations with posttraumatic stress symptoms among recently discharged israeli veterans. J Psychiatr Res 2024; 177:321-329. [PMID: 39067256 DOI: 10.1016/j.jpsychires.2024.07.025] [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: 02/29/2024] [Revised: 05/15/2024] [Accepted: 07/15/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND While it is already known that potentially morally injurious events (PMIEs) have a deleterious effect on veterans, little is known about the changes in PMIEs subjective appraisals over time, as well as its contribution to changes in psychiatric symptoms. In the current study, we longitudinally assessed subjective appraisals of PMIEs experienced during combat military service and their associations with posttraumatic stress symptoms (PTSS) among recently discharged combat veterans. METHOD Participants were 374 veterans who participated in a one-year longitudinal study with three measurement points: T1-one month before discharge from army service, and then again six months and twelve months following discharge (T2 and T3, respectively). RESULTS Latent Growth Mixture Modeling (LGMM) indicated heterogenic patterns of changes in PMIEs across measurements. The 'resilient' (low and stable PMIEs) trajectory best represented PMIE, followed by 'recovery' and 'chronic' fluctuating trajectories. Moreover, the 'resilient' PMIEs trajectory was found to be consistently associated with lower PTSS scores compared to 'chronic' or 'worsening' trajectories. CONCLUSIONS Our findings are the first to identify longitudinal trajectories of PMIEs subjective appraisals and to provide evidence of their association with PTSS, which might serve as potential assessment and intervention targets among recently discharged traumatized veterans.
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Affiliation(s)
- Yoav Levinstein
- Dept. of Health and Well-being, Medical Corps, IDF, School of Social Work, Bar-Ilan University, Ramat-Gan, Israel.
| | - Gadi Zerach
- Dept. of Psychology, Ariel University, Ariel, Israel
| | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| | - George A Bonanno
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
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Tsironis C, Tatsis F, Konstanti Z, Mentis M, Stolakis K, Kotsia V, Mantzoukas S, Dragioti E, Gouva M. Resilience and Self-Compassion: Shields Against Age-Related Declines in Oral Health and Shame. Cureus 2024; 16:e66565. [PMID: 39252728 PMCID: PMC11382438 DOI: 10.7759/cureus.66565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2024] [Indexed: 09/11/2024] Open
Abstract
Objective This study aimed to investigate the complex relationships between demographic factors, oral health indicators, self-compassion, and psychological well-being among elderly individuals by using a path model analysis. Methods The findings of this cross-sectional study are derived from data collected from a sample of 204 patients, including 120 females and 84 males, aged between 60 and 92 years, with an average age of 74.2 years (SD = 7.1). Participants took part in assessments including the Geriatric Oral Health Assessment Index (GOHAI) to measure oral health (physical function, psychosocial function, pain/discomfort), self-compassion scale, and measures of shame and "other as shamer" experiences. Demographic information including age and gender was also collected. Path analysis was employed to examine the direct and indirect effects of demographic variables, oral health indicators, and self-compassion on psychological well-being. Results Older age was consistently associated with poorer oral health outcomes across all GOHAI oral health subscales. However, resilience and self-compassion appear to exert a correspondingly large positive influence, neutralizing the negative effects of increasing age on physical and psychosocial aspects of oral health-related quality of life. Additionally, resilience was positively associated with better physical and psychosocial function related to oral health while oral health was confirmed to be related to internal and external (social) shame. However, resilience and self-compassion outperformed oral health as far as their effect on internal and external (social) shame is concerned. Gender had minimal effects on most outcome variables. Conclusions The findings underscore the importance of addressing both physical and psychological aspects of health in elderly care and oral health interventions. By promoting psychological resilience and self-compassion, healthcare providers can potentially enhance oral health-related quality of life and overall well-being among elderly populations. Our results also highlight that promoting social and leisure activities may be a means of improving mental well-being, enhancing oral health outcomes, and reducing shame-related distress among elderly individuals.
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Affiliation(s)
- Christos Tsironis
- Research Laboratory Psychology of Patients, Families and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
| | - Fotios Tatsis
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, GRC
| | - Zoe Konstanti
- Research Laboratory Psychology of Patients, Families and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
| | - Manolis Mentis
- Department of Educational Sciences and Social Work, University of Patras, Patra, GRC
| | - Konstantinos Stolakis
- Department of Educational Sciences and Social Work, University of Patras, Patra, GRC
| | - Vasiliki Kotsia
- Research Laboratory Psychology of Patients, Families and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
| | - Stefanos Mantzoukas
- Research Laboratory Integrated Care, Health and Well-Being, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
| | - Elena Dragioti
- Research Laboratory Psychology of Patients, Families and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
| | - Mary Gouva
- Research Laboratory Psychology of Patients, Families and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
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Rubin DC, Bell CF. Using shame to extend Martin Conway's self-memory system. Memory 2024; 32:666-677. [PMID: 37525335 DOI: 10.1080/09658211.2023.2241673] [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: 05/18/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Abstract
We extend Conway's self-memory system by adding theory and data from shame, an emotion that disrupts the internalised ideals of society needed for a positive self-concept. The event that caused 273 undergraduates their greatest amount of shame was analyzed; 66% were not very negative except for producing shame. Ratings of post-event effects, including two measure of self (self-perceived weakness, and centrality to identity) and four clinical symptoms (intrusions, avoidance, anxiety, and depression), were attributed separately to the remembered event, behaviour during the event, and shame from the event. The effects of shame were generally as large as the those of the event and larger than those of the behaviour, demonstrating the importance of shame's effects. The Tonic Immobility Scale (TIS), which measures tonic immobility (i.e., freezing), was obtained for the event that produced the most tonic immobility but that was not the event that caused the most shame. The post-event symptoms measured on the event that caused the most shame and the TIS correlated highly, suggesting that shame and tonic immobility may belong to a cluster of phylogenetically conserved submissive defensive mechanisms that could account for effects currently attributed to goals in self-memory systems.
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Affiliation(s)
- David C Rubin
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Center on Autobiographical Memory Research, Aarhus University, Aarhus, Denmark
| | - Carolyn F Bell
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
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Heriot-Maitland C, Wykes T, Peters E. Social influences on the relationship between dissociation and psychotic-like experiences. Psychol Med 2024:1-9. [PMID: 38825863 DOI: 10.1017/s0033291724001405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
BACKGROUND Shame is experienced as a threat to social self, and so activates threat-protective responses. There is evidence that shame has trauma-like characteristics, suggesting it can be understood within the same conceptual framework as trauma and dissociation. Evidence for causal links among trauma, dissociation, and psychosis thus warrant the investigation of how shame may influence causal mechanisms for psychosis symptoms. METHODS This study tested the interaction between dissociation and shame, specifically external shame (feeling shamed by others), in predicting psychotic-like experiences (PLEs) six months later in a general population sample (N = 314). It also tested if social safeness moderates these effects. A longitudinal, online questionnaire design tested a moderation model (dissociation-shame) and a moderated moderation model (adding social safeness), using multiple regressions with bootstrap procedures. RESULTS Although there was no direct effect of dissociation on PLEs six months later, there was a significant interaction effect with shame, controlling for PLEs at baseline. There were complex patterns in the directions of effects: For high-shame-scorers, higher dissociation predicted higher PLE scores, but for low-shame-scorers, higher dissociation predicted lower PLE scores. Social safeness was found to significantly moderate these interaction effects, which were unexpectedly more pronounced in the context of higher social safeness. CONCLUSIONS The results demonstrate evidence for an interaction between dissociation and shame on its impact on PLEs, which manifests particularly for those experiencing higher social safeness. This suggests a potential role of social mechanisms in both the etiology and treatment of psychosis, which warrants further testing in clinical populations.
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Affiliation(s)
- Charles Heriot-Maitland
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Til Wykes
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Emmanuelle Peters
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Hu Y, Yang Y, He Z, Wang D, Xu F, Zhu X, Wang K. Self-concept mediates the relationships between childhood traumatic experiences and adolescent depression in both clinical and community samples. BMC Psychiatry 2024; 24:224. [PMID: 38532347 DOI: 10.1186/s12888-024-05671-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/11/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Childhood trauma is a pivotal risk factor for adolescent depression. While the association between childhood trauma and depression is well-established, the mediating role of self-concept has not been acknowledged. Specifically, limited attention has been paid to how childhood maltreatment impacts adolescent depression through physical and social self-concept, both in clinical and community samples. This study aims to investigate how distinct and cumulative childhood trauma affects adolescent depression, as well as the potential mediating role of self-concept in their relationships. METHODS We recruited 227 depressed adolescents (dataset 1, 45 males, age = 15.34 ± 1.96) and 574 community adolescents (dataset 2, 107 males, age = 16.79 ± 0.65). Each participant was assessed on five subtypes of childhood trauma severity, cumulative trauma index, physical and social self-concept, and depression. Mediation models were tested separately in the clinical and community samples. RESULTS Clinically depressed adolescents experienced a higher level of trauma severity, a greater number of trauma subtypes, and had lower levels of physical and social self-concept compared to community adolescents. Analyses on childhood trauma severity and cumulative trauma index jointly indicated that physical and social self-concept played mediation roles in the relationships between childhood trauma experiences and depression. Moreover, the mediating effects of self-concept were stronger in depressed adolescents when compared to community samples. CONCLUSIONS Our findings suggest that physical and social self-concept play mediating roles in the pathway linking childhood trauma and adolescent depression, particularly in clinically depressed individuals.
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Affiliation(s)
- Yufei Hu
- School of Psychology, Shandong Normal University, 250358, Jinan, China
| | - Ying Yang
- Shandong Mental Health Center, 250014, Jinan, China
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, 250012, Jinan, China
| | - Zhengna He
- School of Psychology, Shandong Normal University, 250358, Jinan, China
| | - Duanwei Wang
- Shandong Mental Health Center, 250014, Jinan, China
| | - Feiyu Xu
- Shandong Mental Health Center, 250014, Jinan, China
| | - Xingxing Zhu
- School of Health and Wellbeing, University of Glasgow, G12 8TB, Glasgow, UK.
| | - Kangcheng Wang
- School of Psychology, Shandong Normal University, 250358, Jinan, China.
- Shandong Mental Health Center, 250014, Jinan, China.
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Burback L, Yap S, Purdon SE, Abba-Aji A, O’Shea K, Brémault-Phillips S, Greenshaw AJ, Winkler O. Randomized controlled trial investigating web-based, therapist delivered eye movement desensitization and reprocessing for adults with suicidal ideation. Front Psychiatry 2024; 15:1361086. [PMID: 38435978 PMCID: PMC10904458 DOI: 10.3389/fpsyt.2024.1361086] [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] [Received: 12/24/2023] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Promising preliminary evidence suggests that EMDR may reduce suicidal ideation (SI) when used to treat Major Depressive Disorder, Posttraumatic Stress Disorder, and trauma symptoms in the context of acute mental health crises. EMDR has never been tested specifically for treating SI, and there is a lack of data regarding the safety and effectiveness of web-based, therapist-delivered EMDR in populations with known SI. The primary objective of this study was to investigate the impact of web-based, therapist-delivered EMDR, targeting experiences associated with suicidal thinking. Secondary objectives included examining the effect of EMDR treatment on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation, as well as safety and attrition. Methods This randomized control trial (ClinicalTrials.gov ID number: NCT04181047) assigned adult outpatients reporting SI to either a web-based EMDR intervention or a treatment as usual (TAU) group. TAU included primary and mental health services available within the Canadian public health system. Participants in the EMDR group received up to 12 web-based EMDR desensitization sessions, delivered twice weekly during the COVID-19 pandemic (2021-2023). The Health Research Ethics Board at the University of Alberta approved the protocol prior to initiation of data collection for this study (protocol ID number: Pro00090989). Results Forty-two adult outpatients received either EMDR (n=20) or TAU (n=22). Participants reported a high prevalence of early onset and chronic SI, and there was a high rate of psychiatric comorbidity. In the EMDR group, median SI, depression, anxiety, and posttraumatic symptom scale scores decreased from baseline to the four month follow-up. In the TAU group, only the median SI and posttraumatic symptom scale scores decreased from baseline to four month follow up. Although sample size precludes direct comparison, there were numerically fewer adverse events and fewer dropouts in the EMDR group relative to the TAU group. Conclusion Study results provide promising preliminary evidence that web-based EMDR may be a viable delivery approach to address SI. In this complex population, a short treatment course was associated with reductions of SI and other symptoms across multiple diagnostic categories. Further investigation is warranted to verify and extend these results. Clinical Trial Registration https://clinicaltrials.gov/study/NCT04181047?id=NCT04181047&rank=1, identifier NCT04181047.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Alberta Hospital Edmonton, Edmonton, AB, Canada
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Edmonton, AB, Canada
| | - Sidney Yap
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Scot E. Purdon
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Adam Abba-Aji
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Alberta Hospital Edmonton, Edmonton, AB, Canada
| | - Katie O’Shea
- Eye Movement Desensitization and Reprocessing International Association, Austin, TX, United States
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Olga Winkler
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Alberta Hospital Edmonton, Edmonton, AB, Canada
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Edmonton, AB, Canada
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Lucre K, Ashworth F, Copello A, Jones C, Gilbert P. Compassion Focused Group Psychotherapy for attachment and relational trauma: Engaging people with a diagnosis of personality disorder. Psychol Psychother 2024. [PMID: 38305507 DOI: 10.1111/papt.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES The research aimed to evaluate an exploratory Compassion Focused Group Psychotherapy Programme and the impact on participants' experiences of self-criticism, usage of services and general wellbeing. Participants included patients with a history of complex attachment and relational trauma (A&RT), who might attract a diagnosis of personality disorder. DESIGN This study utilised a quasi-experimental non-randomised within subject controlled design for the evaluation of the efficacy of the programme. METHODS Participants were recruited from tertiary care services. The programme consisted of a 12-week Preparation and Engagement intervention (PEG) which was Compassionate Mind Training and Psychoeducation, followed by a 40-week Compassion Focused Trauma Group intervention. The cohort was then followed up after 12 months during which period they received treatment as usual. A comprehensive selection of self-report measures was administered at various points during the therapeutic process and following completion of the group interventions. RESULTS The results of the research showed that the provision of a long-term, slow-paced, Compassion Focused Group Psychotherapy intervention, resulted in significant changes across all measures which were maintained at 12-month follow-up. These significant results were maintained following intention to treat and reliable change analyses. These data were supported by a significant reduction in service usage and a significant increase in engagement in employment and education. CONCLUSIONS This study has identified that within Compassion Focused Group Psychotherapy, there is a therapeutic process of establishing group-based safeness as a necessary precursor to cultivating compassion and reworking early shame-based trauma memories.
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Affiliation(s)
- Kate Lucre
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | | | - Alex Copello
- School of Psychology University of Birmingham & Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Chris Jones
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Paul Gilbert
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, UK
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Araújo GE, Cruz OS, Moreira D. Maladaptive Beliefs of Young Adults in Interpersonal Relationships: A Systematic Literature Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:646-661. [PMID: 34405741 DOI: 10.1177/15248380211038684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Beliefs that are too rigid and misadjusted may legitimize interpersonal relationships marked by verbal, physical, or sexual violence. A systematic literature review was performed to identify the existence of maladaptive beliefs (MBs) in interpersonal relationships of young adults and their association with problematic behaviors. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, studies were obtained through a search in multiple databases: EBSCOhost, PubMed, and Web of Science. Of the 1,280 articles retrieved, 42 were retained for further analysis and 15 were considered eligible for inclusion. In addition, seven studies were added through manual search, leading to a final sample of 15 articles, published between 1964 and 2021. Only empirical studies with quantitative methodologies were included. Objectives, sample (age in years), sample type, country of origin of studies, instruments, control group, and results and main conclusions were extracted from each study. Results suggest the existence of MBs that may legitimize antisocial behavior and violence, whether physical, sexual, gender, domestic, or in intimate relationships. Some intervention programs were also identified, with different approaches with a reasonable degree of efficacy in changing these beliefs or in reducing the rates of recidivism by the aggressors.
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Affiliation(s)
| | - Olga Souza Cruz
- University of Maia -ISMAI, Maia, Porto, Portugal
- JusGov-Justice and Governance Research Centre, Braga, Portugal
| | - Diana Moreira
- University of Maia -ISMAI, Maia, Porto, Portugal
- University of Porto, Portugal
- Institute of Psychology and Neuropsychology of Porto-IPNP Health, Portugal
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Rubin DC, Bell CF. Tonic immobility (freezing) during sexual and physical assaults produces stronger memory effects than other characteristics of the assaults. Memory 2023; 31:678-688. [PMID: 36933228 DOI: 10.1080/09658211.2023.2188642] [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: 03/19/2023]
Abstract
Tonic immobility (TI) is a phylogenetically conserved, passive, obligatory defense mechanism commonly engaged during sexual and physical assaults. During TI, people become immobile while remaining conscious and later reexperience intrusive memories of both their assault and of its accompanying immobility. Here we show that this well-studied biological process has powerful effects on memory and other processes. Participants had experienced either a serious sexual (n = 234) or physical (n = 137) assault. For both the assault and its accompanying immobility, the standard measure of the peritraumatic severity of TI correlated between .40 and .65 with post-assault effects on memory, including memory of the assault and memory of the immobility, the two memory-based self-concept measures of self-blame and event centrality, and post-assault anxiety and depression. The correlations with TI were much higher than other peritraumatic characteristics commonly used to predict and describe posttraumatic effects in assaults and other traumas. The results suggest that TI should be considered for a broader, more biologically based and ecologically valid understanding of the effects of trauma on memory and memory-based reactions.
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Affiliation(s)
- David C Rubin
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA.,Center on Autobiographical Memory Research, Aarhus University, Aarhus, Denmark
| | - Carolyn F Bell
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
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Remondi C, Casu G, Pozzi C, Greco F, Gremigni P, Brugnera A. A Serial Mediation Model of Insecure Attachment and Psychological Distress: The Role of Dispositional Shame and Shame-Coping Styles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3193. [PMID: 36833888 PMCID: PMC9966328 DOI: 10.3390/ijerph20043193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Shame is an intense, difficult to regulate, self-conscious emotion that predicts aspects of poor psychological functioning and is also strongly related to early relationships. Attachment insecurities, which constitute non-specific risk factors for psychological maladjustment, have been associated with an individual's tendency to experience shame. In this study, we sought to examine the serial mediating roles of dispositional shame and shame-coping styles (i.e., attack other, attack self, withdrawal and avoidance) in the association between anxious and avoidant attachment, and psychological distress. Using a cross-sectional design, self-reported data were collected. The study sample included 978 respondents (57% female) with a mean age of 32.17 ± 13.48 years. The results of the path analysis indicated that both attachment dimensions were sequentially associated with dispositional shame and then with the attack self shame-coping style, which was, in turn, positively related to psychological distress. Further, attachment insecurities were sequentially associated with dispositional shame and then with the avoidance shame-coping style, which was, in turn, negatively related to psychological distress. The model was gender invariant, suggesting that the serial mediation worked in a similar way for men and women. The practical implications of these findings are discussed.
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Affiliation(s)
- Chiara Remondi
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | - Giulia Casu
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Camilla Pozzi
- Independent Researcher, Via Stefano Gobatti 5, 40137 Bologna, Italy
| | - Francesco Greco
- Independent Researcher, Via Stefano Gobatti 5, 40137 Bologna, Italy
| | - Paola Gremigni
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino 2, 29129 Bergamo, Italy
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Mental Health of Czech University Psychology Students: Negative Mental Health Attitudes, Mental Health Shame and Self-Compassion. Healthcare (Basel) 2022; 10:healthcare10040676. [PMID: 35455853 PMCID: PMC9028411 DOI: 10.3390/healthcare10040676] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/22/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023] Open
Abstract
High rates of mental health problems are a growing concern in Czech higher education, negatively impacting students’ performance and wellbeing. Despite the serious nature of poor mental health, students often do not seek help because of negative attitudes and shame over mental health problems. Recent mental health research reports self-compassion is strongly associated with better mental health and reduced shame. However, relationships between those constructs remain to be evaluated among Czech students. This study aims to appraise the relationships between mental health problems, negative mental health attitudes, mental health shame, and self-compassion in this population. An opportunity sample of 119 psychology students from a Czech university completed questionnaires regarding these constructs. Correlation, regression, and path analyses were conducted. Mental health problems were positively associated with negative mental health attitudes and shame, and negatively associated with self-compassion. Self-compassion negatively predicted mental health problems, while negative attitudes and shame did not. Last, self-compassion fully mediated the negative attitudes-mental health problems relationship, and partially mediated the shame-mental health problems relationship. Findings suggest self-compassion is essential for mental health in Czech students and associated with negative mental health attitudes and mental health shame. Czech universities can benefit from incorporating self-compassion training into their curricula to protect students’ mental health.
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Steindl S, Bell T, Dixon A, Kirby JN. Therapist perspectives on working with fears, blocks and resistances to compassion in compassion focused therapy. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Stan Steindl
- Compassionate Mind Research Group School of Psychology University of Queensland Brisbane Queensland Australia
| | - Tobyn Bell
- Division of Psychology and Mental Health School of Health Sciences University of Manchester Manchester UK
| | - Alison Dixon
- Greater Manchester Mental Health NHS Foundation Trust Manchester UK
| | - James N. Kirby
- Compassionate Mind Research Group School of Psychology University of Queensland Brisbane Queensland Australia
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14
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Meier S, Ramos-Ortiz J, Basille K, D'Eramo AC, Diaconu AM, Flores LJ, Hottle S, Mason-Yeary K, Ruiz Y, DeMaria AL. Cross-border reproductive healthcare attitudes and behaviours among women living in Florence, Italy. BMC Health Serv Res 2022; 22:238. [PMID: 35189893 PMCID: PMC8862247 DOI: 10.1186/s12913-022-07621-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The number of women living in Italy and seeking cross-border reproductive care (CBRC), especially for medically assisted reproduction (MAR), has increased. The purpose of this study was to explore CBRC attitudes and behaviours among a cohort of reproductive-aged women who have never engaged in CBRC to gauge social and cultural perceptions and gain a deeper understanding of family planning discourse. METHODS In-depth interviews were conducted during May - June 2018 with 30 women aged 18-50 living in or around Florence, Italy and enrolled in the Italian healthcare system. Interviews offered in-depth insight into CBRC attitudes, behaviours, and experiences among a cohort of women living in Italy who had never engaged in CBRC. Researchers used an expanded grounded theory through open and axial coding. Emergent themes were identified via a constant comparison approach. RESULTS Three themes and two subthemes emerged from the data. Participants discussed how limitations in Italy's access to MAR can lead women to seek reproductive healthcare in other countries. Women had mixed feelings about the effect of religion on legislation and reproductive healthcare access, with many views tied to religious and spiritual norms impacting MAR treatment-seeking in-country and across borders. Participants perceived infertility and CBRC-seeking as socially isolating, as the motherhood identity was highly revered. The financial cost of traveling for CBRC limited access and exacerbated emotional impacts. CONCLUSIONS Findings offered insight into CBRC perceptions and intentions, presenting a deeper understanding of the existing family planning discourse among reproductive-aged women. This may allow policymakers and practitioners to address social and cultural perceptions, increase access to safe and effective local care, and empower women in their family planning decisions.
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Affiliation(s)
- Stephanie Meier
- Division of Consumer Science, Purdue University, West Lafayette, IN, USA
| | - Jaziel Ramos-Ortiz
- Division of Consumer Science, Purdue University, West Lafayette, IN, USA
| | - Kelsie Basille
- School of Nursing, Purdue University, West Lafayette, IN, USA
| | | | - Adria M Diaconu
- Department of Health & Kinesiology, Purdue University, West Lafayette, IN, USA
| | - Lesley J Flores
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Savannah Hottle
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | | | - Yumary Ruiz
- Department of Public Health, Purdue University, 812 West State Street, West Lafayette, IN, 47907, USA
| | - Andrea L DeMaria
- Department of Public Health, Purdue University, 812 West State Street, West Lafayette, IN, 47907, USA.
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15
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Rukundo-Zeller AC, Bambonye M, Mugisha H, Muhoza JA, Ndayikengurukiye T, Nitanga L, Rushoza AA, Crombach A. Is shame the missing link between traumatic experiences and posttraumatic stress disorder in Burundian children living on the streets? Clin Psychol Psychother 2022; 29:1416-1425. [PMID: 35156248 DOI: 10.1002/cpp.2725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Shame is an emotion reflecting an anticipated social devaluation of the self. It is strongly associated with experiences of humiliation and rejection in early life. Individuals suffering from posttraumatic stress disorder (PTSD) often struggle with shame. However, little is known about how shame contributes to the development and maintenance of PTSD symptoms in children. The present study investigated the ways childhood exposure to human-induced traumatic events promotes a coping mechanism of defeat and withdrawal facilitated by the experience of shame. We tested a dose-response relationship between lifetime experienced traumatic event types and PTSD in children using shame as a mediator. METHODS We conducted semi-structured interviews with 33 male children who lived and worked on the streets of Bujumbura, the capital of Burundi at the time of data collection. We assessed self-reported PTSD symptom severity, lifetime traumatic event load, violence experienced on the streets, and shame intensity. RESULTS Mediation analyses revealed a significant indirect effect of lifetime traumatic events on PTSD symptom severity through shame intensity and a significant indirect effect of violence experienced on the streets on PTSD symptom severity through shame intensity. CONCLUSION Our study suggests the mediating role of shame between traumatic experiences as well as violent experiences and PTSD symptom severity in children living on the streets. Shame in children suffering from PTSD seems to play a crucial role in the development and maintenance of PTSD symptoms.
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Affiliation(s)
- Anja C Rukundo-Zeller
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany.,vivo international e.V.,Psychologues sans Frontières, Burundi
| | - Manassé Bambonye
- Université Lumière de Bujumbura, Burundi.,Psychologues sans Frontières, Burundi
| | | | | | | | | | | | - Anselm Crombach
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany.,vivo international e.V.,Université Lumière de Bujumbura, Burundi.,Psychologues sans Frontières, Burundi.,Department of Psychology, Clinical Psychology and Psychotherapy for Children and Adolescents at the University of Saarland, Saarbrücken, Germany
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16
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The roles of self-compassion and psychological flexibility in the psychological well-being of adolescent girls. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02438-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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17
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Farr J, Ononaiye M, Irons C. Early shaming experiences and psychological distress: The role of experiential avoidance and self-compassion. Psychol Psychother 2021; 94:952-972. [PMID: 34296792 DOI: 10.1111/papt.12353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/10/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Early shaming experiences have been suggested to be associated with later psychopathological symptoms. Understanding this relationship is complex, due to a number of psychological processes potentially influencing this. Therefore, the aim of the current study was to further explore the nature of the mediating effect of experiential avoidance in the association between early shame experiences and psychological distress, and whether self-compassion moderates this relationship by mitigating the effects of this. DESIGN A cross-sectional design was conducted using self-report measures of early shaming experiences, experiential avoidance, self-compassion, and psychological distress. METHOD An online study of 556 participants, comprised of participants from the general population and university students participated within this online study. RESULTS The moderated mediation model explained 51% of variance within depressive symptoms. Experiential avoidance was found to mediate the association between early shaming experiences and depressive symptoms. This mediating relationship was shown to be moderated by self-compassion, with higher levels of self-compassion being associated with lower levels of depressive symptoms across all levels of experiential avoidance levels (low, medium, and high). CONCLUSION These findings suggest that self-compassion may play a significant buffering role within attenuating the effects of experiential avoidance associated with depressive symptoms. Such findings present important clinical and theoretical implications in further understanding the protective role of self-compassion within early shaming experiences and the relationship between depressive symptoms. PRACTITIONER POINTS Early shaming experiences have been linked to later psychological distress. Experiential avoidance identified a core underlying psychological process in the relationship between early shaming experiences and psychological distress. Self-compassion offers a range of protective features that may alleviate the effects of experiential avoidance and depressive symptoms. Self-compassion-based interventions that target experiential avoidance may offer greater reductions within depressive symptoms.
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Affiliation(s)
| | | | - Chris Irons
- University College London and Balanced Minds, UK
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18
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Hiramatsu Y, Asano K, Kotera Y, Endo A, Shimizu E, Matos M. Development of the external and internal shame scale: Japanese version. BMC Res Notes 2021; 14:297. [PMID: 34344429 PMCID: PMC8329630 DOI: 10.1186/s13104-021-05698-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022] Open
Abstract
Objective Shame contains external and internal aspects. However, a Japanese language scale for simultaneously assessing both aspects of shame has not been developed to date. This study aimed to standardize the Japanese version of the External and Internal Shame Scale (EISS-J). An online survey was conducted among university students (N = 203) at six universities in Japan (Study 1). A retest questionnaire was sent to the participants by email three weeks after the first survey (Study 2). Study 1 examined the internal consistency, factor structure, and criterion-related validity of the EISS-J, while Study 2 examined its test-retest reliability. Moreover, an additional study was conducted to examine the criterion-related validity of the scale. Results Study 1 demonstrated the high internal consistency of the EISS-J. Moreover, confirmatory factor analysis indicated a two-factor model: external and internal shame. However, exploratory factor analysis indicated a three-factor structure. Study 2 confirmed the test-retest reliability of the scale. Furthermore, both studies indicated correlations between the EISS-J and fear of compassion, anger, humiliation, depression, anxiety, and stress. In addition, the study established the criterion-related validity of the scale. These results confirmed adequate reliability and validity of the EISS-J. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05698-2.
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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 Research and Training, Tokyo, Japan. .,Komachi Clinical Psychology Office, 2-11-1, Minamisaiwai, Nishi-ku, Yokohama-MS Bldg., Yokohama, Kanagawa, 220-0005, Japan.
| | - Kenichi Asano
- 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 Research and Training, Tokyo, Japan.,Department of Psychological Counseling, Faculty of Psychology, Mejiro University, 4-31-1 Nakaochiai, Shinjuku-ku, Tokyo, 161-0032, Japan.,National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yasuhiro Kotera
- Human Sciences Research Centre University of Darby, Kedleston Road, Derby, DE22 1GB, United Kingdom
| | - 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, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Marcela Matos
- University of Coimbra, Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Rua do Colégio Novo 3000-115 Coimbra, Portugal
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Heriot-Maitland C, Levey V. A case report of compassion-focused therapy for distressing voice-hearing experiences. J Clin Psychol 2021; 77:1821-1835. [PMID: 34252979 DOI: 10.1002/jclp.23211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 06/07/2021] [Accepted: 06/22/2021] [Indexed: 11/07/2022]
Abstract
This paper describes a 6-month period of compassion-focused therapy (CFT) for a client who has a 35-year history of hearing voices that are threatening, derogatory, and abusive. In this intervention, the client is encouraged to develop compassionate motives toward herself and to her voices, recognizing that her voices may have been functional in the context of difficult early experiences. The client develops a compassionate self-identity, which becomes the vehicle through which she approaches therapeutic tasks, such as listening and talking to voices, engaging with traumatic childhood pain, and resolving emotional conflicts. The client is an author on this study, so is able to provide valuable first-hand insights into the experience of working compassionately with her voices, and of experiencing CFT techniques for the first time.
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20
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Lucre K, Clapton N. The Compassionate Kitbag: A creative and integrative approach to compassion-focused therapy. Psychol Psychother 2021; 94 Suppl 2:497-516. [PMID: 32639097 DOI: 10.1111/papt.12291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/28/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE This paper outlines the concept of the 'Compassionate Kitbag', a novel multi-sensory-based means of helping draw together the various elements of compassionate mind training and processes within compassion-focused therapy (CFT), to help clients cultivate and facilitate their capacities for compassion. Building on the work of Lucre and Corten (2013, Psychology and Psychotherapy: Theory, Research and Practice, 86, 387), this is the first published work exploring this concept and the theoretical underpinnings, with a specific focus on how this can be used to support people with attachment and relational trauma. METHODS A narrative review of the literature on multi-sensory stimulation in facilitating people's capacities for compassion was conducted, coupled with a review of the literature of the use of non-human and transitional objects as explained by attachment theory and the broader scientific research underpinning the CFT model. RESULTS Clinical examples of how to use the Compassionate Kitbag to help stimulate compassionate therapeutic processes demonstrate the benefits of and how to begin utilizing this approach in compassion-focused work with clients with complex needs. CONCLUSIONS The Compassionate Kitbag's potential therapeutic value lies in offering multifarious creative and tangible means of accessing compassion to a wide range of individuals whom are typically fearful of, blocked, and/or resistant to compassion. Further research into the wider application of the concept of the Compassionate Kitbag is needed. PRACTITIONER POINTS Many patients with ruptured and/or traumatized early attachment relationships can find more traditional talking therapies difficult to access. Compassion-focused therapy (CFT) can offer an evolutionary-based understanding of interpersonal difficulties which can be helpful for such patients. Creatively harnessing and utilizing multi-sensory and non-linguistic social signals in CFT is key to exercising the care-giving and care-receiving social mentalities that facilitate compassionate flow. There is considerable evidence to support the use of a multi-sensory component to the therapeutic work to help patients cultivate and facilitate their capacities for compassion. The Compassionate Kitbag can be a way of supporting patients to create concrete representations of compassion in the context of the compassionate mind training component of the therapeutic work. Some of these objects can become transitional objects which can aid the therapeutic work.
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Affiliation(s)
| | - Neil Clapton
- Avon and Wiltshire Mental Health Partnership NHS Trust, Swindon, UK
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21
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Can the lack of early memories of warmth and safeness explain loneliness and quality of life? A community sample study on young and middle-aged Portuguese adults. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01649-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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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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23
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Fonseca S, Trindade IA, Mendes AL, Ferreira C. The buffer role of psychological flexibility against the impact of major life events on depression symptoms. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12194] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Soraia Fonseca
- CINEICC – Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Inês A. Trindade
- CINEICC – Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Ana Laura Mendes
- CINEICC – Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
| | - Cláudia Ferreira
- CINEICC – Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal,
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24
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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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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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26
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Trindade IA, Irons C, Ferreira C, Portela F, Pinto-Gouveia J. The influence of self-criticism on depression symptoms among ambulatory patients with inflammatory bowel disease. Clin Psychol Psychother 2019; 26:743-750. [PMID: 31614035 DOI: 10.1002/cpp.2398] [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] [Received: 01/21/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 11/07/2022]
Abstract
Considering that self-criticism is an important process in the development and maintenance of depression, and taking into account the stigma associated with inflammatory bowel disease (IBD), the present study aimed to analyse whether self-criticism exacerbates the relationships of depression symptoms with IBD symptomatology and chronic illness-related shame. The sample included 53 ambulatory IBD patients (66% females) with ages from 18 to 65. Moderation analyses were conducted using structural equation modelling. Self-criticism exacerbated the associations of depression with IBD symptoms (b = 0.01; standard error [SE] = 0.00; Z = 3.73; P < .001) and illness shame (b = 0.02; SE = 0.01; Z = 2.40; P = .016). For the same level of IBD symptomatology or chronic illness-related shame, those individuals who present more feelings of inadequacy towards the self, experience more symptoms of depression. This exacerbation effect is stronger when IBD symptomatology and chronic illness-related shame are more intense. A high self-critical IBD patient may view the illness and/or symptomatology as a flaw or error that should be self-corrected. Physicians and other health professionals should be attentive to these pathological mechanisms and should attempt to alleviate them. It may be beneficial to refer high self-critical patients to psychological care.
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Affiliation(s)
- Inês A Trindade
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Cláudia Ferreira
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Francisco Portela
- Gastroenterology Service of the Coimbra University Hospital (Centro Hospitalar Universitário de Coimbra), Coimbra, Portugal
| | - José Pinto-Gouveia
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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27
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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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Oliveira S, Trindade I, Ferreira C. Explaining male body attitudes: the role of early peer emotional experiences and shame. Eat Weight Disord 2018; 23:807-815. [PMID: 30173376 DOI: 10.1007/s40519-018-0569-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE The current study tested a path model that examined the association between early emotional experiences with peers and male body attitudes and whether general feelings of shame and body-focused shame mediate this relationship, while controlling for the effect of body mass index. METHODS The sample comprised 241 men from the general community, aged from 18 to 60, who completed an online survey. RESULTS Correlation analyses showed that the recall of positive early emotional experiences with peers is inversely linked to shame and negative body attitudes. Path analysis results indicated that early emotional experiences with peers had a direct effect on external shame, and an indirect effect on male negative body attitudes mediated by external shame and body-focused shame. Results confirmed the plausibility of the tested model, which accounted for 40% of the variance of male body attitudes. Findings suggested that men who recall fewer positive early peer emotional experiences tend to perceive that they are negatively viewed by others and present more body image-focused shame experiences. This in turn seems to explain a negative self-appreciation of one's muscularity, body fat and height. CONCLUSIONS This study contributes to a better understanding of male body attitudes. Findings suggest that the link between early emotional experiences and male body attitudes may depend on the experience of shame feelings and, particularly, on the extent to which one's body image becomes a source of shame. These data support the relevance of addressing shame experiences when working with men with body image-related difficulties. LEVEL OF EVIDENCE Level V-cross-sectional descriptive study.
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Affiliation(s)
- Sara Oliveira
- CINEICC, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal.
| | - Inês Trindade
- CINEICC, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal
| | - Claúdia Ferreira
- CINEICC, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802, Coimbra, Portugal
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Silva C, Ferreira C, Mendes AL, Marta-Simões J. The relation of early positive emotional memories to women’s social safeness: The role of shame and fear of receiving compassion. Women Health 2018; 59:420-432. [DOI: 10.1080/03630242.2018.1487906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Carolina Silva
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Cláudia Ferreira
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Ana Laura Mendes
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Joana Marta-Simões
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
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30
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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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31
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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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32
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McLean CL, Fiorillo D, Follette VM. Self-Compassion and Psychological Flexibility in a Treatment-Seeking Sample of Women Survivors of Interpersonal Violence. VIOLENCE AND VICTIMS 2018; 33:472-485. [PMID: 30567859 DOI: 10.1891/0886-6708.v33.i3.472] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Interpersonal violence is pervasive and is related to numerous negative psychological outcomes. This study examines self-compassion and psychological flexibility as potential protective factors for the range of diverse problems associated with interpersonal trauma. A community sample of 27 women (mean age = 37.74, SD = 16.16) participated in a larger pilot intervention study for psychological distress related to interpersonal violence. In this treatment-seeking sample, self-compassion was positively associated with psychological flexibility and negatively linked to higher levels of trauma-related distress, including posttraumatic stress disorder (PTSD) symptoms as well as problems related to the self and relations with others. The results suggest that self-compassion and psychological flexibility may function as protective factors in the development of problems in survivors of interpersonal violence.
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33
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McLean L, Steindl SR, Bambling M. Compassion-Focused Therapy as an Intervention for Adult Survivors of Sexual Abuse. JOURNAL OF CHILD SEXUAL ABUSE 2018; 27:161-175. [PMID: 29131716 DOI: 10.1080/10538712.2017.1390718] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Child sexual abuse can have long-term negative impacts across psychological, physical, and interpersonal domains. Some of the common issues for survivors of sexual abuse include shame and self-blame, attachment-based difficulties, avoidant coping strategies, and reduced capacity for self-compassion. Compassion-focused therapy is a transdiagnostic intervention that specifically responds to these concerns. Compassion-focused therapy was originally developed for clients who experience high levels of shame and self-criticism and aims to strengthen the soothing and affiliative system through the cultivation of compassion. This article will highlight the theoretical alignment between some of the common issues and impacts associated with experiences of sexual abuse, with the core underlying principles of compassion-focused therapy. This includes (a) the capacity of the therapy's evolutionary framework to reduce perceptions of self-blame, (b) the cultivation of compassion to respond to feelings of shame, (c) acknowledgment of the role of early attachment experiences and facilitation of corrective affiliative experiences, (d) regulation of the threat-based system following trauma, and (e) provision of an alternative to avoidant-based coping by responding to distress with compassion. It is proposed that the theoretical framework and core focus and aims of compassion-focused therapy are highly applicable for survivors of sexual abuse and therefore holds significant promise as a treatment option for this client group.
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Affiliation(s)
- Lisa McLean
- a School of Medicine, Mayne Medical School , University of Queensland , Herston , Queensland , Australia
| | - Stanley R Steindl
- b School of Psychology , University of Queensland , St. Lucia , Queensland , Australia
| | - Matthew Bambling
- c School of Medicine, Mayne Medical School , University of Queensland , Herston , Australia
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Duarte C, Pinto-Gouveia J. Self-Defining Memories of Body Image Shame and Binge Eating in Men and Women: Body Image Shame and Self-Criticism in Adulthood as Mediating Mechanisms. SEX ROLES 2016. [DOI: 10.1007/s11199-016-0728-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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35
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Contreras PM, Kallivayalil D, Herman JL. Psychotherapy in the Aftermath of Human Trafficking: Working Through the Consequences of Psychological Coercion. WOMEN & THERAPY 2016. [DOI: 10.1080/02703149.2016.1205908] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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36
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Anxiety and Depressive Symptoms Among People Living with HIV and Childhood Sexual Abuse: The Role of Shame and Posttraumatic Growth. AIDS Behav 2016; 20:1609-20. [PMID: 26837633 DOI: 10.1007/s10461-016-1298-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA.
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37
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Trindade IA, Ferreira C, Pinto-Gouveia J. Chronic Illness-Related Shame: Development of a New Scale and Novel Approach for IBD Patients' Depressive Symptomatology. Clin Psychol Psychother 2016; 24:255-263. [DOI: 10.1002/cpp.2035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 06/22/2016] [Accepted: 06/30/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Inês A. Trindade
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences; University of Coimbra; Coimbra Portugal
| | - Cláudia Ferreira
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences; University of Coimbra; Coimbra Portugal
| | - José Pinto-Gouveia
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences; University of Coimbra; Coimbra Portugal
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38
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Nazarov A, Walaszczyk V, Frewen P, Oremus C, Lanius R, McKinnon MC. Moral reasoning in women with posttraumatic stress disorder related to childhood abuse. Eur J Psychotraumatol 2016; 7:31028. [PMID: 27837580 PMCID: PMC5106867 DOI: 10.3402/ejpt.v7.31028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 08/28/2016] [Accepted: 09/05/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Preliminary evidence suggests that relative to healthy controls, patients with posttraumatic stress disorder (PTSD) show deficits on several inter-related social cognitive tasks, including theory of mind, and emotion comprehension. Systematic investigations examining other aspects of social cognition, including moral reasoning, have not been conducted in PTSD stemming from childhood trauma. OBJECTIVE To conduct a comprehensive assessment of moral reasoning performance in individuals with PTSD stemming from childhood abuse. METHOD Moral reasoning performance was assessed in 28 women with PTSD related to prolonged childhood trauma and 19 matched healthy controls. Performance was assessed using 12 modified moral dilemmas and was queried in three domains: utilitarian/deontological sacrificial dilemmas (personal and impersonal), social order vs. compassion, and altruism vs. self-interest. Participants were asked whether a proposed action was morally acceptable or unacceptable and whether or not they would perform this action under the circumstances described. RESULTS Women with PTSD were less likely to carry out utilitarian actions in personal, sacrificial moral dilemmas, a choice driven primarily by consequential intrapersonal disapproval. Increased concern regarding intrapersonal disapproval was related to higher symptoms of guilt in the PTSD group. Patients with PTSD demonstrated less altruistic moral reasoning, primarily associated with decreased empathic role-taking for beneficiaries. CONCLUSIONS Women with PTSD due to childhood trauma show alterations in moral reasoning marked by decreased utilitarian judgment and decreased altruism. Childhood trauma may continue to impact moral choices made into adulthood.
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Affiliation(s)
- Anthony Nazarov
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Victoria Walaszczyk
- Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Paul Frewen
- Department of Psychiatry, Western University, London, ON, Canada.,Department of Psychology, Western University, London, ON, Canada.,Department of Neuroscience, Western University, London, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada
| | - Carolina Oremus
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Ruth Lanius
- Department of Psychiatry, Western University, London, ON, Canada.,Department of Neuroscience, Western University, London, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada.,Imaging Division, Lawson Health Research Institute, London, ON, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Homewood Research Institute, Guelph, ON, Canada;
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39
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Hoffart A, Øktedalen T, Langkaas TF. Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: a study of within-person processes. Front Psychol 2015; 6:1273. [PMID: 26379596 PMCID: PMC4551056 DOI: 10.3389/fpsyg.2015.01273] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/10/2015] [Indexed: 01/08/2023] Open
Abstract
Although self-compassion is considered a promising change agent in the treatment of posttraumatic stress disorder (PTSD), no studies of this hypothesis exist. This study examined the within-person relationship of self-compassion components (self-kindness, common humanity, mindfulness, self-judgment, isolation, over-identification) and subsequent PTSD symptoms over the course of therapy. Method: PTSD patients (n = 65) were randomized to either standard prolonged exposure, which includes imaginal exposure (IE) to the traumatic memory, or modified prolonged exposure, where imagery re-scripting (IR) of the memory replaced IE as the imagery component of prolonged exposure in a 10 weeks residential program. They were assessed weekly on self-compassion and PTSD symptom measures. The centering method of detrending was used to separate the variance related to the within-person process of change over the course of treatment from between-person variance. Results: The self-compassion components self-kindness, self-judgment, isolation, and over-identification had a within-person effect on subsequent PTSD symptoms. These relationships were independent of therapy form. The within-person relationship between self-judgment and subsequent PTSD symptoms was stronger in patients with higher initial self-judgment. By contrast, there were few indications that within-person variations in PTSD symptoms predict subsequent self-compassion components. Conclusion: The results support the role of self-compassion components in maintaining PTSD and imply the recommendation to facilitate decrease of self-judgment, isolation, and over-identification and increase of self-kindness in the treatment of PTSD patients. The reduction of self-judgment appears to be most important, especially for patients with a high initial level of self-judgment.
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Affiliation(s)
- Asle Hoffart
- Research Institute, Modum Bad Vikersund, Norway ; Department of Psychology, University of Oslo Oslo, Norway
| | - Tuva Øktedalen
- Research Institute, Modum Bad Vikersund, Norway ; Department of Psychology, University of Oslo Oslo, Norway
| | - Tomas F Langkaas
- Research Institute, Modum Bad Vikersund, Norway ; Department of Psychology, University of Oslo Oslo, Norway
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40
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Freed S, D'Andrea W. Autonomic Arousal and Emotion in Victims of Interpersonal Violence: Shame Proneness But Not Anxiety Predicts Vagal Tone. J Trauma Dissociation 2015; 16:367-83. [PMID: 25894989 PMCID: PMC4499010 DOI: 10.1080/15299732.2015.1004771] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The redefinition of posttraumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has highlighted a range of posttraumatic affects beyond fear and anxiety. For survivors of interpersonal violence, shame has been shown to be an important contributor of self-reported symptomatology. Although biological models of PTSD emphasize physiological arousal secondary to fear and anxiety, evidence suggests that shame might be related to increased arousal as well. This study tested the contributions of anxiety, fear, and shame to autonomic arousal in a sample of female victims (N = 27) of interpersonal violence with PTSD. Shame proneness was the only significant correlate of autonomic arousal during a trauma reminder paradigm. These findings indicate that shame corresponds to important indicators of changes to the autonomic nervous system that have previously been assumed to be fear related.
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Affiliation(s)
- Steven Freed
- a The New School for Social Research , New York , New York , USA
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41
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Balsamo M, Macchia A, Carlucci L, Picconi L, Tommasi M, Gilbert P, Saggino A. Measurement of external shame: an inside view. J Pers Assess 2014; 97:81-9. [PMID: 25157581 DOI: 10.1080/00223891.2014.947650] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aims of this study were to investigate the construct validity of the Other as Shamer scale (OAS) using confirmatory factor analysis (CFA) and to examine the psychometric properties of its Italian version in a sample of 687 nonclinical individuals. The CFA results indicated that the hypothesized hierarchical model (with 1 higher order factor and 3 first-order factors) was the best fitting solution. Cronbach's alpha indexes, as well as test-retest stability, provided satisfactory results. Correlations of the OAS total score and its subscales with the Beck Depression Inventory-II (rs = .30-.48) and the Teate Depression Inventory (rs = .32-.45) were both substantial and significant (p < .01). Receiver operating characteristic curves were constructed to indicate sensitivity and specificity of the OAS and its subscales when determining those nonclinical subjects who met clinical thresholds for depression symptoms. A series of cutoff scores for the OAS scale and its subscales was developed, with sensitivity values between .70 and .62, and specificity values between .71 and .62, indicating good to fair discrimination between the 2 groups (depressed vs. nondepressed). The theoretical and practical implications of these results were discussed.
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Affiliation(s)
- Michela Balsamo
- a Department of Psychological Sciences, Humanities and Territory , G. d'Annunzio University , Chieti , Italy
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42
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Sansen LM, Iffland B, Neuner F. The trauma of peer victimization: Psychophysiological and emotional characteristics of memory imagery in subjects with social anxiety disorder. Psychophysiology 2014; 52:107-16. [DOI: 10.1111/psyp.12291] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 06/11/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Lisa M. Sansen
- Department of Clinical Psychology and Psychotherapy; Bielefeld University; Bielefeld Germany
- Christoph-Dornier-Stiftung für Klinische Psychologie (Christoph Dornier Foundation); Bielefeld Germany
| | - Benjamin Iffland
- Department of Clinical Psychology and Psychotherapy; Bielefeld University; Bielefeld Germany
| | - Frank Neuner
- Department of Clinical Psychology and Psychotherapy; Bielefeld University; Bielefeld Germany
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43
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Pajak R, Kamboj SK. Experimental single-session imagery rescripting of distressing memories in bowel/bladder-control anxiety: a case series. Front Psychiatry 2014; 5:182. [PMID: 25566101 PMCID: PMC4265982 DOI: 10.3389/fpsyt.2014.00182] [Citation(s) in RCA: 7] [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: 10/20/2014] [Accepted: 12/02/2014] [Indexed: 11/16/2022] Open
Abstract
Bowel and bladder obsession [bowel/bladder-control anxiety (BBCA)] is a viscerally centered phobic syndrome involving a specific concern about losing control of bowel or bladder functioning in a public place. Like other anxiety disorders, BBCA is characterized by intrusive imagery. We have previously described the nature of intrusive mental imagery in BBCA and found imagery themes to be linked to actual experiences of loss of control or to "near misses." A causal role for imagery in symptom maintenance can be inferred by examining the effects of imagery rescripting. Moreover, successful rescripting may point to a potentially efficacious avenue for treatment development. Three cases of imagery rescripting are described here with pre-, post-, and follow-up (1-week) data reported. After rescripting, two participants experienced pronounced reductions in imagery vividness, distress, shame, disgust, and belief conviction. Most importantly, all three participants experienced a reduction in fear-associated bladder and/or bowel sensations. The results support a causal role for mental imagery in bowel-bladder-control anxiety and suggest that rescripting of distressing intrusive memories linked to recurrent images may be a useful avenue for development of cognitive-behavioral treatments of bladder/bowel-control anxiety.
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Affiliation(s)
- Rosanna Pajak
- Research Department of Clinical, Educational and Health Psychology, University College London , London , UK
| | - Sunjeev K Kamboj
- Research Department of Clinical, Educational and Health Psychology, University College London , London , UK
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Wallace R, Russell H. Attachment and Shame in Gender-Nonconforming Children and Their Families: Toward a Theoretical Framework for Evaluating Clinical Interventions. Int J Transgend 2013. [DOI: 10.1080/15532739.2013.824845] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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45
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Frewen PA, Schmittmann VD, Bringmann LF, Borsboom D. Perceived causal relations between anxiety, posttraumatic stress and depression: extension to moderation, mediation, and network analysis. Eur J Psychotraumatol 2013; 4:20656. [PMID: 24003362 PMCID: PMC3758932 DOI: 10.3402/ejpt.v4i0.20656] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 07/10/2013] [Accepted: 07/26/2013] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Previous research demonstrates that posttraumatic memory reexperiencing, depression, anxiety, and guilt-shame are frequently co-occurring problems that may be causally related. OBJECTIVES The present study utilized Perceived Causal Relations (PCR) scaling in order to assess participants' own attributions concerning whether and to what degree these co-occurring problems may be causally interrelated. METHODS 288 young adults rated the frequency and respective PCR scores associating their symptoms of posttraumatic reexperiencing, depression, anxiety, and guilt-shame. RESULTS PCR scores were found to moderate associations between the frequency of posttraumatic memory reexperiencing, depression, anxiety, and guilt-shame. Network analyses showed that the number of feedback loops between PCR scores was positively associated with symptom frequencies. CONCLUSION Results tentatively support the interpretation of PCR scores as moderators of the association between different psychological problems, and lend support to the hypothesis that increased symptom frequencies are observed in the presence of an increased number of causal feedback loops between symptoms. Additionally, a perceived causal role for the reexperiencing of traumatic memories in exacerbating emotional disturbance was identified.
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Affiliation(s)
- Paul A Frewen
- Department of Psychiatry and Psychology, Graduate Program in Neuroscience, Western University Canada, London, Ontario, Canada
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46
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Thomson P, Jaque SV. Exposing shame in dancers and athletes: shame, trauma, and dissociation in a nonclinical population. J Trauma Dissociation 2013; 14:439-54. [PMID: 23796174 DOI: 10.1080/15299732.2012.757714] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The relationship between shame, past traumatic events, and dissociation in a nonclinical university and community sample of pre-professional/professional dancers (n = 140) and recreational/competitive athletes (n = 99) was investigated in this cross-sectional study, which was approved by an institutional review board. Participants completed 3 self-report measures (i.e., the Dissociative Experiences Scale, Internalized Shame Scale, Traumatic Events Questionnaire), and the analyses included correlation, multivariate analysis of variance, and a series of regression analyses. The investigation indicated that dancers had increased shame and dissociation in comparison to athletes, and males had more traumatic experiences and increased dissociation relative to females. In the regression analyses, being a dancer, traumatic experiences, and shame predicted dissociation. Clinical recommendations include integrating shame treatment with dissociative-disordered patients and noting that dancers may need more psychological skill training to manage shame and dissociation.
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Affiliation(s)
- Paula Thomson
- Faculty of Fine Arts, York University, Toronto, Ontario, Canada.
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47
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Matos M, Pinto-Gouveia J, Duarte C. Above and beyond emotional valence: The unique contribution of central and traumatic shame memories to psychopathology vulnerability. Memory 2012; 20:461-77. [DOI: 10.1080/09658211.2012.680962] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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48
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Vásquez DA, de Arellano MA, Reid-Quiñones K, Bridges AJ, Rheingold AA, Stocker RPJ, Danielson CK. Peritraumatic dissociation and peritraumatic emotional predictors of PTSD in Latino youth: results from the Hispanic family study. J Trauma Dissociation 2012; 13:509-25. [PMID: 22989240 PMCID: PMC4769641 DOI: 10.1080/15299732.2012.678471] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This is the 1st study to examine peritraumatic dissociation and peritraumatic emotions as they predict symptoms and diagnosis of posttraumatic stress disorder (PTSD) in Latino youth. Our aim was to test the hypothesis that the degree of peritraumatic dissociation would predict the number of PTSD symptoms and PTSD clinical diagnosis when the influences of other salient factors were statistically controlled. We also explored the possible contributions of peritraumatic emotional responses to PTSD symptomatology and PTSD diagnosis. We expected that peritraumatic dissociation would emerge as a significant predictor of PTSD. A total of 204 Latino youth (mean age = 12.37 years) completed semistructured individual clinical interviews with bilingual research assistants. These interviews assessed trauma exposure, peritraumatic responses, and current psychopathology. A linear regression analysis demonstrated significant relationships between lifetime number of traumatic events, peritraumatic dissociation, shame, and number of PTSD symptoms endorsed. Significant inverse (protective) relationships were demonstrated between anger and guilt and current PTSD symptomatology. Logistic regression analysis demonstrated significant relationships between peritraumatic dissociation, shame, lifetime number of traumatic events experienced, and PTSD diagnosis. The analyses examined both the number of PTSD symptoms as well as diagnosis of PTSD while simultaneously controlling for age, lifetime exposure to traumatic events, time residing in the United States, and gender. These results support an increasingly robust body of empirical literature suggesting that the peritraumatic dissociative and emotional responses to trauma are important predictors of future PTSD diagnosis. Possible cultural factors contributing to the dissociative responses in Latino youth and clinical implications are discussed.
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Affiliation(s)
- Desi Alonzo Vásquez
- Department of Psychiatry and Behavioral Sciences , Medical University of South Carolina, Charleston, South Carolina, USA.
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Pinto-Gouveia J, Matos M. Can shame memories become a key to identity? The centrality of shame memories predicts psychopathology. APPLIED COGNITIVE PSYCHOLOGY 2011. [DOI: 10.1002/acp.1689] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ryan C, Russell ST, Huebner D, Diaz R, Sanchez J. Family acceptance in adolescence and the health of LGBT young adults. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING : OFFICIAL PUBLICATION OF THE ASSOCIATION OF CHILD AND ADOLESCENT PSYCHIATRIC NURSES, INC 2010; 39:241-63. [PMID: 21073595 DOI: 10.1080/0092623x.2011.628439] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
ISSUE the role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. METHODS a quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N= 245). FINDINGS family acceptance predicts greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. CONCLUSIONS family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities.
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Affiliation(s)
- Caitlin Ryan
- Marian Wright Edelman Institute, San Francisco State University, USA.
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