Internalizing Early Memories of Shame and Lack of Safeness and Warmth: The Mediating Role of Shame on Depression

How do early affiliative memories explain body image shame? A 12-month longitudinal study in adolescent girls

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.

Beyond the Centrality of Shame: How Self-Concealment and Fear of Receiving Compassion From Others Impact Psychological Suffering in Transgender Adults

Shame-based social interactions are a minority social stressor commonly experienced by transgender individuals. However, few studies have explored the centrality of shame experiences in transgender identity and mental health. Also, the ability to receive care and soothing support may be influenced by intrapersonal shame- and fear-related factors, which may hinder openness, and support and care seeking, thus contributing to psychological distress. This study aims to examine the relationship between central shame experiences, fear of receiving compassion from others, self-concealment, and psychological distress (depression, anxiety, and stress symptoms) in a sample of Portuguese transgender adults. Following a cross-sectional design, data from a convenience sample of 70 self-identified transgender individuals undergoing gender-affirming medical interventions (GAMIs) were analyzed, using SPSS PROCESS, to determine whether the relationship between central shame experiences and psychological suffering occurred indirectly through fear of receiving compassion from others, and self-concealment. Results suggest that fear of receiving compassion from others, but not self-concealment, was the underlying factor between central shame experiences, and depression and anxiety. Results suggest that the centrality of shame experiences and stress symptomatology associate sequentially through fear of compassion and, in turn, through self-concealment. Clinical implications for mental health interventions with transgender individuals undergoing GAMI are discussed.

Early Emotional Experiences and Prosocial Behavior among Chinese Adolescents: The Roles of Psychological Suzhi and Subjective Socioeconomic Status

Prosocial behavior plays a vital role in adolescents’ well-being and social functioning, with the recall of early emotional experiences being a major influence. Positive experiences such as early memories of warmth and safeness (EMWS) contribute to prosocial interpersonal characteristics, whereas adverse experiences such as child psychological abuse and neglect (CPAN) lead to social withdrawal or behavioral problems. The direct effects of EMWS and CPAN on prosocial behavior were investigated in this study, along with the mediation effect of psychological suzhi and the moderation effect of subjective socioeconomic status (SSS). A sample of 948 adolescents (Mage = 14.05 years, SD = 1.68 years; 43.6% females) was randomly recruited to complete self-report questionnaires. Correlation results indicated that EMWS promoted prosocial behavior, whereas CPAN was negatively associated with prosocial behavior. Path analyses confirmed the mediating role of psychological suzhi on the effects of EMWS and CPAN on prosocial behavior. SSS was shown to moderate the effects of EMWS on prosocial behavior and CPAN on psychological suzhi. Compared to lower SSS, higher SSS would reinforce the positive impact of EMWS on prosocial behavior and exacerbate the negative impact of CPAN on psychological suzhi. The current study provided new insight into understanding the underlying mechanisms of prosocial behavior from the perspective of early emotional experiences.

Feeling Safe and Nostalgia in Healthy Aging

The population of older adults worldwide is growing, with an urgent need for approaches that develop and maintain intrinsic capacity consistent with healthy aging. Theory and empirical research converge on feeling safe as central to healthy aging. However, there has been limited attention to resources that cultivate feeling safe to support healthy aging. Nostalgia, "a sentimental longing for one's past," is established as a source of comfort in response to social threat, existential threat, and self-threat. Drawing from extant theory and research, we build on these findings to position nostalgia as a regulatory resource that cultivates feeling safe and contributes to intrinsic capacity to support healthy aging. Using a narrative review method, we: (a) characterize feeling safe as a distinct affective dimension, (b) summarize the character of nostalgia in alignment with feeling safe, (c) propose a theoretical account of the mechanisms through which nostalgia cultivates feeling safe, (d) highlight the contribution of nostalgia to feeling safe and emotional, physiological, and behavioral regulatory capabilities in healthy aging, and (e) offer conclusions and direction for research.

Internal and External Shame in Healthy and Chronically Ill Samples: Exploring Links to Psychological Health

This study aimed to examine the role of decentering and committed action as mediators of the link of external and internal shame with psychological health, in people with a chronic disease diagnosis (n = 223) and without chronic disease (n = 230). Participants with chronic disease presented higher levels of both external and internal shame. Path analysis results showed that these variables seem to be negatively linked to psychological health and that their effects on this outcome seem to be reduced by the mechanisms of decentering and committed action. The tested model explained 56% of psychological health's variance and was invariant across groups. This study emphasizes the importance of taking a decentered stance towards internal experiences and behaving accordingly to one's personal values on psychosocial functioning, independently of disease status. These results may have particular relevance to individuals with high levels of shame.

Sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorders in British Columbia, Canada

PURPOSE

This study aimed at determining to what extent sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorder diagnosis in British Columbia (BC), Canada, using a population-based survey.

METHODS

This analysis was based on the cross-sectional 2013-2014 Canadian Community Health Survey. The sample was restricted to respondents in BC with valid responses to the survey items considered. A multivariable logistic model, where the behavioral HIV risk score exposure was nested into the sexual minority status modifier, estimated the odds of having a prevalent mood or an anxiety disorder. The behavioral HIV risk score (0, 1, 2, ≥ 3) included the following five measures: (1) age at first intercourse < 14 years, (2) condom use during last intercourse, (3) history of sexually transmitted infections, (5) number of sexual partners in the past 12 months (< 4, ≥ 4), and substance use in the past 12 months.

RESULTS

Of the weighted sample (2,521,252), 97% (95% confidence interval (CI) 97-98) were heterosexual, while 3% (95% CI 2-3) were lesbian, gay, and bisexual (LGB). The prevalence of a mood or anxiety disorder diagnosis was 12% (95% CI 11-13). For every 1-level increment in the behavioral HIV risk score, the adjusted odds ratio of having a prevalent mood or anxiety disorder diagnosis was 1.29 (95% CI 1.03-1.54) for heterosexual respondents and 2.37 (95% CI 1.84-2.90) for LGB respondents.

CONCLUSION

Sexual minority status modified the relationship between HIV risk behavior and prevalent mood or anxiety disorders, with a stronger association among LGB respondents. Healthcare providers should prioritize integrated care that addresses the intersectionality between sexual risk, substance use, and mood or anxiety disorders.

Development and Validation of the Current Experiences of Warmth and Safeness Scale in Community and Residential Care Adolescents

Interpersonal experiences of warmth and safeness have a key role on emotion regulation and social development during childhood and adolescence. This paper presents a new and brief scale designed to assess the adolescents' perception of current experiences of warmth and safeness (CEWSS-A). Its dimensionality and psychometric properties were investigated using a Portuguese sample of 453 adolescents from the community and 319 adolescents from residential care facilities. A confirmatory factor analysis indicated that the 12-item scale has a one-factor measurement model. The CEWSS-A showed adequate internal consistency in the different samples (α > .92) and construct validity in relation to external variables. The CEWSS-A proved to be group invariant. Community adolescents reported a higher frequency of current experiences of warmth and safeness in comparison with residential care participants, and boys showed significantly higher scores than girls, within both samples. The CEWSS-A is an appropriate self-report measure for clinical and research purposes.

Exploring the Impact of Shame on Health-Related Quality of Life in Older Individuals

PURPOSE

To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people.

DESIGN AND METHODS

A cross-sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form-36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software.

RESULTS

Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women b_W = -0.173, p_W = .004, effect on men b_M = -0.138, p_​M = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = -0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (b_W = -0.392, p_W = .002 and b_M = -0.384, p_M = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = -4.267, p = .033).

CONCLUSION

Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health-related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health-related quality of life on mental health components, leading to greater external shame.

CLINICAL RELEVANCE

These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.

Self-Regulation and Shame as Mediators Between Childhood Experiences and Young Adult Health

The purpose of this study was to determine whether self-regulation and shame mediated the relationship between adverse and positive childhood experiences (ACEs and PCEs) and young adult health. Data came from the Flourishing Families Project (FFP), a 10-year longitudinal study. Adolescent participants (N = 489; 51% female) completed an annual survey. Data were analyzed using structural equation modeling. Results indicated that PCEs negatively predicted shame and positively predicted self-regulation while ACEs negatively predicted self-regulation. Shame mediated the relationship between PCEs and depression. Self-regulation mediated the relationship between both ACEs and PCEs with anxiety; self-regulation also mediated the relationship between ACEs and substance abuse. Childhood experiences appear to affect the development and maintenance of self-regulation in adolescence. Self-regulation appears to be especially important in protecting against depression, anxiety, and substance abuse in young adulthood.

Perceived Adverse Parenting in Childhood and Psychological Distress Among Psychotherapy Patients: The Mediating Role of Pathogenic Beliefs

ABSTRACT

The way people derive inferences from actual adverse experiences plays an important role in the development of psychopathology. This study aims to examine the mediating role of pathogenic beliefs (i.e., emotion-laden, powerful, painful convictions about self and others) on the relation between perceived adverse parenting behaviors in childhood and subsequent adult psychopathology. Participants (mostly Caucasian and heterosexual) were 204 consecutively admitted patients with a range of psychological difficulties, including depression, anxiety, and interpersonal problems, at a low-fee outpatient clinic. Participants completed standard self-report assessments of perceived parental style, depressive and anxiety symptoms, and a clinically derived measure of pathogenic beliefs. We examined the indirect effects of adverse parenting on anxiety and depressive symptom severity through pathogenic beliefs. Pathogenic beliefs reflecting the unreliability of others significantly mediated the relationship between adverse parenting and anxiety symptoms. The other mediation model is consistent with the theory that perceived adverse parenting contributes to the severity of depressive symptoms through beliefs about not being deserving and other people being unreliable. Within the limitations of the cross-sectional, retrospective, and self-report nature of the data, our results seem to suggest that attending to intermediary subjective beliefs might be important in understanding psychopathology development in the context of childhood adversity. Aiming to modify the beliefs in therapy might modify the symptoms. However, this would remain to be demonstrated through formal intervention research.

Psychological and clinical correlates of the Centrality of Event Scale: A systematic review

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.

The Origins of Fears of Compassion: Shame and Lack of Safeness Memories, Fears of Compassion and Psychopathology

Empirical and clinical research suggests that some individuals find self-generating compassion and receiving compassion from others difficult and aversive. However, it is unclear how these fears of compassion are linked to early experiences and to psychopathological symptoms. This study explores the relationship between shame traumatic memories, centrality of shame memories, early memories of warmth and safeness, fears of compassion, and depression, anxiety and paranoid symptoms. Participants were 302 individuals from the general community population, who completed self-report measures of fears of compassion, shame memories, early affiliative memories, and psychopathology. Shame traumatic and central memories were positively associated with fears of compassion for self, for others and from others, whereas early memories of warmth and safeness were negatively related to such fears. Path analyses revealed that fears of compassion for self and of receiving compassion from others mediated the effects of shame traumatic memory, centrality of shame memory and early memories of warmth and safeness on depressive, anxious and paranoid symptoms. These findings have implications for therapeutic interventions as these fears, as well as the negative shame-based emotional memories fuelling them, may need to be addressed in therapy to assist patients in self-generating and receiving compassion.

Development of a measure for the assessment of peer-related positive emotional memories

OBJECTIVES

Previous research has demonstrated a link between early experiences of warmth, safeness, and soothing, and positive feelings, health, and well-being outcomes. Although the impact of positive parent-related early relationships and its posterior recall is well documented, research on the recall of warmth and safeness experiences within early peer relationships remains scarce. In fact, it is considered that the protective role of early positive peer relationships deserves intensive research; however, a specific measure that assesses this construct is still to be created. This study describes the development and validation of a new measure designed to assess the recall of early experiences of warmth, safeness, and affection in relation to peers (EMWSS-peers).

DESIGN AND METHODS

Distinct samples, comprising individuals of both genders aged between 18 and 68 years old, were used to test the EMWSS-peers factorial structure through principal axis factoring (PAF) and confirmatory factor analysis (CFA), and to examine its psychometric properties.

RESULTS

Principal axis factoring's results indicated that the 12-item scale presents a one-factor structure explaining a total of 71.50% of the variance. The CFA confirmed the plausibility of this structure. The EMWSS-peers also presented excellent internal consistency and construct, concurrent, and divergent validities.

CONCLUSIONS

The EMWSS-peers seems to be a new avenue for the study of memories of early experiences with friends and colleagues and may entail a relevant contribution to clinical and research fields, particularly for upcoming investigations on the relationship of peer-related affiliative memories with well-being and mental health.

PRACTITIONER POINTS

The EMWSS-peers is a specific measure to assess the recall of warmth and safeness in early peer relationships. The EMWSS-peers is a brief, robust, and reliable self-report instrument. The EMWSS-peers presented excellent internal consistency and construct, concurrent, and divergent validities. The EMWSS-peers may open a new avenue for the study of memories of early peer-related experiences, with potential clinical and research implications.

Group cognitive behavioural therapy with compassion training for depression in a Japanese community: a single-group feasibility study

OBJECTIVE

Depression is a representative mental problem, and more than 350 million people are suffering in the world. Cognitive behavioural therapy (CBT) in individual or group formats is mainly recommended in major guidelines. However, patients with high self-criticism have a poor response to CBT. To treat such patients, psychotherapies focusing on compassion are gaining attention. Although trials have begun to be reported, there are relatively few studies examining the effectiveness of group CBT with compassion work for managing depression. The purpose of this study was to evaluate the feasibility and acceptability and the estimate effect size of group CBT with compassion training for future controlled studies.

RESULTS

Fourteen participants were enrolled in the trial, of which 13 completed the intervention, and 12 completed a 6-month follow-up assessment. Participants received a 1 h group-based CBT with compassion training session every week for 10 weeks. The effect of the intervention on participants' Beck Depression Inventory score was examined using a general linear mixed model. This analysis showed an effect size of d = 1.12 at post intervention and d = 0.92 at 6-month follow-up. Group cognitive behavioural therapy with compassion training for depression shows feasibility and acceptability in a Japanese community. Trial Registration UMIN000015007.

The impact of early shame memories in Binge Eating Disorder: The mediator effect of current body image shame and cognitive fusion

This study examined the phenomenology of shame experiences from childhood and adolescence in a sample of women with Binge Eating Disorder. Moreover, a path analysis was investigated testing whether the association between shame-related memories which are traumatic and central to identity, and binge eating symptoms' severity, is mediated by current external shame, body image shame and body image cognitive fusion. Participants in this study were 114 patients, who were assessed through the Eating Disorder Examination and the Shame Experiences Interview, and through self-report measures of external shame, body image shame, body image cognitive fusion and binge eating symptoms. Shame experiences where physical appearance was negatively commented or criticized by others were the most frequently recalled. A path analysis showed a good fit between the hypothesised mediational model and the data. The traumatic and centrality qualities of shame-related memories predicted current external shame, especially body image shame. Current shame feelings were associated with body image cognitive fusion, which, in turn, predicted levels of binge eating symptomatology. Findings support the relevance of addressing early shame-related memories and negative affective and self-evaluative experiences, namely related to body image, in the understanding and management of binge eating.

How can the recall of early affiliative memories with peers influence on disordered eating behaviours?

The present study aimed to explore the role of early affiliative memories with peers on the adoption of disordered eating attitudes and behaviours through the mechanisms of external shame and self-judgment. The sample used in the current study comprised 632 women from the community, aged between 18 and 60 years old.The tested model explained 22 % of eating psychopathology's variance and showed excellent model fit indices. Results indicated that the impact of the recall of early positive memories with peers on eating psychopathology was fully carried through the mechanisms of external shame and self-judgment. In fact, these findings seem to suggest that the lack of warm and safe affiliative memories with peers is linked to higher levels of shame (e.g., feelings of inferiority and inadequacy), and also to higher vulnerability to engage in maladaptive emotional strategies (such as self-judgmental attitudes), which appears to explain the increase of disordered eating behaviours.These findings contribute to the understanding of the impact of peer-related early affiliative memories in the engagement in disordered eating. Furthermore, this study has significant clinical implications, emphasizing the importance of targeting shame and maladaptive emotional strategies, especially in a context involving early adverse emotional experiences with peers.

Body image flexibility mediates the effect of body image-related victimization experiences and shame on binge eating and weight

OBJECTIVES

The current study examined a path model testing the indirect effect of negative body-image related memories of being teased and bullied in childhood and adolescence on binge eating severity symptoms, via its effect on current body image shame and body image flexibility.

METHODS

Participants were 853 Portuguese women from the general community who completed a set of self-report measures of body image-related bullying and teasing experiences in childhood and adolescence, current body image shame, body image flexibility, binge eating symptoms, body mass index (BMI) and depressive symptoms.

RESULTS

The path model accounted for 40% of the variance of binge eating symptoms and 14% of the variance of BMI, and revealed a very good fit. Findings corroborated the plausibility of the hypothesized associations suggesting that negative body image-related memories and emotional experiences are significantly associated with binge eating symptoms and BMI, and that body image flexibility is a significant mediator of these associations. The examined relationships were preserved after controlling for the effect of depressive symptoms.

CONCLUSIONS

The current study's findings contribute to clarify the role that body image-related memories and emotional experiences may play on individuals' difficulties in regulating eating behaviour and weight, and provides preliminary support for the potential effect of body image flexibility as a self-regulatory process that operates in these associations.

Self-compassion: An adaptive link between early memories and women’s quality of life

Research has emphasized the important role of recalling childhood experiences on adult mental health, and also the benefits of self-compassion on well-being. This study explored self-compassion as a mediator between early memories with family and peers and quality of life, on a wide age range female sample ( N = 645). Path analysis revealed that self-compassion mediated the impact of both types of memories on women’s perceived quality of life. Overall, results revealed that the recall of early positive memories, either with family and peers, associate with a more compassionate self-to-self relationship, and the perception of greater psychological and social well-being.

Shame Experiences Underlying Depression of Adult Turkish Women

Shame is a major component of many mental health problems and affects symptoms, coping styles, remission, and therapeutic ruptures. There are few qualitative studies aimed at understanding shame and its role for patients diagnosed with depression. In this research, we explored the origins of shame, and the coping strategies that patients diagnosed with depression employ to cope with shame. This qualitative research aimed at an in-depth analysis of shame experiences of adult women who had been diagnosed with depression and treated with cognitive behavioral psychotherapy in a Women Health Center in Turkey. Purposive sampling yielded nine high shame prone adult women who were married and had children. Four semi-structured interviews were conducted with each of the nine participants, and 36 semi-structured interviews were analyzed by Interpretative Phenomenological Analysis. According to the results of the analysis, four themes emerged. These were "substitution of rage for the feeling of shame and unworthiness," "perfection struggle to overcompensate the belief of being inadequate," "feeling shame for their own body and sexual acts," and "need for individuation." The results were interpreted by considering the social context and culture of Turkey, and the clinical implications were discussed.

Eating disorders: when social rank perceptions are shaped by early shame experiences

OBJECTIVES

Recent research has shown that early adverse experiences can be an important risk factor for eating disorders. However, the role of early shame memories and how they are structured as traumatic and central memories to self-identity in eating disorders has never been investigated. This study explores the phenomenology of shame memories involving attachment figures and other agents from the wider social domain in patients with eating disorders, and examines the relationship between their traumatic and centrality features, social comparison based on physical appearance, and the severity of eating psychopathology.

DESIGN

The study has a cross-sectional design using a structured interview to assess retrospective data.

METHODS

Participants in this study were 36 patients with an eating disorder diagnosis, who were assessed using Eating Disorder Examination (EDE 16.0D), the Shame Experiences Interview (SEI), and self-report instruments measuring the traumatic features and centrality to identity of shame memories and social comparison.

RESULTS

Results indicated that the traumatic and centrality qualities of shame memories involving social agents other than attachment figures (e.g., peers) are significantly correlated with unfavourable social rank perceptions and with increased eating psychopathology severity. Furthermore, the impact of such shame memories on eating psychopathology is fully mediated by social comparisons based on physical appearance.

CONCLUSIONS

These findings highlight the importance of early shame experiences involving peers and other social agents that become traumatic memories, central to self-identity, to eating disorder patients' perceptions of inferiority and their core psychopathology features.

PRACTITIONER POINTS

Early shame experiences of patients with eating disorders should be carefully assessed. Shame traumatic memories involving social agents outside the family circle (e.g., peers) seem to be especially damaging for patients with eating disorders, and influence how physical appearance is used as a central dimension to establish their social rank. Practitioners should directly work with these shame memories, focusing on diminishing their traumatic nature and reconstruct their central meaning to self-identity.

Exploring self-compassion as a refuge against recalling the body-related shaming of caregiver eating messages on dimensions of objectified body consciousness in college women

Guided by an overarching body-related shame regulation framework, the present investigation examined the associations between caregiver eating messages and dimensions of objectified body consciousness and further explored whether self-compassion moderated these links in a sample of 322 U.S. college women. Correlational findings indicated that retrospective accounts of restrictive/critical caregiver eating messages were positively related to body shame and negatively related to self-compassion and appearance control beliefs. Recollections of experiencing pressure to eat from caregivers were positively correlated with body shame and inversely associated with appearance control beliefs. Higher self-compassion was associated with lower body shame and body surveillance. Self-compassion attenuated the associations between restrictive/critical caregiver eating messages and both body surveillance and body shame. Implications for advancing our understanding of the adaptive properties of a self-compassionate self-regulatory style in mitigating recall of familial body-related shaming on the internalized body-related shame regulating processes of body objectification in emerging adulthood are discussed.