Transforming Shame in the Pandemic: An International Study

Shame-Sensitive Public Health

In this article, we argue that shaming interventions and messages during Covid-19 have drawn the relationship between public health and shame into a heightened state of contention, offering us a valuable opportunity to reconsider shame as a desired outcome of public health work, and to push back against the logics of individual responsibility and blame for illness and disease on which it sits. We begin by defining shame and demonstrating how it is conceptually and practically distinct from stigma. We then set out evidence on the consequences of shame for social and relational health outcomes and assess the past and present dimensions of shame in the context of the Covid-19 pandemic, primarily through a corpus of international news stories on the shaming of people perceived to have transgressed public health directions or advice. Following a brief note on shame (and policymaking) in a cultural context, we turn to the concept and practice of 'shame-sensitivity' in order to theorise a set of practical and adaptable principles that could be used to assist policymakers in short- and medium-term decision-making on urgent, tenacious, and emerging issues within public health. Finally, we consider the longer consequences of pandemic shame, making a wider case for the acknowledgement of the emotion as a key determinant of health.

The differential roles of shame and guilt in the relationship between self-discrepancy and psychological maladjustment

The self-discrepancy theory proposes that having inconsistent self-representations can trigger feelings of shame and guilt, leading to experiences of depression and anxiety. The aim of this study was to determine the distinct characteristics of each shame and guilt in relation to the connection between actual/ideal self-discrepancy and depression, as well as actual/ought self-discrepancy and anxiety. A total of 403 participants completed an online questionnaire assessing their self-discrepancy, shame, guilt, depression, and anxiety. Correlational analysis and structural equation modeling (SEM) analysis were used to assess the goodness of fit of the proposed model and the structural relationships between the variables. The key findings were as follows: (1) There were positive correlations among actual/ideal self-discrepancy, actual/ought self-discrepancy, shame, guilt, depression, and anxiety; (2) Shame partially mediated the association between actual/ideal self-discrepancy and depression; and (3) Guilt fully mediated the association between actual/ought self-discrepancy and anxiety. These outcomes uphold the self-discrepancy theory by confirming a distinct intra-psychological process involving shame and guilt. Each type of self-discrepancy was related to experiences of depression and anxiety. Our data suggest that researchers and practitioners should prioritize shame and guilt when examining individuals' self-discrepancy and related mental health challenges.

Moral Injury and Telemental Health Services: An Overview on Clinician Impact

Moral injury develops from enduring complex moral conflicts that occur when one's beliefs and values are violated by committing, perpetrating, failing to prevent, or witnessing acts that transgress one's deep moral compass. In response to the coronavirus disease 2019 pandemic and the extraordinary impact to patients and health care systems around the globe, telemental health has rapidly expanded as a means to optimize resource use and comply with social distancing mandates. Social determinants of health, which include financial inequity, have influences on pandemic situations, such as physical distancing and lockdowns, resulting in disproportionate delays in timely mental health diagnosis and management. The current article discusses an overview of how the demands of the pandemic have forced mental health clinicians working in telemental health to face a wide range of complex ethical and moral dilemmas. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Stress Experience of COVID-19 Patients as Reported by Psychological Supporters in South Korea: A Qualitative Study

Background

COVID-19 patients experience various stressors during the quarantine period and after release from quarantine. However, stressors experienced during each period remain unclear.

Methods

A total of 15 mental health experts from the integrated psychological support group for COVID-19participated in this study. Psychological support was provided for the total 932 confirmed COVID-19 patients and their families. Qualitative data were collected using Focus Group Interview (FGI). The participants were divided into two groups and semi-structured questions were used to allow participants to speak their minds.

Results

During the quarantine period, difficulties of being diagnosed with COVID-19, concerns about recovery from COVID-19, stress related to quarantine, issues related to the treatment environment, and limited information about COVID-19 and communication were frequently reported. After release from quarantine, the reported main stressors include reinfection or reactivation, concerns about complications, and financial difficulties. Confusion as vectors and victims, stigma and discrimination, and conflicts within a family were observed during both periods.

Conclusions

COVID-19 patients suffered various stressors during the quarantine period and after release from quarantine. Moreover, returning to their daily life required timely psychosocial support, intervention, and treatment for COVID-19 infection.