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Cognition & Emotion Dec 2017Humiliation lacks an empirically derived definition, sometimes simply being equated with shame. We approached the conceptualisation of humiliation from a prototype...
Humiliation lacks an empirically derived definition, sometimes simply being equated with shame. We approached the conceptualisation of humiliation from a prototype perspective, identifying 61 features of humiliation, some of which are more central to humiliation (e.g. losing self-esteem) than others (e.g. shyness). Prototypical humiliation involved feeling powerless, small, and inferior in a situation in which one was brought down and in which an audience was present, leading the person to appraise the situation as unfair and resulting in a mix of emotions, most notably disappointment, anger, and shame. Some of the features overlapped with those of shame (e.g. looking like a fool, losing self-esteem, presence of an audience) whereas other features overlapped with those of anger (e.g. being brought down, unfairness). Which specific features are present may determine whether the humiliation experience becomes more shame- or anger-like (or a combination thereof).
Topics: Anger; Concept Formation; Female; Humans; Male; Shame; Young Adult
PubMed: 27785966
DOI: 10.1080/02699931.2016.1249462 -
Psychodynamic Psychiatry Dec 2023The experience of patient suicide on clinicians is associated with complex affective states that include grief, guilt, shame, and fear and distressing subjective...
The experience of patient suicide on clinicians is associated with complex affective states that include grief, guilt, shame, and fear and distressing subjective experiences of incompetence and helplessness. The authors review the literature of the subject and highlight the work of Rajagopalan and colleagues in Singapore, who implemented a one-time reflective group session to help clinicians process the experience of patient suicide to reduce psychological distress and prevent burnout and moral injury.
Topics: Humans; Suicide; Shame; Guilt; Emotions; Grief
PubMed: 38047673
DOI: 10.1521/pdps.2023.51.4.381 -
Current Psychiatry Reports Feb 2020Studies on the relations between shame and anxiety and obsessive-compulsive and related disorders (OCRDs) are reviewed, with a focus on recent work. (Review)
Review
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.
Topics: Anxiety; Anxiety Disorders; Cross-Sectional Studies; Humans; Obsessive-Compulsive Disorder; Shame
PubMed: 32076847
DOI: 10.1007/s11920-020-1142-9 -
International Journal of Mental Health... Apr 2022Nurses can facilitate opportunities for patients who feel shame to experience healing in their mental health. Disciplines such as psychology have extensive shame... (Review)
Review
Nurses can facilitate opportunities for patients who feel shame to experience healing in their mental health. Disciplines such as psychology have extensive shame research, yet nursing may provide a unique perspective to bolster research on shame. The objective of this analysis is to examine the use of shame as a concept in nursing literature. This review was guided by Beth Rodgers' Evolutionary approach to concept analysis. Rodgers' approach entails investigating attributes, related terms, surrogate terms, antecedents, and consequences of shame; and examining the use of the concept shame over time to determine if its use changed. Sampled literature came from Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, PubMed, Web of Science, and Health Source: Nursing/Academic Edition. The final sample used for analysis included 334 sources published between 1993 and 2020. The use of shame did not change during these years. Attributes were negative sense of self, feeling worthless, and feeling vulnerable. There were no surrogate terms and three related terms: guilt, humiliation, and embarrassment. Antecedents were trauma, stigma, and perception of moral wrongdoing. Consequences included healthcare avoidance, social withdrawal or isolation, negative coping mechanisms, resilience, lifestyle changes, and healthy coping. There is a discrepancy between the conceptualization and use of shame in nursing and other disciplines. Other disciplines, such as psychology, provide more direction about how interpersonal interactions can elicit or alleviate feelings of shame. Nurses can apply this conceptualization in their clinical practice to support patients experiencing shame.
Topics: Humans; Interpersonal Relations; Morals; Shame
PubMed: 34750954
DOI: 10.1111/inm.12948 -
Medical Humanities Dec 2017
Topics: Delivery of Health Care; Humans; Shame; Social Stigma
PubMed: 29196431
DOI: 10.1136/medhum-2017-011395 -
British Journal of Hospital Medicine... Nov 2022Stigma in healthcare has been associated with a range of negative outcomes, such as delays in seeking treatment, avoiding clinical encounters and mental distress. This...
Stigma in healthcare has been associated with a range of negative outcomes, such as delays in seeking treatment, avoiding clinical encounters and mental distress. This editorial discusses the experience of stigma and argues that understanding shame anxiety and adopting 'shame-sensitive' practice is beneficial in healthcare.
Topics: Humans; Shame; Patient Care; Anxiety; Anxiety Disorders
PubMed: 36454068
DOI: 10.12968/hmed.2022.0441 -
Journal of Evaluation in Clinical... Oct 2022Since its foundation in 2010, the annual philosophy thematic edition of this journal has been a forum for authors from a wide range of disciplines and backgrounds,... (Review)
Review
Since its foundation in 2010, the annual philosophy thematic edition of this journal has been a forum for authors from a wide range of disciplines and backgrounds, enabling contributors to raise questions of an urgent and fundamental nature regarding the most pressing problems facing the delivery and organization of healthcare. Authors have successfully exposed and challenged underlying assumptions that framed professional and policy discourse in diverse areas, generating productive and insightful dialogue regarding the relationship between evidence, value, clinical research and practice. These lively debates continue in this thematic edition, which includes a special section on stigma, shame and respect in healthcare. Authors address the problems with identifying and overcoming stigma in the clinic, interactional, structural and phenomenological accounts of stigma and the 'stigma-shame nexus'. Papers examine the lived experience of discreditation, discrimination and degradation in a range of contexts, from the labour room to mental healthcare and the treatment of 'deviancy' and 'looked-after children'. Authors raise challenging questions about the development of our uses of language in the context of care, and the relationship between stigma, disrespect and important analyses of power asymmetry and epistemic injustice. The relationship between respect, autonomy and personhood is explored with reference to contributions from an important conference series, which includes analyses of shame in the context of medically unexplained illness, humour, humiliation and obstetric violence.
Topics: Child; Delivery of Health Care; Humans; Philosophy; Respect; Shame; Social Stigma
PubMed: 36053567
DOI: 10.1111/jep.13755 -
Child Psychiatry and Human Development Dec 2021Self-conscious emotions, like shame and pride, are thought to have an evaluative component in which the self is posited against a set of standards, rules, and goals of...
Self-conscious emotions, like shame and pride, are thought to have an evaluative component in which the self is posited against a set of standards, rules, and goals of society. This study compares the two methods used to examine self-conscious emotions: a self-report questionnaire, the Test of Self-Conscious Affect in Children (TOSCA-C), and a direct observation of behaviors in response to particular tasks, developed by Lewis, Alessandri and Sullivan (1992). 126 young children participated in both tasks at ages 6 and 7. For the observation data, we found that the tendency to be self-evaluative in terms of success were not related to be self-evaluative in failure, and individual consistency across age was found for self-conscious emotions but not for the primary emotions. The questionnaire data showed that children who scored high in shame also scored high in failure, and there were no consistencies across age. There were weak, inconsistent associations between shame measured by the questionnaire technique and sadness observed in the experiment.
Topics: Child; Child, Preschool; Emotions; Guilt; Humans; Self Concept; Self-Assessment; Shame
PubMed: 33185804
DOI: 10.1007/s10578-020-01094-2 -
Journal of Evaluation in Clinical... Oct 2022Stigma has been associated with delays in seeking treatment, avoiding clinical encounters, prolonged risk of transmission, poor adherence to treatment, mental distress,...
Stigma has been associated with delays in seeking treatment, avoiding clinical encounters, prolonged risk of transmission, poor adherence to treatment, mental distress, mental ill health and an increased risk of the recurrence of health problems, among many other factors that negatively impact on health outcomes. While the burdens and consequences of stigma have long been recognized in the health literature, there remains some ambiguity about how stigma is experienced by individuals who live with it. The aim of this paper is to elucidate the phenomenology of stigma, or to describe how it is that stigma shows up in the first-person experience of individuals who live with stigma and its burdens. Exploring the relationship between shame and stigma, I argue that shame anxiety, or the chronic anticipation of shame, best characterises the experience of living with a health-related, or health-relevant, stigma. Understanding the experiential features, or phenomenology, of shame anxiety will give healthcare professionals a greater sensitivity to stigma and its impacts in clinical settings and encounters. I will conclude by suggesting that 'shame-sensitive' practice would be beneficial in healthcare.
Topics: Anxiety; Anxiety Disorders; Humans; Mental Health; Shame; Social Stigma
PubMed: 35903848
DOI: 10.1111/jep.13744 -
The International Journal of Eating... Nov 2021Numerous empirical studies and theoretical models posit that shame is a common experience among individuals across the eating disorder spectrum. In this study we aim to... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Numerous empirical studies and theoretical models posit that shame is a common experience among individuals across the eating disorder spectrum. In this study we aim to investigate the association between shame and eating disorders symptoms using a meta-analytical approach.
METHOD
In this meta-analysis, we synthesized findings from 195 studies to examine the proposed association between shame and eating disorders symptoms. We looked at the associations with both general eating disorders symptoms and with specific eating disorders symptoms (i.e., anorexic, bulimic, and binge-eating symptoms). Moderation analyses testing for the effect of type of shame, type of eating symptoms, clinical status, quality of the study, age, and gender were conducted.
RESULTS
Shame was significantly associated with a medium to large effect size with all types of eating disorders symptoms (rs between .40 and .52). Body shame (r = .55) and shame around eating (r = .59) were more strongly related with eating disorders pathology. Type of eating disorders symptoms did not moderate the relationship between shame and disturbed eating.
DISCUSSION
Overall, the magnitude of the effect size of the association between shame and eating disorders symptoms is a medium to large one. Body shame and shame around eating seem to be the types of shame most closely tied with eating disorders symptoms, suggesting that directly targeting them in interventions might be highly beneficial. Findings highlight current gaps in the literature (e.g., mostly correlational studies, low quality studies) with implications for future research.
Topics: Anorexia; Binge-Eating Disorder; Bulimia; Feeding and Eating Disorders; Humans; Personality Inventory; Shame
PubMed: 34302369
DOI: 10.1002/eat.23583