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Journal of Bioethical Inquiry Jun 2017Addictions are commonly accompanied by a sense of shame or self-stigmatization. Self-stigmatization results from public stigmatization in a process leading to the...
Addictions are commonly accompanied by a sense of shame or self-stigmatization. Self-stigmatization results from public stigmatization in a process leading to the internalization of the social opprobrium attaching to the negative stereotypes associated with addiction. We offer an account of how this process works in terms of a range of looping effects, and this leads to our main claim that for a significant range of cases public stigma figures in the social construction of addiction. This rests on a social constructivist account in which those affected by public stigmatization internalize its norms. Stigma figures as part-constituent of the dynamic process in which addiction is formed. Our thesis is partly theoretical, partly empirical, as we source our claims about the process of internalization from interviews with people in treatment for substance use problems.
Topics: Behavior, Addictive; Humans; Self Concept; Shame; Social Environment; Social Norms; Social Stigma; Stereotyping
PubMed: 28470503
DOI: 10.1007/s11673-017-9784-y -
Annals of General Psychiatry Jan 2022We all have narcissism, but in some cases, the perception of narcissism becomes extreme and pathological. Systematic research has shown that there are three subtypes... (Review)
Review
We all have narcissism, but in some cases, the perception of narcissism becomes extreme and pathological. Systematic research has shown that there are three subtypes typical of narcissistic personality disorder: the grandiose/oblivious, the vulnerable/hypervigilant, and the high-functioning subtype. Both biological and psychological factors are at work, but the true cause of pathological narcissism has not been established. The psychotherapy of narcissistic personality disorder (NPD) is complicated and often frustrating because of the difficulty in engaging a person with narcissistic personality disorder in a psychotherapeutic process. Suicide risk is not rare in patients with narcissism, particularly in the context of severe narcissistic injury, where the patient feels shamed and/or vilified. In conclusion, narcissistic patients are difficult to treat, but the risk of suicide makes it imperative for clinicians to stay involved in the treatment and assist the patient in understanding their vulnerabilities.
PubMed: 35065658
DOI: 10.1186/s12991-022-00380-8 -
American Journal of Physiology.... May 2021This study was designed to investigate whether transcutaneous auricular vagal nerve stimulation (taVNS) would be able to improve major pathophysiologies of functional...
This study was designed to investigate whether transcutaneous auricular vagal nerve stimulation (taVNS) would be able to improve major pathophysiologies of functional dyspepsia (FD) in patients with FD. Thirty-six patients with FD (21 F) were studied in two sessions (taVNS and sham-ES). Physiological measurements, including gastric slow waves, gastric accommodation, and autonomic functions, were assessed by the electrogastrogram (EGG), a nutrient drink test and the spectral analysis of heart rate variability derived from the electrocardiogram (ECG), respectively. Thirty-six patients with FD (25 F) were randomized to receive 2-wk taVNS or sham-ES. The dyspeptic symptom scales, anxiety and depression scores, and the same physiological measurements were assessed at the beginning and the end of the 2-wk treatment. In comparison with sham-ES, acute taVNS improved gastric accommodation ( = 0.008), increased the percentage of normal gastric slow waves (%NSW, fasting: = 0.010; fed: = 0.007) and vagal activity (fasting: = 0.056; fed: = 0.026). In comparison with baseline, 2-wk taVNS but not sham-ES reduced symptoms of dyspepsia ( = 0.010), decreased the scores of anxiety ( = 0.002) and depression ( < 0.001), and improved gastric accommodation ( < 0.001) and the %NSW (fasting: < 0.05; fed: < 0.05) by enhancing vagal efferent activity (fasting: = 0.015; fed: = 0.048). Compared with the HC, the patients showed increased anxiety ( < 0.001) and depression ( < 0.001), and decreased gastric accommodation ( < 0.001) and %NSW ( < 0.001) as well as decreased vagal activity (fasting: = 0.047). The noninvasive taVNS has a therapeutic potential for treating nonsevere FD by improving gastric accommodation and gastric pace-making activity via enhancing vagal activity. Treatment of functional dyspepsia is difficult due to various pathophysiological factors. The proposed method of transcutaneous auricular vagal nerve stimulation improves symptoms of both dyspepsia and depression/anxiety, and gastric functions (accommodation and slow waves), possibly mediated via the enhancement of vagal efferent activity. This noninvasive and easy-to-implement neuromodulation method will be well received by patients and healthcare providers.
Topics: Adolescent; Adult; Aged; Autonomic Nervous System; Dyspepsia; Female; Gastric Emptying; Gastrointestinal Motility; Humans; Male; Middle Aged; Stomach; Treatment Outcome; Vagus Nerve; Vagus Nerve Stimulation; Young Adult
PubMed: 33624527
DOI: 10.1152/ajpgi.00426.2020 -
Evolutionary Human Sciences 2022The shame system appears to be natural selection's solution to the adaptive problem of information-triggered reputational damage. Over evolutionary time, this problem... (Review)
Review
The shame system appears to be natural selection's solution to the adaptive problem of information-triggered reputational damage. Over evolutionary time, this problem would have led to a coordinated set of adaptations - the shame system - designed to minimise the spread of negative information about the self and the likelihood and costs of being socially devalued by others. This can account for much of what we know about shame and generate precise predictions. Here, we analyse the behavioural configuration that people adopt stereotypically when ashamed - slumped posture, downward head tilt, gaze avoidance, inhibition of speech - in light of shame's hypothesised function. This behavioural configuration may have differentially favoured its own replication by (a) hampering the transfer of information (e.g. diminishing audiences' tendency to attend to or encode identifying information - shame ) and/or (b) evoking less severe devaluative responses from audiences (shame ). The shame display hypothesis has received considerable attention and empirical support, whereas the shame camouflage hypothesis has to our knowledge not been advanced or tested. We elaborate on this hypothesis and suggest directions for future research on the shame pose.
PubMed: 37588893
DOI: 10.1017/ehs.2022.43 -
Psychiatria Danubina 2021Optimal psychic response during the COVID-19 pandemic is the result of many different factors. One of the main factors is the psychodynamic understanding of essential...
Optimal psychic response during the COVID-19 pandemic is the result of many different factors. One of the main factors is the psychodynamic understanding of essential emotions such as shame. Despite the immense effort by health workers to address stress- and trauma-related disorders in the course of the COVID-19 pandemic, a large proportion of the people affected by the disorder do not have information regarding the emotion of shame. Lack of mentalizing capacity implies disturbed shame dynamics. The therapeutic relationship and optimal alliance offer the frame for acceptance of shame as useful for psychological growth. Empathy should be a cure for dysfunctional shame, at the individual or social level. We believe that including a psychodynamic approach in the national public and mental health emergency system will empower national prevention strategies.
Topics: COVID-19; Emotions; Humans; Pandemics; SARS-CoV-2; Shame
PubMed: 34718305
DOI: No ID Found -
Perspectives on Medical Education Jun 2018
Topics: Curriculum; Education, Medical, Undergraduate; Humanities; Humans; Shame; Students, Medical
PubMed: 29687333
DOI: 10.1007/s40037-018-0429-6 -
Blood Cancer Discovery Nov 2023In the past year, three new bispecific antibodies have received accelerated FDA approval for the treatment of relapsed/refractory multiple myeloma. In this article, we... (Review)
Review
In the past year, three new bispecific antibodies have received accelerated FDA approval for the treatment of relapsed/refractory multiple myeloma. In this article, we review the available data for these three agents, teclistamab, elranatamab, and talquetamab, and discuss practical considerations for their use in clinical settings while the medical community awaits randomized phase III clinical trial datasets comparing them to standard-of-care regimens.
Topics: Humans; Multiple Myeloma; Antibodies, Bispecific; Embarrassment; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols
PubMed: 37824758
DOI: 10.1158/2643-3230.BCD-23-0176 -
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