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Brain Sciences Mar 2023Self-conscious emotions, such as shame and guilt, play a fundamental role in regulating moral behaviour and in promoting the welfare of society. Despite their relevance,... (Review)
Review
Self-conscious emotions, such as shame and guilt, play a fundamental role in regulating moral behaviour and in promoting the welfare of society. Despite their relevance, the neural bases of these emotions are uncertain. In the present meta-analysis, we performed a systematic literature review in order to single out functional neuroimaging studies on healthy individuals specifically investigating the neural substrates of shame, embarrassment, and guilt. Seventeen studies investigating the neural correlates of shame/embarrassment and seventeen studies investigating guilt brain representation met our inclusion criteria. The analyses revealed that both guilt and shame/embarrassment were associated with the activation of the left anterior insula, involved in emotional awareness processing and arousal. Guilt-specific areas were located within the left temporo-parietal junction, which is thought to be involved in social cognitive processes. Moreover, specific activations for shame/embarrassment involved areas related to social pain (dorsal anterior cingulate and thalamus) and behavioural inhibition (premotor cortex) networks. This pattern of results might reflect the distinct action tendencies associated with the two emotions.
PubMed: 37190524
DOI: 10.3390/brainsci13040559 -
Journal of Sex Research 2022Sexual minority men (SMM) are at increased risk for mental health problems due to effects of sexual minority stigma (e.g., internalized homonegativity (IH)). Both IH and...
Sexual minority men (SMM) are at increased risk for mental health problems due to effects of sexual minority stigma (e.g., internalized homonegativity (IH)). Both IH and emotion dysregulation are contributors to sexual compulsivity; however, the role of feelings of sexual shame have not been examined in this association. A sample of 982 HIV-negative SMM completed online surveys ( = 42.4, = 13.74). Path analyses indicated significant direct effects of IH on sexual shame ( = 0.44, < .001), emotion dysregulation ( = 0.19, < .001), and sexual compulsivity ( = 0.22, < .001). Modeled simultaneously, the association between sexual shame and sexual compulsivity ( = 0.26, < .001) was significant, as was the association between emotion dysregulation and sexual compulsivity ( = 0.27, < .001). Finally, an indirect effect of IH on sexual compulsivity through both sexual shame ( < .001) and emotion dysregulation ( < .001) was significant, and the association between IH and sexual compulsivity was reduced to non-significant ( = 0.01, = .74). Targeting feelings of sexual shame and emotion dysregulation in clinical interventions may help reduce the negative health impact of sexual compulsivity among SMM.
Topics: Emotions; Homosexuality, Male; Humans; Male; Sexual Behavior; Shame; Social Stigma
PubMed: 34410183
DOI: 10.1080/00224499.2021.1963649 -
Addictive Behaviors Reports Dec 2022Blackouts and hangovers may negatively impact college students' health and productivity. However, few studies have considered the impact of cultural differences on...
Blackouts and hangovers may negatively impact college students' health and productivity. However, few studies have considered the impact of cultural differences on students' individual experiences with blackouts and hangovers. To address this issue, the current study explored the potential relationships of shame and resilience with Hispanic ( = 381) and non-Hispanic White (NHW, = 332) students' self-reported blackouts and hangover experiences. Students completed an online survey measuring shame, resilience, presence of lifetime blackout experiences preceding a hangover, and past-year hangover severity. Analyses included separate path models examining shame and resilience, and the interaction between shame and resilience with Hispanic ethnicity in relation to blackouts and hangover experiences. Significant pathways emerged between resilience, but not shame, and blackouts and hangover experiences. A subscale of resilience reflecting personal competence and tenacity was related to greater likelihood of reporting blackouts and greater hangover severity for Hispanics but not NHW students. Conversely, a dimension of resilience characterized by trusting one's instincts and tolerance of negative affect was related to a lower likelihood of reporting a blackout preceding a hangover for Hispanics but not NHW students. Finally, a resilience subscale associated with spiritual influences was positively related to blackouts in the participant population as a whole. These results reinforce the notion that resilience is an important target for intervention and prevention of hazardous drinking, but reveal that it may have both positive and negative effects in college students, which may differ by ethnicity.
PubMed: 36388408
DOI: 10.1016/j.abrep.2022.100466 -
Frontiers in Psychology 2021The experience of pain is subjective, yet many people have their pain invalidated or not believed. Pain invalidation is associated with poor mental health, including...
The experience of pain is subjective, yet many people have their pain invalidated or not believed. Pain invalidation is associated with poor mental health, including depression and lower well-being. Qualitative investigations of invalidating experiences identify themes of depression, but also social withdrawal, self-criticism, and lower self-worth, all of which are core components of shame. Despite this, no studies have quantitatively assessed the interrelationship between pain invalidation, shame, and depression. To explore this relationship, participants recounted the frequency of experienced pain invalidation from family, friends, and medical professionals, as well as their feelings of internalized shame and depressive symptoms. As shame has been shown to be a precursor for depression, we further explored the role of shame as a mediator between pain invalidation and depressive symptoms. All sources of pain invalidation were positively associated with shame and depressive symptoms, and shame fully mediated the relationship between each source of pain invalidation and depression. Relative to other sources, pain invalidation from family was most closely tied to shame and depression. Overall, findings indicate that one mechanism by which pain invalidation may facilitate depression is the experience of shame. Future research may explore shame as a potential upstream precursor to depression in the context of pain. Findings provide more insight into the harmful influence of pain invalidation on mental health and highlight the impact of interpersonal treatment on the experiences of people in pain.
PubMed: 34925146
DOI: 10.3389/fpsyg.2021.743584 -
BMJ Open Diabetes Research & Care Dec 2022Emerging evidence suggests that diabetes stigma and negative emotions associated with it may impair the quality of life of people with diabetes. Among these...
INTRODUCTION
Emerging evidence suggests that diabetes stigma and negative emotions associated with it may impair the quality of life of people with diabetes. Among these psychological distresses, shame is considered the most distressing of all human emotional experiences and may be a condition to which diabetes clinicians should pay attention. This epidemiological study focused on diabetes-related shame and aimed to determine the prevalence of diabetes-related shame, its factors, and its association with psychological indicators.
RESEARCH DESIGN AND METHODS
A cross-sectional online survey was conducted among people with type 2 diabetes preregistered with a research firm. The questionnaire included experience of diabetes-related shame and demographic data such as age, clinical characteristic measures such as hemoglobin A1c (HbA1c), and psychological indicators, including the WHO Five Well-Being Index (WHO-5) and Problem Areas In Diabetes-5 (PAID-5). Differences in each indicator between people with diabetes who experienced shame and those who did not were analyzed with the unpaired t-test. As supplemental analysis, binomial logistic regression analysis was used to identify factors associated with the prevalence of diabetes-related shame.
RESULTS
Of the 510 participants, 32.9% experienced diabetes-related shame and 17.5% concealed their disease from colleagues or friends. Those who had experienced diabetes-related shame showed significantly lower WHO-5 and higher PAID-5 scores (p<0.001). However, no significant difference was found in HbA1c (p=0.36). Binomial logistic regression revealed that women, young adults, those without a college degree, those with low self-efficacy, and those with a strong sense of financial burden or external pressure were at higher risk of experiencing diabetes-related shame.
CONCLUSIONS
Among people with type 2 diabetes mellitus, diabetes-related shame was associated with diabetes-specific emotional distress and low psychological well-being. Further research and care development are needed to address diabetes-related shame and improve the quality of life of people with diabetes.
Topics: Female; Humans; Young Adult; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Quality of Life; Shame; Stress, Psychological
PubMed: 36593661
DOI: 10.1136/bmjdrc-2022-003001 -
Plastic and Reconstructive Surgery.... Oct 2022Doctors and postgraduate students, especially those in the surgical field, face a highly stressful environment and are exposed to various emotions that have been...
UNLABELLED
Doctors and postgraduate students, especially those in the surgical field, face a highly stressful environment and are exposed to various emotions that have been studied, but the concept of shame-based learning (SBL) is still undergoing investigation, especially in the field of plastic surgery. SBL is a teaching method in which an instructor instills a sense of shame in the student, which may cause depression, anxiety, aggression, and poor job performance, leading to burnout, mental health illness, substance abuse, and suicide.
METHODS
From March to May 2022, two cross-sectional electronic surveys were conducted for residents and consultants in Saudi Arabia, respectively, which used a validated questionnaire to assess SBL.
RESULTS
Among the 70 responses received (29 residents and 41 consultants), 75.9% of the residents and 80.5% of the consultants were shamed. For residents, a wrong answer was the most common trigger for shame (44.8%), and the operating room was the most common place for it (51.7%). Losing self-confidence was the most common result of shaming (37.9%) and (41.4%) dealt with it by keeping it to themselves. Although 27.6% of residents stated that they had no negative effect, 20.7% stated that they were motivated. There are consultants who practice shaming directly or indirectly (65.9%), while some agreed that it is not necessary (80.5%).
CONCLUSIONS
Although both groups agreed that SBL is unnecessary for the field and will not be practiced in the future, most residents and consultants experienced shame. The negative impact of SBL has several effects on the trainer, the teaching environment, and patient care.
PubMed: 36312904
DOI: 10.1097/GOX.0000000000004621 -
Frontiers in Psychology 2023The self-discrepancy theory proposes that having inconsistent self-representations can trigger feelings of shame and guilt, leading to experiences of depression and...
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.
PubMed: 37842708
DOI: 10.3389/fpsyg.2023.1215177 -
Frontiers in Psychology 2022The family remains one of the most important relationship systems into early adulthood and provides an important foundation for lifelong mental health. Dysfunctional...
OBJECTIVE
The family remains one of the most important relationship systems into early adulthood and provides an important foundation for lifelong mental health. Dysfunctional family cohesion can promote adjustment problems in adolescents and might also affect adolescents' self-concept and strategies for coping with emotional distress. To test these relationships and the underlying mechanisms, we proposed a dual mediation model describing the associations between family cohesion and internalizing and externalizing problems, mediated by shame-proneness and expressive suppression.
METHODS
A sample of 526 German-speaking adolescents aged 14 to 18 years from Austria, Germany, and Switzerland participated in an online self-report survey encompassing questionnaires on family cohesion, shame-proneness, expressive suppression, and psychological problems. We tested a path model to examine the indirect pathways of the associations between family cohesion and internalizing and externalizing problems via shame-proneness and expressive suppression, while controlling for age, gender, and guilt-proneness.
RESULTS
We found a significant dual mediation of the associations between family cohesion and internalizing and externalizing problems by shame-proneness and expressive suppression. The indirect pathways were all significant, except for the indirect pathway from family cohesion to externalizing problems via shame-proneness.
DISCUSSION
Our results provide a model for the mechanisms by which disrupted family cohesion can be related to psychological problems in adolescents. Expressive suppression emerged as crucial when considering the consequences of shame-proneness in adolescents, as it was only indirectly related to externalizing problems via expressive suppression.
PubMed: 35992453
DOI: 10.3389/fpsyg.2022.921250 -
PloS One 2022The bidirectional associations between negative self-conscious emotions such as shame and guilt and substance use are poorly understood. Longitudinal research is needed... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The bidirectional associations between negative self-conscious emotions such as shame and guilt and substance use are poorly understood. Longitudinal research is needed to examine the causes, consequences, and moderators of negative self-conscious emotions in people who use substances.
METHODS
Using parallel process latent growth curve modeling, we assessed bidirectional associations between shame and guilt and substance use (i.e., number of days in the past 30 used stimulants, alcohol to intoxication, other substances, or injected drugs) as well as the moderating role of positive emotion. Emotions were assessed using the Differential Emotions Scale. The sample included 110 sexual minority cisgender men with biologically confirmed recent methamphetamine use, enrolled in a randomized controlled trial in San Francisco, CA. Participants self-reported emotions and recent substance use behaviors over six time points across 15 months.
RESULTS
Higher initial levels of shame were associated with slower decreases in stimulant use over time (b = 0.23, p = .041) and guilt was positively associated with stimulant use over time (β = 0.85, p < .0001). Initial levels of guilt and alcohol use were positively related (b = 0.29, p = .040), but over time, they had a negative relationship (β = -0.99, p < .0001). Additionally, higher initial levels of other drug use were associated with slower decreases in shame over time (b = 0.02, p = .041). All results were independent of depression, highlighting the specific role of self-conscious emotions.
CONCLUSIONS
Shame and guilt are barriers to reducing stimulant use, and expanded efforts are needed to mitigate the deleterious effects of these self-conscious emotions in recovery from a stimulant use disorder.
Topics: Emotions; Guilt; Humans; Male; Self Concept; Shame; Substance-Related Disorders
PubMed: 35303025
DOI: 10.1371/journal.pone.0265480 -
Qualitative Health Research May 2023There is an urgent need to generate deeper understandings of how suicidality manifests and evolves during pregnancy and the following year. Several perinatal studies...
There is an urgent need to generate deeper understandings of how suicidality manifests and evolves during pregnancy and the following year. Several perinatal studies have examined the incidence of suicidal thoughts and behaviours and associated social and obstetric risk factors; however, there is very limited research offering insights into women's experiences of suicidality at this time in their lives. This study aimed to generate a theory to explain how suicidality evolves in the perinatal period. A grounded theory design was used with data generated using anonymous online surveys (119 participants) and in-depth interviews (20 participants) with women who received pregnancy care in the past 5 years in Australia. The developed theory holds shame as a core concept. Origins and contexts of shame reflect current epidemiological understandings of risk for perinatal suicide, including experiences of gender-based violence, adverse childhood experiences, and a history of mental health difficulties. When women feel that they are defective, are unworthy of love and belonging, and do not possess what it takes to be a good mother, they can conclude that their family is better off without them. Pathways beyond shame were facilitated by compassionate and rehumanising care from family, friends, and care providers. Findings demonstrate that perinatal suicidality is a complex multidimensional phenomenon, influenced by socio-cultural expectations of motherhood and interpersonal, systemic, and intergenerational experiences of trauma. Increasing the prominence of perinatal suicide prevention within health professional education and practice, and addressing systemic barriers to compassionate health care are critical first steps to addressing perinatal suicide.
Topics: Pregnancy; Humans; Female; Empathy; Suicidal Ideation; Grounded Theory; Qualitative Research; Suicide; Shame
PubMed: 36952603
DOI: 10.1177/10497323231164278