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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 -
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 -
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 -
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 -
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 British Journal of Clinical... Mar 2023Due to rumination and self-criticism over unwanted obsessions and repetitive rituals, shame is a common emotion experienced by individuals with obsessive-compulsive... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Due to rumination and self-criticism over unwanted obsessions and repetitive rituals, shame is a common emotion experienced by individuals with obsessive-compulsive disorder (OCD). Shame is also theorized to have relevance to unacceptable thoughts in OCD. However, empirical research looking at the relationship between OCD and shame is still emerging and findings have been mixed.
OBJECTIVES
Our review systematically examines the association of shame with OCD and unacceptable thoughts.
METHODS
The last updated search was conducted across five databases between 27 and 29 February 2022. The final selection included 20 papers, 18 of which were used in the primary meta-analysis to calculate pooled effect sizes between OCD and shame measures using a random effects model. In a separate analysis, three papers were used to calculate pooled effect sizes between shame and OCD symptom dimensions also using a random effects model.
RESULTS
The meta-analyses identified a significant, moderate and positive correlation between total OCD and shame scores r = .352, 95% CI [0.260, 0.438]. In addition, significant, weak and positive relationships were found between shame and three OCD symptom dimensions: unacceptable thoughts r = .252, 95% CI [-0.467, 0.9708], harm obsessions r = .224, CI [-0.190, 0.638] and symmetry concerns r = .200, CI [-0.108, 0.509].
LIMITATIONS
Shame measures in the reviewed studies were not specific to OCD, and between-study variance in the analyses examining unacceptable thoughts was significant.
CONCLUSIONS
Our findings support a medium positive relationship between shame and OCD. As shame in OCD can be a barrier to seeking treatment and impair quality of life, it is imperative to address this emotion through psychoeducation, assessment and treatment.
Topics: Humans; Quality of Life; Obsessive-Compulsive Disorder; Shame; Psychiatric Status Rating Scales; Psychometrics
PubMed: 36300990
DOI: 10.1111/bjc.12392 -
CMAJ : Canadian Medical Association... Apr 2014
Topics: Humans; New York City; Practice Patterns, Physicians'; Primary Health Care; Private Practice; Shame
PubMed: 24638022
DOI: 10.1503/cmaj.131838 -
Maternal & Child Nutrition Jul 2021Negative maternal affect (e.g., depression and anxiety) has been associated with shorter breastfeeding duration and poorer breastfeeding intention, initiation, and... (Review)
Review
Negative maternal affect (e.g., depression and anxiety) has been associated with shorter breastfeeding duration and poorer breastfeeding intention, initiation, and exclusivity. Other affective states, including guilt and shame, have been linked with formula feeding practice, though existing literature has yet to be synthesised. A narrative synthesis of quantitative data and a framework synthesis of qualitative and quantitative data were conducted to explore guilt and/or shame in relation to infant feeding outcomes. Searches were conducted on the DISCOVER database between December 2017 and March 2018. The search strategy was rerun in February 2020, together yielding 467 studies. The study selection process identified 20 articles, published between 1997 and 2017. Quantitative results demonstrated formula feeders experienced guilt more commonly than breastfeeding mothers. Formula feeders experienced external guilt most commonly associated with healthcare professionals, whereas breastfeeding mothers experienced guilt most commonly associated with peers and family. No quantitative literature examined shame in relation to infant feeding outcomes, warranting future research. The framework synthesis generated four distinct themes which explored guilt and/or shame in relation to infant feeding outcomes: 'underprepared and ineffectively supported', 'morality and perceived judgement' (breastfeeding), 'frustration with infant feeding care' and 'failures, fears and forbidden practice' (formula feeding). Both guilt and shame were associated with self-perception as a bad mother and poorer maternal mental health. Guilt and shame experiences were qualitatively different in terms of sources and outcomes, dependent on infant feeding method. Suggestions for tailored care to minimise guilt and shame, while supporting breastfeeding, are provided.
Topics: Breast Feeding; Female; Guilt; Humans; Infant; Mothers; Postpartum Period; Shame
PubMed: 33491303
DOI: 10.1111/mcn.13141 -
Seizure Jan 2022
Topics: COVID-19; Child; Conversion Disorder; Humans; SARS-CoV-2; Seizures; Shame
PubMed: 34875543
DOI: 10.1016/j.seizure.2021.11.025