Shame and depressive symptoms in men: The moderating role of environmental mastery and purpose in life.

BACKGROUND: Feelings of shame are linked to increased risk for depression. Little is known about protective factors that may buffer this effect, particularly in men. Using prospective data from a community sample of Australian men, we examine the extent to which shame is associated with depressive symptoms, and the protective role of psychological wellbeing, specifically environmental mastery and purpose in life. METHODS: Participants (n = 448) were from the longitudinal Men and Parenting Pathways (MAPP) Study. Measures were the Event Related Shame and Guilt Scale for shame, the DASS-21 for depressive symptoms and Ryff's Scales of Psychological Well-Being for environmental mastery and purpose in life. Linear regressions were used to test associations between shame and depressive symptoms concurrently and 1-year later, and the moderating effects of mastery and purpose in life. RESULTS: Shame was strongly associated with concurrent depressive symptoms (ßunadj = .76, p < .001; ßadj = .63, p < .001). This effect was weaker in men with high compared to low environmental mastery (ß+1SD = .46, p < .001; ß-1SD = .55, p < .001) and purpose in life (ß+1SD = .48, p < .001; ß-1SD = .62, p < .001). Shame also predicted subsequent depressive symptoms after adjustment for prior depressive symptoms (ßunadj = .59, p = .001; ßadj = .34, p = .004), although environmental mastery or purpose in life did not moderate these associations. CONCLUSIONS: Our findings suggest that promoting a sense of psychological wellbeing in men may confer protective proximal effects in the context of shame, potentially attenuating depression severity. The current study aligns with calls for strength-based approaches to reducing mental health problems in men.

"I Can't Get No Satisfaction"-Psychosocial Aspects and Awareness of Negative Impacts in Chemsex Users: Results from an Anonymous Online Survey.

Chemsex is the interplay of substance use by men who have sex with men (MSM) in sexual contexts. The minority stress model and the identity process theory are explanatory models. In this study, we investigated whether (i) differences in certain psychosocial aspects (i.e., shame, aspects of queer identity, and sexual self-concepts) exist between chemsex users and non-users, and (ii) which factors influence an awareness of negative impacts in chemsex users. We conducted an anonymous, cross-sectional, online survey, including sociodemography, sexual history, history of substance use, validated scales for shame-proneness, aspects of queer identity, and sexual self-concepts. Our analysis comprised descriptive statistics, t-tests, Spearman's correlations, and a multiple linear regression model. We recorded a total of 3257 datasets with 107 chemsex users. Chemsex users showed higher rates for risky sexual behavior. Values for shame proneness, more negative aspects of queer identity, and sexual self-concepts were elevated in chemsex users with an awareness of negative impacts. Sexual anxiety, intravenous substance use, and having had a difficult process coming out were significant predictors of feeling negative impacts. Aspects of shame, queer identity aspects, and sexual self-concepts play an important role in the field of chemsex. Different explanatory models seem to be relevant for different subgroups of chemsex users. Chemsex users with an awareness of a problem were particularly vulnerable and distressed but had the highest motivation for change. Prevention, counseling, and care might profit from the inclusion of these aspects. Further anti-stigma campaigns and a specialization of the healthcare system are needed. Registration: DRKS00022336, date: 29th of October, 2020.

The role of shame in functional and epileptic seizures.

BACKGROUND: Shame, a complex social emotion, may play a clinically important role in seizure disorders. Therefore, this study examined levels of shame aversion & shame proneness and their relationship with various mental health difficulties (MHDs), and seizure frequency & severity in people with functional seizures (PWFS) and epilepsy (PWE). METHODS: In this cross-sectional study, PWFS (N = 68) and PWE (N = 70) were recruited through a neurology clinic and charities, completed online self-reported measures of shame proneness & aversion, seizure frequency & severity, depression, anxiety, somatic symptoms, and perceived socioeconomic status (PSS). Data analyses involved t-tests, correlations, and moderated regression analyses. RESULTS: Both PWFS and PWE showed high and equivalent levels of shame aversion & proneness; mean levels of these measures were more than a standard deviation higher in PWFS and PWE, than in non-clinical populations of previous studies. Both groups had clinically high levels of depression and somatic symptoms, but not anxiety, with PWFS having significantly higher levels than PWE. Shame aversion predicted anxiety and depression in both groups, even after controlling for PSS, age, and gender. Interestingly, PSS, a demographic control variable, significantly predicted depression, anxiety, somatic symptoms, and seizure frequency in both groups. CONCLUSION: We observed high levels of shame and MHDs in PWFS and PWE. Shame aversion predicted anxiety and depression in both groups, even after controlling for demographic variables. Our findings underline the significant role of shame in people with seizures, despite the differences between PWFS and PWE being smaller than expected.

How sexual objectification marks the brain: fMRI evidence of self-objectification and its harmful emotional consequences.

Female Sexual Objectification refers to perceiving and treating women based on their body appearance. This phenomenon may serve as a precursor for dysfunctional behaviors, particularly among females prone to self-objectification and experiencing shame emotions. Understanding this challenging trajectory by disclosing its neural consequences may be crucial for comprehending extreme psychopathological outcomes. However, investigations in this sense are still scarce. The present study explores the neural correlates of female participants' experiences of being objectified and their relationship with self-objectification, emotional responses and individual dispositions in self-esteem, emotion regulation abilities and self-conscious emotion proneness. To this aim, 25 female participants underwent an fMRI experimental session while they were exposed to interpersonal encounters with objectifying or non-objectifying men. Participants' experienced emotions and levels of attention shifted toward their bodies (self-objectification) was reported after each interaction. The results revealed increased brain activity in objectifying contexts, impacting cortical (frontal, occipital and temporal cortex) and subcortical regions (thalamus, and hippocampus) involved in visual, emotion, and social processing. Remarkably, the inferior temporal gyrus emerged as a crucial neural hub associated in opposite ways with self-esteem and the self-conscious emotion of shame, highlighting its role in self-referential processing during social dynamics. This study points out the importance of adopting a neuroscientific perspective for a deeper understanding of sexual objectification, and to shed light on its possible neural consequences.

Randomized trial on the effects of an EMDR intervention on traumatic and obsessive symptoms during the COVID-19 quarantine: a psychometric study.

Introduction: It has been suggested that the COVID-19 pandemic was a potentially traumatic occurrence that may have induced generalized anxiety and discomfort, particularly in susceptible populations like individuals with mental illnesses. The therapeutic approach known as eye movement desensitization and reprocessing (EMDR) has been shown to be successful in helping patients process traumatic events and restore wellbeing. Nevertheless, little is known about the precise processes through which EMDR fosters symptom recovery. Methods: In order to disentangle these issues, we conducted a randomized controlled trial (ClinicalTrials.gov Identifier NCT06110702) with 107 participants who were selected from university hospitals as a sample of investigation. Random assignments were applied to the participants in order to assign them to the experimental and control groups. The experimental group, but not the control group, underwent an 8-week EMDR intervention. Body perception, disgust, and emotions of guilt and shame, as well as mental contamination and posttraumatic and obsessive-compulsive symptoms, were investigated before and after the EMDR intervention. Results: The EMDR intervention was able to improve all of the variables investigated. Path analysis showed that body perception was able to predict both disgust and emotions of guilt and shame. Disgust was able to predict both mental contamination and obsessive-compulsive symptoms, while guilt and shame were able to predict post-traumatic symptoms. Conclusions: EMDR is an effective therapy for the treatment of post-traumatic and obsessive symptoms that acts through the promotion of improvement of the emotions of guilt/shame and disgust, respectively. Implications for clinical practice are examined. Clinical trial registration: https://www.clinicaltrials.gov, identifier NCT06110702.

Social media and body image: Relationships between social media appearance preoccupation, self-objectification, and body image.

Nearly 85 % of emerging adults report using at least one social media site. Research suggests that viewing and internalizing unrealistic body ideals often displayed online may pose harmful effects on young people's body image. However, studies on the relationships between social media usage and body image have predominantly focused on women's drive for thinness. We sought to explore the relationships between social media appearance-related preoccupation (SMARP), body shame and surveillance, and drives for leanness, muscularity, and thinness, specifically examining the moderating role of gender within these relationships. Data from 939 undergraduate students (n = 240 men) were analyzed using multigroup structural equation modeling. Surveillance significantly mediated the positive associations between SMARP and drive for leanness for women and men. For SMARP and drive for muscularity, surveillance was a mediator for men only. Shame emerged as a significant mediator of the positive association between SMARP and drive for thinness for women and men. Moderated mediation was supported, such that the indirect effect of SMARP on drive for thinness was significantly stronger for women. These results suggest that for men in particular, SMARP is not necessarily associated with increased drives for leanness and muscularity unless men are also engaging in body surveillance.

"The habit of keeping silent": An exploratory-descriptive qualitative study of the knowledge and attitudes of Kazakhstani gynecologists toward dyspareunia.

BACKGROUND: Dyspareunia (pain during sex) is a common condition that causes physical and emotional stress for many women. This condition can be caused by various factors, including physical, hormonal, inflammatory, viral, neoplastic, psychological, and traumatic events. Anatomical causes include pelvic floor muscular weakness, uterine retroversion, hymenal remnants, and pelvic organ prolapse. The etiology of this condition is complex, causing it to be often overlooked. OBJECTIVES: The main aim of this study was to conduct a qualitative exploratory study and provide a comprehensive description of the knowledge and attitudes held by gynecologists in Kazakhstan on the medical validity, diagnosis, and treatment of dyspareunia. DESIGN: This is an exploratory-descriptive qualitative study. METHODS: Semi-structured online interviews were conducted with 10 physicians. They were identified as obstetrics and gynecology specialists, gynecologic oncologists, and outpatient gynecologists. The average number of years spent practicing their specialty is 15.7, with the shortest being 4 years and the longest being 35 years. All the participants are female. Braun and Clarke's six-stage, step-by-step methodology was used for the thematic analysis. RESULTS: Findings suggest that gynecologists in Kazakhstan have knowledge of the most common causes of dyspareunia, although they still often attribute women's distress to psychological rather than physical factors. It was found that due to stigma and mutual embarrassment open dialogue about sexual health was lacking between patients and physicians. In addition, gynecologists describe difficulties discussing symptoms and performing intimate examinations due to time constraints and a lack of privacy at state facilities. CONCLUSION: To knowledgeably diagnose and treat patients with dyspareunia, gynecologists recommend further training to acquire the requisite evidence-based knowledge and competencies.

An Exploratory-Descriptive Qualitative Study of Kazakhstani Gynecologists' Knowledge and Attitudes Toward DyspareuniaBackground: Dyspareunia (pain during sex) is a common condition that causes physical and emotional distress in many women. Biological and psychological factors contribute to the onset of this condition, making diagnosis and management difficult for physicians. This painful condition can have a significant impact on women's physical, emotional, and psychological well-being, as well as their close relationships. Why was the study conducted? A thorough understanding of dyspareunia's causes, risk factors, and treatment techniques is required for effective management of the condition, but little research has been conducted in Kazakhstan on gynecologists' understanding of and attitudes toward dyspareunia. What did the researchers do? A qualitative study used online semi-structured interviews with gynecologists in Kazakhstan. What did the researchers find? The findings show that participating gynecologists are aware of the most common causes of dyspareunia, although they frequently attribute the condition to psychological rather than physical causes. It was found that due to stigma and mutual embarrassment, patients and participants did not engage in open discourse about sexual health. Furthermore, gynecologists have difficulty initiating discussions about women's sexual health and performing intimate examinations due to consultation time restrictions and a lack of privacy at state facilities. What do the researchers conclude? Additional training is recommended to gain the necessary evidence-based knowledge and competencies to accurately diagnose and treat patients with dyspareunia, and to address the lack of treatment protocols for dyspareunia in Kazakhstan, clinical guidelines published worldwide, including those issued by the American College of Obstetricians and Gynaecologists, may be considered for use in Kazakhstan.

"I Cannot Tell Anyone:" There are Many Reasons.

Purpose: The purpose of this study was to investigate variables associated with difficulty disclosing past trauma. Across several prevalence studies, 26% of adults never disclosed childhood abuse until adulthood when they were asked in a research survey or interview question. In this Institutional Review Board approved study, group differences were examined (ability and inability to disclose a traumatic event) as well as predictors for difficulty disclosing past trauma. Method: A non-clinical population (N = 693) was examined to determine prevalence rates and group differences between participants unable to tell someone about a past traumatic event (10%) compared to those who could disclose past traumatic events (90%). Variables included pathological dissociative processing, internalized shame, coping strategies (task, emotion, avoidance), and cumulative trauma exposure. Logistic regression analyses were conducted to determine predicting variables for disclosure difficulties. Findings: The group that had difficulty disclosing a past traumatic event had more cumulative trauma, pathological dissociative processing, emotion-oriented coping, and shame. In the first logistic regression analyses, interpersonal traumatic events were predictors for the inability to disclose a traumatic event (classified 90% of group membership). In the second logistic regression, shame and cumulative traumatic exposure were predicting factors (classified 90% of group membership). Conclusion: Difficulty speaking about a traumatic event was associated with interpersonal adult and childhood traumatic events, more internalized shame, and cumulative trauma exposure. It is recommended that clinicians working with patients with substantial traumatic exposure address shame, pathological dissociative processing, and emotion-oriented coping strategies if they detect trauma disclosure difficulties.

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 Contribution of Shame to Eating Disorder Treatment Outcomes in a Community Mental Health Clinic.

OBJECTIVE: Shame is a powerful self-conscious emotion that is often experienced by individuals with eating disorders (EDs). While the association between EDs and shame is well-established, there is limited research investigating the contribution of pre-treatment shame to clinical outcomes. METHOD: Participants (N = 273) received outpatient cognitive-behavioral therapy for eating disorders (CBT-ED). We investigated pre-treatment shame as a predictor of dropout and as a moderator of change in ED psychopathology and clinical impairment from pre-treatment to post-treatment. We also explored the potentially moderating roles of body mass index, ED diagnostic category, and co-occurring anxiety and depression diagnoses. RESULTS: Shame improved substantially (d = 1.28) despite not being explicitly targeted in treatment. Pre-treatment shame did not predict treatment dropout. Individuals high in shame started and ended treatment with higher ED symptoms and impairment than those with low shame. The contribution of pre-treatment shame on the degree of change in symptoms/impairment depended critically on whether analyses controlled for pre-treatment symptoms/impairment. When those were controlled, high pre-treatment shame was associated with substantially less improvement in ED symptoms and impairment. There was some evidence that ED diagnosis and co-occurring depressive diagnoses may moderate the relationship between shame and treatment outcome. Changes in shame were positively associated with changes in ED symptoms and clinical impairment. DISCUSSION: A high level of shame at pre-treatment is not a contraindication for CBT-ED as good therapeutic outcomes can be achieved. However, outcomes may be enhanced among individuals high in shame by offering adjunctive interventions that explicitly target shame.

Brief Self-Compassion Intervention for Women of Higher Weight and Internalized Weight Bias: A Randomized Pilot Study.

BACKGROUND: Internalized weight bias (IWB) negatively impacts mental and physical health, and disproportionately affects women of higher weight. Although self-compassion training may be advantageous for reducing IWB and associated sequalae, further examination of its clinical significance and cultural acceptability is warranted. METHOD: A randomized pilot study was conducted to evaluate the feasibility, including cultural acceptability, and clinical significance of a 3-session self-compassion intervention (SCI) for women with IWB. Women with BMIs of > 25 and IWB (N = 34) were randomly assigned to the SCI or a waitlist control group. Participants completed pre, post, and 1-month follow-up surveys on IWB, self-compassion, body image, eating behaviors, physical activity, and affect. Analyses of covariance were employed and percentages of change were calculated to examine post-intervention between-group differences in outcomes. Cultural acceptability was evaluated through participants' ratings of the perceived inclusivity and relevancy of the SCI. RESULTS: There were 59% (n = 10) and 47% (n = 8) completion rates in the SCI and waitlist control groups, respectively. Compared to the waitlist control group, SCI participants reported greater pre-post improvements in self-compassion, IWB, body shame and surveillance, uncontrolled eating, and physical activity with medium to large effect sizes, and emotional eating with small effects. The SCI was perceived to be beneficial overall, and cultural acceptability ratings were mostly favorable despite individual differences. CONCLUSION: This brief SCI may be beneficial for women impacted by weight stigma and IWB. Attention to increased diversity and cultural acceptability is warranted in future trials.

Women's experiences of sexual harassment in the retail clothing industry: a grounded theory study.

Introduction: Sexual harassment is a significant problem in workplaces all over the world. Women's reactions to sexual harassment are influenced by various factors. The aim of the current study was to investigate how women respond sexual harassment in the retail clothing industry. Methods: In-depth face-to-face interviews were conducted with 16 women aged 23-44 years (mean 29.18 years) employed for at least 3 years in clothes shops in Shiraz, Iran. A grounded theory approach was used to analysis the data and raise hypotheses. Results: The main perpetrators of sexual harassment for female saleswomen were male customers. The women experienced conflict-induced stimulation (core phenomenon) when they were faced with sexual harassing behaviors (causal conditions). Such stimulation prompted three types of coping strategies: silence, avoidance, or confrontation. Intervening factors like the characteristics of the Iranian society (including family mores, state-imposed hijab regulations, patriarchal culture, educational system, and regulatory monitoring) and contextual factors (including individual and environmental factors and particularly employer expectations) were found to influence the selection of strategies used as well as their potential consequences in challenging situations. Conclusion: The current study used a grounded theory approach to produce an explanatory storyline that can be tested. Sexual harassment induces conflict-induced stimulation and responses are influenced by intervening conditions, contextual factors, selected strategies, and the perceived consequences of the response. The findings of the grounded theory study suggest that there are negative consequences, particularly in terms of lack of employer support and losing one's job, shame, and family disapproval which act as barriers for female saleswomen to counteracting sexual harassment from male customers. Such an understanding can also be applied to develop educational policies to support women as well as ameliorate the prevalence of this essentially illegal problem.

An evaluation and refinement of the "Hep B Story" app, tailored to meet the community's cultural needs.

BACKGROUND: Hepatitis B is endemic amongst the Australian Aboriginal population in the Northern Territory. A participatory action research project identified the lack of culturally appropriate education tools and led to the development of the "Hep B Story" app in the Aboriginal language Yolŋu Matha. This paper describes a formal evaluation of the app's first version, which informed improvements and translation into a further ten Aboriginal languages. METHODS: The evaluation employed Participatory Action Research (PAR) principles to work within Indigenous research methodologies and prioritise Indigenous knowledge to improve the app iteratively. Semi-structured interviews and focus groups were conducted across the Northern Territory with 11 different language groups. Local Community Based Researchers and Aboriginal Research team members coordinated sessions. The recorded, translated conversations were transcribed verbatim and thematically analysed using an inductive and deductive approach. RESULTS: Between November 2018 and September 2020, 94 individuals from 11 language groups participated in 25 semi-structured interviews and 10 focus groups. All participants identified as Aboriginal. Most participants felt the app would be culturally appropriate for Aboriginal communities in the Northern Territory and improve knowledge surrounding hepatitis B. The information gathered from these interviews allowed for identifying five main themes: support for app, relationships, concept versus language, shame, and perceptions of images, along with errors that required modification. CONCLUSIONS: A "real-life" evaluation of the app was comprehensively completed using a PAR approach blended with Indigenous research methods. This evaluation allowed us to develop an updated and enhanced version of the app before creating the additional ten language versions. An iterative approach alongside strong community engagement was pivotal in ensuring the app's cultural safety and appropriateness. We recommend avoiding the use of knowledge-based evaluations in an Aboriginal setting to ensure relevant and culturally appropriate feedback is obtained.

Skin tone ideologies, body shame, and sexual risk in Latinx young adults: The role of self-esteem.

Latinx young adults in the U.S. experience significant disparities related to body image and sexual health. These challenges partly stem from the intersections of racism, ethnocentrism, and colorism perpetuated through Eurocentric beauty standards and norms surrounding sexuality. Despite the salience of skin tone within the Latinx community, the impact of skin tone ideologies on body shame and sexual risk remains unexplored. Addressing this gap, the present study examined the influence of skin tone ideologies (i.e., colorist attraction and skin tone self-concept) on sexual risk and body shame among a sample of 539 Latinx young adults. The study also explored the potential moderating effect of self-esteem on colorist attraction and skin tone self-concept on body shame and sexual risk. Results revealed that both colorist attraction and skin-tone self-concept were positively associated with body shame. Colorist attraction was positively associated with sexual risk, whereas skin tone self-concept was not associated. Furthermore, self-esteem moderated the positive significant association between skin tone self-concept and body shame, such that the association was only significant among Latinx young adults who reported mean and high levels of self-esteem; self-esteem did not moderate any of the other study's associations. These findings inform the development of tailored mental and sexual health interventions to reduce health disparities among Latinx young adults, considering the influence of skin tone socialization.

Testing body-related components of objectification theory: A meta-analysis of the relations between body shame, self-objectification, and body dissatisfaction.

Objectification theory has been instrumental in better understanding risk for eating disorders, depression, and sexual dysfunction, with self-objectification and body shame as serial mediators leading to these outcomes. Although originally proposed to explain these mental health outcomes in heterosexual women, researchers have extended objectification theory to individuals of various ages, racial identities, and sexual and gender identities. We conducted a systematic literature review of empirical peer-reviewed published research examining the relationship between the constructs of self-objectification, body dissatisfaction, and body shame in adult, youth, and LGBTQ+ samples. Our search yielded 5200 results, of which 318 met inclusion criteria. Of the papers included in this review, 26 reported correlations with sexual and gender diverse samples, 43 reported correlations with youth samples, and 249 reported correlations with samples of general adults (non-sexual or gender minorities). The meta-analyses yielded significant, moderate, positive correlations between body dissatisfaction and self-objectification, and between body shame and self-objectification, for each of the sub-samples. The majority of samples were predominantly White and cisgender female, suggesting the need for additional research examining these constructs among racial and gender minority populations. Overall, the results of this review highlight the unique contributions of body shame and body dissatisfaction to self-objectifying behaviors, and identify the moderating role of race and gender in these interrelations.

Unified Protocol Versus Self-Acceptance Group Therapy for Emotional Disorders in People With Severe Shame.

BACKGROUND: Severe shame is a distressing negative emotion, accompanied by intense feelings of worthlessness that contributes to a broad panoply of psychological disorders. This study aimed to compare the effects on shame dysregulation of two transdiagnostic treatments, the Unified Protocol (UP) and Self-Acceptance Group Therapy (SAGT). We additionally addressed the question of whether borderline personality disorder (BPD) can properly be regarded as an emotional disorder. The focus was on outcome measures, primarily shame that cut across individual diagnostic categories and capture emotional dysfunction broadly conceived. METHODS: Individuals suffering from a range of emotional disorders (including BPD) and high levels of shame were randomly allocated to treatment by either UP (N = 280) or SAGT (N = 282). Outcomes were measures of emotion dysfunction-shame, loneliness, neuroticism, emotional dysregulation, positive and negative affect-measured pre-treatment, post-treatment and at 3- and 6-month follow-ups. RESULTS: UP was superior to SAGT in showing better post-treatment retention of therapeutic gains on all outcome measures over the 6-month follow-up period. Compared with those without a BPD diagnosis, those diagnosed with BPD showed significantly higher neuroticism and emotion dysregulation at baseline and a similar post-treatment reduction in almost all outcomes. CONCLUSIONS: The results support the use of both the UP and SAGT in the treatment of severe shame. The superiority of the UP over SAGT in reducing negative emotionality is interpreted in terms of the specific mechanisms targeted by the UP. The results provide support for the theoretical rationale for the UP as a treatment for dysregulated shame and for emotional dysfunction generally.

How do early affiliative memories explain body image shame? A 12-month longitudinal study in adolescent girls.

OBJECTIVE: This study aimed to explain adolescent girls' body image shame across a 12- month longitudinal design, and its relationship with early parental memories of warmth and safeness and fear of receiving compassion from others. DESIGN AND METHODS: Participants included 231 adolescent girls, who completed self-report measures at three different periods: baseline (W1), 6-month follow-up (W2), and 12-month follow-up (W3). Descriptive and correlational analyses were performed, and differences between participants at the different waves were explored through repeated measures ANOVA. A cross-lagged panel model tested the mediational effect of fears of receiving compassion on the association between early affiliative memories (W1) and body image shame (W3). RESULTS: ANOVA results found significant differences throughout time in memories of warmth and safeness (tending to diminish) and in body image shame (tending to rise). Correlation analysis revealed that all variables were significantly associated in the expected directions, across the three waves. Finally, path analysis revealed that early affiliative parental memories (in W1) had a direct effect on body image shame (in W3), through the fear of receiving compassion from others (in W2), accounting for 85% of body image shame's variance (W3). CONCLUSIONS: These findings indicate that the lack of early affiliative memories often leads to the development of defensive mechanisms such as fears of receiving compassion from others which in turn can foster isolation and distant relationships, enhancing feelings of inferiority and inadequacy, which in female adolescents can emerge centered on body image - body image shame. This study further highlights the importance of prevention and intervention strategies based on compassion to specifically target fears of receiving compassion from others, in adolescent girls dealing with feelings of inferiority and shame regarding their body.

The Role of Shame in the Sexual-Orientation Disparity in Mental Health: A Prospective Population-Based Study of Multimodal Emotional Reactions to Stigma.

Despite the prominence of shame in stigma theories, its role in explaining population-level mental health disparities between the stigmatized and non-stigmatized has not been investigated. We assessed shame explicitly (via self-report) and implicitly (via a behavioral task) in a prospective, representative cohort of sexual minority and heterosexual young adults in Sweden (baseline n=2,222). Compared to heterosexuals, sexual minorities evidenced higher explicit and implicit shame, which explained sexual orientation disparities in depression, social anxiety, and suicidal thoughts. Among sexual minorities, there was an indirect effect of shame in the association between interpersonal stigma (i.e., past-year family rejection and childhood bullying) and later experiences of adverse mental health; an indirect effect did not exist for the related construct, internalized stigma. Results suggest extending existing stigma theories to consider emotions like shame as characteristic reactions to stigma and guide the search for treatment targets focused on reducing the mental health sequelae of stigma.

Integrating Guilt and Shame into the Self-Concept: The Influence of Future Opportunities.

This study explored the integration of guilt and shame experiences into the self-concept, focusing on how perceived future opportunities affect this process. The participants in Study 1 (N = 201) and Study 2 (N = 221) recalled experiences that elicited either guilt or shame and that they believed could occur again in the future (i.e., repeatable) or could not (i.e., non-repeatable). The results showed that when the participants viewed an event as repeatable, suggesting that future opportunities for change were possible, they were more likely to accept and integrate the experiences associated with guilt than with shame. This difference disappeared when the target event was non-repeatable, thereby providing no future opportunities for change. Study 2 further demonstrated the moderating role of future coping confidence in the relationship between the interaction effect of emotion type and event repeatability on self-integration. These findings underscore the different roles of guilt and shame in identity development and intrapersonal learning.

Two Sides of the Same Coin in Female Borderline Personality Disorder: Self-Reported Guilt and Shame and Their Neurofunctional Correlates.

OBJECTIVE: Patients with borderline personality disorder (BPD) report to be especially prone to social emotions like shame and guilt. At the same time, these emotions seem to play an important role in BPD pathology. The present study aimed to deepen the knowledge about the processes behind shame and guilt in patients with BPD. METHODS: Twenty patients with BPD and twenty healthy controls (HCs) took part in an experiment that induced shame and guilt by imagining scenarios during scanning using functional brain imaging. Participants also filled out self-report questionnaires and took part in diagnostic interviews. RESULTS: BPD patients reported more proneness to guilt but not to shame than the HCs. There was no difference in the self-reported intensity rating of experimentally induced emotions between the groups. Between-group contrast of neural signals in the shame condition revealed a stronger activation of cingulate and fusiform gyrus for the BPD patients compared to the controls, and a more pronounced activation in the lingual gyrus and cuneus for the HCs. In the guilt condition, activation in the caudate nucleus, the fusiform gyrus, and the posterior cingulate cortex was stronger in BPD patients, while HC showed stronger activations in cuneus, lingual gyrus, and fronto-temporal regions. CONCLUSIONS: Differences in the neuro-functional processes between BPD patients and HC were found, even though the two groups did not differ in their self-report of subjective proneness to guilt and emotional intensity of shame and guilt during the experiment. While the HCs may be engaged more by the emotional scenarios themselves, the BPD patients may be more occupied with cognitive regulatory and self-referential processing.