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More or less than human: the influence of shame on psychological distress
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.ORCID iD: 0000-0001-8440-6881
2011 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Övermänsklig eller undermänsklig : skammens inflytande på psykisk ohälsa (Swedish)
Abstract [en]

Background Shame is a powerful emotion involved in a wide variety of phenomena including psychopathology. The propensity to react with shame to situations of transgression is formed early in life, but the processes by which elevated shame-proneness causes higher levels of psychological distress and functional impairment in some people rather than in others is as yet poorly understood.

Objectives The main objective of this thesis was to further elucidate these processes by investigating the implications for shame states, guilt, general coping strategies, attachment styles, and shame-related coping in this context, as well as to evaluate an assessment method for shame-proneness.

Methods The self-report questionnaires Test of Self-Conscious Affect (TOSCA), Compass of Shame Scale (CoSS-5), Harvard Trauma Questionnaire (HTQ), Ways of Coping Questionnaire (WCQ), Attachment Style Questionnaire (ASQ), Symptom Checklist 90 (SCL-90), and an interview measure for event-related shame and guilt were used for assessment in adult normative, healthy-only, crime victim, and patient samples (n=25-361). A combination of uni- and bivariate approaches and multivariate soft and hard modeling approaches were used for statistical analysis.

Results Paper I showed that the TOSCA could be used as a reliable measure for shame-proneness. Paper II showed that guilt was unrelated to post-victimization distress. Elevated shame-proneness was related to higher levels of post-victimization distress. This effect was partially mediated by event-related shame. Paper III showed that in CFS patients, higher levels of shame-proneness, escape-avoidance, and accepting responsibility coping contributed to elevated levels of psychological distress. Seeking support, positive reappraisal coping, and proneness to detachment contributed in the opposite direction. These relationships were weaker in the comparison groups. Paper IV showed that shame-proneness was associated with secure attachment style in a negative direction. Higher levels of secure attachment style contributed to lower levels of psychological distress, whereas shame-proneness, insecure attachment styles and withdrawal, attack self, and attack other shame coping strategies contributed in the opposite direction. There were mean differences between women and men regarding most of the variables, butiithe relationships between variables did not differ between men and women.

Conclusions The association between shame-proneness and psycho-logical distress seem to involve a complex balancing act between motives toward preserving close relationships and protecting a relatively positive sense of self. If others are perceived as trustworthy and compassionate and are utilized for support in times of need, the effects of shame-proneness may be less debilitating, whereas if others are perceived as distancing or disapproving, and life stress and social transgressions are managed by escape strategies, social withdrawal, self-blame or by transferring blame onto others, the distress effects become more severe. The inner psychodynamics of these functional patterns seem to be rather similar in women and men.

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2011. , 60 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1465
Keyword [en]
Shame, shame-proneness, guilt, self-conscious emotions, psychological distress, coping, attachment styles, Compass of Shame
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:umu:diva-50080ISBN: 978-91-7459-327-3 (print)OAI: oai:DiVA.org:umu-50080DiVA: diva2:459013
Public defence
2011-12-16, Psykiatriska klinikens föreläsningssal A, byggnad 23 (målpunkt F), suterrängplanet (noll-planet), Norrlands universitetssjukhus, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2011-11-25 Created: 2011-11-24 Last updated: 2015-04-29Bibliographically approved
List of papers
1. Assessment of self-conscious emotions: a Swedish psychometric and structure evaluation of the test of self-conscious affect (TOSCA)
Open this publication in new window or tab >>Assessment of self-conscious emotions: a Swedish psychometric and structure evaluation of the test of self-conscious affect (TOSCA)
2009 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 50, no 1, 71-77 p.Article in journal (Refereed) Published
Abstract [en]

The Test of Self-Conscious Affect (TOSCA) is a well-established scenario-based questionnaire assessing self-conscious emotions, such as shame and guilt, which have been shown to be differentially associated with a variety of functional, motivational, behavioral and health outcomes. The aim of this study was to evaluate the psychometric properties and internal structure of a Swedish version of TOSCA in a sample of 361 healthy adults. The psychometric properties and internal consistency of the Swedish version were at level with the original US TOSCA version for shame, guilt and detachment. The internal structure of the Swedish version was acceptable for shame, guilt and detachment but contained shortcomings in assessment of externalization.

Place, publisher, year, edition, pages
Wiley, 2009
Keyword
test of Self-Conscious Affect (TOSCA), psychometric properties, confirmatory factor analysis (CFA), shame proneness, guilt proneness
National Category
Psychiatry Psychology
Research subject
Psychiatry; Psychology
Identifiers
urn:nbn:se:umu:diva-10513 (URN)10.1111/j.1467-9450.2008.00674.x (DOI)
Available from: 2008-09-23 Created: 2008-09-23 Last updated: 2015-04-29Bibliographically approved
2. Distress after a single violent crime: how shame-proneness and event-related shame work together as risk factors for post-victimization symptoms
Open this publication in new window or tab >>Distress after a single violent crime: how shame-proneness and event-related shame work together as risk factors for post-victimization symptoms
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2011 (English)In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 109, no 1, 3-23 p.Article in journal (Refereed) Published
Abstract [en]

To increase understanding of post-victimization symptom development, the present study investigated the role of shame- and guilt-proneness and event-related shame and guilt as potential risk factors. 35 individuals (M age = 31.7 yr.; 48.5% women), recently victimized by a single event of severe violent crime, were assessed regarding shame- and guilt-proneness, event-related shame and guilt, and post-victimization symptoms. The mediating role of event-related shame was investigated with structural equation modeling (SEM), using bootstrapping. The guilt measures were unrelated to each other and to post-victimization symptoms. The shame measures were highly intercorrelated and were both positively correlated to more severe post-victimization symptom levels. Event-related shame as mediator between shame-proneness and post-victimization symptoms was demonstrated by prevalent significant indirect effects. Both shame measures are potent risk factors for distress after victimization, whereby part of the effect of shame-proneness on post-victimization symptoms is explained by event-related shame.

National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:umu:diva-42791 (URN)10.2466/02.09.15.16.PR0.109.4.3-23 (DOI)000295760000001 ()22049643 (PubMedID)
Available from: 2011-04-13 Created: 2011-04-13 Last updated: 2017-12-11Bibliographically approved
3. Relationships among shame-proneness, coping, and psychological distress in chronic fatigue syndrome patients
Open this publication in new window or tab >>Relationships among shame-proneness, coping, and psychological distress in chronic fatigue syndrome patients
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:umu:diva-50074 (URN)
Available from: 2011-11-24 Created: 2011-11-24 Last updated: 2015-04-29Bibliographically approved
4. Shame and psychological distress: the influence of attachment styles, shame-proneness and shame coping among women and men
Open this publication in new window or tab >>Shame and psychological distress: the influence of attachment styles, shame-proneness and shame coping among women and men
(English)Manuscript (preprint) (Other academic)
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:umu:diva-50078 (URN)
Available from: 2011-11-24 Created: 2011-11-24 Last updated: 2015-04-29Bibliographically approved

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