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Carvalho SA, Carvalho F, Fonseca L, Santos G, Castilho P. Beyond the Centrality of Shame: How Self-Concealment and Fear of Receiving Compassion From Others Impact Psychological Suffering in Transgender Adults. J Homosex 2024; 71:1373-1391. [PMID: 36043899 DOI: 10.1080/00918369.2022.2114398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Shame-based social interactions are a minority social stressor commonly experienced by transgender individuals. However, few studies have explored the centrality of shame experiences in transgender identity and mental health. Also, the ability to receive care and soothing support may be influenced by intrapersonal shame- and fear-related factors, which may hinder openness, and support and care seeking, thus contributing to psychological distress. This study aims to examine the relationship between central shame experiences, fear of receiving compassion from others, self-concealment, and psychological distress (depression, anxiety, and stress symptoms) in a sample of Portuguese transgender adults. Following a cross-sectional design, data from a convenience sample of 70 self-identified transgender individuals undergoing gender-affirming medical interventions (GAMIs) were analyzed, using SPSS PROCESS, to determine whether the relationship between central shame experiences and psychological suffering occurred indirectly through fear of receiving compassion from others, and self-concealment. Results suggest that fear of receiving compassion from others, but not self-concealment, was the underlying factor between central shame experiences, and depression and anxiety. Results suggest that the centrality of shame experiences and stress symptomatology associate sequentially through fear of compassion and, in turn, through self-concealment. Clinical implications for mental health interventions with transgender individuals undergoing GAMI are discussed.
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Affiliation(s)
- Sérgio A Carvalho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, School of Psychology and Life Sciences (EPCV), Lusófona University, Lisbon, Portugal
| | - Frederica Carvalho
- Faculty of Medicine, Institute of Psychological Medicine (IPM), University of Coimbra, Coimbra, Portugal
| | - Lígia Fonseca
- CHUC, Centro de Responsabilidade Integrada de Psiquiatria (CRIP), Coimbra University Hospital, Coimbra, Portugal
| | - Graça Santos
- CHUC, Centro de Responsabilidade Integrada de Psiquiatria (CRIP), Coimbra University Hospital, Coimbra, Portugal
| | - Paula Castilho
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
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Kato TA, Sartorius N, Shinfuku N. Shifting the paradigm of social withdrawal: a new era of coexisting pathological and non-pathological hikikomori. Curr Opin Psychiatry 2024; 37:177-184. [PMID: 38415743 PMCID: PMC10990035 DOI: 10.1097/yco.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW Social withdrawal syndrome, known as "hikikomori," has been highlighted since the late 1990 s in Japan. Hikikomori is more common in urban areas, and often comorbid with mental disorders, and now spreading throughout the world. In the post-COVID-19 era, not outing is no longer considered pathological in itself as the "new normal," and a novel concept of hikikomori is needed. This review summarizes the concept of hikikomori, and presents the latest methods for identification of hikikomori. RECENT FINDINGS The novel definition can distinguish between pathological and non-pathological hikikomori using the scale of "Hikikomori Diagnostic Evaluation (HiDE)," which has been developed in the hikikomori research lab at Kyushu University. An online survey among non-working adults has revealed that persons who have become pathological hikikomori for less than three months showed a particularly strong tendency toward gaming disorder and depression. SUMMARY Now, physical isolation itself is not pathological, but when dysfunction and distress are present, rapid mental health support should be provided. In the novel urban society, the establishment of a checkup system to assess whether persons who stay home are happy or suffering is important for prevention against mental disorders triggered by social isolation.
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Affiliation(s)
- Takahiro A. Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University
- Mood Disorder & Hikikomori Clinic, Kyushu University Hospital
- Hikikomori Research Lab, Kyushu University, Fukuoka, Japan
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programs, Geneva, Switzerland
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Poku O, Attoh-Okine ND, Corbeil T, Chen Y, Kluisza L, Ahmed A, Liotta L, Morrison C, Dolezal C, Robbins RN, Mellins CA. Assessing the Validity of the Social Impact Scale Among a Longitudinal Cohort of Adolescents and Young Adults Living With Perinatally Acquired HIV. J Acquir Immune Defic Syndr 2024; 96:11-17. [PMID: 38301642 PMCID: PMC11009064 DOI: 10.1097/qai.0000000000003390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/18/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND With few psychometrically evaluated HIV-related stigma measures for adolescents and young adults living with HIV, we examined the developmental applicability (ie, validity) of 2 subscales of the commonly used stigma measure, the Social Impact Scale, among a cohort of adolescents and young adults with perinatally acquired HIV. SETTING Data were obtained from a New York City longitudinal study (N = 340). This study primarily comprised Black and Latinx adolescents and young adults with either perinatally acquired HIV or those with perinatal exposure but who are uninfected. Data for this analysis were obtained from the population with perinatally acquired HIV and spanned approximately a 15-year survey period (2003-2018). METHODS A confirmatory factor analysis was used at 7 time points to assess whether the Social Rejection and Internalized Shame subscales were consistent in this cohort over time. Overall and individual Cronbach alphas were reported to show the strength of the internal consistency. RESULTS The mean age from baseline to follow-up 6 ranged from 12 to 23 years over the study period. The Social Rejection subscale was acceptably valid across follow-up periods with strong factor loadings and Cronbach alphas higher than 0.70. However, the Internalized Shame subscale was less valid among younger adolescents. Starting at follow-up 2, we observed better validity with the Internalized Shame subscale performance. CONCLUSION Future research must consider mechanisms for developing and adapting measures from a developmental perspective to best measure the experiences of HIV-related stigma among younger populations.
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Affiliation(s)
- Ohemaa Poku
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Naa-Djama Attoh-Okine
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
- Department of Surgery, Jamaica Hospital Medical Center, Jamaica, NY; and
| | - Thomas Corbeil
- Mental Health Data Science, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Ying Chen
- Mental Health Data Science, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Afifa Ahmed
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Lucy Liotta
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Corey Morrison
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
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4
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Frankel J. Treating the sequelae of chronic childhood emotional abandonment. J Clin Psychol 2024; 80:809-823. [PMID: 36724326 DOI: 10.1002/jclp.23490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/30/2022] [Accepted: 01/16/2023] [Indexed: 02/03/2023]
Abstract
Chronic emotional abandonment is traumatic for children, and often leads them to identify with the aggressor (IWA)-in order to hold onto their needed attachment to their parents, they feel, think, and do what their parents require, blame themselves for being abused and for their family's unhappiness, and feel ashamed. IWA often persists as a general tendency. Treatment requires therapists' dependability, attunement, empathy, interest, humility, and perhaps playfulness. Patients' history of abandonment should be explored in detail, though patients may be protective of their parents. Therapists should explore their own behavior if necessary, and acknowledge lapses; normalize and explore patients' shame; and avoid trying to "rescue" patients. Patients must be helped to re-find authority and agency over their own lives, and mourn their early loss of feeling "the right to a life." The treatment of "Claire," a 40-something child of two depressed parents, illustrates some of these points.
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Affiliation(s)
- Jay Frankel
- Postdoctoral Program in Psychotherapy and Psychoanalysis, New York University, New York, New York, USA
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Yeung NCY, Lee EKP, Kong APS, Leung MKW. " Shame on Me": Exploring the Role of Self-Stigma in Psychological Outcomes Among Type 2 Diabetes Patients in Hong Kong. Int J Behav Med 2024; 31:241-251. [PMID: 37010798 DOI: 10.1007/s12529-023-10176-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Studies have suggested that type 2 diabetes mellitus (T2DM) are at risk of self-stigmatization (i.e., internalized sense of shame about having diabetes). Self-stigma has been found to be associated with poorer psychological outcomes among chronic disease patients; relevant studies examining such an association and its psychosocial mechanisms are scarce among Chinese T2DM patients. This study aimed to examine the association between self-stigma and psychological outcomes among T2DM patients in Hong Kong. Self-stigma was hypothesized to be associated with higher psychological distress and lower quality of life (QoL). Such associations were also hypothesized to be mediated by lower perceived social support, lower self-care self-efficacy, plus higher self-perceived burden to significant others. METHODS T2DM patients (N = 206) recruited from hospitals and clinics in Hong Kong were invited to complete a cross-sectional survey measuring the aforementioned variables. RESULTS After controlling for covariates, multiple mediation analysis results indicated the indirect effects from self-stigma to psychological distress via increased self-perceived burden (β = 0.07; 95% CI = 0.02, 0.15) and decreased self-care self-efficacy (β = 0.05; 95% CI = 0.01, 0.11) were significant. Moreover, the indirect effect from self-stigma to QoL via decreased self-care self-efficacy was also significant (β = -0.07; 95% CI = -0.14, -0.02). After considering the mediators, the direct effects from self-stigma to higher psychological distress and lower QoL remained significant (βs = 0.15 and -0.15 respectively, ps < .05). CONCLUSIONS Self-stigma could be linked to poorer psychological outcomes through increased self-perceived burden and decreased self-care self-efficacy among T2DM patients. Targeting those variables when designing interventions might facilitate those patients' psychological adjustments.
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Affiliation(s)
- Nelson C Y Yeung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Jockey Club School of Public Health and Primary Care, Room 508, Postgraduate Education Centre, Prince of Wales Hospital, School of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Eric Kam Pui Lee
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alice Pik Shan Kong
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Abstract
Emotion-focused therapy (EFT) is an empirically supported treatment of depression, and an integrative, transdiagnostic therapy approach focusing on transforming emotions that are the cause of a person's emotional pain and suffering. In-session experiential work and two-chair interventions are consolidated and expanded by between-session homework which is viewed as a natural extension of in-session work. As the focus on emotion in EFT necessitates the provision of a safe, attuned, empathic relationship and a good collaboration on the tasks and goals of therapy the use of homework is very well-suited to this approach. An EFT case example is discussed to illustrate how homework can be an important ingredient to strengthen and facilitate change in treating a depressed client with a core underlying feeling of shame related to unresolved childhood trauma.
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Affiliation(s)
- Serine Warwar
- Centre for Psychology and Emotional Health, Toronto, Ontario, Canada
- Greenberg Institute of Emotion-Focused Therapy, Toronto, Ontario, Canada
- Emotion-Focused Therapy Clinic, York University, Toronto, Ontario, Canada
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Thamm C, McCarthy AL, Yates P. A Discourse of Deviance: Blame, Shame, Stigma and the Social Construction of Head and Neck Cancer. Qual Health Res 2024; 34:398-410. [PMID: 38019709 PMCID: PMC10996294 DOI: 10.1177/10497323231213819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Cancer of the head and neck is a confronting condition, as the disease and its treatments alter the appearance and function of body organs associated with physical appearance and identity. Many of the risk factors for head and neck cancers, including tobacco, alcohol, and human papilloma virus, can also have significant negative social and moral permutations. Language and action (discourse) plays an important role in constructing disease and illness and shape the way it is managed, both institutionally and socially. This research used a critical constructionist lens to investigate how the common discourses surrounding head and neck cancer are constructed within the healthcare context and how this influences patients and healthcare professionals' responses to the illness. Data were collected through semi-structured interviews, field noting, journaling and literature reviews. Analysis was guided by a three-dimensional approach to critical discourse analysis that investigated text, discursive practices, and social context. The overarching finding was that deviance dominates the common discourse and shapes head and neck cancer and responses to it. Deviance is channelled through metaphors, adjectives, descriptors, and collective nouns and is made overt through labelling, avoidance, blaming, shame, and categorization. Discourse is contextualized by a sociocultural understanding that when someone deviates from what is perceived as normal, they are devalued. Open dialogue and reflection on head and neck cancer discourse could enable better understanding of how people experience their condition and inform more supportive responses.
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Affiliation(s)
- Carla Thamm
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Patsy Yates
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, QLD, Australia
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McLeod DA, Ozturk B, Butler-King RL, Peek H. Male Survivors of Domestic Violence, Challenges in Cultural Response, and Impact on Identity and Help-Seeking Behaviors: A Systematic Review. Trauma Violence Abuse 2024; 25:1397-1410. [PMID: 37272373 DOI: 10.1177/15248380231177318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Male experiences of domestic and relational violence have been only marginally explored in the literature. In connection to this, attitudes in the community and among service providers and criminal justice system entities can vary dramatically. This variance in attitudes creates an instability which has a differential impact on the help-seeking behaviors of victims. Additionally, help-seeking behaviors are often influenced by internalized shame and confusion on the part of the survivors themselves when their social constructions of masculinity do not align with lived experience. More is needed to understand the nature of male survivorship in situations of relational violence. A systematic review was conducted to begin organizing the data on the topic. This review started with 15,547 peer-reviewed articles. Those were systematically narrowed to a total of 16 of the most recent pieces of empirical science on the topic. The final articles were thematically analyzed. Findings suggest (a) cultural stigma around constructions of masculinity, (b) fear of disclosure, and (c) negative experiences with criminal justice and support system responses, among the highest drivers for the disparate experience and hesitation to seek help.
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9
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Weatherford JV, Ruork AK, Yin Q, Lopez AC, Rizvi SL. Shame, suicidal ideation, and urges for non-suicidal self-injury among individuals with borderline personality disorder receiving dialectical behavior therapy: The mediating role of anger. Suicide Life Threat Behav 2024; 54:338-348. [PMID: 38265111 DOI: 10.1111/sltb.13045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/16/2023] [Accepted: 01/03/2024] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Borderline personality disorder (BPD) is a disorder of pervasive emotion dysregulation associated with high rates of self-injurious thoughts and behaviors (SITB). Understanding specific emotion states in relation to SITB is important for effective intervention. METHODS The current study examined whether, and how, the specific emotion of shame contributes to suicide ideation and urges to engage in non-suicidal self-injury (NSSI) both directly, and indirectly via anger, among individuals with BPD. Participants (N = 100) were enrolled in a 6-month comprehensive dialectical behavior therapy (DBT) program and provided daily ratings of shame, anger, suicide ideation, and urges for NSSI. RESULTS We found that higher daily ratings of shame and anger were directly associated with higher same-day ratings of both suicidal ideation and urges for NSSI. Furthermore, anger partially mediated the relationships between shame and both suicidal ideation and urges for NSSI. CONCLUSION These findings highlight shame and anger as potential antecedents of SITB among individuals with BPD. Clinical approaches, such as DBT, that include personalized, ongoing, clinical assessment of these specific affective states may be particularly important for treatment of SITB.
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Affiliation(s)
- Jessica V Weatherford
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Allison K Ruork
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Qingqing Yin
- Department of Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Ana C Lopez
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Shireen L Rizvi
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
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10
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Haran U, Van Dijk D, Barina M, Krief M, Rosenzweig S. Winning isn't everything: Guilt proneness and competitive vs. non-competitive motivation. J Pers 2024; 92:457-479. [PMID: 37002803 DOI: 10.1111/jopy.12834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE Guilt proneness is associated with both high motivation to succeed and enhanced concern for others. However, in competition, achieving success requires harming others' interests, which demotivates guilt-prone individuals. Given the prevalence of competition in social and professional life, we examine the relation between guilt proneness, general motivation, and competitive motivation. METHOD Two experiments and two laboratory studies (N = 1735) measured guilt proneness, general motivation, and competitive motivation, and their effects on competitive preferences and choices. Study settings included students' choice of playing a game individually vs. competitively (Study 1), physicians' likelihood to seek residency in medical fields characterized by high competitiveness (Study 2), amateur athletes' preferences between inclusive and win-oriented team strategies (Study 3), and online workers' evaluations of a hypothetical scenario (Study 4). RESULTS Guilt proneness was related positively to general motivation, but negatively to competitive motivation. Guilt proneness, indirectly through lower competitive motivation, predicted a lower likelihood of pursuing competitive paths and preference for non-competitive strategies. Emphasizing prosocial aspects of competitiveness attenuated these effects. CONCLUSIONS Guilt proneness is related to high general motivation but to a lower desire to win. Guilt-prone individuals strive for excellence, but through non-competitive paths, whereas people with lower guilt proneness prefer competing.
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Affiliation(s)
- Uriel Haran
- Department of Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dina Van Dijk
- Department of Health Policy and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michal Barina
- Department of Health Policy and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Mor Krief
- Department of Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Stav Rosenzweig
- Department of Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Mirabile M, Gnatt I, Sharp JL, Mackelprang JL. Shame and Emotion Dysregulation as Pathways to Posttraumatic Stress Symptoms Among Women With a History of Interpersonal Trauma. J Interpers Violence 2024; 39:1853-1876. [PMID: 37942893 PMCID: PMC10913341 DOI: 10.1177/08862605231211924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Women who have survived interpersonal trauma are at elevated risk of developing posttraumatic stress disorder (PTSD), and potentially modifiable factors that may be targeted in treatment warrant further investigation. This study examined a pathway from interpersonal trauma to PTSD symptoms via emotion dysregulation and shame in a large non-clinical sample of women. The sample comprised 380 women, aged 18 to 59 years (M = 31.70, standard deviation = 10.06), all of whom had a history of interpersonal trauma. Participants completed the Experience of Shame Scale, the Difficulties in Emotion Regulation Scale-Short Form, and the Life Events Checklist for DSM-5. A serial and parallel process model with interpersonal trauma as a predictor of PTSD symptoms, emotional dysregulation and facets of shame as intermediary variables, was analyzed using Statistical Package for Social Sciences Statistics PROCESS Model 81with bias-corrected bootstrap tests of indirect effects. Non-interpersonal trauma was included as a covariate. Interpersonal trauma, emotion dysregulation, and characterological and bodily shame were significantly and directly associated with PTSD symptoms, together explaining 59% of the variation in PTSD symptoms. While emotion dysregulation was associated with behavioral shame, interpersonal trauma was not associated with behavioral shame, nor was behavioral shame associated with PTSD symptoms. Tests of indirect effects supported a pathway from interpersonal trauma to PTSD symptoms via emotion dysregulation and characterological and bodily shame. These findings suggest interventions that are particularly effective at reducing emotion dysregulation and characterological and bodily shame, such as compassion and acceptance-based approaches, may complement evidence-based PTSD interventions when working with women who have survived interpersonal trauma.
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Affiliation(s)
| | - Inge Gnatt
- Swinburne University of Technology, Melbourne, VIC, Australia
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12
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Baska A, Świder K, Zgliczyński WS, Kłoda K, Mastalerz-Migas A, Babicki M. Is Obesity a Cause for Shame? Weight Bias and Stigma among Physicians, Dietitians, and Other Healthcare Professionals in Poland-A Cross-Sectional Study. Nutrients 2024; 16:999. [PMID: 38613032 PMCID: PMC11013468 DOI: 10.3390/nu16070999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/14/2024] Open
Abstract
Weight bias and weight stigma pose significant challenges in healthcare, particularly affecting obesity management practices and patient care quality. Our study evaluates their prevalence and impact among healthcare professionals in Poland. Using the Fat Phobia Scale and custom questions, we surveyed 686 professionals via Computer-Assisted Web Interview (CAWI). Results reveal a moderate level of explicit weight bias (mean score: 3.60 ± 0.57), with significant variations across professional groups: physicians (3.70 ± 0.48), dietitians (3.51 ± 0.48), and others (3.44 ± 0.77). Common feelings towards individuals with obesity include willingness to help (57.0%) and compassion (37.8%), yet 29.9% perceive obesity as shameful. The results also vary depending on the respondent's sex or BMI. These findings underscore the need for evidence-based interventions to mitigate weight stigma and enhance understanding of obesity among healthcare professionals.
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Affiliation(s)
- Alicja Baska
- Department of Lifestyle Medicine, School of Public Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
- Polish Society of Lifestyle Medicine, 00-382 Warsaw, Poland
| | | | - Wojciech Stefan Zgliczyński
- Department of Lifestyle Medicine, School of Public Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland;
- Polish Society of Lifestyle Medicine, 00-382 Warsaw, Poland
| | - Karolina Kłoda
- MEDFIT Karolina Kłoda, 70-240 Szczecin, Poland;
- Scientific Section of the Polish Society of Family Medicine, 51-141 Wroclaw, Poland; (A.M.-M.); (M.B.)
| | - Agnieszka Mastalerz-Migas
- Scientific Section of the Polish Society of Family Medicine, 51-141 Wroclaw, Poland; (A.M.-M.); (M.B.)
- Department of Family Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Mateusz Babicki
- Scientific Section of the Polish Society of Family Medicine, 51-141 Wroclaw, Poland; (A.M.-M.); (M.B.)
- Department of Family Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
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Tan KJ, Anderson JR. Internalized Sexual Stigma and Mental Health Outcomes for Gay, Lesbian, and Bisexual Asian Americans: The Moderating Role of Guilt and Shame. Int J Environ Res Public Health 2024; 21:384. [PMID: 38673297 DOI: 10.3390/ijerph21040384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/25/2024] [Accepted: 03/17/2024] [Indexed: 04/28/2024]
Abstract
The literature unequivocally demonstrates that lesbian, gay, and bisexual (LGB) individuals experience disproportionate mental health and social wellbeing impacts. Here, we respond to recent calls for research in the field of sexual minority health to better understand why various overlapping and intersecting identities can further drive health disparities. In this paper, we focus on the specific intersections of ethnicity and sexuality for Asian LGB individuals and the role of internalized stigma in driving poorer mental health outcomes for this group. We recruited 148 LGB Asian participants residing in the United States (Mage = 22.82 years, SD = 4.88) to participate in our online cross-sectional survey in which we collected data on their internalized stigma, levels of guilt and shame about their sexuality, and measures of depression, anxiety, and distress. Contrary to our predictions, there were no bivariate relationships between internalized sexual stigma and any of the mental health outcomes. However, a parallel mediation analysis revealed that guilt, but not shame, mediates the relationship between internalized sexual stigma and all mental health outcomes (depression, anxiety, and stress) for LGB Asian American individuals. This research highlights the important of exploring additional variables that may exacerbate of protect against poor mental health for individuals with multiple intersecting identities.
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Affiliation(s)
- Kian Jin Tan
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne Campus (St Patrick), Locked Bag 4115, Melbourne, VIC 3065, Australia
| | - Joel R Anderson
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne Campus (St Patrick), Locked Bag 4115, Melbourne, VIC 3065, Australia
- Australian Research Centre in Sex, Health and Society (ARCSHS), La Trobe University, Melbourne, VIC 3086, Australia
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Thomas S, Schäfer J, Kanske P, Trautmann S. Patterns of social-affective responses to trauma exposure and their relation to psychopathology. PLoS One 2024; 19:e0289664. [PMID: 38442107 PMCID: PMC10914253 DOI: 10.1371/journal.pone.0289664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 02/01/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Traumatic event exposure is a risk factor for the development and maintenance of psychopathology. Social-affective responses to trauma exposure (e.g. shame, guilt, revenge, social alienation) could moderate this relationship, but little is known about their relevance for different types of psychopathology. Moreover, the interplay of different social-affective responses to trauma exposure in predicting psychopathology is poorly understood. METHODS In a sample of N = 1321 trauma-exposed German soldiers, we examined cross-sectional associations of trauma-related social alienation, revenge, guilt and shame with depressive disorder, alcohol use disorder, posttraumatic stress disorder and dimensional measures of depression and anxiety. Latent class analysis was conducted to identify possible patterns of social-affective responses to trauma exposure, and their relation to psychopathology. RESULTS All social-affective responses to trauma exposure predicted current posttraumatic stress disorder, depressive disorder, alcohol use disorder and higher depressive and anxiety symptoms. Three latent classes fitted the data best, reflecting groups with (1) low, (2) moderate and (3) high risk for social-affective responses to trauma exposure. The low-risk group demonstrated the lowest expressions on all psychopathology measures. CONCLUSIONS Trauma-related social alienation, shame, guilt, and revenge are characteristic of individuals with posttraumatic stress disorder, depressive disorder, alcohol use disorder, and with higher anxiety and depressive symptoms. There was little evidence for distinctive patterns of social-affective responses to trauma exposure despite variation in the overall proneness to show social-affective responses. Social-affective responses to trauma exposure could represent promising treatment targets for both cognitive and emotion-focused interventions.
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Affiliation(s)
- Sarah Thomas
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Judith Schäfer
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany
- ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
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15
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16
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Gunawan J. "Feel shame and afraid to be judged by others": The need for promoting academic honesty in chatbot-facilitated writing. J Nurs Scholarsh 2024; 56:351. [PMID: 38329013 DOI: 10.1111/jnu.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 02/09/2024]
Affiliation(s)
- Joko Gunawan
- Belitung Raya Foundation, Manggar, Bangka Belitung Province, Indonesia
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17
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Saraiya TC, Jones AC, Lopez-Castro T, Hood CO, Flores J, Badour CL. Trauma-related shame predicts daily non-medical prescription opioid use among individuals with PTSD symptoms. J Psychiatr Res 2024; 171:171-176. [PMID: 38290235 PMCID: PMC10922897 DOI: 10.1016/j.jpsychires.2024.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/21/2024] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
Non-medical prescription opioid use (NMPOU) is the use of opioids without a prescription or in a way different from how they were prescribed and is the fourth most common type of drug use in the United States. Separate research has shown that trauma-related shame is linked to posttraumatic stress disorder (PTSD) and, respectively, opioid use. However, no study to date has empirically examined the association between trauma-related shame and NMPOU among individuals with PTSD symptoms. Forty adults with clinical or subclinical PTSD who reported engaging in NMPOU at least one day in the prior month before the study completed 28 days of daily surveys. Trauma-related shame was measured at baseline. NMPOU and underlying motives to engage in NMPOU were assessed once daily via a smartphone app. Twenty-four participants (60 %) reported NMPOU over the 28-day period. After controlling for PTSD symptoms and covariates, mixed models showed that higher trauma-related shame significantly predicted higher risk of daily NMPOU (B = 0.06, SE = 0.03, t = 2.14, p=.03). After controlling for false discovery rates, trauma-related shame also significantly predicted NMPOU due to the following motives (p's < 0.031): to manage depression/sadness, to manage anxiety, to manage other stress/worry, and to get high. Among individuals with PTSD, higher baseline trauma-related shame prospectively and positively predicted greater NMPOU over a four-week daily monitoring period. Findings suggest a need to attend to trauma-related shame and its impact on subsequent motivations to engage in NMPOU. Future research should examine how treatments may effectively target trauma-related shame to reduce NMPOU and more severe PTSD symptoms.
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Affiliation(s)
- Tanya C Saraiya
- Center for Alcohol & Substance Use Studies, Rutgers University, Piscataway, NJ, USA; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Alyssa C Jones
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; Southeast Mental Illness Research, Education, and Clinical Centers, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | | | - Caitlyn O Hood
- Department of Psychiatry, University of Kentucky, Lexington, KY, USA
| | - Jessica Flores
- South Texas Veterans Health Care System, San Antonio, TX, USA; Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Christal L Badour
- Department of Psychology, University of Kentucky, Lexington, KY, USA
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18
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Hai R, Wong PWC. Emerging trends in Hikikomori behaviour among young people in China: Implications for research and policy. Asian J Psychiatr 2024; 93:103925. [PMID: 38232442 DOI: 10.1016/j.ajp.2024.103925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/19/2024]
Affiliation(s)
- Ri Hai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Paul Wai-Ching Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.
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19
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Carels RA, Jansen E, Mansour L, Byrd R, Metzler AL. An examination of the unique contributions of body image and internalized weight bias to psychological well-being outcomes. Body Image 2024; 48:101668. [PMID: 38091859 DOI: 10.1016/j.bodyim.2023.101668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/01/2023] [Accepted: 12/03/2023] [Indexed: 03/05/2024]
Abstract
High correlations between measures of internalized weight bias (IWB) and body image (BI) have resulted in concerns that IWB is conceptually redundant with BI. This investigation examined the contribution of the unique variance of BI and IWB on three important, weight-related factors: self-esteem, depressive symptoms, and body shame. The study included 403 participants recruited through a Qualtrics research panel. Participants were required to be aged 18 + and have a BMI > 25. The sample contained three equally represented, self-identified racial/ethnic groups: Black non-Hispanic (N = 140), Hispanic (N = 133), and White non-Hispanic (N = 130). When BI was entered in the first step of the regression model, it accounted for 14-40% of the variance in various models; the addition of IWB in step two contributed 11-18% of unique variance. By contrast, when IWB was entered in the first step, it accounted for 25-56% of the variance in various models, with the addition of BI contributing between 0% and 2% unique variance. Therefore, even with a high correlation among the constructs of IWB and BI, IWB was able to contribute unique variance in predicting depressive symptoms, self-esteem, and body shame, and is not redundant with the construct of BI.
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Affiliation(s)
- Robert A Carels
- Department of Psychology, East Carolina University, United States.
| | - Emily Jansen
- Department of Psychology, East Carolina University, United States
| | - Lydia Mansour
- Department of Psychology, East Carolina University, United States
| | - Rhonda Byrd
- Department of Psychology, East Carolina University, United States
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20
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Cutrer-Párraga EA, Allen GEK, Miller EE, Garrett MF, Conklin H, Franklin CN, Norton A, Hee C, Coffey BK. Perceptions and barriers about mental health services among Pacific Islanders: An interpretative phenomenological analysis. J Couns Psychol 2024; 71:89-103. [PMID: 38376929 DOI: 10.1037/cou0000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Every year, millions of Americans do not receive needed mental health (MH) services. Although Pacific Islanders (PI) have a high need for MH services, this group has the lowest rate of MH care help seeking. This is especially concerning as the rate of suicide has been increasing within the PI community. This study explored how Pacific Islanders think about MH supports, including their attitudes toward and perceptions of barriers to receiving MH services. An interpretative phenomenological analysis focus group study was conducted with cross-generational Pacific Islanders residing in one western state. The findings include (a) PI perceptions that MH help seeking results in family burdensomeness, stigma, and shame; (b) negotiating PI social customs and beliefs related to MH help seeking, care, and support; and (c) PI mistrust of institutional resources. These themes seemed to interact with each other and create perpetuate barriers which prevent help-seeking behaviors. Clinical and research implications will be provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - G E Kawika Allen
- Department of Counseling Psychology and Special Education, Brigham Young University
| | | | | | | | | | - Abigail Norton
- Department of Counseling Psychology and Special Education, Brigham Young University
| | - Cameron Hee
- Counseling and Psychological Services, Brigham Young University
| | - Benjamin K Coffey
- Department of Counseling Psychology and Special Education, Brigham Young University
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21
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Li Q, Zhuo L, Zhang T. Shame in patients undergoing ureterostomy: A cross-sectional survey. Int Wound J 2024; 21:e14793. [PMID: 38453161 PMCID: PMC10920030 DOI: 10.1111/iwj.14793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/16/2024] [Accepted: 02/02/2024] [Indexed: 03/09/2024] Open
Abstract
Shame has an important impact on the mental health and quality of life of patients. The shame in patients with ureterostomy after cystectomy remains unclear. This survey aimed to evaluate the status quo and influencing factors of shame in patients with ureterostomy after cystectomy, to provide support for the clinical care. Patients with ureterostomy after cystectomy treated in the wound stomy clinic of a third-class hospital from 1 June 2022 to 31 July 2023 were included. General data questionnaire and social impact scale (SIS) were used for data collection. Univariate and multiple linear regression analysis were performed to evaluate the influencing factors of shame in patients with ureterostomy after cystectomy. One hundred and sixty four patients with ureterostomy after cystectomy were included. The total score of shame in patients with ureterostomy was (60.75 ± 6.31), which was in the high level. Age (r = 0.442), home place (r = 0.427), per capita monthly household income (r = 0.605), self-care ability (r = 0.597) and complications of stoma (r = 0.542) were correlated with the SIS score in patients with ureterostomy after cystectomy (all p < 0.05). Multiple linear regression analyses indicated that age, home place, per capita monthly household income, self-care ability and complications of stoma were the influencing factors of SIS score in patients with ureterostomy after cystectomy (all p < 0.05). The five variables explained 64.5% of the patients' sense of shame variation. Patients with ureterostomy after cystectomy have a serious sense of shame in the early stage after operation and there are many influencing factors. Health care providers should take early nursing interventions targeted on those influencing factors to reduce the patients' sense of shame.
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Affiliation(s)
- Qin Li
- Department of UrologyPingxiang People's HospitalPingxiangJiangxi ProvinceChina
| | - Lin Zhuo
- Department of UrologyPingxiang People's HospitalPingxiangJiangxi ProvinceChina
| | - Ting Zhang
- Department of NursingPingxiang People's HospitalPingxiangJiangxi ProvinceChina
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22
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Orsini GD, Tarabay J, Hardy-Johnson PL, Barker SL, Greenway FT. The homeless period: a qualitative evidence synthesis. Women Health 2024; 64:250-260. [PMID: 38343133 DOI: 10.1080/03630242.2024.2310716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/17/2024] [Indexed: 03/12/2024]
Abstract
Women experiencing homelessness are marginalized not only through their housing status but also through their access and ability to manage their menstrual health. Currently, there are no existing published reviews exploring this topic. This study aimed to begin closing that gap, by systematically reviewing the literature examining women's experiences of menstruation whilst being homeless. In June 2020 (and updated in December 2022), we conducted comprehensive and systematic searches of four electronic databases: Medline, Web of Science, CINAHL, and PsychINFO, from which nine studies were found. The findings were thematically analyzed, using the enhancing transparency in reporting the synthesis of qualitative research tools (ENTREQ) guidelines. Three themes related to menstrual experiences were found: (1) challenges in the logistics of managing menstruation while homeless, (2) feelings of embarrassment, shame, and dignity linked to maintaining menstrual health, and (3) making do: how people experiencing homelessness manage challenges related to menstruation. We discuss barriers women face in getting necessary products and in accessing private, safe, and clean facilities to manage menstrual health. The study found that women living with homelessness often abandon other basic needs in favor of managing menstruation (i.e. using unsuitable materials, stealing, etc.), which furthers their risk. The findings highlight the need for future research to investigate the experiences of women who are menstruating while being homeless and what support they would find helpful. Results show that it is high time for commissioners and policy-makers to address the provision of menstrual resources as a basic human right.
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Affiliation(s)
| | - Jennifer Tarabay
- Department of Psychology, University of Southampton, Southampton, UK
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23
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Knipschild R, Klip H, Winkelhorst K, Stutterheim T, van Minnen A. BLAME-LESS STUDY: a two-arm randomized controlled trial evaluating the effects of an online psychoeducation programme for adolescents who have experienced physical/sexual violence or sexual abuse. Rationale, study design, and methods. Eur J Psychotraumatol 2024; 15:2315794. [PMID: 38372268 PMCID: PMC10878330 DOI: 10.1080/20008066.2024.2315794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/20/2024] [Indexed: 02/20/2024] Open
Abstract
Background: Victims of physical/sexual violence or sexual abuse commonly experience defense responses that result in feelings of guilt and shame. Although trauma-focused interventions are effective in treating post-traumatic stress disorder symptoms, the presence of trauma-related shame and guilt can potentially hinder the process of disclosure during treatment, thus diminishing their overall effectiveness. It is hypothesized that providing psychoeducation about common defense responses will reduce feelings of shame and guilt, thereby increasing receptivity to trauma-focused treatment.Objective: This paper describes the rationale, study design, and methods of the BLAME-LESS study. The effects of a brief online psychoeducation program will be compared with a waiting-list control group. The intervention aims to reduce feelings of trauma-related shame and guilt that adolescents experience regarding their own defense responses during and after physical/sexual violence or sexual abuse.Methods: Adolescents (12 - 18 years old) with a history of physical/sexual violence or sexual abuse who suffer from trauma-related feelings of shame and guilt can participate in the study. The study follows a two-arm RCT that includes 34 participants. The primary outcomes includes trauma-related feelings of shame and guilt. The secondary outcomes includes PTSD symptoms, anxiety and depression symptoms, traumatic cognitions, readiness to disclose details of memories of the trauma, and motivation to engage in trauma-focused therapy. Assessments take place after screening, at baseline, two weeks after allocation to the intervention or waiting-list, and, only for the waiting-list participants, seven weeks after allocation to the intervention.Conclusions: There is a need for treatment approaches that target trauma-related feelings of shame and guilt. A recently developed brief online psychoeducation program on defense responses during and after trauma offers victims of physical/sexual violence or sexual abuse a free and accessible way to obtain reliable and valid information. The proposed RCT will evaluate the effectiveness of this online psychoeducation program.Trial Registration: Request is pending.
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Affiliation(s)
- Rik Knipschild
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
| | - Helen Klip
- Karakter, Child and Adolescent Psychiatry, Almelo, the Netherlands
| | | | | | - Agnes van Minnen
- Psychotrauma Expertise Centre (PSYTREC), Bilthoven, the Netherlands
- Behavioural Science Institute (BSI), Radboud University, Nijmegen, the Netherlands
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Correia Lopes F, Pinto da Costa M, Fernandez-Lazaro CI, Lara-Abelenda FJ, Pereira-Sanchez V, Teo AR, Alvarez-Mon MA. Analysis of the hikikomori phenomenon - an international infodemiology study of Twitter data in Portuguese. BMC Public Health 2024; 24:518. [PMID: 38373925 PMCID: PMC10875796 DOI: 10.1186/s12889-023-17617-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/29/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Hikikomori refers to the extreme isolation of individuals in their own homes, lasting at least six months. In recent years social isolation has become an important clinical, social, and public health problem, with increased awareness of hikikomori around the globe. Portuguese is one of the six most spoken languages in the world, but no studies have analysed the content regarding this phenomenon expressed in Portuguese. OBJECTIVE To explore the hikikomori phenomenon on Twitter in Portuguese, utilising a mixed-methods approach encompassing content analysis, emotional analysis, and correlation analysis. METHODS A mixed methods analysis of all publicly available tweets in the Portuguese language using a specific keyword (hikikomori) between 1st January 2008 and 19th October 2022. The content analysis involved categorising tweets based on tone, content, and user types, while correlation analysis was used to investigate user engagement and geographical distribution. Statistical analysis and artificial intelligence were employed to classify and interpret the tweet data. RESULTS Among the total of 13,915 tweets generated, in terms of tone 10,731 were classified as "negative", and 3184 as "positive". Regarding content, "curiosities" was the most posted, as well as the most retweeted and liked topic. Worldwide, most of the hikikomori related tweets in Portuguese were posted in Europe, while "individuals with hikikomori" were the users most active posting. Regarding emotion analysis, the majority of tweets were "neutral". CONCLUSIONS These findings show the global prevalence of the discourse on hikikomori phenomenon among Portuguese speakers. It also indicates an increase in the number of tweets on this topic in certain continents over the years. These findings can contribute to developing specific interventions, support networks, and awareness-raising campaigns for affected individuals.
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Affiliation(s)
| | - Mariana Pinto da Costa
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
- Institute of Psychiatry Psychology & Neuroscience, King´s College London, London, UK.
| | - Cesar I Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Francisco J Lara-Abelenda
- Department of Signal Theory and Communications and Telematic Systems and Computing, School of Telecommunications Engineering, Rey Juan Carlos University, 28942, Madrid, Spain
| | | | - Alan R Teo
- Health Services Research & Development Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, Spain
- Department of Psychiatry and Mental Health, University Hospital Infanta Leonor, Madrid, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
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25
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Sadath A, Kavalidou K, McMahon E, Malone K, McLoughlin A. Associations between humiliation, shame, self-harm and suicidality among adolescents and young adults: A systematic review. PLoS One 2024; 19:e0292691. [PMID: 38329967 PMCID: PMC10852296 DOI: 10.1371/journal.pone.0292691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/26/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Suicide is the second leading cause of death among young people worldwide. Research indicates that negative social contexts involving familial and peer relationships have far-reaching influences on levels of suicidality in later life. While previous systematic reviews have focused on evaluating associations between negative life events such as abuse and bullying in childhood and subsequent suicidality, this systematic review examines the prevalence of, and association between the processes of humiliation and shame in later self-harm, suicidal ideation, and suicide among adolescents and young adults. METHODS A systematic literature search of databases including MEDLINE, Web of Science Core Collection, CINAHL, PsycINFO, and Embase was conducted to identify potential studies. ProQuest was searched to identify relevant grey literature research. A combination of MESH terms and keywords was used. All original quantitative studies published in English that examined the prevalence, or association between humiliation or shame and suicidal behaviours and/or death by suicide were included. Studies were assessed for methodological quality using Joanna Briggs Institute critical appraisal tools. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) [CRD42022289843]. RESULTS Narrative synthesis was performed. A total of 33 studies reporting the prevalence of, or association between humiliation (n = 10) or shame (n = 23) and suicidal thoughts/behaviours were included. The prevalence of humiliation among those with any suicidality ranged from 18% to 28.1%, excluding an outlier (67.1%), with two studies presenting a significant association between humiliation and self-harm in their fully adjusted analyses. The studies that outlined humiliation and suicidal thinking (intent/suicide plan) had no association after adjustment for confounders. For shame, half of the studies found an association in adjusted models (n = 10), and this was evident for both suicidal ideation and self-harm. CONCLUSION To our knowledge, this is the first study to attempt a systematic review on this topic. The dearth of research in this field of enquiry is reflective of unique challenges associated with assessments of humiliation and shame in various clinical settings amongst adolescent and young adult populations. Nonetheless, given the importance and relevance of the psychological imprint of humiliation in youth morbidity and mortality in the field of mental health, it is timely to attempt such a systematic review. In light of the associated role of humiliation and shame in self-harm and suicidality among young people, we recommend that these processes need to be explored further via prospective studies and assessed as part of a comprehensive bio-psycho-social assessment when focusing on life stressors for adolescent and young adults presenting with suicidality to emergency departments and mental health services.
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Affiliation(s)
- Anvar Sadath
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Katerina Kavalidou
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- National Clinical Programme, Health Service Executive (HSE), Dublin, Ireland
| | - Elaine McMahon
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Kevin Malone
- Department of Psychiatry and Mental Health Research, St. Vincent’s University Hospital, University College Dublin, Dublin, Ireland
| | - Aoibheann McLoughlin
- Department of Psychiatry and Mental Health Research, St. Vincent’s University Hospital, University College Dublin, Dublin, Ireland
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Müller-Engelmann M, Bahnemann L, Kümmerle S. The effects of a combination of cognitive interventions and loving-kindness meditations (C-METTA) on guilt, shame and PTSD symptoms: results from a pilot randomized controlled trial. Eur J Psychotraumatol 2024; 15:2308439. [PMID: 38323870 PMCID: PMC10851818 DOI: 10.1080/20008066.2024.2308439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/22/2023] [Indexed: 02/08/2024] Open
Abstract
Background: Trauma-related guilt and shame are crucial for the development and maintenance of PTSD (posttraumatic stress disorder). We developed an intervention combining cognitive techniques with loving-kindness meditations (C-METTA) that specifically target these emotions. C-METTA is an intervention of six weekly individual treatment sessions followed by a four-week practice phase.Objective: This study examined C-METTA in a proof-of-concept study within a randomized wait-list controlled trial.Method: We randomly assigned 32 trauma-exposed patients with a DSM-5 diagnosis to C-METTA or a wait-list condition (WL). Primary outcomes were clinician-rated PTSD symptoms (CAPS-5) and trauma-related guilt and shame. Secondary outcomes included psychopathology, self-criticism, well-being, and self-compassion. Outcomes were assessed before the intervention phase and after the practice phase.Results: Mixed-design analyses showed greater reductions in C-METTA versus WL in clinician-rated PTSD symptoms (d = -1.09), guilt (d = -2.85), shame (d = -2.14), psychopathology and self-criticism.Conclusion: Our findings support positive outcomes of C-METTA and might contribute to improved care for patients with stress-related disorders. The study was registered in the German Clinical Trials Register (DRKS00023470).
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Affiliation(s)
- Meike Müller-Engelmann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt/Main, Germany
- Faculty Human Sciences, Department Psychology, Medical School Hamburg, Hamburg, Germany
| | - Luisa Bahnemann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt/Main, Germany
| | - Stella Kümmerle
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt/Main, Germany
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27
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Miou M, Fujimoto H, Yotsumoto K, Hirota M, Nishigaki S, Hashimoto T. Exploring Psychiatric Home-Visit Nursing Practices for Patients with Schizophrenia and Hikikomori with a Thematic Analysis. Int J Environ Res Public Health 2024; 21:181. [PMID: 38397672 PMCID: PMC10887901 DOI: 10.3390/ijerph21020181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
The phenomenon of some patients with schizophrenia withdrawing and becoming hikikomori needs to be resolved. In some countries, outreach methods are being employed. In Japan, psychiatric home-visit nursing for patients with schizophrenia and hikikomori is being implemented. However, it is not based on sufficient evidence and relies on the experience and intuition of individual nurses. This study explored the underlying themes in the nursing practices of psychiatric home-visit nurses via semi-structured interviews with 10 nurses and a thematic analysis. Nine key themes emerged. Four themes-(i) understanding the patient's world, (ii) supporting the patients as they are, (iii) providing a sense of relief, and (iv) having equal relationships-highlighted the nurses' commitment to respecting patients' individuality while building and sustaining relationships. Two themes-(v) exploring the right timing and (vi) waiting for the appropriate timing-illustrated the nurses' anticipation of proactive patient engagement. Finally, three themes-(vii) working together on things, (viii) continuing care for expanding the patient's world, and (ix) nursing care for the patient's future-underscored the nurses' gradual and methodical approach to working alongside patients. Nursing practices based on these nine themes cultivated meaningful relationships and secured a sense of relief for the patients. Additionally, they awaited patients' proactive engagement and delivered timely support to facilitate positive daily life changes. These findings contribute to the establishment of evidence-based nursing practices for patients with schizophrenia and hikikomori.
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Affiliation(s)
- Maki Miou
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan; (K.Y.); (M.H.); (T.H.)
- Faculty of Nursing, Osaka Shin-Ai Gakuin University, 6-2-28 Tsurumi, Tsurumi-ku, Osaka 5380053, Japan
| | - Hirokazu Fujimoto
- Faculty of Nursing, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe 6508530, Japan
| | - Kayano Yotsumoto
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan; (K.Y.); (M.H.); (T.H.)
| | - Misato Hirota
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan; (K.Y.); (M.H.); (T.H.)
| | - Satoshi Nishigaki
- School of Nursing, Takarazuka University, 1-13-16 Shibata, Kita-ku, Osaka 5300012, Japan;
| | - Takeshi Hashimoto
- Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan; (K.Y.); (M.H.); (T.H.)
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Thomas V, Bizumic B, Cruwys T, Walsh E. Measuring civilian moral injury: Adaptation and validation of the Moral Injury Events Scale (Civilian) and Expressions of Moral Injury Scale (Civilian). Psychol Trauma 2024; 16:270-279. [PMID: 37166915 DOI: 10.1037/tra0001490] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Moral injury (MI) research has been expanded to populations beyond the military in recent years. A key barrier to further research into MI in civilian populations is the lack of valid, reliable measures of the construct appropriate for general civilian use. This article addresses this barrier by adapting two existing military measures and exploring their psychometrics in a general civilian sample: the Moral Injury Events Scale-Civilian (MIES-C) and Expressions of Moral Injury Scale-Military (EMIS-C). METHOD A sample of civilian women (n = 192) and men (n = 88) completed the above measures, and additional scales designed to capture theoretically supported primary and secondary markers of MI (guilt, shame, anger; depression, posttraumatic stress symptoms, anxiety). RESULTS Confirmatory factor analyses found that the factor structure of the MIES-C and EMIS-C replicated well within our civilian sample. Discriminant validity was indicated through a significant negative correlation with well-being. Both measures correlated as predicted with each other and measures of MI markers at the total score level. Correlations of individual subscales with each of these measures were more varied. CONCLUSIONS Results shed light on differential relationships between the type of MI event and clinical outcomes, suggesting some conceptual differences in how MI is experienced in general civilian populations. Results suggest that civilian populations are also susceptible to MI, but that existing measures may have problems capturing this effectively. While the MIES-C and EMIS-C are supported for civilian use, further scale construction efforts for this population are warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Victoria Thomas
- Research School of Psychology, Australian National University
| | - Boris Bizumic
- Research School of Psychology, Australian National University
| | - Tegan Cruwys
- Research School of Psychology, Australian National University
| | - Erin Walsh
- Research School of Psychology, Australian National University
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Norman SB, Griffin BJ, Pietrzak RH, McLean C, Hamblen JL, Maguen S. The Moral Injury and Distress Scale: Psychometric evaluation and initial validation in three high-risk populations. Psychol Trauma 2024; 16:280-291. [PMID: 37347882 DOI: 10.1037/tra0001533] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
OBJECTIVE The concept of moral injury resonates with impacted populations, but research has been limited by existing measures, which have primarily focused on war veterans and asked about exposure to potentially morally injurious events (PMIEs) rather than PMIE exposure outcomes. Our goal was to develop and examine the psychometric properties of the Moral Injury and Distress Scale (MIDS), a new measure of the possible emotional, cognitive, behavioral, social, and/or spiritual sequelae of PMIE exposure. METHOD The MIDS was validated by surveying three groups: military veterans, healthcare workers, and first responders (N = 1,232). RESULTS Most respondents (75.0%; n = 924) reported PMIE exposure. Analyses yielded 18 items that contributed to a single latent factor representing moral distress with fully or partially invariant configurations, loadings, and intercepts across occupational groups. The MIDS full-scale score demonstrated excellent internal consistency (α = .95) and moderate 2-week stability (r = .68, p < .001, n = 155). For convergent validity, associations between the MIDS and PMIE exposure measures, as well as putative indicators of moral injury (e.g., guilt, shame), were positive and large (r = .59-.69, p < .001), as were correlations with posttraumatic stress, depressive, and insomnia symptoms (r = .51-.67, p < .001). The MIDS was a stronger predictor of functioning than PMIE exposure measures, explaining seven times greater unique variance (9% vs. 1%-1.3%). CONCLUSIONS The MIDS is the first scale to assess moral injury symptoms indexed to a specific PMIE that is validated across several high-risk populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Brandon J Griffin
- Center for Mental Healthcare & Outcomes Research, Health Services Research and Development Service
| | | | - Carmen McLean
- Dissemination and Training Division, National Center for PTSD
| | | | - Shira Maguen
- Mental Health Service, San Francisco VA Health Care System
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Grady S, Twomey C, Cullen C, Gaynor K. Does affect mediate the relationship between interpersonal trauma and psychosis? A systematic review and meta-analysis. Schizophr Res 2024; 264:435-447. [PMID: 38245930 DOI: 10.1016/j.schres.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/24/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024]
Abstract
INTRODUCTION The relationship between interpersonal trauma and psychosis is well established, and research is now focused on identifying mechanisms that may explain this relationship. Models of trauma and psychosis increasingly emphasize a broad range of affective processes, yet the overall effect of these affective processes is not well understood. AIM This review systematically examined the effect of any form of long-term affective dysfunction on the relationship between interpersonal trauma and psychosis. Where possible, it used meta-analytic techniques to quantify the overall magnitude of this effect. METHOD Searches were conducted using PsychINFO, MEDLINE and CINAHL databases, and eligible studies were appraised for methodological quality. Narrative synthesis and meta-analytic methods were used to evaluate evidence. RESULTS Twenty-nine studies met criteria for inclusion. Five affective mediators were found; depression, anxiety, affective dysregulation, loneliness and attachment. Findings from both the narrative synthesis (n = 29) and meta-analysis (n = 8) indicated that, overall, affect is a small but significant mediator of the relationship between interpersonal trauma and psychosis (pooled Cohen's d = 0.178; pooled 95 % CI: 0.022-0.334). CONCLUSIONS Overall, findings support affective pathways to psychosis, though highlight the need for further research on broader affective mediators (loneliness, shame). The small effect size found in the meta-analysis also points to the potential importance of non-affective mediators. Clinically, these findings highlight the value of treatment modalities that attend to multiple mechanisms in the relationship between interpersonal trauma and psychosis. Future research should focus on the interplay and causal sequence between these mechanisms to further understand pathways between interpersonal trauma and psychosis.
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Affiliation(s)
- Shelley Grady
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland.
| | - Conal Twomey
- Dept. of Psychology, St Patrick's University Hospital, Dublin, Ireland
| | - Clare Cullen
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland; DETECT, Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
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Lima Y, Öz ND, Denerel N, Treeby MS, Rice S. Mental health correlates of athletic shame and guilt among elite-level youth athletes in Turkey. J Sci Med Sport 2024; 27:72-77. [PMID: 37949775 DOI: 10.1016/j.jsams.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 09/09/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES This study evaluated the mental health correlates of athletic shame and guilt among elite-level youth athletes and provided psychometric data on the Turkish version of the Athletic Perceptions of Performance Scale. DESIGN Cross-sectional. METHODS An online survey was sent to 645 Turkish elite-level youth athletes incorporating standardized scales assessing athletic shame, guilt, and symptoms of high prevalence mental disorders. A subset of participants (n = 45) provided test-retest data at 30 days. RESULTS A total of 301 elite youth athletes participated (M = 16.42 ± 0.49 years; 48.7 % response rate) equally representing team and individual sports. Confirmatory factor analysis validated the Turkish version of the Athletic Perceptions of Performance Scale and test-retest data supported temporal stability. Female athletes (compared to male athletes) and athletes participating in an individual sport (compared to participating in a team sport) reported higher athletic shame-proneness scores (p < 0.01 and p = 0.04; respectively). The Turkish version of the Athletic Perceptions of Performance Scale shame-proneness and no-concern scores were associated with athlete-specific stress, anxiety, and depression scores. The Turkish version of the Athletic Perceptions of Performance Scale guilt-proneness was associated with athlete-specific stress and anxiety scores. CONCLUSIONS Findings provide cross-cultural validation of the Athletic Perceptions of Performance Scale assessing athletic shame and guilt, demonstrating that female athletes and athletes participating in an individual sport were more likely to experience athletic shame-proneness. Results suggest that athletes experiencing shame-proneness and performance concerns may benefit from supportive coaching and/or mental health supports.
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Affiliation(s)
- Yavuz Lima
- Istanbul University Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Sports Medicine Department, Turkey. https://twitter.com/Yavuzlymma
| | - Nazlı D Öz
- Selcuk University Faculty of Sports Science, Recreation Department, Turkey
| | - Nevzad Denerel
- Eastern Mediterranean University Faculty of Health Sciences, Sports Medicine Department, Cyprus
| | - Matt S Treeby
- School of Psychology and Public Health, La Trobe University, Australia
| | - Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Australia; The University of Melbourne, Centre for Youth Mental Health, Australia. https://twitter.com/ClinPsyc
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Kudinova AY, Brick LA, Armey M, Nugent NR. Micro-sequences of anger and shame and non-suicidal self-injury in youth: an ecological momentary assessment study. J Child Psychol Psychiatry 2024; 65:137-147. [PMID: 37525367 PMCID: PMC10828100 DOI: 10.1111/jcpp.13869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is a significant mental health concern with the highest prevalence among adolescents. NSSI has been conceptualized as one of the maladaptive strategies to cope with challenging affect or a form of self-punishment. Although characterizing moment-to-moment associations between shame and NSSI in individuals' real-world environment and partitioning between- and within-person effects is critical for mobile and timely interventions, most studies examined habitual experiences of negative affective states and focused on adults. METHOD In this study, we focused on in vivo anger at self and others and shame and NSSI among 158 adolescents 3 weeks following their psychiatric hospitalizations using ecological momentary assessment (EMA) technology. RESULTS We found that greater between-person levels of anger at self and others were linked to a higher number of subsequent NSSI occurrences within a day. These findings remained primarily unchanged when we statistically adjusted for participants' age, sex assigned at birth, the number of current psychiatric diagnoses, EMA response rates, and youth lifetime history of SI. Within-person increases in NSSI were linked to increased anger at self over and beyond between-person average levels of NSSI. CONCLUSIONS These findings highlight the potential regulatory role of NSSI to decrease negative affective states and point to the clinical utility of assessing and early mobile interventions targeting challenging affect in youth.
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Affiliation(s)
- Anastacia Y Kudinova
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Division of Child Psychiatry, Bradley Hospital, Providence, RI, USA
| | - Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael Armey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Nicole R Nugent
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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Sajadian M, Younesi SJ, Jafari P, Azkhosh M, Yarandi RB, Kordbagheri M. Shame, fear of compassion, self-criticism, and self-reassurance mediate the effect of early life events on emotional disorders among male prisoners: A structural equation modeling analysis. Acta Psychol (Amst) 2024; 242:104116. [PMID: 38113609 DOI: 10.1016/j.actpsy.2023.104116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Early negative experiences in childhood are potent predictors of criminal behavior in youth and adulthood. This study aimed to identify the mediation effects of Shame, Fear of Compassion, Self-criticism, and Self-reassurance on the effect of Early Life Events on Emotional Disorders. METHOD This cross-sectional study was conducted among 368 male prisoners (Mean age: 33.26 ± 8.41 years) with convenient sampling method, from Ilam, Iran. A set of self-reported instruments were used for data collection. The ultimate model was constructed using structural equation modeling after confirming the construct validity of the measures via confirmatory factor analysis. RESULTS Shame, fear of compassion, self-criticism, and self-reassurance significantly mediated the relationship between Early Life Events and emotional disorders. The mediating effect accounted for 77 % of the total effect in the mediating model. According to Pearson's correlation, a positive and significant relationship existed between early life events and self-criticism, shame, fear of compassion and emotional disorders (P < .001). In conclusion, the presented model has an appropriate and acceptable fit, as evidenced by the results of the chi-square test (χ2 = 48.067, p < .001) and other relevant fit indices. However, self-reassurance's mediating role was insignificant (P > .05). CONCLUSIONS The present results showed that shame, fear of compassion, and self-criticism are important mediators in the relationship between early life events and emotional disorders among male prisoners. So, it is necessary to develop related protocols to increase the mental health of prisoners.
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Affiliation(s)
- Maryam Sajadian
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Jalal Younesi
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Parvin Jafari
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Manouchehr Azkhosh
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Razieh Bidhendi Yarandi
- Epidemiology and Biostatistics Department, University of social welfare and rehabilitation sciences, Tehran, Iran
| | - Mohammadreza Kordbagheri
- Department of Statistics, Faculty of Mathematical Sciences, Shahid Beheshti University, Tehran, Iran
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Arif N. From shame to solidarity: how we can reverse harmful narratives on period stigma. BMJ 2024; 384:q152. [PMID: 38253394 DOI: 10.1136/bmj.q152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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35
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Burychka D, Miragall M, Baños RM. The Role of Body Compassion in the Risk of Eating Disorders: Mediational Effects of Body Appreciation and Body Shame. Psicothema 2024; 36:36-45. [PMID: 38227298 DOI: 10.7334/psicothema2023.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
BACKGROUND Body compassion is a protective factor in the field of eating disorders (ED) that has been associated with higher body appreciation and lower body shame. However, more studies are needed in order to disentangle the protective role of compassion in regard to the risk of ED. The study’s aims were to (1) analyze the psychometric properties of the Spanish adaptation of the Body Compassion Scale (BCS) and (2) determine whether body appreciation and body shame were mediators in the relationship between body compassion and the risk of ED. METHOD 288 women (range: 18-40 years old; M = 24.65 ± 5.02) from the general Spanish population completed online questionnaires. RESULTS The Spanish adaptation of the BCS was reliable and valid. Results of a serial and parallel mediation model confirmed the protective role of body compassion and body appreciation on body shame and the risk of ED, accounting for 68.88% of the variance. CONCLUSIONS Findings indicate that women who present higher body compassion tend to show higher body appreciation, which in turn leads to lower internal body shame and lower risk of ED. These results support the need to develop a positive and compassionate relationship with one’s body, in order to prevent ED.
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Affiliation(s)
- Diana Burychka
- Polibienestar Research Institute, University of Valencia (Spain), Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia (Spain)
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia (Spain)
| | - Marta Miragall
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia (Spain)
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid (Spain)
| | - Rosa M Baños
- Polibienestar Research Institute, University of Valencia (Spain), Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia (Spain)
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia (Spain)
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid (Spain)
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Jackson L, Fallon V, Harrold JA, De Pascalis L. Psychosocial predictors of post-natal anxiety and depression: Using Structural Equation Modelling to investigate the relationship between pressure to breastfeed, health care professional support, post-natal guilt and shame, and post-natal anxiety and depression within an infant feeding context. Matern Child Nutr 2024; 20:e13558. [PMID: 37752680 PMCID: PMC10750005 DOI: 10.1111/mcn.13558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/30/2023] [Accepted: 08/03/2023] [Indexed: 09/28/2023]
Abstract
High perceived pressure to breastfeed and poor perceived quality of health care professional support have been associated with early breastfeeding cessation, guilt, and shame. This is problematic because guilt and shame significantly predict post-natal anxiety and depression. No previous attempts have been made to provide quantitative evidence for relationships mapped between the post-natal social context, infant feeding method and post-natal emotional well-being. The current study aimed to empirically investigate aforementioned pathways. Structural equation modelling was applied to survey data provided online by 876 mothers. Guilt and shame both significantly predicted anxiety and depression. Poor health care professional support and high pressure to breastfeed increased anxiety and depression, and these effects were explained by indirect pathways through increases in guilt and shame. Formula feeding exclusivity was negatively correlated with post-natal anxiety symptoms. This finding may be explained by feelings of relief associated with observed infant weight gain and being able to share infant feeding responsibilities others e.g., with one's partner. This relationship was counterbalanced by an indirect pathway where greater formula feeding exclusivity positively predicted guilt, which increased post-natal anxiety score. While guilt acted as mediator of infant feeding method to increase post-natal depression and anxiety, shame acted independently of infant feeding method. These identified differences provide empirical support for the transferability of general definitions of guilt (i.e., as remorse for having committed a moral transgression) and shame (i.e., internalisation of transgressive remorse to the self), to an infant feeding context. Recommendations for health care practitioners and the maternal social support network are discussed.
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Affiliation(s)
- Leanne Jackson
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
| | - Vicky Fallon
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
| | - Joanne A. Harrold
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
| | - Leonardo De Pascalis
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolMerseysideUK
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Chen YL, Huang KJ, Scoglio AAJ, Borgogna NC, Potenza MN, Blycker GR, Kraus SW. A Network Comparison of Sexual Dysfunction, Psychological Factors, and Body Dissociation between Individuals with and without Sexual Trauma Histories. J Trauma Dissociation 2024; 25:62-82. [PMID: 37415426 DOI: 10.1080/15299732.2023.2231915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 05/09/2023] [Indexed: 07/08/2023]
Abstract
Sexual dysfunction is associated with psychological symptoms, including depression and anxiety. Sexual dysfunctions are often attributed to dissociation symptoms in individuals who reported sexual trauma histories. This study utilized a network approach to analyze relationships between sexual and psychological symptoms and examine whether the identified network structures differed between individuals who reported a history of sexual trauma and those who did not. Sexual dysfunction, history of sexual trauma, internalizing symptoms, dissociation symptoms, sex-related shame, and negative body image were assessed in 1,937 United States college students (women = 69.5%). Nearly half (46.8%) of the participants reported a sexual trauma history in their lifetime. Using regularized partial correlation networks, the relationships between sexual and psychological symptoms were analyzed and compared between groups with and without trauma histories. Internalizing symptoms were positively correlated with sexual dysfunction regardless of the presence of sexual trauma history. Anxiety had a stronger influence in the trauma network than in the no-trauma network. Feeling separated from the body during sexual activity was a central symptom and was related to difficulties relaxing and enjoying sex only in the trauma network. Sex-related shame appeared to play a more important role in men compared to women. To improve clinical practice of assessing and treating sexual dysfunction, researchers and clinicians should consider core symptoms that connect different aspects of sexual and psychological functioning while being aware of the unique role of dissociation in the context of traumatic stress.
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Affiliation(s)
- Yen-Ling Chen
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
| | - Kuan-Ju Huang
- Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Arielle A J Scoglio
- Epidemiology Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Natural and Applied Sciences, Bentley University, Waltham, Massachusetts, USA
| | - Nicholas C Borgogna
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Connecticut Mental Health Center, New Haven, Connecticut, USA
- Connecticut Council on Problem Gambling, Wethersfield, Connecticut, USA
- Department of Neuroscience, Yale University, New Haven, Connecticut, USA
- Wu Tsai Institute, Yale University, New Haven, Connecticut, USA
| | - Gretchen R Blycker
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- College of Nursing, University of Rhode Island, Kingston, Rhode Island, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Nevada, USA
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Clark E, Munday J, Watts A. Stigma, shame and family secrets as consequences of mental illness in previous generations: A micro-history approach. Health (London) 2024; 28:74-89. [PMID: 35912777 DOI: 10.1177/13634593221114751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this article we evaluate micro-history as a method for investigating the meaning of stigma, shame and family secrets through generations. We present micro-histories of two Australian soldiers who developed mental illness years after serving in World War 1 and were committed to a psychiatric hospital where they died. Data were drawn from publicly available records and interviews with family members. The contrasting stories held by the families of each man illustrate the transmission of stigma and secrets through families. We explore possible reasons for the differences between the families related to the wider literature on stigma and mental health and show why the family stories people present should be considered social constructions rather than facts. We also address ethical issues that arose during the research, and which have relevance for researchers investigating sensitive or potentially stigmatising topics.
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Coady A, Godard R, Holtzman S. Understanding the link between pain invalidation and depressive symptoms: The role of shame and social support in people with chronic pain. J Health Psychol 2024; 29:52-64. [PMID: 37565664 PMCID: PMC10757395 DOI: 10.1177/13591053231191919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
Pain invalidation (e.g., having pain discounted) is a risk factor for depression among people with chronic pain, but the mechanisms remain unclear. Shame is a common, yet understudied, aspect of the pain experience. This study investigated whether pain-related shame helps explain the relationship between pain discounting and heightened depressive symptoms. The secondary aim was to examine whether social support can protect against the harmful effects of discounting. Patients with chronic pain (N = 305) were recruited from outpatient pain clinics. Participants completed an online cross-sectional survey and data were analyzed using moderated mediation analysis. Greater discounting was associated with greater depressive symptoms, and pain-related shame significantly mediated this relationship. Perceived social support attenuated the relationship between discounting and depressive symptoms. Greater attention towards pain-related shame as a treatment target is needed. Individual- and system-level interventions are required to address pain invalidation and bolster support for this population.
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Özgen MH, Vos CMD, Yağmur Ö, Sevelius J. Online Group Psychotherapy to Increase Self-acceptance and Reduce Shame Among Transgender Migrants: An Observational Report. Turk Psikiyatri Derg 2024; 35:8-13. [PMID: 38556932 PMCID: PMC11003373 DOI: 10.5080/u27170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/19/2023] [Indexed: 04/02/2024]
Abstract
OBJECTIVE Transgender and gender diverse (TGD) people experience higher levels of stigma, discrimination, and interpersonal violence due to their gender identity and/or expression, particularly TGD people with a migration background. This study aimed to conduct and evaluate group psychotherapy for TGD migrants to provide opportunities for exploring and developing interpersonal skills and relationships. METHOD The group therapy included five individuals who identified as TGD and originated from the Middle East. The TGD group therapy consisted of 12 weekly sessions of 90 minutes each and was facilitated by a psychiatrist. All sessions were conducted online and in Turkish. The sessions were guided by the group process and discussions. RESULTS After completing 12 group therapy sessions, members of the group reported benefiting from observing and emulating others who shared their problem constellation. Through the interpersonal skills that they built up throughout the sessions, they became more open to share their feelings experiencing fewer social barriers, and reduced anxiety. CONCLUSION This observational study indicates the significance of offering group-based psychotherapy to enhance affirmation and social connection within gender minority groups and emphasizes the need to empirically evaluate the effectiveness of group psychotherapy with TGD individuals, with special attention to the unique needs of TGD migrants.
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Affiliation(s)
- Mihriban Heval Özgen
- Psychiatrist, Intercultural Psychiatry, Parnassia Academy, Den Haag, Netherlands
| | | | - Özgün Yağmur
- Psychiatrist, Brown University, Department of Psychiatry, Boston, USA
| | - Jae Sevelius
- Prof., Department of Clinical Psychology, UCSF, San Francisco, USA
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Yamazaki S, Ura C, Inagaki H, Sugiyama M, Miyamae F, Edahiro A, Ito K, Iwasaki M, Sasai H, Okamura T, Hirano H, Awata S. Social isolation and well-being among families of middle-aged and older hikikomori people. Psychogeriatrics 2024; 24:145-147. [PMID: 37932240 DOI: 10.1111/psyg.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/26/2023] [Accepted: 10/21/2023] [Indexed: 11/08/2023]
Affiliation(s)
| | - Chiaki Ura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Mika Sugiyama
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Fumiko Miyamae
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kae Ito
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Zhang R, Chen J, Zhang C, Xu W. Longitudinal association of mindfulness with aggression and non-suicidal self-injury in adolescence: The mediating role of shame-proneness. Aggress Behav 2024; 50:e22121. [PMID: 37909325 DOI: 10.1002/ab.22121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023]
Abstract
The aim of the current study was to investigate the longitudinal association of facets of mindfulness with aggression and non-suicidal self-injury (NSSI) among adolescents and to explore whether shame-proneness can mediate the longitudinal association. The present longitudinal study investigated the associations between mindfulness, aggression, and NSSI in a sample of 706 Chinese adolescents (M = 15.33; SD = 1.34; 50.20% girls). Five facet mindfulness questionnaire was completed at baseline and middle school students' shame scale was completed at 6-month follow-up. The Chinese version of Buss-Perry aggression questionnaire and adolescents' self-harm scale were completed at both baseline and 6-month follow-up. Shame-proneness significantly mediated the longitudinal association between (a) describing and aggression (-0.107, 95% CI: [-0.151 to -0.067]), and NSSI (-0.041, 95% CI: [-0.069 to -0.019]). (b) Acting with awareness and aggression (-0.094, 95% CI: [-0.139 to -0.061]), and NSSI (-0.036, 95% CI: [-0.062 to -0.016]). (c) Nonjudging and aggression (-0.062, 95% CI: [-0.107 to -0.024]) and NSSI (-0.024, 95% CI: [-0.047 to -0.008]). Describing, acting with awareness, and nonjudging were predictive factors of aggression and self-injury in adolescents, and shame-proneness played a crucial role in the negative longitudinal association between them. Findings from the current study may offer some implications in the domains of clinical practice and education to improve mental health and further ameliorate the misbehavior among adolescents.
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Affiliation(s)
- Ruotong Zhang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jing Chen
- Institute of Psychology, Chinese Academic of Sciences, Beijing, China
| | - Chunyang Zhang
- China Academy of Civil Aviation Science and Technology, Beijing, China
| | - Wei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
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Brody R, Emrich M, Williams C, Haug NA. The Role of Shame in the Relationship between Alcohol Use Severity and Relational Intimacy among Sexual Minority Women. Subst Use Misuse 2023; 59:177-183. [PMID: 37942565 DOI: 10.1080/10826084.2023.2267108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Background: Sexual Minority Women (SMW) are disproportionately likely to struggle with substance use and shame, two factors that are associated with poorer relationship quality and decreased relational intimacy (Doyle & Molix, 2015). However, there is a dearth of research examining shame and substance use concurrently among SMW. Objectives: The current study elucidated the role of shame-based cognitions (SBCs) and shame-based behaviors (SBBs) in explaining the relationship between alcohol use severity and relational intimacy. We recruited adult cisgender women (N = 105) in a romantic relationship who self-identified as a sexual minority and reported alcohol use during the past three months through Amazon Mechanical Turk. Participants completed an online survey assessing alcohol use, SBCs, SBBs, and relational intimacy. Results: There was a significant positive relationship between alcohol use severity with SBCs (r = .29, p = .003) and with SBBs (r = .62, p <.001). SBBs were shown to be negatively correlated with relational intimacy (r = -.48, p < .001). Parallel mediation analysis demonstrated that SBCs and SBBs accounted for approximately 34.4% of the variance in intimacy. The indirect effects of SBCs were significant (β = .10, 95% CI [.02, .18] while SBBs (β = -.14, 95% CI [-.29, .01]) did not show effects. Discussions: Given the disproportionate rates of alcohol use among SMW, this study offers a nuanced picture of the relationships between constructs known to impact alcohol use. The findings underscore the importance of SBCs and point to a potential treatment target among SMW presenting with alcohol use and diminished relational intimacy.
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Affiliation(s)
- Robin Brody
- PGSP-Stanford Psy.D. Consortium, Palo Alto University, Palo Alto, California, USA
| | - Mariel Emrich
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Christian Williams
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Nancy A Haug
- PGSP-Stanford Psy.D. Consortium, Palo Alto University, Palo Alto, California, USA
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Uvais NA, Moideen S. Shared or Induced Olfactory Reference Syndrome. Prim Care Companion CNS Disord 2023; 25:23cr03582. [PMID: 38134408 DOI: 10.4088/pcc.23cr03582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Affiliation(s)
- N A Uvais
- Department of Psychiatry, Iqraa International Hospital and Research Centre, Calicut, India
- Corresponding Author: N. A. Uvais, MBBS, DPM, Iqraa International Hospital and Research Centre, Calicut, Kerala, India
| | - Shamsudeen Moideen
- Department of Internal Medicine, Iqraa International Hospital and Research Centre, Calicut, Kerala, India
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Abstract
In this narrative medicine essay, a pediatric oncologist grapples with the emotions of loss and guilt while attending the memorial service of her 8-year-old patient.
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Affiliation(s)
- Mallory R Taylor
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
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Thompson CM, Babu S, Makos S. Women's Experiences of Health-Related Communicative Disenfranchisement. Health Commun 2023; 38:3135-3146. [PMID: 36281957 DOI: 10.1080/10410236.2022.2137772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Women's inequitable healthcare experiences are epistemic injustices by which women are discredited and harmed in their position as knowers of their health and their bodies. Drawing on the theory of communicative disenfranchisement (TCD), we sought to amplify voices of women experiencing communicative disenfranchisement (CD) and to unify their stories according to theoretical premises, namely, attention to power, material conditions, discourse, identities and relationships, and process. We interviewed 36 women living in the United States whose health issues have not been taken seriously by health care providers, friends, and family - pervasive sources of disenfranchising talk surrounding health. Mapping onto the TCD framework, our findings explicate the process of CD, including the material and immaterial consequences of disenfranchising talk and women's responses to such talk. CD unfolded as a protracted and often circular process of women seeking care but encountering health dismissals and minimalizations, blaming and shaming, normalizing of their pain, and psychologizing. We unpack how disenfranchising talk rendered women crazy and dehumanized them and inflicted shame and loss. Women responded to disenfranchising talk with silence, and they (re)claimed their voice by resisting psychogenic explanations for their problems, critiquing women's healthcare, asserting their needs, and advocating for others. We discuss the implications of this research for theory and praxis.
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Downey JI, Alfonso CA. The Impact of Patient Suicide on Clinicians. Psychodyn Psychiatry 2023; 51:381-385. [PMID: 38047673 DOI: 10.1521/pdps.2023.51.4.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
The experience of patient suicide on clinicians is associated with complex affective states that include grief, guilt, shame, and fear and distressing subjective experiences of incompetence and helplessness. The authors review the literature of the subject and highlight the work of Rajagopalan and colleagues in Singapore, who implemented a one-time reflective group session to help clinicians process the experience of patient suicide to reduce psychological distress and prevent burnout and moral injury.
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Affiliation(s)
- Jennifer I Downey
- Clinical Professor of Psychiatry at Columbia University and Editor of Psychodynamic Psychiatry. She is a Past President of the AAPDPP
| | - César A Alfonso
- Clinical Professor of Psychiatry at Columbia University and Editor of Psychodynamic Psychiatry. He is the President of the World Federation for Psychotherapy and a Past President of the AAPDPP
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48
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Tomasello M. Differences in the Social Motivations and Emotions of Humans and Other Great Apes. Hum Nat 2023; 34:588-604. [PMID: 37971576 PMCID: PMC10739453 DOI: 10.1007/s12110-023-09464-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
Humans share with other mammals and primates many social motivations and emotions, but they are also much more cooperative than even their closest primate relatives. Here I review recent comparative experiments and analyses that illustrate humans' species-typical social motivations and emotions for cooperation in comparison with those of other great apes. These may be classified most generally as (i) 'you > me' (e.g., prosocial sympathy, informative and pedagogical motives in communication); (ii) 'you = me' (e.g., feelings of mutual respect, fairness, resentment); (iii) 'we > me' (e.g., feelings of obligation and guilt); and (iv) 'WE (in the group) > me' (e.g., in-group loyalty and conformity to norms, shame, and many in-group biases). The existence of these species-typical and species-universal motivations and emotions provides compelling evidence for the importance of cooperative activities in the human species.
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Affiliation(s)
- Michael Tomasello
- Duke University, Durham, NC, USA.
- Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.
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Coscas S, Benyamina A. [Women and alcohol, the addictologist's point of view and treatment]. Rev Infirm 2023; 72:22-25. [PMID: 38071011 DOI: 10.1016/j.revinf.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Women have difficulty seeking help for alcohol-related problems. Shame and guilt are often present, which is why the caregiver must succeed in establishing a climate of trust so that things can be said, in order to best assess the impact of consumption and find alternatives. Treatment is often multidisciplinary. The nurse's role is essential, not only to identify drug use, but also to provide a link between the various players involved.
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Affiliation(s)
- Sarah Coscas
- Hôpital universitaire Paul-Brousse, AP-HP, 12, avenue Paul-Vaillant-Couturier, 94800 Villejuif, France.
| | - Amine Benyamina
- Centre d'enseignement, de recherche et de traitement des addictions, Hôpital universitaire Paul-Brousse, Université Paris-Saclay, UR Psycomadd, 12, avenue Paul-Vaillant Couturier B.P 200, 94804 Villejuif, France
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50
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Brennan ME, Bell K, Hamid G, Gilchrist J, Gillingham J. Consumer experiences of shame in clinical encounters for breast cancer treatment. "Who do you think you are- Angelina Jolie?". Breast 2023; 72:103587. [PMID: 37812962 PMCID: PMC10568266 DOI: 10.1016/j.breast.2023.103587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/20/2023] [Accepted: 10/04/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Shame is a powerful negative emotion that has the potential to affect health. Due to the intimate nature of breast cancer treatment and its impact on body image, it is hypothesised that shame may be experienced during treatment. The aim of this study was to explore shame experiences related to clinical encounters for breast cancer treatment. METHODS People with a lived experience of breast cancer were invited to anonymously share their stories of shame through an online survey. Using qualitative methodology, the stories were examined, and themes identified. PARTICIPANTS Participants were members of the consumer organisation Breast Cancer Network Australia. RESULTS Stories were contributed by 38 participants. Most (n = 28, 73.7 %) were >5 years post-diagnosis. Shame was experienced in a range of clinical settings (consulting rooms, wards, operating theatres, radiotherapy departments). They involved a different health professionals (oncologists, surgeons, nurses, radiation therapists, psychologists.) Five themes were identified: (1) Body shame (sub-themes: Naked/vulnerable and Weight), (2) Communication (subthemes: Lack of compassion/impersonal manner and Not listening), (3) Being blamed (subthemes: diagnosis and complications), (4) Feeling unworthy (subthemes: Burden to staff and Unworthy of care), (5) Judgement for treatment choices. CONCLUSIONS Shame can be experienced in a range of situations, from scrutiny of the naked body to comments from health professionals. The impact of these experiences is profound, and the feelings of shame are carried for many years. These findings can inform strategies to support consumers and educate health professionals with the aim of reducing harm related to cancer treatment.
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Affiliation(s)
- M E Brennan
- Westmead Breast Cancer Institute, Westmead Hospital, NSW, Australia; National School of Medicine, The University of Notre Dame Australia, NSW, Australia; Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
| | - K Bell
- Consumer representative, Breast Cancer Network Australia (BCNA), Victoria, Australia
| | - G Hamid
- Westmead Breast Cancer Institute, Westmead Hospital, NSW, Australia
| | | | - J Gillingham
- Westmead Breast Cancer Institute, Westmead Hospital, NSW, Australia
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