Childhood maltreatment, shame, and self-esteem: an exploratory analysis of influencing factors on criminal behavior in juvenile female offenders.

OBJECTIVE: This study aimed to investigate the relationships between childhood maltreatment, shame, and self-esteem among juvenile female offenders and to explore the potential influencing factors on their criminal behavior. METHODS: Using a stratified cluster sampling method, 1,227 juvenile female offenders from 11 provinces in China were surveyed using the Childhood Trauma Questionnaire (CTQ), Self-Esteem Scale (SES), and a self-developed Shame Questionnaire for Juvenile Offenders. Data were analyzed using descriptive statistics, correlation analysis, chi-square tests, t-tests, and structural equation modeling with mediation analysis. RESULTS: (1) Childhood maltreatment have a significant potential influencing factors on criminal behavior; (2) Childhood maltreatment was positively correlated with self-esteem(ß = 0.351, p < 0.001); (3) shame (ß = 0.042, p < 0.001) mediate the relationship between Childhood maltreatment and self-esteem (childhood maltreatment → shame → self-esteem (95% Cl: 0.033, 0.052)). CONCLUSION: This study demonstrates that childhood maltreatment is a significant predictor of criminal behavior among juvenile female offenders. childhood maltreatment can directly influence of self-esteem, which can also affect juvenile female offenders'self-esteem indirectly through shame. The findings suggest that shame are important variables that mediate the effect of the juvenile female offenders'childhood maltreatment on their self-esteem.

Toward a memory perspective on eating psychopathology: An investigation of the types of childhood and adolescence memories that are associated with eating disorder symptoms.

The cognitive mechanisms through which specific life events affect the development and maintenance of eating disorders (ED) have received limited attention in the scientific literature. The present research aims to address this gap by adopting a memory perspective to explore the type of life events associated with eating psychopathology and how these events are encoded and reconstructed as memories. Two studies (n = 208 and n = 193) were conducted to investigate the relationship between specific memories and eating disorder psychopathology. Study 1 focused on parent-related memories, while Study 2 examined childhood/adolescence memories. Results from both studies revealed that need thwarting and shame in memories were associated with eating disorder symptoms, but only when individuals drew symbolic connections between these memories and food or eating behavior. Moreover, need thwarting and shame in such memories were associated with other eating and body image outcomes, including uncontrolled eating and body esteem. These results also held after controlling for a host of known predictors of eating disorder psychopathology, such as BMI, perfectionism, or thin ideal internalization. Overall, the present findings suggest that the reprocessing of memories symbolically and idiosyncratically linked to food and eating behavior might be a fruitful clinical intervention.

The Reintegration of Men into Society after a Sexual Offense: A Hermeneutic Phenomenology Study.

The purpose of this study was to describe the lived experience and meaning of being a 'sex offender' for the individual who is reintegrating into society, considering issues associated with self-perception, perception of others, stigma and humanization. Fourteen male adults were invited to participate in this hermeneutic phenomenological study. Data analysis was completed using an iterative process as described by van Manen. Five major themes were identified: exposed secret leads to humiliation; being considered a sex offender is living in fear of the unknown; stigma and shame consume the identity of the individual charged with a sexual offense; reframing and "leveling" of the crime are coping strategies; and the path toward healing and forgiveness is complex. Contextualizing individuals' experiences and examining barriers and motivators post-charge are essential to minimize stigma and risk factors linked to recidivism, as well as to facilitate recovery and healing.

Online Group Psychotherapy to Increase Self-acceptance and Reduce Shame Among Transgender Migrants: An Observational Report. / Transgender Göçmenler Arasinda Öz Kabulü Arttirmak ve Çekimserligi Azaltmak için Çevrimiçi Grup Psikoterapisi: Bir Gözlemsel Rapor.

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.

Is Obesity a Cause for Shame? Weight Bias and Stigma among Physicians, Dietitians, and Other Healthcare Professionals in Poland-A Cross-Sectional Study.

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.

Internalized Sexual Stigma and Mental Health Outcomes for Gay, Lesbian, and Bisexual Asian Americans: The Moderating Role of Guilt and Shame.

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.

Patterns of social-affective responses to trauma exposure and their relation to psychopathology.

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.

Shame in patients undergoing ureterostomy: A cross-sectional survey.

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.

Non-fear emotions in changes in posttraumatic stress disorder symptoms during treatment.

BACKGROUND AND OBJECTIVES: Posttraumatic stress disorder (PTSD) is not only associated with fear but also with other emotions. The present study aimed to examine if changes in shame, guilt, anger, and disgust predicted changes in PTSD symptoms during treatment, while also testing if PTSD symptoms, in turn, predicted changes in these emotions. METHODS: Participants (N = 155) with childhood-related PTSD received a maximum of 12 sessions of eye movement desensitization and reprocessing or imagery rescripting. The data was analyzed using Granger causality models across 12 treatment sessions and 6 assessment sessions (up until one year after the start of treatment). Differences between the two treatments were explored. RESULTS: Across treatment sessions, shame, and disgust showed a reciprocal relationship with PTSD symptoms, while changes in guilt preceded PTSD symptoms. Across assessments, anger was reciprocally related to PTSD, suggesting that anger might play a more important role in the longer term. LIMITATIONS: The individual emotion items were not yet validated, and the CAPS was not administered at all assessments. CONCLUSIONS: These findings partly differ from earlier studies that suggested a unidirectional relationship in which changes in emotions preceded changes in PTSD symptoms during treatment. This is in line with the idea that non-fear emotions do play an important role in the treatment of PTSD and constitute an important focus of treatment and further research.

Interpersonal trauma, shame, and substance use: A systematic review.

BACKGROUND: Interpersonal trauma is a risk factor for a wide array of adverse mental health outcomes, including substance use. Research has begun investigating the role of shame in the intersection between substance use and interpersonal trauma. The current systematic review summarizes the existing literature documenting the relation among shame, substance use, and interpersonal trauma. METHOD: Articles were collected using a Boolean search strategy of terms related to interpersonal trauma, substance use, and shame across six databases. Independent search and screening by three researchers led to a final review of 27 articles, 15 of which were qualitative studies. RESULTS: Findings highlight robust associations among shame, interpersonal violence, and substance use across varied samples. Findings emphasize that increased shame is associated with greater substance use among survivors of interpersonal violence and elevated shame and greater interpersonal violence are present among individuals who use substances given the high prevalence rates. Burgeoning research suggests that shame mediates the relationship between interpersonal violence and substance use. CONCLUSION: Results from our review suggest that shame may be an important treatment target for individuals presenting with substance use and a history of interpersonal violence. Future studies, with longitudinal designs, are needed to parse out the temporal relation among shame, substance use, and interpersonal violence.

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.

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).

C-METTA is an intervention that addresses trauma-related guilt and shame and combines cognitive interventions with loving-kindness meditations.A proof-of-concept study was conducted examining C-METTA in a wait-list randomized controlled trialC-METTA led to reductions in trauma-related guilt and shame and PTSD symptoms.

Assessing the Validity of the Social Impact Scale Among a Longitudinal Cohort of Adolescents and Young Adults Living With Perinatally Acquired HIV.

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.

Perceptions and barriers about mental health services among Pacific Islanders: An interpretative phenomenological analysis.

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).

Shifting the paradigm of social withdrawal: a new era of coexisting pathological and non-pathological hikikomori.

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.

"I am ashamed that I exist. I feel like apologizing for existing": The phenomenology of shame in patients with borderline personality disorder: A qualitative study.

Shame is an essential affect in many patients with borderline personality disorder (BPD) and can be associated with most of the BPD diagnostic criteria. Severe shame is a highly aversive emotion with concomitant beliefs about the self as deeply inferior, insignificant, disgusting, and unloved. Shame and how it is manifested in the subjective experience and behavior in people diagnosed with BPD is remarkably under-researched, and our knowledge of the phenomenology of shame in BPD needs to be improved. Severe shame is often less accessible and available to conscious awareness, making it difficult to access via questionnaires and self-report measures. Therefore, this study is based on semi-structured interviews with 21 women Structural clinical interview for DSM-5 disorders' diagnosed with BPD. All interviews were analyzed using the interpretive phenomenological approach. Based on the analysis, the participants' descriptions of how severe shame manifests itself in their subjective experience and behavior are classified into 10 themes: the self is deeply flawed and unlovable; self-hatred/self-contempt; eye contact is awkward and shameful; shameful over being mentally ill; shameful identity diffusion; hiding behind façade/social roles; pleasing others/performing to avoid shame; self-destructive behavior to mitigate shame; sex associated with shame; and shame during the therapy session. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring Psychiatric Home-Visit Nursing Practices for Patients with Schizophrenia and Hikikomori with a Thematic Analysis.

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.