Above and beyond emotional valence: the unique contribution of central and traumatic shame memories to psychopathology vulnerability

This paper explores whether shame memories have a distinct impact on emotional difficulties and psychopathology that goes beyond their negative emotional valence. Study 1 (N=292) investigates the contribution of centrality of shame memory, in comparison to the centrality of fear and sadness memories, to explain the memory's traumatic impact, shame, depression, anxiety, stress, paranoid, and dissociative symptoms. Study 2 (N=192) explores the impact of shame traumatic memory on shame and depression, anxiety, and stress symptoms, in comparison to fear and sadness traumatic memories. Both studies used undergraduate student samples. Results show that shame memories' centrality and traumatic features made an independent contribution to current external and internal shame and distinct psychopathological symptoms, after controlling for the effect of fear and sadness, centrality, and traumatic qualities. Moreover, shame memories' centrality and traumatic features were the best global predictors of external and internal shame and depressive symptoms. Centrality of shame memories was also the only significant predictor of paranoid ideation and dissociation. These results offer novel perspectives on the nature of shame and its relation to psychopathology, emphasising the distinct role of shame memories in human functioning and suffering, which goes above and beyond its negative emotional valence.     

The Origins of Fears of Compassion: Shame and Lack of Safeness Memories,Fears of Compassion and Psychopathology

Empirical and clinical research suggests that some individuals find self-generating compassion and receiving compassion from others difficult and aversive. However, it is unclear how these fears of compassion are linked to early experiences and to psychopathological symptoms. This study explores the relationship between shame traumatic memories, centrality of shame memories, early memories of warmth and safeness, fears of compassion, and depression, anxiety and paranoid symptoms. Participants were 302 individuals from the general community population, who completed self-report measures of fears of compassion, shame memories, early affiliative memories, and psychopathology. Shame traumatic and central memories were positively associated with fears of compassion for self, for others and from others, whereas early memories of warmth and safeness were negatively related to such fears. Path analyses revealed that fears of compassion for self and of receiving compassion from others mediated the effects of shame traumatic memory, centrality of shame memory and early memories of warmth and safeness on depressive, anxious and paranoid symptoms. These findings have implications for therapeutic interventions as these fears, as well as the negative shame-based emotional memories fuelling them, may need to be addressed in therapy to assist patients in self-generating and receiving compassion.     

Can shame memories become a key to identity? The centrality of shame memories predicts psychopathology

This study investigates the premise that a shame memory can become a central component of personal identity, a turning point in the life story and a reference point for everyday inferences. We assessed shame, centrality of shame memory, depression, anxiety, stress and traumatic stress reactions in 811 participants from general population (481 undergraduate students and 330 subjects from normal population) to explore the interactions between these variables. Results show that early shame experiences do indeed reveal centrality of memory characteristics. Furthermore, the centrality of shame memories is associated with current feelings of internal and external shame in adulthood. Key to our findings is that the centrality of shame memories shows a unique and independent contribution to depression, anxiety and stress prediction, even when controlling for shame measures. In addition, our results show that the centrality of shame memories is highly and positively associated with traumatic stress reactions. Copyright © 2010 John Wiley & Sons, Ltd.     

Self-Compassion and Emotional Intelligence in Adolescence: A Multigroup Mediational Study of the Impact of Shame Memories on Depressive Symptoms

Several studies have highlighted the adaptive role of self-compassion on human suffering and on a wide range of psychopathological conditions. Extensive research has shown that emotional intelligence has been associated with well-being, mental and physical health and quality of interpersonal relationships. We set out to explore the mediating role of self-compassion and emotional intelligence on the relationship between shame traumatic memories and depressive symptoms, and to explore if these were different between female and male adolescents. The sample was composed of 1101 adolescents from general population, whose age ranged from 14 to 18 years. Participants filled out a battery of self-report questionnaires designed to measure shame traumatic memories, self-compassion, emotional intelligence and depressive symptoms. Correlational analysis showed that in male and female adolescents, shame traumatic memories are associated with more depressive symptoms and with lower levels of self-compassion and emotional intelligence. Multigroup analysis showed that emotional intelligence has a greater impact on depression in female adolescents. Also, the impact of shame traumatic memories on depression is stronger in males, even though females report shame traumatic memories as more impactful. This study provides preliminary evidence that self-compassion and emotional intelligence are important emotion regulation processes for depressive symptoms in adolescence.     

Autobiographical memory for shame or guilt provoking events: Association with psychological symptoms

The diagnostic criteria for posttraumatic stress disorder (PTSD) specify that a qualifying traumatic stressor must incite extreme peritraumatic fear, horror, or helplessness. However, research suggests that events inciting guilt or shame may be associated with PTSD. We devised a web-based survey in which non-clinical participants identified an event associated with shame or guilt and completed questionnaire measures of shame, guilt, PTSD, and depression. In addition, we assessed characteristics of memory for the event, including visual perspective and the centrality of the memory to the participant’s autobiographical narrative (CES). Shame predicted depression and PTSD symptoms. There was no association between guilt and psychological symptoms after controlling statistically for the effects of shame. CES predicted the severity of depression and PTSD symptoms. In addition, CES mediated the moderating effect of visual perspective on the relationship between emotional intensity and PTSD symptoms. Our results suggest shame is capable of eliciting the intrusive and distressing memories characteristic of PTSD. Furthermore, our results suggest aversive emotional events are associated with psychological distress when memory for those events becomes central to one’s identity and autobiographical narrative.     

Self-Defining Memories of Body Image Shame and Binge Eating in Men and Women: Body Image Shame and Self-Criticism in Adulthood as Mediating Mechanisms

Despite the growing evidence of the association between shame experiences and eating psychopathology, the specific effect of body image-focused shame memories on binge eating remains largely unexplored. The current study examined this association and considered current body image shame and self-criticism as mediators. A multi-group path analysis was conducted to examine gender differences in these relationships. The sample included 222 women and 109 men from the Portuguese general and college student populations who recalled an early body image-focused shame experience and completed measures of the centrality of the shame memory, current body image shame, binge eating symptoms, depressive symptoms, and self-criticism. For both men and women, the effect of the centrality of shame memories related to body image on binge eating symptoms was fully mediated by body image shame and self-criticism. In women, these effects were further mediated by self-criticism focused on a sense of inadequacy and also on self-hatred. In men, only the form of self-criticism focused on a sense of inadequacy mediated these associations. The present study has important implications for the conceptualization and treatment of binge eating symptoms. Findings suggest that, in both genders, body image-focused shame experiences are associated with binge eating symptoms via their effect on current body image shame and self-criticism.     

Emotion Appraisal and Anxiety Symptomatology in a University Sample

Current conceptualizations for anxiety disorders focus heavily on cognitive and behavioral aspects of anxiety and address other emotions to a far lesser extent. Studies have demonstrated that negative appraisals of anxiety and fear (e.g., anxiety sensitivity) are elevated in each of the anxiety disorders and depressive disorders. Much less is known about how the appraisal of other emotions is related to anxiety disorder symptom presentation. The current study examines the appraisal of specific aversive emotions in relation to anxiety symptomatology. Undergraduate university students (N = 530) completed measures of specific anxiety and depressive symptoms, as well as a measure of emotional appraisal. A maximum likelihood estimated multivariate regression model was used to examine the unique relationships between emotional appraisal and anxiety and depressive symptoms. Results indicated that anxiety symptoms varied in their relationships with emotional appraisal. Each symptom group was highly related to fear of appraisals of anxiety; however, some anxiety symptoms were also related to fear of other emotional states, including guilt, sadness, disgust, lust, and embarrassment. Understanding the full range of appraisals of emotional experiences in anxiety conditions may help inform conceptualizations, and potentially treatments, by guiding the focus to the feared emotional states of the individual. The present study helps to clarify some of the relationships between emotion appraisal and anxiety symptoms.     

Emotional Reactions During and After Trauma: A Comparison of Trauma Types

Peri- and posttraumatic emotional responses have been understudied, and furthermore, have rarely been compared among trauma types. The current study compared college students' retrospective self-reports of peri- and posttraumatic responses of fear, shame, guilt, anger, and sadness among four types of traumatic events: sexual assault, physical assault, transportation accident, and illness/injury. Overall emotional responding was generally high for all trauma types, and for those in the sexual assault group, emotion increased sharply from the peri- to posttraumatic time point. Generally, fear was higher during the trauma compared to after the trauma, whereas the other emotions tended to remain stable or increase posttrauma. The sexual assault group tended to report higher levels of posttrauma emotion than the other trauma type groups.     

Emotion dysregulation and adolescent psychopathology: a prospective study

Background

Emotion regulation deficits have been consistently linked to psychopathology in cross-sectional studies. However, the direction of the relationship between emotion regulation and psychopathology is unclear. This study examined the longitudinal and reciprocal relationships between emotion regulation deficits and psychopathology in adolescents.

Methods

Emotion dysregulation and symptomatology (depression, anxiety, aggressive behavior, and eating pathology) were assessed in a large, diverse sample of adolescents (N = 1065) at two time points separated by seven months. Structural equation modeling was used to examine the longitudinal and reciprocal relationships between emotion dysregulation and symptoms of psychopathology.

Results

The three distinct emotion processes examined here (emotional understanding, dysregulated expression of sadness and anger, and ruminative responses to distress) formed a unitary latent emotion dysregulation factor. Emotion dysregulation predicted increases in anxiety symptoms, aggressive behavior, and eating pathology after controlling for baseline symptoms but did not predict depressive symptoms. In contrast, none of the four types of psychopathology predicted increases in emotion dysregulation after controlling for baseline emotion dysregulation.

Conclusions

Emotion dysregulation appears to be an important transdiagnostic factor that increases risk for a wide range of psychopathology outcomes in adolescence. These results suggest targets for preventive interventions during this developmental period of risk.     

Changes in Emotions Over the Course of Dialectical Behavior Therapy and the Moderating Role of Depression,Anxiety, and Posttraumatic Stress Disorder

Evidence-based borderline personality disorder (BPD) treatments such as dialectical behavior therapy (DBT) emphasize the acquisition and use of strategies to down regulate negative emotion. However, little research examines whether specific emotions change during DBT. Further, it is unclear if BPD-relevant comorbidities that involve heightened emotion—namely, depression, anxiety disorders, and posttraumatic stress disorder (PTSD)—moderate these outcomes. This study investigated which specific emotions (hostility/anger, fear, shame/guilt, and sadness) decrease during DBT, and whether comorbid depression, anxiety disorders, and PTSD moderate these outcomes. Individuals with BPD (N = 101) completed 6 months of standard DBT and provided measurements of specific emotions at every session and at pre-, mid-, and posttreatment. Generalized estimating equations revealed moderate effect-sized reductions in anger at major assessment time points. Anxiety disorders and PTSD moderated the effect of time on fear, shame, and guilt. PTSD also moderated the effect of time on sadness. For all moderating effects, individuals with the comorbidity exhibited greater reductions than those without. These findings corroborate that DBT reduces several specific emotions, and comorbid PTSD and anxiety disorders may facilitate this effect for fear, shame/guilt, and sadness (clinical trial registration number = NCT03123198).     

Vivid memories of distant trauma: Examining the characteristics of trauma memories and the relationship with the centrality of event and posttraumatic stress 26 years after trauma

In the present study, we investigated the phenomenological characteristics of distant trauma memories and the relationship between the vividness of trauma memories, the centrality of event and symptoms of posttraumatic stress in two groups with different types of trauma exposure, namely survivors and bereaved, from the fire on the passenger ferry, Scandinavian Star, 26 years earlier. More than two decades after the fire, the traumatic event was represented as a vivid, emotional recollection for many of the victims. For both the survivors and the bereaved, a higher degree of vividness of trauma memories and centrality of the event were associated with higher levels of posttraumatic stress. The present findings show that even very distant trauma memories can be represented as vivid recollections. Furthermore, the findings suggest that both vividness of trauma memories and event centrality may contribute to explain how posttraumatic stress reactions can remain present over a very long time.     

Memories of positive and negative emotional events

Women's memories of emotional events differing by both valence and intensity were examined for differences in narrative content and structure, as well as subjective memory ratings. Emotional valence was related to the content of the women's narratives, and emotional intensity was related to the subjective ratings of the memories. Negative narratives contained more negative emotion, cognitive processing words, and passive sentences than positive narratives, and positive narratives contained more positive emotion words and were more complex than negative narratives. Intensely negative narratives were the longest and the least complex, and intensely positive narratives were the most coherent. Women rated both intensely negative and intensely positive events, in general, as more frequently talked/thought about, significant, unique, emotional, and vivid than moderately emotional events, and negative events were rated as more emotional than positive narratives. There was little relation between the objective content of the narratives and the women's subjective ratings of their memory experiences. Finally, researcher‐defined traumatic events did not differ from other intensely negative events. The results of this study have important implications for narrative research in general, methodological issues such as the validity of text analysis programs and subjective memory ratings, and the quality of traumatic memories. Copyright © 2004 John Wiley & Sons, Ltd.     

Can Self-Reassurance Buffer against the Impact of Bullying? Effects on Body Shame and Disordered Eating in Adolescence

Bullying experiences are associated with body image and eating-related problems. Nonetheless, research on possible resilience factors is scant. The current study tested a path model examining the association between emotional memories of experiences of warmth and safeness, and self-reassuring abilities, and whether these abilities moderate the impact of bullying experiences on body image shame and eating psychopathology. We tested this model in a nonclinical sample of 609 adolescent girls aged 12–18 years. The examined model accounted for 22?% of body image shame variance and 51?% of eating psychopathology variance. Memories of warmth and safeness were significantly associated with self-reassurance, and negatively linked to body image shame and eating psychopathology. Self-reassurance significantly moderated the association between bullying experiences and both body image shame and eating psychopathology. The present findings suggest the relevance of assessing the quality of interpersonal experiences reported by adolescents and their potential association with self-reassuring abilities. Moreover, these results suggest that the ability to reassure and soothe the self may have a buffering effect against the negative impact of bullying experiences on adolescents’ body image and eating behaviors.     

Phenomenological characteristics of emotional memories in younger and older adults

Older adults sometimes show a “positivity effect” in memory, remembering proportionally more positive information than younger adults. Using a modified Memory Characteristics Questionnaire, this study examined whether emotional valence impacts the phenomenological qualities of young and older adults’ memories. Ageing did not impact the effect of valence on the qualities of high-arousal memories. However, ageing sometimes impacted subjective memory for details of low-arousal memories: In Experiment 2, older adults reported remembering more thoughts, feelings, and temporal order details about positive low-arousal stimuli, while young adults’ ratings for those dimensions were higher for negative low-arousal stimuli. These findings suggest that valence most readily affects the qualities of young and older adults’ emotional memories when those memories are low in arousal.     

"Hotspots" in trauma memories in the treatment of post-traumatic stress disorder: a replication

"Hotspots" refer to memories of detailed moments of peak emotional distress during a traumatic event. This study investigates hotspot frequency, and the emotions and cognitions contained in hotspots of memory for trauma, to replicate a previous study in this area (Holmes, Grey, & Young, 2005). Participants were patients receiving treatment for post-traumatic stress disorder (PTSD) at a specialist outpatient clinic after experiencing a range of traumatic events. The main finding was that, after fear, the most common emotions reported were anger and sadness. Cognitions related to psychological threat to the self were more common than those related to physical threat.     

Affective individual differences and startle reflex modulation

Potentiation of startle has been demonstrated in experimentally produced aversive emotional states, and clinical reports suggest that potentiated startle may be associated with fear or anxiety. To test the generalizability of startle potentiation across a variety of emotional states as well as its sensitivity to individual differences in fearfulness, the acoustic startle response of 17 high- and 15 low-fear adult subjects was assessed during fear, anger, joy, sadness, pleasant relaxation, and neutral imagery. Startle responses were larger in all aversive affective states than during pleasant imagery. This effect was enhanced among high fear subjects, although followup testing indicated that other affective individual differences (depression and anger) may also be related to increased potentiation of startle in negative affect. Startle latency was reduced during high- rather than low-arousal imagery but was unaffected by emotional valence.     

Shame in Relation to the Body,Sex, and Death: A Clinical Exploration of the Psychotic Levels of Shame

This paper explores the topic of shame in relation to the body, viewing it as the expression of a basic conflict that threatens to obstruct the growth of personality by breaking up the body-mind relationship. The paper presents the psychoanalysis of a psychotic patient whose paranoid shame was associated with the delusion of being noticed. During this analysis, the patient's bodily manifestations and hatred were acknowledged as related to his getting closer to an authentic existence of his own. Particular emphasis is given to the analyst's involvement in the analytic process, in the form of both bodily countertransference and dream activation. The containment and working-through of concrete aspects of hatred and death anxiety, together with the analysand's recognizing the value of sensory perception of his own body, fostered an abatement of symptoms, including his tendency to flee and to attempt to burst the confines of his body. The activation of a connection with the body seems a prerequisite to the development of abstract thinking. The paper describes similar dynamics in two vignettes of less dramatic clinical cases.     

“Hotspots” in trauma memories in the treatment of post-traumatic stress disorder: A replication

“Hotspots” refer to memories of detailed moments of peak emotional distress during a traumatic event. This study investigates hotspot frequency, and the emotions and cognitions contained in hotspots of memory for trauma, to replicate a previous study in this area (Holmes, Grey, & Young, 2005). Participants were patients receiving treatment for post-traumatic stress disorder (PTSD) at a specialist outpatient clinic after experiencing a range of traumatic events. The main finding was that, after fear, the most common emotions reported were anger and sadness. Cognitions related to psychological threat to the self were more common than those related to physical threat.     

Potentially Traumatic Experiences,Academic Performance,and Psychological Distress: The Role of Shame

The purpose of this study was to investigate the role of shame associated with previous potentially traumatic experiences, satisfaction with academic performance, and psychological distress among college students (N = 245) in Mainland China. Results indicated that previous experiences of potentially traumatic events were directly related to depressive symptoms and indirectly related through characterological shame and hopelessness. In addition, characterological shame and bodily shame were 2 distinct forms of shame that had unique associations with psychological distress.     

Do shame and perfectionistic self-presentation explain the link between early affiliative memories and eating psychopathology?

This study tested a model examining the impact that early affiliative memories (both with family and peers) on eating psychopathology, and whether these links are carried by the mechanisms of external shame and body image-related perfectionistic self-presentation, in a sample of 480 female college students. Path analyses’ results revealed that this model accounted for 48% of disordered eating’s variance and suggests that the lack of early positive emotional memories is associated with higher levels of shame (feelings of inferiority and unattractiveness), and with higher tendency to adopt body image-related perfectionistic strategies, that seem to explain excessive eating concern and rigid control of one’s eating behaviors. This study offers important insights for future research and for the development of intervention programs, by revealing the importance of assessing and targeting shame and perfectionistic strategies and suggesting the importance of promoting adaptive emotion regulation strategies.