Shame and guilt الخجل والذنب

يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ تُوبُوٓاْ إِلَى ٱللَّهِ تَوۡبَةࣰ نَّصُوحًا عَسَىٰ رَبُّكُمۡ أَن يُكَفِّرَ عَنكُمۡ سَيِّـَٔاتِكُمۡ وَيُدۡخِلَكُمۡ جَنَّٰتࣲ تَجۡرِي مِن تَحۡتِهَا ٱلۡأَنۡهَٰرُ يَوۡمَ لَا يُخۡزِي ٱللَّهُ ٱلنَّبِيَّ وَٱلَّذِينَ ءَامَنُواْ مَعَهُۥۖ نُورُهُمۡ يَسۡعَىٰ بَيۡنَ أَيۡدِيهِمۡ وَبِأَيۡمَٰنِهِمۡ يَقُولُونَ رَبَّنَآ أَتۡمِمۡ لَنَا نُورَنَا وَٱغۡفِرۡ لَنَآۖ إِنَّكَ عَلَىٰ كُلِّ شَيۡءࣲ قَدِيرࣱ‏

Believers, turn to God in sincere repentance. Your Lord may well cancel your bad deeds for you and admit you into Gardens graced with flowing streams, on a Day when God will not disgrace the Prophet or those who have believed with him. With their lights streaming out ahead of them and to their right, they will say, ‘Lord, perfect our lights for us and forgive us: You have power over everything.’

إِنَّمَا ٱلتَّوۡبَةُ عَلَى ٱللَّهِ لِلَّذِينَ يَعۡمَلُونَ ٱلسُّوٓءَ بِجَهَٰلَةࣲ ثُمَّ يَتُوبُونَ مِن قَرِيبࣲ فَأُوْلَٰٓئِكَ يَتُوبُ ٱللَّهُ عَلَيۡهِمۡۗ وَكَانَ ٱللَّهُ عَلِيمًا حَكِيمࣰ ا

But God only undertakes to accept repentance from those who do evil out of ignorance and soon afterwards repent: these are the ones God will forgive, He is all knowing, all wise

وَلَيۡسَتِ ٱلتَّوۡبَةُ لِلَّذِينَ يَعۡمَلُونَ ٱلسَّيِّـَٔاتِ حَتَّىٰٓ إِذَا حَضَرَ أَحَدَهُمُ ٱلۡمَوۡتُ قَالَ إِنِّي تُبۡتُ ٱلۡـَٰٔنَ وَلَا ٱلَّذِينَ يَمُوتُونَ وَهُمۡ كُفَّارٌۚ أُوْلَٰٓئِكَ أَعۡتَدۡنَا لَهُمۡ عَذَابًا أَلِيمࣰ ا

It is not true repentance when people continue to do evil until death confronts them and then say, ‘Now I repent,’ nor when they die defiant: We have prepared a painful torment for these

وَهُوَ ٱلَّذِي يَقۡبَلُ ٱلتَّوۡبَةَ عَنۡ عِبَادِهِۦ وَيَعۡفُواْ عَنِ ٱلسَّيِّـَٔاتِ وَيَعۡلَمُ مَا تَفۡعَلُونَ

it is He who accepts repentance from His servants and pardons bad deeds- He knows everything you do

أَلَمۡ يَعۡلَمُوٓاْ أَنَّ ٱللَّهَ هُوَ يَقۡبَلُ ٱلتَّوۡبَةَ عَنۡ عِبَادِهِۦ وَيَأۡخُذُ ٱلصَّدَقَٰتِ وَأَنَّ ٱللَّهَ هُوَ ٱلتَّوَّابُ ٱلرَّحِيمُ

Do they not know that it is God Himself who accepts repentance from His servants and receives what is given freely for His sake? He is always ready to accept repentance, most merciful

وَإِذۡ قَالَ مُوسَىٰ لِقَوۡمِهِۦ يَٰقَوۡمِ إِنَّكُمۡ ظَلَمۡتُمۡ أَنفُسَكُم بِٱتِّخَاذِكُمُ ٱلۡعِجۡلَ فَتُوبُوٓاْ إِلَىٰ بَارِئِكُمۡ فَٱقۡتُلُوٓاْ أَنفُسَكُمۡ ذَٰلِكُمۡ خَيۡرࣱ لَّكُمۡ عِندَ بَارِئِكُمۡ فَتَابَ عَلَيۡكُمۡۚ إِنَّهُۥ هُوَ ٱلتَّوَّابُ ٱلرَّحِيمُ

Moses said to his people, ‘My people, you have wronged yourselves by worshipping the calf, so repent to your Maker and kill [the guilty among] you. That is the best you can do in the eyes of your Maker.’ He accepted your repentance: He is the Ever Relenting and the Most Merciful

O you who have faith, repent to God with true repentance. “O believers, familiars, and friends, all of you repent! Come back to My threshold! Turn to Me! Though you have done what comes from you, I will do what comes from Me! Nobody accepts the defective except here. Come back! No threshold forgives sins but here. Seek shelter in Me! Come from the unkindly to the Lovingly Kind! Come from the pain of despair to hope! I have no fear of forgiving sins, come back! I am not ashamed to accept the defective, return!” Read the equivalent of this verse in “Be penitent toward your Lord” [39:54]. The station of penitence is higher than the station of repentance. Penitence is the servant's return to his Lord with heart and aspiration, and repentance is the servant's return from disobedience to obedience. What is penitence? Coming from the valley of hypocrisy on the feet of truthfulness to the valley

O you who believe! Repent to God with sincere repentance read nasūhan or nusūhan a truthful repentance so that one does not return to committing that sin again nor have the desire to return to it. It may be that your Lord ‘asā an expression denoting ‘a hope’ that will be realised will absolve you of your misdeeds and admit you into gardens orchards underneath which rivers flow on the day when God will not let down by admitting into the Fire the Prophet and those who believe with him. Their light will be running before them in front of them and it will be on their right. They will say yaqūlūna this denotes the beginning of a new syntactically independent sentence ‘Our Lord! Perfect our light for us towards Paradise — whereas the hypocrites their light will be extinguished — and forgive us Our Lord. Assuredly You have power over all things’.

It is for God to turn only toward those who do the ugly in ignorance and then soon turn. Those-God will turn toward them. And God is knowing, wise. Turning/repentance [tawba] is the mark of the road, the leader to the court, the key to the treasure, the intercessor of union, the head of every happiness, and the basis of freedom. First is regret in the heart, second apology with the tongue, and then cutting off from bad things and bad people. It has come in the report that when someone repents but does not put aside bad friends, he is not a repenter. When someone repents but does not put aside food and drink, he is not a repenter. When someone repents but does not put aside his bedclothes and empty his eyes of sleep, he is not a repenter. When someone repents but does not expend the wealth left over after food, he is not a repenter. The precondition of repentance is that you detach your h

This turning will not belong to those who keep on doing ugly deeds until death is present for one of them, and then he says: “Surely now I have turned.” In the tongue of learning, one must repent before death, even if it be one moment. In the tongue of practice, one must repent before the soul has the habit of seeing itself and worshiping itself. When someone is pleased with himself and gazes upon himself habitually, the door to repentance has been shut to him and the water of deliverance taken away from him. Quit being the companion of self-nurturing habit-worshipers! Kiss the dust beneath the feet of those who have disowned self! [DS 972] Not everyone who has repented in the road of the Shariah, thereby reaching pardon and forgive- ness, has reached truthfulness in love in respect of the Haqiqah. For a long time David the prophet wept and pleaded. At last it was said to him, “O David!

The repentance that God accepts that is the one which He has prescribed for Himself to accept out of His bounty is only of those who do evil an act of disobedience in ignorance bi-jahālatin a circumstantial qualifier in other words ‘they are ignorant’ while they are disobeying their Lord; then repent shortly thereafter before the last gasps of death; God will relent to those He will accept their repentance. And God is ever Knowing of His creatures Wise in what He does with them.

Repentance is not for those who do evil deeds sins until when death approaches one of them and the pangs of death begin he says upon witnessing his predicament ‘Indeed now I repent’ for this would not avail him and would not be accepted from him; neither for those who die disbelieving if they repent in the Hereafter upon seeing the chastisement it will not be accepted from them. Those — We have prepared for them a painful chastisement.

حَدَّثَنَا عَبَّاسُ بْنُ عَبْدِ الْعَظِيمِ الْعَنْبَرِيُّ، وَغَيْرُ، وَاحِدٍ، قَالُوا حَدَّثَنَا أَبُو دَاوُدَ الطَّيَالِسِيُّ، حَدَّثَنَا عِمْرَانُ الْقَطَّانُ، عَنْ قَتَادَةَ، عَنْ سَعِيدِ بْنِ أَبِي الْحَسَنِ، عَنْ أَبِي هُرَيْرَةَ، رضى الله عنه عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ لَيْسَ شَيْءٌ أَكْرَمَ عَلَى اللَّهِ تَعَالَى مِنَ الدُّعَاءِ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ لاَ نَعْرِفُهُ مَرْفُوعًا إِلاَّ مِنْ حَدِيثِ عِمْرَانَ الْقَطَّانِ وَعِمْرَانُ الْقَطَّانُ هُوَ ابْنُ دَاوَرَ وَيُكْنَى أَبَا الْعَوَّامِ ‏.‏ حَدَّثَنَا مُحَمَّدُ بْنُ بَشَّارٍ، حَدَّثَنَا عَبْدُ الرَّحْمَنِ بْنُ مَهْدِيٍّ، عَنْ عِمْرَانَ الْقَطَّانِ، بِهَذَا الإِسْنَادِ نَحْوَهُ ‏.‏

Abu Hurairah narrated that:The Prophet said: “There is nothing more honorable with Allah [Most High] than supplication.”

حَدَّثَنَا أَحْمَدُ بْنُ مَنِيعٍ، حَدَّثَنَا مَرْوَانُ بْنُ مُعَاوِيَةَ، عَنِ الأَعْمَشِ، عَنْ ذَرٍّ، عَنْ يُسَيْعٍ، عَنِ النُّعْمَانِ بْنِ بَشِيرٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏"‏ الدُّعَاءُ هُوَ الْعِبَادَةُ ‏"‏ ‏.‏ ثُمَّ قَرَأََ ‏:‏ ‏(‏وقالَ رَبُّكُمُ ادْعُونِي أَسْتَجِبْ لَكُمْ إِنَّ الَّذِينَ يَسْتَكْبِرُونَ عَنْ عِبَادَتِي سَيَدْخُلُونَ جَهَنَّمَ دَاخِرِينَ ‏)‏ ‏.‏ قَالَ هَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ ‏.‏ وَقَدْ رَوَاهُ مَنْصُورٌ وَالأَعْمَشُ عَنْ ذَرٍّ وَلاَ نَعْرِفُهُ إِلاَّ مِنْ حَدِيثِ ذَرٍّ ‏.‏ هُوَ ذَرُّ بْنُ عَبْدِ اللَّهِ الْهَمْدَانِيُّ ثِقَةٌ وَالِدُ عُمَرَ بْنِ ذَرٍّ ‏.‏

An-Nu`man bin Bashir narrated that:The Prophet said: “The supplication, is worship.” Then he recited: And Your Lord said: “Call upon me, I will respond to you. Verily, those who scorn My worship, they will surely enter Hell humiliated

وإن كان في معصية فمراقبته بالتوبة والندم والإقلاع والحياء والاشتغال بالتفكر

وأما النوع الرابع وهو المنجيات فهو التوبة والندم على الذنوب والصبر على البلاء والشكر على النعماء والخوف والرجاء والزهد في الدنيا والإخلاص والصدق في الطاعات ومحبة الله وتعظيمه والرضا بأفعاله والشوق إليه والخشوع والتواضع له

فإذا أراد أن يكتسب لنفسه أحوال التوبة والندم فليفتش ذنوبه أولا وليتفكر فيها وليجمعها على نفسه وليعظمها في قلبه

قال وشرائط التوبة ثلاثة الندم والإقلاع والإعتذار

فحقيقة التوبة هي الندم على ما سلف منه في الماضي والإقلاع عنه في الحال والعزم على أن لا يعاوده في المستقبل

فأما الندم فإنه لا تتحقق التوبة إلا به إذ من لم يندم على القبيح فذلك دليل على رضاه به وإصراره عليه وفي المسند الندم توبة

Gender differences in self-conscious emotional experience: a meta-analysis.: The self-conscious emotions (SCE) of guilt, shame, pride, and embarrassment are moral emotions, which motivate adherence to social norms and personal standards and emerge in early childhood following the development of self-awareness. Gender stereotypes of emotion maintain that women experience more guilt, shame, and embarrassment but that men experience more pride. To estimate the magnitude of gender differences in SCE experience and to determine the circumstances under which these gender diffe

Shame and the motivation to change the self.: A central question of human psychology is whether and when people change for the better. Although it has long been assumed that emotion plays a central role in self-regulation, the role of specific emotions in motivating a desire for self-change has been largely ignored. We report 2 studies examining people's lived experiences of self-conscious emotions, particularly shame, in motivating a desire for self-change. Study 1 revealed that when participants recalled experiences of shame, guilt, or em

An examination of the relationship between shame, guilt and self-harm: A systematic review and meta-analysis.: Self-harm is a major public health concern associated with suicide risk and significant psychological distress. Theories suggest that aversive emotional states are an important process that drives self-harm. Shame and guilt may, in particular, be important emotions in self-harm. This review therefore sought to provide a systematic review and meta-analysis of the relationship between shame, guilt, and self-harm. A systematic search of electronic databases (PsycINFO; Medline; CINAHL Plus; Web of S

Shame-proneness, guilt-proneness and anxiety symptoms: A meta-analysis.: There is a growing body of investigations showing that shame and guilt are important features of various psychological problems including anxiety disorders. This study quantitatively summarized the magnitude of the associations of shame and guilt with anxiety symptoms. We looked both at the associations with broader categories of anxiety symptoms (i.e., undifferentiated anxiety symptoms, trait and state anxiety), but also with symptoms specific to individual anxiety disorders. In most cases, sha

Shame, guilt, and posttraumatic stress symptoms: A three-level meta-analysis.: Existing empirical findings are inconsistent on the correlations of shame and guilt with posttraumatic stress symptoms (PTSS). This study aimed to quantitatively summarize the strength of the associations of shame and guilt with PTSS and explore potential moderators. Based on a three-level meta-analytic method, shame was positively correlated with PTSS, no matter whether the effects of guilt were controlled; guilt also had a positive correlation with PTSS, regardless of whether the effects of sh

Shame, guilt, and depressive symptoms: a meta-analytic review.: Recent theoretical and empirical work has facilitated the drawing of sharp conceptual distinctions between shame and guilt. A clear view of these distinctions has permitted development of a research literature aimed at evaluating the differential associations of shame and guilt with depressive symptoms. This study quantitatively summarized the magnitude of associations of shame and guilt with depressive symptoms. Two hundred forty-two effect sizes were obtained from 108 studies employing 22,411

Music therapy in supportive cancer care.

The purpose of this paper is to show some aspects of music therapy application in cancer care and to present the integration of music therapy program into a continuous supportive cancer care for inpatients. A cancer diagnosis is one of the most feared and serious life events that causes stress in individuals and families. Cancer disrupts social, physical and emotional well-being and results in a range of emotions, including anger, fear, sadness, guilt, embarrassment and shame. Music therapy is a part of a complementary medicine program in supportive cancer care which accompanies medical treatment. There are many benefits of music therapy for cancer patients-interactive music therapy techniques (instrumental improvisation, singing) as well as receptive music therapy techniques (listening to recorded or live music, music and imaginary) can be used to improve mood, decrease stress, pain, an…

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Genetic counseling for isolated GnRH deficiency.

As our understanding of the complexities of the various etiologies and complex genetic architecture of GnRH deficiency grows, so too does the need to apply newly-developed genetic tools in a way that: (a) is meaningful to individuals and their families; (b) integrates all of the phenotypic features of this syndrome into a rationale; and (c) provides up-to-date diagnostic technologies in a cost-effective algorithm of genetic testing. Genetic counseling aims to accomplish these goals through ascertainment of detailed family histories, targeted comprehensive phenotypic evaluations, informed selection of genetic testing, interpretation of genetic test results, and the provision of highly specific risk assessments and psychological support to individuals diagnosed with this reproductive condition. This chapter offers a guide to incorporating this rapidly evolving state of knowledge of the ped…

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Disgust: the disease-avoidance emotion and its dysfunctions.

This review analyses the accumulating evidence from psychological, psychophysiological, neurobiological and cognitive studies suggesting that the disease-avoidance emotion of disgust is a predominant emotion experienced in a number of psychopathologies. Current evidence suggests that disgust is significantly related to small animal phobias (particularly spider phobia), blood-injection-injury phobia and obsessive-compulsive disorder contamination fears, and these are all disorders that have primary disgust elicitors as a significant component of their psychopathology. Disgust propensity and sensitivity are also significantly associated with measures of a number of other psychopathologies, including eating disorders, sexual dysfunctions, hypochondriasis, height phobia, claustrophobia, separation anxiety, agoraphobia and symptoms of schizophrenia--even though many of these psychopathologies…

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Sexual addictions.

Unlabelled: The potential adverse consequences, personal distress, shame and guilt presented by patients who suffer from sexual addiction require a more in-depth understanding of the phenomenology and psychobiology of this disorder. Methods: A bibliographic review was conducted using MEDLINE and EBSCO databases with the following keywords: "sexual addiction," "hypersexuality," "compulsive sexual behavior," "behavioural addiction," "treatment," and "addiction." Results: Several conceptualizations of excessive nonparaphilic sexual disorder have been proposed based on the models of, respectively, obsessive compulsive disorder, impulse control disorder, out of control excessive sexual disorder, and addictive disorder. Despite the lack of robust scientific data, a number of clinical elements, such as the frequent preoccupation with this type of behavior, the time spent in sexual activities, t…

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The assessment of the family of people with eating disorders.

The National Institute for Clinical Excellence (NICE) guidelines for eating disorders recommend that carers should be provided with information and support and that their needs should be considered if relevant. The aim of this paper is to describe how to structure an assessment of carers needs so that the family factors that can contribute to the maintenance of eating disorder symptoms are examined. We describe in detail the pattern of interpersonal reactions that can result when a family member has an eating disorder. Shared traits such as anxiety, compulsivity and abnormal eating behaviours contribute to some of the misperceptions, misunderstandings and confusion about the meaning of the eating disorder for family members. Unhelpful attributions can fuel a variety of emotional reactions (criticism, hostility, overprotection, guilt and shame). Gradually these forces cause family members…

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The burden of schizophrenia on caregivers: a review.

Schizophrenia is a disabling, chronic psychiatric disorder that poses numerous challenges in its management and consequences. It extols a significant cost to the patient in terms of personal suffering, on the caregiver as a result of the shift of burden of care from hospital to families, and on society at large in terms of significant direct and indirect costs that include frequent hospitalizations and the need for long-term psychosocial and economic support, as well as life-time lost productivity. 'Burden of care' is a complex construct that challenges simple definition, and is frequently criticized for being broad and generally negative. Frequently, burden of care is more defined by its impacts and consequences on caregivers. In addition to the emotional, psychological, physical and economic impact, the concept of 'burden of care' involves subtle but distressing notions such as shame, …

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Enhancing Understanding of Eating Psychopathology: A Network Analysis Study.

Compassion Focused Therapy for eating disorders (CFT-E) has been shown to be effective in treating eating psychopathology. Exploring which processes identified by the CFT-E model are most linked with eating disorder symptoms could help develop targeted treatments. However, the relationship between these variables requires further investigation. This study explores the interconnections between eating disorder symptoms and processes identified by the CFT-E using a network analysis approach. Participants were 497 individuals (77.3% female) from a community sample who completed measures to assess body dissatisfaction, shape and weight overvaluation, cognitive restraint, bingeing, emotional eating, purging, self-compassion, social comparison through appearance, self-criticism, appearance-related shame, guilt and pride, and positive and negative affect. A regularized partial correlation networ…

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Social anxiety and emotion regulation flexibility: a daily diary approach.

Previous research suggests that social anxiety symptoms are maintained and intensified by inflexible emotion regulation (ER). Therefore, we examined whether trait-level social anxiety moderates ER flexibility operationalised at both between-person (covariation between variability in emotional intensity and variability in strategy use across occasions) and within-person (associations between emotional intensity and strategy use on a given day) levels. In a sample of healthy college-aged adults (N = 185, Mage = 21.89), we examined overall and emotion-specific intensities (shame, guilt, anxiety, anger, sadness) and regulatory strategies (i.e. experiential avoidance, expressive suppression, and rumination) in response to each day's most emotionally intense event over 6 days. During the study period, we found a positive association between variability in emotional intensity and variability of…

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Measuring civilian moral injury: Adaptation and validation of the Moral Injury Events Scale (Civilian) and Expressions of Moral Injury Scale (Civilian).

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 wit…

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The ongoing rewriting of the therapeutic contract in Metacognitive Interpersonal Therapy for narcissistic personality disorder: The case of Mark.

In order to effectively treat individuals suffering from Narcissistic Personality Disorder (NPD), it is crucial to establish therapeutic goals and identify tasks to achieve them. However, this is a challenging process with NPD patients because they often struggle to find meaningful goals beyond the pursuit of status. Moreover, in order to change Furthermore, to promote change, they must confront painful emotions such as shame, guilt, or fear, which they habitually try to avoid. Additionally, they face difficulties in forming a positive perception of their therapists and cooperating towards mutually agreed-upon goals and tasks. As a consequence, NPD patients ask for change but hardly engage themselves in the work necessary to achieve it. Therapists therefore need to pay the uttermost attention to drafting, negotiating and continuously updating a reasonable and realistic therapeutic contra…

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Changes in Trauma-Related Cognitions and Emotions After Eliciting Moral Elevation: Examining the Effects of Viewing Others' Virtuous Behavior on Veterans with PTSD.

Moral elevation is described as feeling inspired after witnessing someone perform a virtuous act. Past work suggests the features of moral elevation may be contrary to PTSD, yet few studies have directly tested its impact on relevant symptoms. This experimental study assessed changes in trauma-related cognitions and emotions from after a trauma reminder task to after an elevation induction exercise. We hypothesized that higher elevation after the induction exercise would be associated with greater reductions in cognitions and emotions. Veterans with probable PTSD (N = 38) completed measures of trauma-related cognitions and emotions, once after a written trauma narrative exercise (T1) and again after watching two videos designed to elicit elevation (T2). Veterans also completed measures of state elevation after each video. Results suggest veterans experienced small, significant decreases …

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Contemplative practice, acceptance, and healing in moral injury.

Moral injury is a soul struggle for many veterans. It includes a deep sense of regret, shame, and division within themselves due to morally injurious events. Spiritual practices like Centering Prayer are complementary disciplines that help veterans heal from moral injury and process embedded trauma, guilt, and shame. Contemplative practices can help with acceptance of difficult emotions and thoughts connected to past moral injury and help veterans refocus on values that are part of their community, faith, and social backgrounds. At the Loveland VA, a group of veterans are following the guidelines outlined by Contemplative Outreach for a Centering Prayer practice. The guidelines and the intended outcomes are outlined in this paper and include previously researched benefits of mindfulness and meditation-based practices for PTSD, which often co-occurs with moral injury. Veterans' feedback f…

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Hot and cold cognitive disturbances in antidepressant-free patients with major depressive disorder: a NeuroPharm study.

Background: Cognitive disturbances are common and disabling features of major depressive disorder (MDD). Previous studies provide limited insight into the co-occurrence of hot (emotion-dependent) and cold (emotion-independent) cognitive disturbances in MDD. Therefore, we here map both hot and cold cognition in depressed patients compared to healthy individuals. Methods: We collected neuropsychological data from 92 antidepressant-free MDD patients and 103 healthy controls. All participants completed a comprehensive neuropsychological test battery assessing hot cognition including emotion processing, affective verbal memory and social cognition as well as cold cognition including verbal and working memory and reaction time. Results: The depressed patients showed small to moderate negative affective biases on emotion processing outcomes, moderate increases in ratings of guilt and shame and …

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Dispositional shame and guilt as predictors of depressive symptoms and anxiety among adults with lung cancer: The mediational role of internalized stigma.

Purpose: The current study investigated whether dispositional tendencies to experience shame and guilt (i.e., shame- and guilt- proneness) were associated with higher levels of internalized stigma and, in turn, higher depressive symptoms and anxiety in adults with lung cancer. Method: Participants (N = 50, 56.0% female) were men and women who received a clinical consultation for lung cancer and completed validated questionnaires. Mediation modeling using bootstrapping was used to characterize relationships between shame- and guilt-proneness, lung cancer stigma, depressive symptoms, and anxiety. Results: Higher guilt-proneness was associated significantly with higher anxiety (b = 0.69, SE=0.28, 95% CI [0.13, 1.26]) and higher shame-proneness was associated significantly with higher depressive symptoms (b = 0.56, SE = 0.19, 95% CI [0.18, 0.93]), beyond sociodemographic, medical, and smokin…

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A meta-ethnography to understand the experience of living with urinary incontinence: 'is it just part and parcel of life?'

Background: Urinary incontinence (UI) is highly prevalent and affects the lives of many men and women. We aimed to conduct a qualitative evidence synthesis (QES) to explore the experience of living with UI and to develop a conceptual model that can help us to understand this experience, and the potential barriers to appropriate healthcare. Methods: We used the methods of meta-ethnography developed by Noblit and Hare and recently refined for larger studies. Meta-ethnography involves identifying concepts from the studies and abstracting these concepts into a line of argument. We searched for studies that explored the experience of adults with UI. We used the GRADE-CERQual framework to assess confidence in review findings. Results: We screened 2307 titles, 429 abstracts, 107 full texts and included 41 studies (36 unique samples) in the synthesis. We organised the concepts into 26 conceptual…

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Military moral injury: A concept analysis.

Moral injury is the current term describing the breaching or violation of one's moral code and has gained international research attention due to suicide linkages in military populations (Jamieson et al., Invisible wounds and suicide: Moral injury and veteran mental health. International Journal of Mental Health Nursing, 29, 105-109, 2020). Moral injury's core features are spiritual/existential conflict, shame, guilt and self-condemnation. To date, research focuses on the core features of moral injury and or the nature of events that exposed individuals to moral injury. Walker and Avant (Strategies for Theory Construction in Nursing, Prentice Hall New York, 2011) concept analysis model was used to examine the literature. The aim of this study is to enhance understanding of the defining attributes, antecedents, consequences and empirical referents of moral injury and systematically analys…

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What are the emotions underlying feeling fat and fear of weight gain?

Background: Eating disorders (EDs) are most always accompanied by cognitive-affective comorbidities, such as anxiety and depression. In addition to these common comorbidities, EDs are unique in that they are characterized by affective symptoms centered on body image and weight. Two of these primary, yet understudied, affective symptoms are feelings of fatness and fears of weight gain, which are theorized to be maintaining symptoms of EDs and are highly common in those with EDs. Despite the importance of these symptoms, there is no research characterizing which cognitive-affective symptoms contribute to feelings of fatness and fears of weight gain. Methods: The current study (N=168 individuals with an ED) tested cross-sectional and prospective models of cognitive-affect variables (negative affect, guilt, shame, fear of negative evaluation, anxiety sensitivity, and depression) to identify …

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The Internalization of Social Stigma Among Minor-Attracted Persons: Implications for Treatment.

In this article, we sought to build on existing stigmatization research by examining the extent to which internalized stigmatization (i.e., the personal adoption and incorporation of social views, operationalized as thought suppression-an avoidant coping strategy-and low psychological well-being) among minor-attracted persons (MAPs) may impact upon help-seeking behaviors and their avoidance of children. We adopted a cross-sectional anonymous survey design to recruit a sample of self-identified MAPs (N = 183) from prominent online support fora. We found that increased levels of suppression and lower levels of psychological well-being were associated with lower levels of hope about the future, but higher levels of both shame and guilt about having a sexual interest in minors. Thought suppression was not significantly associated with outcomes related to help-seeking behaviors, but did signi…

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Associations Among Exposure to Potentially Morally Injurious Experiences, Spiritual Injury, and Alcohol Use Among Combat Veterans.

Potentially morally injurious experiences (PMIEs) are events that may violate deeply held values or belief systems. Combat engagement places service members at a heightened risk for PMIE exposure. Exposure to PMIEs may elicit internal conflict between moral beliefs and experiences and, if unresolved, conflict may manifest as feelings of guilt, shame, and spiritual or existential crisis. Further, distress caused by these experiences may promote harmful behaviors (e.g., excessive alcohol use), which may serve as attempts to cope with PMIEs veterans have witnessed or participated in. The present study examined a sequential mediation model in which combat exposure was associated with alcohol use (i.e., alcohol consumption, dependence symptoms, and alcohol-related problems) via PMIE exposure and spiritual injury (e.g., alienation from and/or anger towards respective higher power) in a communi…

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Mechanisms of Moral Injury Following Military Sexual Trauma and Combat in Post-9/11 U.S. War Veterans.

Objective: Moral injury may result from perpetration-based and betrayal-based acts that violate deeply held norms; however, researchers and clinicians have little guidance about the moral injury syndrome's specific developmental pathways following morally injurious events. The present study's objective was to examine the direct and indirect pathways proposed in a frequently cited model of moral injury (1) in relation to two types of military-related traumas [experiencing military sexual trauma (MST) and combat exposure]. Methods: Secondary analyses were conducted within a sample of post-9/11 veterans at a Southwestern Veterans Health Care System (N = 310) across two time-points. Structural equation modeling tested the direct and indirect pathways from MST and combat to a PTSD-depression factor via betrayal, perpetration, guilt, and shame. Results: Betrayal accounted for the association b…

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Shame is bad and guilt is good: An examination of the impaired control over drinking pathway to alcohol use and related problems.

Tension Reduction Theory (Kushner et al., 1994) suggests alcohol is used as a means to alleviate negative affect (NA) such as shame and guilt. Shame is an internalized response in which blame is placed on the self, while guilt is not internalized and the blame is placed on the situation (Dearing et al., 2005). This study aims to investigate relationships of shame and guilt to alcohol use and problems through the mechanisms of multiple facets of impulsivity (i.e. UPPS) and impaired control over drinking (IC), which reflect behavioral control processes. The sample consisted of 419 college students (53% female). We examined direct and indirect relationships of shame and guilt on alcohol use and related problems through facets of impulsivity and IC. Shame and guilt were found to diverge (Woien et al., 2003). We found that those higher on shame-proneness used more alcohol and experienced more…

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Shame and avoidance as barriers in midwives' communication about body weight with pregnant women: A qualitative interview study.

Introduction: Excessive gestational weight gain, regardless of initial BMI, is associated with perinatal risks for both mother and offspring and contributes to obesity in women. Studies report that healthcare professionals find it difficult to communicate about weight and pregnant women perceive healthcare professionals as unconcerned, leaving many women uninformed about weight recommendations and risks. We aimed to explore how midwives approach communication about gestational weight gain recommendations, and to characterize communication barriers and facilitators. Methods: Seventeen midwives from different areas in Sweden were interviewed by a therapist using semi-structured interviews. Interviews were transcribed verbatim and analysed by three researchers using latent content analysis. Recurrent themes were identified and formulated. Results: The main theme identified in the latent par…

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Reconsidering the Differences Between Shame and Guilt.

Although most researchers maintain that shame and guilt are distinct emotions, the debate on their differences is still open. We aim to show that some of the current distinctions between shame and guilt need to be redrawn, and their adaptive and social implications need to be revisited. We suggest the following distinguishing criteria: the kind of self-evaluation involved (inadequacy versus harmfulness); one's focus on the perceived discrepancy between actual and ideal self versus one's focus on the perceived responsibility for one's fault; and consequently the different domains of self-esteem involved. Although these criteria have been in part suggested or alluded to in the relevant literature, we use and integrate them with each other in a novel way. This allows to better distinguish between shame and guilt, as well as to account for their possible coexistence or the shift from one emo…

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Indirect Relations Between Transgressive Acts and General Combat Exposure and Moral Injury.

Introduction: Moral injury describes the deleterious effects of acts of commission (e.g., killing noncombatants), omission (e.g., failing to prevent a massacre), or betrayal (i.e., by a trusted authority figure) during military service that transgress accepted behavioral boundaries and norms. Transgressive acts are proposed to lead to a guilt- and shame-based syndrome consisting of post-traumatic stress disorder (PTSD) symptoms, demoralization, self-handicapping, and self-injury. In this study, we tested a frequently cited model of moral injury and assessed the associations between potentially transgressive acts, moral injury outcomes, and guilt and fear. Additionally, we sought to clarify the relative contribution of transgressive and nontransgressive/general combat exposure to moral injury. On the basis of previous research and theory, we anticipated that the transgressive acts would b…

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Predictors of Sexual Minority Youth's Reported Suicide Attempts and Mental Health.

Lesbian, gay, and bisexual youth (LGBY) report higher rates of mental health concerns compared to heterosexual youth due to minority stressors. This study examined the interpersonal and intrapersonal variables that predict psychological distress and self-reported suicide attempts in a sample of 61 LGBY in the Mid-South, which is a highly overlooked regional area for LGBY research. Youth who lost friends when coming out were 29 times more likely to report suicide attempts, and those who experienced psychological maltreatment from caregivers were 9.5 times more likely to report a suicide attempt. Internalized heterosexism, feelings of guilt or shame, and psychological maltreatment from caregivers were significant predictors of depression and anxiety symptoms. This study highlights the importance of creating affirming spaces for LGBY, particularly in areas of the country that experience gre…

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