Castilho Paula, Pinto-Gouveia José, Duarte Joana
Cognitive and Behavioural Centre for Research and Intervention, University of Coimbra, Portugal.
Psychol Psychother. 2017 Mar;90(1):44-54. doi: 10.1111/papt.12094. Epub 2016 Jun 1.
This study explored the relation between external shame, two types of self-criticism, and depressive, anxious and stress symptoms, in a clinical sample. Specifically, we set out to test whether the impact of external shame on such symptoms would be mediated by two forms of self-criticism.
A total of 279 patients (228 female and 51 male; mean age of 28.58) with axis I and II disorders recruited from several outpatients psychiatric services in Portugal completed the Other as Shamer Scale (OAS), the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS), and the Depression, Anxiety and Stress Scale (DASS-42).
Self-criticism mediated in part the shame-psychopathological symptoms link, especially the hated self form. The alternative model where shame mediates the link between self-criticism and psychopathological symptoms was also significant. This result suggests that fear of being devalued in the minds of others has a significant impact on people's psychological well-being, and this effect can be partially explained by self-criticism.
This study highlights that inadequate self and hated self are separable types of self-criticism, because they show different patterns of association with psychopathology. Shame and self-criticism appear to mutually enhance one another, and both are associated with psychopathological symptoms. External shame and self-criticism should be a target in treatment.
External shame and self-criticism are associated with depressive, anxious, and stress symptoms, in a clinical sample. Self-criticism, especially hatred for the self, mediates the shame-psychopathological symptoms link. Shame and self-criticism should be addressed in therapeutic interventions targeting the reduction of depression, anxiety, and stress symptoms.
本研究在临床样本中探讨了外部羞耻感、两种自我批评类型与抑郁、焦虑和压力症状之间的关系。具体而言，我们着手检验外部羞耻感对这些症状的影响是否会通过两种自我批评形式进行介导。
从葡萄牙多家门诊精神科服务机构招募的279例患有轴I和轴II障碍的患者（228例女性，51例男性；平均年龄28.58岁）完成了“他人作为羞辱者量表”（OAS）、“自我批评/攻击与自我安慰形式量表”（FSCRS）以及“抑郁、焦虑和压力量表”（DASS - 42）。
自我批评部分介导了羞耻感与心理病理症状之间的联系，尤其是“讨厌自己”这种形式。羞耻感介导自我批评与心理病理症状之间联系的替代模型也具有显著性。这一结果表明，担心在他人心目中被贬低对人们的心理健康有重大影响，且这种影响可部分通过自我批评来解释。
本研究强调，不适当的自我和讨厌自己是可区分的自我批评类型，因为它们与精神病理学表现出不同的关联模式。羞耻感和自我批评似乎相互强化，且均与心理病理症状相关。外部羞耻感和自我批评应成为治疗的目标。
在临床样本中，外部羞耻感和自我批评与抑郁、焦虑和压力症状相关。自我批评，尤其是对自己的厌恶，介导了羞耻感与心理病理症状之间的联系。在旨在减轻抑郁、焦虑和压力症状的治疗干预中，应处理羞耻感和自我批评。
