Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugveien 1-3, 0484 Oslo, Norway. Electronic address: http://www.nkvts.no.
Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugveien 1-3, 0484 Oslo, Norway.
Soc Sci Med. 2018 Aug;211:183-189. doi: 10.1016/j.socscimed.2018.06.002. Epub 2018 Jun 18.
Shame related to childhood violence can be detrimental to mental and physical health. Shame may erode social bonds.
In this study we tested whether loneliness is an important pathway between violence-related shame and health problems.
Individuals who reported exposure to childhood violence in a telephone interview survey in 2013 (wave one) were re-contacted 12-18 months later (wave two), as part of a more general survey of the Norwegian adult population. In total, 505 adolescent and young adult participants (mean age = 21 years) responded to questions about violence exposure, violence-related shame, loneliness, anxiety/depression symptoms, and somatic health complaints. We used counterfactually based causal mediation analysis within the structural equation modelling framework to test whether loneliness mediated a potential association between shame and health.
Shame had a profound effect on anxiety/depression symptoms and we identified both direct and indirect effects. Loneliness mediated about one third of the relationship between shame and anxiety/depression symptoms. The relationship between shame and somatic health complaints was weaker in total, but this more modest effect largely occurred indirectly through loneliness.
Our results add to the literature by highlighting the role of loneliness in the relationship between shame and health. Shame may have the potential to break down social connectedness, with a detrimental effect on health. Clinicians may find it helpful to pay close attention to the way shame regulates social interaction. Preventing social isolation and loneliness may promote good health in violence victims.
与童年时期暴力相关的羞耻感可能对身心健康有害。羞耻感可能会破坏社会关系。
本研究旨在检验孤独感是否是与暴力相关的羞耻感和健康问题之间的重要途径。
在 2013 年的电话访谈调查（第一波）中报告了童年期暴力暴露的个体，在 12-18 个月后（第二波）再次联系，作为对挪威成年人口更广泛调查的一部分。共有 505 名青少年和年轻成人参与者（平均年龄 21 岁）回答了有关暴力暴露、与暴力相关的羞耻感、孤独感、焦虑/抑郁症状和躯体健康投诉的问题。我们在结构方程建模框架内使用基于反事实的因果中介分析来检验孤独感是否在羞耻感和健康之间的潜在关联中起中介作用。
羞耻感对焦虑/抑郁症状有深远的影响，我们确定了直接和间接的影响。孤独感介导了羞耻感和焦虑/抑郁症状之间约三分之一的关系。羞耻感与躯体健康投诉的关系总体上较弱，但这种更为温和的影响主要是通过孤独感间接发生的。
我们的研究结果通过强调孤独感在羞耻感与健康之间关系中的作用，为文献增添了新的内容。羞耻感可能有破坏社会联系的潜力，对健康产生不利影响。临床医生可能会发现，密切关注羞耻感调节社会互动的方式很有帮助。预防社交孤立和孤独感可能会促进暴力受害者的身体健康。
