Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA; Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, One Bowdoin Square, 6th Floor, Boston, MA 02114, USA.
Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, One Bowdoin Square, 6th Floor, Boston, MA 02114, USA.
J Affect Disord. 2020 Feb 15;263:405-412. doi: 10.1016/j.jad.2019.11.164. Epub 2019 Dec 2.
Self-blame following bereavement has been implicated in the development of post-loss psychopathology. However, prior studies have not distinguished between the emotions of shame versus guilt. This study examined the cross-sectional associations among bereavement-related shame, bereavement-related guilt, and two mental disorders that commonly arise after bereavement: complicated grief and depression. In addition, exploratory analyses examined the associations between bereavement-related pride and post-loss psychopathology.
Participants included 92 bereaved adults who experienced the death of a family member at least one year prior to the study. Participants completed self-report measures of complicated grief symptoms, depression symptoms, shame, guilt, and pride.
Shame and guilt were positively correlated with complicated grief and depression symptoms. When controlling for their shared variance, only shame remained a significant predictor of post-loss psychopathology. Follow-up analyses indicated that the effect of guilt on psychopathology depended on the level of shame, and vice versa. At low shame, guilt predicted psychopathology; however guilt did not predict psychopathology at moderate to high shame. At low to moderate guilt, shame predicted psychopathology; however shame did not predict psychopathology at high guilt. Pride negatively predicted depression symptoms, but not complicated grief symptoms, when we controlled for shame and guilt.
Limitations include the cross-sectional design and modest sample size.
Our analyses identify shame as the more pathogenic moral emotion for bereaved adults. However, whereas guilt in the absence of shame is often considered adaptive, we found that guilt predicted greater psychological distress at low levels of shame in this sample.
丧亲后的自责与丧亲后心理病理学的发展有关。然而,先前的研究并没有区分羞耻感和内疚感。本研究考察了与丧亲相关的羞耻感、与丧亲相关的内疚感与两种常见于丧亲后的精神障碍(复杂悲伤和抑郁)之间的横断面关联。此外,探索性分析还考察了与丧亲相关的自豪感与丧亲后心理病理学之间的关联。
参与者包括 92 名丧亲成年人,他们在研究前至少一年经历了家庭成员的死亡。参与者完成了复杂悲伤症状、抑郁症状、羞耻感、内疚感和自豪感的自我报告测量。
羞耻感和内疚感与复杂悲伤和抑郁症状呈正相关。在控制它们的共同方差后,只有羞耻感仍然是丧亲后心理病理学的一个显著预测因素。后续分析表明,内疚感对心理病理学的影响取决于羞耻感的水平,反之亦然。在低羞耻感时,内疚感预测心理病理学;然而,在中至高羞耻感时,内疚感并不预测心理病理学。在低至中高内疚感时,羞耻感预测心理病理学;然而,在高内疚感时,羞耻感并不预测心理病理学。自豪感负向预测抑郁症状,但不能预测复杂悲伤症状,当我们控制羞耻感和内疚感时。
局限性包括横断面设计和样本量较小。
我们的分析确定羞耻感是丧亲成年人更具致病性的道德情感。然而,在缺乏羞耻感的情况下,内疚感通常被认为是适应性的,而我们发现,在本样本中,当羞耻感较低时,内疚感预测了更大的心理困扰。