Shame: associations with childhood maltreatment and mental health

Abstract

Research consistently reports a relationship between childhood maltreatment and the experience of psychological distress in adulthood. More recently, researchers have
sought to identify the emotional consequences of these experiences. The current literature review focuses on the experience of shame. In particular, research is presented which demonstrates how childhood maltreatment, especially
psychological abuse, has been associated with the experience of internalised shame. Furthermore, research is presented demonstrating an association between internalised shame the experience of psychological distress in adulthood. A burgeoning evidence base illustrates how shame partially mediates the relationship
between childhood maltreatment and the experience of psychological distress in adulthood, although the review concludes that this research remains limited, and the
models presented require further investigation to broaden the understanding of the role of shame in the relationship between childhood maltreatment and psychopathology.

The empirical paper explores the associations between childhood maltreatment and internalised shame in a sample of participants with a diagnosis of bipolar disorder (BD; n = 35), compared with a control group of participants with no psychiatric diagnoses (n = 35). Participants completed measures of maltreatment, internalised shame, and resource loss and gain. Participants in the BD group
reported significantly higher levels of internalised shame, resource loss, and most sub-types of childhood maltreatment, compared with participants in the control
iii group. Internalised shame was significantly correlated with childhood emotional abuse and neglect, even when controlled for the effect of low mood and mania. The
theoretical and clinical implications are discussed, and directions for further investigation are indicated.

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