Nicole J LeBlanc1, Emma R Toner2, Emily B O'Day3, Cynthia W Moore4, Luana Marques5, Donald J Robinaugh6, Richard J McNally7. 1. 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. Electronic address: njleblanc@mgh.harvard.edu. 2. Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, One Bowdoin Square, 6th Floor, Boston, MA 02114, USA. 3. Department of Psychology, Temple University, 1701 North 13th Street, Office 417, Philadelphia, PA 19122, USA. 4. Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, 55 Fruit Street, YAW 6900, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, One Bowdoin Square, 6th Floor, Boston, MA 02114, USA. 5. Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, One Bowdoin Square, 6th Floor, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, One Bowdoin Square, 6th Floor, Boston, MA 02114, USA; Community Psychiatry Program for Research in Implementation and Dissemination of Evidence-Based Treatments, Massachusetts General Hospital, One Bowdoin Square, 6th Floor, Boston, MA 02114, USA. 6. Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, One Bowdoin Square, 6th Floor, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, One Bowdoin Square, 6th Floor, Boston, MA 02114, USA. 7. Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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: Limitations include the cross-sectional design and modest sample size. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: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. RESULTS: 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: Limitations include the cross-sectional design and modest sample size. CONCLUSIONS: 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.
Authors: Maja O'Connor; Mathias Lasgaard; Lene Larsen; Maja Johannsen; Marie Lundorff; Ingeborg Farver-Vestergaard; Paul A Boelen Journal: J Affect Disord Date: 2019-03-18 Impact factor: 4.839