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Social anxiety disorder and shame cognitions in psychosis

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Michail, Maria and Birchwood, M. J. (2013) Social anxiety disorder and shame cognitions in psychosis. Psychological Medicine, 43 (1). pp. 133-142. doi:10.1017/S0033291712001146 ISSN 0033-2917.

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Official URL: http://dx.doi.org/10.1017/S0033291712001146

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Abstract

BACKGROUND:
Social anxiety disorder (SAD) is surprisingly prevalent among people with psychosis and exerts significant impact on social disability. The processes that underlie its development remain unclear. The aim of this study was to investigate the relationship between shame cognitions arising from a stigmatizing psychosis illness and perceived loss of social status in co-morbid SAD in psychosis.
METHOD:
This was a cross-sectional study. A sample of individuals with SAD (with or without psychosis) was compared with a sample with psychosis only and healthy controls on shame proneness, shame cognitions linked to psychosis and perceived social status.
RESULTS:
Shame proneness (p < 0.01) and loss of social status (p < 0.01) were significantly elevated in those with SAD (with or without psychosis) compared to those with psychosis only and healthy controls. Individuals with psychosis and social anxiety expressed significantly greater levels of shame (p < 0.05), rejection (p < 0.01) and appraisals of entrapment (p < 0.01) linked to their diagnosis and associated stigma, compared to those without social anxiety.
CONCLUSIONS:
These findings suggest that shame cognitions arising from a stigmatizing illness play a significant role in social anxiety in psychosis. Psychological interventions could be enhanced by taking into consideration these idiosyncratic shame appraisals when addressing symptoms of social anxiety and associated distress in psychosis. Further investigation into the content of shame cognitions and their role in motivating concealment of the stigmatized identity of being 'ill' is needed.

Item Type: Journal Article
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Social phobia , Psychoses, Shame
Journal or Publication Title: Psychological Medicine
Publisher: Cambridge University Press
ISSN: 0033-2917
Official Date: 1 January 2013
Dates:
DateEvent
1 January 2013Published
21 May 2012Available
29 April 2012Accepted
31 May 2011Submitted
Volume: 43
Number: 1
Page Range: pp. 133-142
DOI: 10.1017/S0033291712001146
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDNational Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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