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Exploring the Associations between Social Rank and External Shame with Experiences of Psychosis

Published online by Cambridge University Press:  24 September 2015

Lisa Wood*
Affiliation:
North East London Foundation Trust, UK
Chris Irons
Affiliation:
East London Foundation Trust, UK
*
Reprint requests to Lisa Wood, Inpatient and Acute Directorate, North East London Foundation Trust, Goodmayes Hospital, Barley Lane, Ilford IG3 8XJ, UK. E-mail: lisawood3@nhs.net

Abstract

Background: Low social rank and external shame have been found to be significantly associated with anxiety and depression. However, their relevance to experiences of psychosis has rarely been explored. Aims: This study aims to examine the relationship of social rank and external shame to personal recovery, depression and positive symptoms in psychosis. Method: A cross sectional correlational design was adopted to examine the relationship between all variables. Fifty-two service users, aged between 18 to 65 years, with experiences of psychosis were recruited for the study. Participants were administered outcome measures examining social rank, external shame, positive symptoms of psychosis, depression and personal recovery. Multiple regression analyses were conducted on the data. Results: Significant correlations were found between all variables. Low social rank was significantly associated with lower reported personal recovery, and higher levels of external shame and depression symptomology. The relationship between external shame and positive symptoms of psychosis and personal recovery was found to be mediated by participants’ level of depression. Conclusion: Findings suggest that social rank and external shame are relevant to those who experience psychosis. Therapeutic approaches may need to focus on perceptions of social rank and external shame in working with experiences of psychosis.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

Addington, D., Addington, J. and Maticka-Tyndale, E. (1994). Specificity of the Calgary Depression Scale for schizophrenics. Schizophrenia Research, 11, 239244.CrossRefGoogle ScholarPubMed
Allan, S. and Gilbert, P. (1995). A social comparison scale: psychometric properties and relationship to psychopathology. Personal and Individual Differences, 19, 293299.CrossRefGoogle Scholar
Allison, G., Harrop, C. and Ellett, L. (2013). Perception of peer group rank of individuals with early psychosis. British Journal of Clinical Psychology, 52, 111.CrossRefGoogle Scholar
Baron, R. M. and Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 11731182.CrossRefGoogle ScholarPubMed
Birchwood, M., Meaden, A., Trower, P., Gilbert, P. and Plaistow, J. (2000). The power and omnipotence of voices: subordination and entrapment by voices and significant others. Psychological Medicine, 2, 337344.CrossRefGoogle Scholar
Braehler, C., Gumley, A., Harper, J., Wallace, S., Norrie, J. and Gilbert, P. (2013). Exploring change processes in compassion focused therapy in psychosis: results of a feasibility randomized controlled trial. British Journal of Clinical Psychology, 52, 199214.CrossRefGoogle ScholarPubMed
Buckley, P. F., Miller, B. J., Lehrer, D. S. and Castle, D. J. (2009). Psychiatric comorbidities and schizophrenia. Schizophrenia Bulletin, 35, 383402.CrossRefGoogle ScholarPubMed
Chadwick, P. (1997). Recovery from psychosis: learning more from patients. Journal of Mental Health, 6, 577588.CrossRefGoogle Scholar
Cheung, M. S., Gilbert, P. and Irons, C. (2004). An exploration of shame, social rank and rumination in relation to depression. Personal and Individual Differences, 36, 11431153.CrossRefGoogle Scholar
Cohen, J. and Cohen, P. (1975). Applied Multiple Regression/Correlation Analysis for the Behavioural Sciences. Hillsdale, NJ: Erlbaum.Google Scholar
Drayton, M., Birchwood, M. and Trower, P. (1998). Early attachment experience and recovery from psychosis. British Journal of Clinical Psychology, 37, 269284.CrossRefGoogle ScholarPubMed
Fox, J. R., Gray, N. S. and Lewis, H. (2004). Factors determining compliance with command hallucinations with violent content: the role of social rank, perceived power of the voice and voice malevolence. Journal of Forensic Psychiatry and Psychology, 15, 511531.CrossRefGoogle Scholar
Freeman, D., Garety, P., Bebbington, P., Smith, B., Rollinson, R., Fowler, D., et al. (2005). Psychological investigation of the structure of paranoia in a non-clinical population. British Journal of Psychiatry, 186, 427435.CrossRefGoogle Scholar
Garety, P. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31, 189195.CrossRefGoogle ScholarPubMed
Gilbert, P. (2000). The relationship of shame, social anxiety and depression: the role of evaluation of social rank. Clinical Psychology and Psychotherapy, 7, 174189.3.0.CO;2-U>CrossRefGoogle Scholar
Gilbert, P. (2010). Compassion Focused Therapy. Hove: Routledge.CrossRefGoogle Scholar
Gilbert, P. and Allan, S. (1998). The role of defeat and entrapment (arrested fight) in depression: an exploration of an evolutionary view. Psychological Medicine, 28, 584597.CrossRefGoogle Scholar
Gilbert, P., Birchwood, M., Gilbert, J., Trower, P., Hay, J., Murphy, B., et al. (2001). An exploration of evolved mental mechanisms for dominant and subordinate behaviour in relation to auditory hallucinations in schizophrenia and critical thoughts in depression. Psychological Medicine, 31, 11171127.CrossRefGoogle ScholarPubMed
Gilbert, P., Boxall, M., Cheung, M. and Irons, C. (2005). The relation of paranoid ideation and social anxiety in a mixed clinical population. Clinical Psychology and Psychotherapy, 12, 124133.CrossRefGoogle Scholar
Gilbert, P. and Miles, J. (2000). Sensitivity to social put-down: its relationship to perceptions of social rank, shame, social anxiety, depression, anger and self-other blame. Personality and Individual Differences, 29, 757774.CrossRefGoogle Scholar
Goss, K., Gilbert, P. and Allan, S. (1994). An exploration of shame measures: I: the “Other as Shamer” scale. Personality and Individual Differences, 17, 713717.CrossRefGoogle Scholar
Green, S. B. (1991). How many subjects does it take to do a regression analysis? Multivariate Behavioral Research, 26, 499510.CrossRefGoogle Scholar
Gumley, A., Braehler, C., Laithwaite, H. M., MacBeth, A. and Gilbert, P. (2010). A compassion focused model of recovery after psychosis. International Journal of Cognitive Therapy, 3, 186201.CrossRefGoogle Scholar
IBM Corporation (2011). IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.Google Scholar
Janssen, I., Versmissen, D., Campo, J. A., Myin-Germeys, I., Van Os, J. and Krabbendam, L. (2006). Attribution style and psychosis: evidence for an externalizing bias in patients but not individuals at high risk. Psychological Medicine, 36, 771778.CrossRefGoogle Scholar
Jauhar, S., McKenna, P. J., Radua, J., Fung, E., Salvador, R. and Laws, K. (2014). Cognitive-behavioural therapy for the symptoms of schizophrenia: systematic review and meta-analysis with examination of potential bias. British Journal of Psychiatry, 204, 2029.CrossRefGoogle ScholarPubMed
Kay, S. R., Fiszbein, A. and Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261276.CrossRefGoogle ScholarPubMed
Krabbendam, L., Janssen, I., Bijl, R. V., Vollerburgh, W. A. M. and Van Os, J. (2002). Neuroticism and low self-esteem as risk factors for psychosis. Social Psychiatry and Psychiatric Epidemiology, 37, 16.CrossRefGoogle ScholarPubMed
Laithwaite, H. M., O’Hanlon, M., Collins, P., Doyle, P., Abraham, L., Porter, S., et al. (2009). Recovery After Psychosis (RAP): a compassion focused programme for individuals residing in high security settings. Behavioural and Cognitive Psychotherapy, 37, 511526.CrossRefGoogle Scholar
Matos, M., Pinto-Gouveia, J. and Gilbert, P. (2012). The effect of shame and shame memories on paranoid ideation and social anxiety. Clinical Psychology and Psychotherapy. doi: 10.1002/cpp.1766 Google Scholar
Mayhew, S. L. and Gilbert, P. (2008). Compassionate mind training with people who hear malevolent voices: a case series report. Clinical Psychology and Psychotherapy, 15, 113118.CrossRefGoogle Scholar
Morrison, A. P. (2001). The interpretation of intrusions in psychosis: an integrative cognitive approach to hallucinations and delusions. Behavioural and Cognitive Psychotherapy, 29, 257276.CrossRefGoogle Scholar
Morrison, A., Hutton, P., Wardle, M., Spencer, H., Barratt, S., Brabban, A., et al. (2012). Cognitive therapy for people with a schizophrenia spectrum diagnosis not taking antipsychotic medication: an exploratory trial. Psychological Medicine, 42, 10491056.CrossRefGoogle Scholar
Mortimer, A. M. (2007). Symptom rating scales and outcome in schizophrenia. The British Journal of Psychiatry, 191 (50), s714. doi: 10.1192/bjp.191.50.s7 CrossRefGoogle Scholar
Neil, S. T., Kilbride, M., Pitt, L., Welford, M., Nothard, S., Sellwood, W., et al. (2009). The Questionnaire about the Process of Recovery (QPR): a research instrument developed in collaboration with service users. Psychosis, 1, 145155.CrossRefGoogle Scholar
NICE (2014). Psychosis and Schizophrenia in Adults: treatment and management. London: National Institute of Clinical Excellence.Google Scholar
Pinto-Gouveia, J., Matos, M., Castilho, P. and Xavier, A. (2012). Differences between depression and paranoia: the role of emotional memories, shame and subordination. Clinical Psychology and Psychotherapy. doi: 10.1002/cpp.1818 Google ScholarPubMed
Pitt, L., Kilbride, M., Nothard, S., Welford, M. and Morrison, A. P. (2007). Researching recovery from psychosis: a user-led project. Psychiatry Bulletin, 31, 5560.CrossRefGoogle Scholar
Price, J., Sloman, L., Gardner, R. Jr, Gilbert, P. and Rohde, P. (1994). The social competition hypothesis of depression. British Journal of Psychiatry, 164, 309315.CrossRefGoogle ScholarPubMed
Priebe, S., Richardson, M., Cooney, M., Adedeji, O. and McCabe, R. (2011). Does the therapeutic relationship predict outcomes of psychiatric treatment in patients with psychosis? A systematic review. Psychotherapy and Pychosomatics, 80, 7077.CrossRefGoogle ScholarPubMed
Silverstein, S. M. and Bellack, A. S. (2008). A scientific agenda for the concept of recovery as it applies to schizophrenia. Clinical Psychology Review, 28, 11081124.CrossRefGoogle ScholarPubMed
Tabachnick, B. G. and Fidell, L. S. (1996). Using Multivariate Statistics. New York: Harper Collins.Google Scholar
Wood, L., Price, J., Morrison, A. P. and Haddock, G. (2010). Conceptualisation of recovery from psychosis: a service-user led perspective. The Psychiatrist, 34, 465470.CrossRefGoogle Scholar
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