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Depression in Institutionalized Adolescents: The Role of Memories of Warmth and Safeness, Shame and Self-criticism

Published online by Cambridge University Press:  23 April 2021

Sara Santos*
Affiliation:
Universidade de Coimbra (Portugal)
Maria do Céu Salvador
Affiliation:
Universidade de Coimbra (Portugal)
*
Correspondence concerning this article should be addressed to Sara Santos. Universidade de Coimbra. Faculdade de Psicologia e de Ciências da Educação. Centro de Investigação em Neuropsicologia e Intervenção Cognitivo-Comportamental (CINEICC). E-mail: saradsantos28@gmail.com

Abstract

Institutionalization is a current problem, related to several indicators of psychological maladjustment. In the same way, there are several studies that point to the role of shame and self-criticism in the development of psychopathology. Therefore, our study explored, in institutionalized adolescents, whether early memories of warmth and safeness (EMWS) were associated to depression through external shame and self-criticism. The sample included 171 institutionalized adolescents (60.2% girls; Mage = 15.56; SD = 1.49). Depression, EMWS, external shame and self-criticism were assessed. The EMWS didn’t show a direct effect on depression, exerting its effect indirectly through external shame and self-criticism. The relationship between EMWS and self-criticism was fully mediated by external shame, and the relationship between external shame and depression was fully mediated by self-criticism. In conclusion, the way the individual sees and relates to the self seems to impact on psychological adjustment and in the development of psychopathology. The fact that external shame and self-criticism fully mediated the relationship between EMWS and depression emphasizes the relevance of preventive and therapeutic approaches that aim to promote a healthier way of relating to the self.

Type
Research Article
Copyright
© Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2021

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Footnotes

Conflicts of Interest: None

Funding Statement: This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

References

Alberto, I. (2003). Como pássaros em gaiolas? Reflexões em torno da institucionalização de menores em risco. [Like birds in cages? Reflections on the institutionalization of minors at risk] In Machado, C. & Gonçalves, R. A. (Coords.), Violência e vítimas de crime [Violence and crime victims], Vol.II: Crianças (pp. 223244). Quarteto Editora.Google Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th Ed.). Author. http://doi.org/10.1176/appi.books.9780890425596CrossRefGoogle Scholar
Anderson, J., & Simonitch, B. (1981). Reactive depression in youths experiencing emancipation. Child Welfare, 60(6), 383390.Google ScholarPubMed
Andrews, B., & Hunter, E. (1997). Shame, early abuse, and course of depression in a clinical sample: A preliminary study. Cognition and Emotion, 11(4), 373381. http://doi.org/10.1080/026999397379845CrossRefGoogle Scholar
Arpini, M. D. (2003). Pensando a perspetiva institucional e a intervenção em abrigos para crianças e adolescents [Thinking about the institutional perspective and the intervention in shelters for children and adolescents]. Psicologia: Ciência e Profissão, 23(1), 7075. http://doi.org/10.1590/S1414-98932003000100010Google Scholar
Barry, C. T., Loflin, D. C., & Doucette, H. (2015). Adolescent self-compassion: Associations with narcissism, self-esteem, aggression, and internalizing symptoms in at-risk males. Personality and Individual Differences, 77, 118123. http://doi.org/10.1016/j.paid.2014.12.036CrossRefGoogle Scholar
Beck, A. (1964). Thinking and depression II: Theory and therapy. Archives of General Psychiatry, 10, 561571. https://doi.org/10.1001/archpsyc.1964.01720240015003CrossRefGoogle ScholarPubMed
Cantazaro, A., & Wei, M. (2010). Adult attachment, dependence, self-criticism, and depressive symptoms: A test of a mediational model. Journal of Personality, 78(4), 11351162. http://doi.org/10.1111/j.1467-6494.2010.00645.xGoogle ScholarPubMed
Castilho, P., Pinto-Gouveia, J., & Duarte, J. (2016). Two forms of self-criticism mediate differently the shame-psychopathological symptoms link. Psychology and Psychotherapy: Theory, Research and Practice, 90(1), 4454. http://doi.org/10.1111/papt.12094CrossRefGoogle ScholarPubMed
Cheung, M. S.-P., Gilbert, P., & Irons, C. (2004). An exploration of shame, social rank and rumination in relation to depression. Personality and Individual Differences, 36, 11431153. http://doi.org/10.1016/S0191-8869(03)00206-XCrossRefGoogle Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155159. https://doi.org/10.1037/0033-2909.112.1.155CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd Ed.). Lawrence Erlbaum Associates. https://doi.org/10.4324/9780203771587Google Scholar
Cummings, K. (2016). The impact of foster care on depression: An examination of placement type and mental health service utilization among children and adolescents [Doctoral dissertation]. The City University of New York. https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1720&context=gc_etdsGoogle Scholar
Cunha, M., Martinho, M. I., Xavier, A. M., & Espírito Santo, H. (2013). 1405—Early memories of positive emotions and its relationships to attachment styles, self-compassion and psychopathology in adolescence. European Psychiatry, 28(1), 1. http://doi.org/10.1016/S0924-9338(13)76444-7CrossRefGoogle Scholar
Cunha, M., Xavier, A. M. d. J., Cherpe, S., & Pinto-Gouveia, J. (2016). Avaliação da vergonha externa em adolescentes: ‘Other as Shamer Scale’ [Assessment of shame in adolescents: The ‘Other as Shamer’ Scale]. Psicologia: Teoria e Pesquisa, 33, 19. http://doi.org/10.1590/0102.3772e3336Google Scholar
Dickerson, S. S., Gruenewald, T. L., & Kemeny, M. E. (2004). When the social self is threatened: Shame, physiology, and health. Journal of Personality, 72, 11921216. http://doi.org/10.1111/j.1467-6494.2004.00295.xCrossRefGoogle ScholarPubMed
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 11491160. http://doi.org/10.3758/BRM.41.4.1149CrossRefGoogle ScholarPubMed
Gilbert, P. (2014). Evolutionary models: Practical and conceptual utility for the treatment and study of social anxiety disorder. In Weeks, J. (Ed.), The Wiley Blackwell handbook of social anxiety disorder. Wiley Blackwell. https://doi.org/10.1002/9781118653920.ch2Google Scholar
Gilbert, P., Baldwin, M. W., Irons, C., Baccus, J. R., & Palmer, M. (2006). Self-criticism and self-warmth: An imagery study exploring their relation to depression. Journal of Cognitive Psychotherapy, 20(2), 183200. http://doi.org/10.1891/jcop.20.2.183CrossRefGoogle Scholar
Gilbert, P., Clarke, M., Hempel, S., Miles, J., & Irons, C. (2004). Criticizing and reassuring oneself: An exploration of forms, styles and reasons in female students. Journal of Clinical Psychology, 43(1), 3150. http://doi.org/10.1348/014466504772812959CrossRefGoogle ScholarPubMed
Gilbert, P., & Irons, C. (2005). Focused therapies and compassionate mind training for shame and self-attacking. In Gilbert, P. (Ed.), Compassion, conceptualizations, research and use in psychotherapy (pp. 263325).Routledge.Google Scholar
Gilbert, P., & Irons, C. (2009). Shame, self-criticism, and self-compassion in adolescence. In. Allen, N. B. & Sheeber, L. B. (Eds.), Adolescent emotional development and the emergence of depressive disorders (pp. 195214). Cambridge University Press. https://doi.org/10.1017/CBO9780511551963.011Google Scholar
Gilbert, P., & Perris, C. (2000). Early experiences and subsequent psychosocial adaptation: An introduction. Clinical Psychology & Psychotherapy, 7, 243245. http://doi.org/10.1002/1099-0879(200010)7:4%3C243::AID-CPP254%3E3.0.CO;2-H3.0.CO;2-H>CrossRefGoogle Scholar
Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13, 353379. http://doi.org/10.1002/cpp.507CrossRefGoogle Scholar
Goss, K., Gilbert, P., & Allan, S. (1994). An exploration of shame measures–I. The Other as Shamer Scale. Personality and Individual Differences, 17, 713717. http://doi.org/10.1016/0191-8869(94)90149-XCrossRefGoogle Scholar
Hayes, A. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. The Guilford Press.Google Scholar
Instituto de Segurança Social. (2016). CASA 2015: Relatório de caracterização anual da situação de acolhimento das crianças e jovens [CASA 2015: Report of the annual characterization of institutional care of children and young people]. http://www.seg-social.pt/documents/10152/15292962/Relatorio_CASA_2016/b0df4047-13b1-46d7-a9a7-f41b93f3eae7Google Scholar
Instituto de Segurança Social. (2019). CASA 2018: Relatório de caracterização anual da situação de acolhimento das crianças e jovens [CASA 2018: Report of the annual characterization of institutional care of children and young people]. http://www.seg-social.pt/documents/10152/16662972/Relat%C3%B3rio_CASA2018/f2bd8e0a-7e57-4664-ad1e-f1cebcc6498eGoogle Scholar
Irons, C., Gilbert, P., Baldwin, M. W., Baccus, J. R., & Palmer, M. (2006). Parental recall attachment relating and self-attacking/self-reassurance: Their relationship with depression. British Journal of Clinical Psychology, 45, 297308. http://doi.org/10.1348/014466505X68230CrossRefGoogle ScholarPubMed
Kelly, A. C., & Carter, J. C. (2013). Why self-critical patients present with more severe eating disorder pathology: The mediating role of shame. British Journal of Clinical Psychology, 52, 148161. http://doi.org/10.1111/bjc.12006CrossRefGoogle ScholarPubMed
Kelly, A. C., Zuroff, D. C., & Shapira, L. B. (2009). Soothing oneself and resisting self-attacks: The treatment of two intrapersonal deficits in depression vulnerability. Cognitive Therapy and Research, 33(3), Article 301. http://doi.org/10.1007/s10608-008-9202-1CrossRefGoogle Scholar
Leal, I., Antunes, R., Passos, T., Pais-Ribeiro, J., & Maroco, J. (2009). Estudo da Escala de Depressão, Ansiedade e Stresse para Crianças (EADS-C) [A study of Depression, Anxiety and Stress Scale-children (EADS-C) ]. Psicologia, Saúde e Doenças, 10(2), 277284.Google Scholar
Lei nº 23/2017, de 23 de maio, terceira alteração à Lei n.º 147/99, de 1 de setembro, Lei de Proteção de Crianças e Jovens em Perigo [Law of protection of children and young people in danger]. (2017). Diário da República n.º 99/2017, Série I. https://dre.pt/home/-/dre/107061811/details/maximizedGoogle Scholar
Lovibond, P., & Lovibond, S. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335343. http://doi.org/10.1016/0005-7967(94)00075-uCrossRefGoogle ScholarPubMed
Luyten, P., Sabbe, B., Blatt, S. J., Meganck, S., Jansen, B., De Grave, C., Maes, F., & Corveleyn, J. (2007). Dependency and self-criticism: Relationship with major depressive disorder, severity of depression, and clinical presentation. Depression and Anxiety, 24(8), 586596. http://doi.org/10.1002/da.20272CrossRefGoogle ScholarPubMed
Marshall, M. B., Zuroff, D. C., McBride, C., & Bagby, R. M. (2008). Self-criticism predicts differential response to treatment for major depression. Journal of Clinical Psychology, 64(3), 231244. http://doi.org/10.1002/jclp.20438CrossRefGoogle ScholarPubMed
Martins, M. J., Macedo, A., Carvalho, C. B., Pereira, A. T., & Castilho, P. (2020). Are shame and self‐criticism the path to the pervasive effect of social stress reactivity on social functioning in psychosis? Clinical Psychology & Psychotherapy, 27(1), 5260. https://doi.org/10.1002/cpp.2406CrossRefGoogle ScholarPubMed
Matos, M., Pinto-Gouveia, J., Gilbert, P., Duarte, C., & Figueiredo, C. (2015). The Other as Shamer Scale–2: Development and validation of a short version of a measure of external shame. Personality and Individual Differences, 74, 611. http://doi.org/10.1016/j.paid.2014.09.037CrossRefGoogle Scholar
McMillen, J. C., Zima, B. T., Scott, L. D., Auslander, W. F., Munson, M. R., Ollie, M. T., & Spitznagel, E. L. (2005). Prevalence of psychiatric disorders among older youths in the foster care system. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 8895. http://doi.org/10.1097/01.chi.0000145806.24274.d2CrossRefGoogle ScholarPubMed
Miklowitz, D. J. (2015). Delinquency, depression, and psychosis among adolescents in foster care: What holds three heads together? Journal of American Academy of Child & Adolescent Psychiatry, 53(12), 12511253. http://doi.org/10.1016/j.jaac.2014.09.006CrossRefGoogle Scholar
Pace, T. W. W., Negi, L. T., Dodson-Lavelle, B., Ozawa-de Silva, B., Reddy, S. D., Cole, S. P., Danese, A., Craighead, L. W., & Raison, C. L. (2013). Engagement with cognitively-based compassion training is associated with reduced salivary C-reactive protein from before to after training in foster care program adolescents. Psychoneuroendocrinology, 38, 294299. http://doi.org/10.1016/j.psyneuen.2012.05.019CrossRefGoogle ScholarPubMed
Pestana, M. H., & Gageiro, J. N. (2008). Análise de dados para Ciências Sociais: A complementaridade do SPSS (5th Ed.) [Data analysis for Social Sciences: The complementarity of SPSS (5th Ed.)]. Edições Sílabo.Google Scholar
Pinto-Gouveia, J., Castilho, P., Matos, M., & Xavier, A. (2013). Centrality of shame memories and psychopathology: The mediator effect of self-criticism. Clinical Psychology: Science and Practice, 20(3), 323334. https://doi.org/10.1111/cpsp.12044Google Scholar
Reddy, S. D., Negi, L. T., Dodson-Lavelle, B., Ozawa-de Silva, B., Pace, T. W. W., Cole, S. P., Raison, C. L., & Craighead, L. W. (2013). Cognitive-based compassion training: A promising prevention strategy for at-risk adolescents. Journal of Child and Family Studies, 22, 219230. http://doi.org/10.1007/s10826-012-9571-7CrossRefGoogle Scholar
Richter, A., Gilbert, P., & McEwan, K. (2009). Development of an Early Memories of Warmth and Safeness Scale and its relationship to psychopathology. Psychology and Psychotherapy: Theory, Research and Practice, 82, 171184. http://doi.org/10.1348/147608308X395213CrossRefGoogle ScholarPubMed
Ross, N. D., Kaminski, P. L., & Herrington, R. (2019). From childhood emotional maltreatment to depressive symptoms in adulthood: The roles of self-compassion and shame. Child Abuse & Neglect, 92, 3242. https://doi.org/10.1016/j.chiabu.2019.03.016CrossRefGoogle ScholarPubMed
Salazar, A. M., Keller, T. E., & Courtney, M. E. (2011). Understanding social support’s role in the relationship between maltreatment and depression in youth with foster care experience. Child Maltreatment, 16(2), 102113. http://doi.org/10.1177/1077559511402985CrossRefGoogle ScholarPubMed
Santos, S., & Salvador, M. C. (2018). Bem-me-quer(o), mal-me-quer(o): Ajustamento psicológico de adolescentes institucionalizados e não institucionalizados [I love me, I love me not: Psychological adjustment in institutionalized and non-institutionalized adolescents]. Revista de Psicologia da Criança e do Adolescente, 9(1), 83102.Google Scholar
Shahar, B., Doron, G., & Szepsenwol, O. (2014). Childhood maltreatment, shame-proneness and self-criticism in social anxiety disorder: A sequential mediational model. Clinical Psychology & Psychoterapy, 22(6), 570579. https://doi.org/10.1002/cpp.1918bgt6CrossRefGoogle ScholarPubMed
Silva, M., & Bizarro, L. (2011). O bem-estar subjetivo de adolescentes institucionalizados [The subjective well-being of institutionalized adolescents]. [Doctoral dissertation]. Faculdade de Psicologia da Universidade de Lisboa, Portugal.Google Scholar
Silva, C., & Salvador, M. C. (2010). A Escala das Formas de Auto-Criticismo e de Auto-Traquilização (FSCRS): Características psicométricas na população adolescente [Forms of Self-Criticising & Self-Reassuring Scale (FSCRS): Psychometric characteristics in the adolescent population]. [Unpublished manuscript]. Faculdade de Psicologia e Ciências da Educação da Universidade de Coimbra, Portugal.Google Scholar
Simões, M. (1994). Investigações no âmbito da aferição nacional do teste das matrizes progressivas coloridas de Raven (M.P.C.R.) [Investigation in the context of the national measurement of the Raven’s Coloured Progressive Matrices test] [Doctoral dissertation]. Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra, Portugal.Google Scholar
Stevens, S. (2009). An examination of mental health factors related to risk-taking behaviors in children and adolescents [Doctoral dissertation]. Department of Psychology West Virginia University.Google Scholar
Stoner, A. M., Leon, S. C., & Fuller, A. K. (2015). Predictors of reduction in symptoms of depression for children and adolescents in foster care. Journal of Child and Family Studies, 24, 784797. http://doi.org/10.1007/s10826-013-9889-9CrossRefGoogle Scholar
Strecht, P. (1997). Crescer vazio: Repercussões psíquicas do abandono, negligência e maus-tratos em crianças e adolescentes [Growing up empty: Psychic repercussions of abandonment, neglect and abuse in children and adolescents]. Author.Google Scholar
Szabó, M. (2010). The short version of the Depression Anxiety Stress Scales (DASS–21): Factor structure in a young adolescent sample. Journal of Adolescence, 33, 18. http://doi.org/10.1016/j.adolescence.2009.05.014CrossRefGoogle Scholar
Vagos, P., da Silva, D. R., Brazão, N., Rijo, D., & Gilbert, P. (2016). The Early Memories of Warmth and Safeness Scale for Adolescents: Cross-Sample validation of the complete and brief versions. Clinical Psychology & Psychoterapy, 24(3), 793804. http://doi.org/10.1002/cpp.2059CrossRefGoogle ScholarPubMed
Whelton, W. J., & Greenberg, L. S. (2005). Emotion in self-criticism. Personality and Individual Differences, 38, 15831595. https://doi.org/10.1016/j.paid.2004.09.024CrossRefGoogle Scholar