Skip to main content
SpringerLink
Log in

The Trauma Related Shame Inventory: Measuring Trauma-Related Shame Among Patients with PTSD

  • Published:
Journal of Psychopathology and Behavioral Assessment Aims and scope Submit manuscript

Abstract

This article proposes a new measurement instrument of trauma-related shame. The purpose of this study is to investigate the psychometric properties of the scores derived from the Trauma Related Shame Inventory (TRSI) by means of generalizability theory (G-theory). The psychometric analyses are based on a sample of 50 patients in treatment for Post-traumatic Stress Disorder (PTSD). The results provided supporting construct validity evidence for the interpretation of TRSI as a homogeneous construct. The 24-item version of internal and external referenced shame yielded generalizability and dependability coefficients of .874 and .868, respectively. The distinction between shame and guilt was supported by a high generalizability coefficient of .812 for the difference scores between TRSI and guilt cognition scale. Further validity evidence was provided by a positive relationship between TRSI and a) self-judgment subscale in Self-Compassion Scale (SCS; Neff Self and Identity 2:(3), 223–250, 2003) and b) Beck Depression Inventory (Beck Steer and Brown 1996a) when controlled for guilt. The results of the present study provided promising support for using the 24-item version of TRSI in both clinical research and practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Andrews, B., Qian, M., & Valentine, J. (2002). Predicting depressive symptoms with a new measure of shame: the experience of shame scale. British Journal of Clinical Psychology, 41, 29–42.

    Article  PubMed  Google Scholar 

  • Arntz, A., Tiesema, M., Kindt, M. (2007). Treatment of PTSD: a comparison of imaginal exposure with and without imagery rescripting. Journal of Behavior Therapy and Experimental Psychology, 38(4), 345–370.

    Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996a). Manual for beck depression inventory-II. San Antonio: Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. (1996b). Comparison of beck depression inventories IA and II in psychiatric outpatients. Journal of Personality Assessment, 67, 588–597.

    Article  PubMed  Google Scholar 

  • Beck, J. G., McNiff, J., Clapp, J. D., Olsen, S. A., Avery, M. L., & Hagewood, J. H. (2011). Exploring negative emotion in women experiencing intimate partner violence: shame, guilt, and PTSD. Behavioral Therapy, 42, 740–750.

    Article  Google Scholar 

  • Benson, J., & Hagtvet, K. A. (1996). The interplay among design, data analysis and theory in the measurement of coping. In S. Norman, Endler, & Z. Moshe (Eds.), Handbook of coping: Theory, research, applications (Vol. 5, pp. 83–106). New York: Wiley.

    Google Scholar 

  • Blatt, S. J., D’Afflitti, J., & Quinlan, D. (1976). Experiences of depression in young adults. Journal of Abnormal Psychology, 65, 383–389.

    Article  Google Scholar 

  • Blum, A. (2008). Shame and guilt, misconceptions and controversies: a critical review of the literature. Traumatology, 14, 91–102.

    Article  Google Scholar 

  • Brennan, R. L. (1983). Elements of generalizability theory. Iowa City: American College Testing.

    Google Scholar 

  • Brennan, R. L. (1992a). Generalizability theory. Educational Measurement: Issues and Practice, 11, 225–232.

    Article  Google Scholar 

  • Brennan, R. L. (1992b). Elements of generalizability theory. Iowa City: ACT.

    Google Scholar 

  • Brennan, R. L. (1994). Variance Components in Generalizability Theory. In R. R. Cecil (Ed.), Cognititive assessment – a multidisciplinary perspective (pp. 175–206). New York: Plenum Press.

    Google Scholar 

  • Brennan, R. L. (1999). Manual for mGENOVA. Iowa testing programs occasional papers number 47.

  • Brennan, R. L. (2001a). Manual for urGENOVA. Iowa City: Iowa Testing Programs, University of Iowa.

    Google Scholar 

  • Brennan, R. L. (2001b). Generalizability theory. New York: Springer.

    Book  Google Scholar 

  • Brennan, R. L. (2003). Coefficients and Indices in Generalizability Theory. Center for Advanced Studies in Measurement and Assessment, CASMA Research Report, 1, 1–44.

  • Brennan, R. L. (2010). Generalizability theory and classical test theory. Applied Measurement in Education, 24, 1–21.

    Article  Google Scholar 

  • Brennan, R. L., Gao, X., & Colton, D. A. (1995). Generalizability analyses of work keys listening and writing tests. Educational and Psychological Measurement, 55(2), 157–176.

    Article  Google Scholar 

  • Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103, 670–686.

    Article  PubMed  Google Scholar 

  • Cook, D. R. (1988). Measuring shame: the internalized shame scale. Alcoholism Treatment Quarterly, 4, 197–215.

    Article  Google Scholar 

  • Cook, D. R. (1989). Internalized Shame Scale (ISS). Stout: University of Wisconsin.

    Google Scholar 

  • Cook, D. R. (1991). Shame, attachment and addictions: implications for family therapists. Contemporary Family Therapy, 13, 405–419.

    Article  Google Scholar 

  • Cook, D. R. (1993). The internalized shame scale manual. Channel Press, Menomonie, WI (Available from author; Rt. 7, Box 270a, Menomonie, WI 54751, U.S.A.).

  • Cronbach, L. J., & Shavelson, R. J. (2004). My current thoughts on coefficient alpha and successor procedures. Educational and Psychological Measurement, 64, 391–418.

    Article  Google Scholar 

  • Cronbach, L. J., Gleser, G. C., Nanda, H., & Rajaratnam, N. (1972). The dependability of behavioral measurements: Theory of generalizability for scores and profiles. New York: Wiley.

    Google Scholar 

  • DePrince, A. P., Zurbriggen, E., Chu, A. T., & Smart, L. (2010). Development of the Trauma Appraisal Questionnaire. Journal of Aggression, Maltreatment, and Trauma, 19, 275–299.

    Google Scholar 

  • Donders, J. (1997). Using a short form of the WISC-III: sinful or Smart? Child Neuropsychology, 7, 99–103.

    Article  Google Scholar 

  • Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behavioral Research Therapy, 38, 319–345.

    Article  Google Scholar 

  • Eikeland, H.-M. (1973). Generalizability estimates for differenece scores: An aspect of the construct validity of tests. Departmental Research Report, University of Oslo. https://bora.uib.no/bitstream/handle/1956/4803/Generalizability.pdf

  • Feldt, L. S., Brennan, R. L. (1989). Reliability. In R. L. Linn (Ed.), Educational Measurement (3rd ed) (pp. 105–146).

  • Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459–474.

    Article  Google Scholar 

  • Gilbert, P. (1997). The evolution of social attractiveness and its role in shame, humiliation, guilt and therapy. British Journal of Medicational Pscychology, 70, 113–147.

    Article  Google Scholar 

  • Gilbert, P. (2000). The relationship of shame, social anxiety and depression: the Role of the evaluation of social rank. Clinical Psychology and Psychotherapy, 7, 174–189.

    Google Scholar 

  • Gilbert, P., & Andrews, B. (1998). Shame: Interpersonal behavior, psychopathology, and culture (pp. 99–125). New York: Oxford University Press.

    Google Scholar 

  • Gilbert, P., & Miles, J. N. V. (2000). Sensitivity to putdown: its relationship to perceptions of shame, social anxiety, depression, anger and self–other blame. Personality and Individual Differences, 29, 757–774.

    Article  Google Scholar 

  • Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13, 353–379.

    Article  Google Scholar 

  • Greenberg, L. S., & Paivio, S. C. (1997). Working with the emotions in psychotherapy. New York: Guilford.

    Google Scholar 

  • Grunert, B. K., Smucker, M. R., Weis, J., & Rusch, M. D. (2003). When prolonged exposure fails: adding an imagery-based cognitive restructuring component in the treatment of industrial accident victims suffering from PTSD. Cognitive and Behavioral Practice, 10(4), 333–346.

    Article  Google Scholar 

  • Grunert, B. K., Weis, J. M., Smucker, M. R., & Christianson, H. F. (2007). Imagery rescripting and reprocessing therapy after failed prolonged imaginal exposure for post-traumatic stress disorder following industrial injury. Journal of Behavior Therapy and Experimental Psychiatry, 38, 317–328.

    Article  PubMed  Google Scholar 

  • Harman, R., & Lee, D. (2010). The role of shame and self-critical thinking in the development and maintenance of current threat in post-traumatic stress disorder. Clinical Psychology and Psychotherapy, 17, 13–24.

    PubMed  Google Scholar 

  • Holmes, E. A., Grey, N., & Young, K. A. D. (2005). Intrusive images and “hotspots” of trauma memories in posttraumatic stress disorder: an exploratory investigation of emotions and cognitive themes. Journal of Behavior Therapy and Experimental Psychiatry, 36(1), 3–17.

    Article  PubMed  Google Scholar 

  • Kane, M. T. (1982). A sampling model for validity. Applied Psychological Measurement, 6, 125–160.

    Article  Google Scholar 

  • Kane, M. T. (2001). Current concerns in validity theory. Journal of Educational Measurement, 38, 319–342.

    Article  Google Scholar 

  • Kubany, E. S., & Manke, F. P. (1995). Cognitive therapy for trauma-related guilt: conceptual bases and treatment outlines. Cognitive and Behavioural Practice, 2, 27–61.

    Google Scholar 

  • Kubany, E. S., & Watson, S. B. (2003). Guilt: elaboration of a multidimensional model. Psychological Record, 53, 51–90.

    Google Scholar 

  • Kubany, E. S., Haynes, S. N., Abueg, F. R., Manke, F. P., Brennan, J. M., & Stahura, C. (1996). Development and Validation of the Trauma-Related Guilt Inventory (TRGI). Psychological Assessment, 8, 428–444.

    Article  Google Scholar 

  • Lee, D. A. (2005). The perfect nurturer: A model to develop a compassionate mind within the context of cognitive therapy. In P. Gilbert (Ed.), Compassion: Conceptualisations, research and use in psychotherapy (pp. 326–351). Hove, UK: Routledge.

  • Lee, D. A., Scragg, P., & Turner, S. (2001). The role of shame and guilt in traumatic events: a clinical model of shame-based and guilt-based PTSD. British Journal of Medical Psychology, 74, 451–466.

    Article  PubMed  Google Scholar 

  • Leskela, J., Dieperink, M., & Thuras, P. (2002). Shame and posttraumatic stress disorder. Journal of Traumatic Stress, 15, 223–226.

    Article  PubMed  Google Scholar 

  • Lewis, H. B. (1971). Shame and guilt in neurosis. Psychoanalytic Review, 58, 419–438.

    PubMed  Google Scholar 

  • Lewis, M. (1995). Shame–the exposed self. New York: The Free Press.

    Google Scholar 

  • Lindsay-Hartz, J. (1984). Contrasting experiences of shame and guilt. American Behavioral Scientist, 27, 689–704.

    Article  Google Scholar 

  • Macdonald, J., & Morley, I. (2001). Shame and non-disclosure: a study of the emotional isolation of people referred to psychotherapy. British Journal of Medical Psychology, 74, 1–21.

    Article  Google Scholar 

  • Martens, W. (2005). A multicomponential model of shame. Journal for the Theory of Social Behaviour, 35, 399–415.

    Article  Google Scholar 

  • Matos, M., & Pinto-Gouveia, J. (2010). Shame as a traumatic memory. Clinical Psychology & Psychotherapy, 17, 299–312.

    Google Scholar 

  • Messick. (1995). Standards of validity and the validity of standards in performance asessment. Educational Measurement Issues and Practice, 14, 5–8.

    Article  Google Scholar 

  • Nathanson, D. L. (1987). The many faces of shame. New York: The Guilford Press.

    Google Scholar 

  • Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250.

    Article  Google Scholar 

  • Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). New York: McGraw-Hill.

    Google Scholar 

  • Orth, U., Berking, M., & Burkhardt, S. (2006). Selfconscious emotions and depression: rumination explains why shame but not guilt is maladaptive. Personality and Social Psychology Bulletin, 32, 1608–1619.

    Google Scholar 

  • Platt, M., & Freyd, J. (2012). Trauma and negative underlying assumptions in feelings of shame: anexploratory study. Psychological Trauma Theory Research Practice and Policy, 4, 370–378.

    Article  Google Scholar 

  • Power, M., & Dalgleish, T. (2008). Cognition and Emotion – From Order to Disorder, second edition. Psychology Press.

  • Resick, P. A, & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology, 60(5), 748–56.

    Google Scholar 

  • Resick, P. A., & Schnicke, M. K. (1993). Cognitive processing for rape victims. Newbury Park: Sage.

  • Resick, P. A., Galovski, T. E., O’Brien Uhlmansiek, M., Scher, C. D., Clum, G. A., & Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243–258.

    Article  PubMed  PubMed Central  Google Scholar 

  • Santor, D. A., & Coyne, J. C. (1997). Shortening the CES–D to improve its ability to detect cases of depression. Psychological Assessment, 9, 233–243.

    Article  Google Scholar 

  • Semb, O., Strömsten, L. M., Sundbom, E., Fransson, P., & Henningsson, M. (2011). Distress after a single violent crime: how shame-proneness and event-related shame work together as risk factors for post-victimization symptoms. Psychological Reports, 09, 3–23.

    Article  Google Scholar 

  • Shavelson, R. J., & Webb, N. M. (1991). Generalizability theory: A primer. Newbury Park: Sage.

    Google Scholar 

  • Shavelson, R. J., Webb, N. M., & Rowley, G. L. (1989). Generalizability theory. American Psychologist, 44(6), 922–932.

    Article  Google Scholar 

  • Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: uses in assessing rater reliability. Psychological Bulletin, 2, 420–428.

    Article  Google Scholar 

  • Smith, G. T., McCarthy, D. M., & Anderson, K. G. (2000). On the sins of short-form development. Psychological Assessment, 12, 102–111.

    Article  PubMed  Google Scholar 

  • Smith, E. R., Duax, J. M., & Rauch, S. A. M. (2013). Perceived perpetration during traumatic events: clinical suggestions from experts in prolonged exposure therapy. Cognitive and Behavioral Practice, 20, 461–470.

    Article  Google Scholar 

  • Smucker, M. R., Grunert, B. K., & Weis, J. (2003). Posttraumatic Stress Disorder: A New Algorithm Treatment Model. In R. L. Leahy (Ed.), Overcoming roadblocks in cognitive therapy practice (pp. 175–194). New York: Guilford Publications.

    Google Scholar 

  • Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). STAI manual for the state-trait anxiety inventory. Palo Alto: Consulting Psychologists Press.

    Google Scholar 

  • Steenkamp, M., Nash, W. P., Lebowitz, L., & Litz, B. T. (2013). How best to treat deployment-related guilt and shame: commentary on Smith, Duax, and Rauch (2013). Cognitive and Behavioral Practice, 20, 471–475.

    Article  Google Scholar 

  • Stone, A. M. (1992). The role of shame in post-traumatic stress disorder. American Journal of Orthopsychiathry, 62, 131–136.

    Article  Google Scholar 

  • Street, A. E., & Arias, I. (2001). Psychological abuse and posttraumatic stress disorder in battered women. Examining the role of shame and guilt. Violence and Victims, 16, 65–78.

    PubMed  Google Scholar 

  • Tangney, J. P. (1991). Moral affect: the good, the bad and the ugly. Journal of Personality and Social Psychology, 61, 598–607.

    Article  PubMed  Google Scholar 

  • Tangney, J. P., & Dearing, R. L. (2003). Shame & Guilt. New York: The Guilford Press.

    Google Scholar 

  • Tangney, J. P., Wagner, R., & Gramzov, R. (1989). The test of self-conscious affect. Fairfax: George Mason University.

    Google Scholar 

  • Tangney, J. P., Miller, R. S., Flicker, L., & Barlow, D. H. (1996). Are shame, guilt and embarrassment distinct emotions? Journal of Personality and Social Psychology, 70, 1256–1269.

    Article  PubMed  Google Scholar 

  • Tomkins, S. (1987). Shame. In D. L. Nathanson (Ed.), The many faces of shame (pp. 133–161). New York: The Guilford Press.

  • Wicker, F. W., Payne, G. C., & Morgan, R. D. (1983). Participant description of shame and guilt. Motivation and Emotion, 7, 25–39.

    Article  Google Scholar 

  • Wilson, J. P., Drozdek, B., & Turkovic, S. (2006). Posttraumatic shame and guilt. Trauma Violence and Abuse, 7, 122–141.

    Article  Google Scholar 

  • Wong, M. R., & Cook, D. (1992). Shame and its contribution to PTSD. Journal of Traumatic Stress, 5, 557–562.

    Article  Google Scholar 

Download references

Conflict of Interest

There are no conflicts involved in the present study.

Experiment Participants

The study was approved by the Regional Ethics Committee and the patients gave informed consent after the procedure had been fully explained.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Oslo & Research Institute at Modum Bad, Gordon Johnsens vei, 3370, Vikersund, Norway

    Tuva Øktedalen, Asle Hoffart & Tomas Formo Langkaas

  2. Department of Psychology, University of Oslo, Forskningsveien 3A, 0137, Oslo, Norway

    Knut Arne Hagtvet

  3. IRRT Zentrum, Hamburg, Germany

    Mervin Smucker

Authors
  1. Tuva Øktedalen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Knut Arne Hagtvet
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Asle Hoffart
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tomas Formo Langkaas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mervin Smucker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tuva Øktedalen.

Appendix

Appendix

Table 5 Trauma-Related Shamess Inventory (TRSI-24 item English version). Individuals who experience traumas often have many different types of reactions. Below are a number of statements that describe thoughts and feelings that people sometimes have about themselves. Please read each statement carefully, and decide how much it applies to you check the option that best describes how much the statement is true for you over the past week
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Øktedalen, T., Hagtvet, K.A., Hoffart, A. et al. The Trauma Related Shame Inventory: Measuring Trauma-Related Shame Among Patients with PTSD. J Psychopathol Behav Assess 36, 600–615 (2014). https://doi.org/10.1007/s10862-014-9422-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10862-014-9422-5

Keywords

Search

Navigation