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Internal and External Shame in Healthy and Chronically Ill Samples: Exploring Links to Psychological Health

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Abstract

This study aimed to examine the role of decentering and committed action as mediators of the link of external and internal shame with psychological health, in people with a chronic disease diagnosis (n = 223) and without chronic disease (n = 230). Participants with chronic disease presented higher levels of both external and internal shame. Path analysis results showed that these variables seem to be negatively linked to psychological health and that their effects on this outcome seem to be reduced by the mechanisms of decentering and committed action. The tested model explained 56% of psychological health’s variance and was invariant across groups. This study emphasizes the importance of taking a decentered stance towards internal experiences and behaving accordingly to one’s personal values on psychosocial functioning, independently of disease status. These results may have particular relevance to individuals with high levels of shame.

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Acknowledgements

We would like to thank the Association for the Support of Patients with Leukemia and Lymphoma, Portuguese Lung Foundation, National Association of Cystic Fibrosis, Portuguese Federation of People with Diabetes, Portuguese Association for Supporting Women with Endometriosis, Portuguese League Against Rheumatic Diseases, and Portuguese Association of Renal Insufficient for their help during the recruitment process of the sample of patients with physical chronic disease.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. CINEICC, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal

    Inês Matos-Pina & Cláudia Ferreira

  2. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Inês A. Trindade

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  1. Inês Matos-Pina
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  2. Inês A. Trindade
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  3. Cláudia Ferreira
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Contributions

Authors CF and IAT designed the study, prepared the measures and wrote the protocol. Author IM-P recruited and assessed the participants. All the authors conducted literature research and provided summaries of previous research studies, conducted the statistical analysis and wrote the manuscript throughout its development stages. CF supervised and contributed throughout the conduction of these tasks and approved the final manuscript.

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Correspondence to Inês Matos-Pina.

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Conflict of interest

Inês Matos-Pina, Inês A. Trindade, and Cláudia Ferreira declares that they have no conflict of interest.

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All participants gave their informed consent before participating.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The present study was approved by the Ethical Board of the Faculty of Psychology and Education Sciences of the University of Coimbra.

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Matos-Pina, I., Trindade, I.A. & Ferreira, C. Internal and External Shame in Healthy and Chronically Ill Samples: Exploring Links to Psychological Health. J Clin Psychol Med Settings 29, 412–420 (2022). https://doi.org/10.1007/s10880-022-09855-y

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