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The contribution of shame to post-psychotic trauma


Correspondence should be addressed to Mark Bernard, Early Intervention Service, 1 Miller Street, Aston, Birmingham B6 4NF, UK (e-mail:



The current study examined shame in a clinical sample recovering from a first episode of psychosis by focusing on the contribution of different types of shame to post-psychotic trauma while controlling for current affective symptoms.


The study used a cross-sectional correlational design.


Fifty individuals who met the criteria for a psychotic disorder whose acute psychotic symptoms were in remission completed measures of internal and external shame associated with psychosis, general shame, post-psychotic trauma, and depression.


Post-psychotic trauma symptoms were correlated with internal and external shame associated with psychosis and general shame. However, the relation between post-psychotic trauma and external shame associated with psychosis remained after controlling for general shame and current affective symptoms. In addition, internal shame had a stronger association with depression. Thus, internal and external shame due to psychosis had different associations with different types of post-psychotic emotional dysfunction.


The results support the importance of assessing shame as a multi-faceted construct and suggest that assessing shame directly associated with mental illness is a worthwhile endeavour.

Practitioner Points

  • Assessing different types of shame following psychosis can inform assessments, formulations, and interventions with post-psychotic trauma.
  • Our results support the application of Compassionate Mind Therapy to psychosis.
  • However, we did not assess self-criticism or self-reassurance.
  • We also did not investigate the relation between specific psychotic symptoms and different types of shame.