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A Compassion-based Intervention for Internal and External Shame

Not Applicable
Completed
Conditions
Compassion
Shame
Registration Number
NCT04600557
Lead Sponsor
University of Texas at Austin
Brief Summary

This is a four-arm randomized pilot study aimed at reducing internal and/or external shame using self-compassion and/or compassion from others. The study is designed to test the theory that trait shame is comprised of both internal and external shame and to test compassion for others as an intervention for external shame.

Detailed Description

Shame is a common, painful emotion involving negative evaluations of the self. It has been theorized that trait shame involves both internal shame (i.e., evaluating oneself negatively) and external shame (i.e., perceiving that others evaluate the self negatively). Shame is experienced across a variety of psychiatric illnesses, yet it has been highly understudied.

Self-compassion has been used as an intervention for reducing shame in a variety of research studies, often in the context of a specific psychiatric disorder. However, self-compassion interventions, which aim to change the way one thinks and feels about oneself, may specifically target internal shame but not external shame. It is proposed that receiving compassion from others is an analogous and plausible intervention for external shame. In order to test the theory that trait shame is comprised of both internal and external shame and to test compassion for others as an intervention for external shame, a four-arm randomized pilot study aimed at reducing internal and/or external shame using self-compassion and/or compassion from others is proposed here.

Participants (N=180) scoring high on both internal and external shame on self-report measures will be assessed at baseline using both questionnaires and a shame-memory recall. Participants will be randomized to one of four conditions: a) describing a shameful experience using a self-compassionate prompt and receiving no verbal responses from confederates (self-compassion only), b) describing a shameful experience using a neutral prompt and receiving compassionate responses from confederates (compassion from others only), c) both describing a shameful experience using a self-compassionate prompt and receiving compassionate responses from confederates (self-compassion plus compassion from others), or d) describing a shameful experience using a neutral prompt and receiving no verbal responses from confederates (sharing-only control). Participants will complete questionnaires and shame-memory recalls again immediately following the sharing intervention and at a one-week post-intervention follow-up.

The two primary outcome measures will be state internal shame, as measured by the Internalized Shame Sclae, and state external shame, as measured by the Other As a Shamer scale. Both the Internalized Shame Scale and Other As a Shamer scale will be administered at baseline (immediately pre-treatment), immediately post-treatment, and a one-week post-intervention follow-up. Secondary outcome measures will include the Positive and Negative Affect Scale, and a real-time assessment of state shame.

It is expected that (a) participants assigned to describe a shameful experience using self-compassionate instructions will display larger reductions in internal shame relative to those assigned to describe a shameful experience using neutral instructions; (b) participants who receive compassionate responses from others after sharing a shameful experience will display larger reductions in external shame relative to those assigned to a listening-only control; and (c) participants assigned to describe a shameful experience using self-compassionate instructions combined with receiving compassionate responses from others will display larger reductions in both internal and external shame relative to participants who receive either component alone.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
439
Inclusion Criteria
  • Elevated levels of internal and external shame
  • Can recall two shameful experiences
Exclusion Criteria
  • Active suicidal ideation as measured by endorsement of 2 (I would like to kill myself) or 3 (I would kill myself if I had the chance) on BDI-II item 9
  • Endorses intent to harm or kill others

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Internal shame5 minutes post-intervention

Measured by scores on Internalized Shame Scale (range: 0-120, higher indicates more shame)

External shame5 minutes post-intervention

Measured by scores on Other As Shamer Scale (range: 0-72, higher indicates more shame)

Secondary Outcome Measures
NameTimeMethod
Shame activationone-week follow-up

Real-time assessment of shame activation during shame memory recall tasks (range: 0-100)

State shameone-week follow-up

Micro-assessment of state shame using Positive and Negative Affect Scale (range: 1-5, higher indicates more shame)

Electrodermal response to shameone-week follow-up

Measured in microsiemens (μS) by Empatica E4 during shame memory recall tasks

Blood volume pulse in reaction to shameone-week follow-up

Changes in blood volume measured by Empatica E4 during shame memory recall tasks

Motion in reaction to shameone-week follow-up

Measured by 3-axis accelerometer sensor in the range \[-2g, 2g\] using Empatica E4 during shame memory recall tasks

Skin temperature reaction to shameone-week follow-up

Temperature measured in degrees Celcius by Empatica E4 during shame memory recall tasks

Trial Locations

Locations (1)

The University of Texas at Austin

🇺🇸

Austin, Texas, United States

The University of Texas at Austin
🇺🇸Austin, Texas, United States

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