
Am J Psychiatry 164:500-508, March 2007
doi: 10.1176/appi.ajp.164.3.500
© 2007 American Psychiatric Association
Shame and Implicit Self-Concept in Women With Borderline Personality Disorder
Nicolas Rüsch, M.D.,
Klaus Lieb, M.D.,
Ines Göttler, M.D.,
Christiane Hermann, Ph.D.,
Elisabeth Schramm, Ph.D.,
Harald Richter, Ph.D.,
Gitta A. Jacob, Ph.D.,
Patrick W. Corrigan, Psy.D., and
Martin Bohus, M.D.
OBJECTIVE: Shame is considered to be a central emotion in borderline personality disorder and to be related to self-injurious behavior, chronic suicidality, and anger-hostility. However, its level and impact on people with borderline personality disorder are largely unknown. The authors examined levels of self-reported shame, guilt, anxiety, and implicit shame-related self-concept in women with borderline personality disorder and assessed the association of shame with self-esteem, quality of life, and anger-hostility. METHOD: Sixty women with borderline personality disorder completed self-report measures of shame- and guilt-proneness, state shame, anxiety, depression, self-esteem, quality of life, and clinical symptoms. Comparison groups consisted of 30 women with social phobia and 60 healthy women. Implicit shame-related self-concept (relative to anxiety) was assessed by the Implicit Association Test. RESULTS: Women with borderline personality disorder reported higher levels of shame- and guilt-proneness, state shame, and anxiety than women with social phobia and healthy comparison subjects. The implicit self-concept in women with borderline personality disorder was more shame-prone (relative to anxiety-prone) than in women in the comparison groups. After depression was controlled for, shame-proneness was negatively correlated with self-esteem and quality of life and positively correlated with anger-hostility. CONCLUSIONS: Shame, an emotion that is prominent in women with borderline personality disorder, is associated with the implicit self-concept as well as with poorer quality of life and self-esteem and greater anger-hostility. Psychotherapeutic approaches to borderline personality disorder need to address explicit and implicit aspects of shame.
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Shame as a Central Feature of Borderline Personality Disorder
Journal Watch Psychiatry,
April 23, 2007;
2007(423):
2 - 2.
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