Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Jan 15:171:74-84.
doi: 10.1016/j.jad.2014.09.010. Epub 2014 Sep 20.

Shame in the obsessive compulsive related disorders: a conceptual review

Hilary Weingarden  1 , Keith D Renshaw  2
Affiliations
Review

Shame in the obsessive compulsive related disorders: a conceptual review

Hilary Weingarden et al. J Affect Disord. .

Abstract

Background: Theoretical and anecdotal support for the role of shame in obsessive compulsive related disorders (OCRDs) is prominent. Developing our understanding of shame׳s role in OCRDs is important to building knowledge about this new diagnostic category. This review aims to consolidate our understanding of shame in each OCRD, through summarizing existing clinical, conceptual, and empirical work.

Methods: We provide an overview of shame, its measurement considerations, and a full review of 110 articles addressing shame in OCRDs.

Results: General shame and shame about having a mental illness are the broadest types of shame relevant to OCRDs; symptom-based shame and body shame may be more specific to OCRDs. In OCD, violent, sexual, or blasphemous obsessions may trigger symptom-based shame. In trichotillomania (TTM) and skin picking (SP), symptom-based shame may be related to pulling, picking, and post-pulling/picking behaviors. In hoarding disorder, symptom-based shame may accompany beliefs about being defective due to living with clutter. Body shame appears inherent to body dysmorphic disorder, while in TTM and SP it may arise as a secondary response to damage resulting from body focused repetitive behaviors.

Limitations: Much of the current knowledge on shame in OCRDs comes from anecdotal, case, and conceptual work. Empirical studies do not always assess specific types of shame, instead assessing shame as a general construct.

Conclusions: Shame is closely related to OCRDs. Clinical and research recommendations drawing from the literature are provided.

Keywords: Body dysmorphic disorder (BDD); Obsessive compulsive disorder (OCD); Obsessive-compulsive related disorders; Shame; Skin picking (SP); Trichotillomania (TTM).

PubMed Disclaimer

Conflict of interest statement

No conflicts of interest to report.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Abbey RD, Clopton JR, Humphreys JD. Obsessive-compulsive disorder and romantic functioning. Journal of Clinical Psychology. 2007;63:1181–1192. - PubMed
    1. Albertini RS, Phillips KA. Thirty-three cases of body dysmorphic disorder in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry. 1999;38:453–459. - PubMed
    1. Andrews B, Qian M, Valentine JD. Predicting depressive symptoms with a new measure of shame: The Experience of Shame Scale. British Journal of Clinical Psychology. 2002;41:29–42. - PubMed
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5. American Psychiatric Association; Washington, DC: 2013.
    1. Becker MP, Nitsch AM, Schlosser R, Koch K, Schachtzabel C, Wagner G, Miltner WH, Straube T. Altered emotional and BOLD responses to negative, positive and ambiguous performance feedback in OCD. Social Cognitive and Affective Neuroscience. 2013:1–7. - PMC - PubMed

Publication types