Childhood Maltreatment and Internalized Shame in Adults with a Diagnosis of Bipolar Disorder

Abstract

The frequency of reports of childhood trauma would appear to be higher amongst adults with a diagnosis of BD compared with individuals with no psychiatric diagnoses. Levels of internalized shame in adulthood are also likely to be higher than those in the general population, although the current literature does not shed light on the relationship between childhood abuse and neglect, mood-related behaviour, and shame. Experiences of childhood abuse and neglect, particularly childhood emotional abuse and emotional neglect, are likely to be frequently reported by clients with a diagnosis of BD. Clinicians should therefore explicitly consider these experiences in their assessment, formulation and intervention with clients with a diagnosis of BD.

Shame and resilience among Pakeha New Zealanders

“…This is clearly a negative and problematic effect of shame. As reported by Fowke et al (2012), Claesson and Sohlberg (2002), and Chan et al (2005), and echoed by participants in the present study, succumbing to shame through the internalisation of negative core beliefs is strongly associated with psychiatric symptomology.…”

“…The shame literature suggests that internalised shame is associated with mood disorders such as depression, bipolar disorder, and anxiety disorders, a finding that is not surprising given that these mental illnesses share a negativity in interpreting life's events that is also common among individuals with high levels of internalised shame (Fowke, Ross, & Ashcroft, 2012). Claesson and Sohlberg (2002) investigated internalised shame and suggested that being met with indifference, neglect, or rejection from caregivers during early childhood was strongly associated with high levels of internalised shame.…”

Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature

“…In addition, childhood trauma is associated with lower self-esteem (Fowke et al 2012), and elevated behavioural hostility (Lysaker et al 2002) dissociative symptoms (Sar et al 2010;Schäfer et al 2012;Braehler et al 2013) and suicide risk (Etain et al 2013;Ferraz et al 2013;Links et al 2013) compared with those patients without exposure to trauma. These factors may also be driving poor functioning.…”

Child abuse and neglect in complex dissociative disorder, abuse-related chronic PTSD, and mixed psychiatric samples

“…Karan et al (2014) found that child emotional abuse was a key predictor of shame in BPD. Emotional abuse has been repeatedly associated with shame, with the taunts, undermining and dismissing remarks, and verbal aggression that make-up this form of abuse eroding self confidence and leaving the person with an internalised view of self that is inferior, inadequate and weak (e.g., Fowke et al, 2012;Harvey, Dorahy, Vertue, & Duthie, 2012). As Shahar, Doron and Szepsenwol (2014) explain, "early experiences of being shamed, by caregivers or peers, lead to intense shame states, which are then internalized and lead to the development of a more stable shame-based self-schema" (p. 2).…”

“…These include dissociative symptoms (e.g., Dalenberg et al, 2012), shame and guilt (e.g., Fowke, Ross, & Ashcroft, 2012;Karan et al, 2014) and relationship difficulties (e.g., Kendall-Tackett, 2002). Most frequently, childhood physical and sexual abuse have been associated with dissociation in adult trauma disorders, but emotional abuse also makes a contribution.…”