A longitudinal approach to the contribution of trauma and external shame on depressive symptoms in adolescence

Authors

  • Marina Cunha Instituto Superior Miguel Torga; Centro de Investigação em Neuropsicologia e Intervenção Cognitivo-comportamental, Universidade Coimbra, Portugal http://orcid.org/0000-0002-5957-1903
  • Rute Almeida Instituto Piaget de Viseu, Instituto Superior Miguel Torga, Coimbra, Portugal http://orcid.org/0000-0003-1994-6069
  • Sónia Cherpe Centro de Investigação em Neuropsicologia e Intervenção Cognitivo-comportamental, Universidade de Coimbra, Portugal http://orcid.org/0000-0001-8248-3488
  • Sónia Simões Instituto Superior Miguel Torga, Coimbra, Portugal http://orcid.org/0000-0002-6691-7941
  • Mariana Marques Serviço de psicologia médica, Universidade de Coimbra; Instituto Superior Miguel Torga, Coimbra; Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal http://orcid.org/0000-0002-7856-280X

DOI:

https://doi.org/10.31211/rpics.2018.4.2.62

Keywords:

Depression, Adolescents, Traumatic events, Shame feelings, Longitudinal study

Abstract

Background: The review of the literature on potential predictors of depressive symptoms has shown that traumatic experiences during childhood, experiences of shame, and gender have a relevant contribution. Aim: This study aimed to observe the intra-individual variability of shame, traumatic events, and gender and to test the predictive power of these variables in the evolution of depressive symptoms (dependent variable) at six months, in adolescents. Method: The sample consisted of 325 adolescents, aged between 12 and 18 years old, distributed in the center of Portugal and attending the secondary/high school. The Children's Depression Inventory, the Brief Scale of Shame, and the Childhood Trauma Questionnaire were used to assess the listed variables. Longitudinal results were analyzed by multiple linear regression analysis. Results: There was a positive association between experiences reported as traumatic and perceptions of shame (T1) and depressive symptoms (T2, after six months). The multiple linear regression model explained 63% of the depressive symptoms’ variance at T2, and belonging to the female gender, the experience of shame and perceived events of emotional and sexual abuse, as emotional neglect (variables of the trauma) seems to predict depressive symptoms in adolescence. Conclusions: Given that there is some evidence of the impact of traumatic events of childhood abuse/neglect, and perceptions of shame during adolescence on the evolution of depressive symptoms, it is relevant that these variables are considered in the assessment and in the psychotherapeutic interventions at this stage of human development. This study contributes to highlight the role of vulnerability factors for the depressive symptoms in adolescence.

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Author Biographies

Marina Cunha, Instituto Superior Miguel Torga; Centro de Investigação em Neuropsicologia e Intervenção Cognitivo-comportamental, Universidade Coimbra, Portugal

Assistant Professor, Clinical Psychologist, Researcher

Rute Almeida, Instituto Piaget de Viseu, Instituto Superior Miguel Torga, Coimbra, Portugal

Mestre em Psicologia Clinica, Ramo Terapia-Cognitivo Comportamental, Instituto Superior Miguel Torga

Sónia Cherpe, Centro de Investigação em Neuropsicologia e Intervenção Cognitivo-comportamental, Universidade de Coimbra, Portugal

Clinical Psychologist

Sónia Simões, Instituto Superior Miguel Torga, Coimbra, Portugal

Assistant Professor, Clinical Psychologist

Mariana Marques, Serviço de psicologia médica, Universidade de Coimbra; Instituto Superior Miguel Torga, Coimbra; Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal

Assistant Professor, Clinical Psychologist

References

Ackard, D. M., Croll, J. K., & Kearney-Cooke, A. (2002). Dieting frequency among college females: Association with disordered eating, body image, and related psychological problems. Journal of Psychosomatic Research, 52(3), 129–136. [Google Scholar] [CrossRef]

Ahmed, S. P., Bittencourt-Hewitt, A., & Sebastian, C. L. (2015). Neurocognitive bases of emotion regulation development in adolescence. Developmental Cognitive Neuroscience, 15, 11–25. [Google Scholar] [CrossRef]

Andrews, B., Qian, M., &Valentine, D. J. (2002). Predicting depressive symptoms with a new measure of shame: The Experience of Shame Scale. British Journal of Clinical Psychology, 41(1), 29–42. [Google Scholar] [CrossRef]

Åslund, C., Nilsson, K. W., Starrin, B., & Sjöberg, R. L. (2007). Shaming experiences and the association between adolescent depression and psychosocial risk factors. European Child and Adolescent Psychiatry, 16(5), 298–304. [Google Scholar] [CrossRef]

Balsamo, M., Macchia, A., Carlucci, L., Picconi, L., Tommasi, M., Gilbert, P., & Saggino, A. (2015). Measurement of external shame: An inside view. Journal of Personality Assessment, 97(1), 81–89. [Google Scholar] [CrossRef]

Barry, M., Murphy, M., & O’Donovan, H. (2017). Assessing the effectiveness of a cognitive behavioural group coaching intervention in reducing symptoms of depression among adolescent males in a school setting. International Coaching Psychology Review, 12(2), 101–109. [Google Scholar] [URL]

Bennett, D. S., Sullivan, M. W., & Lewis, M. (2010). Neglect children, shame-proneness, and depressive symptoms. Child Maltreatment, 15(4), 305–314. [Google Scholar] [CrossRef]

Bernstein, D. P., & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report manual. San Antonio, TX: The Psychological Corporation. [Google Scholar]

Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., … Zule, W. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect, 27(2), 169–190. [Google Scholar] [CrossRef]

Bonanno, G. A., Keltner, D., Noll, J. G., Putnam, F. W., Trickett, P. K., LeJeune, J., & Anderson, C. (2002). When the face reveals what words do not: Facial expressions of emotion, smiling, and the willingness to disclose childhood sexual abuse. Journal of Personality and Social Psychology, 83(1), 94–110. [Google Scholar] [CrossRef]

Cardoso, P. M. S., Rodrigues, C., & Vilar, A. (2004). Prevalência de sintomas depressivos em adolescentes portugueses. Análise Psicológica, 22(4), 667–675. [Google Scholar] [CrossRef]

Cherpe, S., Matos, A. P., & Pereira, A. (2010). Versão Portuguesa do Childhood Trauma Questionnaire [Portuguese version of the Childhood Trauma Questionnaire]. Manuscrito não publicado, Faculdade de Psicologia e Ciências da Educação da Universidade de Coimbra, Portugal.

Costello, E. J., Copeland, W., & Angold, A. (2011). Trends in psychopathology across the adolescent years: What changes when children become adolescents, and when adolescents become adults? Journal of Child Psychology and Psychiatry, 52(10), 1015–1025. [Google Scholar] [CrossRef]

Cunha, M., Matos, M., Faria, D., & Zagalo, S. (2012). Shame memories and psychopathology in adolescence: The mediator effect of shame. International Journal of Psychology & Psychological Therapy, 12(2), 203–218. [Google Scholar] [PDF]

Cunha, M., Xavier, A. M. J., Cherpe, S., & Pinto-Gouveia, J. (2017). Assessment of shame in adolescents: The ‘Other as Shamer’ Scale. Psicologia: Teoria e Pesquisa, 33, 1–9. [Google Scholar] [CrossRef]

Dahl, R. E. (2004). Adolescent brain development: A period of vulnerabilities and opportunities. Keynote address. Annals of the New York Academy of Sciences, 1021(1), 1–22. [Google Scholar] [CrossRef]

De Rubeis, S., & Hollenstein, T. (2009). Individual differences in shame and depressive symptoms during early adolescence. Personality and Individual Differences, 46(4), 477–482. [Google Scholar] [CrossRef]

Dunn, E. C., McLaughlin, K. A., Slopen, N., Rosand, J., & Smoller, J. W. (2013). Developmental timing of child maltreatment and symptoms of depression and suicidal ideation in young adulthood: Results from the National Longitudinal Study on Adolescent Health. Depression and Anxiety, 30(10), 955–964. [Google Scholar] [CrossRef]

English, D. J., Widom, C. S., & Brandford, C. (2004). Another look at the effects of child abuse. National Institute of Justice Journal, 251, 23–24. [Google Scholar] [PDF]

Feiring, C. (2005). Emotional development, shame, and adaptation to child maltreatment. Child Maltreatment, 10(4), 307–310. [Google Scholar] [CrossRef]

Firth, M. T. (2014). Childhood abuse and depressive vulnerability in clients with gender dysphoria. Counselling and Psychotherapy Research, 14(4), 297–305. [Google Scholar] [CrossRef]

Grassi-Oliveira, R., Stein, L. M., & Pezzi, J. C. (2006). Tradução e validação de conteúdo da versão em português do Childhood Trauma Questionnaire [Translation and content validation of the Childhood Trauma Questionnaire into Portuguese language]. Revista de Saúde Pública, 40(2) 249–255. [Google Scholar] [CrossRef]

Gibb, B. E., Alloy, L. B., Abramson, L. Y., Rose, D. T., Whitehouse, W. G., Donovan, P., … Tierney, S. (2001). History of childhood maltreatment, negative cognitive style, and episodes of depression in adulthood. Cognitive Therapy and Research, 25(4), 425–446. [Google Scholar] [PDF]

Gilbert, P. (1998). What is shame? Some core issues and controversies. In P. Gilbert & B. Andrews (Eds.), Shame: Interpersonal behavior, psychopathology, and culture (pp. 3–38). New York, NY: Oxford University Press. [Google Scholar]

Gilbert, P. (2002). Understanding the biopsychosocial approach: Conceptualization. Clinical Psychology, 14, 13–17. [Google Scholar] [URL]

Gilbert, P. (2006). A biopsychosocial and evolutionary approach to formulation with a special focus on shame. In N. Tarrier (Ed.), Case formulation in cognitive behaviour therapy: The treatment of challenging and complex cases (pp. 81–112). New York, NY: Routledge/Taylor & Francis Group. [Google Scholar]

Gilbert, P., & Irons, C., (2009). Shame, self-criticism, and self-compassion in adolescence. In N. Allen (Ed.), Psychopathology in adolescence. Cambridge: Cambridge University Press. [Google Scholar]

Gore, F. M., Bloem, P. J., Patton, G. C., Ferguson, J., Joseph, V., Coffey, C., ... Mathers, C. D. (2011). Global burden of disease in young people aged 10–24 years: A systematic analysis. The Lancet, 377(9783), 2093-2102. [Google Scholar] [CrossRef]

Goss, K., Gilbert, P., & Allan, S. (1994). An exploration of shame measures – I: The Other as Shamer Scale. Personality and Individual Differences, 17(5), 713–717. [Google Scholar] [CrossRef]

Hopwood, C. J., Ansell, E. B., Fehon, D. C., & Grilo, C. M. (2011). The mediational significance of negative/depressive affect in the relationship of childhood maltreatment and eating disorder features in adolescent psychiatric inpatients. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 16(1), e9–e16. [Google Scholar] [CrossRef]

Infurna, F. J., Rivers, C. T., Reich, J., & Zautra, A. J. (2015). Childhood trauma and personal mastery: Their influence on emotional reactivity to everyday events in a community sample of middle-aged adults. PLoS ONE, 10(4), e0121840. [Google Scholar] [CrossRef]

Irons, C., & Gilbert, P. (2005). Evolved mechanisms in adolescent anxiety and depression symptoms: The role of the attachment and social rank systems. Journal of Adolescence, 28(3), 325–341. [Google Scholar] [CrossRef]

Kim, J., & Cicchetti, D. (2006). Longitudinal trajectories of self-system processes and depressive symptoms among maltreated and nonmaltreated children. Child Development, 77(3), 624–639. [Google Scholar] [CrossRef]

Kim, J., Talbot, N. L., & Cicchetti, D. (2009). Childhood abuse and current interpersonal conflict: The role of shame. Child Abuse & Neglect, 33(6), 362–371. [Google Scholar] [CrossRef]

Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York, NY: Guilford Press. [Google Scholar]

Kovacs, M. (1985). The Children's Depression Inventory (CDI). Psychopharmacology Bulletin, 21(4), 995-998. [Google Scholar]

Liu, R. T., Alloy, L. B., Abramson, L. Y., Iacoviello, B. M., & Whitehouse, W. G. (2009). Emotional maltreatment and depression: Prospective prediction of depressive episodes. Depression and Anxiety, 26(2), 174-181. [Google Scholar] [CrossRef]

Lopes, B., Pinto-Gouveia, J., & Castilho, P. (2005). Portuguese version of the Others as Shamer Scale. Unpublish manuscript.

Mandelli, L., Petrelli, C., & Serretti, A. (2015). The role of specific early trauma in adult depression: A meta-analysis of published literature. Childhood trauma and adult depression. European Psychiatry, 30(6), 665–680. [Google Scholar] [CrossRef]

Marôco, J. (2011). Análise estatística com o SPSS Statistics [Statistical analysis with SPSS Statistics] (5th ed.). Pero Pinheiro: Report Number. [Google Scholar]

Matos, M., & Pinto-Gouveia, J. (2010). Shame as a traumatic memory. Clinical Psychology and Psychotherapy, 17(4), 299–312. [Google Scholar] [CrossRef]

Matos, M., Pinto-Gouveia, J., & Duarte, C. (2012). When I don't like myself: Portuguese version of the internalized shame scale. The Spanish Journal of Psychology, 15(3), 1411–1423. [Google Scholar] [CrossRef]

Matos, M., Pinto-Gouveia, J., & Duarte, C. (2013). Internalizing early memories of shame and lack of safeness and warmth: The mediating role of shame on depression. Behavioural and Cognitive Psychotherapy, 41(4), 479–493. [Google Scholar] [CrossRef]

Marujo, H. (1994). Síndromas depressivos na infância e na adolescência [Depressive syndromes in childhood and adolescence] (Unpublished doctoral dissertation). Faculdade de Psicologia e Ciências da Educação da Universidade de Lisboa, Lisboa, Portugal.

McLean, K. C., Breen, A. V., & Fournier, M. A. (2010). Constructing the self in early, middle, and late adolescent boys: Narrative identity, individuation, and well-being. Journal of Research on Adolescence, 20(1), 166-187. [Google Scholar] [CrossRef]

Monteiro, S., Matos, A. P., & Oliveira, S. (2015). The moderating effect of gender: Traumatic experiences and depression in adolescence. Procedia - Social and Behavioral Sciences, 165, 251–259. [Google Scholar] [CrossRef]

Moylan, C. A., Herrenkohl, T. I., Sousa, C., Tajima, E. A., Herrenkohl, R. C., & Russo, M. J. (2010). The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. Journal of Family Violence, 25(1), 53–63. [Google Scholar] [CrossRef]

Muris, P., Meesters, C., Heijmans, J., van Hulten, S., Kaanen, L., Oerlemans, B., ... Tielemans, T. (2016). Lack of guilt, guilt, and shame: A multi-informant study on the relations between self-conscious emotions and psychopathology in clinically referred children and adolescents. European Child & Adolescent Psychiatry, 25(4), 383–396. [Google Scholar] [CrossRef]

Muris, P., & Meesters, C. (2014). Small or big in the eyes of the other: On the developmental psychopathology of self-conscious emotions as shame, guilt, and pride. Clinical Child and Family Psychology Review, 17(1), 19–40. [Google Scholar] [CrossRef]

Musliner, K. L., & Singer, J. B. (2014) Emotional support and adult depression in survivors of childhood sexual abuse. Child Abuse & Neglect, 38(8), 1331–1340. [Google Scholar] [CrossRef]

Negrao, C., Bonanno, A. G., Noll, J. G., Putnam, F. W., & Trickett, P. K. (2005). Shame, humiliation, and childhood sexual abuse: Distinct contributions and emotional coherence. Child Maltreatment, 10(4), 350–363. [Google Scholar] [CrossRef]

Papalia, D. E., Olds, S. W., & Feldman, R. D. (2006). Desenvolvimento Humano (8th ed.). Porto Alegre: Artmed. [Google Scholar]

Pallant, J. (2013). SPSS survival manual: A step by step guide to data analysis using IBM SPSS (5th ed.). Crows Nest, NSW: Allen & Unwin. [Google Scholar]

Pereira, I. M., Matos, A. P., & Azevedo, A. (2014). Versão portuguesa do Questionário de Pensamentos Automáticos-Revisto: Relação com sintomatologia depressiva em adolescentes [Portuguese version of the automatic thoughts questionnaires – revised: Relation with depressive symptomatology in adolescents]. Psicologia, Saúde & Doenças, 15(1), 36–46. [Google Scholar] [CrossRef]

Pinquart, M., & Shen, Y. (2011). Depressive symptoms in children and adolescents with chronic physical illness: An updated meta-analysis. Journal of Pediatric Psychology, 36(4), 375–384. [Google Scholar] [CrossRef]

Price, M., Higa-McMillan, C., Kim, S., & Frueh, C. (2013). Trauma experience in children and adolescents: An assessment of the effects of trauma type and role of interpersonal proximity. Journal of Anxiety Disorders, 27(7), 652–660. [Google Scholar] [CrossRef]

Rosso, A. D., Beber, S., Bianco, F., Gregorio, D. D., Paolo, M. D., Lauriola, A. L., … Basile, B. (2014). La vergogna in psicopatologia [Shame in psychopathology]. Cognitivismo Clinico, 11(1), 27–61. [Google Scholar] [PDF]

Shore, L., Toumbourou, J. W., Lewis, A. J., & Kremer, P. (2018). Longitudinal trajectories of child and adolescent depressive symptoms and their predictors – A systematic review and meta‐analysis. Child and Adolescent Mental Health, 23(2), 107-120. [Google Scholar] [CrossRef]

Slep, A. M. S., Heyman, R. E., & Snarr, J. D. (2011). Child emotional agression and abuse: Definitions and prevalence. Child Abuse & Neglect, 35(10), 783–796. [Google Scholar] [CrossRef]

Sousa, C., Herrenkohl, T. I., Moylan, C. A., Tajima, E. A., Klika, J. B., Herrenkohl, R. C., & Russo, M. J. (2011). Longitudinal study on the effects of child abuse and children’s exposure to domestic violence, parent-child attachments, and antisocial behavior in adolescence. Journal Interpersonal Violence, 26(1), 111–136. [Google Scholar] [CrossRef]

Spinhoven, P., Penninx, B. W., Hickendorff, M., van Hemert, A. M., Bernstein, D. P., & Elzinga, B. M. (2014). Childhood Trauma Questionnaire: Factor structure, measurement invariance, and validity across emotional disorders. Psychological Assessment, 26(3), 717-729. [Google Scholar] [CrossRef]

Steinberg, L. (2005). Cognitive and affective development in adolescence. Trends in Cognitive Sciences, 9(2), 69-74. [Google Scholar] [CrossRef]

Steinberg, L. (2010). A behavioral scientist looks at the science of adolescent brain development. Brain and Cognition, 72(1), 160–164. [Google Scholar] [CrossRef]

Stuewing, J., & McCloskey, L. A. (2005). The relation of child maltreatment to shame and guilt among adolescents: Psychological routes to depression and delinquency. Child Maltreatment, 10(4), 324–336. [Google Scholar] [CrossRef]

Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston: Pearson Education Inc. [Google Scholar]

Tangney, J. P., & Dearing, R. L. (2002). Shame and guilt (1st ed.). New York, NY: Guilford Press. [Google Scholar]

Thapar, A., Collishaw, S., Pine, D. S., & Thapar, A. K. (2012). Depression in adolescence. The Lancet, 379(9820), 1056-1067. [Google Scholar] [CrossRef]

Szentágotai-Tătar, A., Chis, A., Vulturar, R., Dobrean, A., Cândea, D. M., & Miu, A. C. (2015). Shame and guilt-proneness in adolescents: Gene-environment interactions. PLoS ONE, 10(7), e0134716. [Google Scholar] [CrossRef]

Tolchinsky, A. (2014). Acute trauma in adulthood in the context of childhood traumatic experiences. Neuropsychoanalysis: An Interdisciplinary Journal for Psychoanalysis and the Neurosciences, 16(2), 129–137. [Google Scholar] [CrossRef]

World Health Organization. (2018). Adolescents: Health risks and solutions. [URL]

Published

2018-10-01

How to Cite

Cunha, M., Almeida, R., Cherpe, S., Simões, S., & Marques, M. (2018). A longitudinal approach to the contribution of trauma and external shame on depressive symptoms in adolescence. Portuguese Journal of Behavioral and Social Research, 4(2), 49–59. https://doi.org/10.31211/rpics.2018.4.2.62

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