Shame and implicit self-concept in women with borderline personality disorder.
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.


METHODS
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.
Rüsch
Nicolas
N
Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstrasse 5, D-79104 Freiburg, Germany. nicolas.ruesch@uniklinik-freiburg.de
Lieb
Klaus
K
Göttler
Ines
I
Hermann
Christiane
C
Schramm
Elisabeth
E
Richter
Harald
H
Jacob
Gitta A
GA
Corrigan
Patrick W
PW
Bohus
Martin
M
D000293:Adolescent; D000328:Adult; D000786:Anger; D001007:Anxiety; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003937:Diagnosis, Differential; D004644:Emotions; D005260:Female; D006167:Guilt; D006791:Hostility; D006801:Humans; D008875:Middle Aged; D010555:Personality Inventory; D010698:Phobic Disorders / Q000175:diagnosis / Q000523:psychology; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D012649:Self Concept; D012737:Sex Factors; D012752:Shame; D011795:Surveys and Questionnaires