title: Shame in the obsessive compulsive related disorders: a conceptual review.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA 22030-4444, USA. Electronic address: hweingar@masonlive.gmu.edu.
authors.forename: Hilary
authors.initials: H
authors.lastname: Weingarden
authors.affiliation: Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA 22030-4444, USA.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Renshaw
mesh_terms: D001294:Attitude to Health; D057215:Body Dysmorphic Disorders / Q000523:psychology; D000067836:Hoarding Disorder / Q000523:psychology; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D012752:Shame; D014256:Trichotillomania / Q000523:psychology
keywords: Body dysmorphic disorder (BDD); Obsessive compulsive disorder (OCD); Obsessive-compulsive related disorders; Shame; Skin picking (SP); Trichotillomania (TTM)