title: Two forms of self-criticism mediate differently the shame-psychopathological symptoms link.
abstract: This study explored the relation between external shame, two types of self-criticism, and depressive, anxious and stress symptoms, in a clinical sample. Specifically, we set out to test whether the impact of external shame on such symptoms would be mediated by two forms of self-criticism.
  
  
  
  A total of 279 patients (228 female and 51 male; mean age of 28.58) with axis I and II disorders recruited from several outpatients psychiatric services in Portugal completed the Other as Shamer Scale (OAS), the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS), and the Depression, Anxiety and Stress Scale (DASS-42).
  
  
  
  Self-criticism mediated in part the shame-psychopathological symptoms link, especially the hated self form. The alternative model where shame mediates the link between self-criticism and psychopathological symptoms was also significant. This result suggests that fear of being devalued in the minds of others has a significant impact on people's psychological well-being, and this effect can be partially explained by self-criticism.
  
  
  
  This study highlights that inadequate self and hated self are separable types of self-criticism, because they show different patterns of association with psychopathology. Shame and self-criticism appear to mutually enhance one another, and both are associated with psychopathological symptoms. External shame and self-criticism should be a target in treatment.
  
  
  
  External shame and self-criticism are associated with depressive, anxious, and stress symptoms, in a clinical sample. Self-criticism, especially hatred for the self, mediates the shame-psychopathological symptoms link. Shame and self-criticism should be addressed in therapeutic interventions targeting the reduction of depression, anxiety, and stress symptoms.
authors.affiliation: Cognitive and Behavioural Centre for Research and Intervention, University of Coimbra, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Castilho
authors.affiliation: Cognitive and Behavioural Centre for Research and Intervention, University of Coimbra, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Pinto-Gouveia
authors.affiliation: Cognitive and Behavioural Centre for Research and Intervention, University of Coimbra, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Duarte
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D011174:Portugal; D011569:Psychiatric Status Rating Scales; D012647:Self-Assessment; D012752:Shame; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: clinical sample; depression, anxiety and stress; external shame; self-criticism