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A meta-analysis of the association between shame and dissociation
Journal of Traumatic Stress ( IF 2.4 ) Pub Date : 2022-06-24 , DOI: 10.1002/jts.22854
Justine A Rudy 1 , Scott McKernan 1 , Nicole Kouri 2 , Wendy D'Andrea 1
Affiliation  

Shame and dissociation have been implicated theoretically and empirically in trauma exposure and its sequelae, with shame understood as an intense negative emotion and dissociation as a reaction to intense negative emotions. Understanding the connection between shame and dissociation is important for theory and practice; however, the strength of this association remains unclear. For example, in therapy, both shame and dissociation serve as a barrier to engaging with emotion. Theoretically, these two states should be distinct, as one (dissociation) confers low affective intensity and the other (shame) high intensity. The present meta-analysis focused on the magnitude of the association between these two phenomena and investigated the extent to which gender, trauma exposure, psychiatric comorbidities, and demographic characteristics influence this association given their independent links to shame and dissociation. An initial search of six databases identified 151,844 articles. Duplicates were removed, and additional articles were excluded based on abstract and title screening. After contacting authors for missing data, a full-text screen yielded 25 articles for the present analysis. The results indicate that shame and dissociation were moderately correlated (k = 33, n = 4,705), r = .42, 95% CI [.35, .48], p < .001, but no clear clinical moderators emerged. Despite this association, very few studies utilized experimental designs to examine the association between these constructs. Future research should focus on experimental study designs to investigate the extent to which shame induces dissociation or vice versa.

中文翻译:

羞耻与分离之间关联的元分析

羞耻和解离在理论上和经验上都与创伤暴露及其后遗症有关,羞耻被理解为一种强烈的负面情绪,而解离被理解为对强烈负面情绪的反应。了解羞耻与分离之间的联系对于理论和实践都很重要;然而,该协会的实力仍不明朗。例如,在治疗中,羞耻感和分离感都是情感参与的障碍。从理论上讲,这两种状态应该是不同的,因为一种(分离)赋予低情感强度而另一种(羞耻)赋予高强度。目前的荟萃分析侧重于这两种现象之间关联的程度,并调查了性别、创伤暴露、精神病合并症、考虑到它们与羞耻和解离的独立联系,人口统计特征会影响这种关联。对六个数据库的初步搜索确定了 151,844 篇文章。删除了重复项,并根据摘要和标题筛选排除了其他文章。在就缺失数据联系作者后,全文​​筛选产生了 25 篇文章用于当前分析。结果表明羞耻感和解离感呈中度相关(k = 33, n = 4,705), r = .42, 95% CI [.35, .48], p < .001,但没有出现明确的临床调节因素。尽管存在这种关联,但很少有研究利用实验设计来检验这些结构之间的关联。未来的研究应侧重于实验研究设计,以调查羞耻感在多大程度上诱发分离,反之亦然。
更新日期:2022-06-24
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