Two forms of self-criticism mediate differently the shame–psychopathological symptoms link

Objectives: 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. Method: 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). Results: 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. Conclusions: 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. Practitioner points: 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.