Exploring the Associations between Social Rank and External Shame with Experiences of Psychosis

Low social rank and external shame have been found to be significantly associated with anxiety and depression. However, their relevance to experiences of psychosis has rarely been explored.

This study aims to examine the relationship of social rank and external shame to personal recovery, depression and positive symptoms in psychosis.

A cross sectional correlational design was adopted to examine the relationship between all variables. Fifty-two service users, aged between 18 to 65 years, with experiences of psychosis were recruited for the study. Participants were administered outcome measures examining social rank, external shame, positive symptoms of psychosis, depression and personal recovery. Multiple regression analyses were conducted on the data.

Significant correlations were found between all variables. Low social rank was significantly associated with lower reported personal recovery, and higher levels of external shame and depression symptomology. The relationship between external shame and positive symptoms of psychosis and personal recovery was found to be mediated by participants' level of depression.

Findings suggest that social rank and external shame are relevant to those who experience psychosis. Therapeutic approaches may need to focus on perceptions of social rank and external shame in working with experiences of psychosis.