Related Experiment Video
Updated: Jun 12, 2025

Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder
Published on: March 8, 2018
Does shame mediate the influence of trauma on psychosis? A systematic review and meta-analytic structural equation
Kimberley Davies1, Julia M Lappin1, Nancy Briggs2
1Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW 2052, Australia; The Tertiary Referral Service for Psychosis, Prince of Wales Hospital, Randwick 2031, NSW, Australia.
Background:
Meta-analytic evidence has linked shame separately to both potentially traumatic events (PTEs) and psychosis, but the influence of shame on the relationship between PTEs and psychosis has not yet been examined. This study used meta-analytic structural equation modelling (MASEM) to examine whether shame plays a mediatory role between PTEs and experiences of psychosis.
Methods:
A nested search was conducted within a previous systematic review on psychosis and shame to identify articles that contained a measure of PTEs. Included studies reported a quantitative association between psychosis and shame, and additionally a quantitative relationship between either i) PTEs and psychosis; or ii) PTEs and shame.
Findings:
Of the 40 articles initially included, 14 met criteria and 13 were included in the analyses. Overall, shame partially mediated the relationship between PTE's and psychosis, observed through a significant indirect effect (β = 0.15, 95 % CI: 0.11-0.19) and a reduction in the direct path that remained significant (β = 0.13, 95 % CI: 0.06-0.20). Indirect paths through shame between childhood PTEs and psychosis (β = 0.07, 95 % CI: 0.03-0.11), and between lifespan PTEs and psychosis (β = 0.09, 95 % CI: 0.03-0.11), were both small but significant. Both direct paths remained significant, suggesting that shame acts a partial mediator for both types of PTE.
Conclusions:
Shame is one path through which potentially traumatic events may influence the experience of psychosis and should be considered alongside other affective types in future modelling of psychosis. Qualitative research may aid further understanding of the mechanisms by which shame operates in this relationship.
Related Concept Videos
Psychological and Sociocultural Causes of Schizophrenia
Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
Post-traumatic Stress Disorder
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
Biological Causes of Schizophrenia
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin...
Modeling in Therapy
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in...
Psychodynamic Therapy

