A systematic review of the clinical utility of the concept of self‐disgust

This systematic literature review examined the clinical utility of the construct of self disgust in understanding mental distress. Specifically, the review assessed whether there is a shared conceptual definition of self-disgust, the face and construct validity of the quantitative assessment measures of self-disgust, and the predictive validity of self-disgust in formulating the development of a range of psychological difficulties. A systematic database search supplemented by manual searches of references and citations identified thirty-one relevant papers (27 quantitative, 3 qualitative, 1 mixed). Analysis of qualitative papers indicated a number of shared features in the definition of self-disgust, including a visceral sense of self elicited nausea accompanied by social withdrawal and attempts at cleansing or suppressing aspects of the self. Quantitative assessment measures appeared to capture these dimension and evidenced good psychometric properties, although some measures may have only partially captured the full self-disgust construct. Strong relationships were observed between self disgust and a range of mental health presentations, in particular depression, body-image difficulties, and trauma-related difficulties. However, these relationships are smaller when the effects of other negative self-referential emotions were controlled, and stronger conclusions about the predictive validity of self-disgust are limited by the cross-sectional nature of many of the studies

An examination of the relationship between shame, guilt and self-harm: A systematic review and meta-analysis

Self-harm is a major public health concern associated with suicide risk and significant psychological distress. Theories suggest that aversive emotional states are an important process that drives self-harm. Shame and guilt may , in particular, be important emotions in self-harm. This review therefore sought to provide a systematic review and meta-analysis of the relationship between shame, guilt, and self-harm. A systematic search of electronic databases (PsycINFO; Medline; CINAHL Plus; Web of Science and ProQuest) was undertaken to identify studies measuring shame, guilt and self-harm (including suicidal and non-suicidal behaviour). Meta-analysis was undertaken where papers focused on the same subtype of shame or guilt and shared a common outcome. Thirty studies were identified for inclusion. Most forms of shame were associated with non-suicidal self-injury (NSSI), but research was sparse concerning suicidal behaviour. Fewer studies examined guilt and findings were more varied. Methodological issues included a paucity of longitudinal designs and lack of justification for sample sizes. Results of this review support the link between shame and self-harm, particularly NSSI. The direction of this relationship is yet to be established. Clinically, consideration should be given to the role of shame amongst individuals who present with NSSI. This review was pre-registered on PROSPERO (CRD42017056165)