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Harm-doing and victim's racial or orthopedic stigma as determinants of helping behavior.

Three experiments tested a prediction derived from an ambivalence theory of behavior toward the stigmatized. The prediction was that unintentional harm-doers would be more likely to make restitution by doing a favor for a stigmatized victim than for a nonstigmatized one. In Experiment 1 it was upheld for black versus white victims. In Experiment 2, where the victim of harm-doing was either physically handicapped or normal, the prediction was upheld only among older subjects, following the post hoc introduction of an age variable. Experiment 3 also used a physical disability variable. The data were consistent with the prediction, although the adequacy of the harm-doing manipulation was not checked empirically. On the whole, these results are seen as complementing previous findings of amplified post-harm-doing denigration of black and disabled victims. An assumption that the relationship between harm-doing and altruism was mediated by guilt arousal received only fragmentary support. That is, self-reports of guilt were highest in the harm-doing black confederate condition in Experiment 1, and self-reports of negative affect were highest in the harm-doing/wheelchair confederate condition in Experiment 3, but there were no significant relationships between individual differences in guilt or negative affect on the one hand, and amount of helping, on the other.

Adolescent↗

The psychologic of forgiving.

Psychologic is an attempt to systematize the commonsense psychology embedded in ordinary language. In this system, the concepts of respect, anger, and guilt, are directly linked, since messages of disrespect, and only those, create anger in the receiver and guilt in the sender. This paper deals with the process of forgiving, whereby respect is reaffirmed and anger and guilt are alleviated. Forgiving depends on clarification of misunderstanding as well as on apology and atonement. The distinction between forgiving others and forgiving oneself is treated. It is concluded that what goes on inside persons and between persons has the same structure.

Anger↗

Negative emotions in children with newly diagnosed epilepsy.

PURPOSE: To understand the emotional predicament in children with recently diagnosed idiopathic or cryptogenic epilepsy. METHODS: We used the well-tried method of structured projection for the first time in children with epilepsy. Thirty-six children with epilepsy, aged 7-15 years (mean age, 9.5 years) and in 35 control children aged 7-15 years (mean age, 9.4 years), attributed shame and guilt in relation to three types of situation (non-illness related, illness related, and epilepsy related). Children were evaluated twice: shortly after diagnosis, before antiepileptic drug (AED) use and after an interval of 3 months. RESULTS: Children with epilepsy and healthy controls were similar in their way of attributing shame and guilt. However, the type of situation was of influence: Both children with epilepsy and healthy children attributed more shame to incompetence due to epilepsy than to incompetence due to other illnesses. CONCLUSIONS: Increased affective problems in childhood epilepsy cannot be explained by excessive attribution of shame and guilt, affects known to be important precursors of psychopathology, yet both healthy children and children with epilepsy attribute more shame to epilepsy than to other illnesses. Epilepsy is not like any other disease.

Adolescent↗

Mood modulation by food: an exploration of affect and cravings in 'chocolate addicts'.

To test the hypothesis that some foods are eaten to alter mood, the relationship between mood and intake of chocolate was investigated in 40 women. Twenty self-identified chocolate 'addicts' and 20 controls rated hunger, mood, intensity of craving and amount of chocolate eaten in a diary for seven consecutive days. The 'addicts' reported a significantly greater number of eating episodes and consumed a larger amount of chocolate than controls. 'Addicts' also rated depression, guilt and craving higher and feeling content and relaxed as lower before eating than controls. However, eating chocolate resulted in increased feelings of guilt in the 'addicts' and no significant changes in feeling depressed or relaxed. On indices of disordered eating and depression, 'addicts' scored significantly higher than controls; however, eating chocolate did not improve mood. Although chocolate is a food which provides pleasure, for those who consider intake of this food to be excessive, any pleasure experienced is short lived and accompanied by feelings of guilt.

Adult↗

Prevalence of depressive episodes with psychotic features in the general population.

OBJECTIVE: The study evaluated the prevalence of major depressive episodes with psychotic features in the general population and sought to determine which depressive symptoms are most frequently associated with psychotic features. METHOD: The sample was composed of 18,980 subjects aged 15-100 years who were representative of the general populations of the United Kingdom, Germany, Italy, Portugal, and Spain. The participants were interviewed by telephone by using the Sleep-EVAL system. The questionnaire included a series of questions about depressive disorders, delusions, and hallucinations. RESULTS: Overall, 16.5% of the sample reported at least one depressive symptom at the time of the interview. Among these subjects, 12.5% had either delusions or hallucinations. More than 10% of the subjects who reported feelings of worthlessness or guilt and suicidal thoughts also had delusions. Feelings of worthlessness or guilt were also associated with high rates of hallucinations (9.7%) and combinations of hallucinations and delusions (4.5%). The current prevalence of major depressive episode with psychotic features was 0.4% (95% CI=0.35%-0.54%), and the prevalence of a current major depressive episode without psychotic features was 2.0% (95% CI=1.9%-2.1%), with higher rates in women than in men. In all, 18.5% of the subjects who fulfilled the criteria for a major depressive episode had psychotic features. Past consultations for treatment of depression were more common in depressed subjects with psychotic features than in depressed subjects with no psychotic features. CONCLUSIONS: Major depressive episodes with psychotic features are relatively frequent in the general population, affecting four of 1,000 individuals. Feelings of worthlessness or guilt can be a good indicator of the presence of psychotic features.

Adolescent↗

Hidden shame.

Shame dynamics, after decades of neglect, reappeared in psychoanalytic thinking with increasing prevalence in the last thirty years. Shame that is hidden is an aspect of complex clinical phenomenology that is particularly likely to be missed and hidden further by partial psychoanalytic explanations that drive shame more and more from view. Shame is often hidden theoretically by formulations limiting conflict to conflict between drives or impulses and something opposing them. By contrast, the incompatible idea model propounded by Freud in Studies on Hysteria emphasizes awareness incompatible with the dictates of conscience, and hence is broader in scope and closer to actual experience. Although shame and guilt arise developmentally earlier than does a true sense of morality, these emotions and their unconscious variants become entwined with the individual's sense of morality as development proceeds. The dynamics of shame and guilt are considerably more complex than their phenomenology as overt emotions. Shame emphasizes weakness, vulnerability, and the likelihood of rejection--so much so that its acknowledgment often generates more shame. Guilt, however, since it is action- and power-oriented, often obscures shame and so defends against it.

Awareness↗

Sibling incest aversion as an index of oedipal conflict.

This study examines sibling incest aversion as an index of the Oedipus complex. The scale's construction and its relation to presence of opposite sex siblings, guilt, and neuroticism is described. Males displayed less aversion and more variability in incest aversion than did females. There was a positive relation between aversion and having an opposite sex sibling for males, but not for females. For both sexes there was a positive relation between sex guilt and aversion. Compared to high or low incest aversion females, middle females displayed a mild obsessive-compulsive pattern, higher hostility guilt, more neurotic complaints, less extraversion and more sensitization. The high reliability and significant relations with relevant variables demonstrate the usefulness of this scale.

Adolescent↗

Surviving bone marrow transplantation: the patient in the other bed.

Patients hospitalized for bone marrow transplantation tend to deny the significance for them of the death of another transplant patient. Patients emphasize, often with encouragement from the medical staff, the differences between their conditions. Interviews held after discharge with the survivors of five pairs of patients hospitalized together in which one patient died show that the death of another patient having bone marrow transplantation has a major impact on the surviving patient. Early identification develops between patients, and after one patient dies there are attempts at distancing and denial of identification, survivor guilt, and fears of a similar fate that continue after transplantation. Healthy reactions are differentiated from nonadaptive reactions. Similarities to other forms of survivor guilt are discussed, including the guilt of the medical staff.

Adolescent↗

[A controlled study of irrational interpretations of intrusive thoughts in obsessive-compulsive disorder].

UNLABELLED: Recent research suggested that the irrational interpretations of intrusive thoughts might be cognitive structures underlying obsessive compulsive disorder (OCD). We present a study on intrusive thoughts and their interpretations in 36 patients suffering from OCD (DSM IV criteria), compared with 36 sex and age matched non clinical subjects, with the Intrusive Thoughts and their Interpretations Questionnaire-revised version (ITIQ-r). This questionnaire measures intrusive thoughts intensity and three types of interpretation: responsibility, guilt and inferiority. The measures of OCD, of depression, of social phobia and of anxiety have been used. RESULT: OCD patients reported more frequent intrusive thoughts and higher irrational interpretations than controls. The higher the intrusive thoughts, the higher the irrational interpretations. The multiple regression showed that both intrusive thoughts and irrational interpretations were respectively predicted by obsessional compulsive pathology (the Obsessive Thoughts Checklist or the Y-BOCS). The Y-BOCS was the only predictor for inferiority interpretation, but there was no significant predictor for responsibility or for guilt interpretations. Responsibility correlated only with aggressive intrusive thoughts. Guilt was related to intrusions about fear of loss. Inferiority was highly correlated with intrusive thoughts about perfectionism and sexuality.

Adolescent↗

[Psychopathological study of lie motif in schizophrenia].

The theme of a statement is called "lie motif" by the authors when schizophrenic patients say "I have lied to anybody". We tried to analyse of the psychopathological characteristics and anthropological meanings of the lie motifs in schizophrenia, which has not been thematically examined until now, based on 4 cases, and contrasting with the lie motif (Lügenmotiv) in depression taken up by A. Kraus (1989). We classified the lie motifs in schizophrenia into the following two types: a) the past directive lie motif: the patients speak about their real lie regarding it as a 'petty fault' in their distant past with self-guilty feeling, b) the present directive lie motif: the patients say repeatedly 'I have lied' (about their present speech and behavior), retreating from their previous commitments. The observed false confessions of innocent fault by the patients seem to belong to the present directed lie motif. In comparison with the lie motif in depression, it is characteristic for the lie motif in schizophrenia that the patients feel themselves to already have been caught out by others before they confess the lie. The lie motif in schizophrenia seems to come into being through the attribution process of taking the others' blame on ones' own shoulders, which has been pointed out to be common in the guilt experience in schizophrenia. The others' blame on this occasion is due to "the others' gaze" in the experience of the initial self-centralization (i.e. non delusional self-referential experience) in the early stage of schizophrenia (S. Kato 1999). The others' gaze is supposed to bring about the feeling of amorphous self-revelation which could also be regarded as the guilt feeling without content, to the patients. When the guilt feeling is bound with a past concrete fault, the patients tell the past directive lie motif. On the other hand, when the patients cannot find a past fixed content, and feel their present actions as uncertain and experience them as lies, the present directive lie motif is told. Lie motifs are considered to have the effect of restoring the patient's own subjectivity by the following ways: (a) by actualizing the structural constituents elementary for the establishment of subjectivity, (b) by conducting a kind of speech act for declaring themselves as an active lying subject to co-presenting others for the resettlement in our inter-subjective world.

Adolescent↗

A journey to pain.

This paper explored the restoration of the capacity to feel pain and guilt as a result of the emotional experience in analysis. This was illustrated by the first part of an analysis of a woman who lost her four-month-old baby in a car accident. Analysis revealed in this case a fragmented self unable to deal with unbearable feelings of pain and guilt which threatened to annihilate it. She connected the accident to a series of events which appeared to her to be the realization of her aggressive wishes towards primary objects throughout her life. The perception of the impairment and loss of loved objects as due to her destructiveness led to the inability to differentiate self from object, the impairment in the work of mourning, and aggression turned against the self. The analyst's survival of the destructive attack without retaliation enabled the differentiation, a better adaptation to reality and the restoration of the capacity to feel pain and guilt.

Accidents, Traffic↗

[Awareness of death and interpersonal relations in induced abortion].

So far no research has been carried out into the way in which women come to terms with abortion. There are four levels of experience. First, normal psychological experience, with feelings of guilt, reproach, stability, indifference; deeper awareness is suppressed with the aid of forms of defense such as scientific objectivism, positivism, and reductionism. This level is sociopsychologically well documented. Second, breakthrough of destructive deep awareness, with chaos and panic, revulsion and hate-this level is being researched by psychoanalytic methods. Third, acceptance of existential reality, experiencing guilt at having been party to killing a child. Fourth, responsibility and a feeling of guilt toward the dead child; it is here that the interhuman relationship is fulfilled, because the mental image of the child becomes like and independent being. Only at this point does full awareness of death occur. "He who knows the invisible, which has no material substance, but nevertheless an effect, is a physician."

Abortion, Induced↗

[Changes in depressive symptomatology in Austria].

A study of psychopathological manifestations of depressive in-patients, treated in the Salzburg psychiatric clinic in the last ten years, showed a masked shift of symptoms. The shift is away from guilt-feelings as well as away from religious content to a more general moral one. Also noted was a definite increase in feelings on insufficiency and hypochondric ideas. A comparison with tendencies in the Maghreb areas, in which a shift from the masked-somatic symptoms toward guilt-depression is reported, our results show here in Europe a renewed tendency of a shift from guilt-depression to hypochondric or anxiety-depression.

Africa, Northern↗

[Brief analytic essay on unconscious forces facilitating transgenerational repetition of physical or sexual abuse].

Transmission of abusive conduct is mainly determined by unconscious guilt and identification with the aggressor. The abused child is bound to split the parental object. The hostile side is eclipsed due to dependence and regression. Therefore deprived of the hated object, the guilt surges forcefully with the role reversal of the following generation. The former victim, whose identifications with the aggressor are actuated, discharges his guilt by projective identifications with the new victims. The ongoing splitting perpetuates the pathology of the relation.

Adult↗

[Depression, culture and evil].

The author has written this article as a reflexion on the relation between depression and guilt feelings by comparing her clinical experience-acquired in a western context-to knowledge gained from psychiatric anthropology studies. Manifestations of suffering are different according to different cultural contexts; in the western world the idea of guilt is prevalent, whereas it is somatic troubles and the idea of persecution that are in the foreground in non-western cultures, more particularly in Black Africa and the Maghreb. In the western world melancholy is not only a genuine standard model of depression but is also a cultural fact as witnessed by the numerous references in the literary and pictorial fields. The author asks us to ponder relations between the strength and frequency of guilt feelings on the one hand and the question of the debt and interiority of evil (sin) in the western christian tradition.

Christianity↗

Gender differences in affective reactions to first coitus.

Men's and women's affective reactions to their first sexual intercourse experience were examined. Eighty-seven college men and 122 college women completed questionnaires about first coital experience. Women were significantly more likely to report that their first sexual experience left them feeling less pleasure, satisfaction, and excitement than men, and more sadness, guilt, nervousness, tension, embarrassment, and fear. Factor analyses were used to group emotions into coherent factors for each sex. Four factors emerged for men: pleasure, romance, anxiety, and guilt. Three factors emerged for women: pleasure/romance, anxiety and guilt.

Adolescent↗

[Delusion in depression].

The present article endeavours an outline of depressive delusions, their symptomatology and their various topics. Their relations to depressive feelings of guilt and anxiety are discussed and differentiated. Delusions of guilt, poverty or disease including their preliminary states are by no means rare but regularly occurring symptoms which substantiate the diagnosis of major depressive disorder/endogenous depression/melancholia. Preliminary states like hypochondriatic fears of guilt and poverty are likewise characteristic clinical signs which may be differentiated with high validity from the kind of anxiety associated to neurotic depression/dysthmia. Delusional depression did not prove to be a nosological entity but as a concept may bear considerable heuristic value concerning therapeutic considerations. This particularly serious form of depression requires specific therapeutic procedures.

Delusions↗

Identifying the behavioural phenotype in Fetal Alcohol Spectrum Disorder: sensitivity, specificity and screening potential.

BACKGROUND: In most cases of Fetal Alcohol Spectrum Disorder (FASD), the pathognomonic facial features are absent making diagnosis challenging, if not impossible, particularly when no history of maternal drinking is available. Also because FASD is often comorbid with Attention Deficit Hyperactivity Disorder (ADHD), children with FASD are frequently improperly diagnosed and receive the wrong treatment. Since access to psychological testing is typically limited or non-existent in remote areas, other diagnostic methods are needed to provide necessary interventions. OBJECTIVES: To determine if a characteristic behavioural phenotype distinguishes children with FASD from typically developing children and children with ADHD and use this information to create a screening tool for FASD diagnosis. METHODS: Parents and caregivers completed the Child Behavior Checklist (CBCL), a well-established standardized tool for evaluating children's behavioural problems. Results from 30 children with Fetal Alcohol Syndrome or Alcohol-Related Neurodevelopmental Disability, 30 children with ADHD, and 30 typically developing healthy children matched for age and socioeconomic status with FASD were analyzed. Based on our previous work, 12 CBCL items that significantly differentiated FASD and control groups were selected for further analyses. Stepwise discriminant function analysis identified behavioural characteristics most strongly differentiating groups and Receiver Operating Characteristics (ROC) curve analyses determined sensitivity and specificity of different item combinations. RESULTS: Seven items reflecting hyperactivity, inattention, lying and cheating, lack of guilt, and disobedience significantly differentiated children with FASD from controls. ROC analyses showed scores of 6 or higher on these items differentiated groups with a sensitivity of 86%, specificity of 82%. For FASD and ADHD, two combinations of items significantly differentiated groups with high sensitivity and specificity (i) no guilt, cruelty, and acts young (sensitivity = 70%; specificity = 80% (ii) acts young, cruelty, no guilt, lying or cheating, steals from home, and steals outside (sensitivity = 81%; specificity = 72%). These items were used to construct a potential FASD screening tool. CONCLUSIONS: Our findings identifying the behavioural characteristics differentiating children with FASD from typically developing children or children with ADHD have the potential for development of an empirically derived tool for FASD tool to be used in remote areas where psychological services are not readily available. This technique may speed up diagnosis and intervention for children without ready access to formal assessments.

Attention Deficit Disorder with Hyperactivity↗