People with OCD often grapple with intrusive thoughts they deem morally unacceptable, leading to feelings of shame. In an attempt to alleviate the distress from these thoughts, many engage in compulsive rituals, which, if perceived as irrational, can further contribute to feelings of shame. This sense of embarrassment is intensified by their perceived lack of control over both the obsessive thoughts and the compulsive behaviors, despite being aware of their irrational nature.
Key Points
Rationale
Cognitive models propose that feelings of shame can emerge in OCD due to dysfunctional appraisals about obsessional thoughts, which can perpetuate negative self-beliefs (Bhar & Kyrios, 2007).
However, empirical research on shame in OCD has provided mixed results (Cândea & Szentagotai-Tăta, 2018).
Thissystematic reviewandmeta-analysisaimed to clarify the association between shame, OCD and unacceptable thoughts.
Method
Sample:
Statistical measures:
Results
Implications
Future Research
Strengths & Limitations
The study had many methodological strengths, including:
However, this meta analysis was limited in a few ways:
Conclusion
These findings support a medium positive association between shame and OCD overall. Shame appears particularly linked to unacceptable thoughts,harm obsessions, andsymmetry concerns.
Further research using OCD-specific shame measures is needed to enrich understanding of this relationship and its clinical relevance.
References
Primary Paper
Laving, M., Foroni, F., Ferrari, M., Turner, C., & Yap, K. (2023). The association between OCD and Shame: A systematic review and meta‐analysis.British Journal of Clinical Psychology,62(1), 28-52.
Other References
Bhar, S. S., & Kyrios, M. (2007). An investigation of self-ambivalence in obsessive-compulsive disorder.Behaviour Research and Therapy, 45(8), 1845-1857.https://doi.org/10.1016/j.brat.2007.02.005
Cândea, D.-M., & Szentagotai-Tăta, A. (2018). Shame-proneness, guilt-proneness and anxiety symptoms: A meta-analysis.Journal of Anxiety Disorders, 58, 78–106.https://doi.org/10.1016/j.janxdis.2018.07.005
Further Information
Learning Check
How might social stigma around OCD symptoms like unacceptable thoughts contribute to shame for sufferers? Should greater education be provided to the public to reduce stigma?If OCD treatments like CBT aim to reduce dysfunctional thinking patterns, how might they also help alleviate shame? Could compassion-focused therapies that address shame and self-criticism also be beneficial?The study found a link between symmetry concerns and shame – why might perfectionistic tendencies associated with symmetry OCD exacerbate shame?What are some ethical considerations in researching private mental health issues like shame and intrusive thoughts? Should researchers aim to further understand these issues despite potential complexities?If OCD sufferers underreport shame due to social desirability biases, how else might researchers effectively measure shame? Could implicit or indirect measures be developed?How might cultural factors relating to OCD symptoms and shame be considered in future research? Would an international study allow for cross-cultural comparisons?
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
