Journal of Contextual Behavioral Science 12 (2019) 7–12 Contents lists available at ScienceDirect Journal of Contextual Behavioral Science journal homepage: www.elsevier.com/locate/jcbs Elucidating the relationships between shame, anger, and self-destructive behaviors: The role of aversive responses to emotions T ⁎ Clair Cassiello-Robbinsa, , Julianne G. Wilnera, Jessica R. Petersb, Kate H. Bentleyc, Shannon Sauer-Zavalaa a Center for Anxiety and Related Disorders at Boston University, Boston University, 648 Beacon St, 6th Floor, Boston, MA 02215, USA b Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and Rhode Island Hospital, USA c Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA ARTICLE INFO ABSTRACT Keywords: Shame and anger are distinct yet interrelated emotions that have both been implicated in the occurrence of Shame impulsive, self-destructive behavior (ISDB); however, the intricacies of these relations remain sparsely ex- Anger amined. Some research, mostly with anxiety and depression, suggests that an aversive reaction to the experience Self-destructive behavior of negative emotions can result in efforts to escape or avoid such experiences. The current study sought to extend Functional analysis this model to the experience of shame. Consistently, we predicted that aversive reactions to shame would be associated with anger, which would be associated with ISDB. Four hundred and seventy-five undergraduate students completed a series of online questionnaires. Serial mediation was performed and r-square indicated that 35.55% of the variance in impulsive behavior was explained by this model. As predicted, shame had a significant indirect effect on anger through aversive reactions to emotions and on ISDB through aversive reactions to emotions and anger. Unexpectedly the reverse model, with an aversive reaction to anger predicting shame and ISDB, was also significant suggesting possible bidirectional relations between these constructs. This study is among the first to examine a possible mechanism by which shame can lead to ISDB, providing potential points of intervention for treatment. 1. Introduction threatened by another individual) or internal (e.g., painful memories or emotions; Plutchik, 2001). Shame and anger are distinct, complex, and interrelated emotions. Even though these emotions have a functional purpose, they can As with all emotions, they function by providing information about become dysregulated (i.e., out of proportion to a given situation) and one's environment and prompting behavioral responses (e.g., behaviors prompt behaviors that interfere with an individual's productivity or that promote survival in response to fear). Shame can be considered an survival. For example, in some contexts, shame can lead to self-pun- emotional state in which an individual perceives themselves as having ishment or anger can lead to unnecessary physical altercations. Of an enduring, global defect. Though often confused with guilt, the dis- particular concern, both shame and anger have been associated with tinction between these emotions is important as guilt typically involves impulsive, self-destructive behaviors (ISDB) including engagement in feeling bad about a specific behavior, but does not generalize to one's suicidal and non-suicidal self-injury, substance abuse, and unprotected sense of self (Tangney, Wagner, Hill-Barlow, Marschall, & Gramzow, sex (Brown, Comtois, & Linehan, 2002; Bryan, Morrow, Eteinne, & Ray- 1996). In some contexts, shame regulates interpersonal behavior by Sannerud, 2013; Hawkins et al., 2014; Randles & Tracy, 2013; Stuewig indicating when one has violated social and ethical standards and ty- et al., 2015). Given these associations, it is not surprising that elevated pically elicits withdrawal, which may preserve social relationships in shame and anger predict greater symptom severity for several psycho- which individuals share resources (e.g., food or childcare; Dunbar & logical disorders, including depression (e.g., Bennett, Traub, Mace, Shultz, 2007; Stuewig, Tangney, Heigel, Harty, & McCloskey, 2010; Juarascio, & O'Hayer, 2016; Fava et al., 1993), anxiety disorders (e.g., Tangney et al., 1996). Anger is typically considered an activating Cassiello‐Robbins & Barlow, 2016), and borderline personality disorder emotion that can motivate protective or assertive behavior in response (BPD; e.g., Scott et al., 2017). These findings are particularly con- to perceived threats, whether those threats are external (e.g., being cerning given that shame and anger may interfere with help-seeking for ⁎ Corresponding author. E-mail address: [email protected] (C. Cassiello-Robbins). https://doi.org/10.1016/j.jcbs.2018.12.004 Received 1 August 2018; Received in revised form 7 December 2018; Accepted 10 December 2018 2212-1447/ Published by Elsevier Inc. on behalf of Association for Contextual Behavioral Science. C. Cassiello-Robbins et al. Journal of Contextual Behavioral Science 12 (2019) 7–12 mental health (Cassiello-Robbins & Barlow, 2016; Clement et al., 2015). 2. Method Given shame's association with behavioral withdrawal and avoid- ance (covert behaviors), the relations between shame and ISDBs that 2.1. Participants are overt in nature (e.g., self-harm, etc.) appears counterintuitive. Research on emotional processes might lend some insight into these Participants were 475 undergraduate psychology students at a relations. Such work has demonstrated that an aversive reaction to the university in the United States who volunteered to complete an online experience of a negative emotions (i.e., the perception of these ex- questionnaire battery (see Measures) in exchange for course credit. The periences as unacceptable and uncontrollable) can lead to the use of sample was predominantly female (76.4%) with an average age of avoidance-based emotion regulation strategies (e.g., suppression; 18.97 years (SD=1.78, range 18–43). The majority of the sample Barlow, 1991; Brown & Barlow, 2009; Campbell-Sills, Barlow, Brown, & (48.6%) identified as African American or Caucasian. Due to an ad- Hoffman, 2006; Mennin, Heimberg, Turk, & Fresco, 2005). These ministrative error in the survey, the options for “Black or African emotion regulation efforts paradoxically reduce emotional intensity in American” and “Caucasian” were combined, which made it impossible the short-term while maintaining dysregulated emotions in the long- to further parse apart the race with which a portion of our sample term (Aldao, Nolen-Hoeksema, & Schweizer, 2010; Tull & Roemer, identified. However, the demographic composition of the class of 2019 2007). Over time, the repeated experience of some emotions as un- (38.2% Caucasian and 5.6% Black or African American), suggests that acceptable coupled with efforts to escape or avoid them can lead to the the sample was most likely predominantly Caucasian (Undergraduate development of emotional disorders (e.g., mood, anxiety, and related Admissions, 2015). Additionally, 38.1% identified as Asian, 8.0% as disorders; Campbell-Sills et al., 2006). more than one race, 0.4% as Native American, 0.6% as Pacific Islander, While primarily applied to the experience of emotions such as an- and 4.0% did not report their race; 12.8% identified as Hispanic or xiety and depression, extant theoretical and empirical evidence offers Latino. Modal family income was over $100,000 per year. Consistent some support for understanding this process as applied to the experi- previous literature (i.e., Eisenberg, Gollust, Golberstein, & Hefner, ence of shame. Theorists suggest shame can be so painful that it is often 2007; Ibrahim, Kelly, Adams, & Glazebrook, 2013), a portion of the suppressed and replaced by other negative emotions, especially anger current sample indicated that they had a current mood or anxiety dis- (Scheff & Retzinger, 1991; Tangney et al., 1996; Thomaes, Stegge, order (8.8%) and 4.8% had a current diagnosis of both. Olthof, Bushman, & Nezlek, 2011). Preliminary empirical support comes from several undergraduate samples in which proneness to 2.2. Measures shame predicted dysregulated anger responses, including anger arousal, hostility, and a propensity to blame others for negative events (Tangney 2.2.1. Anger et al., 1996; Tangney, Wagner, Fletcher, & Gramzow, 1992). Early The Clinical Anger Scale (CAS; Snell, Gum, Shuck, Mosley, & Hite, longitudinal research identified this relation as directional, with higher 1995) is a 21-item self-report assessment of the psychological, physio- levels of shame predicting later increases in hostility, and the reverse logical, affective, cognitive, and behavioral symptoms that constitute relation yielding insignificant results (Heaven, Ciarrochi, & Leeson, clinical anger. Each item consists of four statements, and respondents 2010). select which of the statements best reflects how they feel. For instance, Consistent with the aforementioned framework, aversive reactions they may select one of the following four options: I do not feel angry, I to the experience of shame may lead to avoidant coping that is mani- feel angry, I am angry most of the time now,orI am so angry and hostile all fested as anger, which is typically associated with more overt action the time that I can’t stand it. The CAS has demonstrated a unidimensional tendencies (e.g., ISDBs). A recent study explored the pathway through factor structure, and had strong internal consistency in the study which shame (both situational shame, and trait [global] shame)