Examining shame: mindfulness-program effects and multilevel longitudinal mediation

Abstract

Shame, negative self-evaluation in response to a social evaluative threat, is associated with many unwanted outcomes if it remains unresolved through coping skills. Mindfulness-based interventions (MBIs) aim to increase mindful attention and/or self-compassion as well as emotion regulation, which are coping characteristics that may aid in approaching and resolving shame. These theoretical paths of influence require further testing as does the ability of specific interventions to mitigate shame. Additionally, to facilitate future tailoring of interventions to support those who are currently underserved, more research is needed to assess variability in individual participant response to interventions and potential causes of this variability. Two studies were conducted to address these issues in the context of shame management via mindfulness processes. Study 1 assessed whether college-student participants in the six-session MBI Learning to BREATHE demonstrated significant average reduction in internalized shame and then employed reliable change analysis to identify response and nonresponse in individual participants. Participants (N = 48) on average experienced moderate reduction in shame and could be categorized into three distinct participant subgroups based on pretest shame level and trajectory of change in shame. Responding participants experienced pronounced decrease in shame; nonresponding participants with low pretest shame did not decrease further in shame due to limited room for improvement; nonresponding participants with high pretest shame did not decrease in shame despite ample room for improvement. Testing of candidate factors as predictors of change in shame revealed that low pretest mindful attention and pre- to posttest decrease in anxiety were significantly associated with decrease in shame. Notably, shame nonresponders with both high pre- and post-intervention shame did experience significant improvements in coping characteristics (mindful attention, self-compassion, and emotion regulation). Demographic predictors of change in shame were recommended for testing in future studies with larger sample sizes. Study 2 tested theoretical paths of influence from mindful attention to shame, among others. Multiple models were tested via multilevel mediation using intensive repeated measures (1,183 observations) from daily participant surveys across six weeks. Not only were self-compassion and emotion regulation mediators of the effect of mindful attention on shame, shame itself was conversely also a mediator between mindful attention and the latter coping characteristics. These findings suggest the possibility of bidirectional processes, and that directly and explicitly addressing shame in MBI may further improve participant coping characteristics and overall benefits of MBIs.