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ShameNCT04600557

A Compassion-based Intervention for Internal and External Shame

A study testing Receiving compassionate responses from confederates and Receiving no response from confederates in people with Shame and Compassion, run by University of Texas at Austin at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a four-arm randomized pilot study aimed at reducing internal and/or external shame using self-compassion and/or compassion from others. The study is designed to test the theory that trait shame is comprised of both internal and external shame and to test compassion for others as an intervention for external… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Shame, Compassion
What is being tested?
Receiving compassionate responses from confederates and Receiving no response from confederates
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
439 participants
Where
1 siteUnited States
Study dates
12 Feb 2019to 18 Nov 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Elevated levels of internal and external shame
  • Can recall two shameful experiences

Who cannot join

  • Active suicidal ideation as measured by endorsement of 2 (I would like to kill myself) or 3 (I would kill myself if I had the chance) on BDI-II item 9
  • Endorses intent to harm or kill others

Trial locations and contacts

1 site in 1 country.

United States1 site
  • The University of Texas at Austin

    Austin, Texas, 78705

Other trials in United States

About this study

This is a four-arm randomized pilot study aimed at reducing internal and/or external shame using self-compassion and/or compassion from others. The study is designed to test the theory that trait shame is comprised of both internal and external shame and to test compassion for others as an intervention for external shame.

Read the detailed description

Shame is a common, painful emotion involving negative evaluations of the self. It has been theorized that trait shame involves both internal shame (i.e., evaluating oneself negatively) and external shame (i.e., perceiving that others evaluate the self negatively). Shame is experienced across a variety of psychiatric illnesses, yet it has been highly understudied.

Self-compassion has been used as an intervention for reducing shame in a variety of research studies, often in the context of a specific psychiatric disorder. However, self-compassion interventions, which aim to change the way one thinks and feels about oneself, may specifically target internal shame but not external shame. It is proposed that receiving compassion from others is an analogous and plausible intervention for external shame. In order to test the theory that trait shame is comprised of both internal and external shame and to test compassion for others as an intervention for external shame, a four-arm randomized pilot study aimed at reducing internal and/or external shame using self-compassion and/or compassion from others is proposed here.

Participants (N=180) scoring high on both internal and external shame on self-report measures will be assessed at baseline using both questionnaires and a shame-memory recall. Participants will be randomized to one of four conditions: a) describing a shameful experience using a self-compassionate prompt and receiving no verbal responses from confederates (self-compassion only), b) describing a shameful experience using a neutral prompt and receiving compassionate responses from confederates (compassion from others only), c) both describing a shameful experience using a self-compassionate prompt and receiving compassionate responses from confederates (self-compassion plus compassion from others), or d) describing a shameful experience using a neutral prompt and receiving no verbal responses from confederates (sharing-only control). Participants will complete questionnaires and shame-memory recalls again immediately following the sharing intervention and at a one-week post-intervention follow-up.

The two primary outcome measures will be state internal shame, as measured by the Internalized Shame Sclae, and state external shame, as measured by the Other As a Shamer scale. Both the Internalized Shame Scale and Other As a Shamer scale will be administered at baseline (immediately pre-treatment), immediately post-treatment, and a one-week post-intervention follow-up. Secondary outcome measures will include the Positive and Negative Affect Scale, and a real-time assessment of state shame.

It is expected that (a) participants assigned to describe a shameful experience using self-compassionate instructions will display larger reductions in internal shame relative to those assigned to describe a shameful experience using neutral instructions; (b) participants who receive compassionate responses from others after sharing a shameful experience will display larger reductions in external shame relative to those assigned to a listening-only control; and (c) participants assigned to describe a shameful experience using self-compassionate instructions combined with receiving compassionate responses from others will display larger reductions in both internal and external shame relative to participants who receive either component alone.

Conditions
Shame, Compassion
Being tested
Describing a shameful experience using a self-compassionate prompt, Receiving compassionate responses from confederates, Describing a shameful experience using a neutral prompt, Receiving no response from confederates
Keywords
compassion, self-compassion, shame

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Describing a shameful experience using a self-compassionate promptBehavioural

    Also called Self-compassionate prompt

    Participants will be instructed to describe a shameful experience to two confederates using a self-compassionate prompt

  • Receiving compassionate responses from confederatesBehavioural

    Also called Compassionate confederates

    Following the participant's description of a shameful experience, two confederates will respond with compassionate responses

  • Describing a shameful experience using a neutral promptBehavioural

    Also called Neutral prompt

    Participants will be instructed to describe a shameful experience to two confederates using a neutral (i.e., not self-compassionate) prompt

  • Receiving no response from confederatesBehavioural

    Also called Neutral confederates

    Following the participant's description of a shameful experience, two confederates will not be allowed to provide any verbal response

Study groups in NCT04600557
Study groupRoleWhat they receive
Self-compassion onlyExperimentalDescribing a shameful experience using a self-compassionate prompt and receiving no verbal responses from confederates
Receives: Behavioral: Describing a shameful experience using a self-compassionate prompt; Behavioral: Receiving no response from confederates
Compassion from others onlyExperimentalDescribing a shameful experience using a neutral prompt and receiving compassionate responses from confederates
Receives: Behavioral: Receiving compassionate responses from confederates; Behavioral: Describing a shameful experience using a neutral prompt
Self-compassion plus compassion from othersExperimentalBoth describing a shameful experience using a self-compassionate prompt and receiving compassionate responses from confederates
Receives: Behavioral: Describing a shameful experience using a self-compassionate prompt; Behavioral: Receiving compassionate responses from confederates
Sharing-only controlActive comparatorDescribing a shameful experience using a neutral prompt and receiving no verbal responses from confederates
Receives: Behavioral: Describing a shameful experience using a neutral prompt; Behavioral: Receiving no response from confederates

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Internal shame

    Measured by scores on Internalized Shame Scale (range: 0-120, higher indicates more shame)

    Measured: One-week post-intervention

  2. Internal shame

    Measured by scores on Internalized Shame Scale (range: 0-120, higher indicates more shame)

    Measured: 5 minutes post-intervention

  3. External shame

    Measured by scores on Other As Shamer Scale (range: 0-72, higher indicates more shame)

    Measured: One-week post-intervention

  4. External shame

    Measured by scores on Other As Shamer Scale (range: 0-72, higher indicates more shame)

    Measured: 5 minutes post-intervention

Secondary outcomes (12)
  1. Shame activation

    Real-time assessment of shame activation during shame memory recall tasks (range: 0-100)

    Measured: 5 minutes post-intervention

  2. Shame activation

    Real-time assessment of shame activation during shame memory recall tasks (range: 0-100)

    Measured: one-week follow-up

  3. State shame

    Micro-assessment of state shame using Positive and Negative Affect Scale (range: 1-5, higher indicates more shame)

    Measured: 5 minutes post-intervention

  4. State shame

    Micro-assessment of state shame using Positive and Negative Affect Scale (range: 1-5, higher indicates more shame)

    Measured: one-week follow-up

  5. Electrodermal response to shame

    Measured in microsiemens (μS) by Empatica E4 during shame memory recall tasks

    Measured: 5 minutes post-intervention

  6. Electrodermal response to shame

    Measured in microsiemens (μS) by Empatica E4 during shame memory recall tasks

    Measured: one-week follow-up

  7. Blood volume pulse in reaction to shame

    Changes in blood volume measured by Empatica E4 during shame memory recall tasks

    Measured: 5 minutes post-intervention

  8. Blood volume pulse in reaction to shame

    Changes in blood volume measured by Empatica E4 during shame memory recall tasks

    Measured: one-week follow-up

  9. Motion in reaction to shame

    Measured by 3-axis accelerometer sensor in the range [-2g, 2g] using Empatica E4 during shame memory recall tasks

    Measured: 5 minutes post-intervention

  10. Motion in reaction to shame

    Measured by 3-axis accelerometer sensor in the range [-2g, 2g] using Empatica E4 during shame memory recall tasks

    Measured: one-week follow-up

  11. Skin temperature reaction to shame

    Temperature measured in degrees Celcius by Empatica E4 during shame memory recall tasks

    Measured: 5 minutes post-intervention

  12. Skin temperature reaction to shame

    Temperature measured in degrees Celcius by Empatica E4 during shame memory recall tasks

    Measured: one-week follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Oct 2020
  2. Study start12 Feb 2019
  3. Primary completion18 Nov 2021
  4. Study completion18 Nov 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants are randomly assigned to one of four conditions throughout the study.
Masking
Single blind
Who is masked
Participant
Enrolment
439 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04600557
Sponsor's protocol ID
2018-07-0058
Status last verified
Nov 2021
First submitted
10 Oct 2020
Last updated
1 Dec 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Cook, D. R. Measuring shame: the internalized shame scale. Alcoholism Treatment Quarterly, 1987; 4, 197- 215.

  • del Rosario, P.M., & White, R.M. The Internalized Shame Scale: Temporal stability, internal consistency, and principal components analysis. Personality and Individual Differences. 2006; 41, 95-103.

  • Goss, K., Gilbert, P., & Allen, S. An exploration of shame measures-I: The Other As Shamer scale. Person. Individ. Diff.,1994; 17(5), 713-717.

  • Andrews B, Qian M, Valentine JD. Predicting depressive symptoms with a new measure of shame: The Experience of Shame Scale. Br J Clin Psychol. 2002 Mar;41(Pt 1):29-42. doi: 10.1348/014466502163778.

    PubMed 11931676
  • Neff, K.D. The development and validation of a scale to measure self-compassion. Self and Identity. 2003; 2, 223-250.

  • Rybak, C.J. & Brown, B. Assessment of internalized shame: Validity and reliability of the Internalized Shame Scale. Alcoholism Treatment Quarterly. 1996; 14:1.

  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. 2013.

  • Au TM, Sauer-Zavala S, King MW, Petrocchi N, Barlow DH, Litz BT. Compassion-Based Therapy for Trauma-Related Shame and Posttraumatic Stress: Initial Evaluation Using a Multiple Baseline Design. Behav Ther. 2017 Mar;48(2):207-221. doi: 10.1016/j.beth.2016.11.012. Epub 2016 Nov 29.

    PubMed 28270331
  • Gilbert P. The evolution of social attractiveness and its role in shame, humiliation, guilt and therapy. Br J Med Psychol. 1997 Jun;70(2):113-47. doi: 10.1111/j.2044-8341.1997.tb01893.x.

    PubMed 9210990
  • Gilbert, P. What Is shame? Some core issues and controversies. In Shame: Interpersonal behavior, psychopathology, and culture. 1998.

  • Gilbert, P., & Procter, S. Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. In Clinical Psychology and Psychotherapy. 2006; 13(6): 353-379. https://doi.org/10.1002/cpp.507

  • Johnson, E. A., & O'Brien, K. A. Self-Compassion Soothes the Savage EGO-Threat System: Effects on Negative Affect, Shame, Rumination, and Depressive Symptoms. Journal of Social and Clinical Psychology. 2013; 32(9), 939-963. https://doi.org/10.1521/jscp.2013.32.9.939

  • Judge, L., Cleghorn, A., McEwan, K., & Gilbert, P. An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team. International Journal of Cognitive Therapy. 2012. https://doi.org/10.1521/ijct.2012.5.4.420

  • Kim S, Thibodeau R, Jorgensen RS. Shame, guilt, and depressive symptoms: a meta-analytic review. Psychol Bull. 2011 Jan;137(1):68-96. doi: 10.1037/a0021466.

    PubMed 21219057
  • Lewis, M. Shame: The exposed self. New York: Free Press. 1992.

Questions about this trial

What is this clinical trial studying?

A study testing Receiving compassionate responses from confederates and Receiving no response from confederates in people with Shame and Compassion, run by University of Texas at Austin at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Dec 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Internal shame (time frame: One-week post-intervention). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04600557, which also lists 18 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Dec 2021.

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