Abstract
Objectives: The central objective of this study was to investigate the relationship between shame and substance use. The Experiences of Shame Scale (ESS) was used to differentiate between different sources of shame, namely character, behaviour and body shame. Drug-related shame was examined as a possible additional source of shame. The study also aimed to investigate potential constructs underlying the association between shame and substance use. Aggression was considered alongside the self-related concepts of self-ambivalence and self-esteem as potential mediators. Finally, the relationship between shame and distress disclosure was examined. Method: 100 participants were recruited for the study; 50 poly-drug users were recruited from drug and alcohol services for the substance use (SU) group and 50 non-substance using participants were recruited online via mental health charities for the comparison group. The study used a cross-sectional design to investigate differences between the groups. Standardised self-report questionnaire measures were used. Results: Findings indicate that the SU group participants scored higher on all ESS subscales. After adjusting for demographic differences between the groups, only differences on Character shame remained significant. Aggression was found to be a significant mediator of the relationship between Character shame and substance use. Findings also suggest that the highest level of shame experienced by SU participants is related to substance use. Moreover, self-ambivalence, self-esteem and willingness to disclose distress were associated with shame, regardless of substance use. Conclusions: The findings of this study support the association between shame about one’s character and substance use, with aggression identified as an important factor in this relationship. The current study further contributes to the wider shame literature, suggesting self-related constructs to be useful in understanding experiences of shame. Implications for clinical practice are discussed. Directions for future research are considered in light of this study’s limitations.