Cited by 215Suicide and Self-Harm StudiesAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesEmotions and Moral Behavior

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Self‐harm in a mixed clinical population: The roles of self‐criticism, shame, and social rank

Gilbert, Paul., McEwan, Kirsten., Irons, Chris., Bhundia, Rakhee., Christie, Rachael., Broomhead, Claire., Rockliff, Helen.·2010·British Journal of Clinical Psychology

DOI 10.1348/014466509x479771

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Abstract

Objectives. This study explored the relationship of forms and functions of self‐criticism, shame, and social rank variables to self‐harm, depression, and anxiety. Design. The study used a questionnaire design. Method. In‐patients and day‐patients ( N = 73) completed a series of questionnaires measuring self‐harm, mood, self‐criticism, shame, and social comparison. Results. Self‐harm was significantly associated with forms and functions of self‐criticism, shame, and feelings of inferiority (low social rank). The self‐persecuting function of self‐criticism was especially linked to self‐harm, depression, and anxiety. Conclusions. This study adds to a growing literature on the importance of recognizing the pathogenic effects of negative self‐critical thoughts and feelings about the self and the value of distinguishing different types of self‐criticism.

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“For instance, this model is supported by consistent correlations between both propensities for negative attitudes towards the self, especially self-criticism, and self-conscious negative emotions that are linked to self-criticism, such as shame and guilt (Castilho, Pinto-Gouveia, & Duarte, 2017; Gilbert et al., 2010;…”
BackgroundResult
Self-Criticism and Depressive Symptoms Mediate the Relationship Between Emotional Experiences With Family and Peers and Self-Injury in Adolescence
Xavier, A., Pinto‐Gouveia, J., Cunha, M. I. V. A., & Carvalho, S. A. (2016) · The Journal of Psychology · doi:10.1080/00223980.2016.1235538 · Cited by 30
“Studies showed that this pervasive form of self-criticism is associated with depressive symptoms (Castilho, Pinto-Gouveia, & Duarte, 2013; Gilbert et al., 2004) and NSSI (Gilbert et al., 2010; Xavier, Pinto-Gouveia, & Cunha, 2016).”
Background
Body weight perception outweighs body weight when predicting shame, criticism, depression and anxiety for lower BMI range and higher BMI range adults
Carter, A., Hoang, A., Gilbert, P., & Kirby, J. N. (2021) · Journal of Health Psychology · doi:10.1177/13591053211027641 · Cited by 29
“However, the forms and functions of self-criticism can be either (a) about inadequacies that need improving, or (b) attacking self-hatred in order to remove or expel, with the latter being particularly toxic and linked to depression (Gilbert et al., 2010).”
BackgroundSelf-citation
A systematic review of self‐report measures of generalized shame
Lear, M. K., Lee, E. B., Smith, S. M., & Luoma, J. B. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23311 · Cited by 34
Targeting the link between social media and eating disorder risk: A randomized controlled pilot study
de Valle, M. K., & Wade, T. D. (2022) · International Journal of Eating Disorders · doi:10.1002/eat.23756 · Cited by 33
The Self-perpetuating Cycle of Shame and Self-injury
Gunnarsson, N. V. (2020) · Humanity & Society · doi:10.1177/0160597620904475 · Cited by 25
“…research, shame is typically studied as one of many other possible variables involved in self-injury, or indirectly, for example, through self-hatred, low self-esteem, self-punishment, and self-dissatisfaction (e.g., Gilbert et al., 2010; Ivanhoff, Linehan, and Brown 2001; Victor and Klonsky 2013).”
Background
The influence of self-compassion on mental health of postgraduates: Mediating role of help-seeking behavior
Lin, M., Ni, J., & Lin, M.-Y. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.915190 · Cited by 20
“Even after controlling variables such as self-criticism and self-esteem, selfcompassion is negatively correlated with anxiety and depression, indicating that people with low levels of self-compassion might bemore prone to self-criticism and self-aggression (Gilbert et al., 2010).”
Background
Trauma Typology as a Risk Factor for Aggression and Self-Harm in a Complex PTSD Population: The Mediating Role of Alterations in Self-Perception
Dyer, K. F. W., Dorahy, M. J., Shannon, M., & Corry, M. (2012) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2012.710184 · Cited by 23
“In Nathanson's (1992) compass of shame model, self-harm represents an “attack self” coping strategy whereby individuals cope with the aversive feeling of shame by engaging in self-harm to punish themselves as a result of self-loathing or as a means of directly regulating such a diffuse, unsettling emotion ( Gilbert et…”
Background
Negative self-evaluation and the genesis of internal threat: beyond a continuum of suicidal thought and behaviour
Butter, S., Shevlin, M. E., & Murphy, J. (2018) · Psychological Medicine · doi:10.1017/s0033291718003562 · Cited by 23
A Brief Breathing Space: Experiences of Brief Admission by Self-Referral for Self-Harming and Suicidal Individuals with a History of Extensive Psychiatric Inpatient Care
Lindkvist, R., Westling, S., Liljedahl, S., & Landgren, K. (2020) · Issues in Mental Health Nursing · doi:10.1080/01612840.2020.1789787 · Cited by 21
Cognition and Non-Suicidal Self-Injury: Exploring Relationships with Psychological Functions
Sorgi, K. M., Cheung, J. C., Ciesinski, N. K., & McCloskey, M. S. (2022) · Archives of Suicide Research · doi:10.1080/13811118.2022.2106919 · Cited by 22
“Regarding the relationship between self-criticism and psychological functions, NSSI is linked to self-critical thoughts rooted in a desire to hurt or take revenge on oneself (Gilbert et al., 2010).”
Longitudinal Pathways for the Maintenance of Non-Suicidal Self-Injury in Adolescence: The Pernicious Blend of Depressive Symptoms and Self-Criticism
Xavier, A., Pinto‐Gouveia, J., Cunha, M. I. V. A., & Dinis, A. (2017) · Child & Youth Care Forum · doi:10.1007/s10566-017-9406-1 · Cited by 31
Shame in Anxiety and Obsessive-Compulsive Disorders
Szentágotai-Tătar, A., Nechita, D., & Miu, A. C. (2020) · Current Psychiatry Reports · doi:10.1007/s11920-020-1142-9 · Cited by 21
Emotional changes following discrimination induction in gender- and sexuality-diverse adolescents.
Smith, D. M. Y., Fox, K. R., Carter, M. L., Thoma, B. C., & Hooley, J. M. (2020) · Emotion · doi:10.1037/emo0000862 · Cited by 21
“We focused on these constructs because there is substantial research linking self-criticism (e.g., Fox, et al., 2018; Gilbert et al., 2010; Glassman, Weierich, Hooley, Deliberto, & Nock, 2007; St Germain & Hooley, 2012) and self-reported emotion reactivity (Franklin et al.”
Background
Dyslexia: Investigating Self-Harm and Suicidal Thoughts/Attempts as a Coping Strategy
Alexander‐Passe, N. (2015) · Journal of Psychology & Psychotherapy · doi:10.4172/2161-0487.1000224 · Cited by 25
“[43] describes self-harm as being often:”
Self-referential processing in individuals with nonsuicidal self-injury: An fMRI study
Nam, G., Moon, H., Lee, J.-H., & Hur, J. (2022) · NeuroImage Clinical · doi:10.1016/j.nicl.2022.103058 · Cited by 20
“For example, individuals who engage in NSSI exhibit a high level of self-criticism (Gilbert et al., 2010; Zelkowitz and Cole, 2019), negative feelings about the self (Forrester et al.”
Background
Assessment of Different Dimensions of Shame Proneness: Validation of the SHAME
Scheel, C. N., Eisenbarth, H., & Rentzsch, K. (2018) · Assessment · doi:10.1177/1073191118820130 · Cited by 18
“Shame is a highly aversive self-conscious emotion that is typically evoked after moral transgressions or the experience of incompetence and is accompanied by intense feelings of worthlessness, inferiority, and a damaged selfimage (de Hooge, 2013; de Hooge, Zeelenberg, & Breugelmans, 2011; Gilbert et al., 2010; M. Lewi…”
Background
When body dysmorphia symptomatology meets disordered eating: The role of shame and self-criticism
de Matos, M. B. C., Coimbra, M., & Ferreira, C. (2023) · Appetite · doi:10.1016/j.appet.2023.106552 · Cited by 17
Self-compassion and responses to health information in middle-aged and older women: An observational cohort study
Semenchuk, B. N., Boreskie, K. F., Hay, J. L., Miller, C., Duhamel, T. A., & Strachan, S. M. (2020) · Journal of Health Psychology · doi:10.1177/1359105320909860 · Cited by 17
“…(e.g. shame) associated with chronic conditions can lead to depression and stress (e.g. Pinto-Gouveia et al., 2014) and are known to interfere with self-regulation (Gilbert et al., 2010; Gross, 2002) including engagement in health-promoting behaviors (Sirois, 2015b; Sirois and Hirsch, 2019).”
Background
The Effects of Self-Criticism and Self-Compassion on Adolescents’ Depressive Symptoms and Nonsuicidal Self-Injury
Gao, Y., Liu, X., Liu, J., & Wang, H. (2023) · Psychology Research and Behavior Management · doi:10.2147/prbm.s417258 · Cited by 16
“Under adverse conditions, self-criticism can stimulate the threat system, eliciting feelings of anger and hatred with the self.(18) Individuals who are fearful of experiencing and expressing these negative self-directed emotions may be more likely to feel depressed and hurt themselves.”
Background
Working With Clients Who Self‐Injure: A Grounded Theory Approach
Whisenhunt, J. L., Chang, C. Y., Flowers, L. R., Brack, G., O’Hara, C. L., & Raines, T. C. (2014) · Journal of Counseling & Development · doi:10.1002/j.1556-6676.2014.00165.x · Cited by 16
Inhibitors and facilitators of compassion‐focused imagery in personality disorder
Naismith, I., Mwale, A. L., & Feigenbaum, J. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2161 · Cited by 21
Neural and Self-Report Markers of Reassurance: A Generalized Additive Modelling Approach
Kim, J. J., Henderson, T., Best, T., Cunnington, R., & Kirby, J. N. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.566141 · Cited by 16
“What this self-report scale measures is the degree to which an individual feels inadequate and inferior, and therefore their self-criticism is used to correct and improve the self, in order to try harder, to achieve goals and to maintain certain standards (32, 33).”
Background
‘I’m on the train and I can't stop it': Western Canadians' reactions to prediabetes and the role of self-compassion
Strachan, S. M., Bean, C. N., & Jung, M. E. (2018) · Health & Social Care in the Community · doi:10.1111/hsc.12628 · Cited by 20
Persönlichkeitsfunktionsniveau, maladaptive Traits und Kindheitstraumata
Back, S. N., Zettl, M., Bertsch, K., & Taubner, S. (2020) · Psychotherapeut · doi:10.1007/s00278-020-00445-7 · Cited by 15
“Traumatische Kindheitserlebnisse stellen einen erheblichen Risikofaktor für psychische Störungen, chronische Erkrankungen, Suizidalität sowie eine insgesamt verkürzte Lebenserwartung dar (Brown et al. 2009; Felitti 1998; Gilbert et al. 2010; Metzler et al. 2017).”
Background
Suicide Probability in Adolescents With a History of Childhood Maltreatment: The Role of Non-Suicidal Self-Injury, Emotion Regulation Difficulties, and Forms of Self-Criticism
Khanipour, H., Shooshtari, M. H., & Bidaki, R. (2016) · international journal high risk behaviors & addiction · doi:10.5812/ijhrba.23675 · Cited by 16
“According to the evolutionary model of self-criticism (18), self-criticism triggers threat and defensive emotions and behaviors, which lead to negative emotions that are difficult to regulate; thus, different kinds of psychopathology, like suicide behaviors, occur.”
Background
Predicting the Social-Emotional Competence Based on Childhood Trauma, Internalized Shame, Disability/Shame Scheme, Cognitive Flexibility, Distress Tolerance and Alexithymia in an Iranian Sample Using Bayesian Regression
Farahani, H., Azadfallah, P., Watson, P., Qaderi, K., Pasha, A., Dirmina, F., Esrafilian, F., Koulaie, B., Fayazi, N., Sepehrnia, N., et al. (2022) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-022-00501-1 · Cited by 19
The cognitive appraisal path of stroke knowledge, coping traits, family functioning and stigma among stroke patients: A moderated parallel mediation model
Liu, H., Liu, Q., Li, Z., Deng, C., Zhang, X., & Wan, L. (2024) · Journal of Clinical Nursing · doi:10.1111/jocn.16909 · Cited by 14
The relation of early positive emotional memories to women’s social safeness: The role of shame and fear of receiving compassion
Silva, C., Ferreira, C., Mendes, A. L., & Marta-Simões, J. (2019) · Women & Health · doi:10.1080/03630242.2018.1487906 · Cited by 13
“Also, recent studies suggested that the fear of receiving compassion from others is associated to alexithymia, depression, anxiety, self-criticism and low self-reassurance (Gilbert et al. 2011a, 2010).”
Background
Assessing self-criticism and self-reassurance: Examining psychometric properties and clinical usefulness of the Short-Form of the Forms of Self-Criticizing/Attacking & Self-Reassuring Scale (FSCRS-SF) in Spanish sample
Navarrete, J., Herrero, R., Soler, J., Domínguez-Clavé, E., Baños, R., & Cebolla, A. (2021) · PLOS ONE · doi:10.1371/journal.pone.0252089 · Cited by 13
“It underlies the development and maintenance of depressive [7–11], anxiety [12,13], and psychotic symptoms [14], eating disorders [15–18], non-suicidal self-injury [19], and suicidality [20,21].”
BackgroundResult
Targeting self‐criticism in the treatment of nonsuicidal self‐injury in dialectical behavior therapy for adolescents: a randomized clinical trial
Ramsey, W. A., Berlin, K. S., Conte, G. S. D., Lightsey, O. R., Schimmel‐Bristow, A., Marks, L. R., & Strohmer, D. C. (2021) · Child and Adolescent Mental Health · doi:10.1111/camh.12452 · Cited by 15
Low Perceived Social Rank Increases the Impact of Mental Health Symptoms on Suicidal Ideation: Evidence among Young Adults from the Philippines
Dizon, J. I. W. T., & Mendoza, N. B. (2022) · Archives of Suicide Research · doi:10.1080/13811118.2021.2022050 · Cited by 13
“…2014) and depression (Appel, Crusius, & Gerlach, 2015; Furnham & Brewin, 1988; Radovic, Gmelin, Stein, & Miller, 2017; see Wetherall et al., 2019, for a review) but also to possible selfharm (Gilbert, Mcewan, Bellew, Mills, & Gale, 2009, Gilbert et al., 2010; Williams, Gilbert, & McEwan, 2009).”
Bringing forth stories of blame and shame in dialogues with families affected by adolescent self‐harm
Amoss, S., Lynch, M., & Bratley, M. (2016) · Journal of Family Therapy · doi:10.1111/1467-6427.12101 · Cited by 15
Development and Psychometric Properties of the Test of Passive Aggression
Schanz, C. G., Equit, M., Schäfer, S. K., Käfer, M., Mattheus, H. K., & Michael, T. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.579183 · Cited by 13
Secondary Impacts of COVID-19 Pandemic in Fatigue, Self-Compassion, Physical and Mental Health of People with Multiple Sclerosis and Caregivers: The Teruel Study
Giménez‐Llort, L., Martín-González, J. J., & Maurel, S. (2021) · Brain Sciences · doi:10.3390/brainsci11091233 · Cited by 16
“[57], with reference to self-compassion, he discovered that different subsystems of the nervous system are activated when we are compassionate and when we feel threatened.”
Background
Self‐criticism and self‐reassurance in individuals with recurrent depression: Effects of mindfulness‐based cognitive therapy and relationship to relapse
Schanche, E., Vøllestad, J., Visted, E., Svendsen, J. L., Binder, P., Osnes, B., Franer, P., & Sørensen, L. (2021) · Counselling and Psychotherapy Research · doi:10.1002/capr.12381 · Cited by 12
The Toxicity of Shame Applications for Acceptance and Commitment Therapy
Gutiérrez, D., & Hagedorn, W. B. (2013) · Journal of Mental Health Counseling · doi:10.17744/mehc.35.1.5n16p4x782601253 · Cited by 16

Authors: Gilbert, P., McEwan, K., Irons, C., Bhundia, R., Christie, R., Broomhead, C., & Rockliff, H.
Corresponding author: Gilbert, Paul.
ORCID: Gilbert, Paul.
McEwan, Kirsten.
Irons, Chris.
Venue: British Journal of Clinical Psychology
Publisher: Wiley
Published: 2010-11
Volume: 49
Issue: 4
Pages: 563-576
ISSN: 0144-6657 (ISSN-L)
2044-8260
DOI: 10.1348/014466509x479771
OpenAlex: W2030095275
Cited by: 214
References: 51
Citations by year: 2026: 13 · 2025: 14 · 2024: 7 · 2023: 23 · 2022: 15 · 2021: 18 · 2020: 18 · 2019: 15 · 2018: 20 · 2017: 15 · 2016: 17 · 2015: 12 · 2014: 8 · 2013: 8 · 2012: 10
FWCI: 7.01
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 53 d)
Locations: British Journal of Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
University of Derby Online Research Archive. (University of Derby) (submittedVersion)
ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Funders: National Institute for Health and Care Research
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Social Psychology › Emotions and Moral Behavior
Keywords: self-harm, self-criticism, shame, social rank, social comparison, depression, anxiety, inferiority feelings
MeSH terms: Adult, Aged, Alcoholism, Anxiety Disorders, Bipolar Disorder, Cross-Sectional Studies, Depressive Disorder, Dominance-Subordination, Female, Humans, Male, Middle Aged, Personality Disorders, Personality Inventory, Phobic Disorders, Psychometrics, Self Concept, Shame, Comorbidity, Self-Injurious Behavior, Substance-Related Disorders, Young Adult

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Self‐harm in a mixed clinical population: The roles of self‐criticism, shame, and social rank

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