Vestergaard Andersen, Karen; (2002) Exploration of shame and disclosure in chronic drug dependence. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

This thesis explores levels of shame in 31 chronic poly-drug users, in an out-patient methadone prescription program, compared to 31 non-drug users closely matched on gender, ethnicity, and socio-economic and employment status. In addition to this, this thesis looks at the relationship between shame and disclosure. All participants completed the Experience of Shame Scale (ESS; Andrews et al., 2002) as well as standard measures of depression, aggression and dissociation. Chronic drug users scored significantly higher on levels of characterological and behavioural shame, but not on bodily shame. However, when controlling for levels of depression, only the group difference on characterological shame remained. Within the chronic drug user group, the level of shame about drug use was significantly higher than characterological, behavioural and bodily shame. Thirty-two percent of the chronic drug users were identified as non-disclosers. Non-disclosure was associated with increased levels of depression and shame on all three standard shame sub-scales on the ESS, but not with shame about drug use. This study replicates previous findings, based on shame measures more susceptible to mood-state effects, that drug dependence is associated with increased shame. It extends the existing literature in terms of suggesting possible sources of shame particular to drug dependence and their relationship to non-disclosure. Implications for treatment and future research are discussed.

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