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Psychol Psychother. 2018 Dec;91(4):434-449. doi: 10.1111/papt.12170. Epub 2018 Jan 18.

Effects of mindfulness-based cognitive therapy on shame, self-compassion and psychological distress in anxious and depressed patients: A pilot study.

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School of Psychology, The University of Adelaide, South Australia, Australia.
Centre for Treatment of Anxiety and Depression, SA Health, Thebarton, South Australia, Australia.
The University of Adelaide, South Australia, Australia.



The tendency to experience shame or guilt is associated differentially with anxiety and depression, with shame being associated with greater psychopathology. Correlational studies have shown self-compassion to be related to lower shame and rumination, and mindfulness-based interventions increase self-compassion. Therefore, mindfulness-based interventions may decrease shame. This pilot study aimed to assess the association of shame, rumination, self-compassion, and psychological distress and the effects of a mindfulness-based intervention on these measures in a clinical sample.


Single-group design with pre-test and post-test measures.


Thirty-two service users who experienced clinically diagnosed depressive or anxiety disorders in a mindfulness-based cognitive therapy programme were assessed before and twenty-two after therapy with measures of shame-proneness, external shame, rumination, self-compassion, and psychological distress.


Shame-proneness and external shame were positively correlated with self-coldness, and external shame was positively correlated with stress and depressive symptoms. Self-compassion increased and self-coldness decreased, while shame-proneness, rumination, anxiety, and stress symptoms decreased from pre- to post-treatment. There was no significant reduction in depressive symptoms, guilt-proneness, or external shame.


Our preliminary findings suggest that mindfulness-based approaches may be helpful in increasing self-compassion and reducing shame-proneness in mixed groups of anxious and depressed patients. Controlled studies of the effects of mindfulness-based interventions on shame in clinical populations are warranted.


Shame-proneness and external shame showed different patterns of relationship with depressive and stress symptoms and with self-compassion. Shame-proneness decreased to a greater extent than external shame decreased following participation in an MBCT group. Mindfulness-based interventions may benefit shame-proneness to a greater extent than external shame.


anxiety; depression; mindfulness; rumination; self-compassion; shame


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