Feelings of shame may be more likely to drive a person to misuse drugs or alcohol than guilt, according to a new study that links shame to substance abuse.

Researchers say the findings suggest that drawing a distinction between shame, defined as feeling bad about oneself, and guilt -- feeling bad about a specific event or behavior -- may be important in treating and preventing substance abuse.

"Successfully reducing shame is likely to result in better treatment outcomes," says researcher Rhonda Dearing of the University of Buffalo's Research Institute on Addictions, in a news release.

"Whether or not shame is a cause of problematic substance use," says Dearing, "other problems that go hand-in-hand with shame such as anger or interpersonal difficulties are sufficient justification for implementing shame-reduction interventions into treatment."

Mental Illness and Substance Abuse

Shame May Lead to Substance Abuse

The study appears in the August issue of Addictive Behaviors. Researchers studied three groups of people with differing levels of substance abuse problems: two groups of college students and another group of prison inmates.

Researchers found that proneness to shame was significantly linked to substance abuse problems in all three groups. In other words, people who had a tendency to feel bad about themselves were more likely to misuse drugs or alcohol than others.

In contrast, people who were prone to feeling guilty about a specific action or event were generally less likely to have substance abuse problems.

Researchers say the results suggest that feelings of guilt and shame should be considered separately when designing substance abuse treatment and prevention programs.

They write that studies on the development of substance-use disorder should shed light on whether shame proneness is a risk factor for drug and alcohol abuse problems as well as help determine whether the propensity to experience guilt is a protective factor against alcohol and drug abuse.

Techniques that decrease shame-proneness and enhance guilt-proneness may be a promising avenue for intervention in substance-abusing groups, they write.

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By Jennifer Warner, reviewed by Brunilda Nazario, MD

SOURCES: Dearing, R. Addictive Behaviors, August 2005; vol 30: pp 1392-1404. News release, University of Buffalo's Research Institute on Addictions.