Short CommunicationGuilt-proneness is associated with the use of protective behavioral strategies during episodes of alcohol use
Introduction
Shame and guilt-prone personality styles have emerged as having different implications for the regulation of substance use and the experience of substance use-related harms. The two emotions are alike in that they both occur in response to failures or transgressions that involve a contravention of an internalised code or principle (Tangney & Dearing, 2002). With highly aversive experiences of shame, the individual evaluates their transgressive behavior as evidence that the self is painfully flawed (e.g., “I'm a failure”: Lewis, 1971). In contrast, the individual experiencing guilt remains focused on their problematic behavior and the resultant harms to the self and or others. Focussed firmly on the negative consequences of their transgression, the guilty individual tends to learn from their poor behavior, make amends for their transgression, and modify their behavior to avoid repeated mistakes (Tangney, Stuewig, & Mashek, 2007). Proneness to shame and guilt fall on a continuum and individuals may experience shame, guilt, or a combination of the two emotions following transgressions (Tangney & Dearing, 2002).
A growing body of research suggests that a guilt-prone disposition may help buffer individuals against the development of disordered substance use (Dearing et al., 2005, Dearing et al., 2013, Treeby and Bruno, 2012). Treeby and Bruno (2012) found that guilt-proneness was negatively associated with overall severity of alcohol use disorder symptoms (e.g., loss of control over drinking and dependence indicators) experienced in the past year, along with the total number and severity of negative alcohol use-related consequences experienced across eight domains including social consequences, impaired control, negative self-perception, self-care neglect, risky behaviors, academic/occupational consequences, physical dependence indicators, and blackout drinking. In a recent longitudinal study, Stuewig et al. (2015) found that guilt-proneness assessed in childhood (ages 10 to 12) was associated with less use of alcohol and other drugs at young adulthood (ages 18–21).
While guilt-proneness appears to buffer individuals against the development of disordered substance use, shame-proneness appears to offer no such protective function and indeed, shame may actually promote addictive processes (Treeby & Bruno, 2012). Across three samples, Dearing et al. (2005) found that shame-proneness was positively associated with multiple indices of substance use including alcohol use-related problems.
Little is currently known about the behaviors that shame and guilt-prone individuals tend to engage in during episodes of alcohol use and it is unclear as to the manner in which trait guilt-proneness helps buffer individuals against disordered alcohol use. Given that guilt-proneness is associated with the successful avoidance of alcohol-related harms (Dearing et al., 2005, Treeby and Bruno, 2012), it is plausible that guilt-prone individuals may be more inclined to employ protective behavioral strategies during drinking episodes to minimise the experience of negative alcohol-related consequences. Such strategies include making explicit attempts to limit the number of drinks consumed (e.g., determine not to exceed a predetermined number of drinks), drinking in a manner that is less likely to result in intoxication (e.g., avoiding drinking games and avoiding trying to “keep up” with others), and engaging in behavior associated with more serious harm avoidance such as remaining vigilant as to where ones drink has been at all times (see Martens, Pedersen, LaBrie, Ferrier, & Cimini, 2007). Given that shame-proneness is positively associated with the experience of negative alcohol use-related consequences, there does not appear to be any evidence to suggest that shame-prone individuals also use protective strategies during drinking episodes.
The aim of the present study was to extend the shame, guilt, and substance use literature by examining whether the two self-conscious affect styles are differentially related to the use of alcohol-related protective behavioral strategies during drinking episodes. It was hypothesised that guilt-proneness would be positively related to the use of alcohol-related protective behavioral strategies while drinking. As shame-proneness fails to inhibit substance use and may promote addictive processes, it was expected shame-proneness would be negatively or unrelated to the use of such protective strategies during episodes of alcohol use.
Section snippets
Participants
Participants comprised 281 individuals sampled from the local community and a variety of degree programs at the University of Tasmania, Australia. Individuals who consumed alcohol at any quantity and frequency within the past year were eligible for participation. The ages of participants ranged from 17 to 62 with a mean age of 22.2 (SD = 7.8) years. The mean age for the 74 male participants and 207 female participants combined was 22.22 (SD = 7.8). With regard to ethnicity, the sample was
Results
Descriptive statistics for the AUDIT-C, TOSCA-3, and PBSS are presented in Table 1. The quantity and frequency of alcohol use (AUDIT-C) was moderately inversely associated with the overall use of protective strategies (r (281) = − 0.57, p < 0.001), the active use stopping and limiting strategies (r (281) = − 0.49, p < 0.001), and the tendency to drink in a manner that increases the chance of intoxication (r (281) = − 0.60, p < 0.001). There was no significant relationship between the AUDIT-C and the use of
Discussion
Findings supported the hypothesis that guilt-proneness would be associated with the use of risk-reducing behaviors during alcohol use episodes. Indeed, guilt-proneness was positively associated with the tendency to engage in serious harm avoidance behaviors while drinking (e.g., using designated drivers to get home safely), the inclination to drink in a controlled and moderated manner (e.g., refraining from participating in drinking games), and the habitual use of strategies to avoid getting
Role of funding sources
SMR was supported by a Mary Elizabeth Watson Early Career Fellowship in Allied Health (MEW-2017-001), awarded by Royal Melbourne Hospital. This funding source had no involvement in study design, collection, analysis, or interpretation of data, writing the manuscript, and the decision to submit the manuscript for publication.
Contributors
The study was conceived by MST and RB. Protocol development, data collection and data analysis was undertaken by MST. SMR, FC and AP assisted with manuscript development, drafting and editing. All authors have approved the final manuscript.
Conflict of interest
The authors declare no conflicts of interest.
References (14)
- et al.
On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use
Addictive Behaviors
(2005) - et al.
Shame and guilt-proneness: Divergent implications for problematic alcohol use and drinking to cope with anxiety and depression symptomatology
Personality and Individual Differences
(2012) - et al.
The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking
Archives of Internal Medicine
(1998) - et al.
Shame in the therapy hour
(2011) - et al.
Prospective changes in alcohol use among hazardous drinkers in the absence of treatment
Psychology of Addictive Behaviors
(2013) Shame and guilt in neurosis
(1971)- et al.
Measuring alcohol-related protective behavioral strategies among college students: Further examination of the Protective Behavioral Strategies Scale
Psychology of Addictive Behaviors
(2007)