Trial reportPloS one2022
The shame spiral of addiction: Negative self-conscious emotion and substance use.
Trial report in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interpersonal trauma, shame, and substance use: A systematic review.Drug and alcohol dependence · 2024Pooled it
- Efficacy of A Virtual Agent-Based Digital Intervention (Echo App V2.0) for Patients With Alcohol Use Disorder: Randomized Controlled Trial.Journal of medical Internet research · 2026Trial
- Shame and stigma in association with the HCV cascade to cure among people who inject drugs.Drug and alcohol dependence · 2023Trial
- Motivations and triggers for non-suicidal self-injury among adolescents with alcohol use disorder in China: a qualitative descriptive study.Child and adolescent psychiatry and mental health · 2026Article
- Correlates of Sexual Minority Stress Profiles in Sexual Minority Men Living with HIV Who Use Stimulants.Archives of sexual behavior · 2026Article
- Multiple Discrimination, Substance-Related Coping, and Depression Among Sexual Minority Men with HIV.Journal of homosexuality · 2026Article
- Meaning in life and the mental health - addiction spiral: testing a unifying model.Frontiers in psychiatry · 2026Article
- Adaptive coping, emotions, and antiretroviral therapy adherence among gay, bisexual, and other men who have sex with men (gbMSM) with HIV.Journal of health psychology · 2025Article
- Trauma-related guilt, shame, and trauma type among patients with co-occurring PTSD and SUD.Alcohol, clinical & experimental research · 2025Article
- Persisting with Purpose: Using Acceptance and Commitment Therapy to Target Comorbid Opioid Use Disorder and Chronic Pain in a Racially and Economically Marginalized Population.Journal of contextual behavioral science · 2025Article
- "I feel like people would look at me like I'm dirty or like I'm a thief:" a qualitative exploration of interpersonal and intrapersonal experiences that influence recovery among adults at risk of opioid-related overdose.Frontiers in public health · 2025Article
- Exploring maternal grief and shame in addiction recovery for pregnant and early parenting women using community-based participatory research: a qualitative descriptive study.Frontiers in global women's health · 2025Article
- Trauma-related shame predicts daily non-medical prescription opioid use among individuals with PTSD symptoms.Journal of psychiatric research · 2024Article
- Using lifestyle interventions and the gut microbiota to improve PTSD symptoms.Frontiers in neuroscience · 2024Review
- Self-Forgiveness and Self-Condemnation in the Context of Addictive Behavior and Suicidal Behavior.Substance abuse and rehabilitation · 2024Review
- Exploring the Unique Therapeutic Potential of Psychedelics to Reduce Chronic Shame Among Sexual and Gender Minority Adults.Psychedelic medicine (New Rochelle, N.Y.) · 2023Review
- Examining the daily relationship between guilt, shame, and substance use among veterans with psychiatric disorders.Drug and alcohol dependence reports · 2023Article
- "The familiar taste of poison": a qualitative study of multi-level motivations for stimulant use in sexual minority men living in South Florida.Harm reduction journal · 2023Article
- A Mediation Moderation Model between Self-Evaluative Emotions and Relapse Rate among Polysubstance Users: A Comparative Cross-Sectional Study.International journal of environmental research and public health · 2023Article
- Labeled as "drug-seeking": nurses use harm reduction philosophy to reflect on mending mutual distrust between healthcare workers and people who use drugs.Frontiers in public health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundThe bidirectional associations between negative self-conscious emotions such as shame and guilt and substance use are poorly understood. Longitudinal research is needed to examine the causes, consequences, and moderators of negative self-conscious emotions in people who use substances.
methodsUsing parallel process latent growth curve modeling, we assessed bidirectional associations between shame and guilt and substance use (i.e., number of days in the past 30 used stimulants, alcohol to intoxication, other substances, or injected drugs) as well as the moderating role of positive emotion. Emotions were assessed using the Differential Emotions Scale. The sample included 110 sexual minority cisgender men with biologically confirmed recent methamphetamine use, enrolled in a randomized controlled trial in San Francisco, CA. Participants self-reported emotions and recent substance use behaviors over six time points across 15 months.
resultsHigher initial levels of shame were associated with slower decreases in stimulant use over time (b = 0.23, p = .041) and guilt was positively associated with stimulant use over time (β = 0.85, p < .0001). Initial levels of guilt and alcohol use were positively related (b = 0.29, p = .040), but over time, they had a negative relationship (β = -0.99, p < .0001). Additionally, higher initial levels of other drug use were associated with slower decreases in shame over time (b = 0.02, p = .041). All results were independent of depression, highlighting the specific role of self-conscious emotions.
conclusionsShame and guilt are barriers to reducing stimulant use, and expanded efforts are needed to mitigate the deleterious effects of these self-conscious emotions in recovery from a stimulant use disorder.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.