ArticleMovement disorders clinical practice2025
The Unseen Burden: Uncovering Shame and Its Determinants in Parkinson's Disease.
Article in Movement disorders clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Living with the Unknown: Intolerance of Uncertainty in Parkinson's Disease.Movement disorders clinical practice · 2026Review
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7 authors.
Funding
Abstract
backgroundShame is frequent in Parkinson's disease (PD) and often overlooked.
objectiveThe aim was to assess factors associated with PD-related shame.
methodsPD-related shame was measured using the Shame and Embarrassment in PD (SPARK) scale in patients without cognitive impairment. Correlation between personal determinants (demographics, psychological traits [shame/guilt propensity, trait anxiety]), PD-related determinants (PD characteristics; motor, cognitive, and neuropsychiatric symptoms; medication; and health-related quality of life [QoL]), and SPARK was analyzed using multiple correlation analysis and generalized linear mixed models. To describe the cohort's response to shame, data-driven clustering based on SPARK was conducted, and clusters' associations with the determinants were analyzed.
resultsForty-seven PD patients were included. PD-related shame correlated with psychological traits (trait anxiety, shame, and guilt propensity), clinical symptoms (dyskinesia, state anxiety, depression, and apathy), and QoL. These determinants explained 79.3% of the total variance in the subsequent linear model analysis, with QoL and anxiety as the strongest covariates of shame. Apathy positively covaried with SPARK self-esteem subscale. Cluster analysis identified 3 patient groups. Highest-intensity shame cluster demonstrated elevated scores on both motor and nonmotor symptom-related shame and was associated with higher levels in anxiety, depression, and apathy, and poorer QoL. The remaining clusters showed a dissociation, with motor symptom-related shame predominating in one and nonmotor symptom-related shame in the other.
conclusionsThis study provides an in-depth understanding of shame, highlighting its multifactorial nature. Due to its impact on QoL, shame should be addressed in clinical practice through pharmacological/nonpharmacological interventions, targeting both shame and its modifiable determinants. Identifying distinct shame profiles underscores the need for tailored interventions.
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