Experienced-Based Versus Scenario-Based Assessments of Shame and Guilt and Their Relationship to Alcohol Consumption and Problems.

BACKGROUND Empirical studies of the relationships between shame, guilt, and drinking are sparse and sometimes appear contradictory. However, a more coherent picture emerges when researchers differentiate between measures of experienced of guilt and shame (i.e., questionnaires that ask how often people experience thoughts, feelings, and sensations associated with the emotion) versus proneness to guilt and shame (i.e., self-report of likely responses to imagined situations) is understood. OBJECTIVES Assess the extent to which experiential versus proneness measures of shame and guilt are associated with alcohol consumption and alcohol-related problems. METHODS Between 2012 and 2013, 89 community-dwelling non-abstaining adults were interviewed on a single occasion about their drinking and completed self-report measures of shame, guilt, and drinking-related behaviors. RESULTS Overall, shame and guilt were most strongly related to alcohol-related problems and not drinking amount per se, and shame was more strongly related to alcohol-related problems than was guilt. A measure of experienced shame, the Internalized Shame Scale, was the strongest predictor of drinking-related problems and predicted problems above and beyond other measures of shame and guilt. While guilt proneness was related to less problematic drinking, guilt experienced at the time of the assessment was related to more problematic drinking. CONCLUSIONS Shame appears to be more central to the experience of problematic drinking than guilt. Results also support the idea that guilt/shame proneness is distinct from experienced shame and guilt. Incorporating this distinction appears to account for the inconsistencies in the literature regarding how shame and guilt are related to drinking.