Comparison of Guilt and Shame Between Men
and Women with Drug Addiction
Institute of Applied Psychology, University of the Punjab, Pakistan
Submission:September 5, 2019; Published: September 24, 2019
*Corresponding author:Mehvish Riaz, Institute of Applied Psychology, University of the Punjab, Lahore, Pakistan
How to cite this article:Mehvish Riaz. Comparison of Guilt and Shame Between Men and Women with Drug Addiction. J Forensic Sci & Criminal Inves.
2019; 12(4): 555845. DOI: 10.19080/JFSCI.2019.12.555845.
The purpose of this study was to explore the comparison of Guilt and Shame between Men and Women with Drug Addiction. The main objective was to determine whether both genders feel guilt or shame or not. Cross- Sectional research design was used to assess moral emotions. State Shame and Guilt questionnaire was used for this purpose. A sample of (N=70) patients (35 men and 35 women) was taken from Pak Clinic, Promise Clinic, Umeed Clinic and Shaaf Clinic from Lahore. Statistical analysis was carried out through Spss (16.5) thus obtaining frequencies and percentages of the data. For further analysis t-test was run to see the differences. The finding of the results showed that both genders had feelings of guilt as well as shame, whether they were from nuclear or joint family, whether they were taking medicines first time or for a long time. Furthermore, the findings of this work have important implications for Researchers who should also study various aspects of drug addict’s behavior. It is also important for the treatment and prognosis of drug addicts. In addition, it is important for our Government who must take some serious steps for reducing the rate of drug use. Above all, the research is important for our society that people should not negatively labialize to drug addicts as an evil soul because drug addicts are also human being.
Keywords: Guilt, Shame, Moral Emotions, Drug Addiction, Men and Women, Negative persistent emotions, Biopsychosocial, Childhood experiences, Psychopathology, Attribution Theory, Drug use among Females
It is generally accepted that chemically dependent clients normally agonize from many psychological and physical problems as well as addiction. As a result, they face difficulty regulating also handling with painful emotions. In recent years, psychoanalytic theory has increasingly fixated on the role of shame and guilt in the etiology of addiction also addiction may lead towards the negative persistent emotions. Weiss  has developed theory of psychopathology and psychotherapy, unfolding that excessive shame and guilt are closely connected with addiction. To explore this study, Purposive sampling strategy was used to explore the feelings of drug addicts. The State Shame and Guilt Scale were applied to see the difference of male and female’s feelings. A cross sectional study design was used to investigate guilt and shame feelings as it involves different groups of people who differ in the variable of interest but share other characteristics, such as socioeconomic status, educational background, and ethnicity. However, the present study derives from this theoretical framework. In this comprehensive research study, description of guilt and shame, relationship between shame guilt and addiction and the biopsychosocial theories of substance abusing become even more complex.
Weiss’s theory as applied specifically to chemically dependent population suggest that people become vulnerable to
drug addiction when they are prevented from chasing ordinary development goals by forbidding pathogenic beliefs. Pathogenic beliefs are derived from disturbing childhood experiences and warn people that if they peruse some certain goals, they may harm themselves or their parents, siblings or their loved ones. Because they undertake themselves as harming person, the belief often causes humanity-based guilt or shame. In reaction to these beliefs, people inhibit themselves from pursuing normal goals in order to avoid or minimize guilt and susceptibility to addiction. Chemically dependent clients often come from troubled families with a history of addiction. From this background many addicted clients inherit both a genetic predisposition and pathogenic beliefs cause them to suffer from maladaptive guilt and shame.
Furthermore, the lifestyle and behaviors linked with drug use lead to additional disturbed feelings of guilt and shame. substance referred to in this study include alcohol and the illicit substances, marijuana and cocaine. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders DSM-V (2013), substance abuse is defined as a cluster of cognitive, behavioral and physiological symptoms signifying that the individual lasts consuming the substance despite significant substance related problems. An important characteristic of substance use disorder is underlying change in brain circuits that may be persist beyond detoxification
particularly in individuals with sever disorders. The behavioral
effect of these changes may be exhibited in the repeated relapses
and intense rug craving when the individuals are exposed to
drug related stimuli. These persistent drug effects may benefit
from long term approaches to treatment. (DSM-V, 2013).
Hrome examined that 30 to 90% of students drink regularly
and up to 70% had tried at least one illegal drug. Bachman, O
Malley, Schulenberg, Johnston, Bryant & Merline, 2002 reported
that in 2008 almost 70% of 21 to 25-year-olds Illegal drug use
was highest among 18 to 20-year-olds at 23%, followed by 21
to 25-year olds at 19%. The same report showed that binge
drinking was the highest among 21 to 25-year-olds (44%) and
second highest among 18 to 20-year olds (37%). Substance
dependence/abuse was also the highest in the 18 to 25-yearold
range at 22% (Arnett, 2000). Hence, substance use is
predominant and warrants further inspection into the factors
that lead to increased use.
Shame is also a threat emotion and motivates escape behavior,
concealment and submissive behavior . Often shame results
in actual withdrawal from the problematic situation. A person
experiencing a shame reaction may undergo a sudden affectshift,
such as a surge of anger or anxiety. They may be crippled
by a blank mind, lose confidence and the ability to think and
act freely. It is thought that shame has distinctive, submissive
facial expressions, and may also engender a range of involuntary
behaviors, experiences, including blushing, a hunched posture,
avoidance of eye-contact and changes in speech. Because of
its intense self-focus, shame impairs one’s ability to generate
effective solutions to interpersonal problems, also diminishes
confidence in one’s ability to implement solutions.
The distinction between shame and guilt has been a subject
in the past several decades. Early theorist . saw that shame
as a response to public exposure of some fault and deficiency in
the person experiencing the emotion and they saw guilt as an
internal matter between the self and the conscience. However,
for, these feelings are used conjointly. Shame has been described
as a failure of being or global self-condemnation, while guilt
has been referred to as a ‘failure of doing’. The former may
result in feelings of inadequacy, deficiency and being exposed.
It appears that shame is directed primarily at the self, whereas
guilt addresses the particular act, and may be concerned in
conformity to societal norms.
Shame relates to negative feelings about the self and has
been described as an intense negative emotion which can
result in feelings of inferiority and powerlessness. Shame can
arise from a difference between the ideal self and the actual
real self-leading to feelings of inadequacy and disgust. Shameproneness
is often internalized and has been associated with
the development of psychopathology, whereas proneness to
guilt, generally more overt, correlates with non-pathological,
adaptive empathy. However, far from being a purely negative
emotional state, feeling shameful warns the individual that their
actions are socially unacceptable and may result in them being
rejected by others. In order to avoid rejection, the individual
seeks to find alternative ways of behaving. Consequently, shame
is characterized by hiding the self.
Brain dopamine systems have been the focus of considerable
attention in behavioral neurobiology. In particular, the ventral
tegmental dopamine system appears to have an important
role in motivated behavior in some types of psychopathology.
This dopamine system has its cell bodies located in the ventral
tegmental area and sends its axonal projections to several brain
regions. It receives neural inputs from many diverse brain sites
and modulates neural activity in cortical and limbic areas which
motive human to adopt repeated behaviors. Addiction is one of
the major highly adaptive behaviors.
One branch of conditioning theory, social-learning theory
Bandura has opened itself to the subjective elements of
reinforcement. Bandura described the essential insight that
reinforces gain meaning only from a given human context enables
to understand  why different people react differently to the
same drugs,  how people can modify these reactions through
their own efforts, and  how people’s relationships with their
environments determine drug reactions rather than vice versa
. according to the theory of social learning, believes that the
observations of other people engaging in addictive behavior can
lead to the development of addiction. When a person observes
the behavior and reactions of other people using addictive
substances (or activities), he may wish to repeat what he saw.
The theory concluded that this learning occurs by observing
how other people act and the consequences of these actions. If
another individual receives a reward for a certain action, this
will encourage an observer to adopt the behavior. It is Bandura’s
and Harlow’s contention that observing an action can have as
much impact as directly experiencing it.
The ability of people to model behavior is highly
advantageous. For instance, if they can observe the negative
impact of abusing drugs, it can save a lot of pain. It means that
the individual can learn about drugs without having to take
them. It is argued that individuals become addicted to alcohol
or drugs because of modeling. If a person observes that other
people are getting enjoyment from these activities, it can make
them appealing. Certainly, behavior modeling does play a part in
why people fall into substance abuse .
Shame and guilt are inherently related to perceptions of
ourselves. They can be discriminated according to Abramson,
Seligman & Teasdale’s dimensions of causal attributions, which consider locus of control (internal versus external), globality
(global versus specific) and stability (stable versus unstable). In
both shame and guilt, internal attributions are made. Whereas
guilt is associated with specific and unstable attributions, shame
involves global and stable attributions. For example, a person
who gets ‘too’ drunk at someone else’s birthday celebration
and behaves inappropriately to the point that it spoils the
atmosphere might feel guilt. They may experience a sense of
tension and remorse over what they have done, focusing on that
specific indiscretion. They know that they are responsible for
their behavior (internal attribution), but acknowledge that the
causes of this misdemeanor are rather specific; they know that
they are not generally an irresponsible or rude person (specific
attribution), and that the antecedents to their behavior were
unique to that particular event (unstable attribution).
Conversely, shame involves a focus on the entire self and is
likely to be relatively persistent. Often internal, stable and global
attributions are made when one experiences shame. Another
person in similar circumstances may experience an acute sense
of shame, feeling disgraced, small and wanting to hide. With a
clear self-focus, they also know they are responsible (internal
attribution) but may believe that the causes of this misdeed
are a reflection of their personality - irritating, loud, aggressive
(global attribution), and that this type of behavior occurs within
various settings (stable attribution).
In many developed countries, drug abuse is no longer
an exclusively or predominantly a male activity. In general,
male and female drug use patterns seem to be more even in
industrialized countries. Substance use disorder is a collection
of physiological, cognitive, and behavioral symptoms that appear
when an individual continues to use a substance even though it is
producing significant problems in the individual’s life American
Psychiatric Association . Substance dependence is exhibited
when a person uses a substance to produce a mood change but
then begins to need the drug more often and in larger amounts
to achieve the same effect. Until the 1970’s, substance abuse
was seen almost exclusively as a male problem .
In the 1950’s, it was estimated that there were five or six male
substance abusers to every female substance abuser. Estimates
in the 1990’s indicate that this ratio is now approximately three
males to every one female. The Center for Substance Abuse
Treatment (1996) reports that 4.5 million women are alcohol
abusers, 3.1 million women use illegal drugs on a regular basis
and 3.5 million women misuse prescription drugs. The growing
recognition that substance abuse is a seriously debilitating
disorder for women has caused tremendous concern within the
past 30 years. This concern has resulted in a dramatic increase
in research surrounding the female substance user. Results from
etiology it indicates women may begin to abuse substances as a
form of self-medication for such disorders as depression, posttraumatic
stress disorder (PTSD), and or an eating disorder.
One of the major factors which favor the increase of drug use
among women is the transition of women from the traditional
roles of mother and homemaker to that of an economic provider
for the family. Although this can be considered a positive gain it
can also impose greater levels of stress and drug use is a possible
response in the absence of other coping mechanisms (United
Nation Offices on Drugs and Crimes Country Office Pakistan).
There is growing evidence that the effects of drug abuse and
addiction do not always impact men and women in the same
manner and the biological mechanisms involved in drug abuse
and dependence are not identical in males and females. As
happens generally with drug abuse, its occurrence among
women has an impact that goes beyond the individual. Women
may be more vulnerable than men to particular consequences of
drug abuse, including addiction.
This greater vulnerability may stem from gender-specific
differences in motivations for drug use, differing sensitivities
to drug effects and a host of other biological and environmental
factors. On the other hand, females who use drugs are more
likely to be stigmatized by society than male drug users because
their activities are considered to be doubly deviant. Because of
this stigma, females are more likely to conceal their drug using
behavior. The drug use scenario among women is not different
for Pakistan as well. However, the available research data reveal
that not much information is available on drug abuse by women
in Pakistan United Nation Offices on Drugs and Crimes Country
Office Pakistan .
Data from the Drug Abuse Warning Network DAWN (1998)
support various gender patterns perceived elsewhere in the
public health literature. Although few significant differences have
been witnessed in the drug involvement of men’s and women’s
emergency room episodes for the past 10 years. But in 1997, data
suggested that the type of drug variation in drug related deaths
by gender. Women more frequently die from antidepressants.
Men also have higher death rates from taking illegal drugs
rather than prescribed drugs. This finding is consistent with
the previous evidence that women are prescribed psychotropic
drugs more often than men. Data show that cocaine, heroin, and
alcohol in combination with other drugs were stated most often
linked in deaths for both males and females. However, males had
higher rates of above mentioned for each of these drugs than did
Hequembourg and Dearing examined the interrelationships
among shame-proneness, guilt-proneness, internalized
heterosexism, and problematic substance use among 389 gay,
lesbian, and bisexual men and women. Problematic alcohol
and drug use were positively related to shame-proneness and
negatively related to guilt-proneness. Bisexuals reported riskier
substance use behaviors, lower levels of guilt-proneness, and
higher levels of internalized heterosexism than gay men and
lesbians. Furthermore, study findings indicated that shame and
internalized heterosexism are related. Additional investigations of these associations would supplement current understanding
of sexual minority stress and would advance the development of
substance-related intervention and prevention efforts targeting
Tracy  reported public shaming has long been thought to
promote positive behavioral change. However, studies suggest
that shame may be a detrimental response to problematic
behavior because it motivates hiding, escape, and general
avoidance of the problem. Researchers tested whether shame
about one’s past addictive drinking (measured via nonverbal
displays and self-report) predicts future drinking behaviors
and changes in health among newly recovering alcoholics (i.e.,
sober < 6.5 months; N = 105; Wave 2, n = 46), recruited from
Alcoholics Anonymous meetings. Results showed that nonverbal
behavioral displays of shame expressed while discussing past
drinking strongly predicted.
(a) the tendency to relapse over the next 3 to 11 months
(b) the severity of that relapse
(c) declines in health.
All results held controlling for a range of potential
confounders (e.g., alcohol dependence, health, personality).
These findings suggest that shame about one’s problematic
past may increase, rather than decrease, future occurrences of
problem behaviors [10-15].
McGiffin and Lyon found that people with drug or alcohol
problems frequently experience feelings of shame and guilt,
which have been associated with poorer recovery. Selfforgiveness
has the potential to reduce negative experiences.
The current study tested theorized mediators (acceptance,
conciliatory behavior, empathy) of the relationships between
shame and guilt with self-forgiveness. A cross-sectional sample
of 133 individuals (74.4% male) receiving residential treatment
for substance abuse completed self-report measures of shame,
guilt, self-forgiveness, and the mediators were assessed. Results
were consistent with research; guilt had a positive association
with self-forgiveness, whereas shame was negatively associated
with self-forgiveness. Acceptance mediated the guilt and selfforgiveness
relationship and had an indirect effect on the shame
and self-forgiveness relationship. These findings emphasize the
importance of targeting acceptance when trying to reduce the
effects of shame and guilt on self-forgiveness .
Meehan and Berry conducted a research and investigated
men and women recovery from addiction were compared on
level of depression, guilt and shame. The measurement of guilt
included subscales of survivor guilt, separation guilt, omnipotent
responsibility guilt, trait guilt, state guilt, and adaptive guilt. The
sample included 75 men and 33 women in residential treatment
community. It was found that women were significantly higher
than men in depression and men were higher in shame. The
recovering subjects to compared with non-addicted subjects and
established norms and it was found that recovering people were
higher of depression, shame and the subscales of guilt. Both men
and women were significantly lower than norms in adaptive
This review has considered the moral standards and moral
emotion for moral behavior. In this sense, the structure of this
review reflects the current state of the field. Little research
has examined the relation between moral standards and moral
emotional factors, much less their interactive influence in
moderating the link between moral standards and people’s moral
behavior. Future directions for research including evaluating
the relative importance of cognitive and emotional factors in
various domains of morality, as well as the degree to which
particular emotional factors are differentially more important
in influencing behavior among particular subpopulations (e.g.,
corporate managers, criminal offenders) and at different points
in development [21-23].
The present research focuses on comparison of guilt and
shame between male and female addicts. This study aims at
finding out difference in guilt and shame between male and
female. It is important to see the difference as it can be helpful
in understanding prognosis, treatment of drug addiction in both
genders. It is also an attempt to investigate differences between
genders with the respect to the addictive behaviors. Moreover,
many people don’t understand why or how other people become
addicted to drugs. They may mistakenly think that those who
use drugs lack moral principles or willpower and that they could
not stop their drug use even after getting treatments. To know
the other related factors of addiction. It is also an attempt to
investigate the comparison of male and female behavior towards
The Purposive sampling strategy was used to explore the
feelings of drug addicts. A purposive sample is a non-probability sample that is selected based on characteristics of a population
and the objective of the study which is intended to explore
in this research . The State Shame and Guilt Scale were
applied to see the difference of male and female’s feelings. The
sample comprised of 35 males and 35 females from various
rehabilitation centers. 12 females were taken from Promise
Rehabilitation Centre, 4 from Shaaf Clinic, and 4 from Pak Clinic.
Remaining data was taken from the Umeed Clinic outdoor.
Furthermore, the male data was also gathered from Pak Clinic
and Shaaf Clinic. Those research participants were selected who
fulfilled the following attachment criteria:
a. Hospitalized patients already diagnosed for addiction
disorder by psychiatrist.
b. No history of any dual diagnosis.
c. Participants who are willing and accessible in all
process of research trial.
d. The sample for the patients with disorder was collected
from different addiction units of Lahore city of Pakistan.
The present study was conducted to measure the guilt and
shame among drug addicts. Guilt involves feelings of tension,
remorse, and regret, but does not affect one’s core identity.
Shame is associated with the desire to undo aspects of the self,
whereas guilt is reported to involve the desire to undo aspects
of behavior. Firstly, a questionnaire was used to investigate
the demographic information of drug addicts. Secondly, State
Shame and Guilt Scale were administered to explore the feelings
of guilt and shame. A cross sectional study design was used to
investigate guilt and shame feelings. Statistical analysis of the
data was carried through the SPSS 16 program, thus obtaining
frequencies and percentages. The individual responses from
participants were Tran scripted using t-test allowing to record
frequencies of specific responses [28-32].
Analysis was carried out to know the mean difference of
male and female addicts. Analysis was carried out through
SPSS 16. Frequencies and percentages of data were obtained.
Individual responses from participants were transcribed using
t-test. Frequencies of specific responses were record .
Participants were assured that identifying information will
not be available to anyone who is not directly involved in the
study. Participant had right to withdraw from participation and
terminate at any time they wish. Verbal consent was taken from
the participant after having explained them the aim and nature
of research [34-36].
The present study was an attempt to know about the
comparison of shame and guilt between men and women with
drug addiction. As stated in the previous chapter, the researcher
selected a sample of 70 respondents from various hospitals
and addiction centers. On this representative sample, a cross
sectional study was carried out to find out the result with close
ended questions. The results for each test were presented in this
chapter. The results were presented in table form. The results
displayed include t-test to see the difference in prescribed
sample. Note: M=Mean, S=Standard Deviation, LL=Lower limit,
Table 1 show that there are significant differences in shame
and guilt among both genders [37-40].
Table 2 indicates that males have significantly higher feelings
of guilt and shame than females. Table 2 show that there are no
significant differences in shame and guilt among family systems
of drug addicts in both genders. Table indicates that people from
nuclear as well as joint family both are equally addicted and
feel shame and guilt. Table 3 show that there are no significant
differences in shame and guilt among patients whose getting
treatment first time or many times. Table 4 indicates that people
who are taking first time medicines and many times both are
equally involved in drug addiction and feel shame and guilt .
The purpose of this research was to investigate the feelings
and thoughts of shame and guilt about addiction between male
and female drug addicts. In this chapter, the main findings
with regard to the hypothesis are summarized and general
conclusions based on the findings of the studies presented in this
thesis are described. Furthermore, the strengths and limitations
of this thesis are considered and suggestions for further are
The main hypothesis was that there is significant difference
in shame and guilt feelings between male and female drug
addicts. The finding of the result confirming the first and main
hypothesis as well as indicates that males are significantly
higher on shame. Beehan and Merry conducted a research and
investigated men and women recovery from addiction were
compared on level of depression, guilt and shame. It was found
that women were significantly higher than men in depression
and the men were significantly higher in shame than females.
The secondary hypothesis that there is a difference in
shame and guilt among drug addicts living in joint or nuclear
families. Although the hypothesis could not be accepted due to
some cultural or methodological factors, but it is assumed that
poor relationship with family and conflictual bonding play an
important role in adopting addiction. Hence, it can be clearly
demonstrated that individual from joint or nuclear family
is equally involved in drug addiction. Schiniedar examined
the relationship of addiction with family patterns. Research
has identified a strong connection between disrupted family
relationships and alcohol and another drug addiction. The
results show that the majority of participants had experienced
painful and traumatic childhoods in their families of origin,
which contributed to their subsequent addictive behavior and
which they felt had affected their current familial relationships.
All participants and their families had suffered from various
forms of family disruption, such as loss of custody of their
children, loss of employment, marital breakdown, physical and
psychological abuse, depression and ill health.
The third hypothesis that there are significant differences
in drug addicts whose getting treatment first time, or many
times could not be accepted due to cultural and methodological
factors. Yet it can be concluded that patients whether taking
medicines first time or for long time both are equally feel shame
and guilt. Zupalko work has shown length of time in drug abuse
treatment is associated with better outcomes, but the role of
therapeutic engagement and process needs further examination.
In the study, the total number of counseling sessions attended by
557 clients in their first 90 days of community-based outpatient
treatment was examined in relation to indicators of treatment
delivery and progress. Significant client improvements were
found on behavioral criteria and psychosocial functioning
during the first 3 months of treatment, and session attendance
was positively related to favorable behavioral changes as well
as to positive perceptions by clients and counselors of their
In current study, it was found that the male patients with
drug addiction felt more guilt and shame feelings. Moreover, it
was also observed that the patients with drug addiction from
any family system both feel shame and guilt equally and it was
also examined that patients with drug addiction whether getting
treatment first time or many times both feel guilt and shame
It was long and complicated procedure in terms of getting
the permission for collecting the data regarding female drug
patients. Complete information regarding the demographics of
the patients could not be found.
Many participants did not cooperate to fill the questionnaire
seriously. The tool used for data collection should have more
probing question that could identify the problems of inmates
more deeply .
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