Cyclical Relationships Between Shame, Guilt, and Negative Consequences of Alcohol Use: A Daily Diary Study.

BACKGROUND: The consequences of alcohol use affect millions of people annually. Feelings of shame and guilt often follow these consequences, with research suggesting that shame also contributes to problematic alcohol use. However, the cyclical nature of this relationship remains largely unexplored, and the relationship between guilt and alcohol use is mixed. METHODS: The current study investigated these relationships in real time, over four consecutive days, using a daily diary assessment. One hundred and five participants, ages 18-50, completed baseline measures of shame, guilt, and alcohol related consequences, as well as repeated measures of each once per day. Multilevel mixed models were assessed for shame and guilt, both predicting and being predicted by alcohol related consequences. RESULTS: We hypothesized that shame (and to a lesser extent guilt) and negative consequences of alcohol use would significantly predict each other in a cyclical fashion such that higher internalized shame would predict greater alcohol related consequences at time 1, which would then predict shame at time 2, and so on through time 3. Trait shame and trait guilt both significantly predicted alcohol consequences, but state shame and state guilt did not. Baseline alcohol consequences also significantly predicted state shame, supporting the hypothesized cyclical relationship. Baseline alcohol consequences did not significantly predict guilt, indicating a unidirectional relationship. CONCLUSIONS: Future research should continue to investigate these relationships over longer periods of time and with more distinct measures of shame and guilt to better understand differences in how those emotions influence, and are influenced by, alcohol related consequences.