{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:23:18Z","timestamp":1791958998526,"version":"4.3.4"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of California, San Francisco Center for AIDS Research's Virology Core","award":["P30\u2010AI027763"],"award-info":[{"award-number":["P30\u2010AI027763"]}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01\u2010DA033854"],"award-info":[{"award-number":["R01\u2010DA033854"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K24\u2010MH093225"],"award-info":[{"award-number":["K24\u2010MH093225"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["P30\u2010MH116867"],"award-info":[{"award-number":["P30\u2010MH116867"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K23DA043418"],"award-info":[{"award-number":["K23DA043418"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher initial levels of shame were associated with slower decreases in stimulant use over time (\n                      <jats:italic>b<\/jats:italic>\n                      = 0.23,\n                      <jats:italic>p<\/jats:italic>\n                      = .041) and guilt was positively associated with stimulant use over time (\u03b2 = 0.85,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .0001). Initial levels of guilt and alcohol use were positively related (\n                      <jats:italic>b<\/jats:italic>\n                      = 0.29,\n                      <jats:italic>p<\/jats:italic>\n                      = .040), but over time, they had a negative relationship (\u03b2 = -0.99,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .0001). Additionally, higher initial levels of other drug use were associated with slower decreases in shame over time (\n                      <jats:italic>b<\/jats:italic>\n                      = 0.02,\n                      <jats:italic>p<\/jats:italic>\n                      = .041). All results were independent of depression, highlighting the specific role of self-conscious emotions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Shame 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0265480","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T13:36:21Z","timestamp":1647610581000},"page":"e0265480","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":45,"title":["The shame spiral of addiction: Negative self-conscious emotion and substance use"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7225-1675","authenticated-orcid":true,"given":"Abigail W.","family":"Batchelder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany R.","family":"Glynn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith T.","family":"Moskowitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten B.","family":"Neilands","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Dilworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara L.","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam W.","family":"Carrico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,3,18]]},"reference":[{"issue":"2","key":"pone.0265480.ref001","doi-asserted-by":"crossref","first-page":"e0116820","DOI":"10.1371\/journal.pone.0116820","article-title":"The Global Burden of Mental, Neurological and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010","volume":"10","author":"HA Whiteford","year":"2015","journal-title":"PLOS ONE."},{"issue":"1","key":"pone.0265480.ref002","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1037\/0033-295X.111.1.33","article-title":"Addiction Motivation Reformulated: An Affective Processing Model of Negative Reinforcement.","volume":"111","author":"TB Baker","year":"2004","journal-title":"Psychol Rev."},{"issue":"5","key":"pone.0265480.ref003","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1037\/0022-3514.69.5.990","article-title":"Drinking to regulate positive and negative emotions: A motivational model of alcohol use","volume":"69","author":"ML Cooper","year":"1995","journal-title":"J Pers Soc Psychol"},{"key":"pone.0265480.ref004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cpr.2019.03.002","article-title":"Substance use and shame: A systematic and meta-analytic review.","volume":"70","author":"JB Luoma","year":"2019","journal-title":"Clin Psychol Rev"},{"key":"pone.0265480.ref005","author":"JP Tangney","year":"2002"},{"key":"pone.0265480.ref006","first-page":"446","volume-title":"Handbook of self and identity.","author":"JP Tangney","year":"2012","edition":"2"},{"issue":"7","key":"pone.0265480.ref007","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1016\/j.addbeh.2005.02.002","article-title":"On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use.","volume":"30","author":"RL Dearing","year":"2005","journal-title":"Addict Behav"},{"key":"pone.0265480.ref008","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1093\/oso\/9780195114799.001.0001","volume-title":"Shame: Interpersonal behavior, psychopathology, and culture","author":"P Gilbert","year":"1998"},{"issue":"3","key":"pone.0265480.ref009","first-page":"419","article-title":"Shame and guilt in neurosis.","volume":"58","author":"HB Lewis","year":"1971","journal-title":"Psychoanal Rev."},{"issue":"6","key":"pone.0265480.ref010","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1037\/pspa0000037","article-title":"When is shame linked to constructive approach orientation? 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