Shame among Forensic and Non-Forensic Patients and the Impact of the Social Determinants of Health: A Pilot Study

ABSTRACT Shame is associated with various mental health and social difficulties. A broad range of social factors increase the risk of shame among individuals. One group that experiences increased shame due to their mental health diagnoses and criminal justice involvement is forensic patients. The purpose of this pilot study was to compare shame levels in forensic and non-forensic patients with a diagnosis of schizophrenia or other psychotic disorder, and to examine whether any social determinants of health impacted the levels of shame among both groups. A self-report shame questionnaire and a measure of experiences with various social determinants of health were completed by 43 patients with schizophrenia or other psychotic disorder (22 forensic and 21 non-forensic patients). Statistical analyses revealed no significant differences in levels of shame between the forensic and non-forensic patients. Early life experience as well as employment and working conditions had the most significant impact on shame levels for both forensic and non-forensic patients. We also found a significant difference between forensic and non-forensic scores in employment and working conditions (p = .046), with forensic patients rating their experiences with this factor as more positive than non-forensic participants. Clinical implications are discussed.