The association between shame and substance misuse in young people: A review of the literature

BACKGROUND: Shame has been associated with a range of maladaptive behaviours, including substance abuse. Young people may be particularly vulnerable to heightened shame sensitivity, and substance abuse is a significant problem amongst UK adolescents. Although there appears to be a relationship between shame and substance abuse, the direction of the relationship remains unclear. AIM: We reviewed the literature relating to shame and substance abuse amongst young people. METHOD: Five electronic databases were searched for articles containing terms related to ‘adolescence’, ‘shame’ and ‘substance abuse’. Of the two hundred and twelve articles identified in the first sweep, six were included in the final analyses. RESULTS: Sexual abuse is indicated as a predictor of shame-proneness. Substance abuse may be a mechanism by which individuals cope with negative feelings. In general, there is a lack of literature investigating the shame-substance abuse relationship among adolescents. The available literature associates shame-proneness with poorer functioning and suggests that this may lead to psychopathology and early-onset substance misuse. Scant attention has been paid to the cognitive and emotional processes implicated. Further research is required to ascertain the strength of the shame-substance abuse relationship in young people and to develop appropriate interventions for this population.