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1
Development of a Semi-Idiographic Measure of Guilt-Proneness for
Adolescents
Erin Elizabeth Brennan
Submitted for the Degree of
Doctor of Psychology(Clinical Psychology)
School of PsychologyFaculty of Arts and Human Sciences
University of Surrey
Guildford, Surrey
United Kingdom
September 2015
2
ABSTRACT
Objective: Guilt is a self-conscious emotion with cognitive, affective and behavioural
components. In young people, it has been linked with prosocial behaviour and academic
achievement but, when excessively or insufficiently expressed, can adversely impact on
mental health. Most existing measures of guilt-proneness for adolescents have scenario-
based designs, which may not capture unique personal and cultural experiences of guilt.
Semi-idiographic measures, where respondents rate responses based on a subjectively
recalled guilt-experience, have been recommended as an alternative, yet no existing
measure for young people has used this format. The main objective was to therefore
develop, pilot and validate a new semi-idiographic measure of guilt-proneness for
adolescents aged 11 to 18.
Design and Participants: The design comprised two studies. Study one involved
measure development and interviews with nine young people. Items were compiled
using interview data and a review of relevant literature. A subsequent focus group was
conducted, during which the drafted measure was piloted. In Study two, the new guilt
measure was validated against measures of anxiety, depression, self-compassion, shame,
guilt and anger with a sample of 412 young people.
Results: Content analysis was used to extract guilt-related thoughts, feelings and
behaviours from the interviews. The Guilt Scale for Adolescents (GSA) was then
drafted. Exploratory factor analysis was conducted on the GSA to examine its
underlying structure and refine and reduce items. A final 19-item GSA was produced,
with four subscales: ‘Inner Turmoil’, ‘Reparation’, ‘Physiological Reactions’ and
‘Regret and Self-Blame’. Validity and reliability hypotheses were supported.
Conclusions: The GSA is the first semi-idiographic measure of guilt for adolescents. It
uniquely breaks down guilt experiences into four different sub-components and scores.
The GSA therefore has the potential to promote further understanding of guilt-proneness
in young people. Limitations and future implications are discussed.
Keywords: Guilt, Adolescence, Assessment, Self-Conscious Emotions
3
ACKNOWLEDGMENTS
I would like to thank the University of Surrey PsychD course team, including my
clinical tutor, research supervisors and the course administration team. I would also like
to thank my fellow trainees in Cohort 41, as well as the many multidisciplinary teams,
supervisors and service users I have met whilst on clinical placement.
Finally, I would like to thank my husband, mom, dad, brother and friends for their
continued love and support throughout the last three years of training.
4
TABLE OF CONTENTS
Research
MRP Empirical Paper (including abstract) ………………………………………………………………….. 6
MRP Empirical Paper Appendices ……………………………………………………………………………….. 69
MRP Proposal (without appendices) ……………………………………………………………………………. 178
MRP Literature Review ………………………………………………………………………………………………… 201
Clinical
Clinical Experience ……………………………………………………………………………………………………….. 254
Assessments
List of Academic Assessments ……………………………………………………………………………………… 258
5
RESEARCH
6
MRP Empirical Paper (including Abstract)
7
Development of a Semi-idiographic Measure of Guilt-proneness for Adolescents
By
Erin Elizabeth Brennan
Submitted in partial fulfilment of the degree of Doctor of Psychology (Clinical
Psychology)
School of Psychology
Faculty of Arts and Human Sciences
University of Surrey
March 2015
Word Count: 9999
8
ABSTRACT
Objective: Guilt is a self-conscious emotion with cognitive, affective and behavioural
components. In young people, it has been linked with prosocial behaviour and academic
achievement but, when excessively or insufficiently expressed, can adversely impact on
mental health. Most existing measures of guilt-proneness for adolescents have scenario-
based designs, which may not capture unique personal and cultural experiences of guilt.
Semi-idiographic measures, where respondents rate responses based on a subjectively
recalled guilt-experience, have been recommended as an alternative, yet no existing
measure for young people has used this format. The main objective was to therefore
develop, pilot and validate a new semi-idiographic measure of guilt-proneness for
adolescents aged 11 to 18.
Design and Participants: The design comprised two studies. Study one involved
measure development and interviews with nine young people. Items were compiled
using interview data and a review of relevant literature. A subsequent focus group was
conducted, during which the drafted measure was piloted. In Study two, the new guilt
measure was validated against measures of anxiety, depression, self-compassion, shame,
guilt and anger with a sample of 412 young people.
Results: Content analysis was used to extract guilt-related thoughts, feelings and
behaviours from the interviews. The Guilt Scale for Adolescents (GSA) was then
drafted. Exploratory factor analysis was conducted on the GSA to examine its
underlying structure and refine and reduce items. A final 19-item GSA was produced,
with four subscales: ‘Inner Turmoil’, ‘Reparation’, ‘Physiological Reactions’ and
‘Regret and Self-Blame’. Validity and reliability hypotheses were supported.
Conclusions: The GSA is the first semi-idiographic measure of guilt for adolescents. It
uniquely breaks down guilt experiences into four different sub-components and scores.
The GSA therefore has the potential to promote further understanding of guilt-proneness
in young people. Limitations and future implications are discussed.
Keywords: Guilt, Adolescence, Assessment, Self-Conscious Emotions
9
STATEMENT OF JOURNAL CHOICE
This paper will be submitted to the Journal of Adolescence. This journal has a
reasonable impact factor of 1.638. This means that articles published in this journal are
widely disseminated and cited amongst other researchers. It is also an international
journal, so has the scope to reach a wide geographical area. Publications within the
Journal of Adolescence target a range of disciplines including psychologists,
psychiatrists, social workers and youth workers in practice, and university faculty in the
fields of psychology, sociology, education, criminal justice and social work.
Publications within this journal therefore have the possibility of reaching a diverse
audience of readers. One of its main target research areas is adolescent development,
with particular emphasis on social and emotional functioning, which has clear relevance
for a new measure of guilt-proneness for adolescence. They have previously published
other measures for young people, which indicates that they may also show interest in a
new measure of guilt-proneness for adolescents. Please see Appendix Y for the
journal’s Guidelines for Authors.
10
ACKNOWLEDGMENTS
I would like to thank my research supervisors, Mary John and Laura Simonds, for all of
their support, guidance and reassurance over the last three years. I would also like to
thank the schools and young people that gave their time and participated in the research,
as well as my fellow trainees in Cohort 41 for providing a space to explore research
highs and lows throughout the process.
Finally, I would like to thank my fiancée for adding love and laughter to the many work-
filled nights and weekends, as well as my mom, dad and brother who, despite being
across the ocean, were always just one telephone call away.
11
INTRODUCTION
Guilt is a self-conscious emotion and an integral component of conscience that
regulates human behavior (Bybee, 1998). It is a complex construct with affective,
cognitive and behavioural elements and involves a moral transgression, real or
imaginary, in which people believe their action or inaction contributed to negative
outcomes (Tilghman-Osborne, Cole, & Felton, 2010). For example, when someone
feels guilty they may think that others will be upset with them, which may cause them to
feel regretful and annoyed with themselves, which in turn may influence their actions
and trigger them to seek reparation and forgiveness. Guilt-proneness refers to the
propensity to have a guilt response in a particular guilt-inducing situation (Bybee, 1998).
In the literature, guilt has been viewed as trait-like or state-like; maladaptive or
adaptive (Bybee, 1998). ‘Trait-like’ refers to dispositional and chronic guilt occurring
across many situations, whereas ‘state-like’ guilt is situation and time-specific (Bybee,
1998). The term ‘maladaptive’ refers to guilt’s potential role in the development and
maintenance of psychopathology, while ‘adaptive’ refers to the more protective and
reparative aspects of the emotion (Tilghman-Osborne, et al., 2010). These different
ideas indicate the potential variability of guilt as an individual experience.
Guilt has been linked to increased helping behaviour, less aggression and
academic achievement (Bybee, 1998). It is an emotion that requires a self-appraisal of
actions and behaviors and has been associated with an increased sense of responsibility
and concern for one’s effect on others (Bybee, 1998; Ferguson, Stegge, Miller, & Olsen,
1999). Guilt feelings may be viewed along a continuum, with problems arising at either
12
extreme (Baker, Baibazarova, Ktistaki, Shelton, & van Goozen, 2012; Bybee, 1998).
For example, a lack of guilt-proneness has been associated with aggression, hostility and
externalisation of blame (Baker, et al., 2012). In contrast, high levels of guilt can
increase rumination and feelings of remorse and regret, which can adversely impact on
mental health and may even be a factor in suicidality (Bybee, 1998). Individuals with
depression, eating disorders and anxiety frequently describe intense feelings of guilt
(Berghold & Lock, 2002; Bybee, 1998). Guilt may therefore become dysfunctional
when it is expressed intensely, frequently and inappropriately relative to the demands of
the situation (Clark & Watson, 1994).
Guilt versus Shame
Guilt and shame, both self-conscious emotions, are two distinct constructs that
often co-occur (Bybee, 1998). The ‘self versus behaviour’ distinction is used by some
theorists to differentiate the two: when people feel shameful they feel bad about the self,
whereas when people feel guilty they feel bad about a specific behaviour (H. Lewis,
1971). Shame involves a sense of exposure and often motivates an avoidance response
(Bybee, 1998). In contrast, guilt focuses on the specific deed, harm caused to others and
desire to make amends (Bybee, 1998).
Some authors have used Attribution Theory to explain the distinction: shame
emerges if one attributes an event to oneself and sees the characteristic as being global,
stable and enduring; guilt emerges when an event is attributed as being an unstable,
time-limited and specific aspect of the self (Hosser, Windzio, & Greve, 2008; Weiner,
1986). Irrespective of the type of situation, it is therefore the attributional response that
13
distinguishes shame and guilt (M. Lewis, 1991). As the same situation can trigger both
emotions, capturing the differentiating response is key in measurement. When
developing a new measure of guilt, it is therefore vital to consider possible
contamination by shame.
Development of Guilt
The expression and capacity to experience guilt appears to change with
developmental stage. In early childhood, guilt is mainly behavioural in nature (e.g.
discomfort shown in facial/bodily distress, apology) and becomes increasingly cognitive
and complex with age and cognitive maturity (Baker, et al., 2012). The Cognitive
Attribution Model states that self-conscious emotions typically arise in the second year
of life because this is when the capacity for self-awareness emerges (M. Lewis, 1991).
A knowledge of standards, rules and goals, and the ability to evaluate oneself in relation
to these standards, also develops and children are able to make the attribution that they
were responsible for the transgression (M. Lewis, 1991).
Hoffman (1984) proposed that, as the self-versus-other distinction develops, the
capacity for empathy and guilt becomes increasingly sophisticated (Hoffman, 1984).
Similarly, within Piaget’s Stages of Cognitive Development, younger children tend to
view the world in more concrete and less abstract ways (Piaget, 1964). After age 10 (as
‘formal operational’ thought develops), children have a greater capacity for abstract
reasoning, information retention and perspective-taking, which has a direct impact on
their appreciation of guilt (Tilghman-Osborne, Cole, & Felton, 2012). Between the ages
of eight and 11, children begin to develop more sophisticated and distinct conceptions of
14
shame and guilt (Bybee, 1998). A conceptual understanding of the emergence of guilt is
critical to the development of psychometrically sound self-report measures of guilt for
young people.
Existing Measures of Guilt
There is only one published review on the measurement of guilt (Tilghman-
Osborne, et al., 2010). This review identified seven measures of guilt for young people.
In 2012, the authors developed an additional measure, totaling eight measures designed
for use with children and adolescents (Appendix A). These included scenario-based,
semi-projective story/play, observational and other informant (e.g. parent-reported)
measures. Of these eight measures, only one (the Test of Self-Conscious Emotions for
Adolescents- Guilt subscale; TOSCA-A) is adolescent-specific.
Having adolescent-specific measurement of guilt is important as, in comparison
to children, adolescents have an increased cognitive ability to engage with concepts
embedded in attribution theory, and recognize less visible failures and transgressions
that transcend time and place (Bybee, 1998). For example, children are often more
inclined to focus on concrete and observable acts, whereas adolescents are more likely to
report guilt over inaction and neglect of responsibilities (Bybee, 1998). The World
Health Organization defines adolescence as young people in between the ages of 10 and
19 and specifies three stages: early adolescence (age 10-13), mid-adolescence (age 14-
15) and later adolescence (age 16-19) (WHO, 2002). It is during these age spans that
noteworthy changes occur in cognitive and emotional development, which results in
increasing moral development and a more complex understanding of right from wrong
15
(Tilghman-Osborne, Cole, Felton, & Ciesla, 2008). During adolescence, a variety of
mental health problems (e.g. depression) also become more prevalent (Bybee, 1998).
Similarly, identity and social roles are rapidly changing, with an increasing separation
from the family and integration into the peer group (Bybee, 1998). Social comparison
also becomes more pertinent and associated self-evaluation has a major role in the
development of distress (Tilghman-Osborne, et al., 2010).
Existing child and adolescent measures of guilt have a number of limitations
(Brennan, 2013; Tilghman-Osborne, et al., 2010). For example, data on validity and
reliability are rarely or inconsistently reported and the construct of shame is often
overlooked in the validation process (Brennan, 2013). In addition, items are often
generated using a ‘top-down’ approach (generated by academics, researchers and
clinicians) rather than with young people themselves, and so may therefore measure
adult-driven concepts of guilt rather than accurately capture young people’s experiences.
Most guilt measures are also scenario-based (Brennan, 2013). In these, examples of
guilt-provoking situations are provided and respondents rate the likelihood of a guilt
response if they were in that situation. Since these provide a limited number and type of
scenarios, they may fail to capture unique personal and cultural situations that trigger
guilt. Semi-idiographic measures (e.g. asking a person to recall a time when they felt
self-conscious emotions such as guilt) are recommended as a way to address these issues
(Simonds et al., Under Review), yet no existing guilt measure has used this format
(Brennan, 2013).
16
Of the existing eight measures of guilt-proneness for young people, the TOSCA-
A is the most commonly used (Brennan, 2013). It is a situation-based self-report
measure adapted from an existing measure of guilt for children, which itself was
modelled on the adult version of the TOSCA. The TOSCA-A scenarios tap self-
conscious emotional responses, including shame and guilt, but the shame and guilt
subscales overlap considerably, suggesting criterion contamination (Simonds, et al.,
Under Review). In response to shortcomings outlined in their review on the
measurement of guilt, Tilghman-Osborne et al. (2012) developed the Inappropriate and
Excessive Guilt Scale (IEGS) to tap maladaptive forms of guilt based on theories of
guilt, depression and negative cognitive errors (Tilghman-Osborne, et al., 2012).
Although there is evidence supporting the validity and reliability of the measure in a
general youth population, the IEGS was developed based on expert opinion and the
available literature only (e.g. did not conduct interviews with young people) and its
overlap with shame was not assessed in validation. Like the TOSCA-A, it is also a
scenario-based measure. The limitations of these scenario-based measures indicate the
potential value of a semi-idiographic measure of guilt-proneness.
Measure Validation
In addition to considering the overlap between guilt and shame when validating a
new measure of guilt, the available literature indicates that measures of depression,
anxiety, anger and self-compassion are useful in establishing construct validity.
Depressive Symptoms
A positive correlation between depression and guilt has been documented from
pre-school to adulthood (Tilghman-Osborne, et al., 2010). Feelings of guilt can involve
17
the self-blame or rumination that underpin depression, and maladaptive guilt responses
have been documented as being more common in young people at risk for depression
(Tilghman-Osborne, et al., 2012). For example, one study found that high levels of
guilt-proneness were related to the onset of childhood depression (Luby et al., 2009).
Similarly, in a two-wave longitudinal study with 221 adolescents aged 11 to 18,
depressive symptoms were found to be positively correlated with guilt over time
(Tilghman-Osborne, et al., 2008). In previous validation studies of guilt measures for
children, adolescents and adults, guilt has been positively correlated with depressive
symptoms (Averill, Diefenbach, Stanley, Breckenridge, & Lusby, 2002; Kochanska,
DeVet, Goldman, Murray, & Putnam, 1994).
Anxiety
Researchers have found guilt to be positively correlated to symptoms of
generalized anxiety disorder, obsessive compulsive disorder and social anxiety disorder
(Fergus, Valentiner, McGrath, & Jencius, 2010; Gilbert, 2000; Shafran, Watkins, &
Charman, 1996; Tilghman-Osborne, et al., 2010). In studies involving adult and
undergraduate student samples, guilt has been noted to be important in the etiology of
obsessive-compulsive disorder and social anxiety disorder symptoms (Gilbert, 2000;
Shafran, Thordarson, & Rachman, 1996). Guilt-proneness is also significantly
positively correlated to post-traumatic stress symptoms in young people with a history of
interpersonal violence (Kletter, Weems, & Carrion, 2009). As expected, previous guilt
measure validation studies have reported significant positive relationships between guilt
and anxiety (Ferguson, Stegge, & Barrett, 1996; Kochanska, et al., 1994).
18
Anger
A lack of guilt-proneness has been associated with externalizing behaviour,
particularly anger (Stuewig & McCloskey, 2005; Tangney & Dearing, 2002). Lower
guilt scores have been correlated with heightened scores of hostility and anger in both
adults and children (Bybee & Williams, 1995; Tangney, Wagner, & Gramzow, 1992).
Young people who are more guilt-prone are reported to engage less in delinquent
offences, potentially due to an increased ability to anticipate the harmful consequences
of their behaviour (Stuewig & McCloskey, 2005). In a longitudinal study following
children for eight years into adolescence, guilt-proneness was linked to less anger and
delinquent behavior (Stuewig & McCloskey, 2005). It may be that young people more
likely to experience guilt are less likely to externalize blame through anger (Bear, Uribe-
Zarain, Manning, & Shiomi, 2009). In contrast, shame is often associated with outward
anger in interpersonal relationships (Tangney & Dearing, 2002).
This negative correlation between externalised anger and guilt in young people
has been reported in a number of different studies, including validation studies of
previously developed child guilt measures (Bear, et al., 2009; Kochanska, et al., 1994;
Menesini & Camodeca, 2008; Stuewig & McCloskey, 2005). Although there is
relatively little research on the relationship between guilt and different types of anger
(e.g. inwardly versus externally expressed), the available literature appears to indicate
that the ability to control and suppress anger may have a positive relationship with guilt-
proneness (Tangney & Dearing, 2002). Existing theories on guilt support this, as a
common function of guilt is to maintain and repair relationships, and this would be
hindered by the expression of anger towards others (Tilghman-Osborne, et al., 2010).
19
Self-Compassion
Self-compassion involves basic kindness, with a deep awareness of the suffering
of oneself and of other living things, coupled with the wish and effort to relieve it
(Gilbert, 2009a; Neff, 2003b). Only two studies were sourced that examined the
relationship between guilt and self-compassion: the first reported a small positive
correlation (Mosewich, Kowalski, Sabiston, Sedgwick, & Tracy, 2011), whereas the
second reported no evidence of correlation (Barnard & Curry, 2012). Despite these
mixed results and a general paucity of research, theory surrounding self-compassion
suggests that increased guilt, and particularly guilt-based self-attacking and self-blame,
may result in a decreased capacity for self-compassion (Gilbert, 2004). It would
therefore be expected that guilt-proneness would negatively correlate with self-
compassion.
Research Aim and Validity Hypotheses
The primary aim was to develop a semi-idiographic measure of guilt-proneness
for adolescents, tapping cognitive, emotional and behavioural responses to guilt across
personally-defined situations. The intended age range for the measure was 11 to 18
based on the World Health Organisation’s definition of adolescence (WHO, 2002). A
companion measure, the Adolescent Shame-Proneness Scale (ASPS) (Simonds, et al.,
Under Review), which is a semi-idiographic measure of shame-proneness, also utilised
this age range. From a cognitive developmental standpoint, associated literature also
suggests that, by age 11, young people begin to develop a more sophisticated conceptual
understanding of guilt (Bybee, 1998). In the validation of the new measure, the
following validity and reliability hypotheses were tested.
20
Concurrent criterion validity
Scores on the Guilt Scale for Adolescents (GSA; new guilt measure) would
positively correlate with scores on another measure of guilt.
Divergent construct validity
Scores on the GSA would be negatively correlated with scores on measures of
trait anger and anger expression scores.
Convergent validity
GSA scores would be positively correlated with scores on measures of
depression and anxiety. It was also expected that GSA scores would be positively
correlated with measures of shame-proneness because, although they are two different
constructs, they are both self-conscious emotions that arise from similar situations. It
was also expected that anger control and anger suppression would be positively
correlated with scores on the GSA, and self-compassion scores would be negatively
correlated with GSA scores.
Reliability
The GSA would have good internal consistency.
Study One
METHODOLOGY
This paper reports two studies: study one involved the development of the GSA;
study two explored its psychometric properties.
21
Design
The GSA was created using a cross-sectional interview-based design.
Participants
Participants aged 11 to 18 were recruited to take part in a semi-structured
interview. The aim was to develop a measure that could be used in both non-clinical and
clinical populations; a clinical sample was therefore not required. Similarly, as guilt is a
normative emotion, there is no need to conceptualise it ‘clinically’ (Bybee, 1998). An
inclusive policy was adopted as recruitment was through English educational
establishments, accessing the country’s National curriculum. Young people who had a
known and significant learning disability (as assessed by the school), and were not able
to participate in a regular classroom learning environment, were excluded from the
research.
Recruitment
A primary aim was to recruit a small number of young people in order to gain
their understanding of the concept of guilt and to help generate age-appropriate items for
the new questionnaire. Co-education secondary schools with a diverse representation of
ethnic and religious backgrounds were identified. Information on diversity was obtained
from the Department of Education, Ofsted and individual school websites. The Heads of
School and Heads of Psychology were sent an information letter, followed by a
telephone call. In total, three schools were approached and one agreed to participate. The
Head of Psychology distributed information packs to 15 students, aged 11 to 18, asking
them to participate in the interviews. Nine adolescents aged 12 to 18 were recruited
22
(60% uptake rate). The Head of Psychology collected all returned and signed parental
and pupil consent forms, and organised a time and date for data collection. The sample
consisted of four boys and five girls, with a mean age of 15.44 (Standard
Deviation=1.88) and from a range of ethnic backgrounds (Appendix B). Five of the
adolescents initially interviewed agreed to participate in a subsequent focus group (56%
response rate). The focus group sample included one boy and four girls, aged 12 to 18.
Ethical Approval
A favourable opinion was received from the University of Surrey Faculty of Arts
and Human Sciences Ethics Committee (Appendix C).
Information & Consent Forms
An information sheet was provided to the young person and his or her
parent/legal guardian (Appendix D). Written consent for participation was required
from the young person and their parent (Appendix D).
Materials
Demographic Questionnaire
This form requested background information on participant ethnicity, age, sex
and language (Appendix E).
Procedure: Phase One
Interviews
Study one had two phases: individual interviews (phase 1) and the measure
pilot/focus group (phase 2). Interviews were used to provide participants with a private,
23
confidential space in which to talk about their views on guilt. The semi-structured
interview schedule was developed based on the schedule used by Simonds et al. to
develop the ASPS, the available guilt and shame literature and input from research
supervisors. It was also theoretically driven by Cognitive Attribution theory and
included questions on the cognitive, affective and behavioural aspects of guilt
(Appendix F). In addition, it covered questions on ‘what situations make others feel
guilty’ and ‘differences between shame and guilt’ in order to gauge their conceptual
understanding of guilt. The semi-structured interviews were approximately 30-minutes
each, and took place in a classroom at the participating school. A teacher was in
attendance but wore noise cancelling headphones to ensure confidentiality. Young
people were also asked to complete a demographic questionnaire. Following the
interviews, participants were de-briefed (e.g. who to talk to if distressed, that
questionnaires were not diagnostic and more information on the research aims).
Interview scripts were audio recorded and transcribed verbatim. Content analysis was
conducted and items developed.
Content Analysis
Interview transcripts were read several times by the researcher and initial ideas
noted. Initial codes were then generated, with the codes aiming to encapsulate and
summarise what was being said across the nine interviews. All of the transcripts were
then re-read and subjected to content analysis (Hsieh & Shannon, 2005; Weber, 1990),
where the frequency of all codes was recorded (Appendix G).
24
Content analysis was used to extract five elements:
• Distinctions made between guilt and shame
• Situations that provoke guilt
• Thoughts associated with guilt
• Feelings associated with guilt
• Behaviours associated with guilt
A theory-driven content analysis was therefore employed (Hsieh & Shannon, 2005;
Weber, 1990).
Item Development
Using the thoughts, feelings and behaviours associated with guilt that had been
generated from the content analysis, initial items were then drafted (Appendix H). The
process for checking the extraction of items included reviewing choices with research
supervisors and consulting previously developed guilt measures and the related
literature. A reliability check on the coded interview data was done by the researcher’s
two supervisors.
Procedure: Phase Two
Focus Group
A few months after the interviews, the nine interviewed young people were
invited back for a focus group, with the aim of piloting the newly developed guilt
measure and eliciting their written and verbal feedback on utility. Five young people
(one boy and four girls; mean age 14) agreed to participate. The focus group semi-
25
structured interview schedule was developed based on discussions with research
supervisors (Appendix I). It covered questions on likes and dislikes about the new guilt
measure, areas for improvement and any difficulties or misunderstandings. All data
were collected at the school in a designated classroom. The focus group lasted
approximately 15 minutes. In order to capture the views of adolescents less likely to
contribute in a group setting, an anonymous written feedback form was also
administered individually before the focus group started (Appendix J). The feedback
form contained the same questions asked in the focus group. Following the focus group,
participants were de-briefed (covering the same areas as in phase one). The focus group
was audio recorded and transcribed verbatim. Feedback from the focus group was then
discussed with supervisors, and helped inform the final design of the measure.
RESULTS
Common themes were established based on number of occurrences in the data
across the interviews, rather than number of participants (see coding extract; Appendix
K). The interview data indicated that young people were able to make distinctions
between shame and guilt, and their answers corresponded with related conceptual theory
(Appendix L). In order to develop measure items, and based on Cognitive Attribution
Theory, line by line coding was used to extract guilt-related thoughts, feelings and
behaviours from the data. A theme/category was assigned, an interpretation was made
based on the literature, potential measure items were devised and a final decision (e.g.
whether the item was retained for the final measure) was recorded (Appendix M). From
the interview data, five categories of guilt-related thoughts (Table 1), five categories of
feelings (Table 2) and five categories of behaviours (Table 3) were identified. In
26
addition, four overarching themes of guilt-inducing situations were extracted, indicating
a number of similarities across interviews (Appendix N).
Table 1.
Interviews: Guilt-related Thoughts
Category Frequency in data (%)
Definition Examples of terms
Impact of behaviour
(24/81; 30%) Involved thinking about the repercussions and impact of their behaviour
“It may damage my reputation”
Confusion and desire to find a solution
(18/81; 22%) Thoughts in this category reflected a desire to fix the problem but being unsure about how to proceed
“I felt cross-minded”
“How am I going to fix this?”
Responsibility (16/81; 20%) Reflected thinking about consequences, feeling responsible and an awareness of doing something ‘wrong’
“I did something wrong”
Regret (15/81; 19%) Reflected wishing that things had turned out differently and thinking that they could have done something better
“It could have been prevented”
Future orientation
(8/81; 10%) Reflected a desire to learn from mistakes and refrain from similar behaviour in the future
“I shouldn’t do it again”
27
Table 2.
Interviews: Guilt-related Feelings
Category Frequency in data (%)
Definition Examples of terms
Sadness (31/70; 44%) It reflected feeling sadness for self and also for the other person that was wronged
‘Sadness’; ‘upset’; ‘self-pity’; ‘depressed’, ‘low’; ‘disappointment’
Anxiety/fear (14/70; 20%) This category reflected feeling anxious about the repercussions and consequences of an act (e.g. impact on ‘popularity’ and whether ‘forgiveness’ would be achieved)
‘Anxious’; ‘stress’; ‘scared’; ‘nervous’; ‘paranoid’
Anger with self (10/70; 14%) This reflected anger with self about having performed the wrongdoing
‘Annoyed with self’; ‘angry’
Uncomfortable (10/70; 14%) This reflected an internal tension, and a desire to rid oneself of the associated negative feelings
‘Feeling awful’; ‘uncomfortable’; ‘deceitful’; ‘conflicted’; ‘judged’; ‘hurts’; ‘painful’; ‘not proud’
Lost confidence (5/70; 7%) This reflected the transient feelings of disempowerment following the act in question.
‘Lost confidence’; ‘lack of control’
28
Table 3.
Interviews: Guilt-related Behaviours
Category Frequencyin data (%)
Definition Examples of Terms
Fixing the problem
(18/44; 41%) Involved thinking about the repercussions and impact of their behavior
‘Fixing the problem’; ‘facing up to the problem’; ‘helping other person’; ‘trying to rebuild the trust’; ‘confront the situation’; ‘introversion’; ‘hiding’; ‘prioritise things’; ‘try to decrease my stress’; ‘owning up to it’; ‘wanting the other person to feel better’.
Compensation (13/44; 30%) It reflected a need to compensate for the wrongdoing.
‘Confessing’; ‘telling the truth’; ‘apologising’; ‘compensating’; ‘try to comfort them’; ‘praying’
Changing future behaviour
(7/44; 16%) It reflected a desire to learn from and not repeat past mistakes.
‘More cautious about what you say and do’; ‘trying not to do it again’.
Rumination (3/44; 7%) It reflected rumination over the wrongdoing, possible solutions and impact of actions
‘Thinking about things constantly’; ‘taking mind off other things’; ‘poor sleep’
Violence (3/44; 7%) It reflected a build-up of frustration and anger from internalised and unresolved guilt, eventually expressed through violence
‘Violence’; ‘killing yourself’
29
The decision-making process (e.g. which items to include in the measure) was
aided by discussions with research supervisors and consultation of the related guilt
literature. Due to the semi-idiographic nature of the measure, and as it is the appraisal
rather than the situation per se that prompts guilt, data collected on specific guilt
situations were therefore not incorporated into questionnaire items. Items were also not
included in the final measure if they reflected shame rather than guilt. The content
validity of the measure was maximised by ensuring items were theoretically grounded
and through consultation with the literature and with child and adolescent mental health
professionals. Furthermore, the knowledge and experiences shared by young people in
the individual interviews provided an important contribution to the content and face
validity of the GSA.
Results from the focus group indicated that the instructions and questionnaire
were easy to understand. Respondents liked the Likert scaling of questions and
questionnaire length. They also reported that they valued generating and using their
own personal guilt-inducing situations to answer the questions, noting that this made the
measure more individualised, capturing genuine experiences.
DISCUSSION
The findings in study one indicate that young people, aged 12 to 18, understand
the concept of guilt and can distinguish guilt from shame. For example, participants
were able to make what Lewis (1971) describes as the ‘self versus other’ distinction for
the two emotions, noting that shame is associated with feeling bad about the self,
whereas guilt is about feeling bad about the specific act of wrongdoing. Similarly, the
30
difference in response (e.g. avoidance and hiding with shame; desire to make amends
with guilt) was noted. Young people also responded that, although distinct, the two
emotions often co-occur, which is significant as the literature notes considerable
conceptual overlap between the two self-conscious emotions (Tilghman-Osborne, et al.,
2010). Another theme that emerged was that shame lasts longer than guilt. This is again
supported by the associated literature, as guilt can be resolved through making amends
whereas shame is often more global, stable and enduring and, as such, may be perceived
as more difficult to resolve (Tangney & Dearing, 2002).
Participants were also able to spontaneously generate a number of guilt-inducing
situations. There were a number of commonalities, and the majority of scenarios related
to damaging relationships. This is expected as guilt most often occurs within the context
of close interpersonal relationships and can have a relationship-mending function (e.g.
through apology and repair) (Bybee, 1998). Failing to take responsibility was the
second most common, which again would be expected as guilt over inaction and neglect
of responsibilities becomes increasingly reported during adolescence (Bybee, 1998).
Interestingly, a number of situations relating to social media were also reported by
young people. This is noteworthy as scenario-based guilt measures, such as the IEGS
and TOSCA-A, do not offer social media scenarios and may therefore fail to capture
contemporary issues in relation to guilt and young people.
Data regarding thoughts, feelings and behaviours associated with guilt also
support young people’s understanding of the concept. For example, common thoughts
surrounded the impact of behaviour and desire to find a solution, and reflected the focus
31
on the specific behaviour rather than a global self-evaluation. The most frequently
reported behaviours included fixing the problem and compensation, and again reflects a
motivation towards approaching the situation rather than avoidance. The majority of
reported feelings included sadness and anxiety, indicating regret over the transgression
and a state of ‘discomfort’ and ‘inner conflict’ in which a solution is eagerly sought in
order to repair the situation. This again reflects the literature, which suggests that such
feelings are highly associated with guilt experiences (Bybee, 1998).
Guilt Scale for Adolescents (GSA)
The Cognitive Attribution Model guided development of the measure, in that it
aimed to tap thoughts, feelings and behaviours (M. Lewis, 1991). Based on the
available conceptual literature it was important to include items representing thoughts
about potential repercussions, taking responsibility, wanting to make amends, regret
over what had happened and not wanting to repeat the act (Tangney & Dearing, 2002).
Similarly, items reflecting attempted problem-solving were also included. These items
differentiate guilt from shame, where the focus in the latter is more on global evaluations
of the self and wanting to hide or avoid rather than approach and fix the situation
(Tangney & Dearing, 2002). Shame-related thoughts and behaviours (e.g. global
negative self-evaluations and avoidance) were not included. Similarly, thoughts
reflecting a ‘damaged reputation’ were not included as they are more likely to arise in
the context of shame (Tangney & Dearing, 2002).
Feelings of anxiety/stress, fear and annoyance with self are consistent with the
experience of ‘inner tension’ that is often associated with guilt (Tangney & Dearing,
32
2002). It was therefore deemed appropriate to include these feelings in the measure.
Feeling ‘awful for what had happened’ reflected a sense of responsibility and regret over
the incident, theoretically-noted aspects of the guilt experience, and were thus deemed
important to include (Tangney & Dearing, 2002). Although sadness, a loss in
confidence and not feeling ‘in control’ can be linked to shame, when they are associated
specifically with an event (rather than global self-evaluations) they are also an aspect of
guilt and were therefore important to capture within the measure (Tangney & Dearing,
2002). Feeling insensitive and angry were not included due to their association with
shame (Tangney & Dearing, 2002).
Regarding behaviours, it was considered crucial to include reparation, rebuilding
trust, confessing and apologising (Tangney & Dearing, 2002). Similarly, a change in
future behaviour (e.g. ‘tried not to do it again’) and rumination over the act and
associated repercussions, commonly associated with guilt, were therefore also included.
The literature notes that rumination can be considered a behaviour or cognition, and in
this case the former categorisation was utilised (Watkins, 2009). ‘Trouble sleeping’ was
an aspect presented within the individual interview data and is an item in the IEGS guilt
measure, so it was included in the drafted GSA. Other physiological expressions of guilt
(e.g. stomach aches, crying and heavy chest) were also included. Introversion (e.g.
‘wanting to go into myself’) and violence were not included in the measure as they are
more often an aspect of shame rather than guilt (Tangney & Dearing, 2002).
The format of the GSA was modelled on the companion ASPS (Simonds, et al.,
Under Review). The content analysis of individual interviews, and associated decision-
33
making process, resulted in the development of 30-items representing cognitive (11-
items), affective (7-items) and behavioural (12-items) components of guilt responses
(Appendix O). Instructions on the GSA were developed to normalise the experience of
guilt, and to remind respondents that guilt can occur as a result of one’s own actions. To
facilitate engagement with the semi-idiographic aspects of the measure, examples of
guilt-inducing situations were provided in the instructions. These were chosen based on
frequency of occurrences in the interviews. Participants are then asked to write down
three of their own personal examples of situations where they had recently felt guilt.
They are then asked to answer the questionnaire items based on how they would
generally think and feel in situations like the ones that they had written down. Items are
rated on a four-point Likert scale: 0 (‘not at all’); 1 (‘a little bit’); 2 (‘quite a bit’); and 3
(‘a lot’). The validation of the measure was then addressed in study two.
Study Two
METHODOLOGY
Design
Validated measures were used in a cross-sectional questionnaire-based design to
assess the psychometric properties of the GSA in a non-clinical population.
Participants
The intended sample was adolescents aged 11 to 18. In total, data were collected
from 412 young people. There were doubts about the responses of one individual, as all
questions were answered with extreme values, so this case was deleted, leaving a total of
411. Of the participants, 261 (64%) were girls and 266 (65%) were White British
34
Appendix P). The mean age was 16.28 (Standard Deviation=1.1), with a range from 12
to 18 years.
Recruitment
Co-education and single-sex schools (secondary schools, sixth-form colleges and
independent schools), from different geographical locations in England, were
approached. The Heads of Psychology or Head Teachers were contacted by telephone
and an information pack was forwarded via email. Twelve schools were contacted and
seven agreed to participate. In total, 430 questionnaire packs were distributed to young
people. Completed packs were returned by 412 adolescents (96% return rate).
Ethical Approval
Ethical approval for study two was gained at the same time as study one.
Information & Consent Forms
Information sheets and consent forms from study one were adapted and provided
to schools and young people (Appendix Q). All school policies were aligned with the
British Psychological Society (BPS)’s recommendations with research conducted in
schools: adolescents aged 16 and older could provide their own informed consent; Heads
of Schools could act in loco parentis for children under 16 if they deemed it part of
normal curriculum (BPS, 2010).
Materials
Demographic Questionnaire
The demographic questionnaire from study one was used again in study two.
35
Measures
1. The Guilt Scale for Adolescents (GSA) – New Guilt Measure
As described in study one.
2. Test of Self-Conscious Affect in Adolescents (TOSCA-A) (Tangney, Wagner, Gavlas,
& Gramzow, 1991)
The TOSCA-A is a scenario-based measure of shame, guilt, pride and
externalisation for young people aged 13 to 18. Previous research has demonstrated its
reliability with adolescents aged 11 to 18 (Simonds et al., Under Review). For the
purpose of this study, only the shame and guilt subscales were used (Appendix R).
Participants are provided with 15 scenarios, with two items relating to each scenario
(one shame response and one guilt response). Items are rated on a five-point Likert scale
with 1=Not at all likely, 2=Unlikely, 3=Maybe, 4=Likely and 5=Very likely; the
subscale scores are the sum of responses for each relevant item. In adolescent samples,
the measure has relatively high predictive and convergent validity (Tangney et al.,
1996). Previous studies have noted its good internal consistency (α=.81 for the guilt
subscale; α=.77 for the shame subscale) (Tangney, 1996). In the present study, the
Cronbach’s alpha was .83 for Guilt and .85 for Shame.
3. The Adolescent Shame-Proneness Scale (ASPS) (Simonds, et al., Under Review)
The ASPS is a semi-idiographic measure of shame-proneness in adolescents,
aged 11 to 18 years old, comprising three components of shame (a total is not
calculated) (Appendix R). Items are rated on a four-point Likert scale with 0=Not at all
likely, 1=A little bit, 2=Quite a bit and 3=A lot; the three subscale scores are the sum of
36
responses for each relevant item. The authors of the measure reported good internal
consistency of the three subscales: Negative Evaluation of Self (α=.90), Humiliated Fury
(α=.82) and Internal Affect (α=.82). Similarly, in the present study, Cronbach’s alphas of
the subscales were as follows: Self Evaluation (α=.85); Humiliated Fury (α=.78); and
Internal Affect (α=.81). The measure has been validated against indices of self-esteem,
anger, shame, guilt and depression.
4. The Revised Child Anxiety and Depression Scale (R-CADS) (Chorpita, Moffitt, &
Gray, 2005)
The R-CADS is self-report questionnaire measuring anxiety and depression in
young people aged six to 18 (Appendix R). Items are rated on a four-point Likert scale
with 0=Never, 1=Sometimes, 2=Often and 3=Always; the six subscale scores are the
sum of responses for each relevant item. It has been shown to have good internal
consistency, convergent and discriminant validity in both community and clinical
samples (Chorpita, et al., 2005; Chorpita, Yim, Moffitt, Umemoto, & Francis, 2000).
Chorpita et al (2005) reported the following values for internal consistency: Social
Phobia (α=.87); Panic Disorder (α=.88); Major Depression (α=.87); Separation Anxiety
(α=.78); Generalised Anxiety (α=.84); and Obsessive Compulsive Anxiety (α=.82).
Similarly, the present study reported the following Cronbach’s alphas: Social Phobia
(α=.87); Panic Disorder (α=.89); Major Depression (α=.87); Separation Anxiety (α=.80);
Generalised Anxiety (α=.82); and Obsessive Compulsive Anxiety (α=.80).
37
5. The Anger Expression Scale for Children (AESC) (Steele, Legerski, Nelson, &
Phipps, 2009)
The AESC is a 26-item self-report measure for young people aged seven to 17
years old that is designed to assess four aspects of anger: Trait Anger, Anger Expression,
Anger Suppression and Anger Control (Appendix R). Previous research has
demonstrated its reliability with adolescents aged 11 to 18 (Simonds et al., Under
Review). Each item on the AESC is scored on a four-point Likert scale of 1=Almost
never, 2=Sometimes, 3=Often and 4=Almost always. The four subscale scores are the
sum of responses for each relevant item. The reliability and validity of the AESC was
explored by Steele et al. (2009) using both healthy children and children with chronic
illnesses. Internal consistencies were found to be: Trait Anger α = .84, Anger Expression
α = .69, Anger Suppression α = .71 and Anger Control α = .79. Test-retest reliability
was found to be adequate, with the trait anger scale showing the greatest stability over
time. Convergent validity for the AESC was investigated and the measure was found to
correlate positively with both parent and child reports of aggression, anger and hostility
when compared to other self-rated anger scales (Steele, et al., 2009). In the present
study, Cronbach’s alphas for the subscales were: Trait Anger (α=.86); Anger Expression
(α=.72); Anger Control (α=.75); Anger Suppression (α=.83).
6. The Self-Compassion Scale (SCS) – Short Form (Neff, 2003a)
The Self-Compassion Scale (SCS), Short Form, is appropriate for ages 14 and
up, so was only used with participants aged 14 to 18 in the current study (Appendix R).
Items are rated on a five-point Likert scale with only the extreme values defined
(1=Almost never; 5=Almost always). It yields a total score of self-compassion, based on
38
12-items that assess self-kindness, common humanity, isolation, mindfulness and over-
identification. Previous studies have reported good validity and internal consistency
(α=.84) of the SCS- Short Form (Neff, 2003a; Raes, 2011). In the present study, a
Cronbach’s alpha of α=.78 was reported. The SCS- Short Form has a near perfect
correlation with the long-form (Neff, 2003a).
Procedure
Data Collection
Data collection involved administering questionnaire packs (completed with
paper and pencil) containing the following: participant information sheet; young
person’s consent form; demographic questionnaire; the GSA (developed in study one);
TOSCA-A; ASPS; R-CADS; AESC; and SCS. Questionnaires were arranged in this
order to ensure young people completed the GSA first and finished the pack with the
self-compassionate questions on the SCS. A crossword puzzle was also included in the
questionnaire pack so that adolescents could choose not to participate without revealing
this to the group. The questionnaire packs took approximately 30-to-45mimutes to
complete and were administered individually in a designated classroom. The primary
researcher was in attendance at all times. As in study one, participants were de-briefed
following data collection (e.g. who to talk to if distressed, that questionnaires not
diagnostic and more information on the research aims).
Statistical Analysis
All analyses were conducted using the statistical programme SPSS version 22.0
(SPSS Inc., 2013).
39
Exploratory Factor Analysis
Principal Axis Factoring (PAF) was employed to examine the underlying
structure of the GSA and to reduce and refine the number of items. Within the literature,
PAF is noted as one of the methods of factor analysis that produces the best results
(Fabrigar, Wegener, MacCallum, & Strahan, 1999). Factor loadings were generated
using oblique rotation (direct oblimin) in order to determine the most interpretable
solution (Floyd & Widaman, 1995). An oblique method of rotation was used as the
psychological constructs being measured were assumed to correlate, and therefore this
method was favoured to an orthogonal technique (Costello & Osborne, 2005; Floyd &
Widaman, 1995).
Reliability
The internal consistency of the GSA was examined using Cronbach’s alpha
coefficients (Cronbach, 1951). Test-retest reliability was not possible due to time
constraints.
Validity
Criterion validity, convergent construct validity and divergent construct validity
were assessed using Pearson’s correlational analyses (Ezekiel & Fox, 1959). With 412
participants, a correlation (two-tailed) of at least 0.2 with 98% Power (alpha=.05) can be
detected (Faul, Erdfelder, Buchner, & Lang, 2009).
40
RESULTS
Suitability of the Data for Factor Analysis
As mean imputation has been criticized within the literature due to its role in
reducing data variability, listwise deletion was used for missing data (Donders, van der
Heijden, Stijnen, & Moons, 2006). There were missing data from 15 participants, and
these cases were therefore not included in the PAF (analysis sample therefore N=396).
The participant to item ratio in the present study was 13:1, which is higher than the
recommended 10:1 rule of thumb (Costello & Osborne, 2005). Tabachnick & Fidell
(2001) report that having at least 300 cases is most preferable for factor analysis.
An examination of the distributions of GSA items suggested that all items were
suitable for factor analysis. The Kaiser-Meyer-Olkin measure of sampling adequacy
was 0.94, exceeding the recommended value of 0.60 (Kaiser, 1960; Tabachnick &
Fidell, 2001). Bartlett’s Test of Sphericity was also highly significant (5993.71,
p<0.001), indicating high sampling adequacy. Most of the inter-item correlations were
above 0.3 but were not above 0.8, and the determinant was >.00001, suggesting no
problems with multicollinearity or singularity. These analyses indicated that this dataset
was suitable for factor analysis.
Exploratory Factor Analysis
The initial analysis indicated five factors with eigenvalues exceeding one,
explaining 58.76% of the variance. Subsequent inspection of the scree plot indicated a
point of inflection at the third and fifth factors (Appendix S) (Cattell, 1966). This
therefore suggested the possibility of three, four and five factor models. After the factor
41
analysis was re-run, the five-factor model was rejected as the fifth factor could not be
interpreted (Appendix T). In comparison to the three-factor model, the four-factor
model highlighted an additional fourth interpretable factor, Regret and Self-Blame
(Appendices T and U). The four-factor model was therefore retained (Table 4).
The extracted four-factor solution explained a total of 55.34% of the variance
(Factor 1 contributing 33.78%; Factor 2: 9.56%; Factor 3: 5.43%; and Factor 4: 3.58%).
The criterion for inclusion of an item in a factor was set at 0.4 in line with
recommendations made by Floyd and Widaman (1995). Seven items did not load at this
level on any factor and were subsequently omitted. An additional two items on Factor 3
(‘I wanted to confess’ and ‘I had trouble thinking straight’) did not fit the factor
category and so were also omitted. This procedure of interpretation, based on the
researcher’s judgment, is advised within the literature (Pallant, 2013). Cross-loading of
one item on Factor 2 and 4 (‘I wanted to be forgiven’) resulted in it also being removed.
The items ‘I tried not to do it again’ and ‘I thought ‘I should not do it again’’ were
considered too similar in nature, risking an over-estimation of internal reliability. The
item ‘I thought ‘I should not do it again’’ had a higher loading and strength than the
item ‘I tried not to do it again’ (0.576 versus 0.465 respectively) and so it was retained.
In total, 11 items were omitted and a total of 19 items were retained.
42
Table 4.
30-Item GSA Factor Loadings and Cronbach’s Alpha for Four Factors
GSA Item Inner Turmoil(α .86)
Reparation(α .83)
Physiological Reactions
(α .85)
Regret and Self-Blame(α .78)
I could not concentrate on school work
.448 .028 - .115 .015
I kept thinking about what had happened
.512 .075 .072 .277
I felt anxious and stressed.
.657 .000 - .075 .067
I felt I was not in control. .668 .066 - .049 - .103
I felt I had lost confidence in myself.
.722 - .013 - .040 - .059
I did not know what to do.
.729 .066 - .075 - .047
I felt scared. .608 - .091 -.193 - .006
I felt sad. .490 .193 - .096 .101
I tried to put things right. .111 .740 .032 - .027
I tried to re-build the trust.
.015 .772 - .147 - .046
I wanted to make it better for the other person.
.177 .733 .056 .026
I had trouble sleeping. .138 .016 - .602 - .030
My heart felt heavy because of what I did.
- .013 .082 - .712 .090
I felt sick in my stomach because of what I did.
.019 - .049 - .837 - .024
I felt like crying. .141 - .064 - .733 - .028
I thought “it was my fault”.
.161 .150 - .120 .409
I thought “I should not do it again”.
- .038 .251 - .011 .576
I regretted what I had done.
- .080 .125 - .099 .714
I thought “I have done something wrong”
.169 - .003 - .060 .486
*Alphas based only on those items loading > 0.4 and were included in the final measure
43
Interpretation of the Factors
Upon examination, all items on Factor 1 (eight items) appeared to reflect the
‘conflicted’ and ‘cross-minded’ (e.g. emotional disequilibrium) nature of guilt that had
been reported in the individual interviews in Study One. It also reflected the
combination of threat, perceived loss of control, negative affect and rumination that can
occur within a guilt experience (Bybee, 1998). This factor was therefore given the label
of ‘Inner Turmoil’. Items in Factor 2 (three items) reflected the desire to fix the
situation and make amends with the other person. It was therefore labelled ‘Reparation’.
Items on Factor 3 (four items) all referred to the physical sensations associated with a
guilt experience, for example trouble sleeping and wanting to cry. It was therefore
labelled ‘Physiological Reactions’. The final and fourth Factor (four items) was
composed of thoughts and feelings such as thinking it was one’s own fault and regret
over what had happened. It was therefore labelled ‘Regret and Self-Blame’. Although
Factors 2, 3 and 4 have only three or four items each, the literature notes that a minimum
of three items per factor is sufficient in identifying common factors (Floyd & Widaman,
1995).
Scoring of the GSA
GSA items are rated on a Likert scale from 0 (‘Not at all’) to 3 (‘A lot’). Higher
scores on each of the four factors/subscales of the GSA are therefore indicative of higher
levels of guilt-proneness. Table 5 shows the mean scores for the four GSA subscales.
Please refer to Appendix V for a copy of the final 19-item GSA.
44
Table 5.
Means and Standard Deviations of GSA Subscales
Factor Number of items
Number of Participants
Scale Mean SD Item Mean
Inner Turmoil 8 408 11.13 5.78 1.39
Reparation 3 406 5.87 2.56 1.96
Physiological Reactions
4 409 5.46 3.96 1.34
Regret and Self-Blame
4 407 8.43 2.79 2.11
TOTAL 19 - - - -
Normality of the GSA and other Measures
The normality of the four GSA subscales was checked by examining histograms,
skewness and kurtosis values, checking for outliers and examining the Kolomorgov-
Smirnov statistic. Although some outliers appeared on the boxplots, the difference
between the 5% trimmed means and means were not substantial. All other measures
involved (e.g. AESC, R-CADS, TOSCA-A and SCS) were similarly investigated and
deemed to be approximately normally distributed (Appendix W). All measures
(including the GSA) had significant Kolomorgov-Smirnov statistics, but this is noted to
be a common occurrence for large sample sizes (Field, 2009). The Kolomorgov-
Smirnov statistic was therefore combined with a visual description of the histogram to
determine normality. Parametric tests are also very robust in nature and can manage
some departure from normality. Furthermore, non-parametric tests were also calculated
45
for the correlational analyses and there was very little difference in results (Appendix
X).
Subscale Inter-correlations
The factor correlation matrix with subscale inter-correlations can be found in
Table 6. All subscales positively correlated with each other with the exception of the
‘Physiological Reactions’ subscale, which was strongly and negatively correlated with
the ‘Internal Turmoil’ (-0.61) and ‘Regret and Self-Blame’ (-0.51) subscales, and
weakly and negatively correlated with the ‘Reparation’ subscale (-0.25). As the four
GSA factors had different numbers of items, a total GSA index score was not derived;
instead, the relevant items in each of the four scales were summed to give four separate
indices of guilt-proneness.
Table 6.
GSA Subscale Inter-correlations
GSA Inner Turmoil
GSA Reparation
GSA Physiological
Reactions
GSA Regret and Self-
BlameGSA Inner Turmoil
1.00 0.31 -0.61 0.40
GSA Reparation
0.31 1.00 -0.25 0.56
GSA Physiological Reactions
-0.61 -0.25 1.00 -0.51
GSA Regret and Self-Blame
0.40 0.56 -0.51 1.00
46
Reliability
Internal Consistency
Please see Table 4 for GSA subscale Cronbach’s alpha values. Internal
consistency is good and all sub-scales are consistently measuring one underlying factor
(Kline, 1994). All inter-item correlations were above .30 and all item-total correlations
were above .50, further supporting the internal reliability of GSA subscales (Appendix
Z) (Pallant, 2013).
Validity
Concurrent Criterion Validity
Criterion validity was investigated by exploring the relationship between the
GSA subscales and the TOSCA-A guilt subscale (Table 7). Pearson’s correlational
analyses were conducted and, as predicted, a significant positive correlation with
moderate effect size was found between the TOSCA-A guilt subscale and the GSA
subscales of ‘Internal Turmoil’, ‘Physiological Reactions’ and ‘Reparation’. A
significant positive correlation, with a large effect size, was found between the TOSCA-
A guilt subscale and the GSA ‘Regret and Self-Blame’ subscale.
47
Table 7.
Pearson’s Correlations between GSA and TOSCA-A Guilt Scale
TOSCA-A Guilt(α .83)
GSA Inner Turmoil .39*, p< .001N=401
GSA Reparation .47*, p< .001N=399
GSA Physiological Reactions .38*, p< .001N=402
GSA Regret and Self-Blame .53*, p< .001N=400
*Statistically significant at p<.001Note. Different sample sizes due to pairwise deletion of missing data
Convergent Validity
Convergent validity was investigated by exploring the relationship between the
GSA subscales and the AESC (Anger Control and Anger Suppression subscales), R-
CADS, SCS, TOSCA-A (Shame subscale) and ASPS scores (Table 8 and 9). Pearson’s
correlational analyses were conducted and, as hypothesised, there was a significant
positive correlation between the AESC Anger Suppression scores and the GSA
‘Reparation’ and ‘Regret and Self-blame’ scores, but the effect size was small. There
was little evidence of correlation between the AESC Anger Suppression subscale and
the GSA ‘Inner Turmoil’ and ‘Physiological Reactions’ subscales. As hypothesised,
there was a positive correlation between AESC Anger Control scores and all four GSA
subscales, but the effect size was small.
48
Table 8.
Pearson’s Correlations between GSA and Measures of Anger, Depression, Anxiety and Self-compassion
GSA Inner Turmoil
GSA Reparation
GSA Physiological
Reactions
GSA Regret and Self-Blame
AESC Trait Anger (α .86)
0.23*, p< .001N=403
- 0.01, p= .753N=400
0.18*, p< .001N=403
0.08, p= .078N=401
AESC Anger Expression (α .72)
0.018, p= .714N=401
- 0.03, p= .466N=399
0.01, p=.811N=402
- 0.03, p=.459N=400
AESC Anger Control (α .75)
0.27*, p<0.001N=406
0.16*, p=0.001N=404
0.18*, p<0.001N=407
0.13*, p<0.008N=405
AESC Anger Suppression (α .83)
0.05, p=0.259N=399
0.20*, p<0.001N=398
0.07, p=0.149N=400
0.18*, p<0.001N=398
SCS Self Compassion (α .78)
-0.40* p<0.001N=387
0.015, p=0.763N=390
- 0.311*, p<0.001N=388
- 0.185*, p<0.005N=389
RCADS Social Phobia (α .87)
0.60*, p<0.001N=396
0.21*, p<0.001N=396
0.49*, p<0.001N=398
0.43*, p<0.001N=396
RCADS Panic Disorder (α .89)
0.54*, p<0.001N=394
0.19*, p<0.001N=394
0.50*, p<0.001N=396
0.28*, p<0.001N=394
RCADS Major Depression (α .87)
0.48*, p<0.001N=393
0.14*, p=0.004N=393
0.44*, p<0.001N=396
0.22*, p<0.001N=394
RCADS Separation Anxiety (α .80)
0.40*, p<0.001N=395
0.12*, p=0.010N=395
0.37*, p<0.001N=398
0.20*, p<0.001N=396
RCADS Generalised Anxiety (α .82)
0.53*, p<0.001N=395
0.18*, p<0.001N=395
0.45*, p<0.001N=398
0.29*, p<0.001N=396
RCADS Obsessive Compulsive Anxiety (α .80)
0.44*, p<0.001N=396
0.15*, p=0.003N=396
0.40*, p<0.001N=399
0.22*, p<0.001N=397
*Statistically Significant at p< .001
49
As predicted, the R-CADS depression and anxiety subscales were all
significantly and positively correlated with the four GSA subscales, with the GSA ‘Inner
Turmoil’ and ‘Physiological Reactions’ subscales yielding the largest effect sizes. As
hypothesised, the SCS scores and GSA ‘Inner Turmoil’ and ‘Physiological Reactions’
scores were significantly and negatively correlated, with moderate effect sizes.
Similarly, the SCS scores and the GSA ‘Regret and Self-Blame’ scores were
significantly and negatively correlated, but had a small effect size. There was no
evidence of correlation between the SCS scores and the GSA ‘Reparation’ scores. As
expected, the four GSA subscale scores and the TOSCA-A shame scores were all
significantly and positively correlated, with effect sizes ranging from small to large
(Table 9). Similarly, the GSA subscales and the ASPS shame scores were significantly
and positively correlated (with effect sizes ranging from small to large), but there was
little evidence of a relationship between the ASPS ‘Humiliated Fury’ scores and the
GSA ‘Reparation’ and ‘Regret and Self-Blame’ scores.
Divergent Validity
Divergent validity, the extent to which traits are distinct (e.g. lack evidence of
correlation), was calculated by exploring the relationship between the GSA guilt
subscales and the AESC Trait Anger and Anger Expression subscales (Table 8)
(Carmines & Zeller, 1979). Contrary to what was hypothesised, the AESC Trait Anger
was positively correlated with the GSA ‘Inner Turmoil’ and ‘Physiological Reactions’
subscales (with small effect size), and there was little evidence of a correlation between
AESC Trait Anger and the GSA ‘Reparation’ and ‘Regret and Self Blame’ subscales.
50
There was also little evidence of correlation between the AESC Anger Expression and
all of the GSA subscales.
Table 9.
Pearson’s Correlations between GSA and TOSCA-A Shame and ASPS Scales GSA Inner Turmoil
GSA Reparation
GSA Physiological Reactions
GSA Regret and Self-Blame
TOSCA-A Shame (α .85)
0.51*, p<0.001N=399
0.22*, p<0.001N=397
0.45*, p<0.001N=400
0.37*, p<0.001N=398
ASPS Self Evaluation (α .91)
0.60*, p<0.001N=401
0.23*, p<0.001N=399
0.57*, p<0.001N=402
0.43*, p<0.001N=400
ASPS Humiliated Fury (α .78)
0.26*, p<0.001N=400
0.04, p=0.365N=398
0.24*, p<0.001N=401
0.05, p=0.314N=399
ASPS Internal Affect(α .81)
0.58*, p<0.001N=403
0.35*, p<0.001N=401
0.52*, p<0.001N=404
0.51*, p<0.001N=402
*Statistically significant at p< 0.001
DISCUSSION
Factor Structure of the new GSA
The exploratory factor analysis yielded a four-factor model for the new GSA.
This resulted in a final 19-item measure with the following subscales: ‘Inner Turmoil’
(8-items); ‘Reparation’ (3-items); ‘Physiological Reactions’ (4-items); and ‘Regret and
Self-Blame’ (4-items). The four factors tapped cognitive, affective and behavioural
aspects of the emotion. The factor ‘Inner Turmoil’ was the most dominant factor, with
the highest number of loadings. This factor captures thoughts and emotions relating to a
sense of ‘moral discomfort’ about the act in question. This corresponds with Lewis’
51
(1971) theory, which suggests that guilt is associated with an inner sense of tension and
a process of mentally undoing some aspect of behaviour. Similarly, Cognitive
Attribution Theory suggests that guilt occurs when the person is negatively evaluated in
connection with a specific activity (H. Lewis, 1971; M. Lewis, 1991). Guilt has also
been described as a form of anxiety, associated with social threats due to misconduct,
and this is captured in the ‘stress’ and ‘anxiety’ items within this factor (Baumeister,
Stillwell, & Heatherton, 1994).
The second factor, ‘Reparation’, included behavioural items that conveyed a
desire to make amends, rebuild the relationship in question and fix the problem.
Reparative responses are considered to be critical and defining elements of guilt
(Tangney & Dearing, 2002). For example, in Cognitive Attribution Theory, guilt arises
from attributing the error to situation-specific factors and motivates the individual to
make amends (M. Lewis, 1991).
The factor ‘Physiological Reactions’ seems novel as very little research has
explored the physiological component of guilt (Baker, et al., 2012). These items were
devised based on the individual interviews and previously developed measures of guilt
in young people. Although younger children have been found to show and report
increased physiological reactions and distress with guilt, little is known about the
physiological response to guilt in adolescents (Bybee, 1998). One study, with a student
population, indicated that young people often subjectively report crying or feeling in
pain in relation to feelings of guilt (Bybee, 1998). Recent research with adult
participants has investigated the relationship between guilt and the Behavioural
52
Inhibition System (BIS), a neuropsychological framework and attentional system that is
sensitive to cues of punishment and which functions to inhibit ongoing behaviour in
order to prepare a response (Fourie et al., 2011). High BIS activation is associated with
increased physiological arousal, vigilance and anxiety (Amodio, Master, Yee, & Taylor,
2008). A positive correlation between BIS activation and increased guilt has been
documented in adults (Fourie, et al., 2011). Guilt may therefore function as a
punishment cue, whereby affective and cognitive components of guilt prompt an
increase in physiological arousal, which inhibits ongoing behaviour and encourages
reparatory behavior in order to decrease distress (Fourie, et al., 2011). The
physiological items in the third factor of the GSA support these ideas and may relate to
some of these experiences.
The factor ‘Regret and Self-Blame’ comprises thoughts and feelings surrounding
responsibility, self-blame and regret. Research exploring guilt in adolescents has found
that regret is the most common reaction to guilt-producing events at every age level, and
that it doubles in prevalence from age 10 to age 16 (Bybee, 1998). Self-blame, with a
focus on ownership and responsibility, is also an important aspect of guilt (Bybee,
1998). In their model of self-conscious emotions and psychopathology, Muris and
Meesters (2014) suggest that self-blame is a secondary appraisal process of guilt that
shapes the individual’s reaction to the social environment. When guilt triggers self-
blame, an individual may be motivated to repair the situation but, if elicited frequently,
can also increase the risk for developing depression and anxiety (Muris & Meesters,
2014).
53
The GSA is a novel measure as all other adolescent guilt scales use a total score
rather than subscale scores. No other existing child and adolescent measure also
quantifies motivation towards reparation with an individual subscale score. The GSA
does not yield a total score, as it would be weighted towards ‘Inner Turmoil’ and might
mask the contributions of other components of guilt. Additionally, a total score would
combine the more unique aspects of guilt (‘Reparation’) with those that overlap with
other emotions (e.g. ‘Physiological Reactions’). This may explain why previous studies
have found shame and guilt to be so similar. The AESC measure has taken a similar
approach for anger, and has subscale scores rather than a total in order to examine the
specific subtypes of the emotion (e.g. anger control, anger expression) (Steele, et al.,
2009).
For the GSA subscale inter-correlations, all subscales were positively correlated
with the exception of ‘Physiological Reactions’ and the other three subscales (‘Inner
Turmoil’, ‘Reparation’ and ‘Regret and Self-Blame’), which were negatively correlated.
The strongest negative correlations were between ‘Physiological Reactions’ and the
‘Inner Turmoil’ and ‘Regret and Self-Blame’ subscales. One possibility may be that
physiological reactions are an externalisation of guilt, whereby an increase results in a
lower sense of internal discomfort (Gross, 2002). Emotional suppression, inhibiting
outward signs of inner feelings, also seems to increase some measures of physiological
activation (e.g. increased heart rate) (Gross, 2002). Consequently, an individual might
theoretically exhibit a physiological arousal reaction without necessarily reporting a
negative emotional state (Campbell & Ehlert, 2012). Further research is needed to
explore the relationship between physiology and other aspects of guilt.
54
Reliability of the GSA
The Cronbach’s alpha of all four subscales demonstrated good internal
consistency. The means and standard deviations of the subscales indicated that the
sample scored typically between ‘1’ (‘a little bit’) and ‘2’ (‘quite a bit’). The
‘Physiological Reactions’ subscale is however noteworthy as its standard deviation was
high in relation to its mean. This indicates more sample variability on this subscale, but
whether this variability would be reported in other samples needs to be reassessed.
Validity of the GSA
The validity hypotheses were generally supported. GSA subscale scores were
positively correlated with another measure of guilt (the TOSCA-A Guilt subscale). GSA
subscale scores were also positively correlated with anxiety, depression and shame, and
negatively correlated with self-compassion. The validity hypotheses for anger were only
supported for Anger Control and Anger Suppression. The literature on the relationship
between guilt and anger is however limited and more research is needed.
GENERAL DISCUSSION
The GSA was designed to tap cognitive, behavioural and affective aspects of
guilt, in line with related conceptual theories, and there is good evidence of its reliability
and validity. The use of individual interviews and a focus group with adolescents
ensured that the language used was understandable and accurately captured young
people’s experiences. In study two, the validation sample size was also much larger
than that of some similar, previous studies (Simonds, et al., Under Review; Tilghman-
Osborne, et al., 2010). Recruitment achieved a sample of young people from diverse
55
cultural and religious backgrounds, around England, which has been a noteworthy
limitation of previously developed guilt measures (Tilghman-Osborne, et al., 2010). For
example 35% of young people in study two were not White British, suggesting the GSA
has validity with different ethnic backgrounds, but further investigation is needed.
The GSA adds significantly to the existing literature, especially as it is the first
semi-idiographic measure of guilt-proneness for adolescents. In comparison to the GSA,
most existing measures of guilt for young people have utilised scenario-based formats.
Scenario-based measures are limited because they soon become dated with the situations
provided and potentially fail to capture personally relevant guilt-inducing experiences.
For example, in the focus group in study one, young people noted that they particularly
liked the GSA’s semi-idiographic format, as it allowed them to tailor the questionnaire
to their own individual experiences. The pre-determined situations in scenario-based
measures are also written from a particular cultural standpoint, and may therefore not
capture other perspectives. This is important as the experience of guilt may be
moderated by cultural context (Bear, et al., 2009; Ferguson, et al., 1999; M. Lewis,
1991). Although the semi-idiographic structure assumes that young people understand
the concept of guilt, there is good evidence to suggest that adolescents aged 11 to 18 are
able to understand the related theoretical underpinnings (Bybee, 1998).
Limitations
Semi-idiographic measures take a relativist stance to the situations that provoke
guilt, but still however take a realist stance to the response (Simonds, et al., Under
Review). This means that, as the response items are fixed and developed from a certain
56
cultural perspective, they may therefore not apply cross-culturally. More research is
needed to determine whether the thoughts, feelings and behaviours tapped by the GSA
are relevant to young people from different cultural backgrounds. Similarly, although
the GSA has space for young people to record their own guilt-inducing situations, a
potential limitation is that the veracity of the situations cannot be established.
Questions might also be raised about the specificity of the GSA ‘Inner Turmoil’
and ‘Physiological Reactions’ subscales to guilt, both conceptually and due to the
overlap with the ASPS and TOSCA-A Shame. It is likely however that these subscales
tap both guilt and shame, which may explain the overlap between these constructs in
other studies (Tilghman-Osborne, et al., 2010). In study one, the measure was also
developed with young people who attended a private fee-paying school, and so may not
be generally representative. Despite this, the interview responses were still consistent
with the conceptual literature on guilt. The sample in study two also had more girls than
boys, but a comparable ratio has been reported in similar published studies (Simonds, et
al., Under Review; Tilghman-Osborne, et al., 2010). Although the sample in study two
was slightly older (mean age=16.28), a longitudinal study tracking the experience of
guilt in adolescents over an eight-year period found that guilt-proneness was remarkably
stable from ages 11 to 18 (Tangney & Dearing, 2002). This suggests that the mean age
in study two is not a major limitation. Test-retest reliability was also not able to be
estimated due to time constraints. Future studies need to address the GSA’s temporal
stability.
57
Implications for Practice and Future Research
More research is needed to look at the applicability of the GSA cross-culturally
and to validate its use in clinical samples. Confirmatory factor analysis would also be
important to confirm the current factor structure of the GSA. Based on the results, guilt
may be negatively correlated with self-compassion. This may be especially true for
those whose guilt-proneness is indicating high ‘Inner Turmoil’ and ‘Physiological
Reactions’. Although Compassion-Focused Therapy has traditionally focused on shame,
perhaps guilt too may benefit (Gilbert, 2009b). More research on this relationship is
therefore warranted. Similarly, the relationship between guilt and different types of
anger needs further investigation. In the past, the lack of a reliable measure of guilt for
young people has resulted in a dearth of research into the relationships between these
different constructs (Tilghman-Osborne, et al., 2010). The GSA will hopefully
encourage further research in the area.
Individual differences in guilt-proneness may contribute to adaptive and
maladaptive interpersonal and intrapersonal processes (Tangney, Wagner, Burggraf,
Gramzow, & Fletcher, 1990). For example, an eight-year longitudinal study found that
10 year-olds with higher guilt-proneness were more likely to later apply to college,
participate in community service and were less likely to use heroin and make suicide
attempts (Tangney & Dearing, 2002). They were also less likely to be arrested,
convicted and incarcerated and had fewer sexual partners. Increased guilt at the
beginning of a prison term has also been correlated with lower rates of recidivism in
youth-offending populations (Ferrer et al., 2010; Hosser, et al., 2008). Although guilt-
58
proneness can be protective, when it is experienced excessively it has been linked to
depression and anxiety (Bybee, 1998).
Guilt-proneness therefore appears central to current conceptualisations of mental
health in adolescents and, trans-diagnostically, individuals may present with varying
levels (Bybee, 1998). The four GSA subscales provide a unique way to breakdown guilt
into subcomponents, allowing for theoretical elaboration and intervention potential (e.g.
by showing which components relate more strongly to indices of psychopathology). For
example, reparation has been noted as a particularly protective and adaptive aspect of
guilt, and the GSA’s corresponding subscale provides a way to capture and measure this
experience (Tangney & Dearing, 2002). In contrast, the ‘Inner Turmoil’, ‘Physiological
Reactions’ and ‘Regret and Self-Blame’ subscales include items relating to rumination,
poor sleep, self-blame, regret and anxiety which, at high levels, have all been linked to
mental health problems (Bybee, 1998). The relative contributions of the different GSA
subscale scores may therefore provide insight into when guilt-proneness becomes more
adaptive or maladaptive for young people. Interactions between subscale scores may
also be useful. For example, scores on ‘Inner Turmoil’ may indicate how levels of inner
tension and anxiety impact a young person’s ability to repair social relationships
(‘Reparation’ score).
The GSA potentially has an advantage over measures such as the TOSCA-A and
IEGS as it does not risk diluting aspects of guilt with a total score. This may allow for
more targeted interventions that explore changes in relation to specific aspects of guilt-
proneness. As the measure was designed to capture the cognitive, affective and
59
behavioural components of guilt, it may also be ideally suited to capture therapeutic
change throughout a Cognitive Behavioural Therapy intervention (Beck, 1979). The
GSA’s application in related clinical settings should therefore be explored in future
research.
60
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Tilghman-Osborne, C., Cole, D., & Felton, J. (2012). Inappropriate and Excessive Guilt:
Instrument Validation and Developmental Differences in Relation to Depression.
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Tilghman-Osborne, C., Cole, D. A., & Felton, J. W. (2010). Definition and measurement
of guilt: Implications for clinical research and practice. Clinical Psychology
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Tilghman-Osborne, C., Cole, D. A., Felton, J. W., & Ciesla, J. A. (2008). Relation of
Guilt, Shame, Behavioral and Characterological Self-Blame to Depressive
Symptoms in Adolescents Over Time. Journal of Social and Clinical
Psychology, 27(8), 809-842.
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Cognitive Behavioural Treatments. Cognitive Behaviour Therapy, 38(sup1), 8-
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Weiner, B. (1986). An attributional theory of motivation and emotion: Springer-Verlag
New York.
WHO. (2002). Adolescent Friendly Health Services: An Agenda for Change Geneva,
Switzerland World Health Organisation.
Zahn-Waxler, C., Kochanska, G., Krupnick, J., & McKnew, D. (1990). Patterns of guilt
in children of depressed and well mothers. Developmental Psychology, 26(1), 51.
69
70
MRP Empirical Paper: Appendices
71
APPENDICIES
Appendix A. Existing Child and Adolescent Measures
Appendix B. Study One Demographics: Individual Interviews
Appendix C. Ethical Approval
Appendix D. Study One Information and Consent Forms
Appendix E. Demographic Form
Appendix F. Individual Interview Schedule
Appendix G. Frequency Codes: Individual Interviews
Appendix H. Draft Measure with Three Dimensions
Appendix I. Focus Group Interview Schedule
Appendix J. Focus Group Feedback Form
Appendix K. Interview Coding Extract
Appendix L. Individual Interviews: Shame versus Guilt Themes
Appendix M. Example of Measure Development Decision Making
Appendix N. Individual Interviews: Situation Themes
Appendix O. New Guilt Scale: Ready for Validation
Appendix P. Study Two Demographics: Measure Validation
Appendix Q. Study Two Information and Consent Forms
Appendix R. Other Measures Used in Validation
Appendix S. Scree Plot
Appendix T. 5-Factor and 3-Factor Solutions
Appendix U. 4-Factor Solution
Appendix V. Final Guilt Scale for Adolescents (GSA)
Appendix W. Measure Normality: Histograms
Appendix X. Non-Parametric Tests
Appendix Y. Journal of Adolescence Guidelines for Authors
Appendix Z. GSA Reliability: Correlations
72
Appendix A. Existing Child and Adolescent Guilt Measures
73
1. Story Completion Measure (Hoffman, 1975)
2. My Child Guilt (Kochanska, et al., 1994)*
3. Inappropriate and Excessive Guilt Scale (Tilghman-Osborne et al, 2012)*
4. Clown-Doll Paradigm (Barrett, Zahn-Waxler, & Cole, 1993)*
5. Children’s Interpretations of Interpersonal Distress and Conflict (CIIDC) (Zahn-Waxler,
Kochanska, Krupnick, & McKnew, 1990)*
6. Test of Self-Conscious Emotions- Adolescent Version (TOSCA-A) (Tangney &
Dearing, 2002; Tangney, et al., 1991)*
7. Test of Self-Conscious Emotions- Child Version (TOSCA-C) (Tangney & Dearing,
2002; Tangney, et al., 1990)*
8. Child-Child Attribution and Reaction Survey (C-CARS) (Ferguson, et al., 1999; Stegge
& Ferguson, 1990)*
74
Appendix B. Demographics: Individual Interviews
75
Descriptive Data Study One
GenderFemale 5 (56%)Male 4 (44%)
Age Mean 15.44Mode 14Maximum 18Minimum 12
Ethnicity White British 4 (44%)Asian 2 (22%)Any other ethnic background
2 (22%)
Indian 1 (11%)Religion
Roman Catholic 3 (33%)No Religion 3 (33%)Church of England 2 (22%)Sikh 1 (11%)
76
Appendix C. Ethical Approval
77
78
Appendix D. Study One Information and Consent Forms
79
PARTICIPANT (Young Person) INFORMATION SHEET (Study 1)
Date:
My name is Erin Brennan and I am training to become a clinical psychologist. I would
like to invite you to take part in my research study. Before you decide, you need to
know what you will be asked to do. Please take the time to read this information sheet.
The research
The aim of this study is to develop a new questionnaire that measures guilt in 11-18
year olds.
What will you need to do?
A teacher will have asked some people if they would like to take part in an interview
about guilt, and the teacher will have given you these forms to take home with you.
Please give your parents this information sheet and the letter to read. Once you have
read these forms you might have decided that you would like to take part in the
interviews. If so, then you and your parents will need to sign the consent forms saying
that you have agreed to do the interview. If you have decided to take part, then I will
arrange with your school a good time for you to have this interview. If you want to ask
any questions about this interview before you decide then you can email me on
e.brennan@surrey.ac.uk.
80
I will try and make the interview as relaxed as possible, so it is more like a chat. You will
be asked about what you think guilt is, and you will also be able to talk about different
situations that might make young people feel guilty. You will not have to talk about
personal situations if you do not want to. I just want to get a better idea of things or
situations that make 11-18 year olds experience guilt so I can use these ideas to design
a new questionnaire. You might tell me something personal which I think someone else
needs to know about. It would only be then that I would need to talk to someone at
school about what you have told me.
A few months after the interview, I will return to your school and ask you to fill out the
new guilt questionnaire and give your feedback (what you think about the
questionnaire) in a group of about 9 other young people. This will take place at your
school and again it is your choice whether or not you would like to participate.
I would also like your permission to audio tape the interview and group feedback
session so that I don’t have to remember everything that is said. This also means that I
will not have to write anything down during the interview. The tapes will be stored safely
and destroyed when the study is finished.
Writing up the research
The things that you share during your interview will be used to help me design a new
guilt questionnaire. This questionnaire, when it is finished, might be published in a
scientific journal or be used in the NHS to help health professionals’ work with children
and teenagers. However, nobody will know who took part in the interviews and your
name will not be on any of the information.
Your rights as a participant
If you decide that you would like to take part in this study, this does not mean that you
cannot change your mind. You will not need to tell me why you have changed your
mind; you can just pull out if you wish. If you feel that you need to talk to someone after
you have taken part in this study then please speak to your form tutor or school
counsellor. If you or your parents have any concerns about you taking part in this study,
please contact me on e.brennan@surrey.ac.uk or Ms Mary John (Course Director of
Psych D in Clinical Psychology) on 01483 689 441.
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Consent Form – Person with parental responsibility
I understand that Erin Brennan (Trainee Clinical Psychologist) would like my permission
for …………….…………………………….. to take part in a research study that is
developing a new questionnaire that measures guilt in 11-18 year olds.
I have read and understood the Information Sheet provided. I have therefore been
given a full explanation by the researchers of the nature, purpose, location and likely
duration of the study, and of what my child will be expected to do.
I understand that the written project will not contain any information that would reveal
the identity of my child or their school. The researcher (Erin Brennan) may be given my
child’s name during data collection, but this information will be then anonymised for the
written report.
I understand that the only people that will have access to the information collected
during this study will be the researcher and her supervisors at the University of Surrey. I
understand that any published work that may result from this study will not contain any
identifiable information about any of the participants.
I understand that the project (and material relating to it) is kept in securely locked
premises.
I understand that my child is free to withdraw from the study at any time without needing
to justify their decision.
I confirm that I have read and understood the above and freely consent to my child
participating in this study.
Name:
Signed:
Date:
Name of researcher: Erin Brennan
Signed:
82
Date:
Assent Form – Young person
I agree to take part in this study that is developing a new guilt questionnaire.
I have read and understood the Information Sheet provided. I have been given a
full explanation of the study and I understand what I need to do.
I understand that the project will not contain any information that will reveal my
name or the name of my school.
I understand that the only people that will have access to the information collected
during this study will be Erin Brennan and her supervisors at the University of
Surrey. I understand that the questionnaire might become a published piece of
work. If this happens, nobody will know the names of the people that took part in the
study.
I understand that the project (and material relating to it) is kept in securely locked
premises.
I understand that I can change my mind at any time and decide that I do not want to
take part anymore. I will not need to say why I have changed my mind.
I confirm that I have read and understood the above and freely agree to take part in
this study.
Name:
Signed:
Date:
Name of researcher: Erin Brennan
Signed:
Date:
83
Consent Form – Young person (Aged 16+ years)
I agree to take part in this study that is developing a new guilt questionnaire.
I have read and understood the Information Sheet provided. I have been given a
full explanation of the study and I understand what I need to do.
I understand that the project will not contain any information that will reveal my
name or the name of my school.
I understand that the only people that will have access to the information collected
during this study will be Erin Brennan and her supervisors at the University of
Surrey. I understand that the questionnaire might become a published piece of
work. If this happens, nobody will know the names of the people that took part in the
study.
I understand that the project (and material relating to it) is kept in securely locked
premises.
I understand that I can change my mind at any time and decide that I do not want to
take part anymore. I will not need to say why I have changed my mind.
I confirm that I have read and understood the above and freely agree to take part in
this study.
Name:
Signed:
Date:
Name of researcher: Erin Brennan
Signed:
Date:
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Appendix E. Demographic Form
85
BACKGROUND INFORMATION
Today’s Date: __________________________ ID Number: __________________________
1. Your age: _________________________
2. Date of Birth: _________________________
3. Are you (please check one):
Male Female
4. What year are you in school? _________________________
5. Ethnicity (please check one that best applies):
White British
White Irish
British other
Black Caribbean
Black African
Asian
Indian
Pakistani
Other
(Please specify: __________________)
6. Language (please check the language that you use most often at home and at school):
English
Polish
French
Punjabi
Spanish
Chinese
Arabic
Other
85
Religion (please check one that best applies):
Church of England
Roman Catholic
Other Christian
Buddhist
Hindu
Jewish
Muslim
Sikh
No Religion
Another Religion (Please specify):
______________________________________________________________________________
86
Appendix F. Individual Interview Schedule
87
Individual Interview Semi-structured Schedule
(Adapted from Simonds et al., Under Review)
Why did you decide to take part in this interview?
What does the word guilt mean to you?
Tell them a definition if needed…ask if they agree/disagree.
What do you think the difference between shame and guilt is?
Again, tell them definitions…ask if they agree/disagree.
Can you each describe a situation that might make someone feel guilty?
What are your experiences of guilt (if want to share)?
What does guilt feel like? In mind? In body?
What does guilt make you think? Examples to get them thinking.
What does guilt make you feel like doing? Does it make you want to hide? Does it
make you angry? What else does it make you feel like doing?
What is the guiltiest thing you can think of?
Who feels guilty? Are some people more prone to feeling like this?
Is there a difference in guilty situations between boys and girls?
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Appendix G. Frequency Codes: Individual Interviews
89
Codes and Frequencies from the Content Analysis: Study One
What is Guilt?
Caused by something you did (10) Doing something bad (4) Sometimes you feel cool about it 1 You have guilt because of the people you have affected (1) Judged by other people… makes people feel guilty (1) With girls… it is more peer pressure and groups… more mental rather than anything
else (1) You can’t feel guilty for someone else (1) Worse on social media (7) More about how you feel about what happened to the other person (1) You want to make it better with the other person and you are worried about how they
feel (2) Made a mistake but still a good person (1) Lapse in judgment (1) More if it is someone close to you (4) Always when someone else is involved (1) Worse in real life than on social media (2) I know I have done something wrong (3) Big driving factor in peoples’ lives (3) Wrong against your conscience (1) Internal conflict (3) Causes damage (2) Can lead to a positive consequence (1) Cognitive process (1) Damages someone’s reputation (1) Hurting someone else (2) Teaches you a lesson not to do it again (3)
Shame and Guilt
Shame is more to do with yourself (2) Guilt you act on it more (1) Shame you hide from things more (2) Shame is more about you and guilt is more about how you feel about what happened
to the other person (1) Guilt is more about the people you have affected (1) Shame is based on judgement and guilt is based on internal conflict (1) You can feel guilt and shame in the same situation (7) Guilt is more about doing something wrong (1) With guilt you want to put things right (1)
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Shame is more related to how you feel… guilt is more about someone else and what you have done to them (1)
Shame is predominantly anger with yourself… guilt is more….you want to make it better for the other person (1)
Shame lasts longer (3) If you feel guilty about something then it is easier for you and anyone else involved
because it is a quicker recovery (1) Guilt you feel like you are a bad person but only momentarily, like you feel like you
have made a mistake, and it reflects badly on your character, but like you are still a good person you just had a lapse in judgment. But shame is more like, you are innately a bad person (1)
Guilt is when you know you’ve done it and like you know it’s wrong. And shame is something more embarrassing. (1)
Guilty you can tell someone, laugh about it, but if you are ashamed about something you wouldn’t tell (1)
Shame is more private (3) Shame is more inside of you (1) Guilt makes you feel more cautious about what you do…. Shame makes you feel
embarrassed (1) Shame is about forgiving yourself, guilt you also want forgiveness but you also feel
angry at yourself because you did something bad (1) Shame you see yourself more as… something bad, disappointment. And guilty… you
see yourself as disappointment because you did something bad (1) Shame is more embarrassment… guilt is the outright knowledge that you have done
something really really bad (1) Shame is worse than guilt (2) Shame is… outright I’m a bad person… guilt is more justifiable (1)
Guilt Situations
Hurting someone physically or emotionally (6) Not doing chores (3) Forgetting to do things (1) Bullying (2) Breaking up with girlfriend (1) Lies (18) Not doing homework/prep (8) Playing games when you are supposed to be studying (2) Robbery, stealing (5) Litter (1) Vandalism (3) Being rude to neighbour (1) Doing something without someone's permission (1) Not revising (1) Hiding something from someone (1) Upset family (1)
91
Do something really bad and have to go to court for it (1) If you don’t confess (1) If you are dragged into doing something (2) Took something without asking (1) Lost something that belonged to someone (1) If you upset someone you care about (1) If you do badly at school (1) If you get in arguments with your friends and someone gets upset (1) If they don’t do something properly, which has an effect on the community (1) Do things behind people's backs (2) Double-faced person (2) If you have duties to do and tell someone else to do them for you (1) Eat chocolates and sweets behind your mum's back and she doesn’t know what you
are eating (1) Telling my brother to do stuff that he shouldn’t be doing (1) Took someone’s book or charger without asking (1) Did something they shouldn't have done like having a house party (1) Did something to jeopardise someone's life like rumours (1) Parents might feel guilty if they are alcoholics, get drunk in front of children (1) Saying you would get good grades and then not get them (2) Kill someone (3) Betray someone (2) Not meeting someone's expectations (1) Modelling unhelpful behaviour (1) Intentionally not help someone (1) Broke someone's belongings (1) Not having said something they should have said (1) Allow someone else to take the blame (3) Skiving class (1) Being found out for not completing an activity (1) Use neighbour's bins instead of your own (1) Waste the teachers time (1) If you are late (1) Making someone else look bad (1) Room untidy (1) Upset a teacher (1) Try to make someone feel bad about themselves (2) Telling people secrets (1) Shout at children (1) Gossip (2) Disappointing someone (1) Didn’t do well in exams because didn't revise (2) Did something bad and sister learnt from me and did the same thing (1) Don't apologise (1) Stay out late (1) Cause your parents to worry (1)
92
Goofing off in class (1) Getting someone else in trouble (1) Social Media (20)
o Posting something on someone's facebook wall without permission (4)o Send something bad to someone (1)o Find out something about someone (1)o Posting something that isn't true (2)o Said something nasty about someone and then that person found out (2)o Put funny comments that you know won't be funny for other person (1)o Cross the line with a joke (1)o Cyber bullying (2)o Commenting on picture, like you are ugly (3)o Publish a negative photo or a very personal photo (1)o Hacking other people's accounts (1)o Posting something that is secretive (1)
Feelings associated with Guilt
Feel awful (1) Anxious (4) Stress (5) Lost confidence (4) Scared (2) Angry (5) Annoyed with self (5) Sadness (13) Upset (5) Disappointment (4) Paranoid (2) Uncomfortable (1) Deceitful (1) Self-pity (2) Not proud (2) Depressed (6) Conflicted (1) Judged (2) Hurts (1) Painful (1) Nervous (1) Lack of control (1) Low (1)
Thoughts associated with Guilt
Could have been prevented (1) Could have done better (3) I was not in control (1)
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I am responsible (5) Thinking about consequences (1) Think of plan (1) Conflicting arguments (2) Cross minded (2) Will I ever regain their trust? (2) I made a mistake (1) No one will like me (1) I am going to get into trouble (1) How am I going to fix this? (1) I could have done better (1) I shouldn't do it again (2) I didn't meet someone's expectations (1) Learn from mistakes (1) Kept thinking about what happened (1) I am insensitive (1) I thought I had damaged relationships (1) Don't know what to do (1) I did something wrong (1) Lapse in judgment (1) Making someone else look bad (1) I was the cause (1) Mixed messages (1) It may damage my reputation (2) Question my own ability (1) It was not my fault (2) Worried that they would be angry with me (1) I hadn't done enough (1) How can I make it up to the other person? (1) I disappointed them (1) What have I done? (1) This is really bad (1) Would you like people doing it to you? (1) Makes me look like a horrible person (1) Please forgive me (1) I want forgiveness (3) Is something bad going to happen to me that is going to change my life? (1) How am I going to sort the situation out? (1) Plays on your mind (3) That was a really stupid thing to do (3) I broke a trust (1) I shouldn’t do it again (3) I am responsible (1) I feel sorry for them (1) I made a mistake (1) I am sorry for what I did (1)
94
I desperately want to improve (1) Someone else is going to get into trouble (3) I have done something bad that will have repercussions (4) My mum's going to kill me (2) I never want to do through that again (1) What I did was really wrong (1)
Behaviours Associated with Guilt
Thinking about things constantly (1) Want to help/for the other person to feel better (9) Face up to the problem (2) Compensate for the guilt (5) Confess (3) Try to fix the problem (2) Try not to do it again (1) Try to rebuild the trust (1) Change my future behaviours (1) Tell the truth (1) Apologise (1) More cautious about what you say and do (3) Prayed (2) Couldn't sleep (1) Affects academically, takes mind off things (1) Confront the situation (1) Prioritise things (1) Try to decrease my stress (1) Strive to be better in front of other people (1) Try to comfort them (1) Kill themselves (3) Violent (1) Owning up to it (1)
Appendix H. Draft Measure with Three Dimensions
95
Initially Developed 30-Item GSA Derived from the Three Dimensions
Cognitive Dimension
1. I thought “others will be disappointed in me” 2. I did not know what to do 3. I thought “I have done something wrong” 4. I thought “I might never be trusted again”
96
5. I thought “it was my fault” 6. I wanted to be forgiven 7. I thought “I should not do it again”8. I thought “I am going to get into trouble” 9. I regretted what I had done 10. I wanted to make it better for the other person 11. I could not concentrate on school work
Affective Dimension
1. I felt awful because of what I had done 2. I felt anxious and stressed 3. I felt I was not in control 4. I felt I had lost confidence in myself 5. I felt scared 6. I felt sad7. I felt annoyed with myself
Behavioural/Physiological Dimension
1. I needed to do something to make myself feel better 2. I tried to put things right 3. I tried not to do it again 4. I tried to rebuild the trust 5. I wanted to confess 6. I had trouble sleeping 7. I wanted to apologise 8. My heart felt heavy because of what I did 9. I felt sick in my stomach because of what I did 10. I felt like crying 11. I had trouble thinking straight 12. I kept thinking about what happened
Appendix I. Focus Group Interview Schedule
97
Focus Group Schedule
Ask the group the following questions:
1. What did you like about the questionnaire?
2. What did you feel could be improved on the questionnaire?
3. Is there anything you think is missing about guilt on the questionnaire?
98
4. What do you think might be difficult about filling in this questionnaire?
5. Any difficulties or misunderstandings?
6. Is there anything else you would like to add?
Appendix J. Focus Group Feedback Form
99
Focus Group Anonymous Feedback Form
Date:
ID Number:
100
1. What did you like about the questionnaire?
2. What did you feel could be improved on the questionnaire?
3. Is there anything you think is missing about guilt on the questionnaire?
4. What do you think might be difficult about filling in this questionnaire?
5. Any difficulties or misunderstandings?
6. Is there anything else you would like to add?
101
Appendix K. Interview Coding Extract
102
103
Appendix L. Individual Interviews: Shame versus Guilt Themes
104
Guilt versus Shame Themes Extracted from the Interviews
Category Frequency in
data (%)
Example from Interviews
Shame is private and internal,
whereas guilt is a more public
emotion that is about the ‘other
person’.
15/49 (31%) “Shame is more about you and guilt is
more about how you feel about what
happened to the other person”
Shame makes you feel like a
bad person, whereas guilt is
about doing something wrong
and making a mistake
14/49 (29%) “Guilt you feel like you are a bad person
but only momentarily, like you feel that you
made a mistake and it reflects badly on
your character, but like you are still a
good person you just had a lapse in
judgment. But like shame is more like, you
feel like you are innately a bad person.”
Guilt and shame can occur at
the same time
7/49 (14%) “I think guilt and shame can happen
together… that they do hand in hand”.
Guilt is about wanting to make
amends and make things right
for the other person, whereas
shame is about wanting to hide
and avoid
7/49 (14%) “… with guilt like you feel so terrible for
the other person you just want to make it
better for the other person as quickly as
possible” versus “Yeah, if you are
ashamed of yourself, you don’t want to be
yourself you want to sort of hide away”.
Shame lasts longer than guilt 6/49 (12%) “If you feel guilty then it is easier for you
and anyone else involved because it is a
quicker recovery”.
105
Appendix M. Example of Measure Development Decision Making
106
Examples of Item Development Decision Making Process
Statement from Interview Theme/Category Interpretation Measure Item Final Decision
“Um it made me feel sort of anxious and deceitful and bad… feel like a bad person.”
Measure Development: Feelings
Uncomfortable: Deceitful It made me feel deceitful. Not used in measure: too complex
“And I think guilt is something that… drives you to show a particular behaviour. For example you might perform suspiciously or try to do something to compensate the guilt…”
Measure Development: Behaviour
Compensation I tried to compensate for what I had done
Not used in measure: duplication
“Um well I guess like when I feel guilty I do feel really bad about myself, which I suppose is shame, like I don’t feel, yeah I do feel like ashamed of myself. So I think that’s probably normal when you feel guilty.”
Conceptual Framework Guilt and shame can co-occur
N/A N/A
“Guilt… I mean… I think it made me a bit more reclusive to be honest… a bit more introverted. I don’t really want to say depressed, but along those lines. Um. Just mainly negative feelings. Anything else you know…. Yeah… a lot more introverted I
Measure Development: Behaviours
Fixing the problem: Introversion
It made me go into myself Not used: more shame-like
107
think.” IEGS Measure Item Alternative items from other
sourcesN/A I had trouble thinking
straight.Used in measure
“Whether …. you like will ever regain their trust or whether it was broken forever.”
Measure Development: Thoughts Impact of Behaviour: Trust
I thought I might never be trusted again. Used in measure
108
Appendix N. Individual Interviews: Situation Themes
109
Guilt-inducing Situations Extracted from Interviews
Category Frequency in
data (%)
Types of Situations
(and number of occurrences)
Damaging relationships 57/134 (43%) - Bullying (20)
- Lying (20)
- Disappointing someone (6)
- Arguments with loved ones (5)
- Betrayal (3)
- Arguments with others (2)
- Breaking up with boyfriend/girlfriend (1)
Failing to fulfill
duties/take responsibility
(43/134; 32%) - Not performing well in school (21)
- Not taking ownership of actions (8)
- Not meeting someone else’s expectations (5)
- Modelling unhelpful behavior (4)
- Not doing household chores (4)
- Having a house party when parents are away
(1)
Social Media (20/134; 15%) - Cyber-bullying (18)
- Making a secret public online (2)
Breaking the Law (14/134; 10%) - Stealing (6)
- Vandalism (3)
- Murder (3)
- Littering (1)
- Having to go to court (1)
110
Appendix O. New Guilt Scale: Ready for Validation
111
GSA
It is common for young people to experience feelings of guilt. However, people vary in the type of situation that makes them feel guilt or guilty. Guilt can occur when you have done something that you think you should not have done, and it makes you feel bad in some way. Here are some examples of situations that might make young people feel guilt:
You bully someone You lie to your friend, teacher or a family member You post something hurtful on someone’s Facebook wall You do badly in a test or examination You steal something that is not yours You blame someone else for something you did
IMPORTANT
Can you think of some situations that have happened recently where you have felt guilt? Please write down a few situations like the examples above.
1.
2.
3.
112
Now read each item below and circle the box next to how you would generally think and feel in situations like the ones you have written down.
EXAMPLE: Thinking back to times when you have felt guilt, if you very often think “I am disappointed in myself” then you would circle the number 3, as shown below.
Not at all A little bit
Quite a bit A lot
I thought “I am disappointed in myself” 0 1 2
Complete the statements below thinking back to the times you have felt guilt.
When I felt guilt……. Not at all
A little bit
Quite a bit
A lot
I could not concentrate on school work. 0 1 2 3
I kept thinking about what had happened. 0 1 2 3
I felt awful because of what I had done. 0 1 2 3
I thought “others will be disappointed in me”. 0 1 2 3
I needed to do something to make myself feel better.
0 1 2 3
I felt anxious and stressed. 0 1 2 3
I felt I was not in control. 0 1 2 3
I felt I had lost confidence in myself. 0 1 2 3
I did not know what to do. 0 1 2 3
I felt scared. 0 1 2 3
I thought “I have done something wrong” 0 1 2 3
I tried to put things right. 0 1 2 3
I thought “I might never be trusted again”. 0 1 2 3
I felt sad. 0 1 2 3
I felt annoyed with myself. 0 1 2 3
I tried not to do it again. 0 1 2 3
I tried to re-build the trust. 0 1 2 3
I wanted to make it better for the other person. 0 1 2 3
I thought “it was my fault”. 0 1 2 3
I wanted to be forgiven. 0 1 2 3
3
113
I thought “I should not do it again”. 0 1 2 3
I thought “I am going to get into trouble”. 0 1 2 3
I wanted to confess. 0 1 2 3
I regretted what I had done. 0 1 2 3
I had trouble sleeping. 0 1 2 3
I wanted to apologise. 0 1 2 3
My heart felt heavy because of what I did. 0 1 2 3
I felt sick in my stomach because of what I did. 0 1 2 3
I felt like crying. 0 1 2 3
I had trouble thinking straight 0 1 2 3
114
Appendix P. Study Two Demographics: Measure Validation
115
Descriptive Data Study Two: Whole Sample
GenderFemale 261 (64%)Male 149 (36%)
Age Mean 16.28Mode 17Maximum 18Minimum 12
Ethnicity White British 266 (65%)Any other ethnic background
51 (12%)
Black African 23 (6%)Asian 21 (5%)British Other 13 (3%)Indian 12 (3%)White Irish 9 (2%)Black Caribbean 5 (1%)Pakistani 5 (1%)Missing 4 (1%)
Religion No Religion 219 (53%)Roman Catholic 56 (14%)Church of England 45 (11%)Muslim 42 (10%)Other Christian 18 (4%)Hindu 12 (3%)Another Religion 8 (2%)Missing 6 (2%)Sikh 2 (1%)Jewish 1 (0.2%)
*Note. Data from seven schools included: 2 co-educational Sixth Form Colleges; 1 independent girls’ school; 1 co-educational independent school; 3 co-educational secondary schools.
116
Appendix Q. Study Two Information and Consent Forms
117
Information Sheet for Young People
Hello. My name is Erin Brennan and I am training to become a Clinical Psychologist. I would like
to invite you to take part in my research study. Before you decide, you need to know what you
will be asked to do. Please take the time to read this information sheet.
The research
The aim of this study is to develop a new questionnaire that measures guilt in 11-18 year olds.
What you will be asked to do?
I am going to ask young people from your school to fill in some questionnaires. These
questionnaires look at different feelings and emotions including guilt, shame, mood and anger. I
have designed one of these questionnaires and as part of my research I need to check if my
questionnaire is working okay. To do this I need lots of 11-18 year olds to fill in the
questionnaires.
You do not have to take part in this study, but if you do want to take part you will need to sign a
consent form (please see the attached forms).
Writing up the research
I am hoping the questionnaire I have designed will be good at measuring guilt. If it is, then my
questionnaire might be published in a scientific journal. It might also be used to help
professionals’ work with children and teenagers who are experiencing problems in their lives.
However, nobody will know who took part in this research, and your name or school will not be
on any of the information that is published or available to others.
Your rights as a participant
If you decide that you would like to take part in this study, this does not mean that you cannot change
your mind. You will not need to tell the researcher why you have changed your mind; you can just pull
out if you wish. If you feel that you need to talk to someone after you have taken part in this study then
118
please speak to your form tutor or school counsellor. If you or your parents have any questions or
concerns about you taking part in this study, please contact me on e.brennan@surrey.ac.uk.
Consent Form – Young person
I agree to take part in this study that is developing a new guilt questionnaire.
I have read and understood the Information Sheet provided. I have been given a full
explanation of the study and I understand what I need to do.
I understand that the project will not contain any information that will reveal my name or
the name of my school.
I understand that the only people that will have access to the information collected during
this study will be Erin Brennan and her supervisors at the University of Surrey. I
understand that the questionnaire might become a published piece of work. If this
happens, nobody will know the names of the people that took part in the study.
I understand that the project (and material relating to it) is kept in securely locked
premises.
I understand that I can change my mind at any time and decide that I do not want to take
part anymore. I will not need to say why I have changed my mind.
I confirm that I have read and understood the above and freely agree to take part in this
study.
Name:
Signed:
Date:
Name of researcher: Erin Brennan
Signed:
Date:
119
Appendix R. Other Measures Used in Validation
120
Test of Self-Conscious Emotion for Adolescents (TOSCA-A): Guilt and Shame Subscales Date:
Name/ID:
Below are descriptions of a variety of situations. After each situation you will see two statements about different ways that people might think or feel. As you read each statement, really imagine that you are in that situation now. Please indicate which box (with a tick) describes how likely it is that the statement would be true for you.
EXAMPLE:
You wake up early one morning on a school day.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would eat breakfast right away.
I would feel like staying in bed.
Now look at the situations below and mark with a tick how true each statement is for you:
1. You trip in the cafeteria and spill your friend’s drink.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would be thinking that everyone is watching me and laughing.I would feel very sorry. I should have watched where I was going.
2. For several days you put off talking to a teacher about a missed assignment. At the last minute you talk to the teacher about it, and all goes well.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
121
I would regret that I put it off.
I would feel like a coward.
3. While playing around, you throw a ball and it hits your friend in the face.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would feel stupid that I can’t even throw a ball.I would apologise and make sure my friend feels better.
4. You and a group of classmates worked very hard on a project. Your teacher singles you out for a better grade than anyone else.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would feel alone and apart from my classmates.I would tell the teacher that everyone should get the same grade.
5. You break something at a friend’s house and then hide it.Not at
all likely
Unlikely Maybe(half and half)
Likely Very likely
I would think ‘This is making me anxious. I need to either fix it or replace it.’I would avoid seeing that friend for a while.
6. At school, you wait until the last minute to plan a project, and it turns out badly.Not at
all likely
Unlikely Maybe(half and half)
Likely Very likely
I would feel useless and incompetent.
I would feel that I deserve a bad grade.
7. You wake up one morning and remember it’s your mother’s birthday. You forgot to get her something.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would think “After everything she has done for me, how could I forget her
122
birthday?”I would feel irresponsible and thoughtless.
8. You walk out of a test thinking you did extremely well. Then you find out you did poorly.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would feel that I should have done better. I should have studied more.I would feel stupid.
9. You make a mistake at school and find out a classmate is blamed for the error.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would keep quiet and avoid the classmate.
I would feel unhappy and eager to correct the situation.
10. You were talking in class, and your friend got blamed. You go to the teacher and tell him the truth.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would feel like I always get people in trouble.I would think “I’m the one who should get into trouble. I shouldn’t have been talking in the first place.”
11. You and a friend are talking in class, and you get in trouble.Not at
all likely
Unlikely Maybe(half and half)
Likely Very likely
I would think “I should know better. I deserve to get into trouble.”I would feel like everyone in the class was looking at me and they were about to laugh.
12. You make plans to meet a friend. Later you realise you stood your friend up. Not at
all likely
Unlikely Maybe(half and
Likely Very likely
123
half)I would think “I’m inconsiderate.”
I would try to make it up to my friend as soon as possible.
13. You volunteer to help raise money for a good cause. Later you want to quit, but you know your help is important.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would feel selfish, and I’d think I am basically lazy.I would think “I should be more concerned about doing whatever I can to help.”
14. Your report isn’t as good as you wanted. You show it to your parents when you get home.Not at
all likely
Unlikely Maybe(half and half)
Likely Very likely
Now that I got a bad report, I would feel worthless.I would think “I should listen to everything the teacher says and study harder.”
15. You have recently moved to a new school, and everyone has been helpful. A few times you had to ask some big favours, but you returned the favours as soon as you could.
Not at all
likely
Unlikely Maybe(half and half)
Likely Very likely
I would feel like a failure.
I would be especially nice to the people who had helped me.
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Adolescent Shame-Proneness Scale (ASPS)
It is common for young people to experience feelings of shame. However, people vary in the type of situation that makes them feel shame or ashamed. Shame can occur when you have done something or when someone else has done something to you. Here are some examples of situations that might make young people feel shame:
You are being bullied You make a mistake in front of your whole class and everyone laughs You do badly in a test or examination Your family can’t afford to buy you all the newest gadgets or most fashionable clothes You are horrible about your best friend behind his/her back
IMPORTANT
Can you think of some situations that have happened recently where you have felt shame? Please write down a few situations like the examples above.
1.
2.
3.
125
Now read each item below and circle the box next to how you would generally think and feel in situations like the ones you have written down.
EXAMPLE: Thinking back to times when you have felt shame, if very often think “I am rubbish at everything” then you would circle the number 3, as shown below.
Not at all A little bit
Quite a bit A lot
I thought “I am rubbish at everything” 0 1 2
Complete the statements below thinking back to the times you have felt shame.
When I felt shame……. Not at all
A little bit
Quite a bit
A lot
I thought “I have let other people down” 0 1 2 3
I felt worthless and small 0 1 2 3
I thought “Other people must think I am no good” 0 1 2 3
I thought “I am a nasty person” 0 1 2 3
I wanted to shout and scream 0 1 2 3
I felt angry at other people 0 1 2 3
I wanted to seek revenge 0 1 2 3
I thought “No one likes me” 0 1 2 3
I felt disappointed 0 1 2 3
I thought “Other people must think I am stupid” 0 1 2 3
I wanted to punch walls or break things 0 1 2 3
I felt sad 0 1 2 3
I had a horrible feeling inside 0 1 2 3
I thought “I am no good” 0 1 2 3
I felt embarrassed 0 1 2 3
I thought “Other people must think I am nasty” 0 1 2 3
I thought “I am stupid” 0 1 2 3
3
126
I felt frustrated 0 1 2 3
I thought “It is better if I was not around” 0 1 2 3
Revised Child Anxiety and Depression Scale (R-CADS)
Date:
Name/ID:
Please put a circle around the word that shows how often each of these things happen to you. There are no right or wrong answers.
1. I worry about things…. Never Sometimes Often Always
2. I feel sad or empty…. Never Sometimes Often Always
3. When I have a problem, I get a funny feeling in my stomach….
Never Sometimes Often Always
4. I worry when I think I have done poorly at something….
Never Sometimes Often Always
5. I would feel afraid of being on my own at home….
Never Sometimes Often Always
6. Nothing is much fun anymore….
Never Sometimes Often Always
7. I feel scared when I have to take a test….
Never Sometimes Often Always
8. I feel worried when I think someone is mad at me….
Never Sometimes Often Always
9. I worry about being away from my parents….
Never Sometimes Often Always
10. I get bothered by bad or silly thoughts or pictures in my mind….
Never Sometimes Often Always
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11. I have trouble sleeping…. Never Sometimes Often Always
12. I worry that I will do badly in my school work….
Never Sometimes Often Always
13. I worry that something awful will happen to someone in my family….
Never Sometimes Often Always
14. I suddenly feel as if I can’t breathe when there is no reason for this….
Never Sometimes Often Always
15. I have problems with my appetite….
Never Sometimes Often Always
16. I have to keep checking I have done things right (like the switch is off, or the door is locked)….
Never Sometimes Often Always
17. I feel scared if I have to sleep on my own….
Never Sometimes Often Always
18. I have trouble going to school in the mornings because I feel nervous or afraid....
Never Sometimes Often Always
19. I have no energy for things….
Never Sometimes Often Always
20. I worry I might look foolish….
Never Sometimes Often Always
21. I am tired a lot…. Never Sometimes Often Always
22. I worry that bad things will happen to me….
Never Sometimes Often Always
23. I can’t seem to get bad or silly thoughts out of my head….
Never Sometimes Often Always
24. When I have a problem, my heart beats really fast….
Never Sometimes Often Always
25. I cannot think clearly…. Never Sometimes Often Always
26. I suddenly start to tremble or shake when there is no
Never Sometimes Often Always
128
reason for this….
27. I worry that something bad will happen to me….
Never Sometimes Often Always
28. When I have a problem, I feel shaky….
Never Sometimes Often Always
29. I feel worthless…. Never Sometimes Often Always
30. I worry about making mistakes….
Never Sometimes Often Always
31. I have to think of special thoughts (like numbers or words) to stop bad things from happening….
Never Sometimes Often Always
32. I worry about what other people think about me….
Never Sometimes Often Always
33. I am afraid of being in crowded places (like shopping centers, the movies, buses, busy playgrounds)….
Never Sometimes Often Always
34. All of a sudden I feel really scared for no reason at all….
Never Sometimes Often Always
35. I worry about what is going to happen….
Never Sometimes Often Always
36. I suddenly become dizzy or faint when there is no reason for this….
Never Sometimes Often Always
37. I think about death…. Never Sometimes Often Always
38. I feel afraid if I have to talk in front of my class….
Never Sometimes Often Always
39. My heart suddenly starts to beat too quickly for no reason….
Never Sometimes Often Always
40. I feel like I don’t want to move….
Never Sometimes Often Always
41. I feel that I will suddenly get a scared feeling when
Never Sometimes Often Always
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there is nothing to be afraid of….
42. I have to do some things over and over again (like washing my hands, cleaning or putting things in a certain order)….
Never Sometimes Often Always
43. I feel afraid that I will make a fool of myself in front of certain people….
Never Sometimes Often Always
44. I have to do some things in just the right way to stop bad things from happening….
Never Sometimes Often Always
45. I worry when I go to bed at night….
Never Sometimes Often Always
46. I would feel scared if I had to stay away from home overnight….
Never Sometimes Often Always
47. I feel restless…. Never Sometimes Often Always
130
Anger Expression Scale for Children (AESC)
Date:
Name/ID:
Everyone feels angry from time to time, but people differ in how they act when they are angry. Below are some statements that people might use to describe themselves and how they act when they feel angry. Read each statement and describe how often the statement applies to you when you feel angry. You should circle the number in the box that you think is true for you.
Almost never
Some-times
Often Almost always
I feel angry. 1 2 3 4
I feel like yelling at someone. 1 2 3 4
I get very impatient if I have to wait for something.
1 2 3 4
I lose my temper easily. 1 2 3 4
I feel like breaking things. 1 2 3 4
I feel grouchy or irritable. 1 2 3 4
I get in a bad mood when things don’t go my way.
1 2 3 4
I have a bad temper. 1 2 3 4
I get very angry if my parent or teacher criticises me.
1 2 3 4
I get in a bad mood easily. 1 2 3 4
I slam doors or stomp my feet. 1 2 3 4
I keep it to myself. 1 2 3 4
I control my temper. 1 2 3 4
I let everybody know it. 1 2 3 4
I try to be patient. 1 2 3 4
131
I argue or fight back. 1 2 3 4
I keep my cool. 1 2 3 4
I hit things or people. 1 2 3 4
I feel it inside, but I don’t show it. 1 2 3 4
I stay well behaved. 1 2 3 4
I say mean or nasty things. 1 2 3 4
I stay mad at people but keep it a secret. 1 2 3 4
I try to stay calm and settle the problem. 1 2 3 4
I have a temper tantrum. 1 2 3 4
I hold my anger in. 1 2 3 4
I try to control my anger feelings. 1 2 3 4
132
Self-Compassion Scale – Short Form (SCS)
HOW I TYPICALLY ACT TOWARDS MYSELF IN DIFFICULT TIMES
Please read each statement carefully before answering. To the left of each item, indicate how often you behave in the stated manner, using the following scale:
Almost Almost
never always
1 2 3 4 5
_____1. When I fail at something important to me I become consumed by feelings of inadequacy.
_____2. I try to be understanding and patient towards those aspects of my personality I don’t like.
_____3. When something painful happens I try to take a balanced view of the situation.
_____4. When I’m feeling down, I tend to feel like most other people are probably happier than I
am.
_____5. I try to see my failings as part of the human condition.
_____6. When I’m going through a very hard time, I give myself the caring and tenderness I need.
_____7. When something upsets me I try to keep my emotions in balance.
_____8. When I fail at something that’s important to me, I tend to feel alone in my failure
_____9. When I’m feeling down I tend to obsess and fixate on everything that’s wrong.
_____10. When I feel inadequate in some way, I try to remind myself that feelings of inadequacy are
shared by most people.
133
_____11. I’m disapproving and judgmental about my own flaws and inadequacies.
_____12. I’m intolerant and impatient towards those aspects of my personality I don’t like.
Appendix S. Scree Plot
134
135
Appendix T. 5-Factor and 3-Factor Solutions
136
Five Factor Solution
GSA Item Factor 1 Factor 2 Factor 3 Factor 4 Factor 5
I could not concentrate on school work
.451 .061 -.083 -.044 .147
I kept thinking about what had happened
.446 .111 .037 .246 .116
I felt awful because of what I had done
.184 .183 -.164 .279 .104
I thought "others will be disappointed in me"
.241 .049 -.200 .114 .215
I needed to do something to make myself feel better.
.283 .182 .047 .030 .122
I felt anxious and stressed.
.602 .022 -.106 .095 .049
I felt I was not in control.
.635 .087 -.069 -.051 -.008
I felt I had lost confidence in myself.
.654 -.008 -.103 .057 -.082
I did not know what to do.
.679 .084 -.108 .019 -.007
I felt scared. .597 -.068 -.175 -.032 .135
I thought “I have done something wrong”
.104 .036 -.092 .376 .198
I tried to put things right.
.125 .791 .066 -.068 .005
I thought “I might never be trusted again”.
.089 .109 -.309 -.005 .297
I felt sad. .388 .126 -.198 .377 -.255
I felt annoyed with myself.
.361 -.082 -.092 .601 -.164
137
I tried not to do it again.
-.006 .454 .050 .300 .014
I tried to re-build the trust.
.031 .777 -.102 -.041 -.011
I wanted to make it better for the other person.
.143 .717 .045 .122 -.103
I thought “it was my fault”.
.088 .156 -.160 .389 .099
I wanted to be forgiven.
.042 .326 -.003 .337 .195
I thought “I should not do it again”.
-.082 .282 .004 .428 .275
I thought “I am going to get into trouble”.
.183 -.143 -.068 .099 .566
I wanted to confess. -.117 .303 -.361 .029 .237
I regretted what I had done.
-.173 .143 -.147 .610 .204
I had trouble sleeping. .125 .002 -.605 .000 .000
I wanted to apologise. -.219 .455 -.370 .247 .025
My heart felt heavy because of what I did.
-.043 .065 -.735 .107 -.001
I felt sick in my stomach because of what I did.
.012 -.069 -.838 -.009 .010
I felt like crying. .127 -.073 -.742 -.012 .009
I had trouble thinking straight
.195 -.026 -.694 -.019 -.005
138
Three Factor Solution
GSA Item Factor 1 Factor 2 Factor 3
I could not concentrate on school work
.456 .026 -.137
I kept thinking about what had happened
.482 .280 -.033
I felt awful because of what I had done
.213 .416 -.201
I thought "others will be disappointed in me"
.234 .212 -.298
I needed to do something to make myself feel better.
.302 .193 .013
I felt anxious and stressed. .651 .032 -.109
I felt I was not in control. .689 -.030 .007
I felt I had lost confidence in myself.
.725 -.062 -.019
I did not know what to do. .752 .014 -.038
I felt scared. .652 -.098 -.183
I thought “I have done something wrong”
.129 .365 -.218
I tried to put things right. .135 .700 .219
I thought “I might never be trusted again”.
.096 .208 -.371
I felt sad. .494 .256 -.082
I felt annoyed with myself. .427 .256 -.117
139
I tried not to do it again. .023 .666 .102
I tried to re-build the trust. .074 .706 .080
I wanted to make it better for the other person.
.191 .736 .218
I thought “it was my fault”. .137 .455 -.218
I wanted to be forgiven. .074 .610 -.079
I thought “I should not do it again”.
-.078 .684 -.137
I thought “I am going to get into trouble”.
.139 .096 -.334
I wanted to confess. -.069 .409 -.352
I regretted what I had done. -.145 .660 -.297
I had trouble sleeping. .214 .000 -.537
I wanted to apologise. -.151 .666 -.292
My heart felt heavy because of what I did.
.075 .153 -.654
I felt sick in my stomach because of what I did.
.127 -.050 -.751
I felt like crying. .248 -.084 -.663
I had trouble thinking straight .328 -.080 -.607
140
Appendix U. 4-Factor Solution
141
30-item GSA factor loadings and Cronbach’s alpha* for four factors
GSA Item Inner Turmoil(α .86)
Reparation(α .83)
Physiological Reactions
(α .85)
Regret and Self-Blame
(α .78)I could not concentrate on school work .448 .028 - .115 .015
I kept thinking about what had happened .512 .075 .072 .277
I felt anxious and stressed. .657 .000 - .075 .067
I felt I was not in control..668 .066 - .049 - .103
I felt I had lost confidence in myself. .722 - .013 - .040 - .059
I did not know what to do. .729 .066 - .075 - .047
I felt scared..608 - .091 -.193 - .006
I felt sad..490 .193 - .096 .101
I tried to put things right..111 .740 .032 - .027
I tried to re-build the trust. .015 .772 - .147 - .046
I wanted to make it better for the other person. .177 .733 .056 .026
I had trouble sleeping..138 .016 - .602 - .030
My heart felt heavy because of what I did. - .013 .082 - .712 .090
142
I felt sick in my stomach because of what I did. .019 - .049 - .837 - .024
I felt like crying..141 - .064 - .733 - .028
I thought “it was my fault”. .161 .150 - .120 .409
I thought “I should not do it again”. - .038 .251 - .011 .576
I regretted what I had done. - .080 .125 - .099 .714
I thought “I have done something wrong”
.169 - .003 - .060 .486
Items not loading at >.4/ Did not fit factor category/ Cross-loading
I wanted to confess.- .132 .247 - .406 .222
I thought “I am going to get into trouble”. .143 - .172 - .195 .376
I wanted to apologise.- .177 .444 - .346 .283
I wanted to be forgiven..082 .303 - .012 .430
I felt annoyed with myself. .480 .023 - .003 .307
I tried not to do it again..042 .465 .064 .270
I thought “I might never be trusted again”. .069 .050 - .364 .201
I had trouble thinking straight .211 - .013 - .687 - .056I felt awful because of what I had done .248 .143 - .120 .341I thought "others will be disappointed in me" .262 - .005 - .208 .249I needed to do something to make myself feel better.
.287 .152 .022 .086
Appendix V. Final Guilt Scale for Adolescents (GSA)
143
144
Guilt Scale for Adolescents (GSA)
It is common for young people to experience feelings of guilt. However, people vary in the type of situation that makes them feel guilt or guilty. Guilt can occur when you have done something that you think you should not have done, and it makes you feel bad in some way. Here are some examples of situations that might make young people feel guilt:
You bully someone You lie to your friend, teacher or a family member You post something hurtful on someone’s Facebook wall You do badly in a test or examination You steal something that is not yours You blame someone else for something you did
IMPORTANT
Can you think of some situations that have happened recently where you have felt guilt? Please write down a few situations like the examples above.
1.
2.
3.
145
Now read each item below and circle the box next to how you would generally think and feel in situations like the ones you have written down.
EXAMPLE: Thinking back to times when you have felt guilt, if you very often think “I am disappointed in myself” then you would circle the number 3, as shown below.
Not at all A little bit
Quite a bit A lot
I thought “I am disappointed in myself” 0 1 2
Complete the statements below thinking back to the times you have felt guilt.
When I felt guilt……. Not at all
A little bit
Quite a bit
A lot
I could not concentrate on school work. 0 1 2 3
I kept thinking about what had happened. 0 1 2 3
I felt anxious and stressed. 0 1 2 3
I felt I was not in control. 0 1 2 3
I felt I had lost confidence in myself. 0 1 2 3
I did not know what to do. 0 1 2 3
I felt scared. 0 1 2 3
I thought “I have done something wrong” 0 1 2 3
I tried to put things right. 0 1 2 3
I felt sad. 0 1 2 3
I tried to re-build the trust. 0 1 2 3
I wanted to make it better for the other person. 0 1 2 3
I thought “it was my fault”. 0 1 2 3
I thought “I should not do it again”. 0 1 2 3
I regretted what I had done. 0 1 2 3
I had trouble sleeping. 0 1 2 3
My heart felt heavy because of what I did. 0 1 2 3
I felt sick in my stomach because of what I did. 0 1 2 3
I felt like crying. 0 1 2 3
3
146
Appendix W. Measure Normality: Histograms
147
GSA Subscale 1
GSA Subscale 2
148
GSA Subscale 3
GSA Subscale 4
149
*Note. ASPS was previously known as the Shame Scale for Adolescents (SSA)
ASPS Subscale 1
ASPS Subscale 2
150
ASPS Subscale 3
AESC Subscale 1
151
AESC Subscale 2
AESC Subscale 3
152
AESC Subscale 4
SCS Total
153
R-CADS Subscale 1
R-CADS Subscale 2
154
R-CADS Subscale 3
R-CADS Subscale 4
155
R-CADS Subscale 5
R-CADS Subscale 6
156
TOSCA-A Guilt
TOSCA-A Shame
157
Appendix X. Non-Parametric Tests
158
Table I.
Spearman’s Rho between GSA and TOSCA-A Guilt Scale
TOSCA-A Guilt(α .83)
GSA Inner Turmoil .37*, p< .001N=401
GSA Reparation .42*, p< .001N=399
GSA Physiological Reactions .38*, p< .001N=402
GSA Regret and Self-Blame .46*, p< .001N=400
*Statistically significant at p<.001
Table II.
Spearman’s Rho between GSA and TOSCA-Shame, SCS, ASPS, AESC and RCADS
GSA Inner GSA Reparation GSA GSA Regret and
159
Turmoil Physiological Reactions
Self-Blame
AESC Trait Anger (α .86)
0.22*, p< .001N=403
- 0.02, p= .661N=400
0.17*, p< .001N=403
0.08, p= .074N=401
AESC Anger Expression (α .72)
0.01, p= .808N=401
- 0.02, p= .604N=399
0.01, p=.906N=402
- 0.03, p=.444N=400
AESC Anger Control (α .75)
0.26*, p<0.001N=406
0.15*, p=0.001N=404
0.17*, p<0.001N=407
0.10*, p<0.008N=405
AESC Anger Suppression (α .83)
0.05, p=0.288N=399
0.20*, p<0.001N=398
0.06, p=0.166N=400
0.17*, p<0.001N=398
SCS Self Compassion(α .78)
-0.38*, p<0.001N=387
0.01, p=.826N=385
-0.29*, p<0.001N=388
-0.18*, p<0.001N=387
RCADS Social Phobia (α .87)
0.59*, p<0.001N=396
0.20*, p<0.001N=396
0.49*, p<0.001N=398
0.41*, p<0.001N=396
RCADS Panic Disorder (α .89)
0.55*, p<0.001N=394
0.20*, p<0.001N=394
0.51*, p<0.001N=396
0.29*, p<0.001N=394
RCADS Major Depression (α .87)
0.46*, p<0.001N=393
0.15*, p=0.004N=393
0.43*, p<0.001N=396
0.21*, p<0.001N=394
RCADS Separation Anxiety (α .80)
0.43*, p<0.001N=395
0.13*, p=0.010N=395
0.39*, p<0.001N=398
0.22*, p<0.001N=396
RCADS Generalised Anxiety (α .82)
0.51*, p<0.001N=395
0.18*, p<0.001N=395
0.46*, p<0.001N=398
0.29*, p<0.001N=396
RCADS Obsessive Compulsive Anxiety (α .80)
0.43*, p<0.001N=396
0.12*, p=0.003N=396
0.39*, p<0.001N=399
0.23*, p<0.001N=397
TOSCA-A
Shame
(α .85)
0.49*, p<0.001N=399
0.19*, p<0.001N=397
0.46*, p<0.001N=400
0.35*, p<0.001N=398
ASPS Self
Evaluation
(α .91)
0.59*, p<0.001N=401
0.21*, p<0.001N=399
0.57*, p<0.001N=402
0.44*, p<0.001N=400
ASPS
Humiliated Fury
(α .78)
0.27*, p<0.001N=400
0.05, p=0.285N=398
0.27*, p<0.001N=401
0.07, p=0.159N=399
160
ASPS Internal
Affect
(α .81)
0.57*, p<0.001N=403
0.32*, p<0.001N=401
0.52*, p<0.001N=404
0.50*, p<0.001N=402
*Statistically significant at p< 0.001
Appendix Y. Journal of Adolescence Guidelines for Authors
161
162
163
164
165
166
167
168
169
170
171
172
173
Appendix Z: GSA Reliability: Correlations
174
GSA Reliability: Item-Total and Inter-item Correlations
GSA Factor 1: Inner Turmoil
Inter-Item Correlation Matrix
I could not
concentrate on
school work
I kept thinking
about what had
happened
I felt anxious and
stressed.
I felt I was not in
control.
I felt I had lost
confidence in
myself.
I did not know
what to do. I felt scared.
I could not concentrate on
school work1.000 .417 .391 .376 .360 .397 .366
I kept thinking about what had
happened.417 1.000 .488 .312 .364 .476 .393
I felt anxious and stressed. .391 .488 1.000 .533 .516 .511 .472
I felt I was not in control. .376 .312 .533 1.000 .562 .543 .476
I felt I had lost confidence in
myself..360 .364 .516 .562 1.000 .591 .479
I did not know what to do. .397 .476 .511 .543 .591 1.000 .627
I felt scared. .366 .393 .472 .476 .479 .627 1.000
175
Item-Total Statistics
Scale Mean if
Item Deleted
Scale Variance if
Item Deleted
Corrected Item-
Total Correlation
Squared Multiple
Correlation
Cronbach's
Alpha if Item
Deleted
I could not concentrate on
school work8.45 21.388 .504 .270 .853
I kept thinking about what
had happened7.55 21.197 .539 .349 .848
I felt anxious and stressed. 7.85 19.124 .660 .452 .832
I felt I was not in control. 8.43 19.169 .639 .448 .835
I felt I had lost confidence in
myself.8.34 18.867 .655 .462 .833
I did not know what to do. 8.30 18.987 .724 .558 .822
I felt scared. 8.58 19.606 .636 .445 .835
176
GSA Factor 2: Reparation
Inter-Item Correlation Matrix
I tried to put
things right.
I tried to re-build
the trust.
I wanted to
make it better for
the other
person.
I tried to put things right. 1.000 .621 .589
I tried to re-build the trust. .621 1.000 .633
I wanted to make it better for
the other person..589 .633 1.000
Item-Total Statistics
Scale Mean if
Item Deleted
Scale Variance if
Item Deleted
Corrected Item-
Total Correlation
Squared Multiple
Correlation
Cronbach's
Alpha if Item
Deleted
I tried to put things right. 3.97 3.150 .670 .450 .775
I tried to re-build the trust. 4.01 3.111 .703 .495 .741
I wanted to make it better for
the other person.3.76 3.267 .678 .463 .766
177
GSA Factor 3: Physiological Reactions
Inter-Item Correlation Matrix
I had trouble
sleeping.
My heart felt
heavy because
of what I did.
I felt sick in my
stomach
because of what
I did. I felt like crying.
I had trouble sleeping. 1.000 .527 .547 .534
My heart felt heavy because
of what I did..527 1.000 .692 .577
I felt sick in my stomach
because of what I did..547 .692 1.000 .649
I felt like crying. .534 .577 .649 1.000
Item-Total Statistics
Scale Mean if
Item Deleted
Scale Variance if
Item Deleted
Corrected Item-
Total Correlation
Squared Multiple
Correlation
Cronbach's
Alpha if Item
Deleted
I had trouble sleeping. 4.22 9.671 .615 .379 .841
My heart felt heavy because
of what I did.3.90 9.515 .706 .525 .804
I felt sick in my stomach
because of what I did.4.11 8.758 .752 .587 .782
I felt like crying. 4.17 9.041 .690 .484 .810
178
GSA Factor 4: Regret and Self-Blame
Inter-Item Correlation Matrix
I thought “I have
done something
wrong”
I thought “it was
my fault”.
I thought “I
should not do it
again”.
I regretted what I
had done.
I thought “I have done
something wrong”1.000 .472 .383 .446
I thought “it was my fault”. .472 1.000 .447 .512
I thought “I should not do it
again”..383 .447 1.000 .584
I regretted what I had done. .446 .512 .584 1.000
Item-Total Statistics
Scale Mean if
Item Deleted
Scale Variance if
Item Deleted
Corrected Item-
Total Correlation
Squared Multiple
Correlation
Cronbach's
Alpha if Item
Deleted
I thought “I have done
something wrong”6.40 5.000 .529 .288 .759
I thought “it was my fault”. 6.39 4.504 .592 .355 .728
I thought “I should not do it
again”.6.24 4.745 .583 .379 .732
I regretted what I had done. 6.28 4.583 .651 .442 .697
178
MRP Proposal (without Appendices)
179
School of Psychology Coursework Form
PSYCHD CLINICAL PSYCHOLOGY
MRP PROPOSAL
September 2013
Year 1
Assignment Title: The development of a new measure of guilt proneness
for adolescents
Student URN: 6243093
Word Count (excluding Title Page, Abstract, Table of Contents,
References and Appendices) = 2995
180
Background and Theoretical Rationale
Guilt, a self-conscious emotion, is an important component of conscience that
regulates human behaviour (Bybee, 1998). It is has cognitive, affective and
behavioural components and involves a moral transgression, real or imaginary, in
which people believe their action or inaction contributed to negative outcomes
(Tilghman-Osborne, et al., 2010). A general consensus on the construct is however
lacking; some view guilt as trait-like (stable across many situations), whereas others
see it as state-like (dependent on circumstances) (Tilghman-Osborne, et al., 2010).
Similarly, inconsistencies have been noted on guilt’s relationship with mental health.
Some authors consider guilt to be adaptive, protective and associated with pro-social
behaviour and academic/vocational achievement (Bybee, 1998). Others have noted
its maladaptive consequences (e.g. association with eating disorders, depression and
antisocial behaviour) when expressed chronically or in an excessive or deficient
manner (Tangney & Dearing, 2002). For example, the Diagnostic and Statistical
Manual (Fourth-Version) (DSM-IV) specifies ‘excessive or inappropriate guilt’ as a
symptom of depression (APA, 2000).
Shame, also a self-conscious emotion, is distinct from guilt yet often co-
occurs (Tangney & Dearing, 2002). Generally, the focus of evaluation for shame is
on the global self, whereas the focus for guilt is on the specific behaviour (e.g. ‘I did
that horrible thing’ versus ‘I did that horrible thing’) (Tangney & Dearing, 2002).
Behaviourally, shame is accompanied by a desire to hide or escape whereas guilt is
often associated with a desire to confess, apologise or repair (Tangney & Dearing,
2002). Associations with psychopathology are also different, with many authors
suggesting shame is more maladaptive than guilt; that guilt is only detrimental when
181
fused with shame (Ferguson, et al., 1999). This finding has however been disputed
by research that has demonstrated chronic and excessive guilt to be associated with
mental health problems even when shame is partialled out (Bybee, 1998).
Another way to differentiate shame and guilt may be through self-
compassion. Self-compassion involves basic kindness, with a deep awareness of the
suffering of oneself and of other living things, coupled with the wish and effort to
relieve it (Gilbert, 2009a; Neff, 2003b). Research surrounding self-compassion has
generally focused on shame rather than guilt (Gilbert, 2009a). Only two studies
examining the relationship of shame, guilt and self-compassion were found in the
literature: the first study (examining self-compassion in female athletes) found that
guilt and self-compassion were positively correlated and shame and self-compassion
were negatively correlated with each other, whereas the second study (an
investigation of Clergy burnout) found that shame was negatively correlated with
self-compassion but that guilt was not related to self-compassion (Barnard & Curry,
2012; Mosewich, Kowalski, Sabiston, Sedgwick, & Tracy, 2011). Due to the paucity
of research, self-compassion’s potential role in differentiating guilt and shame is an
area deserving of future research (Mosewich, et al., 2011).
Similar inconsistencies have been noted in the measurement of guilt, which
remains especially problematic in younger populations (Tilghman-Osborne, et al.,
2010). A recent unpublished review of the literature identified 19 child and
adolescent guilt measures, although only 10 of these were accessible (see Appendix
A) (Brennan, 2013). This review concluded that, due to questionable validity,
reliability and poor research designs, a gold standard for the measurement of guilt in
young people does not exist. For example, data on validity and reliability were
182
rarely and inconsistently reported and measure development did not enhance
construct validity (overlooking important confounding factors). No paper considered
all four of the most common confounding factors (anxiety, depression, anger and
shame) in their analyses (Tilghman-Osborne, et al., 2010). Similarly, only one
measure examined the impact of social desirability (whether young people were
reporting what they thought researchers wanted to hear) (Tilghman-Osborne, et al.,
2010). All of the measures were developed in the USA with samples of primarily
White, Christian, Middle-Class young people and often un-equal representations of
boys and girls. They may therefore be limited in ecological validity and cross-
cultural application.
Very few of the existing measures were piloted during the development stage
and items were generated using a ‘top-down’ approach (generated by academics,
researchers and clinicians rather than young people). The majority of measures were
also scenario-based, where examples of guilt-provoking situations are provided
followed by a Likert-scale of response options. Most were however developed in the
1990s and so may not provide situations that capture accurate experiences of guilt
(e.g. scenarios relating to social media and other technologies). They also provide a
limited number and type of scenarios and may therefore fail to capture unique
personal experiences of guilt. Semi-idiographic measures (e.g. asking a person to
recall a time when they felt guilty) are recommended in the literature as a way to
overcome these issues, yet no existing measure has used this format (John et al.,
2013).
Finally, despite changes in the experience of guilt across development
(becoming increasingly complex with age and cognitive maturity), the review
183
sourced only one measure for adolescence- and it was limited as it was adapted from
an existing child measure, which itself was modified from an adult guilt measure
(Baker, et al., 2012; Tangney, et al., 1991). John et al (2013)’s review states that the
development of a new adolescent guilt measure is therefore a high priority for future
research. Implications include improving clinical interventions and informing
service developments.
Research Questions/Aims
The main research question asks what a new semi-idiographic self-report
measure of guilt-proneness would look like for adolescents. The primary research
aim is therefore to develop the measure and, subsequently, establish its internal
reliability and validity. Influence of social desirability bias will also be considered.
This measure will serve as a compliment to the Shame Scale for Adolescents (SSA),
previously designed within the Department (Simonds et al., Under Review). A
secondary research question will be whether self-compassion differentiates shame
and guilt.
Main Hypotheses
Concurrent criterion validity will be assessed by correlating the New Guilt
Measure (NGM) scores with scores on the guilt subscale of the Test of Self-
Conscious Affect in Adolescents (TOSCA-A); it is expected that the two measures
will be positively correlated. Divergent construct validity will be investigated by
exploring the relationship between the NGM scores and scores from the shame
subscale of the TOSCA-A. A positive correlation is expected. Convergent validity
will be assessed by exploring the relationship between NGM scores and scores on the
Anger Expression Scale for Children (AESC) and Revised Child Anxiety and
184
Depression Scale (R-CADS). Based on the literature, it is expected that the NGM
scores will be positively correlated with R-CADS scores and negatively correlated
with AESC scores (Bybee, 1998). The influence of social desirability will be
investigated by exploring the relationship between the NGM and Children’s Social
Desirability (CSD) scores; a negative correlation is expected. The hypothesis for the
secondary research question, based on Mosewich et al (2011), is that self-compassion
will differentiate guilt and shame by being positively correlated with guilt and
negatively correlated with shame, thus serving to further demonstrate the NGM’s
construct validity.
Method
Participants Adolescents aged 11 to 18 will be recruited. This age range was decided
based on the World Health Organisation’s definition of adolescence and also the age
range used for recruitment in the SSA study (Simonds, et al., Under Review; WHO,
2002). Sampling will take place in non-clinical (school) settings. As per similar
studies, approximately 10 adolescents will be recruited for the measure development
stage and 500 adolescents for measure validation (Simonds, et al., 2010). The
literature has noted that 50% (equivalent to 255 students) is a reasonable response
rate for academic papers, however the SSA study was able to recruit a much higher
number (420 young people from four schools) (Baruch, 1999; Simonds, et al., 2010).
Exclusion criteria will be young people who have a known and significant learning
disability (as assessed by the school) and are not able to participate in a regular
classroom learning environment.
Design
A cross-sectional measure development design will be employed.
185
Measures
See Appendix E for a copy of all measures.
Procedure
See Appendix B for a flow-chart documenting the project’s three stages. A data
collection timeline is outlined in Appendix C.
Stage One This stage will involve measure development. Recruitment will focus on
identifying a co-education secondary school with a diverse representation of ethnic,
socioeconomic and religious backgrounds. Information on diversity will be obtained
from the Department of Education, Ofsted and individual school websites. After a
school has been identified, the head teacher will be sent an information letter (with
Special Education Needs Coordinators and school counsellors copied in as
applicable) followed by a subsequent telephone call. Upon the school’s approval, all
staff will be emailed with the project’s information and printed packs will be
available for the teachers to collect from the head teacher’s office. Two options will
then be presented to the schools: form tutors/teachers can distribute information
packs (with consent forms) to interested students or the researcher can present the
project in a school assembly and ask interested students to take an information pack.
Schools may also be asked to post printed adverts of the study in the school. Consent
forms can be returned to a box in the school office or to individual classroom
teachers and will be collected by the researcher one-week before data collection.
The school can then arrange a time and place for the researcher to interview the
young people who provided consent.
186
Semi-structured interviews will be conducted with approximately 10
adolescents at their school (approximately 30-minutes each), where they will be
asked questions in relation to their understanding and experience of guilt (Appendix
D). They will also be administered a demographic questionnaire (Appendix E).
Interview scripts will then be analysed and items generated. Once the draft measure
has been developed, a focus group (with either the 10 adolescents initially
interviewed or a new set of young people) will be conducted in which participants
will be asked to complete the new questionnaire individually and then feedback
comments as a group (approximately 15minutes) (Appendix F). In order to capture
the experiences of adolescents less likely to contribute in a group setting, an
anonymous written feedback form will also be administered individually (Appendix
G). The interviews and focus group will be audio recorded and transcribed verbatim.
Stage Two Five-hundred adolescents will be recruited for stage two. Recruitment will
target a range of co-education and single-sex schools (secondary schools, sixth-form
colleges and independent schools), both public and private, from different
geographical locations in England and with students from diverse ethnic,
socioeconomic and religious backgrounds. Schools will be identified and contacted
(and information packs distributed/data collection times organised) in the same way
as stage one. Data collection will involve administering questionnaire packs
(completed with paper and pencil) containing the following: Demographic
Questionnaire; the NGM (developed in stage one); TOSCA-A; SSA; R-CADS;
AESC; and CSD. All of the measures have good validity and reliability (see
Appendix H for more information). It is anticipated that the questionnaire pack will
take approximately 30-to-45mimutes to complete.
187
Stage Three Stage three will be run concurrently with stage two. The Self-Compassion
Scale (SCS) (or the short form- SCS-SF) will be administered alongside the other
above-mentioned measures (Neff, 2003a; Raes, Pommier, Neff, & Van Gucht, 2011).
This measure is appropriate for ages 14 and up, so will only be used with participants
aged 14 to 18. A new youth measure is in the early development stages (as per email
correspondence with Kristen Neff, the measure’s developer, on 20th July 2013) but
may not be available in time for the present study. If the measure is available in
time, the whole sample will be administered the new youth self-compassion
questionnaire. The SCS and SCS-SF have reported good validity and reliability
(Neff, 2003a).
Ethical Considerations
An application for ethical approval will be submitted to the University of
Surrey Faculty of Arts and Human Sciences Ethics Committee. Informed consent is
a primary ethical consideration. If the school’s policy is aligned with the British
Psychological Society (BPS)’s recommendations with research conducted in schools
(that heads of schools can allow children under 16 to provide consent if they deem it
part of normal curriculum), consent forms will be provided to the school for the head
teacher and also the individual students (BPS, 2010). If the school’s policy is that
parental consent be provided for students under 16, an ‘opt-out’ form will be
discussed with the head teacher (where parents are sent a text, email or letter in
which the project is described and they are provided with contact information or a
form to return to the school to ask that their child not participate in the study). If
parents at such schools want to allow their children to participate, they would not
need to sign or return anything. Finally, in the case where an opt-out procedure does
188
not align with school policy, ‘opt-in’ written consent will be requested from the
parents/caregivers (where a written consent form is returned to the school if parents
agree for their child to participate). Based on the BPS’s guidelines, adolescents who
are aged 16 and older will be allowed to provide their own informed consent (BPS,
2010).
In case of disclosure, or any other safeguarding issue, the school’s
safeguarding policy will be followed. Mary John, Registered Psychologist and
supervisor, will also be contactable. Participants will be informed, before data
collection begins, that if the researcher becomes concerned or worried about them or
others at any point, someone else at the school would need to become involved. If
required, usual referral paths will be followed. Immediately after data collection, all
young people will be de-briefed (where the researcher will discuss how the
questionnaires are not diagnostic, that there are no right or wrong answers and that
completing such questionnaires often causes increased personal reflection). A plan
of action will be verbally discussed in case students feel they need extra support (e.g.
Childline number, contact names at school) and a written de-brief form (providing
the same) will also be distributed.
In order to not disrupt classroom time, the study will be conducted during a
scheduled break within regular school hours. If this does not suit the school, after or
before school slots can be arranged. Breaks will be offered to young people if they
feel they need to leave the room at any point. Written puzzles will also be included
in the questionnaire pack, so that adolescents can choose not to participate without
revealing this to the group. All participants will be provided with the option to
decline/withdraw from the study at any time. Overall, risk of psychological distress
189
is low and there is no evidence (from other measure development studies in the
literature) that administering similar types and quantities of questionnaires has been
distressing/not tolerated by young participants (Simonds, et al., Under Review;
Tilghman-Osborne, et al., 2012).
Proposed Data Analysis
Statistical analyses will be conducted using SPSS version-19.0 (SPSS Inc.,
2013). Demographic data will be analysed descriptively. Following the initial
interviews and focus groups, a content analysis will be conducted of transcribed
scripts, followed by an exploratory factor analysis to devise measure items (B. G.
Tabachnick, Fidell, & Osterlind, 2001; Weber, 1990). This type of data analysis has
been cited in similar measure development studies (Simonds, et al., Under Review;
Tilghman-Osborne, et al., 2012). Best practice guidelines for exploratory factor
analysis state that the required sample size should be a participant to item ratio of 2:1
to 5:1 (Costello & Osborne, 2005). As shorter measures are generally more
favourable in younger populations, the maximum length of the present measure will
be approximately 20 items (Bybee, 1998). With an estimated sample size of 500,
this would provide 2.5 participants per item (2.5:1), which falls within the literature’s
recommendations (Costello & Osborne, 2005). Although this is at the smaller end of
the required sample size, it is similar to other published studies (Costello & Osborne,
2005).
Data will be checked to ensure no data entry errors or missing data. If
assumptions are met, hypotheses surrounding social desirability and validity will be
addressed using Pearson’s correlations (Ezekiel & Fox, 1959). Correlational
analyses will also be run on the SCS, NGM and SSA to address the study’s second
190
aim (and hypotheses in relation to self-compassion, shame and guilt). With 500
participants, a correlation (two-tailed) of at least 0.2 with 99% Power (alpha at 0.05)
can be detected (Faul, Erdfelder, Buchner, & Lang, 2009). The correlations for
validity are expected to be higher than this (Simonds, et al., Under Review).
Therefore, 500 participants would yield sufficient Power. Internal reliability will be
investigated using Cronbach’s alpha co-efficients (Cronbach, 1951).
Service User and Carer Consultation/Involvement
This proposal has been discussed with a service user and carer representative
at the University. Feedback will continue to be gained from the Co-ordinator of
Service User & Carer Involvement on the University PsychD programme. In
addition to this, the questionnaires pack will be piloted with a small group of
adolescents (children of University staff) prior to the main study. Consent will be
obtained prior to receiving any feedback.
Feasibility Issues
Recruitment and a low response rate may be potential issues. In order to
overcome this, University staff may be emailed during stages two and three,
requesting the participation of their children (aged 11 to 18). If interest is expressed,
information and consent forms can then be provided. Another option to aid
recruitment may be to provide an online option for questionnaire completion.
Psychology A-Level classes may also be particularly interested in the study and
provide a more feasible recruitment route. As an extra incentive, all participating
schools will be offered a free presentation to young people on ‘What is Clinical
Psychology’ (given by the researcher) after the study. In order to make recruitment
191
during stages two and three more manageable, a Psychology undergraduate student
at the University may be involved in data collection.
Dissemination Strategy
A finalised paper will be submitted for publication to a peer-reviewed journal
and presented at an international conference on child and adolescent
psychopathology.
Study Timeline
Please see Gantt chart for the project timeline (Appendix I).
.
192
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MRP Literature Review (with Appendices)
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School of Psychology Coursework Form
PSYCHD CLINICAL PSYCHOLOGY
Literature Review
April 2013
Year 1
Assignment Title: The Measurement of Guilt in Children and Adolescents:
a Literature Review
Student URN: 6243093
Word Count (excluding Title Page, Abstract, Table of Contents,
References and Appendices) = 7994
This review will be submitted to the Clinical Psychology Review for publication. There are
a number of reasons as to why this is the journal of choice. The Clinical Psychology Review
is a very high-impact journal with a rating of 7.071. This means that articles published in
this journal are widely disseminated and cited amongst other researchers. Reviews
published in this journal also have a clear and substantial link to the field of Clinical
203
Psychology. The only other review paper that has examined the measurement of guilt
(across the lifespan) was published in the Clinical Psychology Review in 2010, suggesting
that this journal has an interest in the area.
ABSTRACT
Guilt is a self-conscious emotion that has recently received a surge in
research attention, yet its implications for child and adolescent wellbeing and
adjustment are often debated (Bybee, 1998). Some authors suggest that it is an
adaptive emotion with protective properties, whereas others argue for its maladaptive
features and link with psychopathology (Tangney & Dearing, 2002). Its
measurement is also controversial, with a variety of definitions and methodologies
employed. Ten published journal articles and one edited book in Pubmed,
PsycINFO, MEDLINE, Web of Knowledge databases and from the author’s own
knowledge of the area were sourced and reviewed. The definition of guilt
employed, measure type, design/evaluation methodologies and considerations given
to issues of diversity and culture were specifically examined. Findings highlighted
considerable inconsistencies in the available data and a general paucity of research in
the area. Implications and future recommendations are discussed.
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INTRODUCTION
Guilt is an integral component of conscience that regulates human behaviour
(Bybee, 1998). It is a complex construct with affective, cognitive and behavioural
components and involves a moral transgression (real or imaginary) in which people
believe their action or inaction contributed to negative outcomes (Tilghman-Osborne,
Cole, & Felton, 2010). In the literature, guilt has been viewed as trait-like or state-
like; maladaptive or adaptive (Bybee, 1998). Trait-like refers to dispositional and
chronic guilt occurring across many situations, whereas state-like guilt is situation
and time-specific (Bybee, 1998). A general consensus on the construct is lacking. In
their review of the definition and measurement of guilt, Tilghman-Osborne et al
(2010) noted that such a discrepancy is rare in the social sciences and should be a
reason for concern.
In its adaptive form, guilt is considered protective and associated with pro-
social behaviour, less aggression, academic/vocational achievement and increased
helping rates (Bybee, 1998). ‘Pre-dispositional guilt’, considered to be largely
adaptive, is associated with temperament and arises in response to specific events
(Bybee, 1998). When triggered, it often results in responses that are reconciliatory in
nature (e.g. apologising) and serves to rectify the precipitating event (Bybee, 1998).
Views on pre-dispositional guilt are conflicting however. For example, Bybee
(1998) noted that it is adaptive in individuals who are not depressed, but maladaptive
in individuals who score high on depression.
Some authors suggest that guilt becomes maladaptive when generalised to the
self, whereas others state that it is the extremes in guilt (excessive or deficient) that
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are detrimental and associated with later psychopathology (Baker, Baibazarova,
Ktistaki, Shelton, & van Goozen, 2012; Ferguson, Stegge, Miller, & Olsen, 1999).
The distinctness, consistency and consensual nature of the emotion and its related
behaviour are also key in determining whether guilt is maladaptive or adaptive
(Bybee, 1998). For example, if someone were to display guilt-relevant behaviours in
the presence of different people, in an inconsistent manner and if few others
responded with the same behaviours in similar situations, it might be concluded that
the presenting guilt is maladaptive. Similarly, ‘Chronic Guilt’ has been described in
the literature and relates to unresolved, undirected and unalleviated guilt; an ongoing
condition of guiltiness unattached to a triggering incident (Bybee, 1998). It has been
linked with poor coping strategies and mental health difficulties (Bybee, 1998).
Some authors have suggested that guilt is only maladaptive when it is fused with
shame (Ferguson, et al., 1999). Others have disputed this, indicating that chronic
guilt continues to be related to psychopathology (e.g. anxiety, eating disturbances)
even when shame is partialled out (Bybee, 1998). Associations of guilt and
psychopathology are clearly inconsistent in the literature.
Guilt and shame, both self-conscious emotions, are two distinct constructs
that often co-occur (Bybee, 1998). Although making a clear distinction between the
two is essential, the available research has typically focused on one emotion while
ignoring the other (Tilghman-Osborne, et al., 2010). Many studies use the ‘self
versus behaviour’ distinction in defining shame and guilt: when people feel shameful
they feel bad about the self, whereas when people feel guilty they feel bad about a
specific behaviour (Lewis, 1971). Shame involves a sense of exposure before an
audience, real or imagined, and often motivates an avoidance response (Bybee,
1998). In contrast, guilt focuses on the specific deed, harm caused to others, and
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desire to make amends (Bybee, 1998). Some authors have described this distinction
in terms of Attribution Theory: shame emerges if one attributes an event to oneself
and sees the characteristic as being global, stable and enduring; guilt emerges when
an event is attributed as being an unstable, time-limited and specific aspect of the self
(Hosser, Windzio, & Greve, 2008; Weiner, 1986).
Other theoretical frameworks have also been applied within guilt research.
The Functionalist Approach has been used to promote a more balanced view of guilt,
stating that emotions themselves are not dysfunctional but can become so when
expressed intensively, frequently and inappropriately relative to situational demands
(Campos, Mumme, Kermoian, & Campos, 1994). Beck (1967)’s Cognitive Theory,
which describes cognitive errors associated with depression, has also been applied to
guilt. Based on this work, definitions of ‘inappropriate guilt’ ( thoughts associated
with an incorrect assumption of responsibility) and ‘excessive guilt’ (the
disproportionate negative affect in response to an incident for which one has
assumed such responsibility) have evolved (Tilghman-Osborne, Cole, & Felton,
2012). Developmental Cognitive Theories suggest that broad cognitive abilities are
required in order for guilt to be experienced (Tilghman-Osborne, et al., 2012). For
example, within Piaget’s Stages of Cognitive Development, younger children tend to
view the world in more concrete and less abstract ways (Piaget, 1964). After age 10
(as ‘formal operational’ thought develops), children have a greater capacity for
abstract reasoning, information retention and perspective-taking, which has a direct
impact on their appreciation of guilt (Tilghman-Osborne, et al., 2012).
Although more research is needed on developmental differences in the
experience of guilt, it is becoming increasingly apparent that an appreciation of age
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and cognitive capacity are essential. In comparison to adolescents and adults, the
definition of guilt is more likely to have an adaptive and reparative function when
applied to children (Tilghman-Osborne, et al., 2010). Similarly, guilt may be more
normative for children under the age of 10 (Tilghman-Osborne, et al., 2010). In early
childhood, guilt is mainly behavioural in nature (e.g. discomfort shown in
facial/bodily distress, apology) and becomes increasingly cognitive and complex
with age and cognitive maturity (Baker, et al., 2012). Between the ages of eight and
11, children begin to develop more sophisticated distinct conceptions of shame and
guilt (Bybee, 1998). The frequency and intensity of guilt also changes along the
lifespan- increasing in childhood, declining in early adolescence and then increasing
again in later adolescence as adulthood approaches (Bybee, 1998).
The World Health Organization defines adolescence as young people in
between the ages of 10 and 19 and specifies three different stages: early adolescence
(age 10-13), mid-adolescence (age 14-15) and later adolescence (age 16-19) (WHO,
2002). It is during this age span that noteworthy changes occur in cognitive and
emotional development, which results in increasing moral development and a more
complex understanding of right from wrong (Tilghman-Osborne, Cole, Felton, &
Ciesla, 2008). During adolescence, a variety of mental health problems (e.g.
depression) also become more prevalent (Bybee, 1998). Similarly, identity and
social roles are rapidly changing, with an increasing separation from the family and
integration into the peer group (Bybee, 1998). An attention to adolescence within the
guilt literature is lacking and warrants more research.
Culture and diversity issues (e.g. gender, sexuality and religion) may also
influence the measurement of guilt. Guilt is a concept heavily influenced by
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morality, often defined or expressed within a religion and culture. For example,
some researchers have suggested that guilt is fundamentally different in Asian as
opposed to Western cultures (Tilghman-Osborne, et al., 2010). Similarly, gender
may influence guilt experiences (Bybee, 1998). For example, females often report
more intense and frequent feelings of guilt, especially from adolescence onwards
(Bybee, 1998; Silfver & Helkama, 2007). In comparison to males, they also tend to
experience more guilt in the context of interpersonal relationships (Walter &
Burnaford, 2006). In terms of religion, different affiliations have varying
conceptualizations of guilt and use a variety of processes or rituals to alleviate guilt
(Bybee, 1998). Personal experiences of religion may therefore help shape the
construct of guilt. Similarly, guilt and sexuality, particularly in adolescents, is an
area that is under-explored in the literature (Bybee, 1998).
These issues all impact the measurement of guilt. There has been only one
published review on the measurement of guilt, reflecting the general lack of research
in the area (Tilghman-Osborne, et al., 2010). This review was limited in that it did
not investigate issues relating to culture and diversity. It also examined the
measurement of guilt across the lifespan. Although this perspective is important,
particularly as adult measures are often applied to children and adolescents (see
Appendix A for full list), specific attention to guilt measurement in young people is
warranted. The aim of the present study is to therefore explore these issues in more
detail and to address how guilt is measured in children and adolescents.
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METHOD
An electronic search of four search engines was performed (PsycINFO, Pubmed,
Web of Knowledge and MEDLINE) in November 2012. Titles of papers were
searched using the following terms:
“guilt” and “child*”/“children”/ “youth”/ “paediatrics”/ “juvenile”/
“adolescent”;
“guilt” and “child*”/“children”/ “youth”/ “paediatrics”/ “juvenile”/
“adolescent” and “measure*”/ “outcome”/ “psychometric”/
“instrument”/“questionnaire”.
The inclusion criteria included:
Published after (and including) the year 1990.
English language only.
Children and adolescents only (newborn to age 18); studies with life-range
(e.g. children, adolescents and adults) were not included. Studies with
participants aged 19 to 20 were included if they were defined as adolescents.
Journal articles and book chapters needed to be publically available. Journal
articles needed to be peer-reviewed; dissertations were not considered.
The article’s focus needed to be on the measurement of guilt.
The measure must have a primary focus of guilt. Measures with a secondary
focus (e.g. emotional regulation) were not considered.
If multiple versions of a measure existed, a focus was placed on most recent
publications, therefore concentrating on definitions and measures that were
most completely informed by the author’s research (Tilghman-Osborne, et
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al., 2010). This was on the condition however that the most up-to-date
measure was publically available.
An expert (research supervisor) in the field provided recommended readings
and the reference lists of all articles were hand-searched. The search produced 10
articles and one edited book (see strategy, Figure 1). Ten child and adolescent
measures were sourced from eight of these articles and the edited book (see Table 1).
The remaining two articles outlined the influence of culture on the measurement of
guilt in children and adolescents and are described in Appendix C. Dates of all
publications ranged from 1990 to 2012. Most of the measures were dated from the
1990s; only two measures were from the late 2000s (Donatelli, Bybee, & Buka,
2007; Tilghman-Osborne, et al., 2012). Papers were synthesized using a thematic
approach (Cronin, Ryan, & Coughlan, 2008). After an initial reading of the core
papers (10 articles and one edited book), key themes were identified and used to
structure the present review. These themes included definitions employed, measure
type, measure development/evaluation and appreciation of culture and diversity.
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Figure 1. Search Strategy
Articles Excluded:
Inclusion Criteria not met: n=12,020
Articles Assessed Using Full-Text Review n=15
Included Articles n=9
12,035 Sources for Review of Title and Abstract after Removing Duplicates
Hand-Searched Article Reference Lists, n=10 New Articles Found
Articles Excluded:
Articles not publically available: n=9
Included Articles n=10 Articles
Articles Excluded:
Inclusion Criteria not met: n=6
1 Edited Book Provided by Supervisor
36,646 Total Papers (all searches combined)
Pubmed n=8,599 PsycINFO n=7,010 MEDLINE n=12,459 Web of Knowledge n=8,515
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RESULTS
Type of Measure
Measures were scenario-based, semi-projective, observational or parent-
reported. No global checklist or semi-idiographic guilt measures were sourced.
Scenario-based measures presented specific and common situations, followed by
Likert-scale questions that captured the cognitive, behavioural and affective aspects
of guilt (Tangney & Dearing, 2002). Semi-projective measures presented
photographs depicting ambiguous situations, followed by a series of questions
(Tangney & Dearing, 2002). Observational measures were used by experimenters to
code children’s guilt-relevant behaviours (Barrett, Zahn-waxler, & Cole, 1993).
Scenario-Based
Six scenario-based measures were found. The Test of Self-Conscious Affect
for Children (TOSCA-C) was originally developed in 1990 for children aged eight to
12 and is a scenario-based self-report measure in which 10 negative and five positive
scenarios are presented (Tangney & Dearing, 2002). Children rate on a five-point
Likert scale the extent to which they would feel guilt, shame, pride, detachment and
externalization in relation to each situation. ‘Guilt’ and ‘shame’ terms are not
explicitly used in the measure. The TOSCA-C was adapted for adolescents to
produce the Test of Self-Conscious Affect for Children (TOSCA-A); its structure and
coding are the same (Tangney & Dearing, 2002).
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The Child-Child Attribution and Reaction Survey (C-CARS) is an
interview-based measure (developed in 1990) intended for children aged five to 12
years (Ferguson, et al., 1999). It was adapted from the TOSCA-C. A scenario is
provided (written and pictorial representations) and the child responds on a five-point
Likert scale to questions relating to shame, guilt or externalisation. The Shame and
Guilt Questionnaire (SGQ), similar to the C-CARS, is a Dutch measure developed in
2000 for children aged six to 11 (Olthof, Schouten, Kuiper, Stegge, & Jennekens‐Schinkel, 2000). It has been translated into English but has yet to be validated in an
English-speaking population. The experimenter presents 10 situations (five ‘shame-
only’; five ‘shame-and-guilt’) which feature a protagonist the same sex as the child.
The child then responds, on a five-point Likert scale, the degree to which the
protagonist would experience shame and/or guilt. The Maladaptive Guilt Induction
Measure (MGI) was developed in 2007 and is specifically intended for adolescents
aged 12 to 20 years (Donatelli, et al., 2007). It is a 22-item self-report questionnaire
that examines the young person’s perceived level of parental guilt induction (extent
to which parents make them feel guilty). The respondent is presented with a series of
statements and asked to rate how true/untrue they are on a seven-point Likert scale.
The Inappropriate and Excessive Guilt Scale (IEGS) was developed in 2012
and assesses inappropriate and excessive guilt in young people aged seven to 16
years old (Tilghman-Osborne, et al., 2012). The measure is composed of 24
scenarios with negative outcomes and ambiguous faults; the young person rates on a
three-point Likert scale how they would think/feel if it had happened to them. It is
the first measure to look specifically at maladaptive guilt and its relation to
depression.
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Semi-ProjectiveOne semi-projective measure was located in the literature. The Children’s
Interpretations of Interpersonal Distress and Conflict (CIIDC), developed in 1990, is
a semi-projective narrative measure in which children aged three to nine respond to a
series of questions after viewing four photographs of ambiguous situations (Zahn-
Waxler, Kochanska, Krupnick, & McKnew, 1990).
Observational/Behavioural The Clown-Doll Paradigm was developed in 1993 for children aged 17 to 36
months (Barrett, et al., 1993). Children are invited to play with a toy while the
experimenter goes into another room. Unknown to the child, the toy is already
broken so when the child picks it up, it breaks apart. The child’s behaviours are
coded before and after the incident and before and after the experimenter returns.
The Mishap Guilt paradigm, adapted from the Clown-Doll Paradigm, was developed
in 2002 (Barrett, et al., 1993; Kochanska, Gross, Lin, & Nichols, 2002). It was
designed for the slightly older age bracket of 22 to 45 months old and uses a similar
design to the Clown-Doll Paradigm.
Other Informants The majority of the measures were self-report. Only two measures were
coded by the experimenter (Clown-Doll Paradigm and Mishap Guilt Paradigm) and
one was a parent-reported measure (My Child). My Child was developed in 1994
and is composed of 100 items (expressed as 10 scales) (Kochanska, DeVet,
Goldman, Murray, & Putnam, 1994). Parents rate the child’s experience of guilt,
discomfort or anxiety in response to a real or anticipated transgression, as well as
their ability to self-regulate or refrain from acting on impulses (Kochanska, et al.,
1994). The measure has since been adapted, but the newer version could not be
sourced.
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Measure Development
Definition of Guilt Two measures defined guilt as maladaptive, six defined it as adaptive and two
defined it as being both maladaptive and adaptive. Similarly, eight measures saw
guilt as being a state, whereas two saw it as a trait. The majority of measures
(TOSCA-A, TOSCA-C, C-CARS, SGQ, My Child, Clown-Doll Paradigm) examined
guilt in conjunction with other constructs- most commonly shame, anxiety, pride,
externalization and detachment. Only the IEGS, CIIDC, MGI and Mishap Guilt
Paradigm measured guilt alone.
Target Age
Ages ranged from 25 months to 20 years old. The most commonly targeted
age group was that of young children (aged five to 12 years), used by four measures.
In comparison, only two measures specifically targeted adolescents (aged 12 to 20)
(Donatelli, et al., 2007; Tangney & Dearing, 2002). Of these two, one measured
perceived level of parental guilt induction whereas the other looked at guilt in
addition to shame, externalization, detachment and pride. Neither of these measures
considered different subsets or stages/age brackets of adolescence. Three studies
looked specifically at toddlers (aged 21 to 70 months old) and one measure (IEGS)
was designed for use with a mixture of children and adolescents (aged seven to 16)
(Barrett, et al., 1993; Kochanska, et al., 1994; Kochanska, et al., 2002; Tilghman-
Osborne, et al., 2012). Measures for younger children were observational and
parent-reported, whereas for older children/adolescents measures were self-report
only.
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Item Generation
All measures found, with the exception of the TOSCA-A and TOSCA-C,
used experimenter-generated items (rather than child/adolescent-informed items).
The TOSCA-C and TOSCA-A employed interviews with young people to generate
personal narratives of shame, guilt and pride. Data from those interviews were then
used to develop measure items. My Child, the only parent-reported measure, also
conducted initial interviews with mothers to generate measure items. In contrast,
experimenter-generated measures involved pooling items from the literature and
expert opinion. A few of the measures did not specify how items were generated.
Many of the available child and adolescent measures had been adapted from
previously existing adult measures (e.g. TOSCA-C was adapted from the adult
TOSCA) (Tangney & Dearing, 2002). Others were adapted from earlier child and
adolescent measures (e.g. TOSCA-A and C-CARS were adapted from the TOSCA-
C).
Theoretical Orientation
All but two studies used an established theoretical basis to define guilt and
aid measure development (Donatelli, et al., 2007; Olthof, et al., 2000). The most
common theoretical bases included Lewis (1971)’s Shame versus Guilt distinction
and theories of cognitive development (Kochanska, et al., 2002; Tilghman-Osborne,
et al., 2012; Zahn-Waxler, et al., 1990). Psychodynamic principles were mentioned
in one study- the oldest sourced measure published in 1990 (Freud, 1961; Zahn-
Waxler, et al., 1990). A Mediational Model (stating that fearful temperament
contributes to guilt proneness which serves to inhibit children’s tendency to violate
rules) was noted in the only behavioural/observational measure (Kochanska, et al.,
2002). The most recently developed measure (IEGS) employed Beckian and
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developmental cognitive theories (A. T. Beck, 1967; Piaget, 1964; Tilghman-
Osborne, et al., 2012).
Evaluation of Measure
Only two studies described piloting the measure (Tangney & Dearing, 2002;
Tilghman-Osborne, et al., 2012). Similarly, only two studies (IEGS and My Child)
described validation procedures; the remaining measures discussed development
only. Sample sizes ranged from 43 to 370. All studies, with the exception of
Kochanska et al (2002)’s Mishap Paradigm evaluation, were cross-sectional in
nature. Kochanska et al (2002)’s evaluation was longitudinal and evaluated the
Mishap Guilt Paradigm over the course of 38 months.
Most of the studies were conducted in either research laboratories or schools.
Only one study was conducted in a youth outpatient mental health facility
(Tilghman-Osborne, et al., 2012). The majority were also conducted in urban
locations and only one study administered the measure in the young person’s home
(Donatelli, et al., 2007). Available information on reliability and validity are listed in
Table 1. Data were inconsistently reported. Generally, measures reported good
internal consistency reliability. Studies varied in their reporting of Cronbach alphas:
some reported for subscales only, whereas others reported total scales only. The
majority of papers did not report on convergent, construct, discriminant and
incremental validity. Effect sizes were not reported by any of the studies. All the
measures, with the exception of the MGI, were validated in English-speaking
populations.
Only two of the studies ran comparisons to other, more established, guilt
measures for children and adolescents (Ferguson, et al., 1999; Tilghman-Osborne, et
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al., 2012). Data were not available for the TOSCA-A and TOSCA-C. The IEGS
measure was examined most comprehensively and was compared to the TOSCA-C
and Adult Shame and Guilt Scale (Tilghman-Osborne, et al., 2012). Correlational
data on these comparisons indicated that the guilt measures were significantly and
positively related (ranging from r=0.39 to 0.54).
Confounding Factors
Shame was the most common confounding factor examined, but was still
only considered in six studies. In these six studies, shame was found to highly
covary with guilt. The influence of social desirability, depression, fear and empathy
were mentioned in only a few. Anxiety was also overlooked. The only measure that
considered the construct of anxiety was the IEGS, and even with this measure it was
only considered during the item development stage (not during instrument
validation). Due to the significant variability between studies, a comparison based
on confounding factors was not possible.
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Table 1.
Child and Adolescent Guilt Measures
Author/Date Country Measure Sample Size/Age
Theoretical Basis Ethnicity, Gender & SES
Design/Evaluation Validity/Reliability
Tilghman-Osborne et al. 2012
USA IEGS (Inappropriate and Excessive Guilt Scale)
Pilot: 25 (7-14years).
Validation: 370 (7-16years).
Cognitive (Beckian & Developmental) theories.
94%White; 54% Female; middle to medium-low SES
Scenario-based. Piloted with clinical sample. Validated in non-clinical school sample.
Compared to shame/guilt (TOSCA-C and SGS), social desirability and depression measures.
Good convergent validity: (r=0.43-0.52, p<0.01).
Good construct validity (significantly related to measures of cognitive errors: r= 0.54, p<0.01 and depression, r=0.39, p<0.05).
Good discriminant validity (measure was not related to measure of social desirability, r= -0.05, not statistically significant).
Incremental validity of the IEGS was over-and-above other measures of guilt.
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Reliability not reported.
Positive correlations with other guilt measures, ranging from r=0.39 to 0.54, p<0.01.
Olthof et al. 2000 Netherlands SGQ (Shame and Guilt Questionnaire)
48 (6-11years)
N/A Ethnicity: N/A 50% Male
‘mixed’ SES
Scenario-based. Non-clinical (schools) setting.
Validity and reliability not reported.
Not validated in English-speaking population.
Donatelli et al.
2007
USA MGI (Maladaptive Guilt Induction Measure)
43 children: 12-20 years
43 mothers: 34-42years
N/A Depressed Mothers group: 70% Caucasian; Non-Depressed Mothers Group: 74% Caucasian.
Adolescent Group: 53.4% female.
Scenario-based. Clinical and Non-clinical groups (children of mothers with & without history of depression).
Compared to established depression measure.
MGI- good internal consistency on ‘dispargement’ and ‘self-serving elicitation’ subscales (Cronbach alphas of 0.86 and 0.82 respectively).
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SES: N/A
Zahn-Waxler et al. (1990)
USA CIIDC (Children’s Interpretations of Interpersonal Distress and Conflict)
87 (5-9years) Cognitive-Developmental Theory & Psychodynamic Theory.
Ethnicity: N/A
55% Female
SES: Middle-class
Semi-Projective. Clinical and non-clinical sample (children of depressed and non-depressed mothers).
Good Inter-rater reliability: Cohen’s kappas for 3 pairs of coders: 0.87, 0.90, 0.83.
Poor-to-Good Internal consistency reliability: 50-90% (kappas)
Tangney et al (1996)
USA TOSCA-C (Test of Self-Conscious Emotions Affect for Children)
‘Several hundred’
Lewis(1971)Theory
‘Diverse sample’; N/A
Scenario-based. Modeled after the SCAAI (Adult Self Conscious Affect and Attribution Inventory). .
TOSCA-C Guilt- Acceptable Internal consistency reliability: Cronbach alpha 0.79
TOSCA-C Acceptable Shame- Internal consistency reliability: Cronbach alpha 0.78
Tangney et al (1996)
USA TOSCA-A (Test of Self-Conscious Emotions Affect for Adolescents)
223 (7-16years)
Lewis(1971)Theory
N/A Scenario-based. Developed from the TOSCA (adult version) and TOSCA-C. Piloted in one-to-one interviews with adolescents. Validated with students in urban school.
TOSCA-A Guilt- Good Internal consistency reliability: Cronbach alpha 0.81
TOSCA-A Shame- Acceptable Internal consistency reliability:
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Cronbach alpha 0.77
Kochanska et al 1994
USA My Child Study 1: 171 mother-child dyads (21-70months).
Study 2: 102 mother-child dyads (26-41months).
Cognitive-Developmental Theory
Study 1: Ethnicity ‘mostly Caucasian’. Gender: 53% male children and all mothers. SES- ‘varied’.
Study 2: Ethnicity- 80% Caucasian. Gender: 50% male children and all mothers. SES-mixed.
Parent-Reported.
Study 1: measure development
Study 2: measure validation.
Correlations between maternal reports and child behavior.
Poor-Good Test-retest reliability: 0.29-0.79
Questionable Internal consistency: 0.60
Kochanska et al 2002
USA Mishap Guilt Paradigm
106 children (22-45months)
Mediational Model Ethnicity: 97% White
Gender: 49% female
SES: Majority Middle Class
Observational. Longitudinal (met with researcher at 18, 22, 33 45 and 56-months old). Adapted from Barrett 1993. Children led to believe they damaged object. Behaviour and responses coded. My Child also administered.
Good Internal consistency: Cronbach alpha 0.83
Ferguson et al (1999)
USA C-CARS (Child-Child Attribution and Reaction Survey)
86 children (5-12years)
Functionalist Approach
Ethnicity: 100% White
Gender: 51%
Scenario-based. Based on TOSCA-C.
Good Internal consistency reliability- Guilt: Cronbach alpha 0.86
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male
SES: Lower-Middle Class
Good Internal consistency reliability- Shame: Cronbach alpha 0.81
Good Inter-rater reliability: 0.85
Correlations between shame and guilt: r=0.60, p<0.01
Correlation with CIIDC: r=0.31, p<0.01
Barrett et al (1993) USA Clown-Doll Paradigm
44 Toddlers (25-36months)
Ethnicity: ‘predominantly Caucasian’; 50% Male; SES: Middle-Upper Class
Observational. Modeled after the SCAAI (Adult Self Conscious Affect and Attribution Inventory)
Good Inter-rater reliability: 0.80
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Diversity and Culture
Data on sample gender were available for eight of the 10 measures; information could
not be sourced for the TOSCA-C and TOSCA-A evaluations. Only two studies had samples
with equal representation of males and females (Barrett, et al., 1993; Olthof, et al., 2000).
The remaining six were split- three had more females; three had more males. Six measures
considered the influence of gender in their analyses. Of these six papers, four found a
significant influence of gender, but the associated interpretations of results varied (e.g. some
reported that females demonstrated higher guilt than males, others found the opposite). None
of the studies reported on the sample’s religious background or sexuality. All, except for one,
of the 10 child and adolescent measures were developed and validated in American
populations. No papers were found for United Kingdom (UK) populations. Very few studies
had culturally diverse samples, with the majority being predominantly White and Middle
class.
Two cross-cultural papers of the TOSCA-C were found (Bear, Uribe-Zarain,
Manning, & Shiomi, 2009; Furukawa, Tangney, & Higashibara, 2011). This was the only
child and adolescent measure to be examined cross-culturally in the literature. In Furukawa
et al (2011)’s paper, the TOSCA-C was administered to 144 Japanese, 180 Korean and 688
American children (aged eight to 11 years). Ethnicity was reported only in the American
sample, and was 60% White. There were more females in all three samples (65.2%, 52.2%
and 53.7% in the Japanese, Korean and American samples respectively). Information on
socio-economic status (SES) was reported for the Japanese sample only and ranged from
working class to upper-middle class. Data were collected for the American sample from
1990-1991, from the Japanese sample in 2001-2002 and from the Korean sample in 2002-
2003. Significant group differences were found: Japanese children scored the highest on
shame, Korean children scored the highest on guilt and American children scored the highest
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on pride. Still, the authors stated that correlation patterns were more similar than different
across cultures (e.g. guilt-proneness was associated with a tendency to take responsibility for
transgressions in all groups) and that the TOSCA-C could therefore be effectively applied
cross-culturally (Furukawa, et al., 2011).
In comparison, the second cross-cultural paper compared the TOSCA-C in a sample
of Japanese versus American children, aged nine to 10 years (Bear, et al., 2009). The
Japanese sample was composed of 118 children (100% native Japanese) and the USA sample
was 130 children (89% Caucasian). Both samples were of mainly middle/average SES
background and were recruited from rural schools. The American sample was 69.5% male
and the Japanese sample was 52.3% male. The results indicated that the Japanese children
were more likely to experience shame, guilt and anger and were less likely to externalize
blame. In contrast to the American children, guilt (not shame) was directly negatively related
to anger. These authors suggested that culture may moderate expression of guilt (Bear, et al.,
2009).
DISCUSSION
Results demonstrate the highly inconsistent nature of the literature on guilt
measurement in children and adolescents. A variety of guilt definitions were employed by
the 10 measures. Similarly, the type of measurement used (scenario-based, semi-projective,
observational or parent-reported) was changeable. Measures were generally poorly designed
(e.g. using experimenter rather than respondent/child-generated items) and varying
definitions of guilt, settings and theoretical bases made comparisons difficult. Very few
measures were piloted and data on validity and reliability were inconsistently reported. A
consideration of diversity and culture was also lacking. Overall, the paucity of available
research has been highlighted.
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Definition of Guilt
The definition of guilt directly impacted on the utility of the measure. All ten
measures varied considerably in their definitions of guilt. Some of the measures defined guilt
as being primarily adaptive, others considered it as maladaptive and linked to
psychopathology and the remainder took a more balanced, spectrum view of guilt.
Similarly, some researchers viewed guilt as being a stable trait whereas others saw it as being
situation-specific. This lack of consensus inhibited comparisons between the measures.
Also, although shame has been found to covary highly with guilt, very few measures
considered a definition of guilt within the context of, and in comparison to, shame. In not
making this distinction, these measures were therefore at risk of poor discriminate validity-
essentially measuring shame when the goal was to examine guilt (Tilghman-Osborne, et al.,
2012). Despite adopting a particular definition of guilt, the type of measure further
influenced the form of guilt captured from respondents. For example, it has been argued that
scenario-based measures often tap into more adaptive forms of the construct (Tangney &
Dearing, 2002). Therefore, even if researchers define guilt as being both maladaptive and
adaptive, the instrument itself may be biased towards capturing more adaptive features due to
the scenarios presented.
Definitions were also influenced by overarching theoretical perspectives. A variety of
approaches were used by the 10 measures, but the Functionalist Approach appears to hold
greatest utility for guilt measurement. Allowing for a more balanced perspective of guilt,
incorporating both maladaptive and adaptive properties, may increase the scope and validity
of guilt measures (Bybee, 1998). Still, even within this Functionalist Approach, a variety of
limitations are noteworthy. For example, developmental and diversity-related issues remain
neglected. The Functionalist Approach, like many of the other approaches, is based more on
therapeutic rather than Applied Psychology principles (Ferguson, et al., 1999). Future
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research should address these requirements through the development of a new, more
comprehensive model of guilt in young people.
Developmental Considerations
The definition and measurement of guilt changes as a young person develops. An
appreciation of associated age and cognitive capacity is therefore vital. Despite this, some
studies used samples in which children and adolescents were grouped together (Tilghman-
Osborne, et al., 2010). Similarly, adult measures were often applied and adapted for use with
children and adolescents, without assessing the developmental influences underlying the
construct (Tilghman-Osborne, et al., 2010).
The type of informant is also noteworthy, changing from observational and parent-
reported to self reported with age. Comparing guilt measures for toddlers with similar
measures for children or adolescents was therefore difficult. Guilt in toddlers was often
measured through parent-reported or observational methods. Self-report was generally
introduced to school-age children- the most commonly sampled age group of the 10
measures. Self-report is however complicated with young children by the fact that
respondents may lack the linguistic sophistication necessary to understand the multiple and
sometimes ambiguous definitions of guilt (Bybee, 1998).
There was also a substantial gap in adolescent-specific measures. Only two measures
focused specifically on adolescents and both were limited in scope: one looked at perceived
parental guilt induction whilst the other, although validated in a large adolescent sample, was
adapted from a pre-existing child measure (Donatelli, et al., 2007; Tangney & Dearing,
2002). Adolescents were often caught in the middle of child and adult measures, with neither
fully capturing their unique experiences. The transition issues related to adolescence,
including changing identities and responsibilities, are likely to have a unique relationship
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with guilt. Indeed, guilt has been reported to increase in complexity during this age span
(Bybee, 1998). Adolescence is also a time in which many mental health disorders, such as
depression and eating disorders, emerge for the first time (Bybee, 1998). A better
understanding of guilt and its measurement during this age span is vital.
Type of Measure
A variety of formats were used by the 10 measures, including self-reported scenario-
based and semi-projective, observational and parent-reported measures. The self-reported
measures often used Likert scales, but these varied from three-point scales to seven-point
scales and so were difficult to compare. A benefit of using semi-projective measures is that
they may be more likely to capture the young person’s private world and experiences (Zahn-
Waxler, et al., 1990). Socially-desirable responses are also less common as children ascribe
feelings to a fictional story character rather than to themselves (Ferguson, et al., 1999).
Research indicates that children are more likely to admit to negative emotions when they are
not portrayed as the main character (Bybee, 1998). This strategy is most commonly used by
semi-projective measures and, consequently, these measures tend to capture more
maladaptive features of guilt (Zahn-Waxler, et al., 1990).
Semi-projective measures may however not be accurate in predicting children’s actual
behaviour (Bybee, 1998). In contrast, an advantage of using observational methods is that
they increase the ecological validity of results (recording behaviour in real-life situations)
(Kochanska, et al., 2002). Like semi-projective measures, observational data also appear to
capture maladaptive patterns of guilt (Kochanska, et al., 2002). Observational data are
however more difficult to obtain and may not be practical for older children. The relationship
between observational data and self or parent-reported data is unclear and should be further
researched. As only a limited number of semi-projective and observational measures were
sourced, generalizations and trends were difficult to determine.
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In comparison, scenario-based measures were most commonly reported. Scenario-
based measures allow the experimenter to measure guilt in relation to specific behaviours
(Tangney & Dearing, 2002). They therefore do not rely on the respondent’s ability to define
guilt or to distinguish it from related constructs such as shame (Tangney & Dearing, 2002).
This increases the measure’s adaptability to younger age groups (Tangney & Dearing, 2002).
In comparison to check-list type measures, they are also less likely to evoke defensive
reactions or denial responses (Tangney & Dearing, 2002).
Despite these advantages, scenario-based measures also possess significant
limitations, including a failure to grasp whether the young person has ever been involved in
the situation presented. The portrayed situations are also limited in variety and diversity.
This applies to different cultures as well, as the majority of scenario-based measures were
developed and validated in American samples (and so situations may be particularly relevant
to this culture only). They may also measure moral standards, social adjustment and
consensual societal values rather than the personal construct of guilt itself, thereby potentially
biasing adaptive guilt and failing to capture more maladaptive forms (Tangney & Dearing,
2002). The different scenario-based measures also differed in their use of pictorial aids; these
images are culturally bound and may have influenced responses. Furthermore, some of the
most commonly used scenario-based measures, such as the TOSCA-C and TOSCA-A, were
developed over two decades ago. The applicability of associated situations is questionable in
more current cohorts. For example, these measures do not consider technological influences
of social media, which is highly relevant for many young people in today’s society. Despite
these limitations, scenario-based measures appear to be the most appropriate measure for
school-aged children and adolescents.
Semi-idiographic measures (e.g. asking a person to recall a time when they felt guilty)
were not mentioned in the literature. As they may provide more personally relevant data,
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their complementary use with other forms of guilt measures should be considered in future
research. Only one parent-reported measure, My Child, was available. Unlike child and
adolescent measures within other areas, such as the Achenbach Child Behavior Checklist and
Teacher Report Form, no complementary parent- and teacher-reported guilt measures were
found (Achenbach, McConaughy, & Howell, 1987). Similarly, joint child/adolescent and
parent-reported guilt measure sets were not found in the literature. This trend expands to
other informants, such as siblings and peers, and should be explored in future research.
Item Generation
Many of the measures were based on previously developed child and adolescent
instruments, often adapted without addressing original flaws. Many measures were therefore
constrained by limitations of their predecessors, contributing limited new knowledge to the
research base. The majority of measures also employed experimenter-generated items. This
process significantly limits the ecological validity of the measure, potentially failing to
capture young people’s experiences (Tangney & Dearing, 2002). Measures should instead be
developed from interviews with children and adolescents.
Measure Evaluation
Very few studies piloted their measure. Pilots allow researchers to test and revise
materials before larger validation studies are conducted. Although they are often more costly
and time-consuming, they can help refine measures and ensure validity (Tilghman-Osborne,
et al., 2012). The majority of measures were examined cross-sectionally only. Continued
research should look at how the measurement of guilt changes in children and adolescents
over time. Measures were also often evaluated with small sample sizes and in urban settings,
thus limiting the generalisability of results.
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Data on reliability and validity were inconsistent and difficult to compare. Very few
studies reported on validity. The majority of measures noted good Cronbach alphas,
indicating that they were internally consistent. No effect sizes were reported and even an
attempt to generate effect sizes was problematic due to the lack of data. Discriminant validity
(e.g. whether the measure is capturing guilt or shame) was of particular concern as many of
the measures did not report on the value. Very few studies outlined their validation
procedures. Similarly, few measures were validated against qualitative measures such as
semi-structured interviews or behavioural methods. Future studies should aim to explicitly
address validity and reliability.
A consideration of confounding factors such as shame, anger, anxiety, worry,
depression, embarrassment, fear and empathy are vital in preventing inflated estimates of
guilt (Tilghman-Osborne, et al., 2010). The majority of measures contained items that
confounded guilt with other constructs. Shame, as it is so closely related to guilt, is one of
the most important confounding factors to consider. Social desirability is also important
because young people may provide the answer that they feel the experimenter, most likely an
adult, wants to hear (Tangney & Dearing, 2002). They may also be defensive about guilt and
under-report to preserve self-image (responses essentially influenced by feelings of guilt).
None of the measures looked at the confounding factors of shame, anxiety and depression
together. These factors have important implications clinically, with all four constructs being
highly related, and should be addressed in future research (Tilghman-Osborne, et al., 2012).
Cultural & Diversity Issues
Gender differences in the experience of guilt were inconsistent and highly dependent
on the type of measure used. An investigation of gender differences specifically during
adolescence was not found. Of the studies that did find significant influences of gender, there
were conflicting reports as to whether guilt was reported more often by males or females.
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This may have been influenced by unequal sample distributions: the majority of papers in this
review (including cross-cultural papers) recruited more females than males during measure
development and/or validation. Consequently, the current measures of guilt may be gender-
biased. Scenario-based measures in particular may be presenting stereotypical notions of
femininity and masculinity. For example, situations that are more interpersonal in nature
(e.g. evoking the ‘carer’ image often associated with females) may be biased towards female
respondents. The type of situation is therefore very important in capturing gender
differences.
In terms of gender and responses to acts of wrongdoing, none of the measures
specifically examined relational forms of aggression. This type of aggression (in which harm
is caused by injuring or manipulating a relationship) is most commonly used by females;
physical aggression (harming or threatening to harm through physical damage) is in contrast
much more common in males (Young, Boye, & Nelson, 2006). Examples of relational
aggression include isolating/excluding peers or gossiping (Young, et al., 2006). Excessively
inducing guilt in peers may also be a form of relational aggression. The measurement of guilt
in situations surrounding relational aggression is therefore an area that should be explored in
future research.
The influence of sexuality and religion on the measurement of guilt in young people
has been essentially ignored by researchers. Questions remain in relation to if (and how)
young people experience guilt in relation to issues such as promiscuity, orientation, gender
identity and teenage pregnancy. Similarly, different religions approach guilt, sins and
forgiveness in varying ways, potentially influencing personal experiences and reporting of
guilt. In terms of SES, the majority of measures recruited from middle-upper class
backgrounds. This lack of diversity limits the generalisability of the available measures to
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young people from more disadvantaged backgrounds. Future research should be cognisant of
this fact.
Only one measure was developed and validated in a non-American population
(Olthof, et al., 2000). Consequently, the current definition and measurement of the construct
may be essentially American. Future investigations should be conducted within a UK child
and adolescent population. Aspects such as the UK schooling system and its historical
Church of England influence may shape cultural experience of guilt. Similarly, Britain’s
history of colonialism may have unique inter-generational implications for the collective
expression and understanding of guilt. Stylistic differences in written language have also
been noted; American English uses more “mood”-related words than British English (Acerbi,
Lampos, Garnett, & Bentley, 2013). This may translate to a decreased acceptability of
emotional expression within British culture and has implications for the cross-cultural utility
of the available guilt measures.
The majority of child and adolescent guilt measures were also developed and
validated in non-diverse American samples of primarily White ethnicity. Validity in
ethnically diverse populations is therefore questionable. No study made specific mention of
second-generation immigrants, who may struggle with unique aspects of guilt (not captured
in available measures) in relation to personal identities and the process of assimilating old
and new cultural values. The TOSCA-C was the only child and adolescent measure to be
evaluated cross-culturally. The two studies however had conflicting results: Bear et al (2009)
reported that culture did have an impact on the construct and measurement of guilt, whereas
Furukawa et al (2011) noted more similarities than differences.
The results of Furukawa et al (2011) should be examined with caution, as the
American sample was far more representative than the Japanese and Korean samples (688
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children versus 144 and 180 children respectively). The American data were also collected a
decade earlier than the Japanese and Korean data, so cohort effects may have been present.
Important global events may have differentially impacted guilt conversations in the 1990s
(e.g. reunification of Germany) and the early-2000s (e.g. American World Trade Center
terrorist attacks). Appreciation of the influence of socio-cultural context was essentially
ignored, as the authors attempted to compare datasets regardless of these differences. Data
were also collected from urban school settings only. Urban Korean and Japanese settings
may have more exposure to technology and other sources of globalisation than rural areas,
therefore potentially failing to capture more diverse cultural experiences of guilt.
Additional limitations are common to both cross-cultural studies. Most importantly,
the TOSCA-C was validated in an American English-speaking population and so the
scenarios listed may not be relevant or applicable to other cultures. In terms of design, both
studies were correlational and so a consideration of causation was not possible. The samples
of both studies had unequal representations of male and female participants and were non-
clinical (thus lacking generalisability to clinical groups). Both samples also compared
American samples to Asian cultures only; consideration was not given to other cultures.
Given these methodological limitations, conclusions on the cross-cultural validity of
available child and adolescent guilt measures cannot be made. Current measures may be
lacking culturally sensitive scenarios and language; more research is urgently needed.
Development of a Robust Measure
Following their review in 2010, Tilghman-Osborne et al went on to develop a child
and adolescent guilt measure in 2012. This measure (IEGS) was developed in response to the
numerous discrepancies and limitations noted in the 2010 review (Tilghman-Osborne, et al.,
2012). This study was well-designed with a strong theoretical basis, careful consideration of
the construct of guilt, large sample size and was piloted in a clinical sample (Tilghman-
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Osborne, et al., 2012). It addressed many of the confounding factors that had influenced
other guilt measures. It was well evaluated, demonstrating good construct, incremental,
discriminant and convergent validity (Tilghman-Osborne, et al., 2012).
Still, it is not without its limitations. The measure itself is very specific, designed to
capture inappropriate and excessive guilt (as it relates to the diagnosis of depression), rather
than transdiagnostic. Items were generated by researchers rather than young people, meaning
that the construct of guilt may not be age-appropriate. Reliability of the measure was not
reported. Furthermore, the measure grouped children and adolescents together, not allowing
for developmental considerations across these age groups. The sample also lacked diversity
(e.g. 94% White) and, like the majority of measures, was developed and validated in an
American population. It was also the only measure in which monetary benefit was provided
to participants, which may have influenced participation and responses. Although it is of
high quality in comparison to the other available measures, there remains a significant gap for
a gold standard child and adolescent measure.
Implications & Utility of Measure
These findings have potential implications for parenting and clinical practice.
Parental guilt induction, as addressed in Donatelli et al (2007)’s MGI measure, has been
briefly considered in the guilt literature, but is deserving of more attention. Used
appropriately, and within the context of stable and loving relationships, it may contribute to
the young person’s wellbeing and social adjustment (Bybee, 1998). This has further
implications for parental involvement and training in prevention, early intervention and
treatment programmes for children. More research is needed on the effectiveness of parental
guilt induction, including its application, measurement and acceptability in different cultural
backgrounds.
236
Influences of parental mental health were also largely neglected in the literature
(considered only in two studies, both restricted to maternal depression only) (Donatelli, et al.,
2007; Zahn-Waxler, et al., 1990). A young person with a mentally unwell parent may take on
more responsibility at home, which may in turn influence their experience of guilt (and
associated wellbeing). The development of a new and robust guilt measure may provide
better insight and understanding into the therapeutic management of child and adolescent
emotional and behavioural responses (e.g. depression, antisocial behaviour) (Bybee, 1998).
Empirically-valid measures provide rich information for clinical assessment and treatment
and are actively encouraged as best practice in the UK National Health Service (NHS)
(Goldbeck-Wood & Fonagy, 2004). A measure for the clinical context is therefore needed,
particularly for adolescence when many mental health difficulties initially arise (Bybee,
1998).
Limitations
Accessibility to the literature is a primary limitation. In their review, Tilghman-
Osborne et al noted that, despite finding eight measures for young people, additional
measures were identified but unobtainable. This experience was mirrored in the present
review, as 19 child and adolescent measure citations were located in the literature but access
was granted to only ten (see Appendix B). The remaining papers were unpublished and
inaccessible within the public domain. For some of the measures (e.g. My Child), newer
adaptations have been constructed and validated but were not accessible and so not included
in the present review. Some of the original papers (TOSCA-C, TOSCA-A and C-CARS)
were not publically accessible and so subsequently published papers describing development
and validation of the measure were used instead. Despite these limitations, a number of
strengths are noteworthy. Most importantly, this is the first review to look specifically at the
237
measurement of guilt in child and adolescent populations. The above findings (especially
with regard to diversity and culture) are therefore novel within the literature.
Concluding Thoughts
The aim of the present review was to examine how guilt is measured in children and
adolescents. Due to a general lack of research in the field, more questions than answers
remain. From the present findings, four central questions emerge for future research: how
should guilt be measured across adolescence, does the measurement of guilt in children and
adolescents change cross-culturally, what implications does guilt have on the mental health of
children and adolescents and what would a new theoretical model of guilt for children and
adolescents look like. Continued research will enhance Psychology’s understanding of the
construct of guilt, its measurement and applications for the early intervention and treatment
of associated difficulties in children and adolescents.
238
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245
APPENDIX A. Measures of Guilt- Adults
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1. Personal Feelings Questionnaire (‘PFQ’) (Harder & Zalma, 1990)
2. Test of Self-Conscious Emotions (TOSCA) (Tangney, Wagner, & Gramzow, 1989)
3. The Guilt Inventory (Kugler & Jones, 1992)
4. Interpersonal Guilt Questionnaire (O'Connor, Berry, Weiss, Bush, & Sampson, 1997)
5. Trauma-Related Guilt Inventory (Kubany et al., 1996)
6. The Guilt and Shame Proneness Scale (‘GASP’) (Cohen, Wolf, Panter, & Insko, 2011)
7. Shame and Guilt Scale (SGS) (Alexander, Brewin, Vearnals, Wolff, & Leff, 1999)
8. Guilt and Shame Vignettes (GSV) (Benetti-McQuoid & Bursik, 2002)
9. Feelings of Guilt in Major Depression (FGMD) (Berrios et al., 1992)
10. Fear of Punishment and Need for Reparation Scales (FPNR) (Caprara, Manzi, & Perugini, 1992)
11. Guilt and Shame (Hogan & Cheek, 1983)
12. Beall Shame-Guilt Test (Beall, 1972)
13. Reaction Inventory (RI) (Evans, Jessup, & Hearn, 1975)
14. Adapted Shame/Guilt Scale (ASGS) (Hoblitzelle, 1982)
15. Differential Emotional Scale-IV (DES-IV) (Blumberg & Izard, 1986)
16. Dimensions of Consciousness Questionnaire (DCQ) (Johnson et al., 1987)
17. Shame and Guilt Scale (SGS) (Klass, 1987)
18. Revised Mosher Forced-Choice Guilt Inventory (RMFCGI) (Mosher, 1966)
19. Perceived Guilt Inventory (PGI) (Otterbacher & Munz, 1973)
20. Positive and Negative Affect Scale-Extended (PANAS-X) (Watson, Clark, & Tellegen, 1988)
21. Emotional Experience Questionnaire (EEQ) (Scherer, 1986)
22. Weight- And Body- Related Shame and Guilt Scale (WEB-SG) (Conradt et al., 2007)
23. The Offence-Related Shame and Guilt Scale (Wright & Gudjonsson, 2007)
24. The Shame and Guilt Scale (Gilbert, Allan, & Pehl, 1991)
25. Buss and Durkee Guilt Scale (Buss & Durkee, 1957)
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APPENDIX B. Measures of Guilt- Children and Adolescents
248
9. Self-Conscious Emotions Questionnaire for Children (Dissertation) (Haimowitz, 1996)
10. Story Completion Measure (Hoffman, 1975)
11. My Child Guilt (Kockanska et al., 1994)*
12. My Child-Shame; My Child-Guilt (Ferguson, Stegge, & Barrett, 1996)
13. Inappropriate and Excessive Guilt Scale (Tilghman-Osborne et al 2012)*
14. Interpersonal Guilt Questionnaire – Adolescent Adaptation, Dissertation (Smith, 1998)
15. Clown-Doll Paradigm (Barrett et al., 1993)*
16. State Shame and Guilt Scale (SSGS) (Marschall, Sanftner, & Tangney, 1994)
17. Children’s Interpretations of Interpersonal Distress and Conflict (CIIDC) (Zahn-
Waxler et al., 1990)*
18. Shame and Guilt Questionnaire (Olthof et al 2000)*
19. Trait Affect Measure (Bybee & Williams, 1995)
20. Test of Self-Conscious Emotions- Adolescent Version (TOSCA-A) (Tangney & Dearing,
2002; Tangney, Wagner, Gavlas, & Gramzow, 1991)*
21. Test of Self-Conscious Emotions- Child Version (TOSCA-C) (Tangney & Dearing, 2002;
Tangney, Wagner, Burggraf, Gramzow, & Fletcher, 1990)*
22. Child-Child Attribution and Reaction Survey (C-CARS) (Ferguson, et al., 1999; Stegge
& Ferguson, 1990)*
23. Self Conscious Emotions, Maladaptive and Adaptive Scale (SCEMAS) (Stegge & Ferguson,
1994)
24. Children’s Guilt Inventory (J. Bybee, Williams, & Merisca, 1996)
25. The Maladaptive Guilt Induction Measure (Donatelli et al., 2007)*
*Articles publically available and sourced for review
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APPENDIX C. Additional Papers Sourced for Review
250
Additional Papers Sourced for ReviewAuthor (Date) Title Country Aim Sample Size and
AgeMeasure Setting Design and
Evaluation Methods
Outcome
Baker et al (2012)
Development of fear and guilt in young children: stability over time and relations with psychopathology
Wales To examine association between behaviour and physiological measures of fear and guilt and whether fear in infancy predicts guilt in toddlers.
70 mother-child dyads. Children were aged 1 to 3.
Behavioural Coding (Lab-TAB Fear Paradigm and Mishap Guilt Paradigm), Mother-Reported Fear (Infant Behaviour Questionnaire Revised), Physiological Reactivity (skin conductance level and heart rate) and Mother-Reported Psychopathology (The Child Behaviour Checklist).
Local nurseries and play centres/non-clinical.
Longitudinal; quantitative. Children were seen three times- at ages 1, 2 and 3.
Fear and guilt were significantly associated across measures. Assessments of children in infancy are predictive of how children react 2 years later and therefore lend support to the idea that the emotional thermostat is set in that first 3 years of life. Infant fear is a predictor of guilt, which is an emotion that develops later.
Hosser et al (2008)
Guilt and shame as predictors of recidivism: a longitudinal study with young prisoners.
Germany To examine to what extent feelings of shame and guilt experienced during a prison term influenced recidivism after release.
1243 young people aged 14-24
EMO-16-Week Scale (a German measure; addresses frequency of occurrence of 16 emotions- shame and guilt included) and
Prison- male youth offenders
Longitudinal Feelings of guilt at the beginning of a prison term correlated with lower rates of recidivism, and feelings of shame correlated with higher rates. Feelings of guilt are a protective factor and feelings of shame
251
interviews. are destructive.
Tilghman-Osborne et al (2008)
Relation of Guilt, Shame, Behavioural and Characterological Self-Blame to Depressive Symptoms in Adolescents Over Time.
USA To examine the relation of depressive symptoms and depressive cognitions to shame, guilt, CSB (characterological self-blame) and BSB (behavioral self blame); to estimate the longitudinal relations between depressive symptoms and measures of shame, guilt, BSB and CSB; and to assess the convergent and discriminant validity of shame/CSB measures and guilt/BSB measures.
221 adolescents
(aged 11-18)
TOSCA-A, State Shame and Guilt Scale (SSGS), Self-Blame Measures, Attributional Blame Questionnaire, Child Depression Inventory (CDI), Center for Epidemiological Studies Depression Scale for Children (CES-DC).
High schools- non clinical
Longitudinal (over 5-months).
Shame and CSB converge onto a common construct and are significantly related to depressive symptoms and cognitions. Convergence of guilt and BSB, however, was limited to particular pairs of measures.
Walter and Burnaford (2006)
Developmental Changes in Adolescents' Guilt and Shame: The role of family climate and gender.
USA To explore the relationship between family closeness and self conscious emotions (e.g. shame and guilt)
176 adolescents aged 12-20years
TOSCA-A, Family Closeness Questionnaire
Non-clinical; schools.
Cross-sectional, quantitative
Adolescents from divorced/separated families and those from intact families did not differ in their reported levels of shame and guilt.
252
across adolescence, later adolescence and young adulthood.
Guilt increased with age, but the developmental progression of shame varied by gender. Girls reported more shame and guilt than did boys.
Bear et al (2009) Shame, guilt, blaming and anger: differences between children in Japan and the US.
USA and Japan
To examine the cultural differences (between Japan and USA) in anger, shame, guilt and externalisation of blame.
USA Sample: 130; Japanese Sample: 118. Children aged 9 to 10 years.
Multidimensional School Anger Inventory, TOSCA-C.
Schools, non-clinical.
Cross-cultural cross-sectional comparison.
Compared to American children, Japanese children were more prone to experience shame and guilt and less likely to externalise blame. They were also more likely to experience anger.
Furukawa et al (2011)
Cross-cultural continuities and discontinuities in shame, guilt and pride: a study of children residing in Japan, Korea and the USA
USA, Japan, Korea
To examine cross-cultural continuities and discontinuities in shame, guilt and pride in children residing in Japan, Korea and the USA.
144 Japanese, 180 Korean, 688 USA. Aged 8 to 11 years.
TOSCA-C, Children's Inventory of Anger-Short Form, Anger Response Inventory-Children, Teacher's Child Behaviour Checklist, Devereux
Schools, non-clinical.
Cross-cultural, cross-sectional comparison.
Results supported the cross-cultural equivalence of the TOSCA-C.
Significant differences were observed, with Japanese children scoring highest on shame, Korean
253
Behaviour Rating Scale- School Form.
children scoring highest on guilt, and American children scoring highest on pride.
Patterns of correlations were however more similar than different across cultures.
254
CLINICAL EXPERIENCE
255
My first, year-long, placement was in a working-age adult community mental health
team (CMHT). In this placement, I co-facilitated three different groups: Cognitive
Behavioural Therapy (CBT) for Insomnia, CBT for Bipolar and a CBT coping skills groups.
I also conducted individual interventions using a range of different models, including CBT,
Systemic, Compassion-Focused Therapy (CFT) and Mindfulness-Based Cognitive Therapy
(MBCT). My caseload included service users with a range of presentations and diverse ethnic
and socioeconomic backgrounds. I also gained experience with a range of cognitive
assessments, outcome measures, was involved in initial assessments and had the opportunity
to supervise an assistant psychologist on a piece of clinical work.
For my six-month Child and Family placement, I was split between a Child and
Adolescent Mental Health Service (CAMHS) and a Looked After Children’s (LAC) Service.
This placement involved staff consultations, as well as direct work with foster carers and
young people in care. I gained experience with a wide range of models, including Dyadic
Developmental Psychotherapy (DDP), Systemic theory, Narrative approaches, Social
Constructionist approaches, CBT and Behavioural Therapy. The young people I worked with
were from diverse backgrounds and often had very complex histories and presentations,
which encouraged me to think critically about the available evidence base for looked after
children as well as how outcome measures are applied and interpreted in such settings. My
involvement would also often involve navigating and containing complex networks around
the child, which developed my leadership, reflective and communication skills. I also gained
experience of conducting a range of cognitive assessments, was involved in initial
assessments and further developed my formulation and teaching skills.
In my six-month Older Adults placement, I was split between an Older Adults
community mental health team (CMHT) for adults over the age of 75 with mental health
problems, a Memory Assessment service (e.g. dementia assessments) and a challenging
256
behaviour service (with work based mainly in care homes). I gained experience of working
indirectly with care staff and family members and directly with older adults. I conducted a
range of cognitive assessments and employed systemic, narrative, CBT and psychodynamic
models in supervision and clinical work. I continued to build up my confidence as a
clinician, and began to work more flexibly, creatively and independently. I also supervised
an Assistant Psychologist on a service evaluation research project concerning challenging
behaviour and staff burnout. In addition to this, my teaching, assessment, intervention and
complex formulation skills continued to develop.
In my learning disabilities placement, I was split between Psychology and
Challenging Behaviour teams within a local council’s learning disabilities service. As this
was a social care setting, I was given the opportunity to further develop my multidisciplinary
team working skills. I also learnt to tailor my use of language depending on client cognitive
and language abilities and staff/client group (e.g. with day centre staff, family members,
Psychology network meetings). I worked directly with clients with learning disabilities and
indirectly with care staff and family members in a range of settings. I had the opportunity of
working with transition clients (aged 18-21), as well as adult clients, with diverse
backgrounds and a range of presentations. I also gained experience of using a range of
assessment tools (e.g. supporting the diagnosis of learning disabilities, assessment of sexual
knowledge, autism screenings) and conducting interventions using behavioural, CBT and
systemic models. The placement provided me with opportunities to conduct training
workshops for other professionals, joined-up partnership working and learning more about
service delivery and development.
In my final six-month specialist placement, I split my time between a national
specialist inpatient unit for Deaf children and adolescents (aged six to eighteen), a national
inpatient service for young people with eating disorders and a national outpatient service for
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Deaf children and adolescents. My clinical work included direct individual and group
interventions, clinical assessments (e.g. formal observations, functional assessments,
cognitive assessments, gathering information from the Team Around the Child) and indirect
work with staff (e.g. staff consultation, formulation meetings and facilitating weekly
reflective groups for ward nursing staff). The inpatient settings provided opportunities to
work with young people with a range of acute mental health difficulties, who were often
under section. I gained exposure to a variety of therapeutic models, including CBT,
Dialectical Behaviour Therapy (DBT), Cognitive Remediation Therapy (CRT), systemic,
Mentalization Based Therapy (MBT) and Behavioural therapy. As I was new to the Deaf
community, I also started learning British Sign Language alongside the placement, which
allowed me to explore how to work therapeutically in a new culture and with a different
language, as well as adjusting and adapting to working with interpreters. My formulation,
leadership and supervisory skills also developed in this placement, and I chaired many team
and wider network meetings. As most interventions, assessment tools and outcome measures
have not been standardised for Deaf young people, I also learnt how to tailor these elements
to the individual child and family.
258
ASSESSMENTS
259
Year I Assessments
PROGRAMME COMPONENT
TITLE OF ASSIGNMENT
Fundamentals of Theory and Practice in Clinical Psychology (FTPCP)
Short report of WAIS-III data and practice administration
Practice case report Cognitive Behavioural intervention with an older woman presenting with Bipolar Disorder
Problem Based Learning – Reflective Account
The Relationship to Change
Research – Literature Review
The measurement of guilt in children and adolescents: a literature review
Adult – case report Cognitive Behavioural intervention with young woman diagnosed with Psychotic Illness
Adult – case report Mindfulness-Based Cognitive Therapy intervention with young woman diagnosed with Postnatal Depression
Research – Qualitative Research Project
Trainee Clinical Psychologists’ experiences of religion: An Interpretive Phenomenological Analysis
Research – Major Research Project Proposal
The development of a new measure of guilt-proneness for adolescents
Year II Assessments
PROGRAMME COMPONENT
TITLE OF ASSESSMENT
Research - SRRP An evaluation of an informational DVD for service users in a Traumatic Stress Service
Research Research Methods and Statistics test
Professional Issues Essay ‘Physical contact with clients/service users is never acceptable. Discuss this statement in the context of clinical psychology practice across the lifespan and specialities’
Problem Based Learning – Reflective Account
PBL Reflective Account: ‘The Stride Family’
People with Learning Disabilities/Child and Family/Older People – Case Report
Integrative intervention with a young person within a Looked After Children’s service
260
Personal and Professional Learning Discussion Groups – Process Account
Process Account
People with Learning Disabilities/Child and Family/Older People – Oral Presentation of Clinical Activity
Development of my systemic intervention skills as a Trainee Clinical Psychologist
Year III Assessments
PROGRAMME COMPONENT
ASSESSMENT TITLE
Research – MRP Portfolio Development of a semi-idiographic measure of guilt-proneness for adolescents
Personal and Professional Learning – Final Reflective Account
On becoming a clinical psychologist: A retrospective, developmental, reflective account of the experience of training
Child and Family/People with Learning Disabilities/ Older People/Specialist – Case Report
Neuropsychological assessment with a middle-aged man with a suspected learning disability and autism spectrum disorder
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