Processes and mechanisms

Guilt

Concern about an action or responsibility for harm, distinct from but overlapping with global shame.

Affect/meaningClinically reviewed

AffectCognition

Fit, function and alternatives

Test this factor against the case

A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.

Check alternatives

Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.

Next steps

Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.

Qualification

Check proportionality and context. Do not presume guilt is adaptive or that shame and guilt are mutually exclusive.

Caveats for this record

Educational formulation aid, not a diagnostic instrument, score or treatment order.
No generated history, trauma, protective factor, or patient preference may be asserted without case evidence.

Record status

Record type: Affect/meaning
Population: Adult-general clinical formulation; apply narrower source population limits
Review: Clinically reviewed

Evidence

S38An examination of the relationship between shame, guilt and self-harm: A systematic review and meta-analysis

Clinical Psychology Review (Elsevier) · 10.1016/j.cpr.2019.101779 · Bibliographic record and abstract. Abstract/results/limitations.

Sparse longitudinal evidence and uncertain direction. Do not generalise all NSSI evidence to suicide death or to all ages.

Link withheld: this source remains held and is cited as metadata only.

Evidence references only. Each source's own limitations still apply.

Processes and mechanisms

Affect intolerance Checking / compulsive response Conditioning / learned associations Distress-driven impulsivity / negative urgency Hopelessness / future constriction Intolerance of uncertainty

Guide modules

Rapid clinical formulation guide Foundations, terminology and evidence limits Practical assessment-to-formulation workflow Risk formulation and management linkage Documentation templates and worked examples

How to use this

Record the case evidence yourself. Nothing here is a patient finding, and no factor becomes a cause because it appears in the formulation.

Processes and mechanisms

Guilt

Concern about an action or responsibility for harm, distinct from but overlapping with global shame.

Affect/meaningClinically reviewed

AffectCognition

Fit, function and alternatives

Test this factor against the case

A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.

Check alternatives

Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.

Next steps

Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.

Qualification

Check proportionality and context. Do not presume guilt is adaptive or that shame and guilt are mutually exclusive.

Caveats for this record

Educational formulation aid, not a diagnostic instrument, score or treatment order.
No generated history, trauma, protective factor, or patient preference may be asserted without case evidence.

Record status

Record type: Affect/meaning
Population: Adult-general clinical formulation; apply narrower source population limits
Review: Clinically reviewed

Evidence

S38An examination of the relationship between shame, guilt and self-harm: A systematic review and meta-analysis

Clinical Psychology Review (Elsevier) · 10.1016/j.cpr.2019.101779 · Bibliographic record and abstract. Abstract/results/limitations.

Sparse longitudinal evidence and uncertain direction. Do not generalise all NSSI evidence to suicide death or to all ages.

Link withheld: this source remains held and is cited as metadata only.

Evidence references only. Each source's own limitations still apply.

Processes and mechanisms

Affect intolerance Checking / compulsive response Conditioning / learned associations Distress-driven impulsivity / negative urgency Hopelessness / future constriction Intolerance of uncertainty

Guide modules

How to use this

Record the case evidence yourself. Nothing here is a patient finding, and no factor becomes a cause because it appears in the formulation.