The socioeconomic roots of shame and perceptions of social inadequacy


  • lloyd Brandts
  • Hans Bosma
  • Audrey Simons
  • Danielle Groffen
  • Marjan Akker, van den



Introduction. Cumulating reports on the adverse health effects of income inequality hypothesise on underlying processes related to health compromising, negative social comparisons in people with a low socioeconomic status (compared to those who are socioeconomically better-off). As this hypothesis of “internalized inferiority” has not yet been examined explicitly, we set out to examine whether internalized inferiority is indeed more common in low socioeconomic status groups. Method. Dutch SMILE data on 1,477 participants, aged 58-94 in 2008 were used. Income in adulthood (measured several times between 2002 and 2008), education in adulthood (measured several times between 2002 and 2008), education of parents (measured in 2005), and poverty in childhood (measured in 2004) were related to general shame (measured in 2009) and social inadequacy (measured in 2004 and 2008), using logistic regression analyses. Results. Both education and income-related socioeconomic measures from childhood and adulthood had independent associations with social inadequacy. Poverty in childhood was related to reports of general shame. Discussion.In this cohort the socioeconomic status of middle-aged and older men and women, especially its financial component, impacts cognitions and feelings of internalized inferiority. Childhood socioeconomic circumstances, particularly experiences of poverty, contributed independently. Our findings suggest that negative social comparisons and internalized inferiority might be possible key players in the association between low socioeconomic status and poor health.


M. Akker, van den, M., Spigt, M.G., Raeve, de, L., Steenkiste, van, B., Metsemakers, J.F.M., Voorst, van, E.J. & Vries, de, H. (2008). The SMILE study: a study of medical information and lifestyles in Eindhoven, the rationale and contents of a large prospective dynamic cohort study. BMC Public Health. 8:19.

Demakakos, P., Nazroo, J., Breeze, E. & Marmot, M. (2008). Socioeconomic status and health: the role of subjective social status. Social Science & Medicine. 67: 330-340.

Dickerson, S.S., Gruenewald, T.L. & Kemeny, M.E. (2004). When the social self is threatened: Shame, Physiology, and Health. Journal of Personality. 72(6): 1191-1216.

Gilbert, P. (2000). The relationship of shame, social anxiety and depression: the role of the evaluation of social rank. Clinical Psychology and Psychotherapy. 7: 174-189.

Greca La, A.M. & Lopez, N. (1998) Social Anxiety among adolescents: Linkages with peer relations and friendship. Journal of Abnormal Child Psychology. 26(2): 83-94.

Groffen, D.A.I., Bosma, H., Akker van den, M., Kempen, G.I.J.M. & Eijk van, J.Th.M. (2009). Personality and health as predictors of income decrease in old age: Findings from the longitudinal SMILE study. European Journal of Public Health. 19(4): 418-423.

Hamad, R., Fernald, L.C.H., Karlan, D.S. & Zinman, J. (2008). Social and economic correlates of depressive symptoms and perceived stress in South African adults. Journal of Epidemiology and Community Health. 62: 538-544.

Izard, E. E. (1977). Human Emotions. New York: Plenum Press.

Klabbers, G., Bosma, H., Akker van den, M., Boxtel van, M.P.J., Kempen, G.I.J.M., McDermott, M.R. & Eijk van, J.TH.M. (2009) Measuring Rebelliousness and Predicting Health Behavior and Outcomes: An Investigation of the Construct Validity of the Social Reactivity Scale. Journal of Health Psychology. 14(6): 771-779.

Lemeshow, A.R., Fisher, L., Goodman, R., Kawachi, I., Berkey, C.S. & Colditz, G.A. (2008). Subjective social status in the school and change in adiposity in female adolescents. Archives of Pediatrics & Adolescent Medicine. 162: 23-28.

Luteijn, F., Starren, J., & Van Dijk, H. (2000) Handleiding Nederlandse Persoonlijkheids Vragenlijst (herziene uitgave). Lisse: Swets & Zeitlinger.

Mackenbach, J.P. (2005). Genetics and health inequalities: hypotheses and controversies. J Epidemiol Community Health. 59: 268-273.

Marmot, M.G. (2004). The status syndrome: How social standing affects our health and longevity. New York: Times Books.

McEwen, B.S., & Gianaros, P.J. (2010). Central role of the brain in stress and adaption: links to socioeconomic status, health, and disease. Annals of the New York Academy of Sciences. 1186: 190-222

OECD. (2011). Divided we stand. Why inequality keeps rising. OECD: OECD Publishing.

Orth, U., Berking, M. & Burkhardt, S. (2006). Self-conscious Emotions and Depression: Rumination explains why shame but not guilt is maladaptive. Pers Soc Psychol Bull. 32(12): 1608-1619.

Sapolsky, R.M. (2004). Social Status and Health in Humans and Other Animals. Annual Review of Anthropology. 33: 393-418.

Simons, A.M.W., Groffen, D.A.I. & Bosma, H. (2013) Income-related health inequalities: does perceived discrimination matter. International Journal of Public Health. 58(4): 513-520.

Wilkinson, R.G. (2006). Health, Hierarchy, and Social Anxiety. Annals of the New York Academy of Sciences. 896: 48-63.