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Volume 7
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Article

Invisible Scars: Psychopathology, Shame and Self-Judgment Following Perinatal Loss—A Cross-Sectional Study

by
Mariana Ribeiro
1,*,
Paula Saraiva Carvalho
1,2,
Ana Torres
1,2,3 and
Dário Ferreira
4
1
Department of Psychology and Education, University of Beira Interior, 6200-209 Covilhã, Portugal
2
Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Beira Interior, 6201-001 Covilhã, Portugal
3
RISE-Health Department of Medical Sciences, Faculty of Health Sciences, University of Beira Interior, 6200-506 Covilhã, Portugal
4
Department of Mathematics, Center of Mathematics and Applications, University of Beira Interior, 6201-001 Covilhã, Portugal
*
Author to whom correspondence should be addressed.
Psychiatry Int. 2026, 7(1), 43; https://doi.org/10.3390/psychiatryint7010043
Submission received: 13 November 2025 / Revised: 26 January 2026 / Accepted: 4 February 2026 / Published: 16 February 2026
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Abstract

Perinatal loss affects 23 million pregnancies worldwide each year, representing a painful experience that disrupts expectations and impacts emotional, physical, social, and spiritual well-being. This cross-sectional observational study assessed symptoms of anxiety, depression, self-judgment (self-criticism, isolation, over-identification), and shame in women who experienced perinatal loss, as well as their predictive value for psychopathology. Participants were 501 women, divided into five groups according to time since loss: 0–6 months, 7–18 months, 19–30 months, 31–42 months, and more than 43 months. Findings showed that women 7–18 months post-loss reported the highest psychopathology levels, with significant differences in anxiety. Isolation and shame were the strongest predictors of depressive and anxiety symptoms. Although symptoms decreased over time, they remained elevated years after the loss. These results underscore the lasting psychological impact of perinatal loss and the importance of sustained recognition, assessment, and intervention to support women’s mental health.
Keywords: psychopathology; shame; self-judgment; perinatal loss psychopathology; shame; self-judgment; perinatal loss

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MDPI and ACS Style

Ribeiro, M.; Carvalho, P.S.; Torres, A.; Ferreira, D. Invisible Scars: Psychopathology, Shame and Self-Judgment Following Perinatal Loss—A Cross-Sectional Study. Psychiatry Int. 2026, 7, 43. https://doi.org/10.3390/psychiatryint7010043

AMA Style

Ribeiro M, Carvalho PS, Torres A, Ferreira D. Invisible Scars: Psychopathology, Shame and Self-Judgment Following Perinatal Loss—A Cross-Sectional Study. Psychiatry International. 2026; 7(1):43. https://doi.org/10.3390/psychiatryint7010043

Chicago/Turabian Style

Ribeiro, Mariana, Paula Saraiva Carvalho, Ana Torres, and Dário Ferreira. 2026. "Invisible Scars: Psychopathology, Shame and Self-Judgment Following Perinatal Loss—A Cross-Sectional Study" Psychiatry International 7, no. 1: 43. https://doi.org/10.3390/psychiatryint7010043

APA Style

Ribeiro, M., Carvalho, P. S., Torres, A., & Ferreira, D. (2026). Invisible Scars: Psychopathology, Shame and Self-Judgment Following Perinatal Loss—A Cross-Sectional Study. Psychiatry International, 7(1), 43. https://doi.org/10.3390/psychiatryint7010043

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