Barbanel, RCaruana, NLangdon, RBrüne, MSowman, Paul2026-05-252026-05-252026-01-28Cognitive Neuropsychiatry, ISSN: 1354-6805 (Print); 1464-0619 (Online), Informa UK Limited, 30(5-6), 326-345. doi: 10.1080/13546805.2026.26164681354-68051464-0619http://hdl.handle.net/10292/21219Background and Hypothesis: Adaptive management of guilt and shame is regulated by social approach and withdrawal and thus relates to the quantity and quality of our social interactions. People with schizophrenia (SZ) self-report reduced guilt-proneness compared to healthy controls (HC). However, previous studies have not distinguished between anticipatory and consequential guilt, nor between guilty affect and associated action tendencies. Study Design: We compared 24 SZ with 24 HC on anticipatory guilt, (TOSCA-3, GASP); consequential guilt (PFQ-2), and empathy and Theory of Mind (ToM). Study Results: Differing profiles emerged: SZ reported higher consequential relative to anticipatory guilt, while HC reported the opposite pattern. SZ self-reported reduced repair and increased withdrawal compared to HC. In SZ, anticipatory guilt was predicted by empathic concern and ToM; consequential guilt by social withdrawal and ToM skill. Conclusion: SZ participants anticipated equal affective guilt-proneness but reduced adaptive behavioural responses to guilty feelings, resulting in more chronic guilt in daily life than would be predicted by TOSCA-3 and GASP responses. The discrepancy between emotional experience and expression may partly explain previous findings of reduced TOSCA-3 guilt-proneness, as TOSCA-3 operationalises guilt as reparative, prosocial behaviours. Results highlight perceptions of reparation potential as an intervention target, with likely downstream reductions in chronic and delusional guilt and shame.© 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.https://creativecommons.org/licenses/by/4.0/GuiltTheory of Mindempathyperspective-takingschizophreniaself-reportshame5205 Social and Personality Psychology52 PsychologySerious Mental IllnessSchizophreniaClinical ResearchMental HealthBrain DisordersMental Illness11 Medical and Health Sciences17 Psychology and Cognitive SciencesPsychiatry3209 Neurosciences5202 Biological psychologyHumansGuiltMaleFemaleAdultTheory of MindSchizophrenic PsychologyEmpathySchizophreniaMiddle AgedAnticipation, PsychologicalHumansGuiltEmpathySchizophreniaSchizophrenic PsychologyAdultMiddle AgedFemaleMaleTheory of MindAnticipation, PsychologicalHumansGuiltMaleFemaleAdultTheory of MindSchizophrenic PsychologyEmpathySchizophreniaMiddle AgedAnticipation, PsychologicalJournal ArticleOpenAccess10.1080/13546805.2026.2616468