This thesis consists of two parts; firstly a systematic review exploring the role of shame in post-traumatic stress (PTS) symptoms, and following this a exploratory study examining the role of shame in symptoms of social anxiety and depression. The thesis aims to add to understanding of the role in shame in psychological distress. The reclassification of posttraumatic stress disorder (PTSD) in DSM-5 has implications for clinicians in terms of assessment and intervention. Shame has been added to the cognitive-affective symptom cluster within DSM-5, due its plausible relevance to PTSD development and maintenance (Budden, 2009), however this interplay is not well understood. A systematic literature search for empirical studies examining the relationship between shame and posttraumatic stress (PTS) symptoms was conducted to enhance knowledge in this area. Twelve studies met the inclusion criteria. This review concludes that there is a role of shame in PTSD presentations, and supports emergent socio-cognitive theories of shame-based PTSD. Shame is associated with psychopathology, yet can be difficult to accurately assess via self-report measure due to frequently being experienced at an implicit level (Shaver & Mikulincer, 2005). This empirical study engages in validation analysis of an eye-tracking methodology as an applied measure of shame. Additionally, underlying I schema associated with internal and external shame, and the role in symptoms of social anxiety and depression is explored. Results indicated that eye-tracking data within the current study was not considered to contribute to a valid applied measure of internal or external shame. The EMS of defectiveness was pertinent to both internal and external shame. Remaining EMSs fell within the domain of other-directedness for external shame, and impaired autonomy/performance for internal shame. Path analysis indicated a significant direct influence of internal shame on symptoms of social anxiety. Schema profiles may provide direction for clinical interventions targeting shamebased presentations, and in particular social anxiety.