Cultural Differences in Shame and Guilt As Understandable Reasons For Suicide

Article
Cultural Differences Psychological Reports

0(0) 1–34
in Shame and Guilt ! The Author(s) 2017
Reprints and permissions:
as Understandable sagepub.com/journalsPermissions.nav
DOI: 10.1177/0033294117728288
Reasons for Suicide journals.sagepub.com/home/prx
Marisa K. Crowder and

Markus Kemmelmeier
University of Nevada, Reno, NV, USA
Abstract
According to the World Health Organization, a major barrier to suicide prevention
work is the social stigma surrounding suicide. Since clinical research has long shown
that shame and guilt are often involved in suicide and suicide ideation, the present
two studies explore the extent to which individuals associate shame and guilt
with suicide ideation and behavior according to their cultural background. Using a
scenario approach, 1,147 Americans in two separate studies read about a traumatic
situation in which the target person experienced intense shame or intense guilt.
A mini meta-analysis of these studies showed that all participants were more likely
to link the experience of shame to suicidality than guilt. Additionally, participants
from U.S. dignity states were more likely to report suicide ideation when the target
experienced guilt as opposed to shame. Our findings support the notion that the
centrality of the emotions of shame and guilt varies relative to the social context,
which has implications on how others perceive suicide.
Keywords
Shame, guilt, suicide, honor culture
Introduction
With a suicide rate of approximately 800,000 individuals per year, the World
Health Organization (WHO, 2017) Mental Health Gap Action Programme has
declared suicide a public health priority. However, the stigma surrounding
suicide can be a major barrier to establishing adequate suicide preventions
across the globe (WHO, 2017). For instance, Kelleher, Chambers, Corcoran,
Williamson, and Keeley (1998) showed that countries with greater religious
Corresponding Author:
Marisa K. Crowder, University of Nevada, Reno, Mailstop #1300, Reno, NV 89557, USA.
Email: mcrowder@unr.edu
2 Psychological Reports 0(0)
sanctions against suicide were less inclined to share their suicide data. In order to
adequately identify and address reasons for suicide, it is imperative to finding
ways to combat stigma. We argue that in order to address such barriers, it is
critical to understand cultural differences in the perception of suicide and suicide
behaviors. One means of addressing how individuals might perceive suicide is to
investigate cultural differences in the reasons for suicide.
Patterns of suicide provide a glimpse into the culture of a society (e.g.,
Durkheim, 1897/1951; Lenzi, Colucci, & Minas, 2012). Mental illness, for exam-
ple, is a key predictor of suicide in the United States. Yet, in India, suicides are
more likely to occur in response to socioeconomic difficulties (e.g., Bhatia,
Khan, Mediratta, & Sharma, 1987; see also Parkar, Dawani, & Weiss, 2008).
These differences highlight how important it is that preventative efforts address
how a society’s broader cultural values and scripts give rise to suicide. Since
shared social meanings enable empathy among members of the same culture
(Hardin & Higgins, 1996; LeVine, 2007), we expect members of a culture to
predict if a given situation is likely to give rise to thoughts about suicide
over others. In other words, even though suicide is typically viewed as an
unacceptable behavior, shared cultural backgrounds influence what circumstances
people might consider plausible or understandable reasons for suicide.
We present two studies that investigated cultural differences in the meaning
of suicide. We examined whether individuals from U.S. honor cultures hold
different notions about the emotional experiences that may prompt an individual
to consider suicide than individuals from U.S. dignity cultures. We focused on
the emotions of shame and guilt for two reasons. First, suicide research has well
documented that thoughts about suicide often originate in these deeply negative
emotional experiences (Hastings, Northman, & Tangney, 2002; Lester, 2010;
Mokros, 1995; Sherman, 2014). Second, research also suggests that cultures
differ in the extent to which their members are affected by these emotions
(cf. Cohen, 2003). We explored whether U.S. honor cultures differ from U.S.
dignity cultures in the extent to which they viewed shame and guilt as plausible
antecedents of suicide.
Shame and guilt

Shame and guilt are a part of a class of emotions called the ‘‘self-conscious
emotions.’’ These emotions, which include embarrassment and pride, occur
in response to an evaluation of the self. Whereas the feeling of pride occurs in
response to a positive evaluation of the self, shame, guilt, and embarrassment
occur in response to a negative evaluation of the self (Lewis, 2008; Tangney,
2001; Wong & Tsai, 2007). Although similar in that respect, shame and guilt
differ in important ways. Like embarrassment, shame occurs in response to a
negative evaluation by real or imagined others (Sheikh, 2014; Tangney, 1995).
However, the evaluation that elicits shame typically stems from violating
Crowder and Kemmelmeier 3
important moral or social codes of conduct, whereas the evaluation that elicits
embarrassment typically stems from relatively minor faux pas (Crozier, 2014;
Keltner & Buswell, 1997). Shame’s link to morality renders it conceptually
similar to guilt. Yet, the violation that evokes shame renders the global, or
entire, self into question, whereas guilt occurs when a violation renders a
negative evaluation of the behavior. Though they often co-occur, shame signals
that one is a bad person, whereas guilt signals that one has done a bad deed
(Giner-Sorolla, Castano, Espinosa, & Brown 2008; Tangney, Miller, Flicker, &
Barlow, 1996).
Although both shame and guilt can serve important social functions, such as
engaging in reconciliatory behaviors or improving the self (cf. Kemeny,
Gruenewald, & Dickerson, 2004; Tangney, Stuewig, & Martinez, 2014), both
have also been associated with the inclination to think about or to commit
suicide. The feeling that one can never be rehabilitated in the eyes of others
(shame) or the feeling of not being able to live with ones actions (guilt) is a
recurrent theme in suicide notes and in the accounts of individuals having
survived suicide attempts (Coster & Lester, 2013; Foster, 2003; cf. Shneidman,
1998). Some events can elicit such a strong sense of shame or guilt that
individuals feel that suicide is their only way out (Baumeister, 1990; Bryan,
Morrow, Etienne, & Ray-Sannerud, 2012; Hastings et al., 2002; Lester, 1997).
For instance, when individuals are convinced that their social image is irrepar-
ably compromised and they feel an intense sense of shame, they may view suicide
as a viable option and possibly end their lives. Likewise, when individuals
feel that their conscience has been irrevocably damaged by their misdeeds, the
ensuing sense of guilt might lead individuals to feel unable to continue living
with what they have done (Lester, 1997; Pridmore & McArthur, 2008).
Honor and dignity cultures

Leung and Cohen (2011) distinguish U.S. honor cultures (i.e., the south) from
U.S. dignity cultures (i.e., the north). Honor cultures are characterized by the
belief that self-worth is synonymous with reputation (Cross et al., 2014; Nisbett
& Cohen, 1996). This link renders one’s honor vulnerable to uncertainty and
doubt. Since it is not a stable characteristic, continued active maintenance of
one’s reputation is essential. This includes engaging in behavior that adheres to
cultural mandates as well as engaging in defensive behavior to ward off potential
threats to one’s honor (Kim, Cohen, & Au, 2010). Research on crime and
violence has long documented that defensive honor maintenance entails elevated
levels of aggression. For instance, homicide rates tend to be higher in honor
cultures than in non-honor cultures, especially when it involves arguments
between acquaintances (Cohen, 1998; Cohen & Nisbett, 1994; Nisbett, 1993).
Having to maintain one’s public image seems to make members of honor
cultures more susceptible to suicide (Crowder & Kemmelmeier, 2014; Osterman
& Brown, 2011). Suicide rates are elevated among older men in honor cultures,
presumably because some members of this group have a harder time living up
to the high expectations of masculinity that honor cultures place on them
(Crowder & Kemmelmeier, 2017). Additionally, with members of honor
states being sensitive to honor threats, mental illness is considered particularly
stigmatizing. This deters individuals from honor states from seeking help when
psychologically distressed (Brown, Imura, & Mayeux, 2014). A recent investi-
gation demonstrated that a failure to seek treatment for depression could
account, in part, for the higher suicide rates in U.S. honor cultures
(Crowder & Kemmelmeier, 2017).
In dignity cultures, individuals themselves, and not others, have the power to
define their self-worth. Leung and Cohen (2011) argue that for individuals
to maintain dignity, they must behave in accordance with their own personal
standards. A loss of dignity, in dignity cultures, reflects that an individual has
not behaved according to his or her own personal standards. Although research
examining the relationship between dignity culture and suicide is limited,
evidence suggests that suicide can serve as a means to hold on to one’s dignity
(Chochinov, Hack, McClement, Kristjanson, & Harlos, 2002; Van Der Maas,
Van Delden, Pijnenborg, & Looman, 1991). For example, many of the argu-
ments in support of physician-assisted suicide stress the importance that patients
die with dignity (Hyde, 2001; Kade, 2000). Having a sense of free will over one’s
own death may also provide psychosocial support (Lester, 2006; Mayo, 1998).
Therefore, to the extent that individuals in honor cultures view the loss of honor
as an understandable reason for suicide, individuals in dignity cultures may also
associate the loss of one’s personal dignity with suicide.
Culturally appropriate emotional antecedents to suicide

Personal well-being is often contingent on meeting cultural expectations (e.g.,
Diener & Suh, 2000; Tov & Diener, 2007), and suicide can serve as an ultimate
‘‘way out’’ when people cannot meet important cultural mandates (cf. Crowder
& Kemmelmeier, 2017; Tov & Diener, 2007). As such, differences in
cultural expectations for behavior can give rise to differences in cultural
constructions of suicide.
Arguably, the extent to which shame and guilt are viewed as antecedents to
suicide differs across cultural contexts. Cohen (2003) argued that the experience
of shame is a particularly potent emotion in honor cultures, as members are
more sensitive to how their actions might be viewed by others (Markus &
Kitayama, 1991; Singelis & Sharkey, 1995). Others have suggested that the
experience of guilt is a particularly potent emotion in dignity cultures, as guilt
signals that one has not met important personal standards (Leung & Cohen,
2011). We expected that members of honor cultures are more likely to think of
suicide as the result of extreme shame as opposed to guilt, as they may be more
likely to empathize with a tarnished reputation being a focal concern. Similarly,

we argue that in dignity cultures, guilt is likely a critical emotion because it
reveals that the integrity and self-defined worth of a person has been undermined
by one’s own untoward behavior. Since members of dignity cultures place a
premium on the ability to define their own sense of self-worth, behaving in a
manner that challenges their ability to see the self as worthwhile may be intolerable.
Thus, when someone engages in behavior that violates their self-definition of worth,
members of dignity cultures are likely to be more understanding if the individual, in
response to guilt, contemplates ending their life.
Perceived behavioral control

Whether shame or guilt is seen as appropriate precursors to suicide is likely to be
dependent upon the actor’s controllability over his or her wrongdoing. An actor
who deliberately violated a cultural norm is more likely to be held responsible
for the event and its consequences (e.g., Siemer, Mauss, & Gross, 2007; Weiner,
1995). When such a violation is revealed, the actor can be expected to show
culturally appropriate emotions of shame or guilt. Conversely, any displayed
feelings of shame or guilt on the part of the actor signals that he or she acknow-
ledges his or her agency and blameworthiness (Tracy & Robbins, 2006). If the
distress is severe enough, observers might consider it plausible that such an actor
is considering suicide—in part because the emotions of shame or guilt signal that
the actor is accepting responsibility for his actions.
However, when an actor is not in control of his or her behavior, this circum-
stance may absolve him or her from responsibility for a wrongdoing, even when
he or she experiences shame and guilt in response. That is, observers may be
aware of the kind of emotional dilemma that an actor suffers; yet, they will not
likely hold him or her accountable. Consequently, observers will not consider
suicide or even thoughts of suicide an appropriate response. In short, depending
on the cultural context, shame or guilt may serve as understandable instigators
of thought of suicide primarily when behaviors are controllable.
Present research
To understand cultural differences in the meaning of suicide, the present two
studies test whether suicide is viewed as appropriate or at least understandable
depending upon cultural background and the precipitating emotional experi-
ence. Any differences could illuminate ways in which preventative strategists
could adopt culturally sensitive approaches to suicide. Since honor cultures
place greater emphasis on the social environment, we argue that members of
these states, and those who endorse honor values more strongly, are more likely
to conceptualize and think about suicide as a natural reaction to the reputation-
focused emotion of shame than the individual-focused emotion of guilt.
Therefore, we expect members of these states to anticipate that ashamed indi-

viduals will entertain thoughts of suicide and, therefore, be more understanding
if they consider suicide in response to shame rather than guilt (Hypothesis 1).
Additionally, since dignity cultures tend to emphasize individual experiences, we
argue that members of such states will conceptualize suicide as a reaction to guilt
than shame (Hypothesis 2). Thus, we anticipate members of these states to
be more understanding of suicide in response to guilt as opposed to shame.
These patterns should be more prominent if the shame or guilt is a response
to one’s own actions, rather than an uncontrollable, traumatic circumstance
(Hypothesis 3).
Study 1
We tested whether members of honor (vs. dignity) states conceptualized suicide
as a reaction to shame (vs. guilt). Participants read one of eight short vignettes of
a man who experienced a traumatic life-altering event. We varied the emotional
experience of the man (shame vs. guilt) as well as the controllability of the event.
Participants indicated the extent to which they thought the man would entertain
thoughts of suicide, and how understanding they would be if the man did kill
himself. We then examined whether the honor-dignity status of participants’
state of residence moderated their responses to the target individual as well as
their personal endorsement of cultural values associated with honor and dignity.
Method
The study was administered using the online research tool SurveyMonkey. After
providing consent, participants were randomly assigned to a 2 (controllability:
controllable vs. uncontrollable) 2 (vignette emotion: shame vs. guilt) between-
subjects design. Participants read a story of a man named Sam who had
experienced a traumatic event. Those assigned to the controllable condition
read that the life-altering events came about due to Sam’s actions. Those
assigned to the uncontrollable condition read the event occurred outside of his
control. For participants in the shame condition, vignettes ended by describing
Sam as having experienced extreme humility and a sense of shame. Those in the
guilt condition read vignettes that ended with a description of Sam having
experienced extreme personal anguish and a sense of guilt.
Participants were then asked to complete a series of questions regarding the
vignette. The first set of questions asked participants to rate the extent to which
they thought Sam had felt a series of 12 emotions including shame and guilt.
They then indicated the extent to which they thought Sam was thinking about
committing suicide and the extent to which they would understand if Sam had
decided to commit suicide. Subsequently, all participants responded to a series
of demographic questions, including their current state of residence.
Participants
We obtained two U.S. samples via the online crowdsourcing marketplace,
Amazon Mechanical Turk (MTurk; fall of 2013 n ¼ 215 and spring of 2014,
n ¼ 606).1 Participants in 2013 received $0.20 for participating in a 5- to
10-minute survey and participants in 2014 received $1.50 for participating in a
25-minute survey. Twenty-three individuals participated in both rounds of data
collection; thus, we removed their later entry. We also excluded seven partici-
pants (3.2% of 215) of 2013 who worked on the study for less than 90 seconds,
as inattention to research materials might undermine data quality (Maniaci &
Rogge, 2014). Similarly, 13 participants (2.2% of 583) in 2014 who worked on
the study for less than 3 minutes (n ¼ 6) and more than 40 minutes (n ¼ 7) were
excluded. On average, the 2013 participants took 195.44 seconds (SD ¼ 108.98)
and the 2014 participants 804.82 seconds (SD ¼ 422.65). Across both samples,
we removed an additional 37 individuals who failed the manipulation check and
17 individuals who either resided outside of the United States (n ¼ 15) or in
Washington, DC, (n ¼ 2). In total, we excluded 74 participants (9.0%) of the
overall sample.2
Initial analyses showed no differences between the 2013 and the 2014 samples,
all main and interaction effects, ps > .08; thus, data were combined. The data
included 724 participants (54% female), 77% of which were White, 7% were
African American, 7% were Asian, 5% were Hispanic/Latino, and 3% were
Native American, multi-racial, or other. The average age of participants was
35 years (SD ¼ 11.92; range: 18–81). Also, 24% reported that their annual
household income was less than $25,000, 23% reported that it was between
$25,000 and $39,999, 22% reported that it was $70,000 or more, and the
remaining 31% reported that their annual household income was between
$40,000 and $69,999.
Measures
Vignettes. We generated eight stories to assess participants’ understanding of
suicide (see Appendix 1). In four of the stories, Sam did not have control of
the event (e.g., as a train engineer, he could not stop his train from running over
a teenager; coded 0). In the other set of four stories, Sam had direct control over
the traumatic event (e.g., as a physician he made a wrong decision which
disabled a child; coded 1). For all eight stories, Sam was described as either
experiencing guilt (coded 0) or shame (coded 1) in response to the situation.
The four vignettes in which Sam had control described this ending when the
focus was on guilt3:
Sam could not stop blaming himself for what he had done. Whenever he left
his house, Sam was constantly reminded of the consequences of his actions.
The thought of the pain he had caused and the regret of his behavior eventually
grew to be too much to bear. Sam started wondering how he would be able to live
with the guilt for what he had done.
When the focus was on shame, the same vignettes had this ending:
Sam knew that his family and most people in his community condemned him for
what he had done. Whenever he left his house, Sam could not avoid running into
someone who knew about, or who was in some way affected by what he had done.
The public humiliation eventually grew to be too much to bear. Sam started
wondering how he would be able to live with the shame that he had brought
upon himself.
With regard to the vignettes in which Sam did not have control over that event,
this ending was provided when the focus was on guilt:
Although Sam knew there was nothing he could have done, he could not stop
blaming himself. The thought of the pain he had caused eventually grew to be
too much to bear. Sam started wondering how he would be able to live with the
guilt for what he had done.
When the focus was on shame on the same four vignettes, they included this
ending:
Sam felt as though those around him held him in contempt. The humiliation even-
tually grew to be too much to bear. Sam started wondering how he would be able to
live with the shame that he had brought upon himself.
Suicide ideation. Using a five-point scale ranging from 1 (Not at All) to 5

(Extremely), participants responded a single item: ‘‘How much do you think
Sam is thinking about suicide?’’
Understanding. In 2013 and 2014, participants’ level of understanding was

assessed using this item: ‘‘Would you find it understandable if Sam decided to
commit suicide?’’ with participants again providing ratings on the five-point
scale from 1 (Not at All) to 5 (Extremely).4
Attributed emotions. To assess the emotions that participants perceived Sam felt,
we included a modified version of Brebner’s (2003) emotion intensity scale.
Using a five-point scale, participants were asked to indicate the intensity that
they thought Sam felt five positive (affectionate, contentment, joy, pride, and
shyness) and seven negative (anger, embarrassment, fear, guilt, disgust, sadness,
and shame) emotions.
Honor-dignity. Cohen (1998) classified the U.S. states into honor and non-honor
states based on cultural and historical considerations. U.S. states are categorized
based on their census regions with Southern and Western states classified as
honor states and Northeastern and Midwestern states as dignity states.
Similar to previous research (e.g., Cohen & Nisbett, 1994; Hayes & Lee, 2005;
Leung & Cohen, 2011), we used self-reported state of residence as criterion for
whether participants were members of an honor or a dignity culture.
Unfortunately, our Study 1 assessment did not include how long participants
had lived in an honor or dignity state; however, as reported as part of Study 2, a
large majority of residents in one particular type of state also went to high school
in the same type of state (see also Hayes & Lee, 2005).
Collectivism. We relied on Vandello and Cohen’s (1999) State Collectivism Index

to control for state-level collectivism. Scores range from 31 (least collectivistic) to
91 (most collectivistic).
Analysis plan
Using Stata’s structural equation modeling function, we adopted a path analysis
approach to examine the impact of our emotion manipulation on the responses
to the two outcome variables: the suicide ideation and suicide understanding
items. Model 1 tests the first hypothesis (see Figure 1). Specifically, we examined
the influence of our emotion manipulation (shame vs. guilt) on the actor’s
perceived level of shame (path a), which ultimately predicted suicide ideation
(path b) and understanding (path c). Thus, we expected perceived shame to
mediate the effect of the emotion manipulation on both outcome variables.
However, we did not necessarily assume that the mediation effect would be
complete. As such, we also included the direct effects of the emotion manipula-
tion on suicide ideation (path d) and suicide understanding (path e). To examine
whether state honor-dignity status qualified the aforementioned effects, we
specified it as a moderator for each pathway (paths f– j). Since we expected
participants to respond similarly to each outcome variable, we also allowed
them to covary (path k).
We also included two covariates (not shown in Figure 1): perceived guilt and
state collectivism. Previous research has shown that shame and guilt have
increasingly become conflated with one another within the United States such
that shame has become less salient over time and has increasingly become
replaced with more individualistic emotions such as guilt (Cohen, 2003;
Fessler, 2007). Therefore, we expected that individuals may have a difficult
time differentiating between the two emotions and we examined the effect of
vignette emotion on perceived shame and the outcomes while controlling for
perceived guilt. Indeed, in our own Study 1, perceived shame and guilt
were highly correlated (r ¼ .60). Further, since a state’s honor-dignity status
Figure 1. Conceptual model of the path analyses used to test Hypotheses 1 and 2.
(Control variables are not displayed).
and state-level collectivism are positively correlated (r ¼ .34) but are differen-
tially associated with suicide (Crowder & Kemmelmeier, 2014), state collectiv-
ism was included as a covariate. Statistical significance of parameter estimates
was determined using robust standard errors (RSE).
The same conceptual model displayed in Figure 1 was also used to test
the second hypothesis. We used the same approach except that we examined
perceived guilt as the mediator between the emotion manipulation and the two
outcome variables, while controlling for perceived shame. Finally, to test our
third hypothesis, we used the group command when examining both models to
generate separate coefficients for each controllability condition.
Stata reports the path coefficients, rather than the overall between-subjects
effects. Therefore, to understand our results, it is important to know that for our
dummy variables, groups coded as 0 (guilt condition and dignity-state) are the
reference groups. When involved in a two-way interaction, the coefficient asso-
ciated with the main effect reflects the difference in means when the moderating
variable is 0. The interaction term reflects the change in the mean difference as a
function of the moderating variable. For example, a main effect for the emotion
manipulation on perceived shame reflects the effect when state honor-dignity
status is 0 (dignity states). A significant interaction term with state honor-dignity
status would show the extent to which that effect (mean difference) varied for
members of honor states. In all analyses, and throughout our paper, we set our
significance level at p ¼ .050, though regard effects at p < .100 as marginally
significant, indication a noteworthy trend.
For simplicity, we do not report findings for the covariates. Note that, across
both studies, perceived shame and perceived guilt were consistently related,
ps < .001, and state-level collectivism was never related to perceived shame,
ps > .06, nor the suicide understanding item, ps > .37. However, state-level
collectivism was occasionally related to the suicide ideation item, with bs ranging
from 0.12 to 0.002 and ps ranging from .01 to .97.
Results
Hypothesis 1: Is suicide more closely tied to shame for members of honor states?. Stata
reports the standardized root mean residual (SRMR) when analyses are
based on RSE. For the following model, SRMR indicated good model fit,
SRMR ¼ 0.058, markedly below the 0.080 cutoff suggested by Hu and Bentler
(1999).
Controllable condition. The effect of our emotion manipulation on perceived

shame (path a) showed that those in the shame condition perceived Sam to
be experiencing more shame than those in the guilt condition, b ¼ 0.172,
RSE ¼ 0.074, p ¼ .020. Members of honor states also perceived more shame
than members of dignity states, b ¼ 0.143, RSE ¼ 0.062, p ¼ .021. Both the
emotion manipulation and state honor-dignity status were involved in a two-
way interaction effect, b ¼ 0.172, RSE ¼ 0.073, p ¼ .019 (path f). The additive
effect of the coefficients illustrates that the difference in perceived shame as a
function of the manipulation condition occurred among those from dignity
states. This difference was not significant among members of honor states,
b ¼ 0.014, RSE ¼ 0.034, p ¼ .691. Although members of honor states were
more likely to perceive shame than members of dignity states, this did not
vary across emotion conditions.
We then turned our attention to the suicide ideation item. Results indicated
that perceived shame was positively related to suicide ideation, b ¼ 0.281,
RSE ¼ 0.092, p ¼ .002 (path b). There was no main effect of state honor dignity
status, b ¼ 0.124, RSE ¼ 0.072, p ¼ .084, and state honor-dignity status did
not moderate the relationship between perceived shame and perceived suicide
ideation, b ¼ 0.033, RSE ¼ 0.074, p ¼ .653 (path i). Examining our emotion
manipulation showed a somewhat different pattern. Those who read that
Sam was experiencing shame were less likely to report that he was thinking of
committing suicide than those who read that Sam was experiencing guilt,
b ¼ 0.195, RSE ¼ 0.080, p ¼ .015 (path d). This effect was qualified by state
honor-dignity status, b ¼ 0.258, RSE ¼ 0.095, p ¼ .007 (path g). Thus, the finding
that those in the shame condition reported less suicide ideation occurred among
those from dignity states. Members of honor states did not differ in how
likely they thought Sam was thinking of suicide as a function of the emotion
manipulation, b ¼ 0.084, RSE ¼ 0.066, p ¼ .202. No significant effects emerged
when examining suicide understanding, all ps > .08.
Uncontrollable condition. When faced with uncontrollable situations, those

who read that Sam experienced shame perceived him to be experiencing more
Table 1. Standardized path coefficients for honor and dignity states.
Study 1 Study 2 Mini-meta
Honor Dignity Honor Dignity Honor Dignity
Perceived shame
Emotion manipulation ! Perceived shame
No control 0.053 0.173**
Control 0.011 0.138* 0.035 0.193*** 0.012 0.165*
Perceived shame ! Suicide ideation
No control 0.196* 0.028
Control 0.320*** 0.247* 0.205+ 0.229* 0.262* 0.238*
Emotion manipulation ! Suicide ideation
No control 0.032 0.104
Control 0.078 0.172* 0.008 0.056 0.035 0.058
Perceived shame ! Understanding suicide
Control 0.095 0.082 0.095 0.261** < 0.001 0.172*
Emotion manipulation ! Understanding suicide
Control 0.093 0.100 0.057 0.062 0.076 0.081
Indirect effect from emotion manipulation to suicide ideation
Control 0.007 0.068+ 0.017 0.097+ 0.005 0.083
Indirect effect from emotion manipulation to understanding suicide
Control 0.003 0.032 0.010 0.036* 0.006 0.084
Perceived guilt
Emotion manipulation ! Perceived guilt
Control 0.042 0.140* 0.050 0.219*** 0.046 0.180*
Perceived guilt ! Suicide ideation
No control 0.115 0.250*
Control 0.153 0.143 0.163 0.173 0.005 0.158*
Emotion manipulation ! Suicide ideation
Control 0.078 0.172* 0.008 0.056 0.035 0.058
Perceived guilt ! Understanding suicide
Control 0.054 0.165+ 0.201+ 0.006 0.074 0.079
(continued)
Table 1. Continued.
Study 1 Study 2 Mini-meta
Honor Dignity Honor Dignity Honor Dignity
Emotion manipulation ! Understanding suicide

Control 0.093 0.100 0.057 0.062 0.075 0.081
Indirect effect from emotion manipulation to suicide ideation
Control 0.013 0.040 0.019 0.084 0.003 0.062
Indirect effect from emotion manipulation to understanding suicide
Control 0.006 0.065 0.029 0.004 0.012 0.03
Asterisks for the coefficients of the mini-meta analysis indicate that the 95% confidence intervals did not
include zero.
+p .10, *p .05,**p .01, ***p .001.
shame than those who read that he experienced guilt, b ¼ 0.182, RSE ¼ 0.072,
p ¼ .012 (path a). State honor-dignity status also predicted perceived shame,
b ¼ 0.158, RSE ¼ 0.066, p ¼ .017, and suicide ideation, b ¼ 0.139, RSE ¼ 0.071,
p ¼ .050. Specifically, those from honor states perceived more shame and
reported that Sam was more likely to be considering suicide than members
of dignity states. No other effects approached statistical significance in the
uncontrollable condition, ps > .06.
Mediation analyses. We then examined the indirect effect of perceived shame

between our emotion manipulation and our two outcome variables, separately,
for honor and dignity states (see Table 1). In the controllable condition, the
mediating effect of shame on suicide ideation was significant among members
of dignity states, b ¼ 0.068, RSE ¼ 0.036, p ¼ .056, but not members of honor
states, b ¼ 0.007, RSE ¼ 0.025, p ¼ .781. Perceived shame did not mediate the
effect between the emotion manipulation and suicide understanding across
state honor-dignity status, ps > .38. Whereas this absence of a mediation
effect may be unexpected for members of honor states, it is likely due to a
ceiling effect: Ratings of shame among participants from honor states were
generally higher than those from dignity states. As can be seen in Table 2,
a ceiling effect likely reduced the variance such that a correlation could
not emerge. There were no significant mediation effects in the uncontrollable
conditions, ps > .32.
Hypothesis 2: Is suicide more closely tied to guilt for members of dignity states?. To test
our second hypothesis, we followed the same series of steps but included
Table 2. Average perceived shame by study, emotion manipulation, and state honor-dignity
status.
Shame Guilt Total
M SE M SE M SE
Study 1
Dignity state 4.73a 0.07 4.46b 0.07 4.59 0.05
Honor state 4.65a 0.05 4.68a 0.05 4.66 0.04
Total 4.68 0.04 4.59 0.04
Study 2
Dignity state 4.68a 0.05 4.43b 0.04 4.55 0.03
Honor state 4.48b 0.04 4.44b 0.04 4.46 0.03
Total 4.57 0.03 4.44 0.03
These marginal means reflect analyses that control for perceived guilt. The perceived emotions of Study 1
reflect the items of Brebner’s (2003) scale for those in the controllable condition only. The perceived
emotions of Study 2 reflect Tangney’s (1994) State Shame and Guilt Scale (SSGS). Means with different
superscripts within the same panel differ at p < .05.
perceived guilt as the mediating variable and perceived shame as the covariate,
with the model again fitting the data well, SRMR ¼ 0.068.
Controllable condition. As expected, those in the guilt condition attributed

greater guilt to Sam than those in the shame condition, b ¼ 0.175,
RSE ¼ 0.076, p ¼ .021 (path a). However, neither the main effect nor qualifying
effect of state honor-dignity status reached statistical significance, ps > .11.
Table 3 displays the means of perceived guilt in the controllable condition
across the emotion manipulation and state honor-dignity status.
Perceived guilt was not associated with suicide ideation, b ¼ 0.078,
RSE ¼ 0.075, p ¼ .299 (path b). However, we did find an effect of our emotion
manipulation, b ¼ 0.187, RSE ¼ 0.082, p ¼ .022 (path d), which showed that
those in the guilt condition were significantly more likely to indicate that he was
thinking of committing suicide than those in the shame condition. Although
there was no statistical difference between members of honor and dignity
states in perceived suicide ideation, b ¼ 0.117, RSE ¼ 0.070, p ¼ .094, state
honor-dignity status did moderate the effect of the emotion manipulation,
b ¼ 0.243, RSE ¼ 0.097, p ¼ .012 (path g). The additive effect of these coefficients
indicated that members from dignity states were significantly more likely to
report suicide ideation in the guilt condition than the shame condition, but
there was no difference among members of honor states, b ¼ 0.076,
RSE ¼ 0.066, p ¼ .246. All other paths were not significant, ps > .08.
Table 3. Average perceived guilt by study, emotion manipulation, and state honor-dignity
status.
Shame Guilt Total
M SE M SE M SE
Study 1
Dignity state 4.56a 0.07 4.83c 0.07 4.69 0.05
Honor state 4.68ab 0.05 4.75bc 0.05 4.72 0.04
Total 4.64 0.04 4.78 0.04
Study 2
Dignity state 4.34a 0.05 4.60c 0.04 4.48 0.03
Honor state 4.46b 0.04 4.53c 0.04 4.49 0.03
Total 4.41 0.03 4.56 0.03
These marginal means reflect analyses that control for perceived shame. The perceived emotions of Study 1
reflect the items of Brebner’s (2003) scale. The perceived emotions of Study 2 reflect Tangney’s (1994) State
Shame and Guilt Scale (SSGS). Means with different superscripts within the same panel differ at p < .05.
When examining suicide understanding, findings showed that greater levels

of perceived guilt were marginally associated with greater levels of suicide under-
standing (path c), b ¼ 0.133, RSE ¼ 0.071, p ¼ .059. There was no main effect of
state-honor-dignity status, b ¼ 0.006, RSE ¼ 0.074, p ¼ .941; however, this
was qualified by perceived guilt, b ¼ 0.118, RSE ¼ 0.052, p ¼ .024 (path j).
This pattern indicates that the positive association between perceived guilt and
suicide understanding emerged among members of dignity states. Perceived guilt
was not associated with suicide understanding for members of honor states,
b ¼ 0.042, RSE ¼ 0.073, p ¼ .571. No other pathways to suicide understanding
were statistically significant, ps > .15.
Uncontrollable condition. The emotion manipulation did not have any effect
on perceived guilt, b ¼ 0.084, RSE ¼ 0.075, p ¼ .260 (path a). We found that
perceived guilt was positively related to suicide ideation, b ¼ 0.234, RSE ¼ 0.117,
p ¼ .047 (path b), but no other pathways reached significance, ps > .07.
Mediation analyses. Examining the indirect effects between our emotion

manipulation and our two outcome variables via perceived guilt showed that
there were no significant mediation effects in either the controllable or the
uncontrollable conditions, ps > .15.
Discussion
Findings of Study 1 lent partial support for all three hypotheses. We hypothe-
sized that that members of honor states would be more likely to associate
shame with suicide compared to guilt. Although our findings do not show
this directly, they do suggest that members of honor states may be more sensitive
to shame-cues. Specifically, we found that members of honor states were
much more likely to report that Sam was experiencing shame across both
conditions than participants from dignity states. This, in turn, was associated
with a greater inclination to report that he would consider suicide. Members of
dignity states differentiated between the two contexts more easily in regard
to perceived shame.
Findings also confirmed our second hypothesis. Members from dignity states
were more likely to report suicide ideation in the guilt condition than the shame
condition and were more likely to be understanding of suicide the more guilt
they thought Sam experienced. All of these effects occurred when Sam had
control over the situation, which supports our third hypothesis. When a
trauma is not the fault of the actor, others are less likely to assign the kind of
blame that would have made suicide seem warranted.
Study 2
Study 2 sought to replicate and extend our first study. Because findings of Study
1 supported our hypothesis that the effects would emerge when Sam was in
control of his situation, participants in Study 2 only saw one of the four vign-
ettes from the controllable condition. Second, since members of honor states
were equally likely to report that Sam was experiencing shame for both emotion
conditions, we strengthened our emotion manipulation so participants could
differentiate between perceived shame and guilt. We also removed any mention
of ‘‘shame’’ or ‘‘guilt’’ from the vignettes. Finally, we expanded our assessment
of shame and guilt using a widely used, psychometrically sound scale.
Method
The study was administered using the online research tool Qualtrics. As in Study
1, participants were randomly assigned to one of the two vignette emotion con-
ditions (shame vs. guilt) and asked to complete a series of questions regarding
how much they felt Sam had felt shame and guilt. Except where noted, all other
aspects of Study 2 were identical to Study 1.
Participants. We obtained a sample of 426 U.S. MTurk ‘‘workers’’ who partici-

pated in exchange for $1.00 for an expected 10-minute study. Using the same
reasoning as Study 1, we removed the responses of 14 individuals who worked
on the study for less than 180 seconds (less than 3 minutes) and 6 individuals
who worked on the study for more than 1800 seconds (more than 30 minutes) to
correct for inattention (5% of the overall sample). Additionally, five individuals
were excluded who did not attend high school in the United States. The final
dataset consisted of 401 participants whose average time completing the study
took 518.28 seconds (SD ¼ 263.84).
Fifty-two percent of these participants were female, 82% were White, 9% were
African American, 7% were Asian, 6% were Hispanic/Latino, and 2% were
Native American, multi-racial, or other (participants were allowed to select all
racial/ethnic categories that applied to them). The average age of participants was
37 years (SD ¼ 12.15; range: 19–75). Also, 25% reported that their annual house-
hold income was less than $25,000, 22% reported that it was between $25,000 and
$39,999, 24% reported that it was $70,000 or more, and the remaining 29%
reported that their annual household income was between $40,000 and $69,999.
Measures
Vignettes. To strengthen our emotion manipulation, we revised the four

vignettes by strengthening the language around the emotional experience of
the actor, Sam. When Sam was experiencing shame, we highlighted the public
repercussions of his actions. For example:
Sam knew that his family and most people in his community condemned him for
what he had done. Whenever he left his house, Sam could not avoid running into
someone who knew about, or who was in some way affected by what he had done.
At one point, he was in the grocery store line and he heard people whispering all
around him. Eventually someone burst out: ‘‘You are the guy who ruined our
town!’’ When Sam looked up, everybody in the busy store was looking at him.
Sam just ran out of the store, leaving his full cart behind. Over time, the public
humiliation eventually grew to be too much to bear.
When Sam was experiencing guilt, we highlighted the personal repercussions of

his actions:
Sam could not stop blaming himself for what he had done. Whenever he left his
house, Sam could not avoid being reminded of the consequences of his actions.
At one point, in front of the grocery store he saw a beggar with a sign ‘‘Please
help – lost job and home’’ – and he recognized in the older man a former worker at
the company. Inside the store, he overheard a conversation between two women
with one telling the other that her son had to drop out of college because they could
not afford it any more after both she and her husband had lost their jobs when the
company closed. The thought of the pain he had caused and the regret of his
behavior eventually grew to be too much to bear.
State shame and guilt scale. To examine the extent to which participants
perceived Sam to be experiencing shame and guilt, we used a revised version
of Marschall, Sanftner, and Tangney’s (1994) State Shame and Guilt Scale.
These items are designed to address an individual’s present feelings of shame,
guilt, and pride. Although our analyses only focus on the shame and
guilt subscales, for this study, we tailored all items to address participants’
perceptions of the extent to which Sam, ‘‘. . .wants to sink into the floor and
disappear,’’(sample item of shame scale; a ¼ .77), ‘‘. . .feels remorse, regret,’’
(sample item of guilt scale; a ¼ .84), and ‘‘. . .feels good about himself,’’
(sample item of pride scale; a ¼ .82).5
State culture. In Study 2, we assessed both current state of residence as well as

the state in which participants attended to high school (Cohen, 1998). These two
states might not coincide if participants moved across states or were originally
from outside of the United States. However, in the majority of cases (71%), the
two states were the same. If the two states varied, participants had mostly
migrated from one honor (or dignity) state to another (82%). Put differently,
for 86% of our participants the kind of state in which they had attended high
school was the same as the kind of state in which they currently resided. We used
the state in which participants went to high school to generate our state culture
variables. Use of either state variable produced essentially identical results.
Results
We ran the same path models examining perceived shame, model fit
SRMR ¼ 0.046, and perceived guilt, SRMR ¼ 0.037, as in Study 1, though we
only focused on the vignettes in which Sam had control, since there were no
subgroup analyses.
Model 1: Is suicide more closely tied to shame for members of honor states?. Similar to
Study 1, we found that that our emotion manipulation was effective such that
those in the shame condition perceived Sam to be experiencing greater shame
than those in the guilt condition, b ¼ 0.182, RSE ¼ 0.047, p < .001 (path a).
However, members from honor states did not differ from members of dignity
states in perceived shame, b ¼ 0.010, RSE ¼ 0.048, p ¼ .839. A significant
two-way interaction between state honor-dignity status and the emotion
manipulation, b ¼ 0.139, RSE ¼ 0.059, p ¼ .019 (path f) showed that, as
before, the effect of the emotion manipulation on perceived shame occurred
among members of dignity states, but not among members of honor states,
b ¼ 0.033, RSE ¼ 0.042, p ¼ .434. As can be seen from Table 2, although efforts
to emphasize the distinction between the shame and guilt condition were
somewhat effective among members of honor states, relative to the pattern
shown in Study 1, members of dignity states were still much more sensitive to
the emotion cue; members from honor states were equally likely to perceive
shame across both conditions.
Examining suicide ideation showed that higher levels of perceived shame were
positively with greater reports of suicide ideation, b ¼ 0.276, RSE ¼ 0.109,
p ¼ .011 (path b). No other effects reached statistical significance, ps > .27.
Turning to suicide understanding also revealed a positive effect of perceived
shame, b ¼ 0.224, RSE ¼ 0.096, p ¼ .020 (path c): the more that participants
thought that Sam experienced shame, the more understanding they said they
would be if he decided to commit suicide. Further, members of honor states were
equally likely to be understanding as members of dignity states, b ¼ 0.091,
RSE ¼ 0.071, p ¼ .200. However, a two-way interaction between perceived
shame and state honor-dignity status, b ¼ 0.202, RSE ¼ 0.082, p ¼ .014 (path
h), indicated that the positive relationship between perceived shame and suicide
understanding occurred among participants from dignity states. Perceived
shame was not associated with suicide understanding among participants from
honor states, b ¼ 0.015, RSE ¼ 0.091, p ¼ .868.
Mediation analyses. Similar to Study 1, analyses of the indirect effects showed

that perceived shame mediated the pathway from the emotion manipulation to
suicide understanding, b ¼ 0.136, RSE ¼ 0.066, p ¼ .040, for members of dignity
states. This path was marginally significant for suicide ideation, b ¼ 0.097,
RSE ¼ 0.057, p ¼ .090. Neither pathways approached significance for members
of honor states, ps > .39.
Model 2: Is suicide more closely tied to guilt for members of dignity states?. Again, we
found that those in the guilt condition reported that Sam experienced greater
levels of guilt than those in the shame condition, b ¼ 0.199, RSE ¼ 0.051,
p < .001 (path a). Further, a significant two-way interaction between the emotion
manipulation and state honor-dignity status produced a similar pattern as in
Study 1 (path f). That is, the difference in perceived guilt as a function of our
emotion manipulation occurred for members of dignity states, b ¼ 0.135,
RSE ¼ 0.061, p ¼ .027, but not members of honor states, b ¼ 0.055,
RSE ¼ 0.040, p ¼ .171. From a different angle, this interaction effect showed
that when they read that Sam experienced guilt, no difference between members
of honor and dignity states emerged, b ¼ 0.032, RSE ¼ 0.047, p ¼ .499. Yet,
when participants read that he experienced shame members of honor states
reported significantly higher levels of perceived shame than members of dignity
states, b ¼ 0.111, RSE ¼ 0.051, p ¼ .028.
Perceived guilt was positively associated with suicide ideation, b ¼ 0.201,
RSE ¼ 0.096, p ¼ .037 (path b), but not suicide understanding, b ¼ 0.141,
RSE ¼ 0.093, p ¼ .131 (path c). All other paths, ps > .20.
Mediation analyses. Analyses of the indirect effects showed that perceived guilt
did not mediated the pathway from the emotion manipulation to either outcome
variables regardless of state honor-dignity status, ps > .15.
Discussion
Results of Study 2 showed that members of honor cultures were equally likely
to perceive both shame and guilt across emotion conditions. This pattern
suggests that members of dignity states were more sensitive to the emotion
cues than members of honor cultures states. Although weak, indirect ana-
lyses with regard to perceived shame also replicated: For both studies,
perceived shame mediated the effect of the emotion manipulation on suicide
ideation for members of dignity states only. A discussion of these findings
is provided below.
Internal meta-analysis
Some of the differences we found across studies are likely due to differences in
methodology. To obtain a clearer picture of the effects, we summarize our
findings using Goh, Hall, and Rosenthal’s (2016) ‘‘mini meta’’ approach of
the standardized beta coefficients. To compare ‘‘apples-to-apples,’’ we analyzed
the standardized coefficients of the controllable condition of Study 1 to those
of Study 2 for honor and dignity states, separately. Using this approach is
advantageous because it provides more precise and reliable estimates of
our effects across studies and therefore provides a clearer picture of the
replicability of these findings (see Table 1). Given the nature of this method,
95% confidence intervals are reported, rather than p values, to reflect statistical
significance.
Hypothesis 1: Is suicide more closely tied to shame for members

of honor states?
Results showed that the effect of the emotion manipulation on perceived shame
was only significant for members of dignity states, b ¼ 0.165, 95% CI [0.052,
0.274], not members of honor states, b ¼ 0.012, 95% CI [0.081, 0.104].
For both groups, perceived shame was positively associated with suicide
ideation, bHonor ¼ 0.262, 95% CI [0.174, 0.346]; bDignity ¼ 0.238, 95% CI
[0.127, 0.343], but was only associated with suicide understanding for members
of dignity states, b ¼ 0.172, 95% CI [0.059, 0.280], and not members of
honor states, b < 0.001, 95% CI [0.092, 0.092]. Regardless of individuals’
state honor-dignity status, the emotion manipulation did not have a direct
effect on either suicide ideation, bHonor ¼ 0.035, 95% CI [ 0.058, 0.127];
bDignity ¼ 0.058, 95% CI [0.170, 0.055], or on suicide understanding,
bHonor ¼ 0.076, 95% CI [0.017, 0.167]; bDignity ¼ 0.081, 95% CI [0.033,
0.193]. Thus, individuals were equally likely to say that Sam was thinking
of suicide no matter if they read that he experienced shame or guilt. None
of the aggregated indirect effects were statistically significant (all confidence
intervals encompassed zero).
Hypothesis 2: Is suicide more closely tied to guilt for members
of dignity states?
Again, we see that the emotion manipulation on perceived guilt was only
significant for members of dignity states, b ¼ 0.180, 95% CI [0.288,
0.067], not members of honor states, b ¼ 0.046, 95% CI [0.138, 0.047].
However, perceived guilt was only related to suicide ideation for members of
dignity states as well, b ¼ 0.158, 95% CI [0.044, 0.267], not members of honor
states, b ¼ 0.005, 95% CI [0.085, 0.095]. Perceived guilt did not predict suicide
understanding across state-honor status, bHonor ¼ 0.074, 95% CI [0.018,
0.164]; bDignity ¼ 0.079, 95% CI [0.034, 0.191]. Again, given the similarity of
the models, the emotion manipulation did not have a direct effect on suicide
ideation, bHonor ¼ 0.035, 95% CI [0.058, 0.127]; bDignity ¼ 0.058, 95% CI
[0.170, 0.055], nor suicide understanding, bHonor ¼ 0.075, 95% CI [0.018,
0.167]; bDignity ¼ 0.081, 95% CI [0.033, 0.193], across state honor-dignity
status. Finally, none of the indirect effects were statistically significant (all
confidence intervals encompassed zero).
General discussion
The central goal of this research was to understand whether the conditions under
which suicide is seen as more or less acceptable vary across cultures. Two studies
focused on cultural differences within the United States. We hypothesized that
members from honor and dignity states would respond differently to suicidal
thoughts depending on the antecedent emotion. Specifically, we expected mem-
bers of dignity states would be more likely to link suicidality to the experience of
guilt, since it indicates that one has behaved in a manner that undermines one’s
personal standards and sense of self. Indeed, our findings showed that members
of dignity cultures were more likely to associate perceived guilt to suicide
ideation compared to members of honor cultures. To the best of our knowledge,
this is the first study that demonstrates that members of dignity culture within
the United States respond differently to guilt than to shame, and to link that
difference to perceptions of suicide. Far more work has been done looking at the
relationships among honor cultures, shame, and suicide (cf. Cohen, 2003;
Hollander, 2003; Lester, 1997; Leung & Cohen, 2011).
Since it has been shown that members of honor cultures are particularly respon-
sive to the experience of shame given their sensitivity to social threats (Cohen,
2003; Leung & Cohen, 2011), we also expected that members of honor states
would be more understanding of suicide in response to shame than members of
dignity states. However, this association was not found. Although our findings
supported the notion that members of honor cultures were more sensitive to the
experience of shame in that they were equally likely to perceive it across shame and
guilt eliciting events, the perceived experience of shame was associated with greater
reported ideation for members of honor and dignity states equally.
Shame is an incredibly potent emotion. As mentioned, findings from this

research show that the influence of shame on perceptions of suicide occurred
for everyone, regardless of cultural background. This pattern supports the exten-
sive literature that shows the experience of shame, especially the inescapable
experience of shame, can motivate an individual to end his or her life (Breed,
1972; Bryan et al., 2012; Kolves, Ide, & Leo, 2011). When compared to guilt,
individuals who participated in the present research were much more likely to
associate suicide ideation to shame than to guilt. This is likely due to differences
in the nature of these self-conscious emotions. Whereas the blame is largely
placed on the behavior with regard to guilt, it is more likely a reflection of the
individual, or self, with regard to shame (Giner-Sorolla et al.,2008; Lewis, 2008;
Tangney, 2001). This can have devastating consequences on the individual’s
ability to cope, as it may seem far easier to change one’s behavior than it is to
change one’s self.
This may shed some light as to why members of dignity states were more
receptive to our emotion cues than members of honor cultures. Specifically, it
may be that members of honor states respond equally to both shame and guilt
since they are both self-conscious emotions (Lewis, 2008; Tangney, 2001). Given
that both emotions reflect a negative evaluation of the self, members of honor
states may be sensitive to circumstances that elicit both. Regardless of whether
the event reflects an evaluation of the global self or the behavior, any negative
evaluation of the self may be perceived as a threat to one’s reputation. Members
of dignity states may be more likely to pick up on the distinction. If they are not
led to believe that a person has been humiliated then they may have no reason to
suspect so. However, when they are told that the individual has been humiliated,
they responded accordingly. Consistent with this speculation, we observed that
ratings of perceived shame and perceived guilt were more closely correlated
among participants from honor states compared to those from dignity states
(Study 1 (controllable condition) rHonor ¼ .78 vs. rDignity ¼ .67, Fisher Z ¼ 2.21,
p ¼ .03; Study 2 rHonor ¼ .81 vs. rDignity ¼ .69, Fisher Z ¼ 2.52, p ¼ .01).
Interestingly, different trends emerged depending on whether we examined
participant predictions of suicide ideation or their understanding of suicide.
For the most part, effects that we found were associated with suicide ideation.
We expect that this was because each outcome tapped into suicide understanding
in both indirect and direct ways. Whereas our suicide ideation measure asked
participants to reflect on the mental state of the target character Sam, our suicide
understanding measure asked participants to report their own personal beliefs
toward the matter. Asking participants to indicate the likelihood that Sam
is thinking of suicide is more likely to portray a form of understanding
that encompasses perspective taking and empathy than asking them about
understanding outright. We posit that reporting suicide ideation allowed partici-
pants to project their own subjective understanding of Sam’s situation and of
suicide onto this target person without necessarily running afoul of the otherwise
strong cultural prohibitions against suicide. Put differently, the hypotheticality

of the scenario may have allowed it to serve as a cultural Rorschach test with
regard to a cultural understanding of suicide. Because our measure of suicide
understanding likely addresses participants’ attitudinal response to suicide, we
argue that it offered participants fewer degrees of freedom to indicate that they
would find suicide acceptable under our various contexts. Indeed, it was not
until we highlighted the feelings of shame and guilt in each respective condition
and focused in on the control vignettes than patterns associated with suicide
understanding began to emerge.
Limitations
In this study, we asked participants to respond to a hypothetical scenario with
the goal of allowing participants to take the perspective of another individual
(Sam). A limitation to this approach is that it is still unclear whether guilt and
shame actually precipitate suicide in different cultural realms. Though lacking in
verisimilitude, the hypothetical nature of our scenarios may allow a clearer view
at the nexus of culture, emotion, and suicide than would responses to actual
accounts of suicides. That is, responding to an actual suicide may severely
restrain participants’ degrees of freedom when asked to think about an event
that severely breaches social norms against self-harm. Yet, those interested in
extending the findings presented in this study may gain valuable information
from those who have attempted suicide or from the grievances expressed
within suicide notes to determine whether expressions of shame and guilt vary
cross culturally.
Another component to our novel methodology that warrants further
investigation is the characteristics of the target character. To our knowledge,
these findings are the first to empirically demonstrate that cultural differences
in the meaning of suicide are determined in part by culturally relevant emotions.
As a first step in identifying how the link between shame, or guilt, and suicide
varies across cultures, we felt that it was important to keep the gender of
the target character consistent. Describing a male character also has greater
relevance, as males are more likely to commit suicide than women (Phillips,
Liu, & Zhang, 1999; cf. Rudmin, Ferrada-Noli, & Skolbekken, 2003). We also
did not vary the ethnic-racial background of Sam (which many may have
assumed to be White). Again, this decision reflects our primary interest in the
effects of culture and emotion on understanding.
Additionally, some may be wary of our use of an MTurk sample. We argue,
however, that recruiting an MTurk sample was an easy and inexpensive way to
access people from across the United States, which was crucial for our present
study. Moreover, research has shown that MTurk samples tend be more diverse,
older, more attentive, and reliable in comparison to the frequently used student
samples (Buhrmester, Kwang, & Gosling, 2011; Hauser & Schwarz, 2016).
Lastly, various scholars have argued that honor and dignity cultures
primarily pertain to White Americans (e.g., Brown, 2016; Crowder &
Kemmelmeier, 2017; Hayes & Lee, 2005). Thus, the inclusion of members of
U.S. minority groups, such as African Americans and Asian Americans, could
have dampened our results. However, re-analysis of both studies focusing on
White participants only produced essentially the same results as presently
reported. Still, in light of stark variation in patterns of suicide (e.g., Crowder
& Kemmelmeier, 2017) and cultural attitudes toward suicide (Walker, Lester, &
Joe, 2006), future investigations should tackle how race and ethnicity may qual-
ify the link between guilt, shame, and suicide.
Implications and future directions

Our results add to a relatively new line of research exploring the relationship
between cultural variations in suicide relates and the cultural importance of
shame and guilt. Several researchers have alluded to the fact that shame may
play a larger role for suicide in U.S. honor cultures. Much of the attention in the
literature on the importance of shame in honor cultures has focused on how
shame can lead to aggression, particularly by men, when they cannot defend
their honor or uphold their social image (Bosson, Vandello, Burnaford, Weaver,
& Wasti, 2009; Cohen, 2003; Rodriguez Mosquera, Fischer, Manstead, &
Zaalberg, 2008). Additionally, it was argued that lower levels of anti-depressant
prescriptions are indicative of a hesitance to seek help when psychologically
distressed (Crowder & Kemmelmeier, 2014; Osterman & Brown, 2011). When
unable to maintain one’s honor, individuals are likely to resist further damaging
their reputation with the stigma of mental health (Brown et al., 2014).
Although we expected members of honor culture are to be more affected by
shame-eliciting scenarios, what we found was they are more likely to perceive
shame across multiple types of scenarios. This may suggest that members
of honor cultures are not necessarily sensitive to the experience, or onset, of
shame. Instead, they may be higher in what is called, ‘‘shame proneness’’ in that
they likely have a propensity to experience state shame in response to a perceived
social transgression (Tangney, Youman, & Stuewig, 2009). This likely has
implications for suicide prevention strategies. When working within an honor
culture community, suicide prevention strategies may benefit from focusing
on what individuals attend to in social situations rather than their reactions
to them.
Arguably, guilt, as a precursor to suicide, has received far less attention in the
empirical literature (cf. Bryan et al., 2012; Coster & Lester, 2013). This may stem
from the assumption that guilt often motivates reconciliatory behaviors rather
than withdrawal. However, consistent with the idea that guilt also elicits suicidal
thoughts and behavior (Bryan et al., 2012; Coster & Lester, 2013), we show that
members of dignity culture are particularly sensitive to the experience of guilt.
Our findings also imply that a culturally sensitive approach to suicide with
regard to honor and dignity cultures means focusing on specific nature of the
emotional experience. Since members of honor states seemed to be especially
responsive to cues in the environment that might be socially threatening, we
surmise that suicide-related interventions should be adapted to anticipate that
members of honor cultures may make little distinction between shame- and
guilt-arousing situations. On the other hand, our findings suggest that members
of dignity states are likely to distinguish between the two emotional experiences.
Additional research is needed to investigate implications of these proposed
differences for suicide intervention across the United States.
Our approach assumes that the definitions of shame and guilt utilized in our
present study generalize to non-U.S. samples. Based on Wong and Tsai (2007)
and Sheikh (2014), it is likely that our results are reflective of a Western model
of shame and guilt and may not replicate elsewhere. These authors proposed
that because individualistic societies promote the idea that the individual is a
unique and distinct entity, they are more likely to define emotional experiences
in such a way that differentiates the self from others (Markus & Kitayama,
2010). That is, the differentiation between guilt and shame in terms of the
orientation inward (toward the self) versus outward (to others), respectively,
reflects a Western conception of these emotions. In collectivistic societies,
which promote that the individual is an interconnected and mutually dependent
entity, the perceived boundaries between the external and internal are less
prominent. Therefore, the difference between shame and guilt in this regard is
less pronounced (Wong & Tsai, 2007). Although we focus on honor culture, it is
important to keep in mind that the broader cultural context may make honor
culture within the United States qualitatively different from honor cultures in
other parts of the world.
To conclude, despite legal and social sanctions against it, suicide continues to
persist. In demonstrating that conceptions of suicide may be reflections of cul-
turally focal emotions, the present study highlights the importance of adopting a
culturally sensitive approach to suicide intervention. Understanding the cultural
background of someone fighting suicidal thoughts may influence how the source
of distress is likely to be appraised (i.e., as shame-evoking or guilt-evoking),
which may be an important step in reducing the inclination for suicide.
Knowing how individuals are likely to interpret an event may benefit those
assisting clients in reexamining their cultural beliefs so that they may view
their situation in a different way (Dryden & David, 2008; Ellis, 1994).
Psychologists, therapists, and social workers in honor cultures may benefit
from focusing on how a person who is thinking of suicide may have lost their
status or reputation and can assist them in reducing their feelings of shame and
rebuilding their sense of self-worth. Those in dignity cultures may seek to focus
on what could be done to reduce the experience of guilt so the individual can
forgive him or herself and foster their self-esteem.
Appendix 1
Vignette 1. Sam engages in fraud
Sam was a 45-year-old chief financial officer of a mid-sized technology company
in ABC City, a town with 80,000 inhabitants. This company employed 4000
individuals, making it the town’s largest employer, and has been family owned
for generations. Many residents of Sam’s hometown work for Sam and many
investors in the company are local as well.
Recently, Sam was charged with falsifying the company’s financial state-
ments. It turned out that Sam indicated that the company was profitable
when in fact it had accumulated a large amount of debt. The resulting collapse
of the company cost many investors large sums of money—in some cases their
life’s savings. The closure of the company resulted in many employees losing
their jobs, which plunged the town into an economic crisis. Though Sam avoided
going to prison, it became more and more difficult for him to face his family and
friends, and the public.
Vignette 2. Sam has an affair

in ABC City, a town with 80,000 inhabitants. Sam served as a deacon at a large
community-based Christian church in town and as regular participant in his
community’s politics was well known for his conservative viewpoint.
Sam was recently caught cheating on his wife of 17 years with another man.
His wife accidently stumbled upon explicit photos in Sam’s email account that
dated back to three years prior. The consequences of this intensified as word got
out to his family members, friends, and eventually coworkers. This secret affair
ultimately ruined Sam’s marriage, his relationship with his children, his career,
as well as his extra-marital relationship. As time went on, it became more and
more difficult for Sam to face his family, children, and friends.
Vignette 3. Sam the doctor

Sam, a 45-year-old orthopedic surgeon, recently examined a 2-year-old child
with multiple fractures on her femur (thigh bone). Before the result of all medical
tests were available, Sam made the decision that the child should be allowed to
walk as he figured the fractures were not too severe. Upon receiving the results
of all the tests, however, it was clear that the child should not have been walking.
As a result of this decision, the child suffered permanent bone damage that
would prevent her from walking normally for the rest of her life. The family
sued the doctor for malpractice, and he lost his license and therefore his job. It
became clear that his decision not only deprived a 2-year-old child with a normal
life but also robbed his family of any financial stability.
Vignette 4. Sam has a boating accident

Last June, Sam, a 45-year-old chief financial officer of a large telecommunica-
tions company, and his younger brother went on a boating trip at their local
lake. While on this trip, after having too much to drink, Sam and his brother
decided to continue their party out on the lake so they took the boat for a ride.
After a couple more hours out on the lake, they decided to call it a night. Sam,
intoxicated at the wheel, did not see that he was approaching the boating dock
too fast. He crashed into the dock, injuring himself, and killing his brother.
Vignette 5. Sam has an incurable disease

in ABC City and a champion of independent values. Sam has strived to instill a
sense of independence in his children so that they may never have to depend on
others. Understanding that a healthy lifestyle is an indication of self-discipline,
Sam was proud of his ability to remain physically fit.
Two years ago, Sam was diagnosed with pancreatic cancer. Sam quickly
began deteriorating to the point to which Sam could no longer eat, bathe, or
use the restroom on his own. Because of his long struggle with cancer, the
medical costs for treatment strained his family’s finances and they struggled to
make ends meet. His wife even had to ask her parents for a loan to help pay
some of the utility bills. Sam, who was always proud to have provided for his
family and enable his children to pursue their dreams, now had to question if
they would be able to send their children to college. As the disease progressed,
Sam felt that his situation became unbearable.
Vignette 6. Sam the train engineer

Sam was a 45-year-old train engineer that operated along a long coastal railway.
Since many times people are found walking on the train tracks, to prevent
accidents it is protocol for engineers to sound the train’s horn when going
through coastal towns. One day Sam was travelling north bound through a
small coastal town and following protocol, Sam sounded the horn. When
coming along a bend, Sam noticed a teenage student walking on the tracks.
In an effort to alert the student of the approaching train, Sam repeatedly
sounded the horn. Unfortunately, the student was walking with earphones in
to listen to music. Realizing that the student was not going to move, Sam hit the
breaks. Yet, it was too late. The train hit and killed the student.
The details of the incident soon became public knowledge and many mourned
the loss of such a young life. Seeing as Sam followed the appropriate protocol
during this event and there was little he could do to prevent the accident, there
were no legal ramifications and he was allowed to keep his job. However, the
memory of that day haunted Sam for days to come.
Vignette 7. Sam’s wife’s accident

Sam was a 45-year-old chief financial officer of a mid-sized technology company in
ABC City. One night, he and his fellow coworkers went out after a long day to
have some dinner and some drinks. At the end of the night, Sam decided that
he was not fit to drive home. He called his wife of 17 years, who had been
home sleeping to ask her to come pick him up. Seeing as it was 1 o’ clock in the
morning, his wife refused and told him to call a cab. However, Sam was persistent
and explained to her that calling a cab would be a waste of money when she could
just come get him for free. She finally agreed and drove to go pick him up.
On the way to get Sam, another vehicle had run a red light and struck his
wife’s. She was rushed to the hospital but unfortunately died shortly after. Sam,
who had begged his wife to come pick him up despite her protests, could not
help but feel responsible for his wife’s death.
Vignette 8. Sam the environmentalist

in ABC City and a strong supporter of environmentalist activism. Since moving
to the area only a few years ago, Sam has strived within his community to
establish himself as the town’s key proponent of environment-friendly initia-
tives. He often provided large donations for projects that have implemented
solar power energy in public schools and buildings and has fostered projects
that have reduced carbon emissions from public transportation systems.
Sam’s activism and growing support began to upset some of his political
opponents. They dug into Sam’s history and got hold of some of his old financial
records. They discovered that his personal wealth was almost entirely based on
investments in industrial projects in the developing world. Twelve years ago, the
company in which he invested had cut down large sections of the rain forest in
Ecuador and polluted the ground water which lead to the deaths of young
children in nearby villages. There was also evidence that he had worked as a
financial advisor on this very project. After bringing these facts to the public’s
attention, Sam’s efforts to thwart these allegations proved to be futile as their
truth could not be questioned. Especially his friends felt hurt and offended by
Sam hiding his past, and he eventually lost all support in the community.
Acknowledgments
The authors would like to thank Marcella Shrout and Anthony Papa at the University of
Nevada, Reno, for their valuable comments on earlier drafts of this manuscript.
Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: This research was supported by a SPSSI
Grant-in-Aid.
Notes
1. The 2014 participants completed additional cultural values questionnaires. Findings
regarding those measures are presented with the supplementary materials, which can
be obtained from the authors.
2. Notably, 35% of all participants who fell outside of the reasonable time window failed
the manipulation check, whereas this was only the case for 4.8% of participants who
completed the study within the expected time.
3. We pilot tested the vignettes to ensure that they varied in terms of controllability. Using a
Latin square design, a separate sample of 56 individuals from the same pool (MTurk)
read all of the eight vignettes. After each vignette, participants answered three questions
concerning the controllability of the situation (i.e., ‘‘How much control do you think Sam
had over his situation?’’ as ranged from .77 to .91 across the eight stories). Results of a
multi-level analysis treating vignette controllability and vignette order as nested within
participant and story revealed that a main effect of controllability, F(1, 6.00) ¼ 15.42,
p ¼ .01, was moderated by order, F(7, 378) ¼ 2.92, p ¼ .01. Across vignette ordering,
vignettes that were designed to describe a controllable situation were perceived as sig-
nificantly more controllable than those that were designed to describe an uncontrollable
situation (MControl ¼ 4.48 vs. MNoControl ¼ 2.35), p ¼ .01. Although the size of this differ-
ence varied across order, all contrasts were significant, all ps < .024, Cohen’s ds ranged
from 0.76 to 1.12.
4. Participants in 2014 also received additional items designed to assess their understanding
of suicide. On a five-point scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree),
participants were asked such questions as ‘‘Many people I know would understand why
Sam would want to end his life,’’ and ‘‘Many people would consider suicide if in the same
situation as Sam.’’ When examining the 2014 participants’ understanding, we included the
individual item with the understanding scale by aggregating the standardized responses to
each item (a ¼ .86). Because this scale did not produce any findings that were different
than the individual item, we do not report these analyses in this paper.
5. Participants also answered Brebner’s (2003) emotion intensity scale; however, since the
shame item and SSGS shame scale (r ¼ .55) and the guilt item and the SSGS guilt scale
(r ¼ .53) were strongly correlated and yielded identical results, we only report findings
regarding the SSGS.
References
Baumeister, R. F. (1990). Suicide as escape from self. Psychological Review, 97, 90–113.
Bhatia, S. C., Khan, M. H., Mediratta, R. P., & Sharma, A. (1987). High risk suicide
factors across cultures. The International Journal of Social Psychiatry, 33, 223–236.
Bosson, J. K., Vandello, J. A., Burnaford, R. M., Weaver, J. R., & Wasti, S. A. (2009).
Precarious manhood and displays of physical aggression. Personality and Social
Psychology Bulletin, 35, 623–634.
Brebner, J. (2003). Gender and emotions. Personality and Individual Differences, 34,
387–394.
Breed, W. (1972). Five components of a basic suicide syndrome. Suicide and
Life-Threatening Behavior, 2, 3–18.
Brown, R. P. (2016). Honor bound: How a cultural ideal has shaped the American psyche.
Oxford, England: Oxford University Press.
Brown, R. P., Imura, M., & Mayeux, L. (2014). Honor and the stigma of mental health-
care. Personality and Social Psychology Bulletin, 40, 1119–1131.
Bryan, C. J., Morrow, C. E., Etienne, N., & Ray-Sannerud, B. (2012). Guilt, shame, and
suicidal ideation in a military outpatient clinical sample. Depression and Anxiety, 30,
55–60.
Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s mechanical turk a new source
of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6, 3–5.
Chochinov, H. M., Hack, T., McClement, S., Kristjanson, L., & Harlos, M. (2002).
Dignity in the terminally ill: A developing empirical model. Social Science &
Medicine, 54, 433–443.
Cohen, D. (1998). Culture, social organization, and patterns of violence. Journal of
Personality and Social Psychology, 75, 408–419.
Cohen, D. (2003). The American national conversation about (everything but) shame.
Social Research, 70, 1075–1108.
Cohen, D., & Nisbett, R. E. (1994). Self-protection and the culture of honor: Explaining
southern violence. Personality and Social Psychology Bulletin, 20, 551–567.
Coster, D., & Lester, D. (2013). Last words: Analysis of suicide notes from an RECBT
perspective: An exploratory study. Journal of Rational-Emotive & Cognitive-Behavior
Therapy, 31, 136–151.
Cross, S. E., Uskul, A. K., Gerçek-Swing, B., Sunbay, Z., Alözkan, C., Günsoy,
C., . . . Karakitapoğlu-Aygün, Z. (2014). Cultural prototypes and dimensions of
honor. Personality and Social Psychology Bulletin, 40, 232–249.
Crowder, M. K., & Kemmelmeier, M. (2014). Untreated depression contributes to higher
suicide rates in U.S. honor cultures. Journal of Cross-Cultural Psychology, 45,
1144–1160. doi:10.1177/0022022114534915
Crowder, M. K., & Kemmelmeier, M. (2017). New insights on cultural patterns of suicide
in the United States: The role of honor culture. Cross-Cultural Research. doi:10.1177/
1069397117712192
Crozier, R. (2014). Differentiating shame from embarrassment. Emotion Review, 6,
269–276.
Diener, E., & Suh, E. M. (2000). Culture and subjective well-being. Cambridge, MA: MIT
Press.
Dryden, W., & David, D. (2008). Rational emotive behavior therapy: Current status.
Journal of Cognitive Psychotherapy, 22, 195–209.
Durkheim, E. (1987/1951). Suicide: A study in sociology (J. A. Spaulding & G. Simpson,
Trans.). New York, NY: Free Press.
Ellis, A. (1994). Reason and emotion in psychotherapy: Comprehensive method of treating
human disturbances. New York, NY: Citadel Press.
Fessler, D. M. T. (2007). From appeasement to conformity: Evolutionary and cultural
perspectives on shame, competition, and cooperation. In J. L. Tracy, R. W. Robins &
J. P. Tangney (Eds.), The self-conscious emotions: Theory and research (pp. 174–193).
New York, NY: Guilford.
Foster, T. (2003). Suicide note themes and suicide prevention. The International Journal of
Psychiatry in Medicine, 33, 323–331.
Giner-Sorolla, R., Castano, E., Espinosa, P., & Brown, R. (2008). Shame expressions
reduce the recipient’s insult from outgroup reparations. Journal of Experimental Social
Psychology, 44(3), 519–526. doi:10.1016/j.jesp.2007.08.003
Goh, J. X., Hall, J. A., & Rosenthal, R. (2016). Mini meta-analysis of your own studies:
Some arguments on why and a primer on how. Social and Personality Psychology
Compass, 10, 535–549.
Hardin, C. D., & Higgins, E. T. (1996). Shared reality: How social verification makes the
subjective objective. In E. T. Higgins & R. M. Sorrentino (Eds.), Handbook of motiv-
ation and cognition: The interpersonal context (Vol. III, pp. 28–84). New York, NY:
Guilford.
Hastings, M. E., Northman, L. M., & Tangney, J. P. (2002). Shame, guilt, and suicide.
In T. Joiner & M. D. Rudd (Eds.), Suicide science: Expanding the boundaries
(pp. 67–79). New York, NY: Kluwer.
Hauser, D. J., & Schwarz, N. (2016). Attentive turkers: MTurk participants perform
better on online attention checks than subject pool participants. Behavior Research
Methods, 48, 400–407.
Hayes, T. C., & Lee, M. R. (2005). The southern culture of honor and violent attitudes.
Sociological Spectrum, 25(5), 593–617.
Hollander, J. (2003). Honor dishonorable: Shameful shame. Social Research, 70,
1061–1074.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure
analysis: Conventional criteria versus new alternatives. Structural Equation Modeling,
6, 1–55.
Hyde, M. J. (2001). Defining ‘‘human dignity’’ in the debate over the (im)morality of
physician-assisted suicide. Journal of Medical Humanities, 22, 69–82.
Kade, W. J. (2000). Death with dignity: A case study. Annals of Internal Medicine, 132(6),
504.
Kelleher, M. J., Chambers, D., Corcoran, P., Williamson, E., & Keeley, H. S. (1998).
Religious sanctions and rates of suicide worldwide. Journal of Crisis Intervention and
Suicide Prevention, 19, 78–86.
Keltner, D., & Buswell, B. N. (1997). Embarrassment: Its distinct form and appeasement
functions. Psychological Bulletin, 122, 250–270.
Kemeny, M. E., Gruenewald, T. L., & Dickerson, S. S. (2004). Shame as the emotional
response to threat to the social self: Implications for behavior, physiology, and health.
Psychological Inquiry, 15(2), 153–160.
Kolves, K., Ide, N., & De Leo, D. (2011). Marital breakdown, shame, and suicidality in
men: A direct link? Suicide and Life-Threatening Behavior, 41, 149–159.
Kim, Y. H., Cohen, D., & Au, W. T. (2010). The jury and abjury of my peers: The
self in face and dignity cultures. Journal of Personality and Social Psychology, 98,
904–916.
Lenzi, M., Colucci, E., & Minas, H. (2012). Suicide, culture, and society from a cross-
national perspective. Cross-Cultural Research, 46, 50–71.
Lester, D. (1997). The role of shame in suicide. Suicide & Life-Threatening Behavior, 27,
352–361.
Lester, D. (2006). Can suicide be a good death? Death Studies, 30, 511–527.
Lester, D. (2010). The association of shame and guilt with suicidality. Journal of Social
Psychology, 138, 535–536.
Leung, A. K. Y., & Cohen, D. (2011). Within- and between-culture variation: Individual
differences and the cultural logics of honor, face, and dignity cultures. Journal of
Personality and Social Psychology, 100, 507–526.
LeVine, R. A. (2007). Anthropological foundations of cultural psychology.
In S. Kitayama & D. Cohen (Eds.), Handbook of cultural psychology (pp. 40–58).
Lewis, M. (2008). Self-conscious emotions: Embarrassment, pride, shame, and guilt.
In M. Lewis, J. M. Haviland-Jones & L. F. Barrett (Eds.), Handbook of emotions
(3rd ed., pp. 742–756). New York, NY: Guilford.
Maniaci, M. R., & Rogge, R. D. (2014). Caring about carelessness: Participant inatten-
tion and its effects on research. Journal of Research in Personality, 48, 61–83.
Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implication for cognition,
emotion, and motivation. Psychological Review, 98, 224–253.
Markus, H. R., & Kitayama, S. (2010). Cultures and selves: A cycle of mutual constitu-
tion. Perspectives on Psychological Science, 5, 420–430.
Marschall, D. E., Sanftner, J. L., & Tangney, J. P. (1994). The State Shame and Guilt
Scale (SSGS). Fairfax, VA: George Mason University.
Mayo, D. J. (1998). Rational suicide? Journal of Personal and Interpersonal Loss, 3,
193–203.
Mokros, H. B. (1995). Suicide and shame. American Behavioral Scientist, 38, 1091–1103.
Nisbett, R. E. (1993). Violence and U.S. regional culture. American Psychologist, 48,
441–449.
Nisbett, R. E., & Cohen, D. (1996). Culture of honor: The psychology of violence in the
South. Boulder, CO: Westview.
Osterman, L. L., & Brown, R. P. (2011). Culture of honor and violence against the self.
Personality and Social Psychology Bulletin, 37, 1611–1623.
Parkar, S. R., Dawani, V., & Weiss, M. G. (2008). Gender, suicide, and the sociocultural
context of deliberate self-harm in an urban general hospital in Mumbai, India. Culture,
Medicine, and Psychiatry, 32(4), 492–515.
Phillips, M. R., Liu, H., & Zhang, Y. (1999). Suicide and social change in China. Culture,
Medicine, and Psychiatry, 23, 25–50.
Pridmore, S., & McArthur, M. (2008). Suicide and reputation damage. Australasian
Psychiatry, 16, 312–316.
Rodriguez Mosquera, P. M., Fischer, A. H., Manstead, A. S. R., & Zaalberg, R. (2008).
Attack, disapproval, or withdrawal? The role of honour in anger and shame responses
to being insulted. Cognition and Emotion, 22, 1471–1498.
Rudmin, F. W., Ferrada-Noli, M., & Skolbekken, J. A. (2003). Questions of culture, age
and gender in the epidemiology of suicide. Scandinavian Journal of Psychology, 44,
373–381.
Sheikh, S. (2014). Cultural variations in shame’s responses: A dynamic perspective.
Personality and Social Psychology Review, 18, 387–403.
Sherman, N. (2014). Recovering lost goodness: Shame, guilt, and self-empathy.

Psychoanalytic Psychology, 31, 217–235.
Shneidman, E. S. (1998). The suicidal mind. Quarry Bay, Hong Kong: Oxford University
Press.
Siemer, M., Mauss, I., & Gross, J. J. (2007). Same situation- different emotions: How
appraisals shame our emotions. Emotion, 7, 592–600.
Singelis, T. M., & Sharkey, W. F. (1995). Culture, self-construal, and embarrassability.
Journal of Cross-Cultural Psychology, 26, 622–644.
Tangney, J. P. (1995). Recent advances in the empirical study of shame and guilt.
American Behavioral Scientist, 38, 1132–1145.
Tangney, J. P. (2001). Psychology of self-conscious emotions. In J. D. Wright (Ed.),
International Encyclopedia of the Social and Behavioral Sciences (pp. 13803–13807).
Oxford, England: Elsevier.
Tangney, J. P., Miller, R. S., Flicker, L., & Barlow, D. H. (1996). Are shame, guilt, and
embarrassment distinct emotions? Journal of Personality and Social Psychology, 70,
1256–1269.
Tangney, J. P., Stuewig, J., & Martinez, A. G. (2014). Two faces of shame the roles of
shame and guilt in predicting recidivism. Psychological Science, 25(3), 799–805.
Tangney, J. P., Youman, K., & Stuewig, J. (2009). Proneness to shame and proneness to
guilt. In M. R. Leary & R. H. Hoyle (Eds.), Handbook of individual differences in social
behavior (pp. 192–209). New York, NY: Guilford.
Tov, W., & Diener, E. (2007). Culture and subjective well-being. In D. Cohen &
S. Kitayama (Eds.), Handbook of cultural psychology (pp. 691–713). New York,
NY: Guilford.
Tracy, J. L., & Robins, R. W. (2006). Appraisal antecedents of shame and guilt: Support
for a theoretical model. Personality and Social Psychology Bulletin, 32, 1339–1351.
Van Der Maas, P. J., Van Delden, J. J., Pijnenborg, L., & Looman, C. W. (1991).
Euthanasia and other medical decisions concerning the end of life. Lancet, 338,
669–674.
Vandello, J. A., & Cohen, D. (1999). Patterns of individualism and collectivism across the
United States. Journal of Personality and Social Psychology, 77, 279–292.
Walker, R. L., Lester, D., & Joe, S. (2006). Lay theories of suicide: An examination of
culturally relevant suicide beliefs and attributions among African Americans and
European Americans. Journal of Black Psychology, 32(3), 320–334.
Weiner, B. (1995). Judgments of responsibility: A foundation for a theory of social conduct.
Wong, Y., & Tsai, J. L. (2007). Cultural models of shame and guilt. In J. Tracy,
R. Robins & J. Tangney (Eds.), Handbook of self-conscious emotions (pp. 210–223).
World Health Organization. (2017, March). Suicide. Retrieved from http://www.who.int/
mediacentre/factsheets/fs398/en/
Author Biographies
Marisa K. Crowder is presently a doctoral candidate in the Interdisciplinary
Social Psychology PhD Program at the University of Nevada, Reno. Her
research examines cross-cultural differences in self-conscious emotions and the

link between socioemotional competence and academic outcomes.
Markus Kemmelmeier received his PhD from the University of Michigan in 2001
in social psychology. He is currently a professor in the Interdisciplinary Social
Psychology PhD Program and the Department of Sociology at the University of
Nevada, Reno. His research interests focus on cultural psychology, political
psychology, intergroup relations, and social science methods.

Cultural Differences in Shame and Guilt As Understandable Reasons For Suicide

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Cultural Differences in Shame and Guilt As Understandable Reasons For Suicide

Uploaded by

Copyright:

Available Formats

Article

Cultural Differences Psychological Reports

Marisa K. Crowder and

Shame and guilt

Honor and dignity cultures

Culturally appropriate emotional antecedents to suicide

likely to empathize with a tarnished reputation being a focal concern. Similarly,

Perceived behavioral control

Therefore, we expect members of these states to anticipate that ashamed indi-

Suicide ideation. Using a ﬁve-point scale ranging from 1 (Not at All) to 5

Understanding. In 2013 and 2014, participants’ level of understanding was

Collectivism. We relied on Vandello and Cohen’s (1999) State Collectivism Index

Controllable condition. The eﬀect of our emotion manipulation on perceived

Uncontrollable condition. When faced with uncontrollable situations, those

Table 1. Standardized path coefficients for honor and dignity states.

Study 1 Study 2 Mini-meta

Honor Dignity Honor Dignity Honor Dignity

Study 1 Study 2 Mini-meta

Honor Dignity Honor Dignity Honor Dignity

Emotion manipulation ! Understanding suicide

Mediation analyses. We then examined the indirect eﬀect of perceived shame

Shame Guilt Total

Controllable condition. As expected, those in the guilt condition attributed

Shame Guilt Total

When examining suicide understanding, ﬁndings showed that greater levels

Mediation analyses. Examining the indirect eﬀects between our emotion

Participants. We obtained a sample of 426 U.S. MTurk ‘‘workers’’ who partici-

Vignettes. To strengthen our emotion manipulation, we revised the four

When Sam was experiencing guilt, we highlighted the personal repercussions of

State culture. In Study 2, we assessed both current state of residence as well as

Mediation analyses. Similar to Study 1, analyses of the indirect eﬀects showed

Hypothesis 1: Is suicide more closely tied to shame for members

Shame is an incredibly potent emotion. As mentioned, ﬁndings from this

strong cultural prohibitions against suicide. Put diﬀerently, the hypotheticality

Implications and future directions

Vignette 2. Sam has an affair

Vignette 3. Sam the doctor

Vignette 4. Sam has a boating accident

Vignette 5. Sam has an incurable disease

Vignette 6. Sam the train engineer

Vignette 7. Sam’s wife’s accident

Vignette 8. Sam the environmentalist

Declaration of Conflicting Interests

Sherman, N. (2014). Recovering lost goodness: Shame, guilt, and self-empathy.

research examines cross-cultural differences in self-conscious emotions and the

You might also like