Shame, depression, and complicated grief among suicide loss-survivors: the moderating role of self-disclosure

Abstract

Background: Suicide-loss survivors (SLSs) are recognised as an at-risk population for several psychiatric complications, including complicated grief (CG) and depression (SI). However, whereas shame is known as one of the characteristics of this population, knowledge about possible psychological processes which may moderate the contribution of shame levels to CG and depression in the aftermath of suicide loss is sparse. This study examines the role of self-disclosure – the inclination to share personal information with others – as a possible moderator of the associations of shame with CG and shame with depression over time. Method: Participants were 152 suicide-loss survivors, aged 18–70, who completed questionnaires tapping CG and depression at three time points (T1- index measurement, T2-two years after T1. and T3-four years after T1) and questionnaires tapping shame and SD at T3. Results: Hierarchical regression analyses showed that shame significantly and positively contributed to CG at T3 and to depression at T3, beyond the CG/depression trajectories. Notably, two significant interactions were found: Self-disclosure moderated the contribution of shame to CG at T3 and to depression at T3. At lower self-disclosure levels, shame’s contribution to CG and depression was higher. Conclusion: The study’s findings highlight shame as a significant facilitator of CG and depression in the aftermath of suicide loss. Moreover, the role of interpersonal interaction on SLSs’ distress levels and grieving process was underscored, as this interaction may serve as a buffer against the deleterious sequelae of the suicide of a loved one.

Interpersonal facilitators of complicated grief and depression in the aftermath of suicide loss: The mediated roles of suicide‐related shame and guilt

“…As to the second hypothesis, we firstly found that SLSs with higher levels of shame endured higher CG levels and depressive symptoms. These findings align with many reviews and theoretical papers indicating that suicide‐related shame and guilt in the aftermath of suicide loss carries a considerable deleterious psychological effect (Jordan, 2020; Levi‐Belz & Hamdan, 2023; Pitman et al, 2014). It is thus reasonable to suggest that when SLSs feel guilt or shame following the suicide event, it reinforces self‐stigmatization and loneliness (Hanschmidt et al, 2016), ultimately leading to difficulties adjusting to the post‐suicide life, as reflected in higher CG and depressive symptoms.…”

Reaksi Berduka Pada Penyintas Kehilangan Bunuh Diri: Laporan Kasus

“…(8, Shame, sebagaimana dikutip oleh Levi-Belz dari Brown, adalah perasaan dan penghayatan yang sangat menyakitkan akibat adanya keyakinan bahwa diri kita tercela dan tidak berharga untuk diterima sebagai bagian dari suatu komunitas. (8) Levi-Belz juga mengutip beberapa hasil studi dari Jordan, Pitman, dan Tangney, yang mendapatkan bahwa shame menyebabkan distres yang lebih tinggi dan secara emosional lebih menyakitkan dari rasa bersalah (guilt). (22) Stigma yang dialami oleh penyintas kehilangan bunuh diri terjadi dalam dua perspektif.…”

“…Yang pertama adalah self-stigma yang sangat berkaitan dengan shame, nilai moral tentang bunuh diri, rasa bersalah sebagai penyebab bunuh diri dan kegagalan dalam mencegah hal tersebut. (2,8,23) Perspektif yang kedua adalah stigma di masyarakat.…”

“…(7) Selain itu, rasa malu, penyangkalan diri, dan juga stigma serta praduga kematian akibat bunuh diri akan membuat penyintas kehilangan bunuh diri ragu dan mengalami kesulitan untuk mencari dukungan dan pertolongan. (8,9) Kekhasan dalam proses berduka bagi penyintas kehilangan bunuh diri, serta kebutuhan pendampingan yang harus menjangkau kekhasan tersebut menjadi latar belakang pembahasan laporan kasus tentang reaksi berduka pada penyintas kehilangan bunuh diri. Tujuan dari artikel ini adalah untuk menjadi bekal pengetahuan berbasis bukti yang akan dapat digunakan oleh pemberi layanan kesehatan mental secara umum agar dapat memberikan pertolongan yang lebih optimal bagi penyintas kehilangan bunuh diri.…”

A study of the mediating effect of social support on self-disclosure and demoralization in Chinese older adult homebound breast cancer patients

“…Self-disclosure can help individuals rebuild positive social sharing beliefs ( Tajvar et al, 2018 ; Levi-Belz and Hamdan, 2023 ). Social support influences the self-disclosure of individuals ( Bu et al, 2023 ; Ricciardi et al, 2023 ); adequate social support helps individuals maintain a favorable emotional experience and increase self-confidence.…”