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Background: Guilt and shame are common moral emotions following potentially morally injurious events (PMIEs), which involve events that violate one’s deeply held moral values. However, not all individuals will experience guilt and shame following PMIEs and the mechanisms by which PMIEs lead to guilt and shame are not well understood. This study set out to examine the role of event-related intrusive rumination, event-related deliberate rumination, cognitive flexibility, and their interactions, in predicting PMIE-related guilt and shame. Methods: A subsample of undergraduate participants exposed to an objective PMIE and endorsing a subjective PMIE (N = 323) completed self-report assessments. Results: Higher levels of event-related intrusive rumination and event-related deliberate rumination and lower levels of cognitive flexibility were associated with higher levels of PMIE-related shame. Only higher levels of event-related deliberate rumination were associated with greater PMIE-related guilt. Moreover, the predictors explained much greater variance in PMIE-related shame (R2Adj = 0.44) than PMIE-related guilt (R2Adj = 0.05). There was no significant interaction between event-related rumination and cognitive flexibility in predicting PMIE-related guilt or shame. Limitations: This study was cross-sectional, the sample was mostly female, and all data was collected via self-report. Longitudinal studies are needed to explore these potential mechanistic processes. Conclusions: Our findings suggest that differential pathways may affect whether individuals experience guilt or shame following PMIEs. Rumination and cognitive flexibility may be valuable clinical targets for interventions aimed at addressing PMIE-related shame.

The purpose of this research was to understand the current status of stigma and illness uncertainty in patients with visible burns and explore the correlation between them. Measures to help patients alleviate shame and uncertainty in illness are also discussed. A cross-sectional study was conducted in a tertiary hospital from November 2020 to March 2021 for patients with burns on exposed parts of the face, neck, or limbs. The scales used in this study include demographic data questionnaires, the Social Impact Scale (SIS), and the Mishel Uncertainty in Illness Scale for Adults (MUIS-A). A two-tailed independent t-test was used to evaluate the differences in the respondents' sociodemographic characteristics, stigma, and illness uncertainty. The total stigma and illness uncertainty scores of 146 patients were 57.03 ± 6.762 and 68.59 ± 12.901, respectively. Spearman correlation analysis showed that stigma was positively correlated with illness uncertainty (r = 0.398, p0.01). Multiple regression analysis showed a relationship between stigma and uncertainty of illness (B = 0.215, p = 0.000), itching (B = 2.555, p = 0.01), residence (B = 2.545, p = 0.029), and age (B = 0.074, p = 0.037). The stigma level of patients with visible burns increased with increasing uncertainty regarding illness. Therefore, reducing the patients' uncertainty in illness is a way to intervene in stigma.

Shame and dissociation have been implicated theoretically and empirically in trauma exposure and its sequelae, with shame understood as an intense negative emotion and dissociation as a reaction to intense negative emotions. Understanding the connection between shame and dissociation is important for theory and practice; however, the strength of this association remains unclear. For example, in therapy, both shame and dissociation serve as a barrier to engaging with emotion. Theoretically, these two states should be distinct, as one (dissociation) confers low affective intensity and the other (shame) high intensity. The present meta-analysis focused on the magnitude of the association between these two phenomena and investigated the extent to which gender, trauma exposure, psychiatric comorbidities, and demographic characteristics influence this association given their independent links to shame and dissociation. An initial search of six databases identified 151,844 articles. Duplicates were removed, and additional articles were excluded based on abstract and title screening. After contacting authors for missing data, a full-text screen yielded 25 articles for the present analysis. The results indicate that shame and dissociation were moderately correlated (k = 33, n = 4,705), r = .42, 95% CI [.35, .48], p.001, but no clear clinical moderators emerged. Despite this association, very few studies utilized experimental designs to examine the association between these constructs. Future research should focus on experimental study designs to investigate the extent to which shame induces dissociation or vice versa.

The relationship between sensitivity to punishment (SP) and emotional eating has been previously examined. However, effective variables in this relationship have yet to be recognized. This study aimed to investigate the relationship between SP and emotional eating via facets of shame and rumination.Serial Mediation model was proposed.Female university students in Iran (n = 174) completed Sensitivity to Punishment and Sensitivity to Reward Questionnaire-Revised and Clarified (SPSRQ-RC), Dutch Eating Behaviour Questionnaire (DEBQ), Experience of Shame Scale (ESS) and Ruminative Responses Scale (RRS).SP showed a significant effect on emotional eating. Moreover, we observed that the relationship between SP and emotional eating was separately mediated by shame (general, characterological and bodily shame) and rumination. We further noticed the sequentially mediating role of shame (general, characterological and behavioural shame) and rumination in the relationship between SP and emotional eating.Findings suggest that high SP can increase the risk of emotional eating through negative emotions (e.g. shame) and disturbed cognitions (e.g. rumination). Therefore, for a better understanding, it seems necessary to consider emotional eating a maladaptive behaviour adopted as a possible result of the impairment of temperamental, emotional and cognitive systems.

This study examined the associations of the experience and tolerance of shame-related emotions to suicide risk, as well as the moderating role of sexual minority status.Community adults (N = 360) were recruited via MTurk and completed self-report questionnaires. Hierarchical regression analyses examined the main and interactive associations of sexual minority status and shame-related variables to suicide risk.Results revealed significant positive associations between self-disgust and suicide risk for sexual minority and heterosexual participants, although the magnitude was greater for sexual minority participants. Additionally, tolerance of shame was significantly negatively related to suicide risk only among sexual minority participants. Finally, exploratory analyses examining the three-way interaction of self-disgust, shame tolerance, and sexual minority status revealed a significant negative association between shame tolerance and suicide risk only among sexual minority participants with high levels of self-disgust.Results highlight the relevance of shame-related experiences to suicide risk among sexual minorities.

There is increasing recognition of the occurrence and frequency of male childhood sexual abuse (MCSA). Quantitative and qualitative research has demonstrated a number of adverse outcomes associated with MCSA in terms of mental health, physical health and difficulties in behavioural, social or interrelationship functioning. The present study gives voice to male survivors of childhood sexual abuse by exploring themes around the impact of MCSA over the course of their life. Interpretative phenomenological analysis (IPA) of semi-structured interviews with nine male survivors of childhood sexual abuse identified a single overarching theme of control and six related superordinate themes of: (i) responsibility, blame and shame; (ii) development of knowledge about sex and abuse; (iii) avoidance of coping with abuse; (iv) effects on relationships as adults; (v) disclosure of abuse to others; and (vi) gaining a sense of meaning of the abuse. The findings showed that being sexually abused defines and controls a person’s life, and that despite the difficulties experienced by victims to move past the abuse, some experienced a degree of personal growth. The findings illustrate the way in which individuals can create meaning around their abuse experiences and take back control.

Domestic violence victims frequently visit health care facilities yet rarely disclose, so it is important to understand what factors are barriers and facilitators of disclosure. UK-based qualitative investigations into barriers and facilitators of disclosure in health care settings have suffered from a limited focus on ethnic minority women. Therefore, the aim of this study was to explore victims’ perceptions and experiences of disclosing to health care services and to identify barriers and facilitators of disclosure within an ethnically diverse UK sample. Semi-structured interviews were administered among 29 British (8 ethnic minority) female victims. Content analysis demonstrated that barriers to disclosure were; emotional (e.g., fear, embarrassment/shame and self-blame), physical (e.g., partner’s physical presence, controlling behavior, and manipulation of professionals) and organizational (e.g., appropriateness of setting and time for disclosure). Additional problems for ethnic minority women were language difficulties and religious practices. Facilitators to disclosure were interpersonal relations, safety, and validation from health care professionals. Barriers and facilitators of disclosure in health care services are diverse and some are specific to minority ethnic groups. Health care professionals should receive awareness and skills training to establish a positive, validating, and safe environment for victim disclosure.

Positive religious coping is linked with better mental health outcomes following physical and sexual abuse while negative religious coping is associated with poorer outcomes. Religious coping styles may be linked with dispositional tendencies to experience guilt or shame. This study compared the associations between guilt and shame proneness and religious coping styles and tested whether abuse history moderated these relationships. We conducted a cross-sectional study with 425 college students ( n = 145 with physical and/or sexual abuse history, n = 280 with no abuse history). Participants completed questionnaires assessing positive and negative religious coping style, as well as two dimensions of guilt proneness and shame proneness. Structural equation models were fitted to examine associations between guilt proneness and shame proneness, and positive and negative religious coping, respectively, accounting for abuse history as a binary moderator. Across the full sample, positive religious coping was positively associated with guilt repair (i.e., the tendency to engage in reparative behaviors following one’s wrongdoing), guilt negative behavior evaluation (i.e., the tendency to feel bad about how one acted in a given scenario), and shame withdrawal (i.e., the tendency to try and avoid unpleasant situations in which one has done something wrong), and negatively associated with shame negative self-evaluation (i.e., the tendency to make internal, negative self-attributions about one’s wrongdoing). Negative religious coping was positively associated with shame withdrawal and, for participants with no abuse history, shame negative self-evaluation. Results suggest that positive religious coping is more closely related to guilt proneness, and negative religious coping to shame proneness. Additional research with longitudinal designs and more defined abuse history subgroups is needed.

This study aimed to examine the role of decentering and committed action as mediators of the link of external and internal shame with psychological health, in people with a chronic disease diagnosis (n = 223) and without chronic disease (n = 230). Participants with chronic disease presented higher levels of both external and internal shame. Path analysis results showed that these variables seem to be negatively linked to psychological health and that their effects on this outcome seem to be reduced by the mechanisms of decentering and committed action. The tested model explained 56% of psychological health's variance and was invariant across groups. This study emphasizes the importance of taking a decentered stance towards internal experiences and behaving accordingly to one's personal values on psychosocial functioning, independently of disease status. These results may have particular relevance to individuals with high levels of shame.

OBJECTIVE Immigrant women are vulnerable to intimate partner violence (IPV), and differences in immigration history, language, and culture impact their trauma responses. Although Chinese are the largest Asian immigrant subgroup in the U.S., little IPV research has specifically focused on this population. Therefore, we aimed to gain a better understanding of help-seeking experiences of Chinese immigrant women who had IPV. METHOD Twenty female Chinese immigrant survivors of recent IPV completed a Mandarin-language qualitative phone interview about their IPV experiences, help-seeking behaviors, and barriers to services. Interviews were analyzed using thematic analyses. RESULTS Women in our sample relied on family, friends, and self-help strategies to cope with IPV. They experienced feelings of shame, stigma, and "losing face," and had little social support. They also faced significant sociocultural and immigration-specific problems with formal services (e.g., culturally incongruent therapists, language, financial and transportation barriers, concerns about partner's reputation and legal status), lacked knowledge about available services, and rarely engaged with them. CONCLUSIONS Abused Chinese immigrant women may be exceptionally isolated, and culturally specific barriers may substantially impact both their understanding of their IPV experiences and their use of services. Practitioners need training and support to engage survivors in culturally competent ways. While safety planning and other formal IPV services are critical to safety and trauma recovery, these survivors underutilize them, and community outreach is needed to U.S. Chinese communities to raise awareness regarding available IPV resources and services. Finally, research is needed to develop and test culturally competent, evidence-based interventions for this isolated and vulnerable population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Few studies have investigated emotional experiences in people living with inflammatory bowel disease (IBD). However, self-conscious emotions, including embarrassment and shame, are indicated as a key factor in delayed help-seeking for bowel symptoms, which can result in poorer health outcomes. This study aimed to explore experiences of self-conscious emotions among people with IBD. Fifteen participants were recruited from outpatient IBD clinics and patient groups, and engaged in semi-structured interviews about their experiences of IBD-related self-consciousness. Data were analysed using thematic analysis following an inductive, semantic approach and conducted from a critical realist position. The analysis generated two themes, each with three sub-themes, which captured self-conscious emotions in relation to experiences which threatened participants’ preferred identities. The first theme, ‘Lack of control’ encapsulated participants’ distress relating to fundamental alteration in self-perception, and their attempts to mitigate this. The second, ‘Lack of understanding’ captured distress associated with awareness of being unfairly judged by other people. Clinical implications are identified, including consideration of therapeutic approaches which target self-conscious emotions such as shame, and continued societal efforts to educate others about invisible disabilities such as IBD. Experiences which threatened participants’ identities were implicated in the generation of self-conscious emotions; these should be considered in work with clients with IBD. Future research should target further investigation of these constructs.

Objectification theory has provided a useful framework for the study of women's sexual outcomes. However, little research has been conducted on the role of self-objectification in predicting sexual satisfaction. We conducted a replication of Calogero and Thompson (2009a), which reported a direct relationship between self-surveillance and sexual satisfaction, and expanded upon their work. We tested four path analysis models: Calogero and Thompson's reported and hypothesized models, and two previously untested models, all containing our variables of interest (media internalization, self-surveillance, body shame, sexual self-esteem, and sexual satisfaction). Each model was tested with the full sample (N = 349) and a restricted sample (N = 127) that met Calogero and Thompson's relationship status and sexual frequency inclusion criteria, and with and without BMI covaried. Both samples consisted of U.S. college women recruited in Fall 2019, with a mean age of M = 19.68 in the restricted sample. Results showed good fit for all tested models but failed to replicate the direct pathway between self-surveillance and sexual satisfaction. Instead, our models supported an indirect effect of self-surveillance on sexual satisfaction through body shame and sexual self-esteem. Findings support the role of sociocultural channels in influencing college women's body image and sexual experiences.

Understanding how individuals conceptualize and communicate sexual consent is critical to sexual health and has important implications for the prevention of sexual assault. This study used a data-driven (vs. a theoretical) approach to understand how students’ internal feelings of willingness (i.e., internal consent) and behavioral communication of consent (i.e., external consent) cluster together within sexual encounters. Using data from 610 college students (72% female) who reported on their most recent sexual encounter, latent profile analysis revealed five distinct consent profiles. Most students reported willing encounters that involved the use of several external consent cues (68.9%), a small group reported low levels of both internal and external consent (3.8%), and three groups (27.3% altogether) reported encounters with complex patterns of internal and external consent. Demographic and encounter-level differences were observed across profiles. Programming that trains students to attend to their own internal desires in addition to external consent behaviors could improve emotional health and shift social norms about sexual communication.

College students experience a myriad of stressors in their daily lives. These stressors are associated with negative outcomes for students, both to their academics and well-being. Healthy, effective coping strategies may support students in navigating personal distress. One of the primary aspects of counselling is to help clients develop and apply such strategies. This study aimed to identify intrapersonal factors that predict types of coping strategies. Participants (N = 416) identified as undergraduate college students attending a large public university in the southwestern United States. Results indicated that a problem-focused engagement coping strategy was associated with maladaptive factors such as shame and personal distress. Additionally, a problem-focused engagement coping strategy was predicted by potentially more helpful intrapersonal characteristics including guilt (as a motivator) and two dimensions of empathy. Finally, mean comparisons indicated statistically significant differences between identified gender and coping strategies. Implications for college counsellors are discussed.

The present study took a differentiated perspective on parental psychological control to examine its impact on adolescent adjustment among urban (n = 349, females: 53%) and rural (n = 293, females: 54%) Chinese adolescents (Mage = 12.14 years). Four times over the first 2 years of Junior High school (from October, 2016 to April, 2018), adolescents reported on parental psychological control, their psychological well-being (life satisfaction and depressive symptoms), and academic relative autonomy. Adolescents' grades also were obtained. The findings show generally negative effects of social comparison shame, love withdrawal and harsh psychological control (but not shared shame or parental relationship-oriented guilt induction) on adolescents' psychological well-being, and negative effects of social comparison shame on adolescents' academic functioning.

Background and objectives This thematic analysis of qualitative interviews from participants in Stage II randomized controlled trial examined women's and men's experiences in group therapy for substance use disorders (SUDs). Methods Interviews were conducted with 77 women and 38 men after completion of either the gender-specific Women's Recovery Group (WRG) or mixed-gender Group Drug Counseling (GDC). Interviews were coded for themes using a deductive approach with a coding scheme modified from the Stage I trial. Satisfaction was measured quantitatively posttreatment. Results Participants had high satisfaction scores with no significant differences between groups. Women in GDC rated group gender composition as less helpful than those in WRG. In the GDC group, women more frequently discussed the theme of self-perception (e.g., feelings of comfort, safety, shame) compared with men. Men overwhelmingly expressed the benefits of having women in the group, whereas women expressed advantages and disadvantages of mixed-gender groups and preference for single-gender groups. Guilt and shame were discussed by women and men; however, only women discussed stigma and its important role in their addiction and recovery. Discussion and conclusion Men more frequently endorsed the helpfulness of mixed-gender groups than did women while women appreciated the enhanced support in single-gender SUD groups. Issues of stigma are especially salient for women. Scientific significance Men and women express differences in their experiences of SUD group therapy. Only women endorse stigma as an obstacle to their treatment and recovery. Tailoring treatment to meet women's and men's needs may enhance engagement, retention, and clinical outcomes.

Infants express emotional distress through whining, crying, flailing, silence, etc., which can be viewed as communications that also afflict the caregiver(s). One expressive mode, subtle and often unnoticed except by the parents, is infant gaze avoidance. It often elicits parental feelings of rejection, shame and despair, and may be a reason for seeking parent-infant psychotherapy. In therapy, the symptom often discloses a disturbance in the dyad's emotional interaction. Therapy can bring about relief in the symptom and the relational disorder. Sometimes, the therapist discovers that the infant is avoiding the therapist's, rather than the parents', eyes. This challenges the therapist's expertise in establishing contact with the baby and in perceiving and processing emotional reactions to what may be experienced as the baby's dismissal. Gaze avoidance elicits theoretical questions approached in a previous publication: what does the child seem to avoid in the adult's eyes, and how can we conceptualize the psychodynamics behind the symptom? It also evokes technical questions: how can the therapist make contact with an infant who avoids the mother's or the therapist's eyes? How can the clinician exploit their emotional reactions, the countertransference, to understand and further the dyad's emotional communication? Two case vignettes are provided.

Objectives\ud The current study aimed to examine the mechanisms of change that mediate the impact of a compassionate mind training (CMT) intervention, in particular, whether changes in compassion, fears of compassion and heart rate variability (HRV) would mediate the effects of a brief CMT intervention on psychological vulnerability factors, mental health indicators and positive affect.\ud \ud Methods\ud Using a longitudinal design, general population participants were randomly assigned to one of the two conditions: compassionate mind training (n = 56) and wait list control (n = 37). Participants in the CMT condition attended a psychoeducation session and practiced a set of core CMT exercises for 2 weeks. Self-report measures of compassion, fears of compassion, self-criticism, shame, depression, stress and positive affect were completed, and HRV was assessed at pre- and post-intervention.\ud \ud Results\ud Mediation analyses revealed that increases in compassion for self and from others and reductions in fears of compassion for self, for others and from others mediated the effects of CMT on self-criticism and shame. In depression and stress, compassion for the self and from others and fears of compassion for the self emerged as significant mediators. Compassion for the self and from others and fears of compassion for self and from others significantly mediated the effect of CMT in safe affect. Compassion for the self, fears of compassion for self and for others and HRV mediated changes in relaxed affect.\ud \ud Conclusions\ud Cultivating a compassionate mind/self-identity through the core components of CMT may stimulate vagal regulatory activity and positively impact one’s ability to experience and be open to compassion, and thus promote emotion regulation, well-being and mental health.

Previous research suggest many women do not seek help after experiencing intimate partner violence (IPV) in Ghana. Of those who seek help, many do not report their experiences to the Domestic Violence and Victim Support Unit (DOVVSU)—a department of the Ghana Police Service mandated by the government to handle matters related to domestic violence. This study examined barriers to help-seeking at DOVVSU using data from 565 Ghanaian female victims of IPV and employing logit models. Results indicate a substantial proportion of the respondents did not know if police stations in their communities had DOVVSU units. Those who did not know were significantly less likely to seek help than those who knew about the service (AOR = 0.301).. Women who perceived ‘shame’ (AOR = 0.414) and ‘financial constraints’ (AOR = 0.387) as barriers were significantly less likely to report or seek help at DOVVSU than those who mentioned ‘guilt’. Those who trusted the police were more likely to seek help from DOVVSU (AOR = 1.65) than those who did not. Compared to those with no education, highly educated women had higher odds of seeking help from DOVVSU (AOR-2.36). Our findings suggest the need to improve the visibility of DOVVSU and to intensify education on IPV. In addition, the Ghanaian government should expedite the establishment of the domestic violence fund to mitigate women’s financial constraints in accessing help.

The subjective experience of social stigma has been widely researched in terms of discrimination, rejection, isolation, etc. These are commonly understood within the traditional individualistic framework of affective experience and sociality, which fails to address the transformative effects of social stigma on how one experiences the social realm and the own self in general. Phenomenology and recent work on the relationality of affective experience acknowledge the central role interpersonal interactions play in subjectivity and offer a suitable approach towards addressing the complexity of the subjective experience of social stigma. Focussing on autobiographical accounts, I propose that the experience of social stigmatization is characterized by an affective atmosphere of interpersonal alienation. Its counterpart, an atmosphere of belonging, is closely related to social empathy, which is eroded by prejudicial attitudes and stereotypes. The breakdown of social empathy establishes a peculiar form of relationless relationality that radically transforms one’s subjectivity. The transformation of subjectivity is structurally similar to disturbances of intersubjectivity in psychopathological conditions such as depression and feelings of disconnectedness, loneliness, and even shame are common in both cases.

Objective The aim of this study was to refine the YSQ-L3 by identifying the most statistically and clinically appropriate items for each Early Maladaptive Schema (EMS) using Rasch analysis. Method A Rasch analysis was undertaken on a large sample (N = 838) that included a heterogeneous clinical sample (N = 574) and a smaller non-clinical group (N = 264). Results Overall, 116 out of 232 items showed misfit across a number of statistical indicators. After the removal of these items, the fit improved for all subscales and showed good (.74) to excellent (.86) reliability with the exception of Enmeshment (.57). In line with previous research, items originally measuring Punitiveness were found to better fit two separate subscales, Punitiveness (Self) and Punitiveness (Other). Similarly, items assessing Emotional Inhibition fit better as two different constructs; Emotional Constriction, reflecting an over-control related to shame/embarrassment of showing emotions, and Fear of Losing Control, related to anxiety of the consequences if emotions are not contained. Conclusion This is the first study to apply a rigorous methodological process to item selection from the YSQ-L3. The findings of this study are significant given the wide use of this scale cross-culturally in both clinical and research settings and offer a possible alternative to the current short form.

Objective The ability to trust one's own perceptions is crucial for psychological well-being and growth. The relevance of its opposite, self-invalidation (SI), to the psychopathology of borderline personality disorder (BPD) is emphasized in many contemporary theories of evidence-based treatments for BPD. Empirical research on this topic remains scarce, however. This study aimed to describe manifestations of SI in individuals with BPD during a 40-session psychoeducational intervention based mainly on schema therapy. Method Transcripts of videotaped group sessions were analyzed inductively using qualitative content analysis. Results SI emerged as a recurrent, ubiquitous phenomenon. The content analysis yielded three core categories of SI: (1) a self-critical and harsh attitude towards the self (subcategories reflected punitive internalizations that could engender fear-based inertia, self-erasing, submissive coping behavior, and temporal fluctuation in SI), (2) a deficient sense of normalcy, and self-doubt, and (3) self-stigma. We also found an association of SI with various dimensions of BPD, including difficulty in the identification of emotions, secondary emotional reactions such as guilt, shame, anger, and resentment, self-related and interpersonal problems, and suicidal urges. Conclusions SI is a detrimental cognitive-emotional process relevant to BPD that merits treatment. Efforts to reduce self-stigma, a pernicious aspect of SI, are imperative.

Objectives: Despite numerous advances in the understanding of the development and maintenance of posttraumatic stress disorder (PTSD), current research is often narrowly focused on symptom reduction. Despite this, the impact of PTSD also extends into areas such as interpersonal relationships, pursuit of valued activities, and self-acceptance. These processes appear to be especially relevant in chronic/complex PTSD but are rarely represented in controlled trials. As a result, there is a need to expand the focus of PTSD research beyond symptom reduction to include processes of well-being. Methods: Using a latent growth curve analytical approach, this study examined the impact of change in self-compassion, psychological inflexibility, and interpersonal courage on PTSD symptom reduction, trauma-related shame, quality of life, and valued living for participants in an exposure-based PTSD partial hospitalization program (n = 537; 75% White; 83% female; mean age = 36). Results: All key processes assessed except for interpersonal courage showed clinically meaningful change over the course of the program. For the PTSD and valued living three-piece spline model slopes, only the three self-compassion slopes were significant predictors (p

A purposive sample of 560 counselor education students from 12 CACREP-accredited programs completed the Guilt and Shame Proneness Scale (GASP), an emotional and behavioral assessment of shame and g...

We still have little understanding of short-term predictors of suicidal thoughts and behaviors (STBs). Prior research links increased negative affect to STBs, but the vast majority of earlier work is limited by measuring negative affect at one time point and aiming to predict STBs months or years in the future. Recently, intensive longitudinal studies have shown that negative affect is associated with suicidal thoughts over relatively short, clinically useful time periods; however, the specific patterns and types of negative affect that predict STBs remain unclear. Using ecological momentary assessment (EMA) data from psychiatric inpatients hospitalized for suicide risk (n = 83), this study sought to test whether the patterns (means and variability) of two types of negative affect (anxiety/agitation and shame/self-hatred, which were derived from a larger EMA battery) during hospitalization predict STBs in the 4 weeks after discharge: an extremely high-risk time for suicidal behavior. The mean—but not the variability—of both anxiety/agitation and shame/self-hatred during hospitalization predicted the number of days with suicidal thoughts after discharge. The mean and the variability of shame/self-hatred—but not anxiety/agitation—predicted post-discharge suicide attempt. We discuss implications for assessment and treatment of suicidal individuals and propose key directions for future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s42761-021-00058-6.

The psychological mechanisms connecting shame and anger among men remain underexplored. This study aimed to understand the potential roles of psychological distress and alexithymia in this pathway, both in the form of difficulty identifying and describing one's feelings. Self-report measures were completed by 1,000 men (age mean = 49.6 years; range = 19-86 years). Conditional process analysis investigated a moderated mediation effect to determine whether men's distress mediated the relationship between shame and anger, and whether this effect differed according to severity and type of alexithymia. Findings indicated moderated mediation, with psychological distress a significant mediator in the association between shame and anger. Furthermore, difficulties describing feelings (but not identifying feelings) moderated the relationship between shame and psychological distress. Men's shame can be expressed via anger when experiencing psychological distress, and the inability to express one's feelings exacerbates this pathway. Clinical and public health avenues to reduce the impact of alexithymia are discussed.Supplemental data for this article is available online at https://doi.org/10.1080/00223980.2021.1977598 .