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

• Published in: European journal of psychotraumatology Vol. 14; no. 1; p. 2182820
• Main Authors: Levi-Belz, Yossi, Hamdan, Sami
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 2023; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Basic; Complicated grief; depresión; depression; Depression - psychology; Disclosure; divulgación voluntaria; Duelo complicado; Grief; Humans; Mental depression; Questionnaires; self-disclosure; Shame; sobrevivientes a pérdida por suicidio; Suicide - psychology; suicide-loss survivors; Suicides & suicide attempts; Survivor; Survivors - psychology; vergüenza; 复杂性哀伤; 自我表露; 自杀失败幸存者; shame; Duelo complicado; depresión; sobrevivientes a pérdida por suicidio; self-disclosure; suicide-loss survivors; 复杂性哀伤; vergüenza; 羞耻; divulgación voluntaria; 自杀失败幸存者; depression; 抑郁; Complicated grief; 自我表露
• ISSN: 2000-8066; 2000-8066
• DOI: 10.1080/20008066.2023.2182820

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.
Shame significantly and positively contributed to CG and depression at trajectories.
Self-disclosure moderated the contribution of shame to CG and depression at T3 beyond their natural trajectories.
Interpersonal activities may serve as a buffer against the deleterious effects of suicide in the family.