Last Words: Analysis of Suicide Notes from an RECBT Perspective: An Exploratory Study

A sample of 86 suicide notes was analyzed to identify the common cognitive and emotional themes contained in the text from a rational-emotive and cognitive behavior therapy (RECBT) perspective. Using grounded theory and statistical analysis to examine the data, this study found that the most frequent emotional categories to be present in these suicide notes are autonomous depression, sociotropic depression, guilt, shame, hurt and anger. It was also discovered that men, more than women, are likely to write about their experience of guilt in their suicide notes at the end of a relationship, while women are more likely to express feelings of hurt. This study may enable RECBT practitioners to better understand the cognitive and emotional factors of suicide behavior, and it may encourage future research into more specific suicide prevention protocols.     

Guilt, guilt-evoking events, depression, and eating disorders

A long theoretical tradition has linked guilt with internalizing disorders. We find no evidence, however, that a greater personality proclivity for guilt is related to depression or eating disturbances as reported by 85 female undergraduates. Females also described guilt-producing incidents involving school versus eating and exercise. We examined reactions to the events including guilt feelings and perceived effectiveness in alleviating these feelings, intropunitive responses, action tendencies, and rationalizations. Both depression and eating disturbances were unrelated to guilt feelings over school, but were related to guilt feelings over eating and exercise. Ineffective alleviation of guilt feelings in both domains was correlated with depression and greater eating disturbances. Women who reacted to guilt-producing events with fewer intropunitive responses such as rumination and self-hatred, and by confiding in others, distancing, and rationalizing their actions through justifications and excuses were less likely to have eating disturbances.     

Individual Differences in Experiences of and Responses to Guilt and Shame: Examining the Lenses of Gender and Gender Role

How are experiences of and reactions to guilt and shame a function of gendered views of the self? Individual differences in guilt and shame responses were explored in a sample of 104 young adults, most of whom were European American. Results indicated that, although women reported greater proneness to guilt and shame, men reported more trait guilt. Heightened levels of guilt- and shame-proneness were observed among both men and women with traditionally feminine gender roles, whereas a more traditionally masculine self-concept was associated with decreased shame-proneness for women. Gender schematic women favored verbal responses to ameliorate the experience of guilt, whereas gender schematic men preferred action-oriented responses. These results are discussed as gendered outcomes of schematic versus aschematic gender role socialization.     

Sex differences in expected guilt reactions to hypothetical behaviors of sexual, hostile, and moral substance.

Differences between male and female guilt reactions to hypothetical guilt-inducing situations of a sexual, hostile, and moral nature were investigated. Two independent samples of Ss (56 men, 56 women; and 34 men, 62 women) reported the intensity of their anticipated guilt reactions to 60 hypothetical behavior situations presented in sentence-completion format through the use of scaled response alternatives. Across both samples there were specific behaviors, in which stable sex differences were evidenced, i.e., females' reactions were more intense for those behaviors reflecting sexual transgressions. However, males and females were highly similar in their reactions to hostile and moral guilt-provoking situations. Implications of these results for research on trait-guilt were discussed.     

Shame,Guilt, and Suicide Ideation among Bondage and Discipline,Dominance and Submission,and Sadomasochism Practitioners: Examining the Role of the Interpersonal Theory of Suicide

To date, no study has examined rates of suicide ideation or theory‐based risk factors for suicide ideation among bondage and discipline, dominance and submission, and sadomasochism (BDSM) practitioners. Participants were 321 adults that endorsed BDSM involvement. Thirty‐seven percent of the sample indicated a nonzero level of suicide ideation. Thwarted belongingness and perceived burdensomeness (PB) were positively associated with suicide ideation and their interactive effect predicted additional variance in suicide ideation after adjusting for depressive symptoms. Overall, shame and guilt were positively associated with suicide ideation and these relations were mediated by thwarted belongingness and PB in parallel adjusting for depressive symptoms; however, there were some differences between demographic subgroups. Among BDSM practitioners, stigma‐related internalized feelings (i.e., shame and guilt) may be associated with increased thwarted belongingness and PB, which are associated with suicide ideation.     

Patient Suicide: A Survey of Therapists' Reactions

A substantial proportion of therapists will at some point in their professional life experience the loss of a patient to suicide. Our aims were to assess how therapists react to patient's suicide over time and which factors contribute to the reaction. One third of the therapists, mostly women, suffer from severe distress. The impact is not different for therapists in institutional settings and therapists in private practice. The item “overall distress” immediately after the suicide predicts emotional reactions and changes in behavior. Our data suggest that identifying the severely distressed subgroup could be done using a visual analogue scale for overall distress. As a consequence, more specific and intensified help could be provided to these individuals.     

A Preliminary Study for Exploring Different Sources of Guilt in a Sample of Veterans Who Sought Chaplaincy Services

Limited research has suggested that experiencing guilt may contribute to the risk of suicidal behavior in some veteran populations. Using data collected by chaplains, this study compared the frequency with which 94 veterans with a history of suicide ideation experienced guilt relative to 670 veterans without a history of ideation. We then compared main sources of guilt reported by ideators and nonideators. Ideators reported experiencing guilt significantly more often than nonideators. No differences were noted for the source of guilt among those who reported frequently experiencing this emotion. Ideators with an infrequent experience of guilt significantly more often named life and the military as the main source of this emotion. Clinicians should be mindful of the need to appropriately assess for and address guilt among veterans at increased risk of suicide. A variety of sources, not limited only to military experiences, may contribute to a veteran’s sense of guilt.     

Suicidal behavior, negative affect, gender, and self-reported delinquency in college students

The associations among suicidal behavior, negative affect, and delinquency were assessed via an anonymous self-report survey administered to male and female college students ( N = 383). Contrary to our hypothesized results, there were no gender differences in rates of suicidal ideation and attempts. Confirming our hypotheses about gender differences, college men did report significantly more delinquent behavior than college women. College men also scored higher on the suicide-proneness scale, which contained a mixture of death-related, risk-related, and negative self- and health-related items. Furthermore, as predicted, college students with a history of depression, suicide ideation, and/or suicide attempts all reported significantly more delinquent behavior. Self-reported delinquency and current levels of depressive symptomology emerged as significant predictors of suicide-prone behavior for both college men and women, explaining 34% of the variance for women and 17% for men. Levels of engagement in suicide-prone behavior and feelings of depression were elevated in college students with any type of juvenile arrest history. Students with an arrest history were also more likely to have had a diagnosis of depression and to have engaged in suicide ideation in their past. These findings suggest there are complex links between depression, delinquency, and suicidal behavior in college men and women.     

Stress,self-esteem,and mental health: How does gender make a difference?

Questionnaire responses of 804 women and 127 men were compared to assess sex differences in college students' stress levels and reactions to stress, and the extent to which their self-esteem, interpersonal self-confidence, and self-concepts are associated with their experiences with stress. The men and women reported similar stress levels in most areas of life, but the women reported greater stress regarding family relationships and concern about their mental health. The women reported that when they are under stress, they experience more symptoms of depression and anxiety, and are more likely to express their anger and feelings, whereas the men reported that they become more active in response to stress. For both men and women, levels of stress and reactions to stress were associated with self-esteem, interpersonal self-confidence, and self-concepts. The results indicate that sex differences in dysfunctional reactions to stress can be explained by sex differences in self-concept more persuasively than can differences in areas of stress.The author wishes to thank the presidents of the seven colleges for their support and encouragement; the Seven College Study Advisory Board, campus coordinators, and staff for their contributions; and the students for their interest and participation. The author also expresses her appreciation for the support of the Henry A. Murray Research Center of Radcliffe College. This research was supported in part by a grant from the Josiah Macy, Jr. Foundation.     

Impact of Death by Suicide of Patients on Thai Psychiatrists

The objective of this study was to identify the impact of a patient's suicide on psychiatrists in Thailand. A confidential coded postal questionnaire survey was sent to 320 eligible psychiatrists; with a response rate of 52.18%). The results showed that 94 (56.28%) of responding psychiatrists had a patient die by suicide, consistent with high rates found in similar large‐scale studies in the United States and United Kingdom. Less than half (41.5%) of patients had been diagnosed with schizophrenia, 33% had a depressive disorder, and the others had a wide array of diagnoses. More than 50% of psychiatrists reported personally experiencing sadness, depression, hopelessness, and guilt; 74.5% reported professional reactions, most frequently a review of their practice (93.4% reported being more aggressive in assessment of suicidality). Respondents were diverse in their postvention; 90% of Thai psychiatrists reported that working through with colleagues was most helpful. Family and friends helped. A majority (72.4%) of psychiatrists prayed or did “merit” for the dead patient; 86.8% found it helpful. This finding suggests that cultural sensitivity may be needed to understand the impact of suicide on psychiatrists but also to its response.     

Effects of work‐related norm violations and general beliefs about the world on feelings of shame and guilt: A comparison between Turkey and the Netherlands

This paper aimed at investigating the effects of work‐related norm violations (i.e., violations of interpersonal and work regulation norms) and individuals' general beliefs about the world (i.e., social axioms: reward for application, social cynicism) on feelings of shame and guilt in Turkey and in the Netherlands. An experimental study involving 103 Turkish and 111 Dutch participants showed that work norm violations elicited feelings of guilt and shame differently in Turkey and the Netherlands. Specifically, interpersonal norm violation in Turkey elicited feelings of shame and guilt more strongly than did violation of a work regulation norm, whereas no differential effects were found in the Netherlands. As expected, violation of a work regulation norm elicited feelings of shame and guilt more strongly in the Netherlands than in Turkey, whereas violation of an interpersonal norm elicited feelings of shame and guilt more strongly in Turkey than in the Netherlands. The findings provide further evidence for the moderating effects of social axioms: in both countries, participants high in social cynicism felt less ashamed when they violated a work regulation norm than did those low in social cynicism. Our findings are relevant for understanding the underlying mechanisms of norm violations at work, thereby offering a new avenue for investigating cultural differences in the workplace. The latter may be of particular relevance in times of globalization and diversity in the workplace.     

Erotic Countertransference and Clinical Social Work Practice: A National Survey of Psychotherapists' Sexual Feelings,Attitudes, and Responses

Male and female social work psychotherapists were surveyed on sexual feelings toward clients, sexual behavior with clients, and utilization of erotic countertransference. Relationships between these variables and therapists' self-reports of training in erotic counter-transference, utilization of supervisory consultation, length of clinical experience, and theoretical orientation were also examined. Male therapists were significantly more likely than females to report sexual attraction toward clients, and to report using erotic countertransference to further treatment goals. The frequency of therapists' discussion of sexual feelings toward clients in supervision was related to the reported frequency of utilization of sexual feelings in treatment. The majority of therapists reported that their social work training did not prepare them adequately to work with erotic countertransference.     

When feeling bad makes you look good: Guilt,shame, and person perception

In two studies, we examined how expressions of guilt and shame affected person perception. In the first study, participants read an autobiographical vignette in which the writer did something wrong and reported feeling either guilt, shame, or no emotion. The participants then rated the writer's motivations, beliefs, and traits, as well as their own feelings toward the writer. The person expressing feelings of guilt or shame was perceived more positively on a number of attributes, including moral motivation and social attunement, than the person who reported feeling no emotion. In the second study, the writer of the vignette reported experiencing (or not experiencing) cognitive and motivational aspects of guilt or shame. Expressing a desire to apologise (guilt) or feelings of worthlessness (private shame) resulted in more positive impressions than did reputational concerns (public shame) or a lack of any of these feelings. Our results indicate that verbal expressions of moral emotions such as guilt and shame influence perception of moral character as well as likeability.     

When feeling bad makes you look good: guilt, shame, and person perception

In two studies, we examined how expressions of guilt and shame affected person perception. In the first study, participants read an autobiographical vignette in which the writer did something wrong and reported feeling either guilt, shame, or no emotion. The participants then rated the writer's motivations, beliefs, and traits, as well as their own feelings toward the writer. The person expressing feelings of guilt or shame was perceived more positively on a number of attributes, including moral motivation and social attunement, than the person who reported feeling no emotion. In the second study, the writer of the vignette reported experiencing (or not experiencing) cognitive and motivational aspects of guilt or shame. Expressing a desire to apologise (guilt) or feelings of worthlessness (private shame) resulted in more positive impressions than did reputational concerns (public shame) or a lack of any of these feelings. Our results indicate that verbal expressions of moral emotions such as guilt and shame influence perception of moral character as well as likeability.     

Family Gender Role and Guilt in Spanish Dual-Earner Families

In dual-earner families the balance between work and family demands facilitates the development of guilt feelings when parents perceive a non-fulfillment of their responsibilities in childcare. Specifically, women who aspire to personal and professional development on the basis of more egalitarian gender role models must deal with the traditional stereotypes that maintain an intensive maternity mandate that prioritizes the family. On the other hand, for men the role change is primarily in the family setting with the development of a new father role more involved in the care of their children, which is not easily compatible with the more traditional breadwinner role. This study explored the feelings of guilt about parenting in 251 employed Spanish parents with children between 3 and 6 years of age, through the Scale of Guilt Feelings about Parenting, and its relationship with traditional stereotypes of maternal and family role. The scale addresses diverse situations pertaining to child rearing in which work requirements do not allow parents full availability for the care of their children. This availability is present in the model of intensive maternity and in the new father role model. Results indicate the presence of similar and high levels of guilt in fathers and mothers, although in men guilt is related to a non-traditional family role ideology, whereas in women guilt is related to a more traditional maternal role stereotype.     

A cross-cultural investigation of the communication of suicidal intent in Swedish and Turkish adolescents

A recent study found that Swedish adolescents were more disapproving of a suicidal disclosure by a fictional friend than their Turkish counterparts. Given this finding, the present study investigated whether or not more adolescents in Turkey than in Sweden disclose their own suicidal thoughts to someone, to whom adolescents disclose their suicidal thoughts, what reactions such disclosures produce, and reasons for not disclosing suicidal feelings among 966 Swedish and 956 Turkish high school students. A questionnaire was used to collect information about different aspects of suicidal disclosures. More Turkish than Swedish adolescent suicide ideators disclosed their thoughts. More Turkish than Swedish students believed also that young people thinking about and planning suicide tell others of their plans and thereby ask for help. An overwhelming majority of adolescents in both groups revealed their thoughts to peers. The social reactions to suicidal disclosures in both samples were mainly positive. The two most common reasons for not disclosing in both groups involved interpersonal hopelessness. Adolescents who disclosed their past suicidal thoughts to someone reported having lower current suicidal ideation than those who had not. In line with favorable social attitudes towards suicidal disclosures and lower suicidal mortality rates in Turkey compared with Sweden, more Turkish than Swedish adolescents reported having disclosed their own suicidal thoughts to someone in their social milieu.     

Sex guilt,trait anxiety,and females' subjective sexual arousal to erotica

Subjective sexual arousal and affective reactions of 80 college women to explicit sex films were studied in a 2 (sex guilt) × 2 (trait anxiety) × 2 (films) design. There was a decline in sexual arousal to a film of oral-genital sex and a decline in sex guilt in the present sample in comparison to a similar sample from this laboratory 8 years ago. High-sex-guilt women reported fewer genital sensations and rated themselves lower on sexual arousal during and after the films than did their counterparts less disposed to guilt over sex. High-sex-guilt women reported more affective guilt, disgust, and anxiety-fear as a consequence of viewing an explicit sex film than women below the median on sex guilt. High-trait-anxiety women reported more intense genital sensations and rated their sexual arousal as higher following the films than low-trait-anxiety women. Women above the median on trait anxiety reported more subsequent anxiety-fear and depression-distress following the films than low-scoring women. These results were discussed from the perspective of Izard's differential emotions theory, which regards anxiety as a variable pattern of fundamental emotions rather than as a functional unity.This research was supported in part by a National Science Foundation Grant to the University of Connecticut Computer Center. The authors wish to thank Wendy Cunningham and Linda Wildes for serving as experimenters.     

Emotional communication in close relationships

Emotional communication patterns characterizing interactions between partners in close relationships were investigated by asking 29 couples who were married or living together to engage in a videotaped discussion of a problem they were having in their relationship. In a later experimental session, partners identified specific communications that they believed had an important influence on the discussion and then rated the communications in terms of the feelings the communicator intended to convey and the recipient's reactions. Partners attempted to reciprocate both the positive and negative feelings that they perceived their partner to express toward them. However, only negative feelings were actually reciprocated. This was because subjects were sensitive to differences in the negative feelings their partners reported expressing and interpreted those feelings correctly, but they were inaccurate in perceiving their partners' expressions of positive feelings. Men (but not women) interpreted their partners' failures to express love as an indication of hostility, whereas women (but not men) interpreted their partners' lack of hostility as an indication of love. These and other results were conceptualized in terms of a general model of emotional communication. Parameters of the model pertaining to the hostility of partners' communications were often related to women's satisfaction with their relationship and their beliefs about relationships in general. However, they were unrelated to men's satisfaction and general beliefs. This suggested that women are generally more adversely affected by overt expression of hostility than are men.     

Portuguese Mothers and Fathers Share Similar Levels of Work-Family Guilt According to a Newly Validated Measure

Transformations in family and work life have led to profound changes in the articulation of both spheres. The massive entry of women into the labor market, the decline of a family model based on the male provider, increasing job demands, and persistent gender inequality are factors that can generate work-family conflict and lead to feelings of guilt. Work-family guilt is a topic still rarely studied, particularly in Portugal. Given the importance of understanding the complexity of the relationships underlying the work-family interface and the lack of instruments in Portuguese to assess the feeling of guilt as it pertains to the work-family interface, our goal was to adapt the Work-Family Guilt Scale (WFGS) to the Portuguese population. Our results confirmed the two-dimensional structure of the scale with good reliability and validity. The WFGS was invariant between genders, with no significant mean differences between men and women. Convergent validity with the variables of work-to-family and family-to-work conflict and discriminant validity between the two dimensions of the WFGS was demonstrated. Use of this scale will allow the identification of feelings of guilt, which pose risks to the physical, emotional and psychological well-being of workers. Guilt feelings should, like conflict, be considered as a psychosocial risk that must be mitigated through policies and practices aimed at promoting a balance between family and working life.     

Temporal dynamics of guilt: changes in the role of interpersonal and intrapsychic factors

Baumeister, Stillwell and Heatherton (1994) argue that guilt serves primarily interpersonal functions and take issue with more traditional intrapsychic accounts of guilty feelings, in which causality, responsibility, and blame are emphasized. We examined the validity of these claims by asking 198 college students to imagine that they destroyed the valued property of either their best friend or mother, under each of three conditions of causal responsibility (accidental, foreseeable, unjustifiably intended). They then rated the reactions they anticipated from the victim (anger, disappointment; change in impression of the perpetrator), their perceived blameworthiness, aspects of causality, and how guilty they would feel immediately after perpetrating the harm as well as an entire day later. Imagined guilt was curvilinearly related to responsibility at time 1, but linearly at time 2. Results suggest that people only weigh interpersonal concerns more heavily after time has elapsed, but that both factors integrally affect feelings of guilt. © 1997 John Wiley & Sons, Ltd.