Shame, Guilt, and Suicide: A Mixed Methods Study of Psychiatric Inpatients at Risk for Suicide

Shame and guilt have been empirically examined in the context of suicide; however, inconsistencies in uniformly defining and measuring these emotions exist and lead to contradictory findings. Advancing our understanding of the role of shame and guilt in the trajectory toward suicidal thoughts/actions has important research and practice implications. PURPOSE: (1) To qualitatively explore common themes of shame and guilt within suicide narratives shared during psychotherapy; and (2) To quantitatively determine the association among shame, guilt, suicide-related distorted cognitions, dysregulated emotions, and problematic social problem-solving. METHODS: A cross-sectional, retrospective, mixed methods, and exploratory sequential design was employed. Selected baseline randomized controlled trial (RCT) data from 58 suicidal servicemembers and adult dependents admitted for inpatient psychiatric care and randomized into the treatment arm of the RCT were used. Qualitative analyses focused on patients transcribed7suicide narratives. Magnitude ratings quantified the intensity and relevance of shame and guilt; the ratings were carried over to answer a series of research questions, using regression models.