Date of Award

6-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)

Department

Clinical Psychology

First Advisor/Committee Member

Keyne Law, Ph.D.

Second Advisor/Committee Member

Thane Erickson, Ph.D.

Third Advisor/Committee Member

Joel Jin, Ph.D.

Abstract

Suicide is a global issue with rates continuing to rise despite decades of research and prevention efforts. The role of shame in the development of suicidal ideation, especially within non-Western contexts, remains underexplored. This mixed-methods study explored the relationships among shame, suicidal ideation, and help-seeking intentions in a Taiwanese sample, focusing on four culturally distinct Mandarin terms for shame—diu lian, can kui, xiu kui, and xiu chi. A total of 101 participants who has experiences of suicide-related thoughts or behaviors responded to an online survey. Quantitative analyses revealed that all shame terms were strongly correlated with suicidal ideation, and that help-seeking intention significantly moderated the relationship between shame and suicidal ideation. Thematic analysis of qualitative responses illustrated the dual role of shame, as a risk factor contributing to suicidal thoughts through mechanisms such as perceived failure, loss of status, feelings of inadequacy, and threatens to social identity, and as a potential protective factor motivating reparative help-seeking when individuals felt understood. Participants also identified stigma, fears of burdening others, and fears of judgments from others or themselves as barriers to seeking help, while normalizing conversations around suicide was seen as supportive. These findings underscore the limitations of directly translating Western measures of shame, and highlight the need for culturally grounded suicide prevention efforts that recognize shame’s complex functions. It also emphasizes the need for interventions that normalize help-seeking behaviors, reduce stigma, and foster environments where individuals feel supported in addressing their feelings of shame and thoughts of suicide. Future research should focus on developing context-sensitive measures, examining actual help-seeking behaviors, and addressing methodological issues to enhance validity and applicability.

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