Is Honor Culture Linked With Depression?: Examining the Replicability and Robustness of a Disputed Association at the State and Individual Levels

Abstract

A large body of evidence indicates that U.S. honor states exhibit higher suicide rates than do dignity states. Research into one potential precipitating factor, depression, has yielded conflicting evidence, with support for an honor–depression association observed by some researchers but not by others. The present research (a) reassessed this association using more robust measures, (b) extended prior work by also examining suicidal ideation, and (c) examined the associations among honor, depression, and suicidal ideation at both the state and individual levels. Study 1 showed that, after controlling for relevant covariates, state-level honor was associated with higher levels of depression (both major depressive episodes and lifetime depression diagnoses), especially among non-Hispanic White adults. Furthermore, we found the strongest evidence for the honor–depression association using the continuous honor index. We also found that the honor–suicidal ideation association was mediated by depression. Study 2 (N = 4,235) showed that individual-level honor endorsement was positively associated with depression and suicidal ideation, but not anxiety. Moreover, the individual-level honor–suicidal ideation association was also mediated by depression. We discuss the theoretical and clinical implications of these findings.