Multi-modal measurement of shame in relation to perceived stress and avoidance coping in the context of recent HIV diagnosis

Abstract

In stigmatized illnesses such as HIV, shame and other negative self-conscious emotions are associated with sub-optimal engagement in healthcare via stress and avoidance coping. However, shame is challenging to assess via self-report. We employed multimodal measurement to examine whether indicators of shame could predict stress and avoidance coping. Using 319 video-recorded narratives from people recently diagnosed with HIV, we utilized a confirmatory factor analysis on three modalities of shame (self-report, linguistic, and nonverbal postural movement) and connected latent variables to self-reported stress and avoidance coping. Latent self-reported shame was associated with stress and escape-avoidance coping; linguistic shame was associated with stress; postural movements were associated with distancing. Models indicated no second-order factor. Results showed differential associations between measurement modalities of shame, consistent with prior literature on affect measurement, and imply that understanding the connection between shame and healthcare-relevant outcomes necessitates multiple modes of measurement.