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

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.