Guilt, shame and fear of death predict neonatal intensive care unit-related parental distress

Abstract

Objective: To explore the relationship between parents’ personality proneness to negative self-conscious emotions (guilt, shame and fear of death) and the stressfulness associated with their newborn’s hospitalisation in a neonatal intensive care unit (NICU). Background: Parents commonly blame themselves for their newborn’s hospitalisation and this self-blame may be characterological (shame-based) and/or behavioural (guilt-based) in type. The NICU experience may threaten parents’ cultural worldviews and self-worth, thereby making it mortality-salient. Method: Self-report questionnaires were used to measure NICU-related parental distress, guilt, shame and fear of death in 88 mother–father dyads. The Actor–Partner Interdependence Model method of dyadic analysis was used to measure actor (intrapersonal) and partner (interpersonal) self-conscious emotion effects with parental distress. A mediation analysis was performed to determine if fear of death mediated the relationship of guilt and shame with parental distress. Results: Shame and fear of death had significant actor effects with mothers’ and fathers’ distress, whereas chronic guilt had a significant actor effect with mothers’ distress. None of the partner effects was statistically significant. Overall, these self-conscious emotion predispositions explained 21% of the variance in mothers’ distress and 28% of the variance in fathers’ distress. Fear of death partially mediated the relationship of chronic guilt and shame with parental distress. Conclusion: Personality proneness to chronic guilt, shame and especially fear of death predicted NICU-related parental distress. These self-conscious emotions are aversive and parents may be reluctant to disclose them, yet emotional disclosure may benefit parents’ short- and long-term physical and psychological health.