Abstract
Suicide is a serious global public-health issue that is perceived as the most stigmatizing of sudden losses. Most studies on this topic have examined how bereaved families perceive public stigma, paying less attention to the actual stigma experienced by those not directly bereaved. Therefore, this study examined the association between personality traits and the public stigma attached to families that have lost a member to suicide. Three hundred and eighty (N = 380) Israeli participants completed demographic, Big 5, and stigma questionnaires. The study findings demonstrate that neuroticism and openness to experience are associated with higher levels of public stigma, while conscientiousness is associated with lower levels of public stigma. In addition, Arab participants reported higher levels of public stigma than Jewish participants. These findings make an important contribution to our understanding of the relationship between personality traits and the public stigma attached to families that have lost a member to suicide.
Suicide is a serious global public health issue; it is a leading cause of death worldwide and the second leading cause of death among people aged 15–29 years (World Health Organization, 2019). While suicide bereavement is assumed to be different from bereavement following other types of death, a number of studies have reported several similarities between suicide bereavement and other types of bereavement, in particular, bereavement following a violent death (Bolton et al., 2013; Kõlves et al., 2019). Nevertheless, suicide is unique in that it is often perceived as failure by the victim and the family to deal with emotional issues (Cvinar, 2005). Therefore, suicide is considered the most stigmatizing of sudden losses (Pitman et al., 2018).
The public stigma attached to people bereaved by suicide originated in the Middle Ages. During that era, legal, religious, and social sanctions against suicide arose as a deterrent within Roman Catholic, Jewish, and Islamic communities (Cvinar, 2005; Pritchard & Amanullah, 2007).
Numerous recent studies have demonstrated that members of families that have lost a member to suicide report feelings of shame and of being stigmatized by society (Cvinar, 2005; Dyregrov, 2011; Ghesquiere, 2013; Sveen & Walby, 2008). Due to the stigma associated with suicide, bereaved relatives feel that they are unable to secure sufficient support from friends or family (Young et al., 2012). In addition, public stigma attached to families left bereaved following a suicide adds complications to the course of suicide bereavement (Hanschmidt et al., 2016).
Within this context, public and personal stigma are forms of enacted (or objective) stigma, manifested as mistrust, fear, negative bias, and stereotyping of the bereaved, as well as social embarrassment and avoidance (Cvinar, 2005). However, most studies of this subject have examined the way these bereaved families perceive public stigma while paying less attention to the actual stigma experienced by those who have not been directly bereaved. Thus, this notion is of significant importance especially when taking into account the fact that suicide is a worldwide phenomenon (Bachmann, 2018). Bridging this gap was the main goal of the present study. To that end, we examined social stigma attached to families that have lost a member to suicide. As previous studies have demonstrated the significance of the Big 5 personality traits in the context of public stigma related to various pathologies and emotional distress (Canu et al., 2008; Jennings et al., 2017; Solmi et al., 2020; Yuan et al., 2018), we focused on the relationship between the Big 5 personality traits and public stigma toward families that have lost a member to suicide.
The Big 5 factor model (McCrae & Costa, 2008) posits five major personality traits: neuroticism, extraversion, agreeableness, conscientiousness, and openness. Neuroticism describes a tendency to react with strong emotion to adverse events. Extraversion is characterized by being outgoing, sociable, talkative, and high in positive affect. Agreeableness is a tendency to be responsive and pleasing in social situations. Conscientiousness is characterized by self-discipline, carefulness, and need for achievements. Openness is a tendency to be interested in novel situations, ideas, and experiences. Studies indicate that these five factors have a physiological and genetic foundation and appear to be stable across cultures and over time (Jakšić et al., 2012).
In the realm of public stigma, it has been demonstrated that openness and agreeableness are the strongest predictors of lower levels of public stigma while conscientiousness and extraversion are seldom also related to lower levels of stigma. However, conscientiousness and extraversion are more frequently associated with higher levels of stigma (Brown, 2012; Canu et al., 2008; Ekehammar & Akrami, 2003, 2007; Solmi et al., 2020; Yuan et al., 2018).
Accordingly, our first hypothesis refers to the relationship between the Big 5 personality traits and the public stigma attached to families that have lost a member to suicide. Specifically, we hypothesized that higher levels of agreeableness and openness would be associated with lower levels of public stigma attached to such families; whereas higher levels of extraversion, conscientiousness, and neuroticism would be associated with higher levels of public stigma attached to such families.
Our second hypothesis focused on communal and traditional tendencies and public stigma attached to families that have lost a member to suicide. In Israel, the Arab population is considered to exhibit higher levels of traditionalism and religiosity than the Jewish population (Azaiza, 2013). Therefore, since suicide is perceived negatively in traditional and religious communities (Cvinar, 2005; Pritchard & Amanullah, 2007), we hypothesized that the Arab participants would report higher levels of public stigma toward families that have a lost a member to suicide, as compared to the Jewish participants.
Method
Participants
The sample consisted of 380 Israeli participants (N = 380) including 194 Jews and 186 Arabs. Of the participants, 106 were men (27.9%) and 274 were women (72.1%). The average number of years of education among the participants was 14.77 years (SD = 2.83). One hundred and thirty-five of the participants (35.5%) reported a high financial status, 220 (57.9%) reported an average financial status, and 24 (6.3%) reported a low financial statues. Regarding religiosity, 137 of the Jewish participants were secular, 42 were traditional, and 15 were religious. Among the Arab participants, 56 were secular, 91 were traditional, and 39 were religious. All of the Arab participants were Muslim. The average year of birth was 1987 (SD = 12.30). Of the participants, 105 participants (27.6%) knew a family in which a member had committed or tried to commit suicide and 275 (72.4%) did not know any such family; 72 (18.9%) reported having experienced suicidal ideation and 308 (81.1%) reported no such ideation.
Measures
Demographic Questionnaire
This questionnaire covered variables such as age, gender, financial status, education, religion, acquaintance with a family that had lost a member to suicide, and personal thoughts of suicide.
Big 5 Personality Traits
The Big 5 Inventory (BFI; John et al., 1991) was used to measure the Big 5 personality traits of openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. This questionnaire includes 44 items that are each rated on a 5-point Likert scale ranging from 1 (do not agree at all) to 5 (agree very much). Each of the five personality traits is quantified as the average overall score for the items relevant to that specific trait. Higher scores represent higher levels of the personality trait. Previous studies have reported Cronbach’s alpha coefficients ranging from .87 to .79 for this instrument and reviewed evidence of its validity (John et al., 2008). In the present study, in order to enhance the internal consistency of the personality traits, some items were removed from the subscales. The Cronbach’s alpha coefficient for extraversion was .67. (Items 6, 21, 31, and 26 were removed.) The Cronbach’s alpha coefficient for neuroticism was .80. (Item 19 was removed.) The Cronbach’s alpha coefficient for agreeableness was .64. (Item 22 was removed.) The Cronbach’s alpha coefficient for conscientiousness was .72. The Cronbach’s alpha coefficient for openness to experience was .70. (Items 35 and 41 were removed.)
Stigma
Stigma was measured using the scale for evaluating the public stigma attached to families bereaved by suicide that was developed by Corrigan et al. (2018). This questionnaire includes 41 items that are each rated on a 5-point Likert scale ranging from 1 (do not agree at all) to 5 (agree very much). Higher scores represent higher levels of stigma. The items represent three types of stigma attached to surviving family members including stereotypes (Items 1–5), prejudice (Items 16–23), and discrimination (Items 24–41). The Cronbach’s alpha coefficient for the total scale was .95 and the Cronbach’s alpha coefficients for the subscales were .93 for stereotypes, .92 for prejudice, and .90 for discrimination.
Procedure
Following the approval of the University’s ethics committee (approval number 095/20), research assistants who were trained for the current study distributed the study questionnaire to the general public. However, since the study examined general public stigma attached to families that have lost a member to suicide, those who had lost a family member to suicide were excluded from the study. All participants voluntarily completed the questionnaires. No compensation was offered for participation in this study.
Data Analyses
In the first stage of the data analysis, we examined the means of the research variables and their standard deviations, as well as correlations between those variables (Table 1). In addition, independent-sample t-tests were performed. The Arab population (M = 2.92, SD = .63) reported higher levels of stigma (t(378) = −5.46, p < .001) than the Jewish population (M = 2.55, SD = .68). These significant differences were demonstrated in all three subscales of stigma: stereotypes (M = 3.23, SD = .79 for the Arab population; M = 2.83, SD = .89 for the Jewish population; t(378) = −4.58, p < .001); prejudice (M = 2.87, SD = .96 for the Arab population; M = 2.34, SD = .96 for the Jewish population; t(378) = −5.37, p < .001); and discrimination (M = 2.69, SD = .65 for the Arab population; M = 2.42, SD = .71 for the Jewish population; t(378) = −3.86, p < .001). As shown in Table 1, a positive correlation was found between neuroticism and public stigma (r = .20; p < .01) and negative correlations were found between agreeableness and public stigma (r = –.12; p < .05) and between conscientiousness and public stigma (r = –.20; p < .01).
Means, Standard Deviations, and Correlations Between the Big 5 Personality Traits and Public Stigma.
*p < .05. **p < .01.
In the second stage of the data analysis, we conducted a stepped hierarchal multiple regression to ascertain the relative contributions of the study variables to public stigma (Table 2). The study variables included general and demographic variables (Step 1: gender, age, religiosity, economic situation, education, financial status, acquaintance with a family in which someone committed or tried to commit suicide, past suicidal ideation, and being Jewish or Arab) and the Big 5 personality traits (Step 2: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism). According to Cohen (1992), for a regression analysis with 13 independent variables in which large or medium-sized effects are expected, 176 participants should suffice (Soper, 2020). However, in order to prepare for possible dropouts and missing data, the study sample included 380 participants.
Hierarchal Multiple Regression of Public Stigma.
aJewish = 1; Muslim = 2.
*p < .05. **p < .01.
As shown in Table 2, in Step 1, the explained variance was R2 = .06 (p < .01) and that variance could be explained by being Jewish or Arab. In the second step, when the Big 5 personality traits were entered, the explained variance was R2 = .10 (p < .01). That variance could be explained by neuroticism, conscientiousness, and openness to experience, in addition to being Jewish or Arab.
Discussion
The main goal of this study was to examine the relationships between the Big 5 personality traits and affiliation with a traditional or modern community, on the one hand, and the public stigma attached to families that have lost a member to suicide, on the other. In accordance with our first research hypothesis, neuroticism was associated with higher levels of public stigma. This finding is of great interest as previous studies regarding pathologies and public stigma did not find a strong relationship between neuroticism and public stigma (Brown, 2012; Ekehammar & Akrami, 2007; Solmi et al., 2020; Yuan et al., 2018). On the other hand, studies conducted within the realm of emotional distress, such as trauma, have found that neuroticism is one of the most dominant personality traits associated with elevated levels of distress (Weinberg & Gil, 2016; Caska & Renshaw, 2013; Mattson, James, & Engdahl, 2018; Ogle, Siegler, Beckham, & Rubin, 2017). It is possible that suicide, unlike other pathologies, is often perceived as a personal and familial failure to deal with emotional issues (Cvinar, 2005) and involves a death, which is sometimes also a violent death. These circumstances might have a stronger impact on the public. Accordingly, those who tend to react strongly to adverse events might find it hard to contain drastic, unchangeable conduct such as suicide, leading them to attach higher levels of stigma to families that have lost a member to suicide. However, given the cross-sectional nature of this research, no causal relationships can be established unequivocally.
Contrary to our hypothesis that openness to experience would be associated with lower levels of stigma, the present study found that openness to experience was associated with higher levels of public stigma. This discrepancy could be attributed to the nature of openness to experience and, possibly, the perception of suicide. Openness to experience refers to the tendency to be creative, curious, sensitive to aesthetics, and open to new ideas and experiences (Costa & McCrae, 1992; McCrae & John, 1992). These virtues might represent vitality, flourishment, and capturing the best that life can offer. Moreover, people with openness to experience are proactive, generally good at coping, and relatively creative and flexible in thinking about solutions and alternatives in the face of stressors (Straud et al., 2015). It is possible that suicide and suicide bereavement might represent the opposite of these characteristics, leading to a negative relationship between openness to experience and the public stigma attached to families that have lost a member to suicide.
This notion might also explain the negative association between conscientiousness and public stigma, an association that contradicts our study hypothesis. Conscientiousness reflects self-control, self-discipline, and achievement (Jakšić et al., 2012; McCrae & John, 1992) and situations related to horrific distress such as suicide and suicide bereavement are the kind of situations that allow those qualities to thrive, contain the distress, and be a source of support and comfort for others. These circumstances are strengthened when taking into account the fact that conscientiousness has been shown to be a significant trait in the context of coping with stress (Straud et al., 2015).
Interestingly, the personality traits of agreeableness and extraversion were not associated with public stigma. A possible explanation for this discrepancy could be the use of the Big 5 personality traits scale in the current study. In the examination of the Big 5 personality traits, some items were removed from some of the subscales to enhance their internal consistency. Although there are several questionnaires that use only two items to examine personality traits (for example, the TIPI; Gosling et al., 2003), the removal of items might have limited the study findings.
However, it should be noted that numerous studies have demonstrated that often only some of the Big 5 traits are associated with stigma and emotional distress (Canu et al., 2008; Jennings et al., 2017; Solmi et al., 2020; Straud et al., 2015; Yuan et al., 2018). In addition, it is possible that public stigma differs from direct personal-self issues. This kind of detachment might require a stronger and more dominant relationship to be present between the variables for a significant association to be revealed, which agreeableness and extraversion lack in this context. This concept could also offer an explanation for the lack of association between public stigma and the personal characteristics of age, education, financial status, acquaintance with a family in which someone committed or tried to commit suicide, and past suicidal ideation. The detachment associated with distant issues, as opposed to direct personal issues, means that a stronger and more dominant relationship between the variables would be required for a significant association to be revealed.
In line with our second research hypothesis, the Arab participants reported higher levels of public stigma attached to families that have lost a member to suicide, as compared to the Jewish participants. However, the fact that this study did not involve a randomized sample limits the generalizability of the findings. Nevertheless, research literature demonstrates that, in Israel, the Arab population exhibits higher levels of traditionalism and religiosity than the Jewish population (Azaiza, 2013). Indeed, in our study, the Arab participants were more inclined to religiosity and less inclined to being secular than the Jewish participants. This, in turn, is consistent with the research literature that shows that suicide is perceived negatively in traditional and religious communities (Cvinar, 2005; Pritchard & Amanullah, 2007).
Conclusion
Taken together, the findings of this study have important implications. In communities in which there are individuals who have lost a family member to suicide, social and emotional intervention programs should be provided for community members. These programs should emphasize the relationship between the public stigma attached to families that have lost a member to suicide and the personality traits of neuroticism, openness to experience, and conscientiousness. Attention should also be paid to the traditional societies with higher tendency to religion as they might be inclined to higher levels of public stigma. In addition, we suggest that is important to reflect to these bereaved families the fact that the magnitude of public stigma attached to them is, in fact, not as great as they may perceive it to be.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
