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Using Guilt to Motivate Individuals to Adopt Healthy Habits

Summary and Keywords

In social marketing, the use of guilt appeals can be effective for influencing healthy behaviors. Guilt, being a moral, other-based emotion, can spur people to think of others, act honestly, and be empathetic. Likewise, collective guilt, the feeling that arises when people believe their in-group caused illegitimate harm to others, can lead people to feel positively toward the victimized others and desire policies that will help them. We can see then, that guilt, though often considered “negative” can lead to an array of prosocial, constructive, behaviors. In that vein, a number of researchers have assessed the possibility that guilt based persuasive appeals can induce such positive behaviors.

Clearly, guilt-appeals can be an effective tool for reducing risk (STI testing), increasing prevention practices (encouraging mammograms), and effecting altruistic health-related behaviors (donating blood). In the correct conditions, guilt appeals can induce guilty feelings, lead people to want to “right the wrong,” generate positive attitudes about the message’s advocacy, and intend to engage in a behavior.

Keywords: guilt appeals, social marketing, emotional appeals, persuasion, guilt

Introduction: Using Guilt to Motivate Individuals to Adopt Healthy Habits

It is not necessary to look far to see the critical importance of adopting healthy habits, defined broadly as behaviors that advance or maintain the health of the individual (healthy eating, physical activity, cancer screening), the health of communities (blood donation, bone marrow donation, donation to charities that support communities), and the health of the planet and the environment (recycling, reducing energy consumption, using reusable bags). From vaccinations and HIV testing to nutritious eating and physical activity, the need for preventative health behaviors and risk reduction is vast. Yet the question, "how do we motivate people?" is not an easy one. Although traditionally, there has been an emphasis on cognitive activities to advance prevention, for example, increase knowledge, advance skill sets, provide and explain resources, it is unlikely that increasing audiences’ ability to make changes without changing their motivation to make changes will have little effect. Emotion, though, motivates.

Emotions, which are aroused in response to unique cognitive appraisal patterns of environmental stimuli, affect how we think, what we think, what we pay attention to, and, ultimately, our behavior (Nabi, 1999). And discrete emotions each operate in unique fashions. In other words, even two negative emotions, such as guilt and fear, can elicit quite different cognitive and behavioral outcomes—thus, it is not the valence of emotion that matters most. Emotional states can be the impetus for change; fear of lung cancer may lead someone to quit smoking. And pride in oneself for having quit smoking can lead someone to stay quit. In fact, even anticipated emotions may impact behavior. People who anticipate that they will regret not exercising, for example, are more likely to be physically active (Abraham & Sheeran, 2004). Moreover, risk and health communicators often rely on emotional appeals (e.g., fear appeals, guilt appeals, humor appeals) to affect audiences’ attitudes, intentions, and behaviors (Edell & Burke, 1987; Witte, 1992). The belief therefore is that we can harness the power of emotions by developing persuasive appeals that induce emotions and therefore cause change.

One emotion that has the power to motivate is guilt. Guilt is aroused when people become cognizant of a discrepancy between their actual behavior and their “ideal” behavior (as guided by their values). Guilt causes a desire to reduce the negative state, which can be achieved by engaging in positive behaviors. Likewise, persuasive appeals to guilt (i.e., guilt appeals) have received attention within the field of marketing and persuasion (Coulter & Pinto, 1995; Edmondson, 1986; Huhmann & Brotherton, 1997; Turner & Underhill, 2012). This article introduces the meaning of guilt as an emotion, discusses the influence that organically felt guilt (whether personal or collective) has on behavioral motivations, and the describes the overall effects of guilt appeals on persuasive outcomes. In this article, I take a broad view of healthy behaviors. Here, healthy behaviors are those behaviors that advance and/or maintain the health of the individual (healthy eating, physical activity, cancer screening), the health of communities (blood donation, bone marrow donation, donating to charities that support communities), and the health of the planet/environment (recycling, energy reduction, using reusable bags). Here, the experience of guilt as well as the use of guilt as a strategy for affecting such behaviors will be considered.

What Is Guilt?

Guilt is an unpleasant emotional reaction to an actual or anticipated violation of one’s internalized values or beliefs. When people engage in behaviors that “let themselves down,” guilt is the accompanying emotion, distinguished by a feeling of personal accountability (Izard, 1977; Lazarus, 1991; Strickland, 2001; Wallbott & Scherer, 1995). Guilt is unique compared to other emotions, such as fear, in that it is “other oriented” and not self-oriented. That is, guilt is typically induced via the recognition that one’s actions have the capability of causing others harm (Zeelenberg & Breugelmans, 2008). In this sense, guilt is an emotion caused when a person’s moral code is challenged. Given that moral codes are grounded in culture, it follows that specific events that cause people to feel guilty will vary personally, and by culture.

Personal Guilt

People vary in their propensity to experience guilt. Guilt proneness is an individual personality difference in the likelihood of feeling guilt across various individual offenses. To measure this individual difference, Cohen and colleagues developed the Guilt and Shame Proneness Scale (GASP; Cohen, Wolf, Panter, & Insko, 2011). By using the scale, their research showed that people who are high in guilt proneness are more likely to recognize when their behavior is inconsistent with their values—even when the behavior is private. Guilt prone individuals are more likely to be empathetic, perspective takers, considerate of future consequences, less likely to deceive, and stronger in moral identity (Cohen et al., 2011). Studies also show that, relative to those low in guilt proneness, those high in guilt proneness are also higher in the “H Factor”—a broad disposition incorporating other traits, such as sincerity, fairness, and modesty. Interestingly, women are more likely than men to be guilt prone (about 1 standard deviation higher), and older adults have higher scores on guilt proneness than do younger adults.

Guilt proneness has important implications for motivating people to engage in healthy behaviors. Health behaviors often affect others (e.g., smoking in public, drinking and driving, reducing carbon emissions) and can be considered “morality-based.” For example, disclosing one’s positive HIV status revolves around the desire to take the perspective of one’s partners, avoid deception by omission, and to think of future consequences for oneself and one’s partner(s). Thus, it may be that people high in guilt proneness are more likely to engage or be motivated to engage in such behavior. Those high in guilt proneness might be particularly relevant audience segments for certain health behaviors. Such an audience-segmentation strategy could prove more effective than a demographic or lifestyle-based segmentation strategy.

Collective Guilt

Although guilt can be a personality-level variable, it can also be experienced at the collective level. Collective guilt is experienced when individuals perceive that their in-group, as a whole, is liable for harm-doing (Wohl, Branscombe, & Klar, 2006). Collective guilt differs from both guilt proneness and personal feelings of guilt (Kaiser, Schultz, Berenguer, Corral-Verdugo, & Tankha, 2008). Collective guilt originates from one’s overall sense of collective responsibility and one’s social identity. Collective guilt is most likely to be experienced when individuals feel strong intergroup connections within a homogeneous group, perceive the group to have conducted the wrong doing, and see the wrong doing as having been illegitimate (Zebel, Zimmerman, Viki, & Doosje, 2008). The feeling of collective guilt is tied to the ability to experience efficacy on both a personal and a collective level. And a sense of respect for others is necessary for this collective emotion to arise. Both collective guilt and personal feelings of guilt are strongly associated with behavior.

Guilt and Behavioral Motivations

Qualitative and quantitative research reveals that people experiencing guilt are motivated to make things better, reconcile the situation, believe that there is some control over behavior(s), and to “be forgiven” (Lindsay-Hartz, 1984). For example, a focus-group participant in one study stated, “I think it’s important that you care about people to at least give a real big effort to it.” In sum, people who experience guilt want to repair the situation and correct the wrong.

Hence, guilt affects behavior. The strongest evidence of this comes from the body of interpersonal compliance-gaining literature linking guilty feelings with behavior(s). This idea emerged from a body of literature showing that guilty persons had a stronger desire to be altruistic—as a means of relieving the negative emotional state. After more than 50 years of research (Boster, Cruz, Manata, DeAngelis, & Zhuang, 2016), it is well understood in the early 21st century that regardless of how guilt is created, the subsequent desire is to engage in an activity—typically a prosocial activity—that makes one feel better. Researchers reliably find that participants experiencing guilty feelings show increases in compliance (most often operationalized as helping behaviors). Brock and Becker (1966) created guilt in study participants by having them press a button that either destroyed the experimenter’s research device or discharged a slight puff of smoke. Subsequently, the research team asked participants to sign a petition in support of doubling tuition at the university. The participants in the “no guilt” condition (the puff of smoke) were not willing to sign the petition. But approximately 50% of the subjects in the high-guilt (the damage condition) scenario were willing to sign it (Darlington & Macker, 1966; Freedman, Wallington, & Bless, 1967). In another study that attempted to induce guilt in research participants, Wallace and Sadalla (1966) asked subjects to volunteer for an experiment involving painful shocks. Before the researchers made that request, however, some of the participants were prompted to break an expensive machine. For other participants, the machine was already broken and the participant(s) were not responsible. The authors’ findings indicated that the participants who had broken the machine were significantly more likely to volunteer for the unpleasant experiment than were the subjects who had not broken the machine. In the study by Freedman et al. (1967), the researchers set up an experimental (i.e., contrived) situation in which participants “accidentally” knocked over a stack of purportedly carefully arranged note cards. Subsequently, participants were asked to assist in a public opinion survey, and the participants who believed they had knocked over the cards complied more than non-guilty controls.

The effects of guilt on compliance are robust across a variety of situational differences (O’Keefe, 2002). Guilt leads to behavioral action when the harmed individual makes a request of the participant who did the “harming” (Freedman et al., 1967), when the requests are made by a third party (Boster, Mitchell, Lapinski, Cooper, Orrego, & Reinke, 1999; Regan, 1971), as well as when no obvious request has been made at all (Konecni, 1972). In addition, guilt has been shown to motivate helping behavior, whether indiscretions are accidental or purposeful (Freedman et al., 1967). This effect has been replicated numerous times (e.g., Boster et al., 1999; Carlsmith & Gross, 1969; O’Keefe & Figgé, 1999; Konecni, 1972). The meta-analysis by Boster and colleagues (2016) showed that across 47 effect sizes analyzed, guilt increased compliance with an average effect of p = .26. What are these effects being looked at so carefully here? Certainly, because guilt often ensues when a person engages in health- and risk-related behaviors (public smoking, drug use, drinking and driving, etc.). This body of literature tells us that if individuals are made cognizant of that guilt, they will be more likely to comply with subsequent behavioral requests (e.g., do not drink and drive).

Collective guilt also has important implications for behaviors. Ferguson and Branscombe’s (2010) study on climate change behaviors inferred that inducing Americans to consider future Americans as part of the present-day in-group raises collective guilt with regard to current Americans’ shared greenhouse gas emissions. Ferguson and Branscombe outlined two conditions for predicting when beliefs will elicit collective guilt. First, people must believe that their group is responsible for the harm done. For example, collective guilt is more likely to be experienced when people believe that climate change is being caused by humans versus by natural circumstances. Second, people must believe that it is possible to repair the harm done (Schmitt, Miller, Branscombe, & Brehm, 2008; Wohl et al., 2006). The latter issue refers to response efficacy (Witte, 1992), which is the sense that a recommended behavioral response will avert the threat or risk. This is consistent with research by Brehm and colleagues (Brehm, 1999; Miron, Parkinson, & Brehm, 2007; Silvia & Brehm, 2001) who showed that when it is perceived as difficult or impossible to achieve the goal of an emotion (in the case of guilt, fixing the harm done), then the intensity of the emotion diminishes. More than 15 years of research on collective guilt has painted a picture of the behaviors that might ensue in response to this emotion. First, greater collective guilt leads to more positive attitudes regarding the victimized groups (Stewart, Latu, Branscombe, & Denney, 2010). Greater collective guilt over treatment of Mexican immigrants, for example, will lead to more positive attitudes toward Mexican immigrants. Second, collective guilt leads to more support for reparations. And third, collective guilt will lead to support for specific kinds of reparations (Ferguson & Branscombe, 2010). Thus collective guilt is an ideal emotion to investigate when attempting to change attitudes and behaviors linked to health policy. Collective guilt is also an emotion linked to behaviors attempting to reduce health disparities—especially those due to racism or sexism. Given that guilt is directed at a behavior—and not a stable trait of the self—it may motivate individuals to restore violated personal standards to alleviate the guilty feelings (Izard, 1977).

Although guilt is described as negative and unpleasant, it can lead to constructive health-related outcomes. The perception of personal accountability may motivate individuals to restore personal standards they feel were violated in order to alleviate the guilty feelings (Izard, 1977). Hence, guilt can be worked into persuasive message strategies aimed at causing behavioral action, specifically, healthy or risk-reducing behaviors (Huhmann & Brotherton, 1997) such as reduced substance abuse (Dearing, Stuewig, & Tangney, 2005).

Persuasive Appeals to Guilt

It is critical to distinguish between organically felt guilt and the strategically developed tool—the guilt appeal. As noted earlier, guilt occurs naturally when individuals believe they have engaged in a behavior that violated their own moral code (or that their in-group caused a harm). For example, participants in Boster et al. (1999) felt guilty when they were confronted with a classmate who cheated on a (fictional) test and failed to turn the cheater in to the instructor. The study showed that as participants’ guilty feelings increased, so did their intentions to volunteer to engage in more research without any earned incentives (i.e., extra credit).

Guilt appeals are different from organic guilt in that the message designer points out to the target audience that (a) they have a moral code and (b) that their behavior (or future behavior) is not meeting up to it. The objective can be achieved visually or verbally. In other words, a typical guilt appeal has two parts: (1) imagery or text intended to induce guilt (or anticipated guilt) by drawing attention to an inconsistency between standards and behaviors and (2) a recommended course of action that would evidently trigger the reduction of the transgression and negative affect (Baumeister, Stillwell, & Heatherton, 1994; Basil, Ridgeway, & Basil, 2006, 2008; Hibbert, Smith, Davies, & Ireland, 2007; Lerner & Keltner, 2001; O’Keefe, 2002; O’Keefe, 2002; Smith & Ellsworth, 1985). It is also worth pointing out that, consistent with the appraisal-tendency framework (Lerner & Keltner, 2001), guilt appeals contain message features that are consistent with guilt-appraisal patterns (see Smith & Ellsworth, 1985) as well as core themes of the guilt emotion (Lazarus, 1991; Nabi, 1999; Turner & Underhill, 2012): (a) the guilt-inducing behavior(s) is caused by the self or collective selves (versus others or natural circumstances) and (b) is or was avoidable (i.e., under one’s control).

Before discussing the effects of guilt appeals, it makes sense to discuss the inconsistencies and struggles with operationalizing guilt appeals. One issue is the variance in the operational definition of guilt appeal. A second issue is in developing appeals that vary in the intensity of the guilt they are attempting to induce. A third issue is that guilt appeals do not create guilt in people uniformly. And, a final issue is that scholars studying guilt appeals often measure different outcomes, thus, limiting the ability to compare outcomes across multiple studies. Nevertheless, there are important outcomes of these appeals, despite some methodological issues that need to be shored up by scholars in the future.

The scholarly study of the effect of guilt appeals did not begin in the health domain. Rather, it was commercial marketing and advertising researchers who were curious about whether the power of guilt (to induce compliance) could be harnessed in advertisements to motivate purchasing. Moreover, researchers began to question whether the intensity of the guilt communicated in the appeal (the level of guilt) made a difference in the effects the appeal elicited. Pinto and Priest (1991), for example, examined the effect of weak-, moderate-, and strong-intensity guilt appeals on perceived guilt and anger and, ultimately, on purchasing intentions.1 They proposed a non-monotonic (inverse U) effect of the intensity of guilt appeals on the amount of guilt people would experience: As the intensity of the guilt appeals increased, guilty feelings increased to a threshold point at which felt guilt would begin to decrease (i.e., a non-monotonic inverse-U effect). The data were consistent with Pinto and Priest’s expectations. Moreover, Pinto and Priest found that strong-intensity guilt appeals aroused anger at the source of the message instead of feelings of guilt.

Similarly, Pinto and Worobetz (1992) aroused guilt in working mothers through advertisements attempting to elicit weak, moderate, and strong levels of guilt about purchasing bread. Their data indicated that moderate guilt appeals were more effective at causing intention to buy the bread than were either strong or weak guilt appeals. Likewise, Coulter and Pinto (1995) examined the effects of the intensity of guilt appeals on consumers’ emotional responses, attitudes toward advertisements and brands, attributions about the companies promoting the brands, and purchase intention. Their data also revealed a curvilinear effect of guilt appeals on purchase intentions, such that moderate guilt appeals were the most effective at changing intentions. Their data was also consistent with a linear effect of guilt-appeal intensity on felt anger. And, Coulter and Pinto’s data showed that after reading the strong guilt-appeal, participants reported negative cognitions; specifically, that the corporation referred to in the ad was manipulative and desired to make money. Guilt appeals have been found to successfully induce guilt with the aim of increasing the intention to purchase a product or donate to a charity (Basil et al., 2006, 2008; Bozinoff & Ghingold, 1983; Cotte, Coulter, & Moore, 2005; Coulter, Cotte, & Moore, 1999; Coulter & Pinto, 1995; Hibbert et al., 2007). These studies led researchers to believe that guilt appeals are the most effective if they are communicated with moderate intensity. Yet, at this point in history, researchers had not examined if guilt appeals were effective at changing health-related attitudes, cognitions, or behaviors.

Decades later, in the early 21st century, social scientists understand much more about the mechanisms underlying the effects of guilt appeals. Although many of these studies were not conducted with an eye toward healthy behaviors, a careful review of the studies helps us understand implications for, and generalization toward, healthy behaviors. Across studies, one thing that is imminently clear is that the outcomes of guilt appeals are moderated by a number of other personal, message-related, cognitive, and affective factors. Indeed, the most notable factor has already been highlighted: the intensity of the guilt communicated within the appeal. Scholars have experimentally manipulated several other factors including empathy, profit motivations, shame, and target audience.

Relevant Moderators of the Effects of Guilt Appeals

As noted, several studies in the commercial marketing domain have found that the intensity of the marketing appeal (the guilt appeal) affects the outcome of the guilt appeal such that moderate levels of guilt communicated in the message may be most effective at changing brand attitudes and behaviors. O’Keefe (2002), in his meta-analysis of guilt appeals, found that high-intensity appeals produced more guilt but were perceived to be less persuasive than lower-intensity appeals. O’Keefe, however, did not pull out health-related articles specifically. More recently, though, Xu and Guo (2017) conducted a meta-analysis on the effects of health-related guilt appeals; however, they did not examine for the intensity of the appeal.

Theoretically, the idea is that high-intensity guilt appeals are less effective relative to moderately intense guilt appeals because of their tendency to evoke other unanticipated emotions, such as anger (i.e., reactance; Dillard & Shen, 2005) which inhibits message acceptance (Coulter & Pinto, 1995; O’Keefe, 2002; Pinto & Priest, 1991). Thus, with intense guilt appeals, participants’ anger increases and the effectiveness of the guilt appeal is suppressed (Coulter & Pinto, 1995; O’Keefe, 2002; Pinto & Priest, 1991).

Turner proposed an extension to this explanation: When guilt-appeal intensity reaches a threshold, the guilt appeal can be viewed as being manipulative. Perceived manipulative intent refers to the perception by audiences that advertisers’ attempts to persuade them are inappropriate, unfair, or manipulative (Campbell, 1995). The message receivers become overtly aware that guilt is being employed; and when individuals perceive a message (i.e., advertisement) to be inappropriate, unfair, or manipulative, the appeal may elicit anger along with guilt (Cotte et al., 2005; Coulter et al., 1999; Hibbert et al., 2007). What undermines this synopsis, however, is that not all researchers’ data are consistent with this particular curvilinear effect or that all intense guilt appeals are ineffectual (Bennett, 1998; Lindsey, 2005). Thus, it might be that in particular contexts (a) the use of guilt is not seen as inappropriate (or less so) or (b) the receivers do not become as explicitly conscious that guilt is being used to persuade them. Turner et al. (in press) specifically proposed that guilt appeals should be most effective in prosocial contexts, for example, when advocating for healthy behaviors (nutrition, physical activity, safe sex, etc).

Indeed, several studies in the prosocial (or pro-health) realm show little or no evidence of a curvilinear relationship between the intensity of the guilt appeals and feelings of guilt and other outcomes, such as attitude change. For example, Lindsey (2005) investigated the effect of guilt appeals in helping an unknown other by signing up for a bone marrow registry. Participants were randomly assigned to a control group, a naturalistic guilt appeal (Get tested to join the bone marrow donor registry by contacting the NMDP or one of the organizations certified to work with the program . . . You may save a life!”), or a high-anticipated-guilt appeal (And just think about how bad you might feel if you decided not to help when it is so easy). Lindsey found that guilt appeals caused guilty feelings, thereby influencing behavioral intentions. Unfortunately, Lindsey did not measure anger as an outcome, nor did she report any measures of participants’ awareness that guilt was being employed as a message strategy; so, the full theoretical account cannot be tested with Lindsey’s data.

Other studies in the health-behavior domain provide tentative evidence that high-intensity guilt appeals may not cause a reactance effect (Basil et al., 2006, 2008; Bennett, 1998; Cotte et al., 2005; Hibbert et al., 2007; Lindsey, Yun, & Hill, 2007). Basil et al. (2006) found that guilt appeals targeted at donating money to a children’s charity were effective at creating a need to act, especially if the message also induced empathy. But Basil et al. (2006; see also Basil et al., 2008) did not vary the intensity levels of guilt, making it difficult to assess how intense their messages really were. Basil et al.’s work is addressed at greater length in the section “Positive Role of Empathy and Efficacy in Guilt Appeals.”

Profit Motivations Hinder Guilt Appeals

These studies suggest that source motive serves as a moderating variable. If message designers want to encourage health behaviors with a guilt appeal, they may need to ensure that the messages do not have any motivations to make a profit. In fact, in commercial marketing, there may be an inherent conflict of interest in the use of guilt because such messages ultimately seek to sell a product or service—that is, they have profit motivations. The message receivers may believe that it is inappropriate to use intense guilt to make a profit. In other types of guilt-inducing persuasive messages that are non-profit (such as health messages), profit motivations are typically absent. In these cases, message receivers may not find it manipulative to employ guilt if the objective is to save lives or prevent disease. If profit motivations yield such an effect, it would have important implications for the long-term or repeated use of such appeals in the social-marketing domain. That is, intense guilt appeals in the social-marketing domain may cause feelings of guilt and perceptions of persuasiveness and simultaneously lead to increased anger, decreased ad liking, and decreased positive attitudes toward the source of the message. Several scholars of persuasion have noted that measuring unintended effects of persuasive messages is critical to truly understanding the impact of the message (Coulter et al., 1999; Fishbein & Cappella, 2006; O’Keefe, 2002; Witte, 1992).

Turner et al. (in press) tested this hypothesis in a controlled experiment. Turner’s team developed messages aimed at changing attitudes and intentions toward using reusable grocery sacks at the market. They developed low-, moderate-, and high-intensity guilt appeals (in 30-second radio spots) that communicated either “use” reusable grocery sacks or “purchase” a particular brand of grocery sacks. All other components of the guilt appeals were kept constant. Turner et al., measured persuasiveness of the appeal, ad liking, and brand attitudes. Emotional outcomes such as feelings of guilt and anger were also measured.

The data yielded from this experiment were consistent with the hypothesis that sponsor motive moderates the effects of guilt appeals. When guilt appeals are for-profit, there is a relative failure of high-intensity guilt appeals compared to moderate-intensity guilt appeals. Ad liking and brand attitude were low in the high-intensity condition. Moderate-intensity guilt appeals caused more positive brand attitudes and were liked more than high-intensity appeals. Recall that this finding occurred even though the message was for a good cause. That is, even though the message was for-profit, it advocated using reusable bags at the grocery store. These effects might be more robust if the topic were purely commercial (e.g., selling fast food). Future studies should systematically vary the kinds of commercial products being sold with a guilt appeal to assess whether the product yields an effect on outcomes. Yet when guilt appeals have low- or no-profit motivations, there is a positive relationship between guilt intensity of the ad and perceived persuasiveness.

Overall, these studies imply that guilt can be an effective strategy for changing health behaviors but should be avoided when there are profit motivations. Certainly, there are contexts in which products are being sold to impact health-related behaviors. In global contexts, for example, bed nets may be sold to lower the prevalence of malaria. In the United States, condoms are sold to lower the incidence of HIV. Guilt appeals can be effective at motivating these behaviors, but the messages might stray from talking about “buying” or “paying” for these products.

The Positive Role of Empathy and Efficacy in Guilt Appeals

Empathy is the ability to understand and share the feelings of another. It is distinguished from sympathy, which is the ability to acknowledge others’ emotional challenges and give them comfort and assurance. Like guilt, feelings of empathy revolve around one’s ability to recognize the needs of others. Given that some health behaviors involve the recognition that our behaviors affect others (e.g., sexually transmitted infections, infectious disease, herd immunity [vaccines]), it is critical to engage cognitive and emotional processes related to the notion of others.

For example, guilt appeals are often used for the purposes of raising funds related to behavioral health. Charity appeals often use the stories of those in need (e.g., blood donations, bone marrow, funds for food, etc.) to induce guilt. Yet, in order for such a strategy to work, target audiences would need to feel empathy for the individual(s) conveyed in the appeal. And without empathy, message receivers will not only fail to experience guilt, but would also fail to desire to help the individuals conveyed as “suffering.” Previous studies, though the number of them is limited, show a positive association between feelings of guilt and empathy (Basil et al., 2006, 2008; Tangney, 1995). Moreover, these studies reveal the role of efficacy statements in guilt appeals.

Basil et al. (2008) exposed participants to one mock charity appeal that varied in efficacy (the high-efficacy message stated “Your $2 will help these children”) and empathy (high-empathy message stated “Imagine that you are a child with no home”). The data from this study showed that the messages did cause both empathy and efficacy. And as empathy and efficacy increased, so did feelings of guilt. Guilty feelings predicted donation amount. Finally, Basil et al. found that higher levels of empathy and efficacy led to lower levels of negative and unintentional responses. Basil and colleagues (2006, 2008) proposed that motivating the message recipient to empathize may create a “need to act” and may also serve as an effective tool for lessening anger. It appears that guilt is causally associated with anger, all else being equal, but that the association is moderated by the arousal of empathy. Although studies of this sort have not been replicated in other kinds of behavioral domains, the implications are numerous. First, when developing guilt appeals it may be helpful to also explicitly trigger empathetic reactions in the audience. Empathy and guilt will activate the desire to engage in behaviors that resolve the negative effects of the guilt. Second, guilt appeals (especially those that make explicit use of empathy) might be most effective with audience segments that are high on trait empathy. Understanding this individual level difference will allow message designers to target guilt appeals to the audiences that will be most receptive to them. And, third, guilt appeals might be most effective when they are directed at behaviors that impact others—such as second-hand smoke. It stands to reason then, that when using guilt appeals, it may be more effective to reframe the issue not as one that primarily affects the self, but as a behavior that has implications for those you love. It may be that feelings of guilt, and empathy, are more difficult to generate for behaviors that mostly impact the self.

Shame Impedes Guilt Appeals

One of the more perplexing issues in the guilt-appeal literature is that guilt appeals, especially when they are high intensity, can incite anger in message receivers. Most intriguing is that even when messages were found to be persuasive, they still incited anger (see Turner & Underhill, 2012). Neiderdeppe and colleagues (2008) suggested that an undetected moderating variable in the guilt appeal literature, which might explain this phenomenon, lies within the message features. Elicitation of unintended anger could stem from an emphasis on the individual’s (the message receiver’s) personal traits through the use of the word you in the guilt appeal. Neiderdeppe et al. asserted that “the statement . . . ‘you let a child go hungry again’ produces more guilt and anger than the statement ‘last night, a child went to bed hungry again.’” (p. 502). The rationale behind this assertion is that the overt use of the second-person conveys persuasive intent, which has been shown to be counterproductive (Cotte et al., 2005; Coulter et al., 1999; Coulter & Pinto, 1995). In fact, Eagly, Wood, and Chaiken (1978) previously suggested that when a viewer perceives manipulative intent by an advertiser they are likely to “resist” the message.

Boudewyns, Turner, and Paquin (2013) predicted that the use of “you” in a message may shift the focus onto the person rather than the behavior, evoking feelings of shame rather than feelings of guilt. Importantly, shame is associated with defensive reactions such as anger, lashing out, and blaming others (Lewis, 1971; Tangney, 1995; Tangney & Dearing, 2002). Therefore, perceptions of manipulative intent may not necessarily block feelings of guilt; instead, they may result from feelings of shame. The resultant feelings of shame have numerous negative implications for health behaviors.

Shame is the consequence of an evaluation of failure in relation to individual standards when a global evaluation of the self is made (Lewis, 1991). According to Boudewyns et al. (2013) cognitive-attribution theorists (e.g., Lewis, 1991) proposed that the focus of blame attribution in shame is different from that associated with guilt, resulting in distinct phenomenological outcomes. In fact, Lewis (1971) argued that the key difference between shame and guilt is a focus on the self, relative to a behavior: “The experience of shame is directly about the self, which is the focus of the evaluation. In guilt, the self is not the central object of negative evaluation, but rather the thing done or undone is the focus” (p. 30). When people experience shame they tend to focus on themselves, not on their actions. With guilt, the self is the subject but not the object of the emotion, resulting in a focus on the harm done to another, to a relationship, or to some other perceived indiscretion relative to a set of standards or rules (Tangney et al., 2007). With shame, the person regrets who they are; but, with guilt, the person regrets what they have done (Tangney et al., 2007).

Given this distinction, guilt appeals can cause guilty feelings alone (“shame-free guilt”), but, they can also cause guilt that is infused with feelings of shame (“shame-fused guilt”; Tangney et al., 2007). Tangney et al. asserted “The advantages of guilt are lost when a person’s guilt experience (‘Oh, look at what a horrible thing I have done’) is magnified and generalized to the self (‘. . . and aren’t I a horrible person’)” (Tangney et al., 2007, p. 353). Thus, shame-fused guilt, may have serious consequences due to the different psychological consequences that result from each emotion (Boudewyns et al., 2013). Whereas guilt produces the desire to confess, apologize or repair, shame can result in anger and self-perceptions of not being able to cope, which produce a desire to hide, escape, or strike back (Tangney & Dearing, 2002; Tangney et al., 2007).

Another considerable problem with shame-fused guilt is that there are few options for rectifying feelings of shame—in other words, the target audiences’ efficacy would be low. Given that feelings of shame are focused on who someone is as a person, the source of the shame is perceived to lie within the self. Therefore, there may be a perception that little can be done to fix the problem—leading instead to attempts to contain or deflect the emotion (Tangney & Dearing, 2002). For example, shame could cause individuals to externalize the focus onto a transgressor, whether real or imagined (Lewis, 1992). When health behavior is the ultimate objective of the message, unintentionally eliciting shame instead of guilt is particularly problematic; if blame is externalized the motivation to adopt healthier behavior (or risk reduction) is effectively negated (Boudewyns et al., 2013).

Perhaps most pertinent is that there is an intrinsic link between shame and anger—a claim that has been empirically supported by a number of a studies (Lewis, 1971; Hoglund & Nicholas, 1995; Tangney, 1995, 1996; Tangney & Dearing, 2002; Tangney, Wagner, Fletcher, & Gramzow, 1992). Tangney and colleagues found that whereas self-reported anger was positively correlated with shame-proneness, anger was negatively correlated with guilt-proneness (Tangney & Dearing, 2002). In line with this reasoning, it is possible that the high-guilt messages that led to high levels of anger in previously published studies were actually eliciting a combination of guilt and shame, or even shame by itself. Boudewyns et al. (2013) conducted an experiment to examine this hypothesis. The authors developed two guilt appeals in the form of a print ad in favor of testing for sexually transmitted infections (STIs). The shame-prone ad explicitly communicated that people who ignore STI testing have bad attributes (e.g., “disrespectful people”). The shame-free version used the same overall language, visuals, and format but substituted the word “behavior” for “people” (e.g., “disrespectful behavior”). The data from this experiment indicated that both messages caused feelings of guilt. But, the shame-prone message also caused feelings of anger and perceived manipulative intent, whereas the shame-free message did not.

The Target Audience Matters

It is considered axiomatic in the health-behavior literature that the audience matters above all else. When using guilt appeals in the health-behavior domain it is therefore critical that the target audience actually experiences guilt. For example, people with high levels of trait empathy may be more prone to being persuaded by a guilt appeal. And people with high levels of shame proneness are less likely to be persuaded by guilt appeals. Likewise, those with high guilt proneness are more likely to experience guilt. Particular aspects of the psychological profile of a target audience will moderate the overall effects of message strategies. This is why audience segmentation is considered a crucial step in the process of campaign design and implementation. This is also the case for guilt appeals, although, there is only a modest amount of research on audience factors in this realm. It is nonetheless possible to make some recommendations of the kinds of audience segmentation strategies that might be helpful when considering a guilt-based strategy for a health-behavior campaign.

Life Stage

There is some evidence suggesting that people in different life stages might experience and respond to guilt appeals differently. Indeed, people differ in their reactance proneness, that is, in the tendency to respond with reactance (Dillard & Shen, 2005). Developmental stages, such as the “terrible twos,” adolescence, and late adulthood, are characterized by a heightened need for autonomy and rejection of control by others (Miller, Burgoon, Grandpre, & Alvaro, 2006). Adolescents are particularly sensitive to freedom threats (Scherer & Reppucci, 1988) owing to a fragile sense of autonomy (Frank, Avery, & Laman, 1988). Compared to adults, adolescents perceive a wider range of things as threats to their autonomy, including seemingly innocuous things (Frank et al., 1988). That adolescents have been shown to be reactance prone in a variety of contexts suggests that they are also likely to experience reactance when receiving guilt appeals. Likewise, a number of studies have traced guilt proneness back to childhood. When examining the role of guilt and shame in 3- to 5-year-olds, one study showed that the older children expressed more guilt than did the younger children. Children are also able to differentiate moral from non-moral situations. Only when the situation was moral was shame associated with difficult temperament and with emotional problems; whereas guilt was correlated with adaptive characteristics (Bafunno & Camodeca, 2013).

Just as people vary in reactance proneness and guilt proneness (Dillard & Shen, 2005), they also vary in their susceptibility to guilt appeals. Susceptibility to guilt may be associated with personality characteristics, as well as the interactions between message features and personality variables, such as message referent, culture, and need for uniqueness. Testing this notion, Bessarabova, Turner, Fink, and Blustein (2015) exposed high school students to low-, moderate-, or high-guilt appeals that were either self- or other-referencing. The messages were about “taking school seriously” (i.e., studying, not skipping classes). Overall, their data revealed that adolescents were particularly aware of the guilt strategy—even in the subtle guilt-appeal conditions. As their awareness increased, so did their anger, rendering guilt appeals ineffective among this target audience.

Message Referent and Culture. Researchers have identified distinct persuasive styles across cultures (Burgoon, Dillard, Doran, & Miller, 1982; Glenn, Witmeyer, & Stevenson, 1977; Han & Shavitt, 1994). Han and Shavitt (1994) examined the wording of advertisements in two popular magazines in the United States and Korea; they found that Korean advertisements used significantly more terms emphasizing family integrity, social relationships, and group benefits than did the advertisements in the American magazine. In a follow-up study, the authors manipulated the number of relational terms used in messages and found that Koreans were more persuaded than Americans by advertisements that included more relational terms, whereas Americans were more persuaded by advertisements stressing individualistic benefits.

Guilt appeals also vary in terms of the referent of the offense. A guilt appeal can communicate to receivers that their behavior is harmful to other people or it can communicate that receivers are being harmful to themselves. This referencing of self versus other is known as the message referent. The extent to which individuals are affected by self- as opposed to other-referent messages may depend on their need for uniqueness and their culture.

Individualism-collectivism is a dimension commonly used to compare cultures (Hofstede, 1980; Triandis, 1995). Individualistic cultural values emphasize autonomy and personal choice; place higher priority on the goals, needs, and concerns of the self over those of the group; and are motivated primarily by individual preferences (Triandis, McCusker, Betancourt, Iwao, Leung, Salazar et al., 1993). Collectivistic cultural values emphasize connectedness within in-groups; place higher priority on the goals, needs, and concerns of the group over those of individuals; and are motivated by the social norms prescribed by the society (Triandis et al., 1993).

Addressing individualism-collectivism orientation and norms in both the for-profit advertising (Gregory & Munch, 1997) and prosocial social marketing (Sampson, Witte, Morrison, Liu, Hubbell, & Murray-Johnson, 2001) has been found to have a significant influence on outcomes such as purchase and behavioral intentions. Similar findings were reported by Gregory and Munch (1997) in Mexico: Mexican participants reported greater liking and purchase intention from advertisements that reflected local cultural norms (i.e., collectivistic family norms).

Sampson et al. (2001) showed cultural differences in the effectiveness of fear appeals. Mexican and Hispanic immigrants reported more fear and greater behavioral intention after reading a message emphasizing greater threat to their families than to themselves, whereas African Americans were more influenced by messages emphasizing threat to the individual. Such findings suggest the emphasis on self or the related other in persuasive messages will result in different processing and persuasive outcomes across cultures. Messages that emphasize relationship positively influence Chinese more than Americans.

More specifically, the concept of kin collectivism (i.e., a positive orientation toward one’s family) is grounded in intercultural research on individualism-collectivism (e.g., Hofstede & Hofstede, 2001) and self-construals (e.g., Markus & Kitayama, 1991). Members of collectivistic cultures as well as people with interdependent self-construals are thought to view themselves as an integral part of their group or kin relationships and treat group goals and group well-being as more important than their personal aspirations (Triandis, 1995).

Differences in experiencing guilt may be related to the extent to which individuals have an interdependent or collectivist orientation toward others (Asano, 1988). Guilt is often “caused by violating social norms and by failing to fulfill social obligations” (Eid & Diener, 2001, p. 871), and in collectivistic societies guilt as a response to violations of these norms is deemed socially desirable (Kim-Prieto & Eid, 2004). Due to the desirability of guilt for people who are more collectivistic (and, arguably, have a greater kin-collectivist orientation as well), high kin collectivists may be less prone to experience the reactance induced by guilt appeals. This reduced reactance proneness may indicate that high kin collectivists are predisposed to feel equally guilty as a result of both self-generated and message-induced guilt.2

In addition to differences in kin or group orientation, individuals also differ in their orientation to self. Need for uniqueness is a personality characteristic associated with a self-orientation and is aroused by a desire to be different from others (Snyder & Fromkin, 1977). High need-for-uniqueness individuals are likely to experience reactance when their need for uniqueness is threatened: Receiving a guilt appeal implying that a message recipient’s conduct has violated some standard may act as a catalyst for such a threat.

Turner et al. (2005), inspired by this aforementioned research, examined the effects of low-, moderate- and high-intensity guilt appeals, with both Chinese and American participants, aimed at motivating daughters to talk to their mothers about mammograms that were either self-oriented or other-oriented. Research participants were recruited in their home countries (United States and China) and were delivered randomly assigned messages by the researchers in their native languages.

The data indicated a complex three-way interaction among culture, the level of guilt in the ad, and guilt-intensity level. For Americans, when the message was of moderate guilt intensity the self-referencing message was more effective than other-referencing. But when the message employed intense guilt the other-referencing message was more effective (relative to self-referencing). In many ways, these data are consistent with the research on profit motivations. It may be that participants find the use of intense guilt to be manipulative. In such cases, when the guilt appeal is intense, it might be most palatable when the focus of the message is to help others—not the self.

For the Chinese participants, when the message communicated moderate levels of guilt the self- and the other-referencing messages were equally persuasive. But, when the message employed intense guilt the self-referencing message was more effective. This finding is less straightforward to explain. It might be that if other-referencing messages are common and overused throughout the cultural context, then they might be perceived as manipulative when coupled with intense guilt.


Guilt, being a moral, other-based emotion, can spur people to think of others, act honestly, and be empathetic. Likewise, collective guilt, the feeling that arises when people believe their in-group caused illegitimate harm to others, can lead people to feel positively toward the victimized others and desire policies that will help them. It can be seen, then, that guilt, though often considered “negative,” can lead to an array of prosocial, constructive, behaviors. In that vein, a number of researchers have assessed the possibility that guilt-based persuasive appeals can induce such positive behaviors.

Clearly, guilt appeals can be an effective tool for reducing risk (STI testing), increasing prevention practices (encouraging mammograms), and effecting altruistic health-related behaviors (donating blood). In the correct conditions, guilt appeals can induce guilty feelings, lead people to want to “right the wrong,” generate positive attitudes about the message’s advocacy, and intend to engage in a behavior.

But there are a lot of caveats. First, great caution has to be taken with regard to the message development stage. Although the research is mixed with regard to the intensity of the guilt communicated in the ad, it would be prudent to develop a message that induces guilt in the target audience without making them feel manipulated. In so doing, avoid any communication in the messages that conveys that the source of wrongdoing (the source of the guilt) was a personality or character trait. In fact, avoid use of the word “you” in the message. Following this advice means that the message is less likely to cause feelings of shame. Also, with regard to the message, particular attention should be paid to the referent. In other words, asking the question, who is being “harmed”? Is it the self or someone else? There are two points that need to be made here. First, it is hypothesized that message referent interacts with culture to affect outcomes of the message. For American audiences, the most persuasive scenario is a self-referent message coupled with moderate intensity guilt. The second point is that for messages that are other-referencing, the messages will be most effective when also eliciting empathy. When audiences care about the outcomes of others, they will be more likely to experience guilt and want to help those others.

Second, features of the audience can impact message reception. Relative to adults ages 21 and older, it appears that guilt appeals of any intensity level are ineffective for adolescents (Bessarabova et al., 2015). Guilt appeals appear to evoke anger and perceived manipulation in adolescents—even when the guilt appeal is very subtle. Guilt appeals, especially if they are other-referencing, can be quite effective with individuals high in collectivism (especially kin collectivism).

Finally, context matters. When guilt appeals are used to develop ads for commercial operations, they can invoke anger. Turner argued that as guilt intensity increases in a message, so does the likelihood that the audience will become overtly aware of the use of the tactic. When overt tactic awareness is coupled with profit motivations, it may spur anger and perceptions of being manipulated—both are unintentional consequences that can sink the success of the ad.

Further Reading

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      Cotte, J., Coulter, R. H., & Moore, M. (2005). Enhancing or disrupting guilt: The role of ad credibility and perceived manipulative intent. Journal of Business Research, 58(3), 361–368.Find this resource:

        Coulter, R. H., Cotte, J., & Moore, M. L. (1999). Believe it or not: Persuasion, manipulation and credibility of guilt appeals. Advances in Consumer Research, 26(8), 288–294.Find this resource:

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            Edmondson, B. (1986). The demographics of guilt. American Demographics, 3, 33–56.Find this resource:

              Huhmann, B. A., & Brotherton, T. P. (1997). A content analysis of guilt appeals in popular magazine advertisements. Journal of Advertising, 26(2), 35–45.Find this resource:

                Jiménez, M., & Yang, K. C. C. (2008). How guilt-level affects green advertising effectiveness? Journal of Creative Communications, 3(3), 231–254.Find this resource:

                  O’Keefe, D. J. (2002). Guilt as a mechanism of persuasion. In J. P. Dillard & M. Pfau (Eds.), The persuasion handbook: Developments in theory and practice (pp. 329–344). Thousand Oaks, CA: SAGE.Find this resource:

                    O’Keefe, D. J., & Figgé, M. (1999). Guilt and expected guilt in the door-in-the-face technique. Communication Monographs, 66(4), 312–324.Find this resource:

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                                                                                                                                                                                                                                (1.) Scholars often describe levels of guilt appeals differently. The current article uses the labels weak, moderate, and strong.

                                                                                                                                                                                                                                (2.) The argument that kin-collectivists are less prone to reactance caused by guilt appeals does not imply that people in collectivist societies do not experience reactance (see Quick & Kim, 2009, for the evidence of reactance in collectivistic societies).