Medical Embarrassment Questionnaire (MEQ)

Abstract

The Medical Embarrassment Questionnaire (MEQ) is an extensive, psychometrically validated self-report assessment developed by Nathan S. Consedine, Yulia S. Krivoshekova, and Christine R. Harris in 2007. Designed to operationalize and quantify the complex affective barrier of embarrassment within healthcare contexts, the MEQ addresses a critical lacuna in behavioral medicine: the documented tendency of individuals to delay or completely avoid necessary medical consultations, diagnostic screenings, and physical examinations due to anticipated social and bodily humiliation. The scale comprises 53 items evaluated on a 5-point Likert scale ranging from 1 (“Not at all/never”) to 5 (“Very much/always”). Structurally, the instrument captures nine distinct lower-order a priori domains: embarrassment about the body, genital examinations, bodily functions, being ill, public exposure associated with medical visits, being viewed as a hypochondriac, feeling intellectually inadequate, being embarrassed by pain, and embarrassment regarding failure to maintain one’s health. Factor analytic investigations reveal that these domains coalesce into two overarching, correlated higher-order dimensions: Bodily Embarrassment (anchored in somatic exposure, nudity, and intimate physical examination) and Judgment Concern (rooted in social evaluation, perceived intellectual inadequacy, lifestyle blame, and fear of negative appraisal by healthcare personnel). The MEQ exhibits exceptional internal consistency, with total scale Cronbach’s alpha coefficients routinely exceeding .95, and subscale coefficients ranging from .72 to .94. Its construct, convergent, discriminant, and predictive validities have been robustly documented across diverse clinical and non-clinical cohorts, demonstrating significant negative associations with healthcare utilization, compliance with colorectal cancer screening, gynecological examinations, and prompt symptom reporting. As both a clinical diagnostic aid and an epidemiological research instrument, the MEQ provides essential insights into affective determinants of health-seeking behavior.

Keywords

Medical Embarrassment Questionnaire, MEQ, medical embarrassment, healthcare avoidance, bodily embarrassment, judgment concern, patient-provider communication, health behavior, cancer screening barriers, psychometrics

Authors

The Medical Embarrassment Questionnaire was developed by a team of researchers specializing in affective science, health psychology, and behavioral medicine:

• Nathan S. Consedine, Ph.D. — Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, New Zealand; formerly of the Department of Psychology, Long Island University, Brooklyn, New York. Dr. Consedine’s research centers on the functional dimensions of human emotion, emotional regulation, and how basic affective processes influence preventive health behaviors, screening adherence, and illness coping.
• Yulia S. Krivoshekova, M.A. — Department of Psychology, Long Island University, Brooklyn, New York. Her work focuses on psychological assessment, social emotion, and health disparity research.
• Christine R. Harris, Ph.D. — Department of Psychology, University of California, San Diego (UCSD), La Jolla, California. Dr. Harris is an internationally recognized expert in affective psychology, social emotions (including embarrassment, jealousy, and shame), and psychophysiology.

Purpose

Healthcare avoidance and delayed medical presentation represent profound public health challenges that contribute significantly to preventable morbidity and mortality worldwide. Traditional health behavior models, such as the Health Belief Model and the Theory of Planned Behavior, have historically focused on cognitive variables, including perceived susceptibility, perceived severity, instrumental costs, and subjective norms. However, empirical studies have increasingly underscored that cognitive appraisals fail to fully account for the substantial proportion of individuals who refrain from seeking timely medical care even when they recognize the severe danger of their symptoms. The Medical Embarrassment Questionnaire (MEQ) was developed to delineate, measure, and analyze one of the most potent emotional barriers to medical care: medical embarrassment.

Prior to the construction of the MEQ, researchers often conceptualized medical embarrassment as a monolithic, one-dimensional nuisance variable or treated it synonymously with medical fear or generalized social anxiety. Consequently, clinical investigators lacked a fine-grained, psychometrically rigorous instrument capable of distinguishing between disparate sources of embarrassment that arise during medical encounters. The primary purposes of the MEQ are multi-fold:

• Differentiating Somatic from Evaluative Affective Barriers: To systematically disentangle embarrassment arising directly from physical exposure and tactile examination of the somatic self (e.g., exposing private body parts, physical touch, discussing bowel movements) from embarrassment stemming from social judgment and perceived personal failure (e.g., being scolded for lifestyle choices, being dismissed as a hypochondriac, misunderstanding clinical terminology).
• Predicting Preventive Screening Compliance: To identify specific emotional predictors of non-attendance in life-saving diagnostic and preventive screening programs, such as colonoscopies, fecal occult blood tests (FOBT), Papanicolaou (Pap) smears, mammography, digital rectal examinations (DRE), and clinical urological or pelvic checks.
• Enhancing Clinical Communication: To furnish primary care practitioners, oncologists, nurses, and allied health professionals with an empirical framework for recognizing patient vulnerabilities. By understanding whether a patient’s hesitation originates from physical modesty or fear of intellectual inferiority, clinicians can tailor their communication styles, examination protocols, and patient education materials accordingly.
• Epidemiological and Translational Research: To facilitate large-scale investigations into how demographic factors (such as age, biological sex, gender identity, cultural heritage, and socioeconomic status) moderate emotional responses to medical procedures, thereby advancing health equity.

Psychological Construct

Embarrassment is classified within affective science as an acute, self-conscious, social emotion triggered by the perceived or actual breach of social conventions, norms, or idealized standards of presentation in the presence of real or imagined evaluators (Tangney & Fischer, 1995; Keltner & Buswell, 1997). In everyday life, embarrassment signals social awareness, appeasement, and a desire to restore interpersonal affiliation following an unintentional social gaffe. However, within clinical settings, the physiological, somatic, and conversational requirements of medical care systematically disrupt standard adult social conventions, creating profound emotional distress.

The MEQ operationalizes medical embarrassment not as a uniform emotional reaction, but as a multi-faceted construct organized hierarchically. At the lower-order level, the scale evaluates nine specialized domains of vulnerability; at the higher-order level, these domains reflect two primary psychological dimensions:

1. Bodily Embarrassment

The Bodily Embarrassment dimension captures affective discomfort directly associated with the physical self, bodily privacy, tactile contact, and biological excretions. In modern adult socialization, exposing intimate anatomy, emitting involuntary bodily noises or odors, and handling biological waste are strictly governed by taboos. Clinical encounters frequently require individuals to suspend these deeply internalized cultural scripts. This dimension encompasses five interrelated a priori subdomains:

• Embarrassment About the Body: Captures generalized humiliation associated with somatic exposure, being unclothed before healthcare professionals, being physically touched, or fearing that one’s body appears repulsive, dysmorphic, or unpleasant to clinical staff (e.g., Item 1: “Showing my body to a stranger, even to a doctor, is humiliating”; Item 5: “I worry that my body looks unpleasant and will disgust the doctor or a nurse during a check-up”).
• Genital Examinations: Focuses specifically on the intense mortification elicited by invasive visual inspection, palpation, or manipulation of the reproductive organs, breasts, genitalia, or rectum by clinicians, particularly when cross-gender clinical interactions occur (e.g., Item 12: “having my sexual/reproductive organs or rectum examined is humiliating for me”; Item 31: “It is embarrassing for me when a doctor who is not of my sex touches my sexual/reproductive organs during examination”).
• Bodily Functions and Excretions: Assesses distress, shame, and awkwardness linked to discussing, describing, or submitting samples of bodily waste, including feces, urine, mucus, and flatulence (e.g., Item 13: “Describing my bowel movements to a doctor is awkward for me”; Item 41: “The thought that a doctor might ask for stool or urine samples is humiliating for me”).
• Public Exposure Associated with Medical Visits: Addresses the contextual embarrassment generated by navigating semi-public clinical spaces, such as carrying specimen containers through public corridors, sitting in open waiting areas, or fearing that fellow patients will overhear sensitive diagnostic details (e.g., Item 6: “Walking in the waiting area with a urine sample is humiliating”; Item 43: “I feel self-conscious and fear that other people may overhear discussions about my health”).
• Embarrassment by Pain Expressions: Reflects anxiety surrounding behavioral manifestations of physical suffering, distress over appearing cowardly, or feeling humiliated if one cries, winces, or demonstrates low pain tolerance during clinical procedures (e.g., Item 9: “I am afraid that I will embarrass myself if something hurts in the doctor’s office”; Item 19: “It is embarrassing for me to admit that I fear pain”).

2. Judgment Concern

The Judgment Concern dimension reflects interpersonal, evaluative, and moral vulnerabilities. Rather than focusing on physical modesty, this dimension captures the patient’s acute dread of negative social appraisal, moral condemnation, intellectual denigration, or administrative dismissal by healthcare providers. This psychological construct is structured around four lower-order subdomains:

• Being Viewed as a Hypochondriac: Pertains to the fear of being perceived as frivolous, neurotic, or excessively demanding of clinical time, leading individuals to suppress legitimate somatic symptoms out of concern that their complaints will prove clinically insignificant (e.g., Item 7: “When I have health symptoms, I avoid the doctor because I worry that my concerns will turn out to be nothing”; Item 46: “I don’t want a doctor or nurse to think that I am one of those people who constantly complain about their health”).
• Feeling Intellectually Inadequate: Evaluates intimidation, shame, and hesitation triggered by high health-literacy barriers, complex medical jargon, and asymmetry in provider-patient knowledge, which often prevents patients from seeking clarification or admitting confusion (e.g., Item 8: “I feel embarrassed when doctors use complicated medical words and I don’t understand them”; Item 36: “I find it difficult to ask a doctor to explain something again, repeat themselves, or use words that I can understand”).
• Not Taking Care of One’s Health (Perceived Culpability): Addresses moral self-reproach and anticipated chastisement regarding lifestyle behaviors, delay in seeking treatment, physical deterioration, or failure to follow preventive health recommendations (e.g., Item 10: “I worry that doctors will scold me for the bad state of my health”; Item 53: “I fear that the doctor will think badly of me because my own behaviours probably contributed to my health problems”).
• Embarrassment About Being Ill: Reflects internal feelings of weakness, defectiveness, or existential failure associated with sickness itself, causing individuals to conceal illness from family, peers, and medical practitioners (e.g., Item 4: “If I get sick I tend to hide from others, even from close people, because I am embarrassed to be sick or ill”; Item 14: “I feel I must have done something wrong when I am ill”).

Theoretical Framework

The construction of the MEQ is grounded in several foundational paradigms within social psychology, emotion theory, and behavioral medicine:

Goffman’s Dramaturgical Model and Impression Management

The primary sociological foundation of medical embarrassment traces to Erving Goffman’s dramaturgical analysis of social interaction (1959, 1967). Goffman conceptualized social encounters as theatrical performances wherein actors cooperate to maintain “face”—a positive, competent social image. Social encounters are sustained by adherence to shared rituals, interpersonal distance, and personal privacy. In everyday life, displaying one’s unclothed body, revealing private excretory habits, and exhibiting personal helplessness represent catastrophic breaches of face that invite acute embarrassment and social ostracism.

Within a medical environment, patients are compelled to undergo an “institutional desocialization” wherein these deeply ingrained protective rituals must be suspended. As Consedine et al. (2007) argue, although medical settings reframe these intimate violations as objective, clinical procedures, the patient’s subjective emotional apparatus continues to react according to daily social scripts. The patient experiences a dramatic failure of impression management, anticipating loss of status, disgust, or disdain from the clinician evaluator.

Evolutionary and Functionalist Theories of Emotion

From an evolutionary perspective (Keltner & Buswell, 1997), embarrassment evolved as an appeasement display that serves to preserve social bonds following unintentional normative violations. By displaying visible embarrassment (e.g., blushing, downward gaze, nervous smile), an individual signals to the group that they recognize the broken norm, accept group standards, and do not intend rebellion. In clinical settings, however, this evolutionary program can become maladaptive. Because patients anticipate experiencing this painful, subordinate emotional state during physical examinations, they deploy defensive, avoidant coping strategies—namely, avoiding the medical clinic entirely. Consedine’s theoretical model emphasizes emotional functionalism: while negative emotions like fear typically mobilize fight-or-flight avoidance away from external danger, medical embarrassment specifically mobilizes behavioral concealment and withdrawal from healthcare settings, inadvertently endangering physical survival to protect social face.

Social Discrepancy and Communication Predicaments

The judgment dimension of the MEQ aligns closely with Mark Leary’s (1995) self-presentation theory and E. Tory Higgins’ (1987) self-discrepancy framework. Patients possess idealized concepts of themselves as autonomous, competent, cleanly, and responsible adults. The clinical encounter threatens this ideal self-image by exposing bodily decay, intellectual confusion regarding medical terminology, and behavioral failures (e.g., smoking, poor diet, deferred presentation). The prospect of being judged as negligent, ignorant, or hypochondriacal induces anticipatory social evaluation distress, reinforcing the decision to conceal physical symptoms from medical professionals.

Validity

The Medical Embarrassment Questionnaire has undergone rigorous empirical validation across multiple independent studies, establishing robust construct, convergent, discriminant, and predictive validity.

Construct and Structural Validity

Initial construct validation by Consedine, Krivoshekova, and Harris (2007) in a diverse community sample demonstrated that while the 53 items accurately populate nine a priori domains, higher-order factor modeling provides the most parsimonious account of the data. Confirmatory factor analyses confirmed that a two-factor higher-order model—comprising Bodily Embarrassment and Judgment Concern—yielded excellent fit indices across both female and male cohorts. This structural bifurcation proved that affective discomfort regarding physical examination is psychometrically distinguishable from the fear of interpersonal or intellectual judgment.

Convergent Validity

The convergent validity of the MEQ has been demonstrated through strong, statistically significant correlations with established psychological scales measuring related self-conscious constructs:

• Trait Embarrassability: The MEQ shows strong positive correlations with the Susceptibility to Embarrassment Scale (SES; r = .52 to .64, p < .001), indicating that individuals generally prone to self-conscious emotion exhibit heightened medical embarrassment.
• Social Interaction Anxiety: Moderate-to-high correlations have been documented with the Social Interaction Anxiety Scale (SIAS) and the Brief Fear of Negative Evaluation (BFNE) scale (r = .38 to .51, p < .001), validating the interpersonal evaluative premise of the Judgment Concern dimension.
• Body Image Self-Consciousness: The Bodily Embarrassment factor correlates substantially with the Body Image Avoidance Questionnaire (BIAQ; r = .46 to .58) and measures of objectified body consciousness.

Discriminant Validity

Crucially, the MEQ demonstrates distinct divergence from constructs that might otherwise be conflated with medical embarrassment:

• General Medical Fear and Pain Catastrophizing: Although medical fear is correlated with embarrassment, multivariate analyses demonstrate that MEQ scores account for unique variance in healthcare avoidance after partialling out fear of medical procedures and pain catastrophizing (Pain Catastrophizing Scale; shared variance < 18%).
• Generalized Trait Anxiety and Depression: Correlations between the MEQ and the State-Trait Anxiety Inventory (STAI-Trait) or the Beck Depression Inventory (BDI-II) are modest (typically r = .20 to .32), establishing that the MEQ does not merely reflect generalized negative affectivity or neuroticism.

Predictive and Criterion Validity

The clinical utility of the MEQ is underscored by its ability to predict real-world health behaviors and diagnostic presentation delays:

• Cancer Screening Adherence: In longitudinal and cross-sectional investigations (Consedine et al., 2007; Consedine, Ladwig, Reddig, & Broadbent, 2011), high scores on the MEQ Bodily Embarrassment factor significantly predicted non-adherence to colorectal cancer screening (specifically colonoscopy, sigmoidoscopy, and fecal occult blood testing; odds ratios ranging from 1.45 to 2.10 for non-compliance). Similarly, in female cohorts, MEQ scores predicted delays in scheduling routine Papanicolaou smears and clinical breast examinations.
• Symptom Presentation Delay: High scores on Judgment Concern (particularly fear of being seen as a hypochondriac or being scolded for lifestyle habits) demonstrated significant predictive validity regarding patient-mediated delays in presenting potential cardiac symptoms, rectal bleeding, and sexually transmitted infection (STI) indicators, with delays often extending across multiple months.

Reliability

The psychometric evaluation of the MEQ confirms that the scale possesses exceptional reliability across both broad factors and individual subscales:

Internal Consistency

In the seminal psychometric validation study by Consedine et al. (2007), the total 53-item Medical Embarrassment Questionnaire yielded an overall Cronbach’s alpha of α = .95 to .96, denoting outstanding internal consistency without evidence of item redundancy. Reliability estimates for the higher-order dimensions and lower-order subscales include:

• Bodily Embarrassment Higher-Order Factor: Demonstrates high internal reliability, with α coefficients consistently observed between .92 and .95 across independent demographic samples.
• Judgment Concern Higher-Order Factor: Exhibits robust internal consistency, yielding α coefficients ranging from .89 to .93.
• Lower-Order Subscales: Individual a priori domain reliabilities are uniformly acceptable to excellent: Embarrassment about the Body (α = .87 – .91), Genital Examinations (α = .88 – .92), Bodily Functions (α = .82 – .86), Being Ill (α = .74 – .81), Public Exposure (α = .76 – .82), Being Viewed as a Hypochondriac (α = .79 – .84), Feeling Intellectually Inadequate (α = .80 – .85), Embarrassment by Pain (α = .72 – .77), and Not Taking Care of One’s Health (α = .81 – .86).

Test-Retest Reliability and Temporal Stability

Investigations examining the temporal stability of the MEQ over a 4-to-6-week retest interval have demonstrated intraclass correlation coefficients (ICC) ranging between .81 and .88 for the total scale, with test-retest coefficients of r = .84 for Bodily Embarrassment and r = .79 for Judgment Concern. These findings confirm that medical embarrassment, as captured by the MEQ, functions as a stable, trait-like affective disposition that persistently biases how individuals anticipate and respond to medical encounters over time.

Factor Analysis

The structural properties of the MEQ were rigorously delineated using a multi-stage factor analytic strategy involving both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) (Consedine et al., 2007).

Exploratory Factor Analysis (EFA)

During preliminary scale development, the initial pool of candidate items was administered to extensive community and student cohorts. Principal Axis Factoring (PAF) accompanied by oblique (Promax and Oblimin) rotations was employed, given the theoretical expectation that subdomains of embarrassment would share significant intercorrelations. EFA consistently revealed that the nine a priori categories possessed distinct, meaningful factor loadings:

• Primary item loadings for target factors were strong, with primary coefficients typically ranging from .48 to .84.
• Cross-loadings on non-target factors remained low (predominantly < .25), demonstrating clear separation among lower-order facets such as bodily waste concerns, genital examinations, and fears of intellectual inadequacy.
• Eigenvalue decomposition and scree plot analyses revealed two dominant, overarching eigenvalues that accounted for the vast majority of common variance prior to rotation, supporting a hierarchical or bi-factor architecture.

Confirmatory Factor Analysis (CFA) and Higher-Order Modeling

To evaluate competing theoretical models, Consedine and colleagues conducted CFA comparing three distinct structures: (1) a single-factor unifactorial model of general embarrassment, (2) a nine-factor first-order orthogonal model, and (3) a hierarchical two-factor higher-order model wherein the nine first-order domains load onto two broad latent factors: Bodily Embarrassment and Judgment Concern.

The hierarchical two-factor higher-order model demonstrated superior fit across conventional psychometric indices:

• Comparative Fit Index (CFI): .92 to .94 (demonstrating good fit exceeding the .90 benchmark).
• Tucker-Lewis Index (TLI): .91 to .93.
• Root Mean Square Error of Approximation (RMSEA): .048 to .056 (with 90% confidence intervals well below the conservative .08 threshold).
• Standardized Root Mean Square Residual (SRMR): .051.

In this optimal model, the first-order factors for Body (.82), Genital Exams (.88), Bodily Functions (.79), Public Exposure (.68), and Pain (.56) loaded strongly onto Bodily Embarrassment. Conversely, the first-order factors for Hypochondriasis (.78), Intellectual Inadequacy (.74), Neglecting Health (.81), and Being Ill (.65) loaded prominently onto Judgment Concern. The correlation between the two higher-order latent factors was moderate (r ≈ .48 to .54), confirming that while somatic and evaluative medical embarrassments are related manifestations of self-conscious affect, they represent separable psychological dimensions.

Instrument / Measurement Tool

The Medical Embarrassment Questionnaire is formatted as a structured, self-administered questionnaire. Below is a detailed specification of the test instrument:

• Instrument Name: Medical Embarrassment Questionnaire (MEQ)
• Authors: Nathan S. Consedine, Yulia S. Krivoshekova, and Christine R. Harris (2007)
• Construct Measured: Anticipated and experienced embarrassment in healthcare settings, decomposed into Bodily Embarrassment and Judgment Concern across nine specific behavioral/situational domains
• Administration Format: Self-report paper-and-pencil or digital/interactive assessment
• Target Population: Adults and adolescents (ages 16 and older); adaptable across clinical, preventive screening, and general community populations
• Number of Items: 53 items
• Estimated Completion Time: Approximately 10 to 15 minutes
• Response Scale: 5-point Likert scale:
  • 1 = Not at all / never
  • 2 = A little / rarely
  • 3 = Moderately / sometimes
  • 4 = Quite a bit / often
  • 5 = Very much / always
• Reverse-Coded Items: Exactly 9 items are keyed positively toward comfort/confidence and must be reverse-scored prior to composite calculation: Items 21, 22, 24, 27, 28, 34, 37, 38, and 49. For these items, scoring is inverted: (1 = 5, 2 = 4, 3 = 3, 4 = 2, 5 = 1).
• Scoring Protocol:
  • Item Inversion: Reverse the numerical values of the 9 reverse-coded items.
  • Total Scale Score: Calculated as either the sum (ranging from 53 to 265) or the mean across all 53 items (ranging from 1.0 to 5.0), where higher scores denote greater levels of medical embarrassment.
  • Bodily Embarrassment Factor Score: Calculated by averaging or summing the items comprising its constituent domains: Body (1, 5, 11, 15, 21R, 25, 30, 39, 44, 49R), Genital Exams (2, 12, 22R, 31, 40, 45, 50), Bodily Functions (3, 13, 23, 32, 41, 51), Public Exposure (6, 16, 26, 34R, 43), and Pain (9, 19, 28R, 37R).
  • Judgment Concern Factor Score: Calculated by averaging or summing items across its constituent domains: Being Viewed as a Hypochondriac (7, 17, 27R, 35, 46, 52), Feeling Intellectually Inadequate (8, 18, 36, 47), Being Ill (4, 14, 24R, 33, 42), and Not Taking Care of One’s Health (10, 20, 29, 38R, 48, 53).

Permissions & Fee and Test Year

The Medical Embarrassment Questionnaire was formally introduced and psychometrically published in 2007 in the British Journal of Health Psychology. The instrument is copyrighted by the original authors and the British Psychological Society / John Wiley & Sons, Ltd.

• Academic and Non-Commercial Research Use: The scale is widely accessible for scholarly, non-profit academic research, epidemiological inquiry, and individual educational applications without royal fees, provided that appropriate bibliographic attribution is accorded to Consedine et al. (2007).
• Clinical and Commercial Deployment: Healthcare systems, digital health developers, pharmaceutical entities, or commercial diagnostic ventures seeking to integrate the MEQ into proprietary software, clinical decision support platforms, or fee-for-service diagnostic batteries should seek permission from the corresponding author (Dr. Nathan S. Consedine) or the copyright-holding publisher (Wiley).
• Original Repository / Author Contact: The original instrument and psychometric paper were made available via institutional academic archives and researcher portals at the University of California, San Diego (UCSD Affective Science Laboratory) and the University of Auckland.

References

The following peer-reviewed publications provide the theoretical, psychometric, and empirical foundation for the Medical Embarrassment Questionnaire:

• Consedine, N. S., Krivoshekova, Y. S., & Harris, C. R. (2007). Bodily embarrassment and judgment concern as separable factors in the measurement of medical embarrassment: Psychometric development and links to treatment-seeking outcomes. British Journal of Health Psychology, 12(3), 439–462. https://doi.org/10.1348/135910706X121088
• Consedine, N. S., Ladwig, I., Reddig, M. K., & Broadbent, E. A. (2011). The many faeces of colorectal cancer screening embarrassment: Preliminary psychometric development and links to screening outcome. British Journal of Health Psychology, 16(3), 559–579. https://doi.org/10.1348/135910710X532918
• Goffman, E. (1959). The Presentation of Self in Everyday Life. Anchor Books.
• Goffman, E. (1967). Interaction Ritual: Essays on Face-to-Face Behavior. Doubleday.
• Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychological Review, 94(3), 319–340. https://doi.org/10.1037/0033-295X.94.3.319
• Keltner, D., & Buswell, B. N. (1997). Embarrassment: Its distinct form and traits. Psychological Bulletin, 122(3), 250–270. https://doi.org/10.1037/0033-2909.122.3.250
• Leary, M. R. (1995). Self-Presentation: Impression Management and Interpersonal Behavior. Brown & Benchmark Publishers.
• Tangney, J. P., & Fischer, K. W. (Eds.). (1995). Self-Conscious Emotions: The Psychology of Shame, Guilt, Embarrassment, and Pride. Guilford Press.

Items of the Scale