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Negative emotional appeals are commonly used in health messages to cut through the clutter and promote health behaviour change. A research gap exists as to how the emotions of guilt and shame and respective arousals to these emotions act to influence compliance with health messages. Research rarely distinguishes between guilt and shame appeals, different emotional and psychological responses to the two types of appeals, and the main moderators that influence the response to these appeals. To address this gap, this empirical study builds and tests a model for better understanding the processes by which guilt and shame appeals lead to compliance with health messages. Drawing on the theoretical frameworks of cognition, emotion, motivation and research focusing on guilt or/and shame messages and behavioural intention, this study develops an extended model that incorporates influential variables. These include the significant mediating variable of the coping response to emotion, and the moderating variables of self-construal, regulatory focus, and personal cultural orientation.  Binge drinking among young adults (aged 16 to 30) is the research context for this study. A series of experiments was conducted to test the research model. Data was collected through an online questionnaire survey among university undergraduates in New Zealand. The main survey collected 301 useable responses including the treatment (n = 266) and control (35) groups. The survey data were analysed using a combination of analysis of covariance and covariance-based structural equation modelling. The results broadly support the proposed model for health communications using guilt and shame appeals.  Findings revealed that the coping response has a partial mediating effect on the relationship between guilt/shame arousals and message compliance. Both guilt and shame arousals influence not only message compliance (directly) but also the coping response (indirectly). As predicted, regulatory focus and self-construal were found to moderate guilt/shame arousals from respective emotional appeals. Regulatory focus moderated the levels of shame arousals from shame appeals; that is, prevention-focused individuals exhibited higher shame arousals than their promotion-focused counterparts. Self-construal moderated the levels of guilt arousals from guilt appeals; that is, independent self-construals exhibited higher guilt arousals than their interdependent counterparts. However, there were no interactive effects of self-construal with self-referencing or sources of evaluation on guilt/shame arousals. Personal cultural orientation moderated the impact of shame arousals, but not those of guilt arousals, on message compliance. That is, shame predicted message compliance in collectivists, but not individualists. Interestingly, there was no main differential effect of guilt versus shame arousals in message compliance, but there was an interactive effect of emotion type with personal cultural orientation as previously mentioned.  The contributions of this study include refining understanding of guilt versus shame, developing the coping response construct, and identifying key moderators and illustrating their impacts on self-conscious emotional arousals. These contributions open new lines of inquiry in the health communications and discrete emotions literature. First, previous discrete emotions literature has mentioned the effects of unintentional emotions, but this research controlled for these effects. It examined guilt and shame separately through respective emotional arousals rather than emotional appeals. Second, the study extended the model of the effectiveness of guilt versus shame appeals in health communications where the coping response is an instrumental mediator. This mediator influences whether or not the receivers actually take on compliant behaviour. Third, the present study differentiated the effect of guilt versus shame appeals. It provides conditions where such appeals are effective. These conditions are type of emotion interacting with self-construal, and regulatory focus. In addition, the study identified the condition under which guilt or shame arousals are most effective. Effectiveness depends on emotion type and personal cultural orientation.  The findings have important practical implications. By understanding how distinct emotion (i.e., guilt versus shame) works and how coping responses (i.e., adaptive versus maladaptive) to these emotions are triggered, practitioners can better structure emotional messaging. Knowledge of message receiver attributes will help them select media appropriately. These attributes are independent versus interdependent, promotion focused versus prevention focused, and individualist versus collectivist. Thus, insights from this research could help health marketers, policy makers as well as health promotion agencies to effectively develop health communications campaigns with more appealing message content and appropriate media selection.

Factors in the effectiveness of anticipatory guilt and shame appeals on health communications: The role of self-construal, regulatory focus and personal cultural orientation