Journal of Behavioral Medicine

, Volume 39, Issue 2, pp 262–275 | Cite as

Role of shame and body esteem in cortisol stress responses

  • Sarah B. Lupis
  • Natalie J. Sabik
  • Jutta M. WolfEmail author


Studies assessing the role of shame in HPA axis reactivity report mixed findings. Discrepancies may be due to methodological difficulties and inter-individual differences in the propensity to experience shame in a stressful situation. Hence, the current study combined self-report of shame and facial coding of shame expressions and assessed the role of body esteem as a moderator of the shame–stress link. For this, 44 healthy students (24F, age 20.5 ± 2.1 years) were exposed to an acute psychosocial stress paradigm (Trier Social Stress Test: TSST). Salivary cortisol levels were measured throughout the protocol. Trait shame was measured before the stress test, and state shame immediately afterwards. Video recordings of the TSST were coded to determine emotion expressions. State shame was neither associated with cortisol stress responses nor with body esteem (self-report: all ps ≥ .24; expression: all ps ≥ .31). In contrast, higher trait shame was associated with both negative body esteem (p = .049) and stronger cortisol stress responses (p = .013). Lastly, having lower body esteem predicted stronger cortisol stress responses (p = .022); however, it did not significantly moderate the association between shame indices and cortisol stress responses (all ps ≥ .94). These findings suggest that body esteem and trait shame independently contribute to strength of cortisol stress responses. Thus, in addition to trait shame, body esteem emerged as an important predictor of cortisol stress responses and as such, a potential contributor to stress-related negative health outcomes.


Shame Body esteem Trier Social Stress Test Cortisol Facial action coding system 



This research was supported in part by the NIGMS Brain-Body-Behavior Interface in Learning and Development Across the Lifespan training Grant T32GM084907 (S. B. L) and NIA training Grant T32AG000204 (N. J. S.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with ethical standards

Conflict of interest

Sarah B. Lupis, Natalie J. Sabik and Jutta M. Wolf declare that they have no conflict of interest.

Human and animal rights and informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for being included in the study.


  1. Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks: Sage Publications Inc.Google Scholar
  2. Andreoni, J., & Petrie, R. (2008). Beauty, gender and stereotypes: Evidence from laboratory experiments. Journal of Economic Psychology, 29, 73–93.CrossRefGoogle Scholar
  3. Andrews, B. (1997). Bodily shame in relation to abuse in childhood and bulimia: A preliminary investigation. British Journal of Clinical Psychology, 36, 41–49.CrossRefPubMedGoogle Scholar
  4. Bedford, J. L., & Johnson, C. S. (2006). Societal influences on body image dissatisfaction in younger and older women. Journal of Women and Aging, 18, 41–55.CrossRefPubMedGoogle Scholar
  5. Bessenoff, G., & Snow, D. (2006). Absorbing society’s influence: Body image self-discrepancy and internalized shame. Sex Roles, 54, 727–731.CrossRefGoogle Scholar
  6. Choma, B., Shove, C., Busseri, M., Sadava, S., & Hosker, A. (2009). Assessing the role of body image coping strategies as mediators or moderators of the links between self-objectification, body shame, and well-being. Sex Roles, 61, 699–713.CrossRefGoogle Scholar
  7. Cohen, J. (1988). Statistical power for the social sciences. Hillsdale: Laurence Erlbaum and Associates.Google Scholar
  8. Cohen, J. (1992). Statistical power analysis. Current Directions in Psychological Science, 1, 98–101.CrossRefGoogle Scholar
  9. Crockett, L. J., Schulenberg, J. E., & Petersen, A. C. (1987). Congruence between objective and self-report data in a sample of young adolescents. Journal of Adolescent Research, 2, 383–392.CrossRefGoogle Scholar
  10. Croghan, I. T., Bronars, C., Patten, C. A., Schroeder, D. R., Nirelli, L. M., Thomas, J. L., & Hurt, R. D. (2006). Is smoking related to body image satisfaction, stress, and self-esteem in young adults? American Journal of Health Behavior, 30, 322–333.CrossRefPubMedGoogle Scholar
  11. Denson, T. F., Spanovic, M., & Miller, N. (2009). Cognitive appraisals and emotions predict cortisol and immune responses: A meta-analysis of acute laboratory social stressors and emotion inductions. Psychological Bulletin, 135, 823–853.CrossRefPubMedGoogle Scholar
  12. Derakshan, N., & Eysenck, M. W. (1999). Are repressors self-deceivers or other-deceivers? Cognition and Emotion, 13, 1–17.CrossRefGoogle Scholar
  13. Dickerson, S. S., & Kemeny, M. E. (2004). Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychological Bulletin, 130, 355–391.CrossRefPubMedGoogle Scholar
  14. Ekman, P., & Friesen, W. V. (1978). Facial Action Coding System: A technique for the measurement of facial movement. Palo Alto: Consulting Psychologists Press.Google Scholar
  15. Ekman, P., Friesen, W. V., & Hager, J. C. (2002). Facial Action Coding System: The manual on CD ROM. Salt Lake City: A Human Face.Google Scholar
  16. Ekman, P., Levenson, R. W., & Friesen, W. V. (1983). Autonomic nervous system activity distinguishes among emotions. Science, 221, 1208–1210.CrossRefPubMedGoogle Scholar
  17. Etcoff, N. L. (2000). Survival of the prettiest: The science of beauty. New York: Anchor Books.Google Scholar
  18. Etu, S. F., & Gray, J. J. (2010). A preliminary investigation of the relationship between induced rumination and state body image dissatisfaction and anxiety. Body Image, 7, 82–85.CrossRefPubMedGoogle Scholar
  19. Frank, E. S. (1991). Shame and guilt in eating disorders. American Journal of Orthopsychiatry, 61, 303–306.CrossRefPubMedGoogle Scholar
  20. Franzoi, S. (1995). The body-as-object versus the body-as-process: Gender differences and gender considerations. Sex Roles, 33, 417–437.CrossRefGoogle Scholar
  21. Fredrickson, B. L., & Roberts, T.-A. (1997). Objectification theory. Psychology of Women Quarterly, 21, 173–206.CrossRefGoogle Scholar
  22. Gao, J., Qian, M.-Y., & Wang, W.-Y. (2011). Cognitive emotion regulation of shame and general negative emotions. Chinese Journal of Clinical Psychology, 19, 807–809.Google Scholar
  23. Geiger, A. M., Sabik, N. J., Lupis, S. B., Rene, K., & Wolf, J. M. (2014). Appearance judgments by others moderate the biological stress effects of social exchanges. Biological Psychology, 103, 297–304.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Goldstein, D. S., & McEwen, B. (2002). Allostasis, homeostats, and the nature of stress. Stress, 5, 55–58.CrossRefPubMedGoogle Scholar
  25. Grabe, S., Hyde, J. S., & Lindberg, S. M. (2007). Body objectification and depression in adolescents: The role of gender, shame, and rumination. Psychology of Women Quarterly, 31, 164–175.CrossRefGoogle Scholar
  26. Gruenewald, T. L., Kemeny, M. E., & Aziz, N. (2006). Subjective social status moderates cortisol responses to social threat. Brain, Behavior, and Immunity, 20, 410–419.CrossRefPubMedGoogle Scholar
  27. Gruenewald, T. L., Kemeny, M. E., Aziz, N., & Fahey, J. L. (2004). Acute threat to the social self: Shame, social self-esteem, and cortisol activity. Psychosomatic Medicine, 66, 915–924.CrossRefPubMedGoogle Scholar
  28. Gutiérrez-Maldonado, J., Ferrer-García, M., Caqueo-Urízar, A., & Moreno, E. (2010). Body image in eating disorders: The influence of exposure to virtual-reality environments. Cyberpsychology, Behavior, and Social Networking, 13, 521–531.CrossRefGoogle Scholar
  29. Holmbeck, G. N. (2002). Post-hoc probing of significant moderational and mediational effects in studies of pediatric populations. Journal of Pediatric Psychology, 27, 87–96.CrossRefPubMedGoogle Scholar
  30. Irwin, H. J. (1998). Affective predictors of dissociation. II: Shame and guilt. Journal of Clinical Psychology, 54, 237–245.CrossRefPubMedGoogle Scholar
  31. Keltner, D., & Bonanno, G. A. (1997). A study of laughter and dissociation: Distinct correlates of laughter and smiling during bereavement. Journal of Personality and Social Psychology, 73, 687–702.CrossRefPubMedGoogle Scholar
  32. Kirschbaum, C., Kudielka, B. M., Gaab, J., Schommer, N. C., & Hellhammer, D. H. (1999). Impact of gender, menstrual cycle phase, and oral contraceptives on the activity of the hypothalamic–pituitary–adrenal axis. Psychosomatic Medicine, 61, 154–162.CrossRefPubMedGoogle Scholar
  33. Kirschbaum, C., Pirke, K.-M., & Hellhammer, D. H. (1993). The ‘Trier Social Stress Test’: A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28, 76–81.CrossRefPubMedGoogle Scholar
  34. Lazarus, R. S. (1982). Thoughts on the relations between emotion and cognition. American Psychologist, 37, 1019–1024.CrossRefGoogle Scholar
  35. Levenson, R. W. (1992). Autonomic nervous system differences among emotions. Psychological Science, 3, 23–27.CrossRefGoogle Scholar
  36. Lupis, S. B., Lerman, M., & Wolf, J. M. (2014). Anger responses to psychosocial stress predict heart rate and cortisol stress responses in men but not women. Psychoneuroendocrinology, 49, 84–95.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Marschall, D. E., Sanftner, J., & Tangney, J. (1994). The State Shame and Guilt Scale. Fairfax: George Mason University.Google Scholar
  38. Mason, J. W., Wang, S., Yehuda, R., Riney, S., Charney, D. S., & Southwick, S. M. (2001). Psychogenic lowering of urinary cortisol levels linked to increased emotional numbing and a shame-depressive syndrome in combat-related posttraumatic stress disorder. Psychosomatic Medicine, 63, 387–401.CrossRefPubMedGoogle Scholar
  39. McCabe, M. P., & McGreevy, S. J. (2011). Role of media and peers on body change strategies among adult men: Is body size important? European Eating Disorders Review, 19, 438–446.PubMedGoogle Scholar
  40. McEwen, B. S., & Seeman, T. (1999). Protective and damaging effects of mediators of stress: Elaborating and testing the concepts of allostasis and allostatic load. In N. E. Adler, M. Marmot, B. S. McEwen, & J. Stewart (Eds.), Socioeconomic status and health in industrial nations: Social, psychological, and biological pathways (pp. 30–47). New York: New York Academy of Sciences.Google Scholar
  41. Mendelson, B. K., Mendelson, M. J., & White, D. R. (2001). Body-Esteem Scale for Adolescents and Adults. Journal of Personality Assessment, 76, 90–106.CrossRefPubMedGoogle Scholar
  42. Moffitt, L. B., & Szymanski, D. M. (2011). Experiencing sexually objectifying environments: A qualitative study. The Counseling Psychologist, 39, 67–106.CrossRefGoogle Scholar
  43. Moons, W. G., Eisenberger, N. I., & Taylor, S. E. (2010). Anger and fear responses to stress have different biological profiles. Brain, Behavior, and Immunity, 24, 215–219.CrossRefPubMedGoogle Scholar
  44. Muth, J. L., & Cash, T. F. (1997). Body-image attitudes: What difference does gender make? Journal of Applied Social Psychology, 27, 1438–1452.CrossRefGoogle Scholar
  45. Myers, L. B., & Brewin, C. R. (1995). Repressive coping and the recall of emotional material. Cognition and Emotion, 9, 637–642.CrossRefGoogle Scholar
  46. Noll, S. M., & Fredrickson, B. L. (1998). A medational model linking self-objectification, body shame, and disordered eating. Psychology of Women Quarterly, 22, 623–636.CrossRefGoogle Scholar
  47. Olivardia, R., Pope, H. G, Jr, Borowiecki, J. J, I. I. I., & Cohane, G. H. (2004). Biceps and body image: The relationship between muscularity and self-esteem, depression, and eating disorder symptoms. Psychology of Men & Masculinity, 5, 112–120.CrossRefGoogle Scholar
  48. Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003). Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology, 28, 916–931.CrossRefPubMedGoogle Scholar
  49. Rohleder, N., Chen, E., Wolf, J. M., & Miller, G. E. (2008). The psychobiology of trait shame in young women: Extending the social self preservation theory. Health Psychology, 27, 523–532.CrossRefPubMedGoogle Scholar
  50. Sanftner, J. L., Barlow, D. H., Marschall, D. E., & Tangney, J. P. (1995). The relation of shame and guilt to eating disorder symptomatology. Journal of Social and Clinical Psychology, 14, 315–324.CrossRefGoogle Scholar
  51. Sapolsky, R. M. (2000). Stress hormones: Good and bad. Neurobiology of Disease, 7, 540–542.CrossRefPubMedGoogle Scholar
  52. Sapolsky, R. M., Romero, L. M., & Munck, A. U. (2000). How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions. Endocrinology Review, 21, 55–89.Google Scholar
  53. Slade, P. D. (1994). What is body image? Behaviour Research and Therapy, 32, 497–502.CrossRefPubMedGoogle Scholar
  54. Stice, E. (2002). Sociocultural influences on body image and eating disturbance. In C. G. Fairburn & K. D. Brownell (Eds.), Eating disorders and obesity: A comprehensive handbook (pp. 103–107). New York: Guildford.Google Scholar
  55. Talbot, J. A., Talbot, N. L., & Tu, X. (2004). Shame-proneness as a diathesis for dissociation in women with histories of childhood sexual abuse. Journal of Traumatic Stress, 17, 445–448.CrossRefPubMedGoogle Scholar
  56. Tangney, J. P. (1995). Recent advances in the empirical study of shame and guilt. American Behavioral Scientist, 38, 1132–1145.CrossRefGoogle Scholar
  57. Thompson, J. K., Heinberg, L. J., Altabe, M., & Tantleff-Dunn, S. (1999). Exacting beauty: Theory, assessment, and treatment of body image disturbance. Washington, DC, US: American Psychological Association.CrossRefGoogle Scholar
  58. Thomson, P., & Jaque, S. V. (2013). Exposing shame in dancers and athletes: Shame, trauma, and dissociation in a nonclinical population. Journal of Trauma & Dissociation, 14, 439–454.CrossRefGoogle Scholar
  59. Tops, M., Boksem, M. A., Wester, A. E., Lorist, M. M., & Meijman, T. F. (2006). Task engagement and the relationships between the error-related negativity, agreeableness, behavioral shame proneness and cortisol. Psychoneuroendocrinology, 31, 847–858.CrossRefPubMedGoogle Scholar
  60. Tops, M., Riese, H., Oldehinkel, A. J., Rijsdijk, F. V., & Ormel, J. (2008). Rejection sensitivity relates to hypocortisolism and depressed mood state in young women. Psychoneuroendocrinology, 33, 551–559.CrossRefPubMedGoogle Scholar
  61. Tracy, J. L., Robins, R. W., & Schriber, R. A. (2009). Development of a FACS-verified set of basic and self-conscious emotion expressions. Emotion, 9, 554–559.CrossRefPubMedGoogle Scholar
  62. Tracy, J. L., Robins, R. W., & Tangney, J. P. (2007). The self-conscious emotions: Theory and research. New York: Guilford Press.Google Scholar
  63. Tsigos, C., & Chrousos, G. P. (2002). Hypothalamic–pituitary–adrenal axis, neuroendocrine factors and stress. Journal of Psychosomatic Research, 53, 865–871.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Sarah B. Lupis
    • 1
  • Natalie J. Sabik
    • 1
    • 2
  • Jutta M. Wolf
    • 1
    Email author
  1. 1.Department of PsychologyBrandeis UniversityWalthamUSA
  2. 2.Health StudiesUniversity of Rhode IslandKingstonUSA

Personalised recommendations