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.
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Of note, based on previous research, this sample size was regarded adequate to address the current aims. In more detail, when assessing anger and fear associations with cortisol stress responses, a former study revealed significant yet small effects (e.g., R 2 = .15 for emotion expression; R 2 = .12 for self-reported emotion) in a sample of 32 participants when examining gender-by-emotion interactions predicting cortisol stress responses (Lupis et al., 2014). Thus, the sample size of N = 44 in the current study would be sufficient to detect similar effects.
Two of the three excluded participants were missing the last value (sample 5), while one participant was missing samples 4 and 5. As such, subsequent computation of maximum cortisol increases was not affected for the former two. To assess the effect of only including samples 2 and 3 in the maximum cortisol increase computation for the latter participant, we re-ran all analyses without that participant. As none of the findings changed, we retained the participant’s data in the current dataset.
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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.
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.
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Lupis, S.B., Sabik, N.J. & Wolf, J.M. Role of shame and body esteem in cortisol stress responses. J Behav Med 39, 262–275 (2016). https://doi.org/10.1007/s10865-015-9695-5
- Body esteem
- Trier Social Stress Test
- Facial action coding system