Immunological effects of induced shame and guilt

Psychosom Med. 2004 Jan-Feb;66(1):124-31. doi: 10.1097/01.psy.0000097338.75454.29.


Objective: To determine if inducing self-blame would lead to increases in shame and guilt as well as increases in proinflammatory cytokine activity and cortisol. Based on previous research and theory, it was hypothesized that induced shame would be specifically associated with elevations in proinflammatory cytokine activity.

Materials and methods: Healthy participants were randomly assigned to write about traumatic experiences in which they blamed themselves (N = 31) or neutral experiences (N = 18) during three 20-minute experimental laboratory sessions over 1 week. Tumor necrosis factor-alpha receptor levels (sTNFalphaRII), an indicator of proinflammatory cytokine activity, beta2-microglobulin, cortisol (all obtained from oral fluids), and emotion were assessed prewriting and postwriting.

Results: Participants in the self-blame condition showed an increase in shame and guilt as well as an increase in sTNFalphaRII activity when compared with those in the control condition. Cortisol and beta2-microglobulin levels were unaffected by the procedures. Those individuals in the self-blame condition reporting the greatest increases in shame in response to the task showed the greatest elevations in proinflammatory cytokine activity, while levels of guilt and general negative emotion were unrelated to cytokine changes.

Conclusion: These data suggest that inducing self-related emotions can cause changes in inflammatory products, and that shame may have specific immunological correlates.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antigens, CD / blood*
  • Emotions
  • Female
  • Guilt*
  • Humans
  • Hydrocortisone / analysis
  • Hydrocortisone / physiology*
  • Immunocompetence
  • Inflammation / physiopathology
  • Inflammation / psychology*
  • Male
  • Plasma
  • Psychoneuroimmunology
  • Receptors, Tumor Necrosis Factor / blood*
  • Receptors, Tumor Necrosis Factor, Type II
  • Saliva / chemistry
  • Shame*
  • Tumor Necrosis Factor-alpha / analysis
  • Writing
  • beta 2-Microglobulin / analysis


  • Antigens, CD
  • Receptors, Tumor Necrosis Factor
  • Receptors, Tumor Necrosis Factor, Type II
  • Tumor Necrosis Factor-alpha
  • beta 2-Microglobulin
  • Hydrocortisone