The Effect of Shame on Endothelial Function and Self-Rated Health: Implications of Stigmatization

Abstract

Shame, an unpleasant emotion that happens when we think less of ourselves, is an emotion that many humans have experienced or inflicted upon others at some time in their lives. Common uses of shame include encouraging people to change “undesirable” behaviours (e.g. unhealthy diet) or encouraging people to buy products. Importantly, some people are exposed to shame more often including those who are part of stigmatized groups. Despite the presence and use of shame in our society, very little is known about how shame affects human physiology and health and no studies have examined the impact of shame on cardiovascular function. One important index of cardiovascular function that may be affected by shame is endothelial function which is important for both the function of blood vessels and cardiovascular health. To address this literature gap, this thesis set out to explore the impact of isolated and more real-world shame experiences on endothelial function and health. More specifically, this thesis examined: 1) the effectiveness of an isolated shame induction protocol to induce shame in a laboratory setting; 2) the impact of an isolated acute shame induction protocol on endothelial function; 3) chronic shame as a determinant of self-rated health in middle-aged adults, and; 4) how a more real-world experience of shame moderates the effect of high sugar/fat consumption on endothelial function. The primary findings of this thesis are that: 1) the isolated shame induction protocol was an effective method to increase shame in a laboratory setting; 2) an acute bout of shame brought on by the isolated shame induction protocol impaired FMD in young, healthy men and women; 3) among American middle-aged adults, chronic shame was a significant predictor of poor self-rated health independent of other risk factors, and; 4) feelings of shame did not increase in response to the real-world shame stimulus (consumption of high sugar/fat beverage) but, FMD was only negatively affected when participants perceived the same high sugar/fat beverage to be more harmful and less healthy. The findings of this thesis advance our understanding of the impact of shame and perception on human physiology and health.