Although many health communication researchers use the terms “shame” and “guilt” interchangeably, arguably these constructs are distinct and have widely divergent psychological consequences. The purpose of this study was to explore distinct cognitive and emotional outcomes resulting from shame relative to guilt appeals. Specifically, this paper provides empirical evidence that negative outcomes such as anger and perceived manipulative intent are more likely to be associated with shame than guilt. Using an experimental design, participants were randomly assigned to view either a shame or a guilt appeal about getting tested for STDs and completed an online questionnaire. Shame was correlated with both anger and perceived manipulative intent whereas guilt was not. Participants who viewed the shame appeal reported higher levels of shame, anger, and perceived manipulative intent. Tactics for creating shame-free guilt appeals and future research are discussed.