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When the Social Self Is Threatened: Shame, Physiology, and Health


  • Sally S. Dickerson, Department of Psychology and Social Behavior, University of California, Irvine; Tara L. Gruenewald, Department of Medicine/Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles; Margaret E. Kemeny, Health Psychology Program and Department of Psychiatry, University of California, San Francisco. Preparation of this paper was supported in part by a Health Psychology Training Grant Pre-doctoral Fellowship from the National Institute of Mental Health, a National Science Foundation Graduate Fellowship, a Ruth L. Kirchstein National Research Service Award, and funding from the National Institute of Mental Health (MH42918). We thank Shelly Gable for her thoughtful comments on previous versions of this paper.

concerning this article should be addressed to: Sally S. Dickerson, Department of Psychology and Social Behavior, University of California, Irvine, 3340 Social Ecology II, Irvine, CA 92697-7085. E-mail:


Abstract Our program of research focuses on shame as a key emotional response to “social self” threats (i.e., social evaluation or rejection). We propose that shame may orchestrate specific patterns of psychobiological changes under these conditions. A series of studies demonstrates that acute threats to the social self increase proinflammatory cytokine activity and cortisol and that these changes occur in concert with shame. Chronic social self threats and persistent experience of shame-related cognitive and affective states predict disease-relevant immunological and health outcomes in HIV. Across our laboratory and longitudinal studies, general or composite affective states (e.g., distress) are unrelated to these physiological and health outcomes. These findings support a stressor- and emotional response-specificity model for psychobiological and health research.