Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Muscle Physiology Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Exp Physiol. 2022 Aug;107(8):978-993. doi: 10.1113/EP090396. Epub 2022 Jun 14.
What is the central question of this study? Shame is a form of social stress that involves internalizing social devaluations imposed by others. The aim of this study was to determine, for the first time, how acutely experienced shame impacts endothelial function. What is the main finding and its importance? Brachial artery flow-mediated dilatation, an index of endothelial function, was impaired after an intervention that acutely increased self-reported shame. This occurred without increases in cortisol or tumor necrosis factor alpha receptor binding. Frequent or prolonged shame-induced endothelial dysfunction could have important cardiovascular consequences.
The objective of this study was to examine the impact of a shame induction protocol on endothelial function. Fifteen participants (n = 7 men, n = 8 women) completed both a written shame induction protocol and a control protocol on two different experimental days. Pre- and post-protocol we assessed: (1) endothelial function and arterial shear rate via a standard brachial artery reactive hyperaemia flow-mediated dilatation (FMD) test across two post-intervention time points (15 and 35 min post); (2) perceived shame via the experiential shame scale (ESS); and (3) cortisol and soluble tumor necrosis factor alpha receptor (sTNFαRII) through oral fluid analysis. Shame increased after the shame induction protocol (pre, 2.9 ± 0.6 vs. post, 3.7 ± 0.5, P < 0.001) but not the control protocol (pre, 3.0 ± 0.5 vs. post, 2.8 ± 0.5, P = 0.15; protocol by time interaction, P < 0.001). When all three time points were included in the analysis, %FMD did not change over time. Considering only the lowest post time point, %FMD decreased significantly in response to the shame protocol (pre, 4.8 ± 1.9 vs. post, 3.2 ± 1.6, P < 0.001) but not the control protocol (pre, 4.2 ± 1.8 vs. post, 3.8 ± 1.5, P = 0.45; protocol by time interaction, P = 0.035). Covariation of the shear rate stimulus for FMD did not alter the FMD results. When including both the control and shame protocols, but not the shame protocol alone, increased shame was significantly associated with decreased FMD (r = -0.37, P < 0.046). There were no significant time by protocol interaction effects for cortisol or sTNFαRII. In conclusion, temporary increases in shame might cause transient endothelial dysfunction which, if chronically repeated, could manifest as reduced vasoprotection against atherosclerosis.
本研究的核心问题是什么？羞耻感是一种社会压力形式，涉及内化他人施加的社会贬低。本研究的目的是首次确定急性体验的羞耻感如何影响内皮功能。主要发现及其重要性是什么？肱动脉血流介导的扩张，内皮功能的指标，在一项急性增加自我报告羞耻感的干预后受损。这发生在皮质醇或肿瘤坏死因子α受体结合没有增加的情况下。频繁或长期的羞耻引起的内皮功能障碍可能会产生重要的心血管后果。
本研究旨在研究羞耻感诱导方案对内皮功能的影响。15 名参与者（n=7 名男性，n=8 名女性）在两个不同的实验日分别完成了书面羞耻感诱导方案和对照方案。在方案前后，我们评估了：（1）通过标准的肱动脉反应性充血血流介导的扩张（FMD）测试，在两个干预后时间点（15 和 35 分钟后）评估内皮功能和动脉剪切率；（2）通过经验性羞耻量表（ESS）评估感知到的羞耻感；（3）通过口腔液分析评估皮质醇和可溶性肿瘤坏死因子α受体（sTNFαRII）。在羞耻感诱导方案后，羞耻感增加（前，2.9±0.6 与后，3.7±0.5，P<0.001），但对照方案后没有增加（前，3.0±0.5 与后，2.8±0.5，P=0.15；方案与时间交互作用，P<0.001）。当分析包括所有三个时间点时，FMD 随时间没有变化。仅考虑最低的后时间点，FMD 对羞耻感方案的反应显著下降（前，4.8±1.9 与后，3.2±1.6，P<0.001），但对照方案没有（前，4.2±1.8 与后，3.8±1.5，P=0.45；方案与时间交互作用，P=0.035）。FMD 的剪切率刺激的协变量并没有改变 FMD 的结果。当同时包括对照和羞耻感方案，但仅包括羞耻感方案时，羞耻感的增加与 FMD 的降低显著相关（r=-0.37，P<0.046）。皮质醇或 sTNFαRII 没有显著的时间与方案相互作用效应。总之，暂时增加的羞耻感可能导致短暂的内皮功能障碍，如果反复发生，可能会表现为对动脉粥样硬化的血管保护作用降低。
