Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type



Arts and Sciences



First Advisor

Dr. Suzanne Segerstrom

Second Advisor

Dr. Jamie Studts


The current study investigated the relationships between state shame, guilt, and disease knowledge in women recently diagnosed with cervical intraepithelial neoplasia (CIN) caused by the human papillomavirus (HPV). Recent research has indicated that diagnosis of HPV can elicit negative self-directed affect, including persistent experiences of shame. Studies have also shown that knowledge of HPV is low in the general population, even though it is the most common sexually transmitted infection. It is important to understand how shame affects those with HPV because shame is related to a decline in important immune parameters that may be essential in HPV clearance. A sample of young women (ages 18-28) recently diagnosed with HPV were given measures of shame and guilt-proneness, state shame and guilt, depression, impact of diagnosis, and HPV knowledge. A comparison group of women diagnosed with infectious mononucleosis caused by the Epstein-Barr Virus (EBV) were also given these measures. It was predicted that women diagnosed with HPV would have higher levels of shame and guilt than women diagnosed with EBV. It was also predicted that disease knowledge would moderate negative affect in women with HPV, where increases in HPV knowledge would neutralize feelings of shame and guilt. The results of this study supported the first hypothesis: women with HPV experienced more shame and guilt than women with EBV. Shame largely mediated the relationship between diagnosis of HPV and depression, as well as HPV and distress, but these relationships were not significant for guilt. The hypothesis that disease knowledge would moderate feelings of shame was not supported in this study. Because of the biological and psychological consequences of shameful experiences, research should continue to measure factors that may predict shame after diagnosis of HPV.



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