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Psychologists have long known that emotions can be fleeting or chronic. We refer to short-lived emotional experiences as “states.” For example, a brief flare of sadness that passes once your attention shifts to something happier would be a “state.”

Emotional experiences that are more consistent, like sadness that rarely abates, behave like “traits.” These chronic, trait-like emotions–especially self-conscious emotions like shame and guilt–play key roles in mental health outcomes.

Newly published research reveals that chronic body-related shame and guilt are predictors of depression, anxiety, and eating disorders. These body-focused emotions were even stronger predictors of negative mental health outcomes than more general feelings of guilt or shame.

Self-conscious emotions like guilt and shame are inherently social, linked to the real or imagined judgments of other people. At times, it can be adaptive to experience self-conscious emotions. For example, feeling guilty when you’ve hurt someone can help motivate you to apologize, make amends, and repair the relationship. But feelings like guilt or shame can be paralyzing, inhibiting positive changes. Chronic shame and guilt can also feed depression or anxiety.

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Shame and guilt can be global or domain-specific. For example, a global feeling of shame could be the sense that you’ve fallen short of your culture’s standards for being a “good person.” That’s very different than feeling like you’re a good person overall but experiencing shame because you’ve fallen short in one specific way. For example, if you feel you’re falling short when it comes to your academic or work performance, that might generate a domain-specific type of shame.

The authors of this new research, published in the journal Self and Identity, were particularly interested in the effects of guilt and shame in the domain of the body. Self-conscious emotions about the body focus on physical appearance, often relating to the size or shape of one’s body.

In this new research, just over 500 adults in the U.S. and Canada completed an online survey measuring emotionality and mental health. In addition to global scales of trait-like shame and guilt, respondents completed measures of body-specific shame and guilt. The questions in these measures presented subjects with different scenarios, followed by questions asking subjects to rate how likely they would be to have specific responses in each scenario. For example, one scenario read, “You are at a bar where people are dancing, and no one has seemed interested in dancing with you.” If participants gave a high rating to the response, “You would think, ‘No one wants to be seen dancing with me because of how ugly I am,’” that would indicate body-related shame. A high likelihood rating for “I should have tried harder to look nice tonight” would indicate body-related guilt.

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Participants also completed measures of depression, anxiety, self-esteem, and eating pathology. The measure of eating pathology assessed dysfunctional behaviors and attitudes like bingeing, purging, dietary restraint, and weight/shape concern. The researchers went beyond measures just focusing on negative mental health outcomes, choosing to include a measure of psychological flourishing as well. The scale measuring flourishing included items like, “I lead a purposeful and meaningful life” and “My social relationships are supportive and rewarding.”

The researchers predicted that general (i.e., global) self-conscious guilt and shame would more strongly predict broader mental health indices like depression and anxiety. They anticipated that body-focused guilt and shame would better predict mental health outcomes specific to people’s evaluations of their physical self (i.e., self-esteem and symptoms of disordered eating). Instead, the researchers found consistent evidence that body-focused guilt and shame played a more powerful role in predicting mental health outcomes than general measures of guilt and shame.

Compared to the general measure of shame, body-related shame more strongly predicted depression, anxiety, eating pathology, self-esteem, and flourishing. Body-related guilt showed the same pattern. (The direction of the link with body shame/guilt was reversed for self-esteem and flourishing. More body shame or body guilt predicted lower self-esteem and less flourishing.)

In other words, body-focused shame and guilt seem to be especially powerful when it comes to predicting mental health outcomes. How you feel about the appearance of your body is strongly related to your sense of self-worth, so perhaps it should not be surprising that feeling bad about your appearance is so strongly predictive of anxiety and depression. The researchers speculated that body-focused guilt and shame could be especially potent because of the extreme emphasis on appearance in our culture. These new findings are a reminder that body image struggles should be taken seriously, as they can have a profoundly negative impact on both mental and physical health.