I imagine this would get balanced out in the fiction. Unlike Persuasion or Rhetoric, where they’re slowly convinced of an idea through agreements and logic, this is bluntly laying out something that they don’t want to hear. This truth is ugly, and depending on your relationship with the other person it’s probably not gonna go well. Use Ugly Truth on someone above your station, and they’re probably going to cast you out or make your life hell. Below your station, and that’s how you get poisoned or robbed in the night. Or on the other hand, you might use it for the lower ob to make sure you get through to your best friend, who might still hate hearing it but appreciate your (brutal) honesty. And these are all successful roles. A failed role, you might say the same volatile thing, but they don’t believe it and now they don’t want to hear anything more from you; they cut off other avenues of dealing with them. Or they respond with violence. etc. etc. Overall, NPCs will most likely respond much more sharply to this sort of interaction.
(Just my take.)