Answer: The punishments of sin in this world are either inward, as blindness of mind₁, a reprobate sense₂, strong delusions₃, hardness of heart₄, horror of conscience₅, and vile affections₆; or outward, as the curse of God upon the creatures for our sakes₇, and all other evils that befall us in our bodies, names, estates, relations, and employments₈; together with death itself.₉

1. Ephesians 4:18
2. Romans 1:28
3. 2 Thessalonians 2:11
4. Romans 2:5
5. Isaiah 33:14; Genesis 4:13; Matthew 27:4
6. Romans 1:26
7. Genesis 3:17
8. Deuteronomy 28:15-68
9. Romans 6:21; Romans 6:23

For further study see:

1. Elder Gregory Moeck, First Orthodox Presbyterian Church, San Francisco, on Westminster Larger Catechism 28a – Can sin make you less righteous?