In a culture that often prioritizes social harmony (和谐, héxié) and the preservation of “face” (面子, miànzi), making a public 指控 (zhǐkòng) is a very serious act. It's a step that can irrevocably damage relationships and reputations. For this reason, formal accusations are not made lightly. Compared to the English word “accuse,” 指控 (zhǐkòng) occupies a more formal and serious space. You can “accuse” a friend of eating the last cookie, but you would never use 指控 for such a trivial matter. 指控 is much closer in gravity to the English legal phrases “to press charges,” “to file a charge against,” or “to indict.” It signals that a situation has escalated beyond a personal dispute into the realm of official procedure, whether it be legal, corporate, or political. Failing to substantiate a 指控 can lead to a significant loss of face for the accuser, and in some cases, legal consequences for slander (污蔑, wūmiè).
指控 (zhǐkòng) is predominantly used in formal contexts. You will rarely hear it in casual conversation unless someone is speaking ironically or recounting a very serious event.
The word itself is neutral in that it simply states the action of accusing. However, the context is almost always negative, as it deals with wrongdoing.