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Salemi E, Mirzazade Z, Dehshiri G, Zahraei S. Sensitivity to punishment and emotional eating: The mediating role of shame and rumination. Psychol Psychother 2022; 95:875-887. [PMID: 35661385 DOI: 10.1111/papt.12407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/02/2022] [Accepted: 05/12/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The relationship between sensitivity to punishment (SP) and emotional eating has been previously examined. However, effective variables in this relationship have yet to be recognized. This study aimed to investigate the relationship between SP and emotional eating via facets of shame and rumination. DESIGN Serial Mediation model was proposed. METHOD Female university students in Iran (n = 174) completed Sensitivity to Punishment and Sensitivity to Reward Questionnaire-Revised and Clarified (SPSRQ-RC), Dutch Eating Behaviour Questionnaire (DEBQ), Experience of Shame Scale (ESS) and Ruminative Responses Scale (RRS). RESULTS SP showed a significant effect on emotional eating. Moreover, we observed that the relationship between SP and emotional eating was separately mediated by shame (general, characterological and bodily shame) and rumination. We further noticed the sequentially mediating role of shame (general, characterological and behavioural shame) and rumination in the relationship between SP and emotional eating. CONCLUSION Findings suggest that high SP can increase the risk of emotional eating through negative emotions (e.g. shame) and disturbed cognitions (e.g. rumination). Therefore, for a better understanding, it seems necessary to consider emotional eating a maladaptive behaviour adopted as a possible result of the impairment of temperamental, emotional and cognitive systems.
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Affiliation(s)
- Elnaz Salemi
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Zahra Mirzazade
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Gholamreza Dehshiri
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Shaghayegh Zahraei
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
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Gorrell S, Rienecke RD, Duffy A, Huston E, Mehler PS, Johnson C, Manwaring J, McClanahan S, Blalock DV, Le Grange D. Understanding non-routine discharge: Factors that are associated with premature termination from higher levels of care in adults with anorexia nervosa. Eat Disord 2022; 30:686-699. [PMID: 35175902 PMCID: PMC9869711 DOI: 10.1080/10640266.2021.2011648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study sought to replicate and extend associations between clinical and demographic features at admission and types of premature treatment termination for adults diagnosed with anorexia nervosa (AN) in higher-level-of-care settings. Secondary data analyses examined a study population comprised of adults with AN (N = 565) who were admitted to one of two United States eating disorder treatment centers (April 2015-April 2020) for intensive outpatient, partial hospitalization, residential, or inpatient services. There were no significant differences in the type of non-routine discharge according to level of care. At admission, those with lower BMI were more likely to discharge against medical advice, and those with lower cognitive restraint and elevated binge eating were more likely to discharge against medical advice or by staff-initiated request, respectively. Discharge by parent/patient request was more likely among those who were older or who reported lower baseline desire for muscularity. Overall older age, elevated binge eating, and lower weight, desire for muscularity, and cognitive restraint may be associated with less tolerance/acceptability for AN treatment. Increased understanding of how to better support patients who admit to higher levels of care with these clinical features will contribute to better odds of completion of a full course of treatment.
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Affiliation(s)
- Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Renee D Rienecke
- Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, Colorado, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, Illinois, USA
| | - Alan Duffy
- Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, Colorado, USA
| | - Emma Huston
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
- Department of Psychology and Counseling, Palo Alto University, PGSP - Stanford PsyD Consortium, Palo Alto, California, USA
| | - Philip S Mehler
- Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, Colorado, USA
- Acute Center for Eating Disorders at Denver Health, Denver, Colorado, USA
- University of Colorado School of Medicine, Denver, Colorado, USA
| | - Craig Johnson
- Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, Colorado, USA
| | - Jamie Manwaring
- Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, Colorado, USA
| | - Susan McClanahan
- Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, Colorado, USA
| | - Dan V Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
- Department of Psychiatry & Behavioral Neuroscience, The University of Chicago (Emeritus), Chicago, Illinois, USA
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Davis HA, Keel PK, Tangney JP, Smith GT. Increases in shame following binge eating among women: Laboratory and longitudinal findings. Appetite 2022; 178:106276. [PMID: 35973455 DOI: 10.1016/j.appet.2022.106276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022]
Abstract
This multi-method, two-study investigation tested the hypothesis that, controlling for guilt and negative affect, shame increases following binge eating. Support for this hypothesis constitutes the first step in testing the theory that shame mediates the link between binge eating and comorbid psychopathology. Study 1 employed a laboratory binge-eating paradigm in n = 51 women [21 with bulimia nervosa, 30 controls]. Study 2 employed a naturalistic test of prospective relationships among binge eating, shame, guilt, and negative affect in n = 302 college women over three months. In Study 1, women with bulimia nervosa reported increases in shame that were not explained by changes in guilt or negative affect, following laboratory binge eating, compared with controls. In Study 2, baseline binge eating predicted increased shame at follow-up independently of guilt and negative affect. Should shame prove to mediate the link between binge eating and comorbid disorders, interventions to reduce shame may be useful for those who binge.
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Affiliation(s)
| | - Pamela K Keel
- Department of Psychology, Florida State University, United States
| | - June P Tangney
- Department of Psychology, George Mason University, United States
| | - Gregory T Smith
- Department of Psychology, University of Kentucky, United States
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Nechita DM, Bud S, David D. Shame and eating disorders symptoms: A meta-analysis. Int J Eat Disord 2021; 54:1899-1945. [PMID: 34302369 DOI: 10.1002/eat.23583] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Numerous empirical studies and theoretical models posit that shame is a common experience among individuals across the eating disorder spectrum. In this study we aim to investigate the association between shame and eating disorders symptoms using a meta-analytical approach. METHOD In this meta-analysis, we synthesized findings from 195 studies to examine the proposed association between shame and eating disorders symptoms. We looked at the associations with both general eating disorders symptoms and with specific eating disorders symptoms (i.e., anorexic, bulimic, and binge-eating symptoms). Moderation analyses testing for the effect of type of shame, type of eating symptoms, clinical status, quality of the study, age, and gender were conducted. RESULTS Shame was significantly associated with a medium to large effect size with all types of eating disorders symptoms (rs between .40 and .52). Body shame (r = .55) and shame around eating (r = .59) were more strongly related with eating disorders pathology. Type of eating disorders symptoms did not moderate the relationship between shame and disturbed eating. DISCUSSION Overall, the magnitude of the effect size of the association between shame and eating disorders symptoms is a medium to large one. Body shame and shame around eating seem to be the types of shame most closely tied with eating disorders symptoms, suggesting that directly targeting them in interventions might be highly beneficial. Findings highlight current gaps in the literature (e.g., mostly correlational studies, low quality studies) with implications for future research.
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Affiliation(s)
- Diana-Mirela Nechita
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.,International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Samuel Bud
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania.,Evidence-Based Assessment and Psychological Interventions Doctoral School, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Daniel David
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.,International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
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