Sensitivity to punishment and eating pathology among undergraduate women: The mediating role of shame

Sensitivity to punishment and emotional eating: The mediating role of shame and rumination

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.

Understanding non-routine discharge: Factors that are associated with premature termination from higher levels of care in adults with anorexia nervosa

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.

Increases in shame following binge eating among women: Laboratory and longitudinal findings

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.

Shame and eating disorders symptoms: A meta-analysis

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.