Shame and pride in anorexia nervosa: a qualitative descriptive study (original) (raw)

Shame, Guilt, and Self-Consciousness in Anorexia Nervosa

Journal of Clinical Medicine

Background: the role of self-conscious emotions (SCE) such as shame and guilt in eating disorders (ED) has been systematically studied only in recent years, but it is still debated. This study aims to investigate the role of SCE in anorexia nervosa (AN), evaluating the role of self-consciousness. Methods: fifty-five individuals with AN and seventy-four healthy controls (HC) were enrolled and completed a battery of tests evaluating the proneness to feel shame and guilt, as well as comparing self-consciousness, eating, and general psychopathology. Results: individuals with AN showed a higher proneness to shame. Shame was correlated with body dissatisfaction and drive for thinness, which are core symptoms in AN, after controlling for scores of depression and anxiety. Proneness to guilt seemed to be less correlated with eating and body symptomatology, but it appeared to have a negative correlation with binge-purging symptoms. Furthermore, proneness to shame was independent of guilt or s...

The role of pride in women with anorexia nervosa: A grounded theory study

Psychology and Psychotherapy: Theory, Research and Practice, 2017

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Experiences of shame and guilt in anorexia and bulimia nervosa: A systematic review

Psychology and Psychotherapy: Theory, Research and Practice

Objectives: Emotional states may play an important role in the development and maintenance of Anorexia (AN) and Bulimia Nervosa (BN). This systematic review aimed to examine the evidence regarding the relationship that shame and guilt have with two eating disorders, AN and BN. Methods: Four major databases (Pubmed, PsychINFO, Web of Science, Medline) were searched (up until April 2018) for studies measuring guilt or shame in clinically diagnosed AN and BN groups. Included papers were evaluated for risk of bias. Results: Twenty-four papers met the inclusion criteria. Several methodological issues were noted within the reviewed studies, including a lack of longitudinal data and unaccounted confounding variables. Nonetheless shame was typically more common in those with AN and BN than controls, was positively related to the severity of symptoms, and associated with the onset of eating disorder-related difficulties (e.g. binging or purging). Effect sizes were typically moderate to large. The role of guilt was less clear, with few studies and mixed results. Discussion: There is preliminary evidence that shame is implicated in the aetiology of AN and BN presentations, whilst there is currently insufficient evidence of such a role for guilt. It remains unclear whether shame is a risk factor for the development of AN and BN or a consequence of these difficulties.

An exploration of the main sources of shame in an eating-disordered population

Clinical Psychology & Psychotherapy, 2009

Shame has received increased attention over recent years and has been shown to be a feature of many forms of psychopathology, including eating disorders. The current study contributes to this field by exploring relationships between shame and a variety of factors hypothesised to contribute to shame in a sample of 52 females with eating disorders.

Pride Before a Fall: Shame, Diagnostic Crossover, and Eating Disorders

Journal of Bioethical Inquiry

This paper discusses the findings of qualitative research that examined the accounts of five "mostly recovered" ex-patients who had experienced transition between two or more eating disorder diagnoses. This study found that, in the minds of participants, the different diagnostic labels were associated with various good or bad character traits. This contributed to the belief in a diagnostic hierarchy, whereby individuals diagnosed with anorexia nervosa were viewed as morally better than those diagnosed with bulimia nervosa or binge eating disorder. Consequently, diagnostic crossover from a "better" to a "worse" eating disorder was often experienced as shameful moral failing, and a new diagnosis impacted the individual's sense of self-identity. These findings are of significance for both ethicists and clinicians; the paper concludes by outlining the relevance and possible clinical implications of shame in diagnostic crossover and suggesting avenues for future research.

The Limits to Pride: A Test of the Pro-Anorexia Hypothesis

Eating Disorders, 2015

Many social psychological models propose that positive selfconceptions promote self-esteem. An extreme version of this hypothesis is advanced in "pro-anorexia" communities: identifying with anorexia, in conjunction with disordered eating, can lead to higher self-esteem. The current study empirically tested this hypothesis. Results challenge the pro-anorexia hypothesis. Although those with higher levels of pro-anorexia identification trended towards higher self-esteem with increased disordered eating, this did not overcome the strong negative main effect of pro-anorexia identification. These data suggest a more effective strategy for promoting self-esteem is to encourage rejection of disordered eating and an anorexic identity.