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.
Int J Eat Disord. 2021 Nov;54(11):1899-1945. doi: 10.1002/eat.23583. Epub 2021 Jul 24.
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.
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.
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.
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.
许多实证研究和理论模型假设,羞耻感是饮食障碍谱系中个体的常见体验。在这项研究中,我们旨在采用元分析方法研究羞耻感与饮食障碍症状之间的关系。
在这项元分析中,我们综合了 195 项研究的结果,以检验羞耻感与饮食障碍症状之间的假设关联。我们研究了与一般饮食障碍症状和特定饮食障碍症状(即厌食、贪食和暴食症状)的关联。我们进行了调节分析,以检验羞耻感类型、饮食症状类型、临床状况、研究质量、年龄和性别对关联的影响。
羞耻感与所有类型的饮食障碍症状均呈显著相关,效应大小为中等至较大(rs 在.40 和.52 之间)。身体羞耻感(r=.55)和进食时的羞耻感(r=.59)与饮食障碍病理的关系更为密切。饮食障碍症状的类型并未调节羞耻感与进食障碍之间的关系。
总体而言,羞耻感与饮食障碍症状之间关联的效应大小的量级为中等至较大。身体羞耻感和进食时的羞耻感似乎是与饮食障碍症状最密切相关的羞耻感类型,这表明在干预中直接针对这些类型可能非常有益。研究结果突出了文献中的当前差距(例如,大多为相关研究、低质量研究),这对未来的研究具有启示意义。