Objective: Several studies have investigated shame in eating disorders but most have used non-clinical samples examined only one type of eating disorder or included only a limited range of shame measures. The current study explored shame from multiple perspectives in women who report a range of eating disorder diagnoses and who are at different stages of illness and recovery.
Method: In a postal questionnaire study, 224 women with a history of an eating disorder completed measures of anorexic and bulimic symptoms, depression and shame.
Results: After controlling for levels of depression, shame was associated with eating disorder symptoms. Specifically, shame as a measure of 'perceived involuntary subordination' (external shame) was uniquely associated with severity of anorexia nervosa symptoms, while shame as a measure of 'feelings' (internal shame) was uniquely associated with severity of bulimia nervosa symptoms.
Discussion: Different types of shame are related to different eating disorder symptoms and this may have implications for the aetiology and presentation of these disorders. These affective states may need to be addressed explicitly in therapy.