The impact of early shame memories in Binge Eating Disorder: The mediator effect of current body image shame and cognitive fusion

This study examined the phenomenology of shame experiences from childhood and adolescence in a sample of women with Binge Eating Disorder. Moreover, a path analysis was investigated testing whether the association between shame-related memories which are traumatic and central to identity, and binge eating symptoms' severity, is mediated by current external shame, body image shame and body image cognitive fusion. Participants in this study were 114 patients, who were assessed through the Eating Disorder Examination and the Shame Experiences Interview, and through self-report measures of external shame, body image shame, body image cognitive fusion and binge eating symptoms. Shame experiences where physical appearance was negatively commented or criticized by others were the most frequently recalled. A path analysis showed a good fit between the hypothesised mediational model and the data. The traumatic and centrality qualities of shame-related memories predicted current external shame, especially body image shame. Current shame feelings were associated with body image cognitive fusion, which, in turn, predicted levels of binge eating symptomatology. Findings support the relevance of addressing early shame-related memories and negative affective and self evaluative experiences, namely related to body image, in the understanding and management of binge eating.