Shame, Self-Criticism, Perfectionistic Self-Presentation and Depression in Eating Disorders

Abstract

The complexity of eating disorder (ED) manifestations has increased the interest in understanding the mechanisms underlying the eating psychopathology and it is now widely accepted that there are multiple risk pathways for both the development and maintenance of eating psychopathology. This study examined the association between external shame and depression. We also investigated the possible mediation effect of self-criticism in the relation between shame and depression. Further to that, the current cross-sectional study inspected whether this mediation exists for different conditional values of perfectionistic self-presentation. One hundred and twenty one women diagnosed with eating disorder according to the Eating Disorder Examination (EDE 16.0D) completed a battery of self-report questionnaires to assess external shame, self-criticism, perfectionistic self-presentation and depression. A mediated-moderation analysis was performed. Results showed that the path from external shame to self-criticism depends on the level of perfectionistic self-presentation whereas the effect of self-criticism on depression is constant. Thus, there is an interaction between external shame and perfectionistic self-presentation on self-criticism which, in turn, affects depression. The internalization of an ideal-self sets up a standard that once compared to the actual self, displays negative self-evaluations and feelings that individuals see as reflecting a bad, inferior and flawed self. In this context, a perfectionistic self-presentation is used to create positive images on the minds of others. Although this style of organization is an adaptive way to deal with specific social contexts once it functions as a buffer in the relationship between shame and self-criticism, perfectionistic self-presentation seems to be a useless strategy since it does not prevent them from depression. Implications for future research are discussed.