The relationship between alexithymia, shame, trauma, and body image disorders: investigation over a large clinical sample

Abstract

BackgroundThe connections between eating disorders (EDs) and alexithymia have not been fully clarified. This study aims to define alexithymia’s connections with shame, trauma, dissociation, and body image disorders.MethodsWe administered the Dissociative Experience Scale-II, Trauma Symptom Inventory, Experience of Shame Scale, Toronto Alexithymia Scale-20, and Body Uneasiness Test questionnaires to 143 ED subjects. Extensive statistical analyses were performed.ResultsThe subjects showed higher scores on alexithymia, shame, dissociation, and traumatic feelings scales than the nonclinical population. These aspects are linked with each other in a statistically significant way. Partial correlations highlighted that feelings of shame are correlated to body dissatisfaction, irrespective of trauma or depressed mood. Multiple regression analysis demonstrates that shame (anorexic patients) and perceived traumatic conditions (bulimic and ED not otherwise specified) are associated with adverse image disorders.ConclusionShame seems to hold a central role in the perception of an adverse self-image. Alexithymia may be interpreted as being a consequence of previous unelaborated traumatic experiences and feelings of shame, and it could therefore be conceptualized as a maladaptive–reactive construct.

Emotion generation and regulation in anorexia nervosa: A systematic review and meta-analysis of self-report data

“…There were insufficient data for a shame meta-analysis, but a metaanalysis revealed significantly greater levels of guilt reported by people with AN than by HCs [4 studies; d = 0.85 (95% CI: 0.12, 1.58), p b 0.02] corroborating evidence of elevated guilt and shame in EDs and AN samples found by studies not included in the meta-analysis (Cardi, Di Matteo, Gilbert, & Treasure, 2014;Franzoni et al, 2013;Grabhorn, Stenner, Stanguer, & Kaufhold, 2006;Keith, Gillanders, & Simpson, 2009;Swan & Andrews, 2003;Swift et al, 1986;Troop, Allan, Serpell, & Treasure, 2008).…”

“…By including our own meta-analysis on alexithymia we sought to reduce bias when comparing effect sizes across the review, as studies in all sections were subject to the same inclusion criteria. Taylor et al, 1988) to examine alexithymia in people with AN (Beales & Dolton, 2000;Berthoz, Perdereau, Godart, Corcos, & Haviland, 2007;Corcos et al, 2000;Deborde et al, 2007;De Panfilis, Rabbaglio, Rossi, Zita, & Maggini, 2003;Franzoni et al, 2013;Lawson et al, 2008;Marchesi, Ossola, Tonna, & De Panfilis, 2014;Torres et al, 2015; Appendix A for metaanalysis references). One study used the Bermond-Vorst Alexithymia questionnaire (Vorst & Bermond, 2001) which the authors report has a total score considered equivalent to that of the TAS (Courty et al, 2013).…”

Attachment, Self-Esteem and Shame in Emerging Adulthood

“…Intense feelings related to pathological shame such as a sense of defectiveness, inadequacy, unworthiness or humiliation impact an individual's sense of security, selfconfidence and coping skills (Schimmenti, 2012). Shame can cause body image disorders, low self-esteem and feelings of guilt (Franzoni, Gualandi, Caretti, Schimmenti, Di Pietro, Pellegrini, (…) & Pellicciari, 2013). On the basis of the above considerations, we hypothesized a connection between insecure attachment styles, low selfesteem and feelings of shame.…”

Trauma in relation to psychological characteristics in women with eating disorders

“…Another vital contemporary report on impulsiveness in bulimia and the presence of psychological trauma is provided in the works of Keel, Mitchell, Davis, and Crow (2001) and Keel, Gravener, Joiner, and Haedt (2010). The topics of relational trauma, violence and traumatic events (emotional abandonment, long-lasting childhood deprivation of the need for security on the parents/caretakers' part) are present in foreign research works carried out in samples of people with eating disorders (Franzoni et al, 2013;Tasca et al, 2013;Collins et al, 2014;Litwack et al, 2014;McCormack et al, 2014;Hewett & Loma, 2015;Racine & Wildes, 2015;Madowitz et al, 2015;Moulton et al, 2015;Tahilani, 2015;Caslini et al, 2016). In Poland, however, the topic of trauma in eating disorders is poorly explored and research results appear rarely.…”

“…Numerous studies carried out on samples of people with eating disorders that attempt to verify mutual relationships between having experience trauma and developing symptoms of eating disorders can be found in foreign literature also post 2010 (Franzoni et al, 2013;Tasca et al, 2013;Collins, Fischer, Stojek, & Becker, 2014;Litwack, Mitchell, Sloan, Reardon, & Miller, 2014;McCormack, Lewis, & Wells, 2014;Hewett & Loma, 2015;Racine & Wildes, 2015;Madowitz, Matheson, & Liang, 2015;Moulton, Power, Swanson, & Day, 2015;Tahilani, 2015;Caslini et al, 2016).…”