External shame in anorexia nervosa, bulimia nervosa, and binge-eating disorder : a systematic review ; Does poverty-related shame mediate the link between poverty and depression and poverty and aggression in young adults?

Systematic review: Background: Research has highlighted the link between shame and eating disorders (EDs). However, broad definitions of shame used within the literature make it difficult to identify specific shame-based mechanisms that might play a key role in EDs. Specifically, research has highlighted the social evaluative aspect of ED, however, little attention has been paid to external shame. This systematic review collated research to investigate the relationship between EDs and external shame. Method: Electronic databases were searched for studies on external shame within clinical populations of individuals with an ED published prior to 30th March 2020. A total of 2610 titles were retrieved. Of these, 11 met the inclusion criteria and were included in the review. Results: The results suggested a medium to large effect size in the relationship between external shame and EDs. The association of external shame to specific ED presentations were mixed, with some indication that external shame may be specifically related to anorexia nervosa. Conclusion: External shame appears to be associated with EDs. However, further research is needed to assess the role external shame has across ED diagnoses. Understanding the role of external shame in EDs could help to improve interventions to target key processes that contribute to and maintain EDs. Empirical paper: The association between childhood poverty and mental health difficulties has been well established. However, the mechanisms by which poverty leads to mental health difficulties are less understood. This study examines the role of poverty-related shame in poverty. Specifically, this study looks at the mediating role of poverty-related shame between child poverty and depressive symptoms and aggression in young adults. While the results suggest that high levels of child poverty are associated with increased rates of poverty-related shame, this was not related to depressive symptoms or aggression. However, methodological issues limit the conclusions that can be made. To the best of my knowledge, this study is the first to quantitatively measure poverty-related shame and highlights the need for further research to improve our understanding of the impact of poverty-related shame, protective factors and early interventions.