{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:23:13Z","timestamp":1790821393201,"version":"4.1.0"},"reference-count":95,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T00:00:00Z","timestamp":1536019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychol Psychother"],"published-print":{"date-parts":[[2020,3]]},"abstract":"\n Objectives<\/jats:title>\n \n Emotional states may play an important role in the development and maintenance of anorexia (\n AN<\/jats:styled-content>\n ) and bulimia nervosa (\n BN<\/jats:styled-content>\n ). This systematic review aimed to examine the evidence regarding the relationship that shame and guilt have with two eating disorders,\n AN<\/jats:styled-content>\n and\n BN<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Four major databases (Pubmed, Psych\n INFO<\/jats:styled-content>\n , Web of Science, Medline) were searched (up until April 2018) for studies measuring guilt or shame in clinically diagnosed\n AN<\/jats:styled-content>\n and\n BN<\/jats:styled-content>\n groups. Included papers were evaluated for risk of bias.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Twenty\u2010four papers met the inclusion criteria. Several methodological issues were noted within the reviewed studies, including a lack of longitudinal data and unaccounted confounding variables. Nonetheless, shame was typically more common in those with\n AN<\/jats:styled-content>\n and\n BN<\/jats:styled-content>\n than controls, was positively related to the severity of symptoms, and associated with the onset of eating disorder\u2010related difficulties (e.g., binging or purging). Effect sizes were typically moderate to large. The role of guilt was less clear, with few studies and mixed results.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n \n There is preliminary evidence that shame is implicated in the aetiology of\n AN<\/jats:styled-content>\n and\n BN<\/jats:styled-content>\n presentations, whilst there is currently insufficient evidence of such a role for guilt. It remains unclear whether shame is a risk factor for the development of\n AN<\/jats:styled-content>\n and\n BN<\/jats:styled-content>\n or a consequence of these difficulties.\n <\/jats:p>\n <\/jats:sec>\n \n Practitioner Points<\/jats:title>\n \n \n \n \n Elevated shame appears to be a feature of anorexia (\n AN<\/jats:styled-content>\n ) and bulimia nervosa (\n BN<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:list-item>\n \n Shame appears to fluctuate with the occurrence of eating disordered behaviours like binging, purging or restricted eating.<\/jats:p>\n <\/jats:list-item>\n \n \n Guilt is less consistently linked to\n AN<\/jats:styled-content>\n and\n BN<\/jats:styled-content>\n presentations.\n <\/jats:p>\n <\/jats:list-item>\n \n Interventions directed at shame may be helpful for these populations.<\/jats:p>\n <\/jats:list-item>\n \n A lack of longitudinal data means the temporal features of these relationships are still unclear.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/papt.12198","type":"journal-article","created":{"date-parts":[[2018,9,5]],"date-time":"2018-09-05T01:31:20Z","timestamp":1536111080000},"page":"134-159","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":98,"title":["Experiences of shame and guilt in anorexia and bulimia nervosa: A systematic review"],"prefix":"10.1111","volume":"93","author":[{"given":"Suzanne P. M.","family":"Blythin","sequence":"first","affiliation":[{"name":"Institute of Psychology, Health and Society University of Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah L.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"The School of Psychology University of Central Lancashire Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa G.","family":"Macintyre","sequence":"additional","affiliation":[{"name":"Division of Psychology & Mental Health School of Health Sciences University of Manchester Manchester Academic Health Sciences Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne M.","family":"Dickson","sequence":"additional","affiliation":[{"name":"Institute of Psychology, Health and Society University of Liverpool UK"},{"name":"Department of Psychology School of Arts and Humanities Edith Cowan University Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R. 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