Shame and guilt: Treatment-seeking correlates of eating disorders in college students

The purpose of this study is to examine factors related to eating-disordered individuals' decision to seek or not seek treatment. Two of the factors that are examined include June Price Tangney and Ronda Dearing's concepts of shame and guilt. Although shame and guilt are often used interchangeably when describing eating-disordered individuals, according to Tangney and Dearing, shame and guilt are distinct self-conscious emotions that lead to different outcomes. In their model, shame leads to avoidance and defensiveness, whereas guilt leads to the acceptance of responsibility and the desire to take action. Therefore, participants with higher Guilt scores are predicted to evidence greater treatment-seeking behavior, whereas those with higher Shame scores are predicted to engage in less treatment-seeking behavior. In addition, as most outreach programs on college campuses focus on educating students about the symptoms and health hazards of eating disorders and where to find treatment, this dissertation examines whether these two factors are actually related to treatment-seeking behavior. Also, though Dana Crowley Jack's measure of self-silencing correlates with eating-disorder symptoms, no studies have examined whether self-silencing is related to the decision to seek treatment. Therefore, this study determines what relationship, if any, there is between self-silencing and treatment seeking.; Results showed that those scoring higher on the Shame subscale of the SGSS and the Guilt subscale of the TOSCA were significantly more likely to have favorable treatment attitudes. Also, participants evidencing more self-silencing were less likely to have favorable treatment attitudes. Participants with greater knowledge of eating disorder health hazards and symptoms were found to have more favorable treatment attitudes, whereas participants with greater knowledge of campus resources for eating disorder treatment did not have more favorable treatment attitudes. Counter to the prediction that 9% of the sample would meet the criteria for an eating disorder, 16.76% of the sample met DSM-IV eating-disorder criteria and 17.90% scored above the clinical cut-off on a paper-and-pencil measure of disordered eating.; The hypothesis that sorority/fraternity members and intercollegiate athletes would have a greater incidence of eating disorders than non-members of these groups was not supported. Participants scoring above the clinical cut-off on the EAT-26 were found to have higher Shame and Guilt scores than those without eating disorders, on two different measures of shame and two different measures of guilt. Participants meeting DSM-1V criteria for eating disorder NOS were found to have significantly higher SGSS Guilt scores than non-eating-disordered participants. Suggestions for future research and implications for psychotherapy are discussed.