The Role of Self-Disgust and Body Shame in the Association between Childhood Trauma and Disordered Eating Attitudes among Women: A Serial Model Examination

Abstract

Maladaptive eating attitudes that are common among nonclinical emerging adults may constitute an intense vulnerability for various eating disorders. Although the association between childhood trauma and adulthood eating problems has been widely established, the need for further knowledge of the explanatory role of emotional mechanisms in the relationship remains. Therefore, the study aimed to examine the mediator roles of self-disgust and body shame in the association between childhood trauma and maladaptive eating attitudes. The study sample comprised 397 volunteered women aged between 18 and 25 (M = 21.89, SD = 2.11). The Childhood Trauma Questionnaire, Self- Disgust Scale – Revised Form, Objectified Body Consciousness Scale, and Eating Attitudes Test were administered online for data collection. The results of the correlation analysis revealed a positive relationship among childhood trauma, self-directed disgust, body shame, and disordered eating attitudes. The serial model was also significant, indicating that both self-disgust and body shame independently and together fully mediated the association between childhood trauma and maladaptive eating attitudes. These findings point to the importance of assessing early life traumas and emotional maintaining factors for comprehensive case conceptualizations and preventive and therapeutic applications.

Keywords

• Childhood trauma
• eating attitudes
• self-disgust
• body shame

Kadınlarda Çocukluk Çağı Travmaları ile Bozuk Yeme Tutumu Arasındaki İlişkide Öz Tiksinme ve Beden Utancının Rolü: Bir Seri Aracılık Modeli İncelemesi

Abstract

Bozulmuş yeme tutumları, uyumsuz yeme davranışlarını tetikleyebilmekte ve yeme bozuklukları için bir yatkınlık oluşturabilmektedir. Beliren yetişkinlik döneminde yaygın olarak gözlenen yeme ile ilgili sorunlarda, çocukluk dönemindeki örseleyici yaşantıların rolü ortaya koyulmuş olmakta birlikte, bu ilişkide açıklayıcı duygusal mekanizmalara dair bilgi ihtiyacı devam etmektedir. Bu çalışmada, çocukluk travmaları ile bozuk yeme tutumu arasındaki ilişkide öz tiksinme ve beden utancının aracılık rolünün incelenmesi amaçlanmıştır. Araştırma, yaşları 18 ile 25 (Ort. = 21.89, SS = 2.11) arasında değişen 397 gönüllü kadın katılımcı ile yürütülmüştür. Çalışmanın verisi Çocukluk Çağı Ruhsal Travma Ölçeği, Öz Tiksinme-Revize Formu, Nesneleştirilmiş Beden Bilinci Ölçeği ve Yeme Tutum Testi kullanılarak çevrimiçi toplanmıştır. Korelasyon analizi sonuçları çocukluk travmaları, benliğe yönelik tiksinme, beden utancı ve yeme tutumunda bozulmanın birbirleri ile pozitif yönde ilişkili olduğunu göstermiştir. Seri aracılık modeli de öz tiksinme ve beden utancının hem bağımsız olarak hem de bir arada çocukluk travması ile yeme tutumu arasında tam aracı rolünün olduğunu ortaya koymuştur. Bu bulgular, yeme ile ilgili sorunların kavramsallaştırılmasına katkı sunmakta; önleyici ve sağaltıma yönelik uygulamaların etkililiği için çocukluk dönemindeki travmatik deneyimlerin ve sürdürücü duygusal mekanizmaların değerlendirilmesinin önemine işaret etmektedir.

Keywords

• Çocukluk çağı travması
• yeme tutumu
• öz tiksinme
• beden utancı

Supporting Institution

Mevcut çalışma için bir finansal destek alınmamıştır.

Ethical Statement

Mevcut çalışma için T.C. Maltepe Üniversitesi Etik Kurulu tarafından, 2021/03-02 protokol numarası ile etik izin alınmıştır

References

1. Allen, B., Cramer, R. J., Harris, P. B. ve Rufino, K. A. (2013). Borderline personality symptomatology as a mediator of the link between child maltreatment and adult suicide potential. Archives of Suicide Research, 17(1), 41-51. https://doi.org/10.1080/13811118.2013.748413
2. Arnett, J. J. (2000). Emerging adults: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469-480. https://doi.org/10.1037//0003-066X.55.5.469
3. Andrews, B. (1997). Bodily shame in relation to abuse in childhood and bulimia: A preliminary investigation. British Journal of Clinical Psychology, 36(1), 41–49. https://doi.org/10.1111/j.2044-8260.1997.tb01229.x
4. Armour, C., Elklit, A. ve Christoffersen, M. N. (2014). A latent class analysis of childhood maltreatment: Identifying abuse typologies. Journal of Loss and Trauma, 19(1), 23-39. https://doi.org/10.1080/15325024.2012.734205
5. Bahtiyar, B. ve Yıldırım, A. (2019). Öz Tiksinme Ölçeği-Revize Formu: Türkçe uyarlama, geçerlik ve güvenirlik çalışması. Klinik Psikiyatri Dergisi, 22(3), 304-315. https://doi.org/10.5505/ kpd.2019.72692
6. Bektas, S., Keeler, J. L., Anderson, L. M., Mutwalli, H., Himmerich, H. ve Treasure, J. (2022). Disgust and self-disgust in eating disorders: A systematic review and meta-analysis. Nutrients, 14(9), 1728. https://doi.org/10.3390/nu14091728
7. Bell, B. T., Cassarly, J. A. ve Dunbar, L. (2018). Selfie-objectification: Self-objectification and positive feedback (“likes”) are associated with frequency of posting sexually objectifying self-images on social media. Body Image, 26, 83-89. https://doi.org/10.1016/j.bodyim.2018.06.005
8. Bell, K., Coulthard, H. ve Wildbur, D. (2017). Self‐disgust within eating disordered groups: Associations with anxiety, disgust sensitivity and sensory processing. European Eating Disorders Review, 25(5), 373-380. https://doi.org/10.1002/erv.2529

9. Bernstein, D. P., Fink, L., Handelsman, L., Foote, J., Lovejoy, M., Wenzel, K., Sapareto, E. ve Ruggiero, J. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. The American Journal of Psychiatry, 151(8), 1132-1136. https://doi.org/10.1176/ajp.151.8.1132
10. Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., Stokes, J., Handelsman, L., Medrano, M., Desmond, D. ve Zule, W. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect, 27(2), 169-190. https://doi.org/10.1016/s0145-2134(02)00541-0
11. Bloks, H., Furth, E. F., Callewaert, I. ve Hoek, H. W. (2004). Coping strategies and recovery in patients with a severe eating disorder. Eating Disorders, 12(2), 157-169. https://doi.org/10.1002/erv.920
12. Blythin, S. P., Nicholson, H. L., Macintyre, V. G., Dickson, J. M., Fox, J. R. ve Taylor, P. J. (2020). Experiences of shame and guilt in anorexia and bulimia nervosa: A systematic review. Psychology and Psychotherapy: Theory, Research and Practice, 93(1), 134-159. https://doi.org/10.1111/papt.12198
13. Brake, C. A., Rojas, S. M., Badour, C. L., Dutton, C. E. ve Feldner, M. T. (2017). Self-disgust as a potential mechanism underlying the association between PTSD and suicide risk. Journal of Anxiety Disorders, 47, 1-9. https://doi.org/10.1016/j.janxdis.2017.01.003
14. Breines, J., Toole, A., Tu, C. ve Chen, S. (2014). Self-compassion, body image, and self-reported disordered eating. Self and Identity, 13(4), 432-448. https://doi.org/10.1080/15298868.2013.838992
15. Brewerton, T. D. (2007). Eating disorders, trauma, and comorbidity: Focus on PTSD. Eating disorders, 15(4), 285-304. https://doi.org/10.1080/10640260701454311
16. Brockdorf, A. N., Kennedy, G. A. ve Keel, P. K. (2018). Examining associations among sensitivity to punishment and reward, shame, and eating pathology through tests of mediation. Eating Disorders, 26(5), 407-417. https://doi.org/10.1080/10640266.2017.1408293
17. Cain, A. S., Epler, A. J., Steinley, D. ve Sher, K. J. (2010). Stability and change in patterns of concerns related to eating, weight, and shape in young adult women: A latent transition analysis. Journal of Abnormal Psychology, 119(2), 255-267. https://doi.org/10.1037/a0018117
18. Cicchetti, D. ve Handley, E. D. (2019). Child maltreatment and the development of substance use and disorder. Neurobiology of Stress, 10, 100144. https://doi.org/10.1016/j.ynstr.2018.100144
19. Clarke, A., Simpson, J. ve Varese, F. (2019). A systematic review of the clinical utility of the concept of self‐disgust. Clinical Psychology & Psychotherapy, 26(1), 110-134. https://doi.org/10.1002/cpp.2335
20. Croll, J., Neumark-Sztainer, D., Story, M. ve Ireland, M. (2002). Prevalence and risk and protective factors related to disordered eating behaviors among adolescents: relationship to gender and ethnicity. Journal of Adolescent Health, 31(2), 166-175. https://doi.org/10.1016/S1054-139X(02)00368-3
21. Curtis, V., De Barra, M. ve Aunger, R. (2011). Disgust as an adaptive system for disease avoidance behaviour. Philosophical Transactions of the Royal Society B, 366, 389-401. https://doi.org/10.1098/rstb.2010.0117
22. Cutajar, M. C., Mullen, P. E., Ogloff, J. R., Thomas, S. D., Wells, D. L. ve Spataro, J. (2010). Schizophrenia and other psychotic disorders in a cohort of sexually abused children. Archives of General Psychiatry, 67(11), 1114-1119. https://doi.org/10.1001/archgenpsychiatry.2010.147
23. Daniels, E. A., Zurbriggen, E. L. ve Ward, L. M. (2020). Becoming an object: A review of self-objectification in girls. Body Image, 33, 278-299. https://doi.org/10.1016/j.bodyim.2020.02.016
24. Davey, G. C., Buckland, G., Tantow, B. ve Dallos, R. (1998). Disgust and eating disorders. European Eating Disorders Review: The Professional Journal of the Eating Disorders Association, 6(3), 201-211. https://doi.org/10.1002/(SICI)1099-0968(199809)6:3<201::AID-ERV224>3.0.CO;2-E
25. Doğan, G. (2016). Bir sistemi meşrulaştırma pratiği olarak kendini nesneleştirme. Türk Psikoloji Yazıları, 19(37), 35-45.
26. Doran, J. ve Lewis, C. A. (2012). Components of shame and eating disturbance among clinical and non‐clinical populations. European Eating Disorders Review, 20(4), 265-270. https://doi.org/10.1002/erv.1142
27. Dyer, A. S., Feldmann Jr, R. E. ve Borgmann, E. (2015). Body-related emotions in posttraumatic stress disorder following childhood sexual abuse. Journal of Child Sexual Abuse, 24(6), 627-640. https://doi.org/10.1080/10538712.2015.1057666
28. Erchull, M. J., Liss, M. ve Lichiello, S. (2013). Extending the negative consequences of media internalization and self-objectification to dissociation and self-harm. Sex Roles, 69(11), 583-593. https://doi.org/10.1007/s11199-013-0326-8
29. Erol, A., Toprak, G. ve Yazici, F. (2006). Psychological and physical correlates of disordered eating in male and female Turkish college students. Psychiatry and Clinical Neurosciences, 60(5), 551–557. https://doi.org/10.1111/j.1440-1819.2006.01557.x
30. Espeset, E. M., Gulliksen, K. S., Nordbø, R. H., Skårderud, F. ve Holte, A. (2012). The link between negative emotions and eating disorder behaviour in patients with anorexia nervosa. European Eating Disorders Review, 20(6), 451-460. https://doi.org/10.1002/erv.2183
31. Fredrickson, B. L. ve Roberts, T. A. (1997). Objectification theory. Psychology of Women Quarterly, 21(2), 173-206. https://doi.org/10.1111/j.1471-6402.1997.tb00108.x
32. Fox, J. R, Grange, N. ve Power, M. J. (2015) Self-disgust in eating disorders: A review of the literature and clinical implications. İçinde P. A. Powell, P. G. Overton ve J. Simpson (Edl.), The Revolting Self: Perspectives on the Psychological, Social, and Clinical Implications of Self-Directed Disgust (ss. 167-186). Karnac Books.
33. Garner, D. M. ve Garfinkel, P. E. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological Medicine, 9(2), 273-279. https://doi.org/10.1017/S003329170003076
34. Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E. ve Janson, S. (2009). Burden and consequences of child maltreatment in high-income countries. The Lancet, 373(9657), 68-81. https://doi.org/10.1016/S0140-6736(08)61706-7
35. Glashouwer, K. A. ve de Jong, P. J. (2021). The revolting body: Self-disgust as a key factor in anorexia nervosa. Current Opinion in Psychology, 41, 78-83. https://doi.org/10.1016/j.copsyc.2021.03.008
36. Goss, K. ve Gilbert, P. (2002). Eating disorders, shame and pride: A cognitive-behavoral functional analysis. İçinde P. Gilbert ve J. Miles (Edl.), Body Shame: Conceptualisation, Research and Treatment (ss. 219– 255). Brunner-Routledge.
37. Groleau, P., Steiger, H., Bruce, K., Israel, M., Sycz, L., Ouellette, A. S. ve Badawi, G. (2012). Childhood emotional abuse and eating symptoms in bulimic disorders: An examination of possible mediating variables. International Journal of Eating Disorders, 45(3), 326-332. https://doi.org/10.1002/eat.20939
38. Hasselle, A. J., Howell, K. H., Dormois, M. ve Miller-Graff, L. E. (2017). The influence of childhood polyvictimization on disordered eating symptoms in emerging adulthood. Child Abuse & Neglect, 68, 55-64. https://doi.org/10.1016/j.chiabu.2017.04.003
39. Hayes, A. F. (2022). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (3rd ed.). The Guilford Press.
40. Hoek, H. W. ve Van Hoeken, D. (2003). Review of the prevalence and incidence of eating disorders. International Journal of Eating Disorders, 34(4), 383-396. https://doi.org/10.1002/eat.10222
41. Holland, L. A., Brown, T. A. ve Keel, P. K. (2014). Defining features of unhealthy exercise associated with disordered eating and eating disorder diagnoses. Psychology of Sport and Exercise, 15(1), 116-123. https://doi.org/10.1016/j.psychsport.2013.10.005
42. Holmqvist Larsson, K., Lowén, A., Hellerstedt, L., Bergcrona, L., Salerud, M. ve Zetterqvist, M. (2020). Emotion regulation group skills training: a pilot study of an add-on treatment for eating disorders in a clinical setting. Journal of Eating Disorders, 8(12), 1-11. https://doi.org/10.1186/s40337-020-00289-1
43. Hovens, J. G., Giltay, E. J., Spinhoven, P., van Hemert, A. M. ve Penninx, B. W. (2015). Impact of childhood life events and childhood trauma on the onset and recurrence of depressive and anxiety disorders. The Journal of Clinical Psychiatry, 76(7), 8559. https://doi.org/10.4088/JCP.14m09135
44. Hund, A. R. ve Espelage, D. L. (2006). Childhood emotional abuse and disordered eating among undergraduate females: Mediating influence of alexithymia and distress. Child Abuse & Neglect, 30(4), 393-407. https://doi.org/10.1016/j.chiabu.2005.11.003
45. Ille, R., Schöggl, H., Kapfhammer, H. P., Arendasy, M., Sommer, M. ve Schienle, A. (2014). Self-disgust in mental disorders-symptom-related or disorder-specific? Comprehensive Psychiatry, 55(4), 938-943. https://doi.org/10.1016/j.comppsych.2013.12.020
46. Irving, L. M. ve Neumark-Sztainer, D. (2002). Integrating the prevention of eating disorders and obesity: Feasible or futile? Preventive Medicine, 34(3), 299-309. https://doi.org/10.1006/pmed.2001.0997
47. Jacobi, C., Fittig, E., Bryson, S. W., Wilfley, D., Kraemer, H. C. ve Taylor, C. B. (2011). Who is really at risk? Identifying risk factors for subthreshold and full syndrome eating disorders in a high-risk sample. Psychological Medicine, 41(9), 1939-1949. https://doi.org/10.1017/S0033291710002631
48. Jaffee, S. R. (2017). Child maltreatment and risk for psychopathology in childhood and adulthood. Annual Review of Clinical Psychology, 13, 525-551. https://doi.org/10.1146/annurev-clinpsy-032816-045005
49. Jones, B. A. ve Griffiths, K. M. (2015). Self-objectification and depression: An integrative systematic review. Journal of Affective Disorders, 171, 22-32. https://doi.org/10.1016/j.jad.2014.09.011
50. Keith, L., Gillanders, D. ve Simpson, S. (2009). An exploration of the main sources of shame in an eating‐disordered population. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 16(4), 317-327. https://doi.org/10.1002/cpp.629
51. Keski-Rahkonen, A. (2021). Epidemiology of binge eating disorder: Prevalence, course, comorbidity, and risk factors. Current Opinion in Psychiatry, 34(6), 525-531. https://doi.org/10.1097/YCO.0000000000000750
52. Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S. ve Üstün, T. B. (2007). Age of onset of mental disorders: a review of recent literature. Current Opinion in Psychiatry, 20(4), 359-364. https://doi.org/10.1097/YCO.0b013e32816ebc8c
53. Kong, S. ve Bernstein, K. (2009). Childhood trauma as a predictor of eating psychopathology and its mediating variables in patients with eating disorders. Journal of Clinical Nursing, 18(13), 1897-1907. https://doi.org/10.1111/j.1365-2702.2008.02740.x
54. Kot, E., Grzegorzewski, P., Kostecka, B. ve Kucharska, K. (2021). Self‐disgust and disgust sensitivity are increased in anorexia nervosa inpatients, but only self‐disgust mediates between comorbid and core psychopathology. European Eating Disorders Review, 29(6), 879-892. https://doi.org/10.1002/erv.2862
55. Lejonclou, A., Nilsson, D. ve Holmqvist, R. (2014). Variants of potentially traumatizing life events in eating disorder patients. Psychological Trauma: Theory, Research, Practice, and Policy, 6(6), 661-667. https://doi.org/10.1037/a0034926
56. Lindberg, S. M., Grabe, S. ve Hyde, J. S. (2007). Gender, pubertal development, and peer sexual harassment predict objectified body consciousness in early adolescence. Journal of Research on Adolescence, 17(4), 723-742. https://doi.org/10.1111/j.1532-7795.2007.00544.x
57. Mandelli, L., Petrelli, C. ve Serretti, A. (2015). The role of specific early trauma in adult depression: A meta-analysis of published literature. Childhood trauma and adult depression. European Psychiatry, 30(6), 665-680. https://doi.org/10.1016/j.psyneuen.2008.03.008
58. Marques, C., Simão, M., Guiomar, R. ve Castilho, P. (2021). Self-disgust and urge to be thin in eating disorders: how can self-compassion help? Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 26, 2317-2324. https://doi.org/10.1007/s40519-020-01099-9
59. Mercurio, A. E. ve Landry, L. J. (2008). Self-objectification and well-being. The impact of self-objectification on women’s overall sense of self-worth and life satisfaction. Sex Roles, 58(7-8). https://doi.org/10.1007/s11199-007-9357-3.
60. McKinley, N. M. ve Hyde, J. S. (1996). The objectified body consciousness scale: Development and validation. Psychology of Women Quarterly, 20(2), 181-215. https://doi.org/10.1111/j.1471-6402.1996.tb00467.x
61. Mills, P., Newman, E. F., Cossar, J. ve Murray, G. (2015). Emotional maltreatment and disordered eating in adolescents: Testing the mediating role of emotion regulation. Child Abuse & Neglect, 39, 156-166. https://doi.org/10.1016/j.chiabu.2014.05.011
62. Mitchell, K. S. ve Mazzeo, S. E. (2005). Mediators of the association between abuse and disordered eating in undergraduate men. Eating Behaviors, 6(4), 318–327. https://doi.org/10.1016/j.eatbeh.2005.03.004
63. Molendijk, M. L., Hoek, H. W., Brewerton, T. D. ve Elzinga, B. M. (2017). Childhood maltreatment and eating disorder pathology: A systematic review and dose-response meta-analysis. Psychological Medicine, 47(8), 1402-1416. https://doi.org/10.1017/S0033291716003561
64. Monro, F. ve Huon, G. (2005). Media‐portrayed idealized images, body shame, and appearance anxiety. International Journal of Eating Disorders, 38(1), 85-90. https://doi.org/10.1002/eat.20153
65. Mustapic, J., Marcinko, D. ve Vargek, P. (2015). Eating behaviours in adolescent girls: The role of body shame and body dissatisfaction. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 20, 329-335. https://doi.org/10.1007/s40519-015-0183-2
66. Nelson, M. C., Story, M., Larson, N. I., Neumark-Sztainer, D. ve Lytle, L. A. (2008) Emerging adulthood and college-aged youth: An overlooked age for weight-related behavior change. Obesity, 16, 2205-2211. https://doi.org/10.1038/oby.2008.365
67. Neumark‐Sztainer, D., Story, M., Hannan, P. J., Beuhring, T. ve Resnick, M. D. (2000). Disordered eating among adolescents: associations with sexual/physical abuse and other familial/psychosocial factors. International Journal of Eating Disorders, 28(3), 249-258. https://doi.org/10.1002/1098-108X(200011)28:3<249::AID-EAT1>3.0.CO;2-H
68. Neumark-Sztainer, D., Wall, M., Larson, N. I., Eisenberg, M. E. ve Loth, K. (2011). Dieting and disordered eating behaviors from adolescence to young adulthood: findings from a 10-year longitudinal study. Journal of the American Dietetic Association, 111(7), 1004-1011. https://doi.org/10.1016/j.jada.2011.04.012
69. Noll, S. M. ve Fredrickson, B. L. (1998). A mediational model linking self‐objectification, body shame, and disordered eating. Psychology of Women Quarterly, 22(4), 623-636. https://doi.org/10.1111/j.1471-6402.1998.tb00181.x
70. O'Dea, J. A. (2004). Evidence for a self-esteem approach in the prevention of body image and eating problems among children and adolescents. Eating Disorders, 12(3), 225–239. https://doi.org/10.1080/10640260490481438
71. Overton, P. G., Markland, F. E., Taggart, H. S., Bagshaw, G. L. ve Simpson, J. (2008). Self-disgust mediates the relationship between dysfunctional cognitions and depressive symptomatology. Emotion, 8(3), 379. https://doi.org/10.1037/1528-3542.8.3.379
72. Örsel, S., Karadag, H., Kahilogullari, A. K. ve Aktas, E. A. (2011). Psikiyatri hastalarında çocukluk çağı travmalarının sıklığı ve psikopatoloji ile ilişkisi. Anadolu Psikiyatri Dergisi, 12(2), 130-136.
73. Palmeira, L., Pinto-Gouveia, J. ve Cunha, M. (2019). The role of self-disgust in eating psychopathology in overweight and obesity: Can self-compassion be useful? Journal of Health Psychology, 24(13), 1807-1816. https://doi.org/10.1177/1359105317702212
74. Palmier-Claus, J. E., Berry, K., Bucci, S., Mansell, W. ve Varese, F. (2016). Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. The British Journal of Psychiatry, 209(6), 454-459. https://doi.org/10.1192/bjp.bp.115.179655
75. Peat, C. M. ve Muehlenkamp, J. J. (2011). Self-objectification, disordered eating, and depression: A test of mediational pathways. Psychology of Women Quarterly, 35(3), 441-450. https://doi.org/10.1177/0361684311400389
76. Powell, P. A, Overton, P. G. ve Simpson, J. (2015a). Reflections on the revolting self: a commentary and further directions. İçinde P. A. Powell, P. G. Overton ve J. Simpson (Edl.), The Revolting Self: Perspectives on the Psychological, Social, and Clinical Implications of Self-Directed Disgust (ss. 243-255). Karnac Books.
77. Powell, P. A., Overton, P. G. ve Simpson, J. (2013). The revolting self: An interpretative phenomenological analysis of the experience of self-disgust in females with depressive symptoms. Journal of Clinical Psychology, 70(6), 562–578. https://doi.org/10.1002/jclp.22049
78. Powell, P. A., Simpson, J. ve Overton, P. G. (2015b). An introduction to the revolting self: Self-disgust as an emotion schema. İçinde P. A. Powell, P. G. Overton ve J. Simpson (Edl.), The Revolting Self: Perspectives on the Psychological, Social, and Clinical Implications of Self-Directed Disgust (ss. 1–24). Karnac Books.
79. Reba-Harrelson, L., Von Holle, A., Hamer, R. M., Swann, R., Reyes, M. L. ve Bulik, C. M. (2009). Patterns and prevalence of disordered eating and weight control behaviors in women ages 25–45. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 14, e190-e198. https://doi.org/10.1007/BF03325116
80. Rorty, M., Yager, J. ve Rossotto, E. (1994). Childhood sexual, physical, and psychological abuse. American Journal of Psychiatry ,151(8), 1122-1126.
81. Rousseau, A. ve Eggermont, S. (2018). Tween television and peers: Reinforcing social agents in early adolescents' body surveillance and self‐objectification. Journal of Research on Adolescence, 28(4), 807-823. https://doi.org/10.1111/jora.12367
82. Rozin, P., Haidt, J. ve McCauley, C. R. (2008). Disgust. İçinde M. Lewis, J. M. Haviland-Jones ve L. F. Barrett (Edl.), Handbook of Emotions (ss. 757-776). The Guilford Press.
83. Rüsch, N., Schulz, D., Valerius, G., Steil, R., Bohus, M. ve Schmahl, C. (2011). Disgust and implicit self-concept in women with borderline personality disorder and posttraumatic stress disorder. European Archives of Psychiatry and Clinical Neuroscience, 261(5), 369-376. https://doi.org/10.1007/s00406-010-0174-2
84. Savaşır, I. ve Erol, N. (1989). Anoreksiya Nervoza Belirtileri İndeksi. Türk Psikoloji Dergisi, 7, 19-25.
85. Schaefer, L. M., Burke, N. L., Calogero, R. M., Menzel, J. E., Krawczyk, R. ve Thompson, J. K. (2018). Self-objectification, body shame, and disordered eating: Testing a core mediational model of objectification theory among White, Black, and Hispanic women. Body Image, 24, 5-12. https://doi.org/10.1016/j.bodyim.2017.10.005
86. Simpson, J., Helliwell, B., Varese, F. ve Powell, P. (2020). Self-disgust mediates the relationship between childhood adversities and psychosis. British Journal of Clinical Psychology, 59, 260-275. https://doi.org/10.1111/bjc.12245
87. Smith, N. B., Steele, A. M., Weitzman, M. L., Trueba, A. F. ve Meuret, A. E. (2015). Investigating the role of self-disgust in nonsuicidal self-injury. Archives of Suicide Research, 19(1), 60-74. https://doi.org/10.1080/13811118.2013.850135
88. Smolak, L. ve Murnen, S. K. (2002). A meta‐analytic examination of the relationship between child sexual abuse and eating disorders. International Journal of Eating Disorders, 31(2), 136-150.
89. Stasik-O’Brien, S. M. ve Schmidt, J. (2018). The role of disgust in body image disturbance: Incremental predictive power of self-disgust. Body Image, 27, 128-137. https://doi.org/10.1016/j.bodyim.2018.08.011
90. Svaldi, J., Griepenstroh, J., Tuschen-Caffier, B. ve Ehring, T. (2012). Emotion regulation deficits in eating disorders: a marker of eating pathology or general psychopathology? Psychiatry Research, 197(1), 103-111.
91. Şar, V., Öztürk, E. ve İkikardeş, E. (2012). Çocukluk Çağı Ruhsal Travma Ölçeğinin Türkçe uyarlamasının geçerlilik ve güvenirliği. Türkiye Klinikleri, 32(4), 1054-1063. https://doi.org/10.5336/medsci.2011-26947
92. Talmon, A. ve Ginzburg, K. (2018). “Body self” in the shadow of childhood sexual abuse: The long-term implications of sexual abuse for male and female adult survivors. Child Abuse & Neglect, 76, 416-425. https://doi.org/10.1016/j.chiabu.2017.12.004
93. Tavolacci, M. P., Grigioni, S., Richard, L., Meyrignac, G., Déchelotte, P. ve Ladner, J. (2015). Eating disorders and associated health risks among university students. Journal of Nutrition Education and Behavior, 47(5), 412-420. https://doi.org/10.1016/j.jneb.2015.06.009
94. Tiggemann, M. (2011). Mental health risks of self-objectification: A review of the empirical evidence for disordered eating, depressed mood, and sexual dysfunction. İçinde R. M. Calogero, S. Tantleff-Dunn ve J. K. Thompson (Edl.), Self-Objectification in Women: Causes, Consequences, and Counteractions (ss. 139-159). American Psychological Association. https://doi.org/10.1037/12304-007
95. Troop, N. A., Treasure, J. L. ve Serpell, L. (2002). A further exploration of disgust in eating disorders. European Eating Disorders Review, 10(3), 218-226. https://doi.org/10.1002/erv.444
96. Tylka, T. L. ve Hill, M. S. (2004). Objectification theory as it relates to disordered eating among college women. Sex Roles, 51(11), 719-730.
97. Üzümcü, E. (2022). Duygusal istismar ile yeme bozuklukları arasındaki ilişkide duygu düzenlemenin rolüne ilişkin bir derleme. Türk Psikoloji Yazıları, 25(49), 27-45. https://doi.org/10.31828/tpy1301996120220221m000044
98. Watson, L. B., Matheny, K. B., Gagne, P., Brack, G. ve Ancis, J. R. (2013). A model linking diverse women’s child sexual abuse history with sexual risk taking. Psychology of Women Quarterly, 37(1), 22-37. https://doi.org/10.1177/0361684312454535
99. Webb, J. B., Fiery, M. F. ve Jafari, N. (2016). “You better not leave me shaming!”: Conditional indirect effect analyses of anti-fat attitudes, body shame, and fat talk as a function of self-compassion in college women. Body Image, 18, 5-13. https://doi.org/10.1016/j.bodyim.2016.04.009
100. Williams, T. L. ve Gleaves, D. H. (2003). Childhood sexual abuse, body image, and disordered eating: A structural modeling analysis. Journal of Trauma & Dissociation, 4(4), 91-108. https://doi.org/10.1300/J229v04n04_07
101. Wolf, N. M. ve Elklit, A. (2020). Child maltreatment and disordered eating in adulthood: a mediating role of PTSD and self-esteem? Journal of Child & Adolescent Trauma, 13, 21-32. https://doi.org/10.1007/s40653-018-0224-x
102. Yağmurcu, Y. ve Tosun, L. P. (2018). Nesneleştirilmiş Beden Bilinci Ölçeğinin Türkçeye uyarlanması ve psikometrik özelliklerinin incelenmesi. Nesne Psikoloji Dergisi, 6(13), 225-255. https://doi.org/ 10.7816/nesne-06-13-01
103. Yıldırım, A. ve Bahtiyar, B. (2022). Öz tiksinme ile psikolojik belirtiler arasındaki ilişkide kendini gizlemenin aracı rolü. Türk Psikoloji Dergisi, 37(90), 44-53. https://doi.org/10.31828/tpd1300443320191125m000045
104. Ypsilanti, A., Lazuras, L., Powell, P. ve Overton, P. (2019). Self-disgust as a potential mechanism explaining the association between loneliness and depression. Journal of Affective Disorders, 243, 108-115. https://doi.org/10.1016/j.jad.2018.09.056