Does Shame Amplify the Relations Between Perfectionism and Eating Disorder Symptoms? Cross-Sectional and Longitudinal Tests

Shame and perfectionism are associated with and longitudinal predictors of eating disorder (ED) symptoms. Because shame represents painful emotions that result from negative self-evaluation and perfectionism involves unrealistically high standards for oneself, proneness to shame may intensify the relation between perfectionism and ED symptoms. The current study aimed to examine relations between perfectionism, shame, and ED symptoms (binge eating, body dissatisfaction, and excessive exercise) cross-sectionally and longitudinally across three months. College students [N = 259; 78% women; 71% White, mean (SD) age = 19.21 (1.24)] completed an online baseline survey in August 2022 and a follow-up survey three-months later. Participants completed measures assessing binge eating, body dissatisfaction, excessive exercise, shame, and perfectionism. Data were analyzed using path analysis in Mplus and significant interactions were probed using the Johnson-Neyman technique. Baseline shame was positively associated with baseline levels of binge eating and body dissatisfaction while baseline perfectionism predicted follow-up excessive exercise. There were not main effects of baseline perfectionism on any baseline ED symptoms nor of baseline shame on any follow-up ED symptoms. Interactive effects revealed that baseline perfectionism was negatively associated with follow-up levels of binge eating and excessive exercise for participants with average and high, but not low, levels of shame. There was not an interactive effect between baseline shame and perfectionism in predicting body dissatisfaction. Clinically, among individuals low in perfectionism, binge eating and excessive exercise interventions should address shame.