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How might eating disorders stigmatization worsen eating disorders symptom severity? Evaluation of a stigma internalization model
Author(s) -
Griffiths Scott,
Mitchison Deborah,
Murray Stuart B.,
Mond Jonathan M.,
Bastian Brock B
Publication year - 2018
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.22932
Subject(s) - alienation , eating disorders , psychology , social alienation , social stigma , clinical psychology , internalization , stigma (botany) , psychiatry , medicine , human immunodeficiency virus (hiv) , political science , law , receptor , family medicine
Abstract Objective Eating disorders stigmatization is common and is associated with greater eating disorders symptom severity. This study sought to elucidate stigma internalization as a potential mechanism underlying this association. Two central aspects of stigma internalization were focused on: alienation and social withdrawal. Method A cross‐national sample of individuals with self‐reported eating disorders ( N = 260) completed measures of eating disorders stigmatization, symptom severity, alienation, and social withdrawal. Results The model evidenced excellent fit. Eating disorders stigmatization directly predicted both alienation and social withdrawal, which, in turn, directly predicted symptom severity. Indirect effect analyses indicated that greater eating disorders stigmatization ultimately predicted greater symptom severity via alienation and social withdrawal. Moreover, social withdrawal mediated the association of alienation with symptom severity. Fitting a direct pathway from eating disorder stigmatization to symptom severity did not improve model fit. Discussion Our model provides a potentially useful account of the mechanisms by which eating disorders stigmatization might worsen eating disorder symptom severity. Specifically, the stigma internalization processes of alienation and social withdrawal may be important factors linking stigmatization with symptom severity. The findings have implications for clinicians attempting to help individuals with eating disorders to monitor and modify their responses to eating disorders stigmatization.