Silent Scars: Childhood Trauma, Shame, and Eating Disorders

Objective: The present study used network analysis to examine the relationships between childhood traumatic experiences, eating disorder psychopathology, and shame in relation to eating, in a community sample from Romania (N = 624; 67.6% female). Method: Participants completed measures of eating disorder symptoms, internal and external shame, childhood trauma, maladaptive personality, mentalisation, emotion regulation, alexithymia, and broader psychopathological domains, including anxiety, depression, post-traumatic stress, insomnia, psychosis, dissociation, and suicidality. Results: Moderate to severe emotional abuse was reported by 35.4% of participants, physical abuse by 21.6%, and sexual abuse by 17.8%, and participants were grouped accordingly. Across groups, internal shame, and to a lesser extent external shame, emerged as central nodes, densely interconnected with core eating disorder symptoms such as drive for thinness, bulimia, and body dissatisfaction. Emotion regulation and awareness, together with eating disorder-specific and self-concept variables, served as bridges between communities, linking eating disorder pathology with maladaptive personality traits and broader psychopathological domains. Network comparison tests indicated no significant differences in global structure, edge weights, or centrality indices across trauma groups. Discussion: These findings underscore the central role of shame in eating disorder psychopathology and suggest that trauma-informed interventions should prioritise shame reduction while strengthening emotion regulation and mentalisation capacities.