Le rôle de la honte et des processus cognitifs de régulation émotionnelle dans les comportements répétitifs centrés sur le corps et les troubles alimentaires

Compulsive hair-pulling, skin-picking and nail-biting are destructive and non-functional habits that are classified as body-focused repetitive behaviors (BFRBs). Over the past few years, several studies have highlighted common characteristics between BFRBs and eating disorders (EDs). Notably, theoretical models have highlighted the role played by emotional regulation difficulties during BFRB and binge eating episodes. Several authors have suggested that shame plays an important role in the precipitation and maintenance of these impulsive behaviors. Further, the physical shame and the consequences associated with these behaviors contribute to propelling a “cycle of shame”. To this day, many of the cognitive processes used to characterizing these conditions remain unexplored, including cognitive emotion regulation strategies and self-criticism (i.e., harmful and punitive self-assessment). The investigation of these cognitive processes and shame will contribute to refining existing models. Moreover, studying BFRBs and EDs simultaneously allows us to compare the diverging and converging processes between these often-comorbid conditions. The first article presented within the framework of this thesis aims to identify the relationship between BFRB and ED symptom-severity, self-criticism, shame, and maladaptive cognitive emotion regulation strategies. More exploratory in nature, this study was conducted with an online sample of adults from the community using self-reported questionnaires. The results demonstrate a positive correlation between BFRB and ED symptoms, along with the other processes studied. Additionally, shame and maladaptive emotional regulation strategies partly explained BFRB symptom severity, whereas self-criticism explained ED symptom severity.   The second article of this thesis aims to evaluate the impact of shame on the urge to engage in episodes of BFRBs and binge eating. This experimental study was carried out with three groups of women, namely a control group (n = 18), a BFRB group (n = 18), and a group of people suffering from an ED involving binge eating behaviors (n = 18). Findings confirmed that shame increases the urge to engage in BFRBs, but not the urge to engage in binge eating. Moreover, results highlighted the persistence of feelings of shame following BFRB and binge eating episodes. Findings from this study underline the importance of shame as a precipitating factor to BFRB episodes, as well as a maintenance factor to BFRBs and binge eating. Compared to the control group, the BFRB and binge eating groups demonstrated increased sensitivity to shame. Overall, the results of the present thesis support the role of shame in BFRB symptoms severity, as well as a trigger and maintenance factor for BFRB episodes. In addition to discussing the results of this thesis, its main limitations and strengths will be presented in the discussion. The theoretical and clinical implications, as well as perspectives for future research will also be discussed.

Keyphrases: body-focused repetitive behaviors, BFRB, eating disorders, binge eating, shame, self-criticism, cognitive emotion regulation strategies, emotion regulation