The Effects of Shame and Self-Criticism on Body Image: The Mediating Roles of Maladaptive Perfectionism and Body Dissatisfaction in Adult Clients Attending Psychotherapy Clinics

Abstract

Introduction and Aim: Body image is a fundamental component of psychological well-being and is influenced by various emotional and cognitive factors. The present study aimed to investigate the direct and indirect effects of shame and self-criticism on body image through the mediating roles of maladaptive perfectionism and body dissatisfaction among adult clients attending psychotherapy clinics in Tehran.

Methodology: This correlational study employed a structural equation modeling approach. The statistical population consisted of adult clients attending psychotherapy clinics in Tehran during 2026, from which 420 participants were selected through convenience sampling. Data were collected using the Internalized Shame Scale, the Forms of Self-Criticizing Scale, the Frost Multidimensional Perfectionism Scale, the Body Shape Questionnaire, and the Multidimensional Body-Self Relations Questionnaire. Data analysis was conducted using SPSS version 27 and AMOS version 24 through Pearson correlation analysis, structural equation modeling, and bootstrapping procedures.

Findings: The results indicated that shame had significant direct effects on maladaptive perfectionism (β=0.39), body dissatisfaction (β=0.41), and body image (β=-0.22). Self-criticism also significantly predicted maladaptive perfectionism (β=0.43), body dissatisfaction (β=0.29), and body image (β=-0.19). Maladaptive perfectionism positively predicted body dissatisfaction (β=0.27) and negatively predicted body image (β=-0.18). Body dissatisfaction emerged as the strongest predictor of body image (β=-0.47). All indirect effects were statistically significant according to bootstrap analyses, confirming the mediating roles of maladaptive perfectionism and body dissatisfaction. Furthermore, model fit indices indicated satisfactory model fit (RMSEA=0.059, CFI=0.95, GFI=0.92).

Conclusion: The findings demonstrated that shame and self-criticism undermine body image both directly and indirectly through maladaptive perfectionism and body dissatisfaction. These results highlight the importance of addressing emotional vulnerabilities, perfectionistic tendencies, and body dissatisfaction in psychological interventions designed to improve body image and promote mental health among psychotherapy clients.