The Mediating Role of Internalized Shame in the Relationship Between Childhood Trauma and Unstable Self-Esteem in Individuals Seeking Cosmetic Surgery

Abstract

Purpose: The aim of this study was to test a structural model of unstable self-esteem based on childhood trauma, considering the mediating role of internalized shame among individuals seeking cosmetic surgery. Methods and Materials: This research was fundamental and quantitative in nature, employing a descriptive correlational and structural equation modeling approach. The study population consisted of all individuals seeking cosmetic surgery who were residing in Tehran and visiting cosmetic clinics during 2023-2024. From this population, a sample of 304 individuals who voluntarily agreed to participate was selected using convenience sampling. The study utilized the Bernstein Childhood Trauma Questionnaire (2003), the Unstable Self-Esteem Scale by Chabrol, Rousseau, and Callahan (2006), and the Internalized Shame Scale by Cook (1993) for data collection. Data analysis was conducted using a correlation matrix and structural equation modeling. Findings: The results of data analysis indicated that the indices of the proposed model had an acceptable fit. The path from childhood trauma to unstable self-esteem (β = 0.118, P = 0.035), the path from childhood trauma to internalized shame (β = 0.641, P = 0.001), and the path from internalized shame to unstable self-esteem (β = 0.569, P = 0.000) were significant. Additionally, the mediating role of internalized shame (β = 0.365, P = 0.001) was confirmed at the 95% confidence level. Conclusion: Childhood trauma directly and indirectly, through internalized shame, affects unstable self-esteem in individuals seeking cosmetic surgery.