The Role of Self-compassion in Women's Self-determined Motives to Exercise and Exercise-related Outcomes

Words matter: Reframing exercise is medicine for the general population to optimize motivation and create sustainable behaviour change

Exercise is medicine (EIM) is grounded in strong evidence regarding the benefits of physical activity. Despite the contributions of EIM initiatives worldwide, rates of physical inactivity remain alarmingly high. We propose a reframe of EIM for the general population to improve motivation and foster sustainable behaviour change. We draw on a solid knowledge-base to explain the value of broadening the nomenclature to physical activity and of promoting a message of well-being via enjoyable physical activity.

Self-compassion, body image, and disordered eating: A review of the literature

Self-compassion, treating oneself as a loved friend might, demonstrates beneficial associations with body image and eating behaviors. In this systematic review, 28 studies supporting the role of self-compassion as a protective factor against poor body image and eating pathology are reviewed. Findings across various study designs consistently linked self-compassion to lower levels of eating pathology, and self-compassion was implicated as a protective factor against poor body image and eating pathology, with a few exceptions. These findings offer preliminary support that self-compassion may protect against eating pathology by: (a) decreasing eating disorder-related outcomes directly; (b) preventing initial occurrence of a risk factor of a maladaptive outcome; (c) interacting with risk factors to interrupt their deleterious effects; and (d) disrupting the mediational chain through which risk factors operate. We conclude with suggestions for future research that may inform intervention development, including the utilization of research designs that better afford causal inference.

Brief report: Self-compassion, physical health and the mediating role of health-promoting behaviours

To test the hypothesis that self-compassion predicts better physical health and that this is partially mediated through health-promoting behaviours, 147 adults completed self-report measures of self-compassion, health-promoting behaviours and physical health. Self-compassion and health-promoting behaviours were negatively associated with physical symptom scores. Self-compassion was positively associated with health-promoting behaviours. A bootstrapped mediation model confirmed a significant direct effect of self-compassion on physical health through health-promoting behaviours ( R² = 0.13, b = -8.98, p = 0.015), which was partially mediated through health-promoting behaviours ( R² = 0.06, b = -3.16, 95 per cent confidence interval [-6.78, -0.86]). Findings underscore the potential health-promoting benefits of self-compassion.

Examining the Roles of Work Autonomous and Controlled Motivations on Satisfaction and Anxiety as a Function of Role Ambiguity

Past research in the self-determination theory has shown that autonomous motivation is associated with positive outcomes (e.g., work satisfaction), whereas controlled motivation is related to negative outcomes (e.g., anxiety). The purpose of the present research was to examine the moderating function of role ambiguity on the relationships between work autonomous and controlled motivations on the one hand, and work satisfaction and anxiety on the other. Six hundred and ninety-eight workers (449 men and 249 women) participated in this study. Results revealed that autonomous motivation was most strongly related to satisfaction when ambiguity was low. In addition, controlled motivation was most strongly related to anxiety when ambiguity was high. In other words, the present findings suggest that the outcomes associated with each form of motivation may vary as a function of role ambiguity. The present study thus offers meaningful insights for organizations, managers, and employees.

Understanding the Role of Self-Judgment in the Association between Body Dissatisfaction and Quality of Life on Normal-Weight and Overweight Portuguese Women

Literature has demonstrated the negative impact of body image dissatisfaction on women’s quality of life. Nonetheless, it has been suggested that the relationship between body dissatisfaction and women’s well-being is not linear, and that the processes that mediate this association remain unclear. This study aims to clarify the mediator role of self-judgment in the association between negative body image and psychological quality of life, in two groups: normal-weight and overweight women. This cross-sectional study comprised 200 normal-weight and 92 overweight female college students, aged between 18 and 24 years old, that completed self-report instruments of body dissatisfaction, self-judgment, and quality of life. Results showed that women who presented harsher self-judgment about their perceived failures tended to present lower levels in all quality of life domains. Also, results from mediation analyses indicated the relationship between body dissatisfaction and psychological quality of life was significantly mediated by the mechanisms of self-judgment in the two BMI groups (95% CI [–2.41 to –0.04]; 95% CI [–6.35 to –.89]). This mediational model accounted for 28.3% and 40.7% of psychological quality of life in the normal-weight and overweight groups, respectively. These results suggest that a lower ability to deal with one’s failures or inadequacies (e.g., negative evaluation of body image) in a kind and accepting manner may significantly increase the negative impact of body dissatisfaction on one’s psychological quality of life. In this way, it seems that, the focus of interventions should go beyond body dissatisfaction and also target the development of adaptive attitudes (opposed to self-critical attitudes) to deal with negative body-related experiences.

Internalized weight stigma moderates eating behavior outcomes in women with high BMI participating in a healthy living program

Weight stigma is a significant socio-structural barrier to reducing health disparities and improving quality of life for higher weight individuals. The aim of this study was to examine the impact of internalized weight stigma on eating behaviors after participating in a randomized controlled trial comparing the health benefits of a weight-neutral program to a conventional weight-management program for 80 community women with high body mass index (BMI > 30, age range: 30-45). Programs involved 6 months of facilitator-guided weekly group meetings using structured manuals. Assessments occurred at baseline, post-intervention (6 months), and 24-months post-randomization. Eating behavior outcome measurements included the Eating Disorder Examination-Questionnaire and the Intuitive Eating Scale. Intention-to-treat linear mixed models were used to test for higher-order interactions between internalized weight stigma, group, and time. Findings revealed significant 3-way and 2-way interactions between internalized weight stigma, group, and time for disordered and adaptive eating behaviors, respectively. Only weight-neutral program participants with low internalized weight stigma improved global disordered eating scores. Participants from both programs with low internalized weight stigma improved adaptive eating at 6 months, but only weight-neutral program participants maintained changes at follow-up. Participants with high internalized weight stigma demonstrated no changes in disordered and adaptive eating, regardless of program. In order to enhance the overall benefit from weight-neutral approaches, these findings underscore the need to incorporate more innovative and direct methods to reduce internalized weight stigma for women with high BMI.

Emotional Freedom Techniques in the Treatment of Unhealthy Eating Behaviors and Related Psychological Constructs in Adolescents: A Randomized Controlled Pilot Trial

CONTEXT

In Australia and throughout much of the world, rates of obesity continue to climb as do the prevalence of eating disorders, particularly in adolescents. Psychological consequences of childhood obesity include low self-esteem, depression, body dissatisfaction, and social maladjustment (Young-Hyman et al., 2012).

OBJECTIVE AND INTERVENTION

This feasibility study sought to examine the impact of a six-week Emotional Freedom Techniques (EFT) group treatment program upon eating behaviours, self-esteem, compassion, and psychological symptoms.

DESIGN

Forty-four students were randomly allocated to either the EFT group or the waitlist control group.

RESULTS

Results revealed a delayed effect for both groups at post-intervention, with improved eating habits, self-esteem, and compassion at follow-up. Findings provide preliminary support for EFT as an effective treatment strategy for increasing healthy eating behaviours and improving associated weight-related psychopathology.

Does Kindness Matter? Diabetes, Depression, and Self-Compassion: A Selective Review and Research Agenda

Depression and severe psychological distress are frequently comorbid with diabetes and are associated with reduced adherence to medication and healthy lifestyle regimens, poorer glycemic control, and increased complications. The mixed success of existing treatments for depression in diabetes patients suggests a need for supplementary approaches to this common problem. This article reviews recent evidence for the benefits of self-compassion in chronically ill patients, suggesting its utility as a clinical tool for improving self-care, depression, and glycemic control in diabetes. Possible physical and psychological pathways by which self-compassion may promote better outcomes in diabetes patients are considered, with particular attention given to reductions in negative self-judgment and improved motivation to undertake self-care.

Self-compassion and risk behavior among people living with HIV/AIDS

Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. As part of a larger project, nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the US enrolled 1211 sexually active PLWHA using convenience sampling. The majority of the sample was male, middle-aged, and from the US. Illicit drug use was strongly associated with sexual risk behavior, but participants with higher self-compassion were less likely to report sexual risk behavior, even in the presence of illicit drug use. Self-compassion may be a novel area for behavioral intervention development for PLWHA.

Predictors of medication adherence among HIV-positive women in North America

OBJECTIVE

To explore the relationships among contextual, environmental, and regulatory factors with antiretroviral (ARV) medication adherence to assist care providers in improving care for women living with HIV.

DESIGN

Descriptive, multicenter study.

SETTING

Sixteen HIV clinics and service organizations in North America.

PARTICIPANTS

This convenience sample was drawn from a larger study of 2,182 persons living with HIV recruited from clinics and service from September 2009 to January 2011. We included 383 women living with HIV who were taking ARV medications.

METHODS

We assessed the relationship of contextual, environmental, and psychological factors specific to women living with HIV in relation to adherence to ARV medication. Descriptive and multivariate statistics were used to examine the effects of these factors on self-reported ARV drug adherence.

RESULTS

Age, depression symptoms, stigma, engagement with health care provider, and four psychological factors were correlated with self-reported ARV medication adherence (p = .01). Regression analysis indicated that adherence self-efficacy and depression symptoms accounted for 19% for 3-day and 22% for 30-day self-reported medication adherence.

CONCLUSIONS

Adherence self-efficacy and depression symptoms predict ARV medication adherence in women and should be evaluated by nurses. Future research is needed to identify antecedents to and interventions that support adherence self-efficacy and decrease depression symptoms.

Are improvements in shame and self-compassion early in eating disorders treatment associated with better patient outcomes?

Compassion-focused therapy (CFT; Gilbert, 2005, 2009) is a transdiagnostic treatment approach focused on building self-compassion and reducing shame. It is based on the theory that feelings of shame contribute to the maintenance of psychopathology, whereas self-compassion contributes to the alleviation of shame and psychopathology. We sought to test this theory in a transdiagnostic sample of eating disorder patients by examining whether larger improvements in shame and self-compassion early in treatment would facilitate faster eating disorder symptom remission over 12 weeks. Participants were 97 patients with an eating disorder admitted to specialized day hospital or inpatient treatment. They completed the Eating Disorder Examination-Questionnaire, Experiences of Shame Scale, and Self-Compassion Scale at intake, and again after weeks 3, 6, 9, and 12. Multilevel modeling revealed that patients who experienced greater decreases in their level of shame in the first 4 weeks of treatment had faster decreases in their eating disorder symptoms over 12 weeks of treatment. In addition, patients who had greater increases in their level of self-compassion early in treatment had faster decreases in their feelings of shame over 12 weeks, even when controlling for their early change in eating disorder symptoms. These results suggest that CFT theory may help to explain the maintenance of eating disorders. Clinically, findings suggest that intervening with shame early in treatment, perhaps by building patients' self-compassion, may promote better eating disorders treatment response.

A pilot study and randomized controlled trial of the mindful self-compassion program

OBJECTIVES

The aim of these two studies was to evaluate the effectiveness of the Mindful Self-Compassion (MSC) program, an 8-week workshop designed to train people to be more self-compassionate.

METHODS

Study 1 was a pilot study that examined change scores in self-compassion, mindfulness, and various wellbeing outcomes among community adults (N = 21; mean [M] age = 51.26, 95% female). Study 2 was a randomized controlled trial that compared a treatment group (N = 25; M age = 51.21; 78% female) with a waitlist control group (N = 27; M age = 49.11; 82% female).

RESULTS

Study 1 found significant pre/post gains in self-compassion, mindfulness, and various wellbeing outcomes. Study 2 found that compared with the control group, intervention participants reported significantly larger increases in self-compassion, mindfulness, and wellbeing. Gains were maintained at 6-month and 1-year follow-ups.

CONCLUSIONS

The MSC program appears to be effective at enhancing self-compassion, mindfulness, and wellbeing.

Self-Compassion Increases Self-Improvement Motivation

Can treating oneself with compassion after making a mistake increase self-improvement motivation? In four experiments, the authors examined the hypothesis that self-compassion motivates people to improve personal weaknesses, moral transgressions, and test performance. Participants in a self-compassion condition, compared to a self-esteem control condition and either no intervention or a positive distraction control condition, expressed greater incremental beliefs about a personal weakness (Experiment 1); reported greater motivation to make amends and avoid repeating a recent moral transgression (Experiment 2); spent more time studying for a difficult test following an initial failure (Experiment 3); exhibited a preference for upward social comparison after reflecting on a personal weakness (Experiment 4); and reported greater motivation to change the weakness (Experiment 4). These findings suggest that, somewhat paradoxically, taking an accepting approach to personal failure may make people more motivated to improve themselves.

Exploring the link between self-compassion and body image in university women

The purpose of the present research was to examine the relationships between self-compassion and women's body image. In Study 1, female undergraduates (N=142) completed three measures of body image and measures of self-esteem and self-compassion. Results showed that high self-compassion predicted fewer body concerns independently of self-esteem. Moreover, when both self-compassion and self-esteem were included as predictors, self-compassion accounted for unique variance in body preoccupation and weight concerns whereas self-esteem did not. In Study 2, this finding was partially replicated with one component (self-judgment) of self-compassion uniquely predicting body preoccupation in undergraduate women (N=187). High scores on self-compassion also predicted less eating guilt independent of self-esteem. Additionally, self-compassion was shown to partially mediate the relationship between body preoccupation and depressive symptoms. The findings highlight the possibility that a consideration of self-compassion for body image may contribute to identifying who is most at risk for body/shape concerns.