Comparing the efficacy of a brief self-esteem and self-compassion intervention for state body dissatisfaction and self-improvement motivation

Daily instability in body dissatisfaction in individuals with and without eating disorders

Body dissatisfaction (BD) includes negative thoughts and feelings about one's body shape. Although typically assessed as a trait, BD has been found to fluctuate within a day. The present study examined whether daily instability in BD differs according to trait BD, eating disorder (ED) diagnosis, and engagement in maladaptive exercise. Participants with EDs (n = 166) and controls (n = 44) completed a self-report measure of trait BD and reported BD and engagement in maladaptive exercise five times daily for 14 days as part of an ecological momentary assessment protocol. BD instability was calculated as adjusted mean squared successive difference. On average across assessments, participants with EDs reported a 16% change in their BD ratings between consecutive assessments, which was significantly higher than the 12% change in controls. Trait BD was significantly inversely associated with BD instability in individuals with EDs, but not in controls. BD instability did not differ across ED diagnoses or between days with versus without maladaptive exercise. Findings suggest that BD is a dynamic state that varies within a day, especially in participants with EDs. Further research is needed to clarify whether this heightened instability in BD is a clinically relevant factor underlying ED symptoms.

Self-compassionate reflective writing for affect regulation in Australian perinatal women

The current study investigated the effect of a brief online self-compassionate reflective writing task on affect regulation in a sample of Australian perinatal women. Participants were 55 women (Mage = 35.47, SD = 3.79) who were pregnant (16.4%) and/or had an infant <24 months old (76.4%). State self-compassion, positive and negative affect, and future help-seeking behavior intentions were compared at pre- and post-intervention while controlling for trait self-compassion. Inductive thematic analysis was used to extract themes regarding why participants deemed the intervention helpful or unhelpful. As hypothesized, global state self-compassion and intention to engage in self-care behavior were higher, and negative affect was lower, immediately post-intervention relative to pre-intervention scores. Follow-up subscale analyses revealed that the mechanisms of the shift in state self-compassion scores were via reduced self-judgment and overidentification and increased common humanity. There was no significant change in positive affect or intention to engage in help-seeking behavior. Most participants (75%) indicated that the task was helpful with themes identified as written format, changed perspective, dedicating time to reflect, improved mood, and practicing self-kindness. Self-compassionate reflective writing may be a brief and accessible psychosocial approach with the potential to foster healthy emotion regulation and coping among perinatal women.

Contrasting constructs or continuum? Examining the dimensionality of body appreciation and body dissatisfaction

Individuals experiencing body dissatisfaction have poorer health outcomes in part due to engaging in less physical activity. Body appreciation is protective of health behaviors and proposed to be conceptually different from body dissatisfaction. Two studies evaluated whether body appreciation and dissatisfaction represented two distinct dimensions, and whether body appreciation and dissatisfaction would interact in their effect on activity-related motivation and behavior. Study 1 (n = 313) was prospective and utilized a self-report measure of physical activity whereas Study 2 (n = 123) was prospective and used an objective measure. All hypotheses and analyses were pre-registered. A multiverse approach was taken to demonstrate the robustness of results. In exploratory factor analyses, body appreciation and dissatisfaction did not represent two distinct dimensions of body image as both loaded onto the same factor. This result was largely supported by latent profile analyses, which revealed that participants scored high, moderate, or low on both body satisfaction and appreciation. Additionally, body appreciation did not buffer the negative impact of body dissatisfaction on activity-related motivation and behavior. This study provides the first statistical evaluation of the theoretical proposition that body appreciation and dissatisfaction may be distinct constructs with distinct relationships to outcomes.

An Open Trial of a Brief, Self-Compassion Intervention Targeting Thwarted Belongingness and Perceived Burdensomeness

OBJECTIVE

Suicide is a global health concern and developing brief and accessible interventions that can reduce suicide risk is crucial. Thwarted belongingness (TB; i.e., feeling like one doesn't belong) and perceived burdensomeness (PB; i.e., feeling like one is a burden on others) are associated with suicidality, and changes in these constructs predict changes in suicidal thoughts and behaviors. Self-compassion is a multifaceted construct that involves being open and kind to oneself and can be taught through brief writing tasks. Low self-compassion has been associated with TB, PB, and suicidal ideation, suggesting that enhancing self-compassion may decrease suicide risk. Thus, we conducted an open trial of a brief, online self-compassion intervention targeting TB and PB.

METHOD

Undergraduate students (N = 132) viewed an educational video on self-compassion and completed self-compassion writing tasks over the course of one week.

RESULTS

Reactions to the intervention were positive, and participants reported significantly higher self-compassion scores following the intervention. However, TB and PB scores did not change from the baseline to the post-intervention assessment.

CONCLUSIONS

This open trial demonstrated the feasibility and acceptability of a fully online, brief self-compassion intervention, but its impact on reducing suicide risk should be assessed further using a randomized controlled design.

The role of self-compassion in loneliness during the COVID-19 pandemic: a group-based trajectory modelling approach

Research has suggested an increase in loneliness during the COVID-19 pandemic, but much of this work has been cross-sectional, making causal inferences difficult. In the present research, we employed a longitudinal design to identify loneliness trajectories within a period of twelve months during the COVID-19 pandemic in Belgium (N = 2106). We were particularly interested in the potential protective role of self-compassion in these temporal dynamics. Using a group-based trajectory modelling approach, we identified trajectory groups of individuals following low (11.0%), moderate-low (22.4%), moderate (25.7%), moderate-high (31.3%), and high (9.6%) levels of loneliness. Findings indicated that younger people, women, and individuals with poor quality relationships, high levels of health anxiety, and stress related to COVID-19, all had a higher probability of belonging to the highest loneliness trajectory groups. Importantly, we also found that people high in two of the three facets of self-compassion (self-kindness and common humanity) had a lower probability of belonging to the highest loneliness trajectory groups. Ultimately, we demonstrated that trajectory groups reflecting higher levels of loneliness were associated with lower life satisfaction and greater depressive symptoms. We discuss the possibility that increasing self-compassion may be used to promote better mental health in similarly challenging situations.

Trajectories of self-kindness, common humanity, and mindfulness during the COVID-19 pandemic: A person-oriented multi-trajectory approach

The COVID-19 pandemic has produced unprecedented changes in the lives of many people. Although research has documented associations between concerns related to COVID-19 and poor mental health indicators, fewer studies have focused on positive factors that could help people better cope with this stressful social context. To fill this gap, the present research investigated the trajectories of self-compassion facets in times of dramatic social change. Using a longitudinal research design, we described the trajectories of self-kindness, common humanity, and mindfulness during the first eight months of the COVID-19 pandemic, in a representative sample of Canadian adults (N = 3617). Relying on a multi-trajectory group-based approach, we identified clusters of individuals following persistently low (4.0%), moderate-low (39.3%), moderate-high (46.7%), and high (10.0%) levels of self-kindness, common humanity, and mindfulness. Interestingly, we found that compassionate self-responding trajectories were mainly stable over time with minor fluctuations for some groups of individuals, in line with the epidemiological situation. In terms of covariates, we observed that older women were more likely to follow trajectories of high compassionate self-responding, as compared to the other age and gender groups. In terms of mental health indicators, we demonstrated that trajectory groups with high levels of compassionate self-responding were associated with greater life satisfaction, more happiness, better sleep quality, higher sleep quantity, and fewer negative emotions, as compared to lower trajectory groups. The results supported the idea that self-compassion during the COVID-19 pandemic could have favored better mental health indicators and could possibly be promoted as a psychological intervention in the general population.

Are humorous or distractor images more effective than self-compassion messages for combatting the negative body image consequences of social media? An experimental test of possible micro-intervention stimuli

Appearance-focused images on social media are thought to be particularly detrimental for body image. However, social media sites can also be used to encourage positive health behaviours. Three linked experiments with 620 Instagram users explored the protective capabilities of appearance-related self-compassion and appearance-related humorous messages for women's body image during Instagram use. Using simulated Instagram browsing tasks, participants were exposed to a set of fitspiration Instagram posts mixed with either self-compassion or humorous body image messages, or appearance-neutral images. Results indicated that appearance-related self-compassion and humorous messages were not more effective at protecting against negative appearance and life satisfaction outcomes than appearance-neutral images, and did not influence appearance comparison (Experiment 1), even when the personal relevance to participants' health was reinforced through experimental manipulation (Experiment 2). Rather, the presence of any image which did not contain pictures of women, regardless of image content, led to improved body image outcomes compared to exposure to fitspiration images alone (Experiment 3). Interpersonal factors such as the similarity of a female target's appearance also influenced the nature of comparisons made. The study highlights the importance of diluting appearance-focused content with other social media images in ongoing research practice and for user well-being.

Effects of online self-compassionate writing on stigmatizing and affirming self-perceptions: Potential boundary conditions in undergraduate women

This study investigated the effects of an online self-compassionate writing intervention on stigmatizing and affirming self-views toward the body in a sample of college women (N = 254). Participants were randomly assigned to a self-compassionate writing, attentional-control writing, or wait-list control condition for one week, and completed measures of self-compassion, affirming self-perceptions, and stigmatizing self-perceptions at baseline, one-week post intervention, and one-month post intervention. A series of mixed AN(C)OVAs revealed no significant effects by condition or time on stigmatizing or affirming self-views toward the body when controlling for self-esteem, internalized weight stigma, and eating disorder symptomatology. Follow-up exploratory analyses demonstrated no significant effects by condition on the six facets of self-compassion. Notably, participants were significantly more likely to drop out from the study over time if they were lower in self-compassion and self-esteem, and higher in internalized weight stigma at baseline. These results suggest that online self-compassion writing interventions may need to be longer and more potent, especially for women with more entrenched and stigmatized views about their bodies, as well as potential boundary conditions of cultivating self-compassion in a short-term online intervention.

Self-Esteem and Self-Compassion: A Narrative Review and Meta-Analysis on Their Links to Psychological Problems and Well-Being

The present review addressed the relationship between two self-related concepts that are assumed to play a role in human resilience and well-being: self-esteem and self-compassion. Besides a theoretical exploration of both concepts, a meta-analysis (k = 76, N = 35,537 participants) was conducted to examine the magnitude of the relation between self-esteem and self-compassion and their links to indices of well-being and psychological problems. The average correlation between self-esteem and self-compassion was strong (r = 0.65, effect size = 0.71), suggesting that - despite some distinct features - the overlap between both self-related constructs is considerable. Self-esteem and self-compassion displayed relations of a similar magnitude to measures of well-being and psychological problems, and both concepts accounted for unique variance in these measures once controlling for their shared variance. Self-esteem and self-compassion can best be seen as complementary concepts and we invite researchers to look more at their joint protective role within a context of well-being and mental health as well as to their additive value in the treatment of people with psychological problems.

A pilot randomized trial of self-compassion writing for young adult women engaged in emotional eating in the context of appearance-related cyberbullying

OBJECTIVE

To investigate the effectiveness of a 10-min self-compassion writing in alleviating body dissatisfaction, self-objectification, and emotional eating in young adult women engaged in emotional eating in the context of appearance-related cyberbullying.

METHOD

A total of 175 Chinese young adult women (Mage  = 20.90, SD = 1.65) were randomly assigned to one of the three groups: self-compassion, distraction, or control group. At baseline, participants completed assessments of trait and state body dissatisfaction, trait self-objectification, trait self-compassion, emotional eating, and positive and negative affect. Then they needed to recall an appearance-related cyberbullying victimization experience, after which state body dissatisfaction, state self-objectification, and positive and negative affect were measured. After the intervention, participants completed measures of state body dissatisfaction, state self-objectification, positive and negative affect, state self-compassion, and a food-choosing task. At 1-month follow-up, participants completed measures of trait body dissatisfaction, trait self-objectification, trait self-compassion, and emotional eating.

RESULTS

At post-intervention, state body dissatisfaction and negative affect were significantly lower, and positive affect was significantly higher in both the self-compassion and distraction groups compared to control. State self-objectification was significantly lower in the self-compassion group than in the other two groups. At 1-month follow-up, the self-compassion group showed significantly lower levels of body dissatisfaction than the control group.

DISCUSSION

The findings provide initial evidence for the potential of self-compassion writing in reducing state self-objectification and state body dissatisfaction in the context of appearance-related cyberbullying.

PUBLIC SIGNIFICANCE

Appearance-related cyberbullying, a common phenomenon in social networking sites, has been documented to associate with appearance-related concerns and disordered eating in young adult women. However, effective interventions that can reduce these negative associations are scarce. This study preliminarily found that a brief self-compassion writing could be a potential intervention for reducing state self-objectification and state body dissatisfaction in young adult women who had suffered appearance-related cyberbullying.

The mediating effect of coping styles between self-compassion and body image disturbance in young breast cancer survivors: a cross-sectional study

BACKGROUND

Young breast cancer survivors with body image disturbance have poor quality of life. Self-compassion and different coping styles can influence their body image. The purpose of the study was to investigate the relationship between self-compassion, coping styles, and body image disturbance, and examined the mediation role of coping styles between self-compassion and body image disturbance among young breast cancer survivors in China.

METHODS

In the cross-sectional study, a total of 310 young women with breast cancer were assessed on self-compassion, coping styles, and body image disturbance by self-reported questionnaires in China. Spearman's correlation was used to test the links between variables and to verify the indirect effects between variables by constructing a structural equation model.

RESULTS

There were correlations between self-compassion, different coping styles, and body image disturbance. Confrontation, avoidance, and acceptance-resignation coping had significant mediation effects on the association between self-compassion and body image disturbance. The mediation effects of confrontation coping were greater than avoidance, and acceptance-resignation coping.

CONCLUSIONS

In this study, different coping styles acted as mediators between self-compassion and body image disturbance, providing support for further understanding the mechanism between self-compassion and body image disturbance, and developing comprehensive interventions for body image disturbance. Oncology nurses should pay attention to the breast cancer survivors' self-compassion and coping styles and encourage them to adopt adaptive coping strategies, which can reduce body image disturbance.

Association of self-compassion and body image disturbance among young breast cancer patients: Mediating effect of body surveillance and body shame

Objective

To examine whether body surveillance and body shame mediated the association between self-compassion and body image disturbance among young breast cancer patients.

Methods

In this cross-sectional descriptive study, a total of 310 young women with breast cancer were recruited by convenience sampling. All of them completed self-report measurements of demographic and clinical characteristics, self-compassion scale, body image self-rating questionnaire for breast cancer and body surveillance scale, and body shame scale between September and December 2021 ​at a tertiary cancer hospital in Tianjin, China. Data analysis was performed with correlation analysis and structural equation modeling to verify relationships between key variables.

Results

Less self-compassion was significantly associated with greater body image disturbance, while a positive correlation was found between body image disturbance, body surveillance, and body shame. Self-compassion indirectly negative predicted body image disturbance via the chain mediation of body surveillance and body shame.

Conclusions

The links of self-compassion and body image disturbance were mediated by body surveillance and body shame. Reducing patients' excessive body surveillance and body shame by improving their ability of self-compassion may be an effective measure to reduce body image disturbance.

Self-Compassion May Have Benefits for Body Image among Women with a Higher Body Mass Index and Internalized Weight Bias

Negative attitudes towards one’s own body are common among women and are linked to adverse consequences including negative affect, low self-esteem, and eating pathology. Self-compassion has been found effective in improving body image; however, few published studies have examined self-compassion in populations with higher BMIs despite the positive correlation between weight and body dissatisfaction. The current study examined the efficacy of a self-compassion letter-writing exercise versus two active control groups in response to a negative body image induction. The sample of college-aged females (M age = 20.91 years; SD = 5.47) was split between higher and lower BMI to determine whether self-compassion affects body image, affect, and self-esteem differently across weight groups. Weight bias internalization (WBI: i.e., internalization of society’s negative stigma against those with higher BMIs) was examined as a moderator of this relationship in the higher BMI group. Results suggest that letter writing improved body image regardless of condition (p < 0.001). The self-compassion exercise promoted more adaptive body image (p = 0.007) and self-compassion (p = 0.013) than one control condition for those with high WBI. Results suggest that self-compassion can be helpful in ameliorating negative body image for females of all sizes, and that levels of WBI may alter the effect of body image interventions.

Global and appearance-contingent self-esteem: Associations with health and attractiveness exercise reasons

Whilst some individuals exercise for health-related reasons, others appear to exercise to bolster physical attractiveness. For the latter, this is often attributed to dissatisfaction with appearance. Few studies, however, have explored if differences in self-esteem may relate to diverse exercise reasons. The present study investigated whether global self-esteem, appearance-contingent self-worth, and appearance satisfaction may be differentially associated with health and attractiveness exercise reasons. It was further sought to explore whether these relations coincided with different motivational regulations. Adults from the east midlands of the United Kingdom (N = 209; 75% female, 25% male; mean age = 29.77 years) completed measures relating to their global and appearance-contingent self-esteem, appearance satisfaction, exercise intentions, and motivations. Structural equation modelling revealed that global self-esteem was positively associated with appearance satisfaction and health reasons for exercise, whereas appearance-contingent self-esteem related to lower appearance satisfaction and attractiveness reasons. Appearance satisfaction had no association with either exercise reason but was associated with intrinsic motivation and lower controlled exercise motivations. Health exercise reasons were positively associated with intrinsic, identified, and introjected motivation, whereas attractiveness reasons were exclusively related to external motivation. The findings highlight the conceptual importance of differentiating the level and contingency of exercisers' self-esteem. The findings may also have substantive value for exercise practitioners in understanding different reasons for exercise.

Self-Compassion: Theory, Method, Research, and Intervention

Self-compassion refers to being supportive toward oneself when experiencing suffering or pain-be it caused by personal mistakes and inadequacies or external life challenges. This review presents my theoretical model of self-compassion as comprised of six different elements: increased self-kindness, common humanity, and mindfulness as well as reduced self-judgment, isolation, and overidentification. It discusses the methodology of self-compassion research and reviews the increasingly large number of empirical studies that indicate self-compassion is a productive way of approaching distressing thoughts and emotions that engenders mental and physical well-being. It also reviews research that dispels common myths about self-compassion (e.g., that it is weak, selfish, self-indulgent or undermines motivation). Interventions designed to increase self-compassion, such as compassion-focused therapy and mindful self-compassion, are discussed. Finally, the review considers problematic issues in the field, such as the differential effects fallacy, and considers limitations and future research directions in the field of self-compassion research.

A systematic review of compassion-based interventions for individuals struggling with body weight shame

OBJECTIVE

This systematic review investigated compassion-based interventions and the extent to which they can assist with addressing body weight shame.

DESIGN

The systematic review was pre-registered and conducted according to PRISMA guidelines. Seven electronic databases (PsycNET, Pubmed, Web of science, CINAHL, Scopus, ProQuest, Social Science Database) were searched. The methodological quality of studies was also assessed.

MAIN OUTCOME MEASURES

Main outcomes were body weight shame, and compassion. Secondary outcomes assessed were mental health, eating attitudes and behaviours, physical exercise and Body Mass Index and weight.

RESULTS

25 studies (23 papers) met inclusion criteria and results indicated promise for compassion-based interventions for body weight shame, compassion, and health related behaviour. Mixed results were found for BMI and weight. The studies varied considerably in terms of populations targeted, the duration of interventions, and intervention delivery.Conclusion: Overall, compassion-based interventions were found to reduce body weight shame and improve levels of compassion. However, the impact of compassion-based interventions on BMI and weight is less promising. Recommendations for future research are provided.

Self-Compassion Focused Writing Practices: A Systematic Review

In the current systematic review study, it is focused on examining the interventions of 'self-compassion-focused writing', which is a method that combines the concept of self-compassion, which has gained attention in the psychology literature in recent years, and the Written Emotional Disclosure Paradigm which is based on expressing emotions by writing. For this purpose, ScienceDirect, PsycINFO, Web of Science, PubMed, EbscoHost and DergiPark databases were searched through various keywords. Considering the inclusion and exclusion criteria of the study, 31 studies determined to be fit for purpose were examined in terms of sample characteristics, methodology and results. It was observed that the studies were generally conducted with college students and predominantly female, the results were compared with the active intervention groups, random assignment was made to the groups, and repeated measurements were taken. Generally, it has been determined that self-compassion-focused writing provides positive changes on psychological (depression, positive/negative affect), body-related (body satisfaction, body image) and physical (pain) variables. In the reviewed studies, it was concluded that self-compassion-focused writing generally tended to produce stronger positive results compared to active control groups (traditional writing, self-esteem-based writing). Besides, it was observed that the positive changes obtained in studies that carried out follow-up evaluations tended to continue partially. The results show that self-compassion-focused writing is a promising method.

The body satisfaction and psychological well-being of retired women athletes: A long-term qualitative analysis of bodies in motion

We conducted a qualitative evaluation of Bodies in Motion (BIM), a dissonance, mindful self-compassion-based program that addresses the unique experiences and needs of female athletes with respect to their bodies and their well-being. Using semi-structured interviews, 12 collegiate female athletes (retired 2 - 6 years) reflected and provided feedback on the enduring impact of BIM on their body image, relationship to food and exercise, and overall psychological well-being. Through thematic analysis, we found that these retired athletes, extending from their initial program learning, reported increased awareness of sport and societal messages and their impact on body image, shifted perspectives in their view of themselves and their bodies, and used learned skills to manage body image in their lives. Further, with the passage of time, athletes emphasized how what they had learned in BIM remained essential as they navigated challenging life transitions, such as their retirement from collegiate sports. Our findings indicate that the benefits female athletes report accruing in the immediate aftermath of BIM remain with them, even growing and becoming more salient as they continue to reflect on the program and its impact on their body awareness and how they navigate their lives as women and former athletes.

A randomized controlled trial of a brief self-compassion intervention designed to improve the body image of sexual minority men

Self-compassion involves reflecting on shared human experiences, expressing self-kindness, and responding to feelings in a kind and non-judgmental way. Self-compassion interventions seem to be effective for women's body dissatisfaction, however, such interventions have not been trialed with men, including sexual minority men, who are particularly vulnerable. We conducted a randomized controlled trial of a brief self-compassion intervention designed to reduce body dissatisfaction among sexual minority men (N = 605). We used a 3 (condition: self-compassion, self-esteem, and a benign recollection control) × 5 (time) repeated measures design, whereby participants completed a brief writing task and completed body image measures at multiple time-points. Participants in both the self-compassion and self-esteem conditions showed improved body image and self-compassion following the intervention whereas participants in the control condition did not. Increases in self-compassion mediated body image measures for participants in the self-compassion but not self-esteem or control conditions. Participants in the self-compassion condition also showed increased self-compassion at three-weeks follow-up. While several caveats to our results were noted, our overall interpretation is that self-compassion and self-esteem interventions might be effective for sexual minority men's body image, and more research is necessary. The challenge of inculcating a self-compassionate mindset among men is also discussed.

Adaptive body image can be contagious: An examination of college women facing situational body image threats

The present research examined whether and which adaptive body image displays in peers can promote more adaptive body image in self. In two studies, female-identified undergraduates recalled a personally distressing body image event. In Study 1, participants (N = 158) then heard an alleged female-identified peer responding to her own distressing body image event with either self-compassion, self-esteem enhancement, or distraction. Participants across conditions reported increased body acceptance and body image-related self-compassion, and decreased body image distress, but changes did not vary by condition. Study 2 sought to determine which component(s) common to Study 1's conditions explained the benefits participants experienced. Participants (N = 207) listened to an alleged peer: describe body image distress with which she coped adaptively; express body image distress but no adaptive coping; or deny body image distress and relate positively to her body. Hearing a peer cope adaptively with body image distress yielded the greatest body image benefits, whereas hearing a peer deny body image distress was generally least helpful. Results suggest that learning how a peer copes adaptively with body image distress may be most helpful in the face of personal body image distress, and support the overarching theory that adaptive body image may be socially transmissible.

Testing a self-compassion micro-intervention before appearance-based social media use: Implications for body image

Using social media applications can lead to increased body dissatisfaction among young women, particularly when they compare themselves to such images. One intervention for combating these harmful effects may be through self-compassion, or the ability to treat oneself as a friend. The goal of this study was to determine whether a self-compassion micro-intervention could prevent increases in body dissatisfaction after comparing themselves to thin ideal images on Instagram. In an online study, 230 women (M = 25.88, SD = 0.70) completed measures of state weight and appearance dissatisfaction before completing a brief self-compassion writing task (experimental condition) or a simple sorting task (control condition). After completing the assigned tasks, participants reported state body dissatisfaction. Next, they were asked to compare themselves to pre-selected thin ideal images of a curated Instagram profile before reporting state body dissatisfaction for a final time. The results demonstrated that the self-compassion intervention led to decreased in weight dissatisfaction and appearance dissatisfaction that were maintained after Instagram use. Those in the control condition showed increased in body image concern after Instagram use. These preliminary findings suggest that a self-compassion micro-intervention may serve as an effective buffer against certain adverse effects of social media on body image.

Comparing self-compassion versus body exposure for adult women with moderate to severe body dissatisfaction: A feasibility and pilot trial

This study assessed the feasibility and effectiveness of two brief online interventions for body shame for women with moderate to severe negative body image, to inform the design of a future randomized controlled trial. The primary feasibility outcomes were recruitment, measure completion rates, retention rates and internet connection failure rates. The secondary pilot outcomes were change on clinical measures and state shame ratings during the interventions. Participants were randomized to either online (40‐min single session) body exposure or self‐compassion interventions. Five validated nomothetic outcome measures (body dissatisfaction, appreciation, eating disorder, external shame and anxiety) were taken at three time points (preintervention, postintervention and 2‐week follow‐up). Subjective units of body shame (SUBS 0–100 scale) were rated every 5 min during the interventions. The target of recruiting 30 participants in 60 days was successfully achieved. The measure completion rate was high (100%), and retention rates (80% to 100%) showed moderate‐to‐high acceptability of the interventions. Online delivery was moderately viable with a 12.5% session disconnection rate. The self‐compassion intervention significantly reduced SUBS ratings during the course of the intervention, but there was no significant improvement or difference between the interventions on nomothetic outcome measures. Findings suggest that a fully powered trial is viable, and sample size calculation and methodological requirements are provided.

A Novel, Scalable Social Media-Based Intervention ("Warna-Warni Waktu") to Reduce Body Dissatisfaction Among Young Indonesian Women: Protocol for a Parallel Randomized Controlled Trial

Background

Despite the prevalence of body dissatisfaction among young Indonesian women and its consequential negative impacts, there are currently no evidence-based, culturally appropriate interventions to tackle this issue. Therefore, there is a need to develop scalable, cost-effective, and accessible interventions to improve body image among this population.

Objective

This paper describes the study protocol of a parallel randomized controlled trial to evaluate the effectiveness of Warna-Warni Waktu, a social media–based intervention that aims to reduce state and trait body dissatisfaction and improve mood among young Indonesian women aged 15-19 years.

Methods

The trial will take place online. Approximately 1800 young women from 10 cities in Indonesia, evenly split across the ages of 15-19 years, will be recruited via a local research agency’s established research panel. Participants will be randomly allocated to the intervention condition or a waitlist control condition. The intervention consists of six 5-minute videos, with each video supplemented with up to five brief interactive activities. The videos (and associated activities) will be delivered at a rate of one per day across 6 days. All participants will complete three self-report assessments: at baseline (Day 1), 1 day following the intervention (Day 9), and 1 month following the intervention (Day 36). The primary outcome will be change in trait body dissatisfaction. Secondary outcomes include change in internalization of appearance ideals, trait mood, and skin shade satisfaction. Intervention effectiveness on these outcomes will be analyzed using linear mixed models by a statistician blinded to the randomized condition. Intervention participants will also complete state measures of body satisfaction and mood before and after watching each video to assess the immediate impact of each video. This secondary analysis of state measures will be conducted at the within-group level.

Results

Recruitment began in October 2021, with baseline assessments underway shortly thereafter. The results of the study will be submitted for publication in 2022.

Conclusions

This is the first study to evaluate an eHealth intervention aimed at reducing body dissatisfaction among young Indonesian women. If effective, the intervention will be disseminated to over half a million young women in Indonesia via Facebook, Instagram, and YouTube.

Trial Registration

ClinicalTrials.gov NCT05023213; https://clinicaltrials.gov/ct2/show/NCT05023213

International Registered Report Identifier (IRRID)

PRR1-10.2196/33596

Feel Good, Eat Better: The Role of Self-Compassion and Body Esteem in Mothers' Healthy Eating Behaviours

Mothers’ eating behaviours are important to ensure the health and well-being of themselves and their families. Recent research has pointed to self-compassion, defined as extending kindness to oneself in times of perceived inadequacy or general suffering, as a trait associated with healthy forms of eating, such as intuitive eating, and reduced maladaptive forms of eating, such as emotional eating. However, little is known about the psychological mechanism through which self-compassion relates to healthy eating behaviours. This study examined 100 mothers’ levels of self-compassion, body esteem and eating behaviours. Structural equation modelling revealed that self-compassion was positively associated with diet quality and intuitive eating, while being negatively associated with emotional eating. Moreover, these links occurred, in part, due to higher body esteem. This points to a mechanism through which self-compassion may positively contribute to mothers’ healthy eating behaviours. The implications for eating outcomes and women’s health are discussed.

The Association of Body Image Self-Discrepancy With Female Gender, Calorie-Restricted Diet, and Psychological Symptoms Among Healthy Junior High School Students in Japan

Background: Body image self-discrepancy reflects a preference for weight loss regardless of normal body size and is a distorted cognition that may be a precursor to eating disorders. The aim of this study was to investigate factors associated with body image self-discrepancy among healthy junior high school students in Japan.

Method: This cross-sectional study was conducted at one junior high school in Saitama, Japan, in December 2016. After excluding obese participants (defined as 20% above their ideal weight), 304 students (mean age, 13.9years; n=181 girls, 59.5%) who fell into underweight (n=22, 7.2%) and normal weight categories were selected. Body image self-discrepancy was measured using the Contour Drawing Rating Scale which includes eight separate figures representing body sizes. We then calculated the difference by subtracting ideal from current body sizes and defined body image self-discrepancy if the difference >1.

Results: Girls constituted 92% (n=49) of the 53 students with body image self-discrepancy. In all students, multivariable stepwise models demonstrated that female gender (OR, 6.92, 95% CI: 2.33–20.51), a calorie-restricted diet (OR, 5.18, 95% CI: 2.22–12.05), and psychological symptoms (OR, 1.47, 95% CI: 1.15–1.87) were significantly associated with an increased risk of body image self-discrepancy. Specifically for girls, an increased risk of body image self-discrepancy was associated with calorie-restricted suppers and psychological symptoms.

Conclusion: Body image self-discrepancy among healthy adolescents in Japan was found to be closely linked to being a girl, having a calorie-restricted diet, and having psychological symptoms.

Self-compassion and dissonance-based interventions for body image distress in young adult women

Self-compassion interventions have been suggested as a potentially more acceptable way to address body image distress compared to interventions that emphasize challenging (often firmly entrenched) thin-ideals. In the current randomized controlled trial, young adult women endorsing body image concerns were randomized to a self-compassion (SC) intervention consisting of one in-person session plus one week of self-guided practice (n = 50), a similarly-structured dissonance-based (DB) intervention (n = 50), or a waitlist (WL) control (n = 51). Both brief interventions were acceptable and were more effective than WL. The two interventions did not differ significantly from each other in reducing the global measure of body dissatisfaction, improving body appreciation, or reducing appearance-contingent self-worth. The DB intervention alone decreased thin-ideal internalization, but only among participants with initially high scores. More participants initially expressed a preference for the SC rationale, and at post-test SC participants reported a higher likelihood of recommending the intervention they had received to others. Change in self-compassion emerged as a possible mechanism of action within both interventions, suggesting it may be useful to integrate aspects of both approaches to enhance acceptability and provide the greatest benefits.

The effect of revised process recording on self-focus and self-compassion: A randomized controlled pilot study

DESIGN AND METHODS

Thirty-five university nursing students in Japan participated in this randomized controlled trial. The revised process recording referred to self-compassion. Both the control and intervention groups completed the self-compassion scale (SCS) pre- and post-intervention. A repeated two-way analysis of variance examined the interaction effect of time × group on the SCS subscales.

FINDINGS

A significant interaction effect was observed only for mindfulness; the score only increased in the intervention group.

IMPLICATIONS FOR NURSING PRACTICE

The revised process recording might facilitate self-compassion, making it appropriate for nursing education.

Self-compassion and nursing competency among Japanese psychiatric nurses

PURPOSE

This study examined the association of self-focus and self-compassion with nursing competency.

DESIGN AND METHODS

Data of 433 psychiatric nurses comprising demographics, other-consciousness, self-compassion, self-focus, and nursing competency were analyzed using the Other-Consciousness Scale (OCS), Self-Compassion Scale (SCS), Japanese version of the Rumination-Reflection Questionnaire (RRQ), and Oriented Problem Solving Behavior (OPSN).

FINDINGS

Higher internal aspect and lower fantastic aspect in OCS, higher reflection in RRQ, and lower SCS negative subscales predicted a higher OPSN score. The account rate of variance was 12.5%.

PRACTICE IMPLICATIONS

Psychiatric nursing education should facilitate other-consciousness and reflection enhancement, and assuage uncompassionate attitude towards self.

Evaluating the impact of a brief Health at Every Size®-informed health promotion activity on body positivity and internalized weight-based oppression

Weight-based oppression, including negative attitudes about body weight, and harassment, stigma, and discrimination based on body weight, is a widespread phenomenon that leads to considerable distress and poor health and wellbeing outcomes. Conversely, body positivity is a multi-faceted concept that encompasses body acceptance, body appreciation, and body love, and adaptive approaches protective of health and wellbeing. The aim of this study was to evaluate the impact of a brief health promotion activity informed by Health at Every Size® and critical health promotion principles on body positivity and internalized weight-based oppression in female students at Qatar University. A quasi-experimental mixed methods pre-post evaluation design was used, with quantitative assessment of body positivity and internalized weight-based oppression before the activity, immediately afterwards, and 10 weeks later, and qualitative assessment at the 10-week follow up. Measures used were the Body Appreciation Scale 2, Modified Weight Bias Internalization Scale, Fat Attitudes Assessment Toolkit Size Acceptance and Self Reflection on Body Acceptance subscales, and an open-ended questionnaire. Body acceptance and appreciation increased significantly after the activity. Qualitative results suggest that these improvements were sustained at follow up. Brief Health at Every Size® informed health promotion activities show potential to improve health and wellbeing.

Examination of Weight-Loss Motivators and Family Factors in Relation to Weight Management Strategies and Dietary Behaviors among Adolescents with Obesity

The study aim was to test hypotheses informed by self-determination theory (SDT) regarding associations of adolescent motivators for weight loss and family feeding practices on understanding adolescent weight management and dietary behaviors. Adolescents (n = 71) with obesity were recruited from a large medical center in the Midwest USA and completed questionnaire assessments via an online survey. Results supported hypotheses that endorsement of health motivators for weight loss, conceptualized as autonomous (intrinsic) motivation, and positive family support would be associated with healthier weight management practices and dietary behaviors. Nuanced findings related to social- and self-esteem-related motivators for weight loss indicated a need for further understanding of these weight-loss motivators in the context of SDT. The current study findings highlight the importance of addressing motivational factors and family influences in research and practice related to promoting healthy dietary habits and weight management strategies among adolescents with obesity.

The Effects of Self-Compassion and Self-Esteem Writing Interventions on Women’s Valuation of Weight Management Goals, Body Appreciation, and Eating Behaviors

In this study, we examined the effects of body-focused daily self-compassion and self-esteem expressive writing activities on women’s valuation of weight management goals, body appreciation, bulimic symptoms, and healthy and unhealthy eating behaviors. One-hundred twenty-six women, recruited from the community and a university participant pool ( Mage = 29.3, SD = 13.6), were randomly allocated to one of the three writing conditions: body-focused self-compassion, body-focused self-esteem, or control. Women reflected on a moment within the past 24 hours that made them feel self-conscious about their bodies, eating, or exercise habits (self-compassion and self-esteem conditions) or on a particular situation or feeling that occurred in the past 24 hours (control condition) for 4–7 days. At post-treatment (24 hours after the intervention), women in the self-compassion group demonstrated decreased bulimic symptoms, while women in the self-esteem and control conditions did not. Furthermore, clinically significant changes in bulimic symptoms were associated with being in the self-compassion condition but not in the self-esteem or control conditions. Results suggest that body-focused writing interventions may be more effective in temporarily reducing eating disorder symptoms in women if they focus on harnessing self-compassion. Additional online materials for this article are available on PWQ ’s website at http://journals.sagepub.com/doi/suppl/10.1177/03616843211013465

Body image and the relation to mindfulness and self-compassion in physical education students: a cross-cultural study

The present study investigated the body images of Omani and German physical education students. 199 students completed a body image test, a dispositional mindfulness and a self-compassion measurement, as well as a short physical activity questionnaire. Overall, our results demonstrate that females showed a higher body distortion than males and students in Germany displayed a higher body distortion effect. Concerning mindfulness and self-compassion, students from Oman showed higher values than German students in self-compassion, but not in the dispositional mindfulness measurement. However, self-compassion and mindfulness were not related to the body distortion effect. This is the first study that provides unique data of self-compassion and mindfulness in an Arabic sample, and shows that self-compassion is higher in Omani students.

Unburdening the Weight of Stigma: Findings From a Compassion-Focused Group Program for Women With Overweight and Obesity

OBJECTIVE

The aim of this study was to develop a 2-day intensive-format, Compassion-Focused Therapy (CFT) based group program targeting weight stigma in women with overweight and obesity, and to conduct a pilot study to determine the feasibility and acceptability of the intervention.

METHOD

Participants were 15 females aged 18-62 years (mean [M] = 43.60, standard deviation [SD] = 12.38), who participated in the program and completed measures of self-compassion, internalized weight stigma, psychological distress, life-satisfaction, loneliness, eating self-efficacy, body dissatisfaction, and body shame, at pre-treatment, post-treatment, and 3-month follow-up.

RESULTS

Significant improvements were found from pre-treatment to post-treatment for self-compassion and internalized weight stigma, with gains maintained at 3-month follow-up. Significant improvements were also found on measures of psychological distress, life satisfaction, loneliness, eating self-efficacy, and body dissatisfaction at the post-treatment assessment. Credibility ratings of the program were high.

CONCLUSIONS

This study has contributed to existing stigma research, being the first proof-of-concept study to demonstrate support for an intensive, CFT based group approach targeting the effects of weight stigma for women with overweight and obesity. The findings are discussed in terms of the potential of CFT to assist women develop resilience to the harmful effects of weight stigma, and possible future research directions to further develop and evaluate this approach.

Validation of the Chinese Version of the Body Image Concern Inventory

The Body Image Concern Inventory (BICI) was developed to assess dysmorphic appearance concern and has been found to be a reliable and valid instrument in Western societies. To examine the psychometric properties of a new Chinese BICI, the BICI was administered to 1,231 Chinese young adults (Study 1) and 47 female patients with eating disorders and 56 matched controls (ED; Study 2). In study 1, Cronbach's alpha of .92 and test-retest reliability of .73 over a 6-month interval was observed for the total scale. Confirmatory factor analysis supported a 3-factor model for the BICI: avoidant behaviors (AB), safety behaviors against perceived flaws (SB), and negative appearance evaluation (NE). In study 2, ED patients scored significantly higher on the BICI total and three subscale scores than controls. In addition, AB best differentiated ED patients and matched controls (Cohen's d = 1.52); SB best differentiated between the non-clinical female and male groups (Cohen's d = 0.75); NE was most closely associated with level of negative affect and subjective well-being (inverse relationship) in both clinical and non-clinical groups. In conclusion, the Chinese BICI is a reliable and valid tool for evaluating dysmorphic appearance concern among Chinese speakers.

Is erectile dysfunction related to self-esteem and depression? A prospective case-control study

Sexual activity is important role in life of men. Decreased sexual function has a negative impact on the quality of life of the patients and their partners. In this study, we aimed to evaluate the relationship of erectile dysfunction (ED) with self-esteem, symptom severity and depression. The 80 patients were evaluated prospectively. Group 1 (cases group) included 40 patients who with ED an age range of up to 18-70 years. Group 2 (healthy control group) included 40 patients who apply to the urology clinic for various reasons without ED. All patients were filled international index of erectile function-5 (IIEF-5), Beck Depression questionnaire (BDI-2) and Rosenberg self-esteem questionnaires (RESQ). Demographic characteristics and inventory results of the patients were compared between the two groups. Significant differences were found between the two groups in IIEF-5, RESQ and BDI-2 scores. In Group 1, IIEF-5 score was low, RESQ, BDI-2 scores were significantly higher (All scores p < 0.001). As a result people significantly reflect their sexual satisfaction in their social life. The patients with mild ED are not entirely satisfied in spite of normal sexual frequency. This situation causes significantly low the self-esteem of men. Prevention of ED will contribute to increased self-esteem and happy lives.

Does a Facebook-enhanced Mindful Self-Compassion intervention improve body image? An evaluation study

This study evaluates a brief intervention aimed at improving body image. The intervention comprised a Mindful Self-Compassion workshop complemented by a group discussion on Facebook. Young women (M_age = 18.31), screened for body concerns, were allocated by university campus to a 50-minute workshop intervention (n = 42) or a waitlist control (n = 34). Following the workshop, participants in the intervention group utilized self-compassion techniques when experiencing appearance distress and posted about their experiences on a private Facebook group three times per week for two weeks. Findings showed that, relative to control, the intervention group experienced lower upward appearance comparison, social appearance anxiety, body dissatisfaction, and drive for thinness, and higher body appreciation and self-compassion, at posttest and 1-month follow-up. All effects, except those for body dissatisfaction, were held at 3-month follow-up. Additionally, common humanity predicted gains in body appreciation from pretest to posttest. The Mindful Self-Compassion intervention involving a Facebook group may have resonated with young women as it allowed them to share moments of self-compassionate body image experiences in a private and supportive environment.

A look at the intergenerational associations between self-compassion, body esteem, and emotional eating within dyads of mothers and their adult daughters

Research has demonstrated that mothers transmit body-related attitudes and eating behaviors to their daughters, but little is known about the role of self-compassion-treating oneself with kindness and being mindful about one's experiences-in this transmission. This research examined the intrapersonal and interpersonal associations between mothers' and daughters' self-compassion, body esteem (i.e., positive self-evaluations about one's appearance), and emotional eating (i.e., the tendency to eat in response to negative affect). Dyads (N = 191) of Canadian mothers (mean age: 57.37) and daughters (mean age: 28.76) completed self-report questionnaires. Dyadic, structural equation modeling and bootstrapping analyses were conducted to examine relationships among the study variables. Controlling for mothers' and daughters' body mass index, self-compassionate mothers and daughters reported higher body esteem. Additionally, daughters of self-compassionate mothers were more self-compassionate and had higher body esteem, which in turn predicted lower emotional eating. Adding to the literature on the intergenerational transmission of eating-related attitudes and behaviors, results suggest a relation between mother and daughter self-compassion, body esteem, and eating behaviors. Results also showed that attitudes toward oneself were related to eating behaviors. Mothers' self-compassion might provide a model for daughters, which in turn is associated with daughters' improved body esteem and eating behaviors.

Self-compassion as a moderator of the relationships between shape and weight overvaluation and eating disorder psychopathology, psychosocial impairment, and psychological distress

Shape and weight overvaluation is a core component of body image theorized to drive many of the symptoms of eating disorders (ED) and associated distress and impairment. Identifying variables that protect against the negative effects of shape and weight overvaluation is needed for informing primary intervention targets. Self-compassion may be a protective factor given its role as an adaptive affect regulation strategy. We thus examined whether self-compassion would attenuate the relationships between shape and weight overvaluation and ED psychopathology, psychosocial impairment, and psychological distress. Cross-sectional data were analyzed from 992 (619 women and 373 men) participants. Multiple regression analyses revealed that self-compassion moderated the relationship between shape and weight overvaluation and each dependent variable. Specifically, among men and women with lower levels of self-compassion, overvaluation of shape and weight was strongly associated with each of the criterion variables; however, these relationships were either absent or weaker among those with higher levels of self-compassion. Present findings suggest that it may be beneficial for ED prevention and early intervention programs to explicitly incorporate components of compassion-focused interventions to improve mental health outcomes among the general public.

Is self-compassion relevant to the pathology and treatment of eating and body image concerns? A systematic review and meta-analysis

Eating disorders are severe mental health conditions, with substantial consequences for health and quality of life. Such disorders are strongly associated with body image concerns. It is important to consider treatments that might enhance our ability to treat such cases. Recently, there has been a growing body of research on self-compassion in relation to such problems. However, we are not yet clear about the extent of such effects, given the range of studies and methodologies used. Therefore, a systematic literature review was carried out using four key databases. Meta-analysis was used to reach conclusions about the size of the effects and moderators. Random-effects meta-analyses were conducted with 59 studies. Higher self-compassion was associated with lower eating pathology, reduced body image concerns, and greater positive body image, with medium to strong effect sizes (respectively, r = -0.34, r = -0.45, r = 0.52). Furthermore, self-compassion interventions for eating pathology and body image were effective, and superior to control groups (respectively, g = 0.58, g = 0.39). These findings support the role of self-compassion in understanding and addressing eating and body image concerns. Self-compassion appears to be an adaptive emotion regulation strategy in eating disorders and body image.

The Happy American Body 2.0: Predictors of affective body satisfaction in two U.S. national internet panel surveys

The first national study of body image was reported four decades ago in the article The Happy American Body (Berscheid et al., 1973). To provide a modern follow-up to this study, we used two Internet panel surveys of U.S. adults to examine feelings about appearance (Survey 1: Married N = 1095; Single N = 5481) and weight, appearance, body, and muscle size/tone (Survey 2: N = 1601). Mean ages across samples for men and women ranged from 42-53. On the positive side, many men and women were somewhat-to-very satisfied with their appearance (67 %; 57 %), overall body (61 %; 46 %), weight (54 %; 42 %), and muscle tone/size (56 %; 41 %). Mean gender differences were small (Cohen's ds = 0.18-0.32), as were sexual orientation differences within each gender (ds = |0.00-0.25|). Looking at negative body image, fewer men than women were somewhat-to-very unhappy with their appearance among married (19 %; 29 %) and single participants (29 %; 35 %), and fewer men were somewhat-to-extremely dissatisfied with their appearance (18 %; 24 %), body (27 %; 39 %), weight (36 %; 49 %), muscle tone/size (27 %; 41 %). Nearly one-fifth of men (18 %) and one-fourth of women (27 %) were very-to-extremely dissatisfied with at least one of these traits, highlighting the importance of body image interventions.

Body image states in everyday life: Evidence from ecological momentary assessment methodology

This review highlights the contributions of Professor Thomas Cash to the scholarship of body image experiences in daily life, including his influence on subsequent research in this field. Cash's arguments for capturing a broad range of state-based body image experiences have been heeded, with recent studies exploring positive body image constructs as well as the more studied negative body image experiences. Appearance comparisons are the most commonly studied contextual influence on body image, and they seem to have a consistent effect. However, the experiences of body image in sexual contexts, and among adolescents, those who are pregnant, or have other physical characteristics that may increase the salience of appearance warrant further attention. Findings generally support Cash's contention that trait body image relates to likelihood and level of experience of body image in daily life, though the moderating effects of trait aspects on state-based relationships remains unclear. The discussion concludes with consideration of the impact of assessment schedules on obtained results. It is also discussed how accumulated knowledge regarding state-based body image experiences may be leveraged in treatment contexts, particularly in light of clear evidence that repeated assessment of body image in daily life increases self-awareness of one's body image characteristics.

Evaluating the potential roles of body dissatisfaction in exercise avoidance

Body dissatisfaction is linked to poor physical health, even after actual markers of health have been controlled for. This link is likely due to body dissatisfaction influencing health behaviors-more specifically, cardiovascular exercise. Modifiable reasons for this link have yet to be determined. We conducted a prospective study to evaluate whether active avoidance of exercise may explain the association of body dissatisfaction with exercise, and, if so, whether perceived barriers to exercise account for the association of body dissatisfaction and exercise avoidance. Baseline measures were collected via survey; physical activity was measured over time, via self-report. As expected, avoidance mediated the prospective relationship between dissatisfaction and exercise. Additionally, the relationship between body dissatisfaction and avoidance was mediated by embarrassment and fatigue. Interventions that boost body satisfaction and/or address perceptions of fatigue and embarrassment may be needed for individuals with body dissatisfaction to be more likely to participate in exercise-related programs.