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Pershyn CL, Guyker W, Schlant E, Borden A, Roff C, Evelyn Estey EE, Cook-Cottone C. Eat Breathe Thrive: an interpretative phenomenological analysis of a yoga-based eating disorder intervention. Eat Disord 2024; 32:401-425. [PMID: 38379316 DOI: 10.1080/10640266.2024.2312636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
A growing body of evidence suggests that yoga-based interventions might aid in the prevention and treatment of eating disorders. The current qualitative study used Interpretative Phenomenological Analysis (IPA) to analyze the nature and degree of impact of a yoga and mindfulness-based eating disorder prevention intervention Eat Breath Thrive (EBT). Data was collected via semi-structured interviews with 16 participants over the age of 18 who took part in the EBT program between 2018 and 2022. Using IPA methodology, and after several rounds of coding, emergent themes were interpreted and organized to develop a theoretical model explaining the mechanism of change experienced and described by EBT participants. The resulting model outlines an experiential progression from psychoeducation and skill development/practice to increased mindful awareness, and empowered state experiences which led to the following outcomes: independent positive action, self-initiated positive state experiences, and increased embodied well-being. Participants reported increased self-compassion and self-acceptance, with decreased emphasis on disordered eating behaviors. Qualitative data is necessary for understanding why yoga works, from an experiential perspective. This study adds to the new, and rapidly expanding body of research supporting the positive effects of yoga and mindfulness on the prevention and treatment of eating disorders.
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Affiliation(s)
- Carly Lua Pershyn
- Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, USA
| | - Wendy Guyker
- Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, USA
| | | | - Ashlye Borden
- Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, USA
| | | | - Esther Ellyn Evelyn Estey
- Eat Breathe Thrive, Colorado, USA
- Center for Mindfulness and Compassion, Harvard Medical School, Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Catherine Cook-Cottone
- Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, USA
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White M, Thomas A, Aston M, Joy P. "It's beautiful and it's messy and it's tragic": exploring the role of compassion in the eating disorder recovery processes of 2S/LGBTQ + Canadians. J Eat Disord 2024; 12:23. [PMID: 38326869 PMCID: PMC10848359 DOI: 10.1186/s40337-024-00981-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024] Open
Abstract
This research explores experiences of compassion among 2S/LGBTQ + Canadians living with eating disorders in the context of eating disorder treatment and community support. There is a growing body of scholarship showing disparities in eating disorder care for those within 2S/LGBTQ + communities. Among the reported concerns is a potential lack of compassion in eating disorder treatment and recovery settings, something which may serve to exacerbate feelings of isolation and perpetuate misunderstandings of 2S/LGBTQ + people's experiences. In an effort to understand these dynamics more deeply, we conducted semi-structured interviews with 2S/LGBTQ + Canadians who have experienced eating disorder care. The data collected were then subjected to Foucauldian discourse analysis, which produced three interconnected discursive considerations: feeling lack of structural compassion, 2S/LGBTQ + communities as places of respite, and 2S/LGBTQ + caregiving. One of the common threads among these discursive considerations was cis-heteronormativity ingrained in eating disorder treatment settings and health care systems more broadly. Our findings underscore the critical need for more enhanced compassion for 2S/LGBTQ + patients in eating disorder care settings. We conclude that compassion, when implemented on the levels of individual clinicians, policy and procedure, and institutions, may represent an avenue toward disrupting ingrained cis-heteronormativity and the associated discursive power structures contained in health care systems.
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Affiliation(s)
- Megan White
- Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Andrew Thomas
- Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Megan Aston
- School of Nursing, Dalhousie University, Halifax, Canada
| | - Phillip Joy
- Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada.
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3
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Marques CC, Palmeira L, Castilho P, Rodrigues D, Mayr A, Pina TS, Pereira AT, Castelo-Branco M, Goss K. Online Compassion Focused Therapy for overeating: Feasibility and acceptability pilot study. Int J Eat Disord 2024; 57:410-422. [PMID: 38124655 DOI: 10.1002/eat.24118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/08/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This pilot study aims to investigate the feasibility, acceptability, and potential effectiveness of online Compassion Focused Therapy for overeating (CFT-OE). METHOD Eighteen Portuguese women seeking treatment for overeating were enrolled in this study, and 15 participants completed the CFT-OE. This was a single-arm study. Participants were assessed at pre- and post-intervention and 3-month follow-up. All participants completed measures assessing binge eating, cognitive restraint, uncontrolled eating, emotional eating, general eating psychopathology, general and body shame, self-criticism, self-compassion, and fears of self-compassion. RESULTS The treatment attrition rate was 16.7%, which is relatively low compared to other similar online interventions. Participants gave positive feedback on the program and indicated they would recommend it to people with similar difficulties. CFT-OE improved self-compassion and reduced eating psychopathology symptoms, general and body shame, self-criticism, and fears of self-compassion. Clinical significance analysis showed that the majority of participants were classified as in recovery in all measures at post-intervention and 3-month follow-up. DISCUSSION Preliminary results suggest that the online CFT-OE program is an acceptable and feasible intervention. Results also suggest that CFT-OE is beneficial for the treatment of women with difficulties with overeating. A future randomized controlled trial is necessary to establish the effectiveness of the CFT-OE. PUBLIC SIGNIFICANCE This study indicates that online CFT-OE is a feasible and adequate intervention for women who struggle with overeating. This therapy showed promising results in reducing eating disorder symptoms, shame, and self-criticism and improving self-compassion. As an online intervention, CFT-OE may be more accessible and offer an alternative to in-person therapy.
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Affiliation(s)
- Cristiana C Marques
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, Institute of Psychological Medicine, University of Coimbra, Coimbra, Portugal
| | - Lara Palmeira
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- Portucalense Psychology Institute (I2P), Portucalense University, Porto, Portugal
| | - Paula Castilho
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Dírcea Rodrigues
- Department of Endocrinology, Diabetes and Metabolism, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Andreas Mayr
- Department of Medical Biometrics, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Tiago Soares Pina
- Department of Nutrition and Dietetics, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Ana Telma Pereira
- Faculty of Medicine, Institute of Psychological Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Kenneth Goss
- Coventry & Warwickshire Partnership Trust, Coventry Eating Disorder Service, Coventry, UK
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Muroni O, Sudres JL. [Unconditional self-acceptance and self-compassion: another clinic for anorexia nervosa?]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2023; 68:41-44. [PMID: 38070982 DOI: 10.1016/j.soin.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
People suffering from anorexia have a particular emotional and cognitive profile (altered body and self-perception, emotional dysregulation, perfectionism, obsessive traits), which the disorder can compensate for through emotional distancing strategies. Self-compassion and unconditional self-acceptance have been shown to have therapeutic effects on the barriers to recovery associated with this profile.
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Affiliation(s)
- Océane Muroni
- Laboratoire CERPPS EA 7411 (Centre d'études et de recherches en psychopathologie et psychologie de la santé), Université Toulouse 2 Jean-Jaurès, 5 allée Antonio-Machado, 31058 Toulouse, France
| | - Jean-Luc Sudres
- Laboratoire CERPPS EA 7411 (Centre d'études et de recherches en psychopathologie et psychologie de la santé), Université Toulouse 2 Jean-Jaurès, 5 allée Antonio-Machado, 31058 Toulouse, France; Clinique Castelviel, Hôpital de jour L'Oasis, chemin des Affieux, 31180 Castelmaurou, France.
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Kadriu F, Claes L, Witteman C, Woelk M, Krans J. The effect of imagery rescripting on core beliefs and eating disorder symptoms in a subclinical population. J Behav Ther Exp Psychiatry 2023; 78:101804. [PMID: 36435546 DOI: 10.1016/j.jbtep.2022.101804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 06/08/2022] [Accepted: 10/29/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES This study compared the effect of imagery rescripting focusing on self-compassion, imagery rescripting focusing on mastery, and a positive memory control condition on (1) emotional responses towards the memory (one day after), (2) changes in the believability of negative core beliefs, and dysfunctional eating behaviors (one week after) in individual at risk for developing an eating disorder. METHODS Female participants (N = 69) were allocated to one of three conditions: ImRs focusing on self-compassion (N = 24), ImRs focusing on self-mastery (N = 23), and positive memory control condition (N = 22). Participants in the ImRs conditions received a 20-min self-guided ImRs intervention, whereas participants in the control condition received a 20-min self-guided task focusing on an unrelated positive memory. RESULTS The experimental manipulation successfully induced the use of self-compassion and mastery strategies in the respective imagery rescripting condition. However, our data show that a single 20-min session of self-guided imagery rescripting focusing on compassion and/or mastery has no effect on the emotional response towards the aversive memory or in the change of core beliefs and eating behaviors at follow up. LIMITATIONS We discuss potential reasons for the null findings, including the use of a single imagery rescripting session, the sample size and the measurement of manipulation checks. CONCLUSION Future studies are needed to rule out methodological explanations for the null results. These findings may be of value for the development of future experimental lab paradigms which aim to evaluate the causal effects and working mechanisms of imagery rescripting.
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Affiliation(s)
- Fortesa Kadriu
- Behavioural Science Institute, Radboud University, Thomas van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands; Behavior, Health, and Psychopathology, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium.
| | - Laurence Claes
- Behavior, Health, and Psychopathology, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium; Faculty of Medicine and Health Sciences, University Antwerp, Prinsstraat 13, 2000, Antwerp, Belgium
| | - Cilia Witteman
- Behavioural Science Institute, Radboud University, Thomas van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands
| | - Mandy Woelk
- Department of Clinical Psychology, Utrecht University, the Netherlands
| | - Julie Krans
- Behavioural Science Institute, Radboud University, Thomas van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands; Behavior, Health, and Psychopathology, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium; Pro Persona Overwaal Centre for Anxiety, OCD, and PTSD, Pastoor van Laakstr 48, 6663 CB Nijmegen, the Netherlands
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Carter A, Gilbert P, Kirby JN. A systematic review of compassion-based interventions for individuals struggling with body weight shame. Psychol Health 2023; 38:94-124. [PMID: 34694950 DOI: 10.1080/08870446.2021.1955118] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- Alicia Carter
- Compassionate Mind Research Group, School of Psychology, The University of Queensland, St Lucia, Australia
| | - Paul Gilbert
- Compassionate Mind Research Group, School of Psychology, The University of Queensland, St Lucia, Australia.,Psychology, Derby University, Derby, UK
| | - James N Kirby
- Compassionate Mind Research Group, School of Psychology, The University of Queensland, St Lucia, Australia
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Griffin C, Fenner P, Landorf KB, Cotchett M. Art therapy and eating disorders: a mixed methods feasibility study. ARTS IN PSYCHOTHERAPY 2023. [DOI: 10.1016/j.aip.2023.101994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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8
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Mahon C, Hevey D. Pilot trial of a self-compassion intervention to address adolescents' social media-related body image concerns. Clin Child Psychol Psychiatry 2023; 28:307-322. [PMID: 35549462 PMCID: PMC9908838 DOI: 10.1177/13591045221099215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: Self-compassion interventions reduce body dissatisfaction in adults but have not been extensively investigated in adolescents. A novel 5-week Digital Social Media Adolescent Resilience Training intervention grounded in Gilbert's (2010) Compassionate Mind Training was adapted to address adolescent's social media-related body image concerns. Method: A convenience sample of 102 adolescents, 54 girls (53%), 48 boys (47%), aged 15-17 years (M=15.6, SD=0.46) were recruited from four mixed gender Irish Secondary Schools. Due to data loss because of Covid-19, analyses were conducted on data from 80 participants (24 boys, 56 girls). A mixed methods quasi-experimental design was used. Primary outcomes of self-compassion, self-criticism, social media comparisons and body image perceptions were quantitatively assessed at pre, post-intervention and 3-month follow up, while post-intervention focus groups qualitatively documented adolescents' responses to the programme. Results: Qualitative data indicated that the programme was feasible and acceptable. Analyses revealed significant increases in body appreciation and body satisfaction in the experimental group from pre- to post-intervention. Girls exhibited significant increases in body appreciation and reductions in self-criticism, while boys exhibited increases in body satisfaction. Improvements in body satisfaction were observed at 3-month follow up. Conclusions: Findings indicate that self-compassion has potential to improve adolescent's body image perceptions, but further research is warranted.
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Affiliation(s)
- Ciara Mahon
- School of Psychology, Trinity College Research Centre for Psychological Health, 8809Trinity College Dublin, Dublin, Ireland
| | - David Hevey
- School of Psychology, Trinity College Research Centre for Psychological Health, 8809Trinity College Dublin, Dublin, Ireland
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9
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Brown AC, Latham C, Danquah AN, Dunlop BJ, Taylor PJ. "Cover up your arms, you're triggering people": A Mixed-Methods Investigation of Shame in those who Self-Injure. Psychol Psychother 2022; 95:701-716. [PMID: 35411671 PMCID: PMC9543642 DOI: 10.1111/papt.12394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 03/23/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Shame can be a powerfully aversive emotion that is associated with a wide variety of mental health difficulties including non-suicidal self-injury (NSSI). This study used a novel mixed-methods design (Qualitative Experiential Sequence Tracking; QUEST) to investigate the experiences of shame in a sample of individuals who self-injure. METHODS Six participants received prompts to complete brief online diaries three times per day over a period of 2 weeks. These diaries captured information about the experience of negative emotions, especially shame. Participants then underwent an individualised qualitative interview about their experiences over the previous 2 weeks. RESULTS Thematic analysis suggested that participants experienced shame as a social and relational emotion. Further themes included shame being associated with feelings of failure, being trapped, dangerous or contaminated, and hidden or exposed. The phenomenology of shame, and coping with shame, were also themes. NSSI could occur as a response to shame, but often shame was triggered or exacerbated by the responses of others to NSSI. CONCLUSIONS Consistent with previous research, shame was described as an aversive emotion occurring within interpersonal and broader societal contexts and involving a negative self-focus. A lack of compassion or understanding in response to NSSI, or anticipation of negative responses from others often triggered more intense shame than the NSSI itself. Future studies could use QUEST methodology with more diverse samples or different populations to further investigate experiences of shame.
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Affiliation(s)
- Alexandra C. Brown
- Division of Psychology & Mental HealthSchool of Health SciencesUniversity of ManchesterManchester Academic Health Sciences CentreManchesterUK
| | | | - Adam N. Danquah
- Division of Psychology & Mental HealthSchool of Health SciencesUniversity of ManchesterManchester Academic Health Sciences CentreManchesterUK
| | - Brendan J. Dunlop
- Division of Psychology & Mental HealthSchool of Health SciencesUniversity of ManchesterManchester Academic Health Sciences CentreManchesterUK
| | - Peter J. Taylor
- Division of Psychology & Mental HealthSchool of Health SciencesUniversity of ManchesterManchester Academic Health Sciences CentreManchesterUK
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10
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Rodrigues TF, Ramos R, Vaz AR, Brandão IM, Fernandez-Aranda F, Machado PPP. The mediating role of self-criticism, experiential avoidance and negative urgency on the relationship between ED-related symptoms and difficulties in emotion regulation. EUROPEAN EATING DISORDERS REVIEW 2022; 30:760-771. [PMID: 35501947 DOI: 10.1002/erv.2914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 04/09/2022] [Accepted: 04/16/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Difficulties in emotion regulation are thought to play a transdiagnostic role across eating disorders (ED). In the current study, we explored with a path analysis the mediating role of self-criticism, experiential avoidance and negative urgency on the relationship between ED-related symptoms and dimensions of difficulties in emotion regulation. METHOD Participants were 103 female outpatients recruited at a Portuguese ED hospital unit, diagnosed with an ED, aged 14-60 years old (M = 28.0, SD = 10.5), body mass index (BMI) ranging from 11.72 to 39.44 (M = 20.1, SD = 5.4). RESULTS The path analysis resulted in a model with an adequate fit to the data (SRMR = 0.05; RMSEA = 0.07 [0.00, 0.12], PCLOSE = 0.269; TLI = 0.97; IFI = 0.99; GFI = 0.95). A final model in which the relationship between ED-related symptoms and dimensions of difficulties in emotion regulation was mediated by self-criticism, experiential avoidance and negative urgency, accounted for a variance of 71% for strategies, 57% for non-acceptance, 62% for impulses, 56% for goals and 20% for clarity. CONCLUSION Results suggest that self-criticism, experiential avoidance and negative urgency, combined, are relevant in the relationship between ED-related symptoms and difficulties in emotion regulation. ED treatment and emotion regulation skills may be enhanced through the inclusion of specific components that target self-criticism, experiential avoidance and negative urgency, as they become prominent during the therapeutic process.
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Affiliation(s)
- Tânia F Rodrigues
- Psychotherapy and Psychopathology Research Lab, Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Rita Ramos
- Psychotherapy and Psychopathology Research Lab, Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Ana Rita Vaz
- Psychotherapy and Psychopathology Research Lab, Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Isabel Marques Brandão
- Psychiatry Department, Faculty of Medicine, Hospital of S. João, University of Porto, Porto, Portugal
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Psychoneurobiology of Eating and Addictive Behaviours Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Paulo P P Machado
- Psychotherapy and Psychopathology Research Lab, Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
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Marta-Simões J, Tylka TL, Ferreira C. Adolescent girls' body appreciation: influences of compassion and social safeness, and association with disordered eating. Eat Weight Disord 2022; 27:1359-1366. [PMID: 34302279 DOI: 10.1007/s40519-021-01274-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Adolescence has been stated as a period in which body image and eating difficulties' have its greatest expression, especially in females. Nonetheless, protective factors, such as body appreciation and compassion, are not thoroughly studied in this developmental stage. The current study hypothesized that competences for self-compassion and receiving others' compassion associate positively with social safeness, and the three variables with body appreciation. Moreover, the association between body appreciation and disordered eating was analysed. A sample of Portuguese female adolescents was used. METHODS 205 participants, aged between 12 and 18, completed a set of self-report measures in the school context. Data were explored via descriptive, correlational and path analysis. RESULTS Path analysis indicated that self-compassion and receiving compassion from others associate positively with feelings of social safeness which, in turn, associate with higher body appreciation. All the variables in study associated indirectly and negatively with disordered eating, and body appreciation presented a direct and negative association with disordered eating. CONCLUSION Findings of the current study may suggest the pertinence of developing programs for female adolescents that include the cultivation of compassionate and affiliative skills to promote positive body image and to prevent or intervene with disordered eating symptoms, with potential effects on overall well-being and mental health. LEVEL OF EVIDENCE Cross-sectional descriptive study, Level V.
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Affiliation(s)
- Joana Marta-Simões
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention, University of Coimbra, Coimbra, Portugal.
| | - Tracy L Tylka
- Department of Psychology, The Ohio State University, Columbus, USA
| | - Cláudia Ferreira
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention, University of Coimbra, Coimbra, Portugal
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12
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General and body-related self-conscious emotions predict facets of restrictive eating in undergraduate women. Eat Behav 2022; 45:101624. [PMID: 35334287 DOI: 10.1016/j.eatbeh.2022.101624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 11/24/2022]
Abstract
It is well understood that mood intolerance is a predictor of eating disorder (ED) symptoms. However, it is unclear whether intolerance of specific emotional experiences predicts ED symptoms. The current study used an ecological momentary assessment design to assess associations between the intensity and intolerance of general and body-related self-conscious emotions and facets of restrictive eating. Participants were 151 female undergraduate students (Mage = 18.99, SD = 1.30 years) who completed six surveys per day for 10 consecutive days. Participants reported on the intensity and intolerance of general and body-related shame, guilt, envy, and embarrassment and cognitive restraint (thoughts about restrictive eating) and behavioral restriction (act of restrictive eating) facets of restrictive eating. Data were analyzed using multilevel modeling. Based on the between-person findings, participants higher on intensity and intolerance of general and body-related self-conscious emotions experienced higher levels of cognitive restraint and behavioral restriction relative to individuals with lower levels of the emotion intensity and intolerance predictors on average. Based on the within-person findings, experiencing a higher intolerance of body-related self-conscious emotions compared to one's average was particularly important when examining behavioral restriction. Experiencing a higher intolerance of body-related envy was able to predict increased behavioral restriction at the time of the next report. These findings may inform tailored treatment targets for mood intolerance and restrictive eating.
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13
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Emotional Eating After Manipulating Emotion Regulation: A Laboratory Study in Adolescents. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
It is often assumed that emotional eating occurs when an individual is unable to utilise emotion regulation (ER) to cope with stress. In this stress exposure study, we explored whether manipulating participants’ ER strategies (rumination or self-compassion) influenced their stress-related affect and food consumption. Fifty-three adolescents (Mage = 14.72) were included; half of the participants were instructed to use rumination as their ER strategy, and half were instructed to use self-compassion. We could not demonstrate that the ER strategies differently affected stress-related affect. However, we did find that increased Happiness following ER self-compassion predicted reduced High-Fat Sweet food consumption, whereas increased Happiness following ER rumination instead led to greater High-Fat Sweet food consumption. In participants who ruminated, food consumption reduced feelings of Frustration, but not Boredom or Happiness. Post-hoc exploration revealed that only ER self-compassion, not ER rumination, normalised levels of stress-related affect. The results highlight the need for more research into the complex relationship between ER strategies, affect states, and food types in their effect on emotional eating.
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14
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Steindl SR, Tellegen CL, Filus A, Seppälä E, Doty JR, Kirby JN. The Compassion Motivation and Action Scales: a self-report measure of compassionate and self-compassionate behaviours. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1893110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Stanley R. Steindl
- Compassionate Mind Research Group, School of Psychology, University of Queensland, Brisbane, Australia
| | - Cassandra L. Tellegen
- Compassionate Mind Research Group, School of Psychology, University of Queensland, Brisbane, Australia
| | - Ania Filus
- The University of Southern California, Los Angeles, CA, USA
| | - Emma Seppälä
- The Center for Compassion and Altruism Research and Education, Stanford University, Stanford, CA, USA
| | - James R. Doty
- The Center for Compassion and Altruism Research and Education, Stanford University, Stanford, CA, USA
| | - James N. Kirby
- Compassionate Mind Research Group, School of Psychology, University of Queensland, Brisbane, Australia
- The Center for Compassion and Altruism Research and Education, Stanford University, Stanford, CA, USA
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Perey I, Koenigstorfer J. Appearance Comparisons and Eating Pathology: A Moderated Serial Mediation Analysis Exploring Body Image Flexibility and Body Appreciation as Mediators and Self-Compassion as Moderator. Body Image 2020; 35:255-264. [PMID: 33157399 DOI: 10.1016/j.bodyim.2020.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/27/2020] [Accepted: 09/27/2020] [Indexed: 01/26/2023]
Abstract
Comparing one's body against the bodies of others is related to lower positive body image and higher eating pathology. Underlying mechanisms as well as protective factors of these relationships are yet to be discovered. The present study examined body image flexibility and body appreciation as potential mediators of the association between appearance comparisons and eating disorder psychopathology. Additionally, it was tested whether self-compassion moderates the mediation effects. In an online sample comprising 250 women (Mage = 42.66, SD = 12.24), the inverse relationship between appearance comparisons and body appreciation was mediated by body image flexibility and the positive relationship between appearance comparisons and eating disorder psychopathology was mediated by body image flexibility and serially mediated by body image flexibility and body appreciation, when controlling for body mass index and age. Simple mediations were further moderated by self-compassion, such that indirect effects were attenuated at high levels of self-compassion. Promoting body image flexibility may be one potential target for helping women to engage in less maladaptive and more adaptive ways of treating the body when comparing one's appearance. Building self-compassion may be another potential target that may protect body image flexibility and its correlates in the face of appearance comparisons.
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Affiliation(s)
- Iris Perey
- Chair of Sport and Health Management, Department of Sport and Health Sciences, Technical University of Munich, Germany
| | - Joerg Koenigstorfer
- Chair of Sport and Health Management, Department of Sport and Health Sciences, Technical University of Munich, Germany.
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16
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Finlay‐jones AL. Compassion in Clinical Practice: Current Applications and New Directions. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Amy Louise Finlay‐jones
- School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, Australia,
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17
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Mendes CB, Ferreira C. A social rank approach to disordered eating: Exploring relationships between shame, fears of compassion, striving, and body shame. Psychol Psychother 2020; 93:490-502. [PMID: 31313493 DOI: 10.1111/papt.12241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 05/30/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The impact of a social rank mentality on eating-related difficulties has been previously recognized, although mediating processes involved remain to be clarified. The current study aimed to explore the roles of insecure striving and body image shame on the relationships between external shame and fears of receiving compassion from others with eating difficulties, while controlling for BMI effects. METHODS A total of 335 women from the general population participated in this study, aged between 18 and 62 years, who completed an investigation protocol, with self-report measures. RESULTS Path analysis results showed that, when controlling for BMI, external shame and fears of compassion from others presented an indirect effect on eating difficulties, mediated by insecure striving and body image shame. The model explained 63% of the variance of eating-related difficulties. CONCLUSIONS Findings suggest that, in Western societies, women who highly feel that others negatively evaluate the self and present higher levels of fears of receiving compassion from others may endorse maladaptive strategies (as insecure striving) which in turn may lead to experiencing greater levels of body image shame and eating-related difficulties. PRACTITIONER POINTS This study suggests that therapists may observe that individuals who are vulnerable to developing body image and eating-related difficulties present high levels of shame and fears of compassion from others, as well as a need to compete to avoid inferiority. Therapeutic targets for people with eating-related difficulties may focus on shame, insecure striving, and fears of receiving compassionate and affiliative emotions. Addressing fears of receiving compassion and reducing shame may decrease the need to compete to avoid undesired inferiority and facilitate adaptive eating attitudes and behaviours.
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Affiliation(s)
- Catarina Borralho Mendes
- FPCEUC - Faculty of Psychology and Educational Sciences of the University of Coimbra, Coimbra, Portugal
| | - Cláudia Ferreira
- CINEICC - Centre for Research in Neuropsychology and Cognitive Behavioural Intervention, Coimbra, Portugal
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18
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Brennan MA, Whelton WJ, Sharpe D. Benefits of yoga in the treatment of eating disorders: Results of a randomized controlled trial. Eat Disord 2020; 28:438-457. [PMID: 32182190 DOI: 10.1080/10640266.2020.1731921] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Yoga has begun to be incorporated into the treatment of eating disorders despite limited empirical support for this practice. The purpose of this study was to investigate the efficacy of incorporating Yoga into the treatment of eating disorders. This preliminary randomized controlled trial investigated the benefits of participating in an eight-week Kripalu Yoga program for 53 women with symptoms of bulimia nervosa and binge eating disorder. Compared to waitlist controls, Yoga participants experienced decreases in binge eating frequency, emotional regulation difficulties and self-criticism, and increases in self-compassion. Yoga participants also experienced increases in state mindfulness skills across the eight weeks of the Yoga program. While these results are encouraging and suggest Yoga may have a valuable role to play in the treatment of eating disorders, it is important to stress their tentative nature. Further research, adopting a more rigorous design, is needed to address the limitations of the present study and expand on these findings.
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Affiliation(s)
- Margaret A Brennan
- Department of Educational Psychology, University of Alberta , Edmonton, Canada.,Department of Educational Psychology, University of British Columbia , Vancouver, Canada
| | - William J Whelton
- Department of Educational Psychology, University of Alberta , Edmonton, Canada
| | - Donald Sharpe
- Department of Psychology, University of Regina , Regina, Canada
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19
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Mullen G, Dowling C, Doyle J, O'Reilly G. Experiences of compassion focused therapy in eating disorder recovery: A qualitative model. COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Georgina Mullen
- Department of Psychology University College Dublin Dublin Ireland
| | - Clodagh Dowling
- Department of Psychology St Patrick's University Hospital Dublin Ireland
| | - Jillian Doyle
- Department of Psychology St Patrick's University Hospital Dublin Ireland
| | - Gary O'Reilly
- Department of Psychology University College Dublin Dublin Ireland
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20
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Duarte C, Gilbert P, Stalker C, Catarino F, Basran J, Scott S, Horgan G, Stubbs RJ. Effect of adding a compassion-focused intervention on emotion, eating and weight outcomes in a commercial weight management programme. J Health Psychol 2019; 26:1700-1715. [PMID: 31804147 DOI: 10.1177/1359105319890019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examined whether adding a compassion-focused light touch digital intervention into a commercial multicomponent weight management programme improved eating behaviour, self-evaluation and weight-related outcomes. The compassion intervention significantly reduced binge eating symptomatology and dropout, and improved psychological adjustment and self-evaluation, but did not affect weight outcomes. Compassion, self-reassurance and reductions in shame and self-criticism mediated the effect of the intervention on reductions of binge eating symptomatology. Negative self-evaluation, binge eating symptomatology, susceptibility to hunger and eating guilt were significant predictors of dropout. Findings suggest that compassion-based digital tools may help participants better manage binge eating symptomatology and self-evaluation in weight management interventions.
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21
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Barata-Santos M, Marta-Simões J, Ferreira C. Body compassion safeguards against the impact of major life events on binge eating. Appetite 2019; 134:34-39. [PMID: 30557589 DOI: 10.1016/j.appet.2018.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 11/25/2022]
Abstract
Body compassion is a fresh construct that incorporates two multidimensional concepts: body image and self-compassion. Although self-compassion has revealed a protective role against body image and eating-related problems (e.g., binge eating), the study of this specific compassionate competence focused on body image is still largely unexplored. The present study aimed to test two moderation models which hypothesized that body compassion moderates the impacts of (i) the cumulative number and (ii) negative appraisal of major life events on binge eating behaviours, in a sample of 458 women from the Portuguese general population. Results showed that body compassion was negatively associated with major life events and binge eating. Moderation analysis results demonstrated the moderator effect of body compassion on the relationship between major life events (both cumulative number and negative appraisal) and binge eating, accounting for 34% and 33% of the variance of binge eating, respectively. The moderator effect of body compassion was confirmed to low to medium levels of body compassion and, overall, results seem to suggest that, for the same levels of major life events (in number or negative appraisal), women who present higher body compassion present less binge eating symptoms. Although these data are preliminary and need support from a longitudinal design research, current findings appear to be promising by suggesting the relevance of promoting body compassion in prevention and treatment programs for disordered eating attitudes and behaviours.
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Affiliation(s)
- Mafalda Barata-Santos
- Faculty of Psychology and Educational Sciences of the University of Coimbra, Portugal
| | - Joana Marta-Simões
- CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Portugal.
| | - Cláudia Ferreira
- CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Portugal.
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22
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Pennesi JL, Wade TD. Imagery rescripting and cognitive dissonance: A randomized controlled trial of two brief online interventions for women at risk of developing an eating disorder. Int J Eat Disord 2018; 51:439-448. [PMID: 29500828 DOI: 10.1002/eat.22849] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/31/2018] [Accepted: 02/09/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This pilot study compared two brief online interventions, imagery rescripting and cognitive dissonance, to an assessment-only control condition in a sample of body-dissatisfied young women at risk of developing an eating disorder. We examined the degree to which each intervention reduced disordered eating and modified risk and protective factors for eating disorders. METHOD Female university students (N = 107, 17-28 years of age) completed a screening questionnaire, followed by random allocation to one of the three conditions, followed by a baseline assessment, body dissatisfaction induction, and brief online intervention. Participants in the active conditions then completed online daily home practice and a postintervention questionnaire. RESULTS Findings provide qualified support for the imagery rescripting intervention, with participants reporting higher body image acceptance (Cohen's d = 0.49) than the cognitive dissonance condition, and higher self-compassion (d = 0.59) and lower levels of disordered eating (d = 0.59) than the control condition, at postintervention. There was no significant impact of cognitive dissonance on any factors. Change in body image acceptance and self-compassion mediated the relationship between allocated condition and change in disordered eating at postintervention. DISCUSSION These findings provide preliminary support for the use of online-adapted imagery-based techniques (e.g., imagery rescripting) to reduce risk for the development of an eating disorder by strengthening protective factors (i.e., body image acceptance and self-compassion) and reducing disordered eating. Further exploration of the use of imagery strategies in the prevention of disordered eating is required, including prospective tests of the mechanisms of action.
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Affiliation(s)
- Jamie-Lee Pennesi
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Tracey D Wade
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
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23
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McLean L, Steindl SR, Bambling M. Compassion-Focused Therapy as an Intervention for Adult Survivors of Sexual Abuse. JOURNAL OF CHILD SEXUAL ABUSE 2018; 27:161-175. [PMID: 29131716 DOI: 10.1080/10538712.2017.1390718] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Child sexual abuse can have long-term negative impacts across psychological, physical, and interpersonal domains. Some of the common issues for survivors of sexual abuse include shame and self-blame, attachment-based difficulties, avoidant coping strategies, and reduced capacity for self-compassion. Compassion-focused therapy is a transdiagnostic intervention that specifically responds to these concerns. Compassion-focused therapy was originally developed for clients who experience high levels of shame and self-criticism and aims to strengthen the soothing and affiliative system through the cultivation of compassion. This article will highlight the theoretical alignment between some of the common issues and impacts associated with experiences of sexual abuse, with the core underlying principles of compassion-focused therapy. This includes (a) the capacity of the therapy's evolutionary framework to reduce perceptions of self-blame, (b) the cultivation of compassion to respond to feelings of shame, (c) acknowledgment of the role of early attachment experiences and facilitation of corrective affiliative experiences, (d) regulation of the threat-based system following trauma, and (e) provision of an alternative to avoidant-based coping by responding to distress with compassion. It is proposed that the theoretical framework and core focus and aims of compassion-focused therapy are highly applicable for survivors of sexual abuse and therefore holds significant promise as a treatment option for this client group.
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Affiliation(s)
- Lisa McLean
- a School of Medicine, Mayne Medical School , University of Queensland , Herston , Queensland , Australia
| | - Stanley R Steindl
- b School of Psychology , University of Queensland , St. Lucia , Queensland , Australia
| | - Matthew Bambling
- c School of Medicine, Mayne Medical School , University of Queensland , Herston , Australia
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