RESUMO
In eating disorders inpatient care, mandatory treatment components are central to effective service delivery. Thus, fostering a collaborative care environment that supports autonomy, competence, and connection can be challenging. This study examined whether collaborative care is associated with better outcomes in adult inpatient treatment and explored a possible determinant of collaborative care, the manner in which mandatory treatment components were delivered (e.g. consistent implementation of weight gain guidelines, provision of choices regarding intensity of treatment). Inpatients (N = 146) completed measures of eating disorder symptoms, psychological functioning and readiness and motivation for change, pre and post-treatment. At post, they also completed measures of collaborative care, treatment satisfaction, and a new measure designed to evaluate patients' experiences of mandatory treatment components. After controlling for baseline symptom levels, multiple regression analyses determined that collaborative care was associated with improvements in nearly all symptom domains. Collaborative care was also associated with patient satisfaction and the manner in which mandatory treatment components were delivered (e.g. consistency, provision of choices). In sum, a collaborative environment was associated with improvements in motivation, eating disorder symptoms, and psychiatric functioning and one way in which this may be achieved is in the manner in which mandatory treatment components are delivered.
Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Pacientes Internados , Adulto , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Hospitalização , Humanos , Motivação , Satisfação do PacienteRESUMO
There is growing support for the role of self-compassion in recovery from an eating disorder (ED) and two types of barriers have been identified in this population: (a) fears that self-compassion will result in a failure to meet personal and interpersonal standards (meeting standards); and (b) fears that self-compassion gives rise to difficult emotions such as grief and unworthiness (emotional vulnerability). OBJECTIVE: This research examined the relative contribution of meeting standards and emotional vulnerability barriers to the clinical characteristics of individuals with EDs. METHOD: Participants (N = 349) completed the fears of compassion for self-scale, and measures of self-compassion, ED and psychiatric symptom severity, interpersonal and affective functioning, quality of life and readiness for ED change. RESULTS: Together, the two barrier types accounted for significant variance in all study variables. Meeting standards was associated with lower readiness to change and greater over-control. In contrast, emotional vulnerability was associated with lower self-compassion, readiness, and quality of life, poorer interpersonal and affective functioning, and greater ED and psychiatric severity. CONCLUSION: While both barriers to self-compassion were related to functioning in individuals with EDs, the emotional vulnerability barrier accounted for more variance in pathology and may be most beneficial to target in treatment.
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Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Qualidade de Vida/psicologia , Autoimagem , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Research on self-compassion and depressive symptoms is growing at an exponential pace. This systematic review provides an in-depth exploration of the relation between self-compassion and depressive symptoms in adolescents. In accordance with PRISMA guidelines, MEDLINE, CINAHL, and PsycINFO databases were systematically searched and 18 studies were identified. Results demonstrate the potentially pertinent role that self-compassion may play in the development, maintenance, and treatment of depression in adolescents, yet reflect on the paucity of research on this topic with respect to mechanisms of change. These studies further highlight how the impact of self-compassion may differ according to gender and age and underscore the need to account for other diversity-related variables, such as ethnic-racial group, socioeconomic status, and sexual orientation. Despite such limitations in the literature, the current findings extend research in adults by providing support for the relevance of self-compassion in adolescence, particularly with respect to the prevention of depressive symptoms.
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Depressão/prevenção & controle , Empatia , Autoimagem , Adolescente , Adulto , Depressão/psicologia , Feminino , Humanos , Masculino , Psicologia do AdolescenteRESUMO
This study experimentally tested the effects of taking a one-week break from social media (SM) on body image and self-esteem among young women. Female undergraduate students (N = 66) were randomly assigned to either take a one-week break from SM or continue their normal use (control condition). State self-esteem and body satisfaction were measured at baseline (Time 1) and one week later (Time 2). As predicted, participants in the break condition reported higher body satisfaction and higher state self-esteem (total, performance, social, and appearance domains) at Time 2 than did those in the control condition, controlling for Time 1 scores. The benefits of taking a break from SM on body satisfaction were especially pronounced for women with higher baseline levels of thin-ideal internalization. The findings demonstrate the short-term benefits of taking a break from SM for one week on self-esteem and body image among young women.
Assuntos
Imagem Corporal , Satisfação Pessoal , Autoimagem , Mídias Sociais , Humanos , Feminino , Imagem Corporal/psicologia , Adulto Jovem , Adolescente , Estudantes/psicologia , Adulto , Inquéritos e Questionários , Controle Interno-ExternoRESUMO
Fitspiration, or imagery of thin muscular individuals that displays their physiques while posing or exercising, is a popular type of content on Instagram which ostensibly exists to encourage individuals to engage in a healthy lifestyle. A subtype of fitspiration imagery, "transformation" imagery, depicts physical changes following a "lifestyle change" involving diet and exercise. Despite its intentions, fitspiration imagery largely promotes one idealized body type (the fit ideal) and can be accompanied by messages encouraging restrained eating. Viewing fitspiration imagery has been associated with body dissatisfaction and appearance comparison in women, but the impact of transformation imagery specifically on women's body image has not yet been studied, nor has the impact of the broader fitspiration category and the transformation subtype on women's body image been compared. The current study aimed to clarify the relations between fitspiration and transformation imagery, appearance comparison, and body satisfaction using an experimental design. Female participants (N = 161) completed a measure of body satisfaction and then were randomly assigned to view one of three types of images: fit ideal only, body transformation, or travel (control). Participants then completed measures of appearance comparison and body satisfaction. Viewing fit ideal only and body transformation imagery was associated with lower body satisfaction and higher appearance comparison. The relation between image type and changes in body satisfaction was mediated by appearance comparison. Findings suggest that individuals may benefit from limiting exposure to fit ideal and body transformation imagery, particularly if they are vulnerable to engaging in appearance comparison.
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Insatisfação Corporal , Mídias Sociais , Feminino , Humanos , Imagem Corporal , Exercício Físico , Satisfação PessoalRESUMO
BACKGROUND: Collaborative care is described as showing curiosity and concern for patient experiences, providing choices, and supporting patient autonomy. In contrast, in directive care, the clinician has authority and the patient is expected to adhere to a treatment plan over which they have limited influence. In the treatment of eating disorders, collaborative care has been shown to be more acceptable and produce better outcomes than directive care. Despite widespread patient and clinician preference for collaborative care, it is common for clinicians to be directive in practice, resulting in negative patient attitudes toward treatment and poor adherence. There is a need to understand factors which contribute to its use. PURPOSE: This study examined the contribution of clinicians' experience of distress and how they relate to themselves and others in times of difficulty (self-compassion and compassion for others), to their use of collaborative support. METHOD: Clinicians working with individuals with eating disorders from diverse professional backgrounds (N = 123) completed an online survey. RESULTS: Whereas clinician distress was not associated with use of collaborative or directive support behaviours, self-compassion and compassion for others were. Regression analyses indicated that compassion for others was the most important determinant of collaborative care. DISCUSSION: Relating to their own and others' distress with compassion was most important in determining clinicians' use of collaborative support. Understanding how to cultivate conditions that foster compassion in clinical environments could promote the delivery of collaborative care.
RESUMO
With the popularity of image-based social media platforms like Instagram, researchers have begun to study relationships between social media and body image. Much of this research has used quantitative research methods, which cannot capture the rich, inner experiences of individuals. Given the dearth of qualitative research on what young women internally experience when viewing "Thinspiration" or "Fitspiration," this study used the consensual qualitative research (CQR) method, with the aim of capturing in their own words what young women feel and think in response to viewing fitspiration and thinspiration. Twelve young women viewed Fitspiration and Thinspiration profiles and were interviewed about these and similar everyday experiences. The CQR analytic team identified 10 general, 18 typical, and 11 variant domains (i.e., topic areas). An example general domain was "body image," under which the category "body dissatisfaction," fell; by viewing Thinspiration or Fitspiration, these young women were reminded how they are dissatisfied with how they see their own body or were prompted to believe others are reminded of this when viewing such content. An example typical domain was "diet/disordered eating"; several participants associated Thinspiration or Fitspiration with diet or disordered eating. From five of the 10 general domains emerged what we call an emergent dialectical theory of social media and body image. When viewing Thinspiration or Fitspiration, young women often seemed to feel or think two seemingly opposite things simultaneously within the topic areas of attainability, emotional reactions, social comparison, body image, and health.
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Insatisfação Corporal , Mídias Sociais , Humanos , Feminino , Imagem Corporal/psicologia , Emoções , Pesquisa QualitativaRESUMO
Body image is an integral aspect of the psychology of the self. Idealized body images are ubiquitous in both traditional media forms (e.g., magazines, television) and social media (e.g., Facebook, Instagram). The classic sociocultural model of body image (i.e., the Tripartite Influence Model) emphasizes pathways between idealized body norms, appearance comparisons, internalization of body ideals, and body dissatisfaction and its outcomes. We summarize the model and identify some issues to be addressed in future work, particularly in light of the immense popularity of social media. We review three topics that are not included in the sociocultural model but that provide a more complete picture of the influence of societal body norms on body image: (1) body shame, (2) positive body image, and (3) self-compassion. Research on the nature, assessment, and relevance of these constructs is reviewed in detail. In terms of clinical applications of these areas of research for individuals at risk of body dissatisfaction, we suggest assessing for and targeting body shame, cultivating facets of positive body image, and teaching strategies for developing self-compassion.
RESUMO
BACKGROUND: Individuals with eating disorders (EDs) experience barriers to self-compassion, with two recently identified in this population: Meeting Standards, or concerns that self-compassion would result in showing flaws or lead to loss of achievements or relationships, and Emotional Vulnerability, or concerns that self-compassion would elicit difficult emotions such as grief or anger. This exploratory study examined the utility of self-compassion and two barriers to self-compassion in predicting clinical outcomes in intensive ED treatments. METHOD: Individuals in inpatient (n = 87) and residential (n = 68) treatment completed measures of self-compassion and fears of self-compassion, and ten clinical outcome variables at pre- and post-treatment. RESULTS: Pre-treatment self-compassion was generally not associated with outcomes, whereas pre-treatment self-compassion barriers generally were. In both treatment settings, fewer Emotional Vulnerability barriers were associated with improved interpersonal/affective functioning and quality of life, and fewer Meeting Standards barriers were associated with improved readiness and motivation. Interestingly, whereas Meeting Standards barriers were associated with less ED symptom improvement in inpatient treatment, Emotional Vulnerability barriers were associated with less ED symptom improvement in residential treatment. CONCLUSIONS: Given that few longitudinal predictors of outcome have been established, the finding that pre-treatment barriers to self-compassion predict outcomes in both inpatient and residential settings is noteworthy. Targeting self-compassion barriers early in treatment may be helpful in facilitating ED recovery.
Self-compassion is associated with a number of positive health indicators and has been shown to support recovery from an eating disorder. This exploratory study examined whether self-compassion and barriers to self-compassion predict clinical outcomes in inpatient and residential eating disorders treatment settings. Whereas self-compassion was rarely associated with outcome, self-compassion barriers were associated with the majority of variables investigated. Given that few longitudinal predictors have been established in this field, the relation between barriers to self-compassion and outcome in both inpatient and residential settings is noteworthy. Targeting self-compassion barriers early in treatment may be helpful in facilitating eating disorder recovery.