Adolescent girls' body appreciation: influences of compassion and social safeness, and association with disordered eating.

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.

Potential contributing roles of early affiliative memories, social safeness and body appreciation to adolescents' well-being.

Interpersonal and body image-related factors have been associated with adolescents' well-being. Since data on positive body image in adolescence and its relationship with well-being remain scarce, the present study explored the roles of early affiliative memories, social safeness, and body appreciation in adolescents' well-being. Path analysis' results showed that social safeness and body appreciation mediated the relationship between early affiliative memories and physical, psychological and school environment well-being. This suggests that not only early affiliative memories are important for adolescents' well-being but also current feelings of social belonging and body appreciation. Future longitudinal studies should further confirm these results.

Striving as a paradoxical strategy to deal with fears of compassion: impact on disordered eating.

PURPOSE: Recent literature has documented the relationship between fears of compassion and disordered eating attitudes and behaviours. However, research on the processes underlying this association is still in the early stages. As such, this study tested a mediator model where insecure striving and inflexible eating (i.e. psychological inflexibility focused on eating) were hypothesized to mediate the impact of fears of compassion on the severity of disordered eating, while controlling for the effects of body mass index and age. METHODS: The study's sample comprised 310 Portuguese women from the general population, aged between 18 and 65 years, who completed an online survey. RESULTS: Path analysis results revealed that the impact of fear of compassion for self and for others on disordered eating was fully mediated by insecure striving and inflexible eating, whereas the impact of fear of compassion from others was only partly mediated by these processes. The tested model accounted for 48% of disordered eating's variance and presented excellent fit indices. CONCLUSIONS: These results suggest that fears of experiencing compassion may preclude the experience of social safeness, hindering the activation of social mentalities other than rank-focused mentality. Maladaptive competitive strategies may ensue (insecure striving), such as inflexible eating, which is linked to the development of disordered eating. In terms of clinical implications, these findings stress the need to effectively assess and address fears of compassion, as they not only seem to be involved in the development of disordered eating, but also have been reported to be significant predictors of poor treatment outcomes. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Exploring the paths between self-compassionate attributes and actions, body compassion and disordered eating.

The relationship between self-compassion and well-being and health (e.g. a lower proneness for eating-related disturbances) is well stressed in the literature. However, the specific contribution of self-compassionate attributes, actions, and body compassion remains scarcely studied. The main aim of the present study was to examine whether the link between self-compassionate attributes and disordered eating attitudes and behaviours is mediated by self-compassionate actions and body compassion, in a sample of 299 Portuguese women from the general population. The tested model explained 44% of eating psychopathology's variance and presented excellent fit indices. The most interesting contribution of this study was the suggestion that the ability to act in accordance with self-compassionate attributes is associated with higher levels of body compassion, that is, an attitude of appreciation, acceptance, warmth toward body-related thoughts, perceptions and feelings, which reflects in a lower susceptibility to adopt disordered eating attitudes and behaviours. These results seem to offer an important contribution for research and clinical practice by supporting the importance of including strategies to develop self-compassionate skills and body compassion competencies in prevention and treatment programs in the area of eating psychopathology.Level of evidence Level III, evidence obtained from a well-designed cohort.

Self-to-others and self-to-self relationships: paths to understanding the valence of body image and eating attitudes in emerging adult women.

PURPOSE: Interpersonal and intrapersonal factors contributing to body appreciation in emerging adult women remain poorly explored. Thus, the present study aimed to test the impact of early memories of warmth and safeness with peers, self-compassion, and social safeness, in body appreciation and in disordered eating attitudes and behaviours. METHODS: A total of 387 women aged between 18 and 25 completed a set of self-report questionnaires. Data were analysed through descriptive and correlation statistics, and the suitability of a theoretical model was explored via path analysis. Self-report instruments assessed participants' weight and height, early memories of warmth and safeness with peers, self-compassion, social safeness, body appreciation, as well as disordered eating. RESULTS: Early memories of warmth and safeness with peers associated with higher self-compassion and feelings of social safeness, which were both positively linked to body appreciation. Body appreciation associated with a lower display of disordered eating. CONCLUSION: It seems that childhood and adolescent experiences may have an important influence on the development of self-to-self and self-to-others secure relationships, with consequences on the way women behave and relate with their unique body characteristics. The pertinence of developing self-compassion and affiliative skills to promote positive body image among females is suggested, as well as of applying compassion-based strategies when clinically approaching symptoms of eating disorders. LEVEL OF EVIDENCE: Cross-sectional descriptive study, Level V.

The soothing-affiliation system and body appreciation: recollected and present affect.

Attachment and affiliation-related affect has been stated to be a powerful regulator of human development, maturation, well-being and health. Accordingly, as research on positive body image has evolved, data on the association between non-judgmental interpersonal relationships and body appreciation has emerged. The present study sought to explore a model linking memories of early affiliative relationships with body appreciation via higher current social safeness and the experience of positive affect in a sample of Portuguese women aged between 18 and 50 years (N = 286). Online data collection occurred throughout 2017. The multivariate analyses of the hypothesized model revealed good fit to the data, and results showed that early memories of warmth and safeness were associated with body appreciation via higher current social safeness and higher safeness/contentment affect. Safeness/contentment affect was the positive affect revealed as being more strongly related to body appreciation. These results provide strong support for the importance of early and current emotional bonds for women's body appreciation and suggest that therapists should consider the cultivation of affiliation skills when promoting positive body image.

Early Parental Eating Messages and Disordered Eating: The Role of Body Shame and Inflexible Eating.

The current study tested a path model that examined the association between early caregiver eating messages (restrictive and pressure to eat) and current disordered eating and whether body image shame and inflexible eating mediate this relationship, in a sample of 433 women aged from 18 to 40. Correlation analyses showed that the recall of restrictive/critical caregiver eating messages is linked to body image shame, inflexible eating and disordered eating. Path analysis results indicated the plausibility of the tested model, which accounted for 70% of the variance of disordered eating. Findings suggested that women who recall more restrictive/critical caregiver eating messages tend to present more body image-focused shame experiences and to adopt more inflexible eating rules and, consequently, engage in disordered eating and behaviors. This study contributes to a better understanding of the impact of early caregiver eating messages on disordered eating behaviors and also emphasizes the impact of maladaptive emotions and strategies, such as body image shame and adherence to inflexible eating rules on the display of disordered eating. Therefore, this paper may offer important insights for future research and for the development of intervention programs.

Body compassion safeguards against the impact of major life events on binge eating.

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.

The relation of early positive emotional memories to women's social safeness: The role of shame and fear of receiving compassion.

Early affiliative experiences play an important role in social and emotional development. Several authors have suggested that early positive experiences may be recorded as memories of warmth and soothing. However, the relationship between such memories and current feelings of social safeness and connectedness remains scarcely studied. The current study examined the association between recall of early positive affiliative experiences (with family and peers) and women's social safeness. External shame and fear of others' compassion were hypothesized to be mediators in these associations. The sample was recruited from October 2016 to February 2016 and included 400 women from the Portuguese population, aged between 18 and 55 years. The path model explained 52% of the variance of social safeness. Early positive affiliative memories (with family and peers) were associated with a lower tendency to fear receiving others' compassion and to feel ashamed, which seemed to be associated with an increased sense of social safeness. These findings offer pertinent insights for future studies in and interventions for women´s well-being and mental health by highlighting the importance of addressing shame and fears of compassion when working with women who tend to perceive their social world as unsafe and others' compassion as threatening.

Chronic illness-related cognitive fusion explains the impact of body dissatisfaction and shame on depression symptoms in breast cancer patients.

Breast cancer is linked to psychological distress and mood disorders that are in turn associated with higher psychological dysfunction and decreased breast cancer survival. It is considered that psychological health in breast cancer is considerably affected by body image impairment, which in turn seems to be highly associated with shame. However, the impact of these variables on mental health may not be direct. The current study aimed to explore a comprehensive model regarding the role of chronic illness-related cognitive fusion in the relationship of body image dissatisfaction and chronic illness-related shame with depression symptoms. The sample was composed of 75 women with nonmetastatic breast cancer, recruited in a Radiotherapy Service in central Portugal. The conducted path model presented an excellent fit and accounted for 59% of the variance of depressive symptomatology. Further, it demonstrated that body image dissatisfaction's impact on depressed mood is significantly explained by the mechanisms of chronic illness-related shame and chronic illness-related cognitive fusion. It was also revealed that chronic illness-related cognitive fusion additionally mediated the impact of chronic illness-related shame on depression. These findings are suggestive of the importance of body image and chronic illness shame in the determination of breast cancer patients' depression symptoms and also the central role of chronic illness-related cognitive fusion in these relationships. Therefore, the implementation of acceptance and defusion-based psychotherapeutic interventions to improve mental health in cancer patients seems to be of great importance.

Self-compassion: An adaptive link between early memories and women's quality of life.

Research has emphasized the important role of recalling childhood experiences on adult mental health, and also the benefits of self-compassion on well-being. This study explored self-compassion as a mediator between early memories with family and peers and quality of life, on a wide age range female sample ( N = 645). Path analysis revealed that self-compassion mediated the impact of both types of memories on women's perceived quality of life. Overall, results revealed that the recall of early positive memories, either with family and peers, associate with a more compassionate self-to-self relationship, and the perception of greater psychological and social well-being.

Development of a measure for the assessment of peer-related positive emotional memories.

OBJECTIVES: Previous research has demonstrated a link between early experiences of warmth, safeness, and soothing, and positive feelings, health, and well-being outcomes. Although the impact of positive parent-related early relationships and its posterior recall is well documented, research on the recall of warmth and safeness experiences within early peer relationships remains scarce. In fact, it is considered that the protective role of early positive peer relationships deserves intensive research; however, a specific measure that assesses this construct is still to be created. This study describes the development and validation of a new measure designed to assess the recall of early experiences of warmth, safeness, and affection in relation to peers (EMWSS-peers). DESIGN AND METHODS: Distinct samples, comprising individuals of both genders aged between 18 and 68 years old, were used to test the EMWSS-peers factorial structure through principal axis factoring (PAF) and confirmatory factor analysis (CFA), and to examine its psychometric properties. RESULTS: Principal axis factoring's results indicated that the 12-item scale presents a one-factor structure explaining a total of 71.50% of the variance. The CFA confirmed the plausibility of this structure. The EMWSS-peers also presented excellent internal consistency and construct, concurrent, and divergent validities. CONCLUSIONS: The EMWSS-peers seems to be a new avenue for the study of memories of early experiences with friends and colleagues and may entail a relevant contribution to clinical and research fields, particularly for upcoming investigations on the relationship of peer-related affiliative memories with well-being and mental health. PRACTITIONER POINTS: The EMWSS-peers is a specific measure to assess the recall of warmth and safeness in early peer relationships. The EMWSS-peers is a brief, robust, and reliable self-report instrument. The EMWSS-peers presented excellent internal consistency and construct, concurrent, and divergent validities. The EMWSS-peers may open a new avenue for the study of memories of early peer-related experiences, with potential clinical and research implications.

Developments on committed action: Validity of the CAQ-8 and analysis of committed action's role in depressive symptomatology in breast cancer patients and healthy individuals.

Committed action, a process of acceptance and commitment therapy's psychological flexibility model, is considered an understudied construct that currently can only be measured by one instrument, the Committed Action Questionnaire (CAQ-8). This study aims at analysing the psychometric properties of the CAQ-8 in healthy individuals and breast cancer patients. This study also aims to explore the specific meditational role of committed action in the well-established relationship between experiential avoidance and depression symptoms. The healthy sample comprised 294 adults from the general population, and the breast cancer samples comprised 82 participants. Both groups completed the validated self-report measures. CAQ-8's robustness was examined through validity analyses, confirmatory factor analyses, and multigroup analysis. The meditational model was conducted using structural equation modelling. The CAQ-8 presented good internal consistency and construct, convergent, concurrent, and divergent validity in both samples. Further, the CAQ-8 showed incremental validity over a measure of engaged living. Findings also demonstrated measurement invariance between healthy individuals and breast cancer patients. Regarding the conducted meditational model that was also invariant between the two analysed groups, it was demonstrated that part of the effect that experiential avoidance holds on depressive symptomatology is explained by committed action. This study suggests that the CAQ-8 is adequate for use in healthy and cancer populations. Moreover, it provides novel, empirical support regarding the links between committed action, experiential avoidance, and depressed mood, being also the first investigation to particularly study committed action in a cancer population. Implications for theory and practice are discussed.

Experiential avoidance versus decentering abilities: the role of different emotional processes on disordered eating.

In modern western societies, the female body is a predominantly used dimension in self and social evaluations. In fact, the perceived discrepancy between one's current and ideal body image may act as a pathogenic phenomenon on women's well-being. Furthermore, significant differences in the tendency to engage in disordered eating attitudes and behaviours have been verified between women sharing similar characteristics and perceptions about body's weight and shape, which suggests  that different emotion regulation processes may be involved in this association. This study thus aims to clarify the mediational effect of two different emotional regulation processes, experiential avoidance and decentering, on the association of weight and body shape-related variables  and shame with disordered eating, in a sample of 760 women. The tested path model explained 44 % of disordered eating attitudes and behaviours, and showed an excellent model fit. Results demonstrated that body mass index had a direct effect, albeit weak, on disordered eating behaviours, and that body-image discrepancy and shame presented indirect effects through the mechanisms of experiential avoidance and decentering. Results also revealed that experiential avoidance and decentering showed significant mediator effects on the relationship of weight and body shape and shame with disordered eating behaviours. These findings suggested that while experiential avoidance exacerbates the impact of weight and body shape and shame on disordered eating attitudes and behaviours, decentering seems to attenuate this association. Our findings appear to offer significant clinical and research implications, highlighting the importance of targeting maladaptive emotion processes and of the development of decentering abilities.

How can the recall of early affiliative memories with peers influence on disordered eating behaviours?

The present study aimed to explore the role of early affiliative memories with peers on the adoption of disordered eating attitudes and behaviours through the mechanisms of external shame and self-judgment. The sample used in the current study comprised 632 women from the community, aged between 18 and 60 years old.The tested model explained 22 % of eating psychopathology's variance and showed excellent model fit indices. Results indicated that the impact of the recall of early positive memories with peers on eating psychopathology was fully carried through the mechanisms of external shame and self-judgment. In fact, these findings seem to suggest that the lack of warm and safe affiliative memories with peers is linked to higher levels of shame (e.g., feelings of inferiority and inadequacy), and also to higher vulnerability to engage in maladaptive emotional strategies (such as self-judgmental attitudes), which appears to explain the increase of disordered eating behaviours.These findings contribute to the understanding of the impact of peer-related early affiliative memories in the engagement in disordered eating. Furthermore, this study has significant clinical implications, emphasizing the importance of targeting shame and maladaptive emotional strategies, especially in a context involving early adverse emotional experiences with peers.

Shame and eating psychopathology in Portuguese women: Exploring the roles of self-judgment and fears of receiving compassion.

Shame has been for long associated with the development and maintenance of body image and eating-related difficulties. However, the mechanisms underlying this association remain unclear. Therefore, the current study sought to examine the mechanisms of self-judgment and fears of receiving compassion from others in the association between external shame and disordered eating, while controlling for body mass index (BMI). Participants in this study were 400 women from the general population, aged between 18 and 55 years old. Correlation analyses revealed significant and positive relationships between external shame, self-judgment, fears of receiving compassion from others and eating psychopathology. A path analysis confirmed that, when controlling for the effect of BMI, external shame has a direct effect on disordered eating severity, and also an indirect effect, mediated by higher levels of self-judgment and increased fears of receiving others' kindness and compassion. Results showed the plausibility of the tested model which explained 36% of the variance of disordered eating. These findings seem to support that women who perceive that others view them negatively tend to be defensive and engage in maladaptive emotion regulation strategies (such as harsh critical attitudes towards the self and being resistant to others' compassion), which may trigger maladaptive eating attitudes and behaviours. The current research appears to be an innovative study in the field of body image and eating-related psychopathology and seems to represent a new avenue for future research and for the development of intervention programs.

Assessing positive emotional memories with peers: The Early Memories of Warmth and Safeness with Peers Scale for adolescents.

Research on the association between early positive relational experiences and later psychosocial adjustment is growing. The quality of peer relationships may have a particularly important effect on adolescents' wellbeing and mental health. The current study aimed at examining a measure of personal emotional memories of peer relationships characterized by warmth, safeness and affection, which occurred in childhood and adolescence (EMWSSPeers-A). Distinct samples (N = 584) of adolescents aged between 12 and 18 were used to assess the EMWSSPeers-A' factorial structure through a Principal Component Analysis and a Confirmatory Factor Analysis, and to analyse the scale's psychometric properties. Results indicated a one-dimensional structure with 12 items with very good internal consistency, and construct, convergent, divergent and incremental validities. By allowing the examination of the role played by memories of positive peer relationships on adolescents' psychological adjustment, the EMWSSPeers-A may be potentially useful for future model testing and for the assessment of interventions.

Exploring the effect of external shame on body appreciation among Portuguese young adults: The role of self-compassion.

Studies on body image-related disturbances have recently embraced a fresh and innovative construct: body appreciation. Body appreciation, an aspect of positive body image, defines as the detention of a balanced, affectionate and health-conscious relationship with one's own body's features. Its exploration is considered to be essential to the success of upcoming prevention and intervention programs in the area of body image and eating disorders. The role of shame, although widely studied in negative body image and eating psychopathology, is yet unknown regarding body appreciation. In this line, a main goal of this study was to explore the effect of external shame on body appreciation in a sample of Portuguese young adults. Also, taking into account the similarities between body appreciation and self-compassion, and since self-compassion is known as a powerful tool against the impact of shame on body image-related disturbances, this study also intended to test the role of self-compassion in the relationship between external shame and body appreciation. Results revealed body mass index and external shame as negative correlates, and self-compassion as a positive correlate of body appreciation. Also, path analysis showed that external shame holds a significant effect on body appreciation, both directly and indirectly. Specifically, this analysis revealed that self-compassion acts as a mediator between shame and body appreciation. Present findings seem to support the pertinence of programs to promote an affectionate and healthy relationship with one's own body image, which may benefit from the target of shame and the inclusion of self-compassion practices.

Defensive Responses to Early Memories with Peers: a Possible Pathway to Disordered Eating.

Childhood and early adolescence experiences, specifically those that provide an adulthood enriched with warm and safe memories, are consistently stated in literature as powerful emotional regulators. In contrast, individuals who scarcely recall positive experiences may begin to believe that others see the self as inferior, inadequate and unattractive. In order to cope with a perceived loss of social desirability and achieve other's acceptance, individuals may become submissive, and women, particularly, may resort to the presentation of a perfect body image. Both mechanisms are defensive responses suggested to be associated with mental health difficulties, particularly disordered eating behaviors. The present study aimed at exploring the association between early memories of warmth and safeness with peers and eating psychopathology. Also, a path analysis was conducted to investigate the mediator role of submissiveness and perfectionistic self-presentation focused on body image on this association, in a sample of 342 female students. Results revealed that the absence of early positive memories with peers holds a significant effect over eating psychopathology's severity, and also that this effect is mediated through submissiveness and body image-related perfectionistic self-presentation. This model accounted for 13%, 19% and 51% of submissiveness, perfectionistic self-presentation of body image and eating psychopathology's variances, respectively, and showed excellent model fit.