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Int J Eat Disord. 2016 Jul;49(7):716-22. doi: 10.1002/eat.22527. Epub 2016 Apr 6.

Within-persons predictors of change during eating disorders treatment: An examination of self-compassion, self-criticism, shame, and eating disorder symptoms.

Author information

1
Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
2
Department of Psychiatry, University of Ottawa and the Ottawa Hospital, Ottawa, Ontario, Canada.
3
Department of Psychology, University of Ottawa and the Ottawa Hospital, Ottawa, Ontario, Canada.

Abstract

OBJECTIVE:

Attempts to identify the predictors of change during eating disorders treatment have focused almost exclusively on identifying between-persons factors (i.e., differences between patients). Research on within-person predictors of change (i.e., variations within patients over time) may provide novel and clinically useful information. To illustrate, we test the theory that within patients, self-compassion, self-criticism, shame, and eating disorder symptoms reciprocally influence one another over time.

METHOD:

Seventy-eight patients with an eating disorder completed the Self-Compassion Scale, Experience of Shame Scale, and Eating Disorder Examination Questionnaire every three weeks across 12 weeks of treatment.

RESULTS:

Multilevel modeling revealed that following periods of increased shame, a patient's eating pathology was more severe than usual. Following periods of increased self-compassion or decreased eating pathology, a patient's level of shame was lower than usual. Between-person differences in the relationships among study variables also emerged.

DISCUSSION:

Results support the theory that shame and eating pathology influence one another cyclically within patients over time, and suggest that time-dependent increases in self-compassion may interrupt this cycle. If replicated, these results might suggest that assessing and intervening with increases in a patient's level of shame may help to reduce her eating pathology, and improving a patient's level of self-compassion or eating disorder symptomology may lower her subsequent experiences of shame. Findings highlight the value of administering and examining repeatedly measured within-person predictors of change during eating disorders treatment, and suggest that it may be clinically important to attend to the changes that occur within a given patient over time. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:716-722).

KEYWORDS:

anorexia nervosa; between-persons; bulimia nervosa; eating disorders; multilevel modeling; self-compassion; self-criticism; shame; treatment process; within-persons

PMID:
27061929
DOI:
10.1002/eat.22527
[Indexed for MEDLINE]

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