Shame. Self-Criticism and Self-Compassion in Eating Disorders Alexandra Barrow 2007 Thesis ...

171 Pages·2013·4.65 MB·English

Shame. Self-Criticism and Self-Compassion in Eating Disorders
Alexandra Barrow
2007
Thesis submitted to the University of Leicester in partial fulfilment of the
degree of Doctorate in Clinical Psychology
UMI Number: U2B7171
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Contents
Statement of Originality 4
Acknowledgements 5
Word Counts 6
List of Tables 7
Abstract 9
Literature Review 10
Abstract 11
Introduction 12
Method 14
Results 16
Methodological issues 38
Research and clinical implications 41
Conclusion 44
References 46
Research Report 59
Introduction 60
Research questions 68
Method 71
Design 71
Participants 71
Measures 72
Procedure 78
Results 83
Descriptive statistics 83
Research questions 88
Discussion 98
Summary of findings 98
How do the findings relate to previous studies? 102
Clinical implications 104
Methodological critique 106
Future research 109
Conclusions 111
Research Report References 113
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Critical Appraisal 123
Conceptualisation of research ideas 123
Designing the study 124
Decision-making at key points 126
The importance of the research ‘team’ 128
The impact of the research 129
Ethical issues 130
Main learning points 131
Appendix 133
A. Notes for Contributors (British Journal of Clinical Psychology)
B. Stirling Eating Disorders Scales
C. Internalised Shame Scale
D. Other As Shamer Scale
E. Forms of Self-Criticising / Attacking and Self-Reassuring Scale
F. Functions of Self-Criticising / Attacking Scale
G. Self-Compassion Scale
H. Factor Structure of the Self-Compassion Scale
I. Letters of Ethical Approval
1. Local Research Ethics Committee
2. Local R&D department approval
3. University of Leicester ethical approval
J. Introductory letter to Participants
K. Participant Information Sheet
L. Consent form
3
Statement of Originality
I confirm that this is an original piece of work.
The literature review and research report contained within this thesis have not been
submitted for any other degree, or to any other institution.
4
Acknowledgements
A number of individuals helped in the process of conducting and writing up
this study. I would like to thank Dr Ken Goss, who offered enthusiasm and support
during the undertaking of the research and who, along with all the staff at the eating
disorder service, contributed to a fantastic final year placement. Dr Steve Allan was
generous with his time and offered valuable guidance throughout the study. His
advice on numerous drafts is much appreciated. Carmen Brady at R & D offered
help and assistance with the research proposal and application to the Local Research
Ethics Committee. Thanks also go to Ellie Cavalli and Kathryn Howarth who
worked tirelessly and efficiently on the database. Finally I would like to thank my
friends, family and fellow trainees for their continued support, and Paul for his
patience and belief in me.
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Word Count
Abstract 271
Literature review 7,998
(including abstract)
Research report 10,696
Critical Appraisal 2,421
Total 21,386
6
List of Tables
Table 1. Eating disorder diagnoses 83
Table 2. Key to abbreviations for the scales 84
Table 3. Means, standard deviations and internal consistencies
for all scales 85
Table 4. Correlational analysis of Anorexic and Bulimic Cognitions
and Behaviours scales and the ISS and the OAS 88
Table 5. Correlational analysis of Anorexic and Bulimic Cognitions
and Behaviours and all self-criticism scales 90
Table 6. Correlational analysis of Anorexic and Bulimic Cognitions
and Behaviours and the Self-Compassion Scale 91
Table 7. Correlational analysis of the Self-Compassion Scale and all
shame and self-criticism scales 93
Table 8. Regression analysis of shame and self-criticism variables as
predictors of the Self-Compassion Scale 94
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Table 9. Correlational analysis of the SS and OAS and
self-criticism scales 95
Table 10. Regression analysis of the self-criticism scales as
predictors of the ISS 96
Table 11. Regression analysis of the self-criticism scales as
predictors of the OAS 96
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Shame. Self-Criticism and Self-Compassion in Eating Disorders
Alexandra Barrow
Abstract
Literature Review
Research has suggested that shame and self-criticism are important in eating
disorders. Highly shame-prone individuals are thought to have difficulty feeling
warmth for the self Self-compassion is a new construct associated with being able
to self-soothe and feel kindness for the self. To date, self-compassion has not been
explored clinically in people with eating disorders, however, cognitive therapies
have begun to incorporate related areas such as mindfulness.
Research Report
Objectives: The aim of the study was to explore relationships between eating
disorder symptoms, internal and external shame, self-criticism variables (including
self-reassurance) and self-compassion in a sample of women with eating disorders
attending an outpatient specialist eating disorder service.
Method: The study used a cross-sectional, correlational design. Seventy-six female
participants completed a series of self-report measures assessing anorexic and
bulimic cognition and behaviours, shame, self-criticism and self-compassion. Data
were analysed using Pearson’s Product Moment correlations.
Results: There were significant relationships between anorexic cognitions and
internal and external shame, and between anorexic cognitions and behaviours and
types of self-criticism. Anorexic cognitions were significantly negatively related to
self-compassion. Self-compassion was significantly negatively related to all the
shame and self-criticism variables, and positively related to self-reassuring. Self­
compassion may protect against anorexic cognitions and associated beliefs
associated with shame and self-criticism.
Conclusions: Women with eating disorders are highly shame-prone and engage in
self-critical thinking. Self-compassion may be a clinically useful construct but this
requires further research.
Critical Appraisal
The appraisal draws on the research diary and reflects upon how the ideas for the
research were conceived and highlights some learning points from the process.
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