A Randomised Controlled Trial Examining the Effects of Self-Compassion Meditations on Women's Body Image

The effects of short video app-guided loving-kindness meditation on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation

OBJECTIVE

The study investigated the effects of a short video app guided loving-kindness meditation (LKM) on college students' mindfulness, self-compassion, positive psychological capital, and suicide ideation. The purpose of the study is to investigate the intervention effect of LKM training on suicidal ideation among college students with the help of the short video application and to provide an empirical basis for the exploration of early suicide intervention strategies for college students.

METHODS

We recruited 80 college students from a university in China. The final 74 eligible participants were divided into two groups: app use group (n = 37) and the control group (n = 37). The app group accepted an 8-week app use interference, while the control group underwent no interference. We measured four major variable factors (mindfulness, self-compassion, positive psychological capital, and suicide ideation) before and after the app use intervention.

RESULTS

In the app group, self-compassion and positive psychological capital were significantly higher, and suicide ideation was significantly lower than the control group. In the control group, there were no noticeable differences in any of the four variables between the pre-test and post-test.

CONCLUSIONS

Our findings demonstrate that the short video app guided LKM may help to improve self-compassion, and positive psychological capital, and reduce suicide ideation. The finding of the short video app-guided LKM's effect extends our understanding of the integrative effects of positive psychology and digital media on the reduction of suicide ideation.

The Effect of Mindfulness-Based Sexual Counseling on Sexual Distress, Attitude Toward Sexuality, and Body Image Concerns in Pregnant Women: A Randomized Controlled Trial

INTRODUCTION

Sexual distress during pregnancy can cause a negative attitude toward sexuality during pregnancy, and this can be seen especially in conjunction with body image concerns. This study was conducted to determine the effects of mindfulness-based sexual counseling (MBSC) on sexual distress, attitudes toward sexuality, and body image concerns in pregnant women.

METHODS

A randomized controlled trial was conducted in a sample of women who experienced sexual distress presenting to a Healthy Living Center in eastern Turkey. Women (N = 134) were randomly assigned to receive a 4-week, 8-session counseling program based on mindfulness (experimental group; n = 67) or treatment as usual (control group; n = 67). The primary outcome of the study, sexual distress, was assessed using the Female Sexual Distress Scale-Revised. Secondary outcomes included attitude toward sexuality, assessed using the Attitude Scale toward Sexuality during Pregnancy, and body image concerns, using the Body Image Concerns during Pregnancy Scale. Outcomes were compared postintervention, correcting for baseline using analysis of covariance. The study was registered with ClinicalTrials.gov (NCT04900194).

RESULTS

Mean scores for sexual distress (7.69 vs 17.36; P < .001) and body image concerns (57.76 vs 73.88; P < .001) decreased significantly in the mindfulness group compared with the control group. Similarly, mean scores for attitudes toward sexuality significantly improved in the mindfulness group compared with the control group (133.52 vs 105.78; P < .05).

DISCUSSION

MBSC is a promising strategy to help women experiencing sexual distress during pregnancy to reduce their levels of sexual distress, raise their positive attitudes toward sexuality, and lower their body image concerns. Larger clinical trials of MBSC are recommended to support introduction of MBSC into clinical practice.

A pilot randomized trial of self-compassion writing for young adult women engaged in emotional eating in the context of appearance-related cyberbullying

OBJECTIVE

To investigate the effectiveness of a 10-min self-compassion writing in alleviating body dissatisfaction, self-objectification, and emotional eating in young adult women engaged in emotional eating in the context of appearance-related cyberbullying.

METHOD

A total of 175 Chinese young adult women (Mage  = 20.90, SD = 1.65) were randomly assigned to one of the three groups: self-compassion, distraction, or control group. At baseline, participants completed assessments of trait and state body dissatisfaction, trait self-objectification, trait self-compassion, emotional eating, and positive and negative affect. Then they needed to recall an appearance-related cyberbullying victimization experience, after which state body dissatisfaction, state self-objectification, and positive and negative affect were measured. After the intervention, participants completed measures of state body dissatisfaction, state self-objectification, positive and negative affect, state self-compassion, and a food-choosing task. At 1-month follow-up, participants completed measures of trait body dissatisfaction, trait self-objectification, trait self-compassion, and emotional eating.

RESULTS

At post-intervention, state body dissatisfaction and negative affect were significantly lower, and positive affect was significantly higher in both the self-compassion and distraction groups compared to control. State self-objectification was significantly lower in the self-compassion group than in the other two groups. At 1-month follow-up, the self-compassion group showed significantly lower levels of body dissatisfaction than the control group.

DISCUSSION

The findings provide initial evidence for the potential of self-compassion writing in reducing state self-objectification and state body dissatisfaction in the context of appearance-related cyberbullying.

PUBLIC SIGNIFICANCE

Appearance-related cyberbullying, a common phenomenon in social networking sites, has been documented to associate with appearance-related concerns and disordered eating in young adult women. However, effective interventions that can reduce these negative associations are scarce. This study preliminarily found that a brief self-compassion writing could be a potential intervention for reducing state self-objectification and state body dissatisfaction in young adult women who had suffered appearance-related cyberbullying.

Physiological response to self-compassion versus relaxation in a clinical population

BACKGROUND

Compassion-focused imagery (CFI) can be an effective emotion-regulation technique but can create threat-focused responses in some individuals. However, these findings have been based on tasks involving receiving compassion from others.

AIMS

This study sought to compare responses CFI involving self-compassion to relaxation and a control task, and to see whether any threat-responses to self-compassion and relaxation decrease with practice.

METHOD

25 participants with depression/anxiety symptoms and high self-criticism and/or low self-compassion engaged in three tasks (control task, relaxation imagery, and CFI) at three or four separate testing sessions, every three days. Heart-rate variability (HRV) was used to explore group-level differences between tasks. Additionally, we identified how many individuals showed a clinically significant change in HRV in response to compassion (compared to baseline) and how many showed such a change during relaxation (compared to baseline).

RESULTS

During session 1, more individuals had a clinically significant increase in HRV in response to CFI (56%) than in response to relaxation (44%), and fewer had a clinically significant decrease in HRV during CFI (16%) than during relaxation (28%). Comparing the group as a whole, no significant differences between tasks were seen. Repeated sessions led to fewer positive responses to CFI, perhaps reflecting habituation/boredom.

CONCLUSIONS

These preliminary findings suggest that in high self-critics (those most likely to find self-compassion difficult), self-compassionate imagery is no more challenging than standard relaxation tasks. For both compassion and relaxation, some individuals respond positively and others negatively. For those who are not benefiting, practice alone is not sufficient to improve response. Effects may differ for other compassion tasks.

TRIAL REGISTRATION

Trial number: NCT04647318.

Meditation practices and their relationship with eating behavior, weight changes, and mental health in adults from different regions of Brazil: A cross-sectional study

OBJECTIVES

This study aimed to evaluate the effect of different meditation practices on eating behavior, changes in body weight, and mental health.

METHODS

A virtual questionnaire was used to evaluate meditation practices and current and prepandemic weights. The questionnaire comprised specific and validated instruments to evaluate body image (silhouette scale), eating behavior (21-item three-factor eating questionnaire), current sleep quality (Pittsburgh Sleep Quality Index), and anxiety (Beck Anxiety Inventory). Initially, data from all the respondents were assessed (n = 764). Mindfulness was the most common type of meditation practice in most Brazilian regions.

RESULTS

Lower scores in uncontrolled eating (meditation practitioners = 32.19 ± 19.72 and non-meditation practitioners = 35.17 ± 20.50; P = 0.038) and higher weight loss (meditation practitioners = -0.77 ± 8.44 and non-meditation practitioners = 1.29 ± 6.39; P = 0.013) were observed among those who practiced some type of meditation. To verify the influence of weight, we analyzed the data of individuals who had body mass index ≥25 kg/m²; overweight individuals presented lower uncontrolled eating scores when they practiced meditation. However, no statistical difference was observed between meditation practitioners and non-practitioners when only adequate weight individuals were evaluated. The practice also influenced the perception of body image among men and resulted in lower uncontrolled eating scores on the 21-item three-factor eating questionnaire and greater weight loss during the pandemic among women. Those practicing meditation for >13 mo had a lower final score on the anxiety assessment instrument compared with those practicing for <12 mo (P = 0.002).

CONCLUSIONS

The findings indicate that the inclusion of meditation practice as part of the management of overweight may reduce dysfunctional eating behaviors and negative emotions, thereby contributing to weight loss, especially in the long term.

The Impact of a Woodland Walk on Body Image: A Field Experiment and an Assessment of Dispositional and Environmental Determinants

Studies have shown that nature exposure is associated with a more positive body image, but field studies remain relatively infrequent. Here, we examine the impact of a woodland walk on an index of state positive body image (i.e., state body appreciation), as well as dispositional and environmental determinants of body image improvements. Eighty-seven Polish women went for a walk in Cygański Las, an ancient woodland, and completed a measure of state body appreciation before and after the walk. As hypothesised, state body appreciation was significantly higher post-walk compared to pre-walk (d = 0.56). Additionally, we found that the trait of self-compassion-but not the traits of connectedness to nature, perceived aesthetic qualities of the woodland, or subjective restoration-was significantly associated with larger improvements in state body appreciation. These results suggest that even relatively brief exposure to nature results in elevated state body appreciation, with the dispositional trait of self-compassion being associated with larger effects.

Exploring the impact of a gratitude-focused meditation on body dissatisfaction: Can a brief auditory gratitude intervention protect young women against exposure to the thin ideal?

This study aimed to determine if a brief gratitude-focused meditation would significantly impact body dissatisfaction, and whether it would serve as a protective factor from exposure to thin idealized images in a sample of undergraduate women. 176 participants (M_age= 19.75) engaged in either a gratitude meditation, mindfulness meditation, or listened to a recording of a history textbook. Women were subsequently exposed to a set of neutral images or thin ideal images. Women reported significant decreases in state body dissatisfaction following all auditory conditions, regardless of auditory content. Decreased levels of body dissatisfaction persisted through exposure to neutral images, but not through exposure to thin ideal images. Results indicated that both the gratitude and mindfulness interventions were effective in eliciting a significant increase in self-reported levels of gratitude and mindfulness compared to controls. The results of the study suggest that auditory micro-interventions can decrease body dissatisfaction in young adult women. However, further investigation into the optimal modality, length, and frequency of micro-interventions aimed at buffering the negative effects of idealized thin image exposure on women is needed.

Yoga at Every Size: A Preliminary Evaluation of a Brief Online Size-Inclusive Yoga and Body Gratitude Journaling Intervention to Enhance Positive Embodiment in Higher Weight College Women

The present pilot randomized controlled trial (RCT) evaluated the feasibility, acceptability, and preliminary efficacy of a 4-week online yoga and body gratitude journaling intervention for strengthening positive embodiment among racially-diverse higher weight college women. Seventy-five participants were initially randomized to either the yoga condition (n = 36) or to a wait-list control (n = 39). Participants completed measures of positive and negative body image, weight bias internalization, self-compassion, drive for leanness, and physical activity acceptance at both baseline and post. Preliminary results among the 42 analyzed completers (mean age = 20.9, SD = 2.4; 30% Black or African American) revealed acceptable feasibility given the low-intensity nature of the intervention reflected in a 36% attrition rate. Self-reported adherence was strong for the yoga component with 81% of participants indicating that they practiced with the videos ≥3–4 times per week as suggested. Although 71% reported completing the body gratitude journal ≥1–2 times per week, daily adherence was minimal. Acceptability was also high among participants randomized to the yoga condition as indicated by 86% expressing at least moderate levels of satisfaction with the overall program. Qualitative feedback from participants further supported the acceptability of the program and pointed to important areas in further refining the protocol in the future. Preliminary efficacy was supported by significant reductions in internal body shame and gains in body appreciation, functional body appreciation, functional body satisfaction, functional body awareness, and behavioral commitment to physical activity engagement among the yoga vs. wait-list control participants. These promising findings once replicated in larger, higher-powered trials may have important implications for extending the reach and accessibility of mind-body wellness practices like yoga to benefit racially-/ethnically-diverse college women of higher weight. This research is further responsive to the growing need for efficacious remotely-delivered, and scalable behavioral health interventions in the ongoing era of the COVID-19 pandemic. However, additional research is warranted to explore ways of enhancing engagement of participants with lower levels of positive embodiment and to further incentivize the journaling component of the intervention.

Developing a model linking self-reported nature exposure and positive body image: A study protocol for the body image in nature survey (BINS)

Exposure to natural environments has been shown to be associated with more positive body image, but much of the existing research is limited to Western European nations and little is known about the robustness of these associations in other national contexts. In this protocol paper, we present a conceptual model of the direct and indirect associations (i.e., via self-compassion, connectedness to nature, and restorative experiences in nature) between nature exposure and body appreciation. This model brings together conceptualisations from existing research, but also extends it in a number of important ways. The model will be tested through the Body Image in Nature Survey (BINS), a researcher-crowdsourced project involving researchers in multiple nations worldwide. Data collection began in December 2020 and is expected to be completed in February 2022. Data will be analysed to examine the extent to which our conceptual model is robust across nations, as well as other sociodemographic characteristics. We will also determine the extent to which key variables included in our survey are invariant across nations and associated with cultural, socioeconomic, and gender-related factors. The BINS will likely have important implications for the development of nature-based interventions to promote healthier body appreciation in diverse national contexts.

Self-Compassion Moderates the Association Between Body Dissatisfaction and Suicidal Ideation in Adolescents: A Cross-Sectional Study

Identifying risk and protective factors for suicidal ideation during adolescence is essential for suicide prevention. One potential risk factor is body dissatisfaction which appears to peak during adolescence. The present study investigated the self-compassion buffering effects in the relationship between body dissatisfaction and suicidal ideation. A convenience sample comprising 580 adolescents (mean age 16.35 years; SD = .87; range 14-18 years) was recruited from public schools. The results indicated a strong positive association between body dissatisfaction and suicidal ideation (Cohen's f 2 = .25). The association was significantly moderated by the self-compassion (β =  - .16, SE = .04, p = .01, t  = 2.4.34, .95% CI [- .16, - .01]). Structural equation modeling analysis showed that the lack of self-kindness was associated with a moderate suicidal ideation level (Cohen's f 2 = .14). Also, higher levels of self-judgment predicted suicidal ideation with a moderate to large effect size (Cohen's f 2 = .28). The findings suggest that therapeutic programs designed to develop self-compassion should be implemented to reduce the risk of suicidal ideation among adolescents with body dissatisfaction. The findings empirically show that a higher degree of self-judgment is strongly associated with suicidal thoughts among adolescents, which must be systematically addressed in clinical studies on suicidal risk.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11469-021-00727-4.

Simulated nature and positive body image: A comparison of the impact of exposure to images of blue and green spaces

Previous research has shown that exposure to simulated natural environments, such as still images and film, promotes more positive state body image. However, this body of work has not distinguished between different types of natural environment, with the distinction between blue and green spaces being notable. Here, we asked a sample of 168 university students from the United Kingdom to complete a measure of state body appreciation before and after being randomly assigned to one of three groups in which they viewed images of blue spaces, green spaces, or built environments, respectively. A mixed analysis of variance showed that exposure to images of the natural environments, but not the built environments, significantly elevated state body appreciation. In addition, exposure to images of blue spaces had a stronger effect on state body appreciation than exposure to images of green spaces. These results replicate previous work showing that exposure to simulated natural environments promotes more positive state body image, but additionally shows that blue spaces may be more effective than green spaces. Implications of the present findings for the development of imagery-based interventions aimed at promoting healthier body image are discussed.

Feasibility and pilot study of a brief self-compassion intervention addressing body image distress in breast cancer survivors

BACKGROUND

The majority of breast cancer survivors (BCSs) experience body image concerns following treatment. Body Image distress (BID) is associated with psychological distress and diminished quality of life. A web-based self-compassion focused writing activity (My Changed Body - MyCB) reduces BID in BCSs, yet limited research exists on participant characteristics associated with such intervention adherence. Self-compassion-based meditations are also efficacious in reducing BID in non-BCS populations. This parallel, double-blind pilot randomised controlled trial aimed to assess the feasibility and acceptability of MyCB, with and without an additional meditation component, on BID and related psychological outcomes in BCSs. The trial was registered with the Australian and New Zealand Clinical Trials Registry (#ACTRN12619001693112).

METHODS

BCSs were randomly allocated to MyCB (n = 39), MyCB + Meditation (MyCB + M) (n = 17) or an expressive writing (EW) active control arm (n = 23). The primary outcome was BID. Secondary outcomes were body appreciation, affect (positive and negative), psychological distress (depression, anxiety and stress) and self-compassion (state and trait). Assessments were completed online at baseline, post-intervention and 1-month.

RESULTS

Adherence to the MyCB writing (45%) and meditation (50%) was modest, and acceptability was high for both MyCB and MyCB + M. Intent to treat linear mixed model analyses indicated: Post-intervention - state self-compassion and positive affect increased for MyCB compared to EW; 1-month: BID scores decreased across all conditions; trait self-compassion increased and anxiety decreased for MyCB + M compared to MyCB and EW.

CONCLUSION

These findings provide preliminary evidence for the efficacy and potential clinical use of the MyCB brief web-based self-compassion intervention alone and with the addition of meditation, to increase self-compassion and psychological wellbeing in BCSs.