A meta-analysis of disordered eating and its association with self-criticism and self-compassion

ObjectiveFuture treatments for eating disorders (ED) need to be enhanced by targeting maintaining mechanisms. Literature suggests self-criticism and self-critical perfectionism act as key mechanisms exacerbating ED, and self-compassion protects against self-criticism. This meta-analysis examines associations between self-criticism and self-critical perfectionism on disordered eating (DE), and reviews how self-compassion and self-criticism relate to each other with respect to DE.MethodSearches across three databases yielded 135 studies across 42,952 participants. Heterogeneity, publication bias, and quality assessments were analyzed. Moderation analyses between self-criticism measures, self-compassion measures, between clinical and nonclinical samples, and between cross-sectional and experimental studies were also conducted.ResultsRandom-effects models showed a medium positive link between self-criticism and DE (r = .37), and 10 subgroups pertaining to various measures of self-criticism utilized in literature showed small to large positive links with DE (r = .20-.52). Preliminary evidence also suggests negative relationships between self-compassion and DE (r = -.40 to -.43) and negative relationships between self-compassion and self-criticism (r = -.04 to -.88).DiscussionGreater levels of self-criticism is linked with greater levels of DE and reduced levels of self-compassion, suggesting a need to tackle self-criticism and nurture self-compassion in standard treatments for ED. Understanding these interactions better in conjunction with dismantling intervention studies can help develop more effective and efficient interventions targeting self-criticism and self-compassion for people with DE.Public Significance StatementHigher levels of self-criticism are linked with higher levels of DE and lower self-compassion. Self-compassion interventions could be more effective and efficient in reducing ED symptoms if self-criticism is tackled early in such treatments. ObjetivoResultadosLos futuros tratamientos para los trastornos de la conducta alimentaria (TCA) deben ser mejorados mediante la focalizacion en los mecanismos de mantenimiento. La literatura sugiere que la autocritica y el perfeccionismo autocritico actuan como mecanismos clave que exacerban los TCA, y que la autocompasion protege contra la autocritica. Este meta-analisis examina las asociaciones entre la autocritica y el perfeccionismo autocritico en la alimentacion disfuncional (AD), y revisa como la autocompasion y la autocritica se relacionan entre si con respecto a la AD.MetodoLas busquedas en tres bases de datos arrojaron 135 estudios con 42,952 participantes. Se analizaron la heterogeneidad, el sesgo de publicacion y las evaluaciones de calidad. Tambien se llevaron a cabo analisis de moderacion entre las medidas de autocritica, las medidas de autocompasion, entre muestras clinicas y no clinicas, y entre estudios transversales y experimentales.Los modelos de efectos aleatorios mostraron una asociacion positiva media entre la autocritica y la AD (r = .37), y 10 subgrupos relacionados con diversas medidas de autocritica utilizadas en la literatura mostraron asociaciones positivas pequenas a grandes con la AD (r = .20-.52). Ademas, evidencia preliminar sugiere relaciones negativas entre la autocompasion y la AD (r = -0.40--0.43) y relaciones negativas entre la autocompasion y la autocritica (r = -.04--.88).DiscusionLos niveles mayores de autocritica estan relacionados con mayores niveles de AD y niveles reducidos de autocompasion, lo que sugiere la necesidad de abordar la autocritica y fomentar la autocompasion en los tratamientos estandar para los TCA. Comprender mejor estas interacciones en conjunto con estudios de intervencion puede ayudar a desarrollar intervenciones mas efectivas y eficientes dirigidas a la autocritica y la autocompasion para personas con AD.