Skip to main content
SpringerLink
Log in

Self-disgust and urge to be thin in eating disorders: how can self-compassion help?

  • Original Article
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to examine the moderator role of self-compassion in the relationship between self-disgust and drive for thinness, controlling for external shame, in eating disorder patients and in a community sample.

Methods

Sixty-two female participants with an eating disorder diagnose and 119 female participants from the community, were asked to fill instruments that assess self-disgust, self-compassion, drive for thinness, and external shame.

Results

We found a moderator effect of self-compassion on the association between self-disgust and drive for thinness in the clinical sample when adjusting for shame. The association between self-disgust and drive for thinness was buffered among those who reported medium and lower levels of self-compassion. Replicating the findings in the community sample we found no moderator effect of self-compassion.

Conclusion

These results provide evidence that people with eating disorders who perceive the self as highly disgusting may benefit from promoting a self-compassionate response to diminish drive for thinness.

Level of evidence

Level V, cross-sectional descriptive study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Davey GCL (2011) Disgust: the disease-avoidance emotion and its dysfunctions. Philos Trans R Soc B Biol Sci 366:3453–3465. https://doi.org/10.1098/rstb.2011.0039

    Article  Google Scholar 

  2. Powell PA, Simpson J, Overton PG (2015) An introduction to the revolting self: self-disgust as an emotion schema. In: Powell PA, Overton PG, Simpson J (eds) The revolting self: perspectives on the psychological, social, and clinical implications of self-directed disgust. Karnac Books Ltd, London, pp 1–24

    Google Scholar 

  3. Gilbert P (2015) Self-disgust, self-hatred, and compassion-focused therapy. In: Powell PA, Overton PG, Simpson J (eds) The revolting self: perspectives on the psychological, social, and clinical implications of self-directed disgust. Karnac Books Ltd, London, pp 223–242

    Google Scholar 

  4. Powell PA, Overton PG, Simpson J (2014) The revolting self: an interpretative phenomenological analysis of the experience of self-disgust in females with depressive symptoms. J Clin Psychol 70:562–578. https://doi.org/10.1002/jclp.22049

    Article  PubMed  Google Scholar 

  5. Roberts T-A, Goldenberg JL (2007) Wrestling with nature: an existential perspective on the body and gender in Self-conscious emotions. In: Tracy JL, Robins RW, Tangney JP (eds) The self-conscious emotions: theory and research. The Guilford Press, New York, pp 389–406

    Google Scholar 

  6. Espeset EMS, Gulliksen KS, Nordbã RHS et al (2012) The link between negative emotions and eating disorder behaviour in patients with anorexia nervosa. Eur Eat Disord Rev 20:451–460. https://doi.org/10.1002/erv.2183

    Article  PubMed  Google Scholar 

  7. Powell PA, Simpson J, Overton PG (2013) When disgust leads to dysphoria: a three-wave longitudinal study assessing the temporal relationship between self-disgust and depressive symptoms. Cogn Emot 27:900–913. https://doi.org/10.1080/02699931.2013.767223

    Article  PubMed  Google Scholar 

  8. Clarke A, Simpson J, Varese F (2019) A systematic review of the clinical utility of the concept of self-disgust. Clin Psychol Psychother 26:110–134. https://doi.org/10.1002/cpp.2335

    Article  PubMed  Google Scholar 

  9. Gilbert P, Clarke M, Hempel S et al (2004) Criticizing and reassuring oneself: an exploration of forms, styles and reasons in female students. Br J Clin Psychol 43:31–50. https://doi.org/10.1348/014466504772812959

    Article  CAS  PubMed  Google Scholar 

  10. Amir N, Najmi S, Bomyea J, Burns M (2010) Disgust and anger in social anxiety. Int J Cogn Ther 3:3–10. https://doi.org/10.1521/ijct.2010.3.1.3

    Article  Google Scholar 

  11. Olatunji BO, Cox R, Kim EH (2015) Self-disgust mediates the associations between shame and symptoms of bulimia and obsessive-compulsive disorder. J Soc Clin Psychol 34:239–258. https://doi.org/10.1521/jscp.2015.34.3.239

    Article  Google Scholar 

  12. Overton PG, Markland FE, Taggart HS et al (2008) Self-disgust mediates the relationship between dysfunctional cognitions and depressive symptomatology. Emotion 8:379–385. https://doi.org/10.1037/1528-3542.8.3.379

    Article  CAS  PubMed  Google Scholar 

  13. Chu C, Bodell LP, Ribeiro JD, Joiner TE (2015) Eating disorder symptoms and suicidal ideation: the moderating role of disgust. Eur Eat Disord Rev 23:545–552. https://doi.org/10.1002/erv.2373

    Article  PubMed  Google Scholar 

  14. O’Brien KS, Daníelsdóttir S, Ólafsson RP et al (2013) The relationship between physical appearance concerns, disgust, and anti-fat prejudice. Body Image 10:619–623. https://doi.org/10.1016/j.bodyim.2013.07.012

    Article  PubMed  Google Scholar 

  15. Fredrickson BL, Noll SM, Roberts TA et al (1998) That swimsuit becomes you: sex differences in self-objedification, restrained eating, and math performance. J Pers Soc Psychol 75:269–284. https://doi.org/10.1037/0022-3514.75.1.269

    Article  CAS  PubMed  Google Scholar 

  16. Stasik-O’Brien SM, Schmidt J (2018) The role of disgust in body image disturbance: incremental predictive power of self-disgust. Body Image 27:128–137. https://doi.org/10.1016/j.bodyim.2018.08.011

    Article  PubMed  Google Scholar 

  17. Bornholt L, Brake N, Thomas S et al (2005) Understanding affective and cognitive self-evaluations about the body for adolescent girls. Br J Health Psychol 10:485–503. https://doi.org/10.1348/135910705X41329

    Article  PubMed  Google Scholar 

  18. Ille R, Schöggl H, Kapfhammer HP et al (2014) Self-disgust in mental disorders—symptom-related or disorder-specific? Compr Psychiatry 55:938–943. https://doi.org/10.1016/j.comppsych.2013.12.020

    Article  PubMed  Google Scholar 

  19. Fairburn CG, Cooper Z, Shafran R (2003) Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behav Res Ther 41:509–528. https://doi.org/10.1016/S0005-7967(02)00088-8

    Article  PubMed  Google Scholar 

  20. Engeln-Maddox R (2006) Buying a beauty standard or dreaming of a new life? Expectations associated with media ideals. Psychol Women Q 30:258–266. https://doi.org/10.1111/j.1471-6402.2006.00294.x

    Article  Google Scholar 

  21. Garner DM, Olmstead MP, Polivy J (1983) Development and validation of a Multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia. Int J Eat Disord 2:15–34. https://doi.org/10.1002/1098-108X(198321)2:2<15::AID-EAT2260020203>3.0.CO;2-6

  22. Stice E (2002) Risk and maintenance factors for eating pathology: a meta-analytic review. Psychol Bull 128:825–848. https://doi.org/10.1037/0033-2909.128.5.825

    Article  PubMed  Google Scholar 

  23. Fox JRE, Power MJ (2009) Eating disorders and multi-level models of emotion: an integrated model. Clin Psychol Psychother 16:240–267. https://doi.org/10.1002/cpp.626

    Article  PubMed  Google Scholar 

  24. Gilbert P, Irons C (2005) Focused therapies and compassionate mind training for shame and self-attacking. In: Gilbert P (ed) Compassion: conceptualisations, research and use in psychotherapy. Routledge, London, pp 263–325

    Chapter  Google Scholar 

  25. Gilbert P (2010) Compassion-focused therapy: the CBT distinctive features series. Routledge/Taylor & Francis Group, New York

    Book  Google Scholar 

  26. Goss K, Allan S (2014) The development and application of compassion-focused therapy for eating disorders (CFT-E). Br J Clin Psychol 53:62–77. https://doi.org/10.1111/bjc.12039

    Article  PubMed  Google Scholar 

  27. Leaviss J, Uttley L (2015) Psychotherapeutic benefits of compassion-focused therapy: an early systematic review. Psychol Med 45:927–945. https://doi.org/10.1017/S0033291714002141

    Article  CAS  PubMed  Google Scholar 

  28. Craig C, Hiskey S, Spector A (2020) Compassion focused therapy: a systematic review of its effectiveness and acceptability in clinical populations. Expert Rev Neurother 20:385–400. https://doi.org/10.1080/14737175.2020.1746184

    Article  CAS  PubMed  Google Scholar 

  29. Wilson AC, Mackintosh K, Power K, Chan SWY (2019) Effectiveness of self-compassion related therapies: a systematic review and meta-analysis. Mindfulness (N Y) 10:979–995. https://doi.org/10.1007/s12671-018-1037-6

    Article  Google Scholar 

  30. Kirby JN, Tellegen CL, Steindl SR (2017) A meta-analysis of compassion-based interventions: current state of knowledge and future directions. Behav Ther 48:778–792. https://doi.org/10.1016/j.beth.2017.06.003

    Article  PubMed  Google Scholar 

  31. Gilbert P (2009) The compassionate mind: a new approach to life’s challenges. Constable, London

    Google Scholar 

  32. Gilbert P (2014) The origins and nature of compassion focused therapy. Br J Clin Psychol 53:6–41. https://doi.org/10.1111/bjc.12043

    Article  PubMed  Google Scholar 

  33. Goss K, Allan S (2010) Compassion focused therapy for eating disorders. Int J Cogn Ther 3:141–158. https://doi.org/10.1521/ijct.2010.3.2.141

    Article  Google Scholar 

  34. Palmeira L, Pinto-Gouveia J, Cunha M (2019) The role of self-disgust in eating psychopathology in overweight and obesity: can self-compassion be useful? J Health Psychol 24:1807–1816. https://doi.org/10.1177/1359105317702212

    Article  PubMed  Google Scholar 

  35. Powell PA, Simpson J, Overton PG (2015) Self-affirming trait kindness regulates disgust toward one’s physical appearance. Body Image 12:98–107. https://doi.org/10.1016/j.bodyim.2014.10.006

    Article  PubMed  Google Scholar 

  36. Carreiras D (2014) The toxicity of the self: Developing a new measure and testing a comprehensive model of the nature of self-disgust. Unpublished Master Dissertation, University of Coimbra. https://estudogeral.sib.uc.pt/handle/10316/27653

  37. Neff KD (2003) The development and validation of a scale to measure self-compassion. Self Identity 2:223–250. https://doi.org/10.1080/15298860390209035

    Article  Google Scholar 

  38. Castilho P, Pinto-Gouveia J, Duarte J (2015) Evaluating the multifactor structure of the long and short versions of the Self-Compassion Scale in a clinical sample. J Clin Psychol 71:856–870. https://doi.org/10.1002/jclp.22187

    Article  PubMed  Google Scholar 

  39. Machado PPP, Gonçalves S, Martins C, Soares IC (2001) The Portuguese version of the Eating Disorders Inventory: evaluation of its psychometric properties. Eur Eat Disord Rev 9:43–52. https://doi.org/10.1002/erv.359

    Article  Google Scholar 

  40. Matos M, Pinto-Gouveia J, Gilbert P et al (2015) The Other As Shamer Scale-2: development and validation of a short version of a measure of external shame. Pers Individ Dif 74:6–11. https://doi.org/10.1016/j.paid.2014.09.037

    Article  Google Scholar 

  41. Hayes AF (2018) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach, 2nd edn. The Guilford Press, New York

    Google Scholar 

  42. Ferreira C, Pinto-Gouveia J, Duarte C (2013) Self-compassion in the face of shame and body image dissatisfaction: Implications for eating disorders. Eat Behav 14:207–210. https://doi.org/10.1016/j.eatbeh.2013.01.005

    Article  PubMed  Google Scholar 

  43. Kelly AC, Vimalakanthan K, Carter JC (2014) Understanding the roles of self-esteem, self-compassion, and fear of self-compassion in eating disorder pathology: an examination of female students and eating disorder patients. Eat Behav 15:388–391. https://doi.org/10.1016/j.eatbeh.2014.04.008

    Article  PubMed  Google Scholar 

  44. Davenport E, Rushford N, Soon S, McDermott C (2015) Dysfunctional metacognition and drive for thinness in typical and atypical anorexia nervosa. J Eat Disord 3:24. https://doi.org/10.1186/s40337-015-0060-4

    Article  PubMed  PubMed Central  Google Scholar 

  45. Cesare C, Francesco P, Valentino Z et al (2016) Shame proneness and eating disorders: a comparison between clinical and non-clinical samples. Eat Weight Disord Stud Anorexia, Bulim Obes 21:701–707. https://doi.org/10.1007/s40519-016-0328-y

    Article  Google Scholar 

  46. Tylka TL, Russell HL, Neal AA (2015) Self-compassion as a moderator of thinness-related pressures’ associations with thin-ideal internalization and disordered eating. Eat Behav 17:23–26. https://doi.org/10.1016/j.eatbeh.2014.12.009

    Article  PubMed  Google Scholar 

  47. Goss K (2011) The compassionate mind approach to beating overeating: using compassion focused therapy. Robinson, London

    Google Scholar 

  48. Pinto-Gouveia J, Ferreira C, Duarte C (2014) Thinness in the pursuit for social safeness: an integrative model of social rank mentality to explain eating psychopathology. Clin Psychol Psychother 21:154–165. https://doi.org/10.1002/cpp.1820

    Article  PubMed  Google Scholar 

  49. Neff KD (2003) Self-compassion: an alternative conceptualization of a healthy attitude toward oneself. Self Identity 2:85–101. https://doi.org/10.1080/15298860390129863

    Article  Google Scholar 

  50. Kelly AC, Carter JC, Borairi S (2014) Are improvements in shame and self-compassion early in eating disorders treatment associated with better patient outcomes? Int J Eat Disord 47:54–64. https://doi.org/10.1002/eat.22196

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Marta Simão

    Present address: Santa Casa da Misericórdia de Alvaiázere, 3250-115, Alvaiázere, Portugal

Authors and Affiliations

  1. Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal

    Cristiana Marques, Marta Simão, Raquel Guiomar & Paula Castilho

Authors
  1. Cristiana Marques
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marta Simão
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Raquel Guiomar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paula Castilho
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cristiana Marques.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Marques, C., Simão, M., Guiomar, R. et al. Self-disgust and urge to be thin in eating disorders: how can self-compassion help?. Eat Weight Disord 26, 2317–2324 (2021). https://doi.org/10.1007/s40519-020-01099-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-020-01099-9

Keywords

Search

Navigation