Author: Sarah Paranjothy
Paranjothy, Sarah, 2025 Investigating the Impact on Disordered Eating through the Role of Self-Criticism and Self-Compassion, Flinders University, College of Education, Psychology and Social Work
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With augmentation of treatments for eating disorders (EDs) suggested to improve outcomes (Pennesi et al., 2024), novel interventions that target risk factors which maintain disordered eating (DE) are warranted. While self-criticism is implicated in the onset and maintenance of DE (Werner et al., 2019) and is viewed as a transdiagnostic vulnerability factor due to its impact on various psychopathologies (Ehret et al., 2015; Iancu et al., 2015), the focus has been on self-compassion interventions which have been shown to successfully reduce DE in clinical and non-clinical groups (Ferrari et al., 2019). This thesis addressed several gaps in the literature to examine the relevance of adjunct ED treatments that target self-criticism.
The first study examined the psychometric properties of the Forms of Self-Criticising/Attacking and Self-Reassuring Scale (FSCRS) in a mixed student and clinical sample with EDs. The original model was retained and demonstrated good reliability and validity with related constructs, and unique associations were found for two out of three factors of the FSCRS with ED psychopathology, impairment related to ED, stress and depression. The second study is a published meta-analysis that explored how self-compassion and self-criticism relate to each other with respect to DE. Across 135 studies and an examination of 10 subgroups, small but robust associations revealed that greater self-criticism was linked with greater DE and that greater self-compassion was linked with reduced self-criticism and DE. The third study investigated whether self-criticism over the course of treatment mediated the relationship between fear of self-compassion at the start of treatment and the rate of change in ED symptoms. Results showed that a lower fear of self-compassion at baseline was linked with lower levels of self-criticism during treatment, which was linked with greater reductions in ED symptoms during and after treatment. Finally, a randomised controlled trial investigated a brief DE intervention and its impact on reducing self-criticism and increasing self-compassion, delivered through a guided internet-based condition in four modules over two weeks. University students (N = 84) were screened and randomised (n = 40) to the intervention or waitlist control group. Outcome measures delivered at baseline, one-week and two-weeks post-randomisation measured participants’ self-criticism, fears of compassion, negative affect, ED symptoms, quality of life, and body image flexibility. Group-by-time interactions suggested groups changed at a different rate on two outcomes (fear of receiving compassion from others and body image flexibility), with improvements observed in the treatment while participants in the waitlist group remained stable.
Together, these studies suggest that adjunct treatments may be more efficacious if they target risk factors for DE, including the fear of engaging in compassion-based processes, which may help address self-criticism levels during treatment and thereby result in greater reductions of ED psychopathology over treatment.
Keywords: self-criticism, self-compassion, disordered eating, eating disorders
Subject: Psychology thesis
Thesis type: Doctor of Philosophy
Completed: 2025
School: College of Education, Psychology and Social Work
Supervisor: Tracey Wade