Eating disorder behaviors and depression: a minimal relationship beyond social comparison,self‐esteem,and body dissatisfaction

Existing literature fails to comprehensively identify factors contributing to the comorbid relationship between eating disorder (ED) behaviors and unipolar depression. Maladaptive social comparison, body dissatisfaction, and low self‐esteem are disruptive psychological patterns common to both constructs. It is unclear whether a unique relationship exists between depression and eating disorder behaviors beyond the effects exerted by this negative cognitive triad. The purpose of the present study is to examine whether a unique relationship exists between depression and ED behaviors after controlling for maladaptive social comparison, body dissatisfaction, and low self‐esteem. We predict minimal unique variance in ED behaviors will be explained by depression after controlling for this negative cognitive triad. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1–11, 2009.     

The relationship between body dysmorphic disorder symptoms and self‐construals

Background: Cognitive models of body dysmorphic disorder (BDD) suggest that beliefs and evaluations related to self‐concept are central to the maintenance of the disorder, but such beliefs have received little empirical attention. This study examined the relative importance of contingent self‐worth and self‐ambivalence to BDD symptoms in comparison to their importance to obsessive–compulsive disorder and social phobia symptoms. Method: The sample comprised 194 non‐clinical participants (female, N = 148; males, N = 46) with a mean age of 24.70 years (standard deviation = 9.34). Participants were asked to complete a battery of self‐report questionnaires. Results: While significant relationships were found between the self‐beliefs and symptoms of all three disorders, some specificity was found in the relationships. Conclusions: Self‐worth based upon appearance was most important in BDD, while contingent self‐worth based on the approval of others was important in social phobia. Self‐ambivalence was associated with each disorder. Implications and limitations are discussed.     

The relationship among social support,self‐esteem,affect balance and loneliness in individuals with substance use disorders in China

This study analyzed the potential mediating role of self‐esteem and affect balance on the relationship between social support and loneliness. Respondents were 426 substabce use disorders from the Shifosi and Dalianshan rehab facilities in China who had completed the Multidimensional Scale of Perceived Social Support, Rosenberg Self‐Esteem Scale, Positive and Negative Affect Scales, and UCLA Loneliness Scale. The results indicated that self‐esteem and affect balance fully mediated the relationship between perceived social support and loneliness and all the paths, ranging from social support through self‐esteem and affect balance to loneliness, were significant. Finally, we analyzed possible approaches to decreasing individuals with substance use disorders' loneliness.     

Discrepancies between mother and adolescent perceptions of diabetes-related decision-making autonomy and their relationship to diabetes-related conflict and adherence to treatment

OBJECTIVE: To document the relationship between discrepancies in mother and adolescent perceptions of diabetes-related decision-making autonomy, diabetes-related conflict, and regimen adherence. METHODS: The sample was composed of 82 mother-adolescent dyads. Measures included adolescent and mother reports of diabetes-related decision-making autonomy, diabetes-related conflict, and regimen adherence. Nurses' reports of adherence and number of glucose tests performed each day were also obtained. RESULTS: Discrepancies between mother and adolescent perceptions of decision-making autonomy were related to greater maternal report of diabetes-related conflict. In particular, when adolescents reported that they were more in charge of decisions than reported by their mothers, mothers reported more conflict. Discrepancies between mother and adolescent perceptions of decision-making autonomy were not related to regimen adherence. CONCLUSIONS: The findings suggest that discrepancies between mother and adolescent perceptions of diabetes-related decision-making autonomy may be a potentially important area for intervention.     

Self‐compassion,self‐forgiveness,suicidal ideation,and self‐harm: A systematic review

Self‐compassion has been implicated in the aetiology and course of mental health with evidence suggesting an association between greater self‐compassion and lower emotional distress. However, our understanding of the nature and extent of the relationship between self‐compassion and self‐harm (self‐injury regardless of suicidal intent) or suicidal ideation remains unclear. This review, therefore, aimed to critically evaluate the extant literature investigating this relationship. To do so, a systematic search, including terms synonymous with self‐compassion, was conducted on three main psychological and medical databases (Web of Science, PsycINFO, and Medline). Only studies investigating self‐compassion or self‐forgiveness and self‐harm or suicidal ideation were found to be relevant to the review. Eighteen studies were included in the final narrative synthesis. Heterogeneity of studies was high, and the majority of studies were quantitative and cross‐sectional (n = 16) in design. All studies reported significant associations between higher levels of self‐forgiveness or self‐compassion and lower levels of self‐harm or suicidal ideation. Several studies suggested that self‐compassion or self‐forgiveness may weaken the relationship between negative life events and self‐harm. In conclusion, this review highlights the potential importance of self‐compassion in the aetiology of suicidal thoughts and self‐harm. We discuss the clinical and research implications.     

The influence of self‐criticism on depression symptoms among ambulatory patients with inflammatory bowel disease

Considering that self‐criticism is an important process in the development and maintenance of depression, and taking into account the stigma associated with inflammatory bowel disease (IBD), the present study aimed to analyse whether self‐criticism exacerbates the relationships of depression symptoms with IBD symptomatology and chronic illness‐related shame. The sample included 53 ambulatory IBD patients (66% females) with ages from 18 to 65. Moderation analyses were conducted using structural equation modelling. Self‐criticism exacerbated the associations of depression with IBD symptoms (b = 0.01; standard error [SE] = 0.00; Z = 3.73; P < .001) and illness shame (b = 0.02; SE = 0.01; Z = 2.40; P = .016). For the same level of IBD symptomatology or chronic illness‐related shame, those individuals who present more feelings of inadequacy towards the self, experience more symptoms of depression. This exacerbation effect is stronger when IBD symptomatology and chronic illness‐related shame are more intense. A high self‐critical IBD patient may view the illness and/or symptomatology as a flaw or error that should be self‐corrected. Physicians and other health professionals should be attentive to these pathological mechanisms and should attempt to alleviate them. It may be beneficial to refer high self‐critical patients to psychological care.     

The Role of seeing blood in non‐suicidal self‐injury

Non‐suicidal self‐injury (NSSI) is a growing clinical problem, especially among adolescents and young adults. Anecdotal accounts, clinical reports, and popular media sources suggest that observing the blood resulting from NSSI often plays an important role in the behavior's reinforcement. However, research to date has not systematically assessed the role of blood in NSSI. The current study examined this phenomenon in 64 young adults from a college population with histories of non‐suicidal skin‐cutting. Approximately half the participants reported it was important to see blood during NSSI. These individuals reported spending five minutes or less looking at the blood after each instance of NSSI, and that seeing blood served several functions including “to relieve tension” and “makes me feel calm.” In addition, wanting to see blood was associated with greater lifetime frequency of skin‐cutting and greater endorsement of intrapersonal functions for NSSI (e.g., affect regulation, self‐punishment). Finally, participants who reported wanting to see blood were more likely to endorse symptoms of bulimia nervosa and borderline personality disorder. Theoretical and clinical implications are discussed. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66: 1–8, 2010.     

Distinguishing anxiety and depression in self‐report: purification of the beck anxiety inventory and beck depression inventory‐II

The overlap of symptoms associated with anxiety and depressive disorders hinders their differentiation using self‐report scales. The aim of this study was to develop purified versions of the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory‐II (BDI‐II) that encompass only items highly specific to anxiety and depression, respectively. However, using these purified scales only increased the ability to differentiate anxiety and depressive disorders slightly. Anxiety and depression seem to be inherently linked and, thus, the high comorbidity of anxiety and depressive disorders seems to be not a function of the same types of symptoms being reported for each disorder. Nevertheless, purified BAI and BDI‐II scales might be useful for separating the effects of interventions on anxiety and depressive symptoms. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1–14, 2010.     

Relationships between self‐consistency,trauma‐centred identity,and post‐traumatic adjustment

Background: Post‐traumatic stress disorder (PTSD) models suggest that trauma‐centred self‐change is motivated by self‐consistency. Aim: The objective of this study was to investigate the relationships between self‐consistency, trauma‐centred identity, and PTSD symptoms. Method: University students (n = 134) completed measures of trauma‐centred identity (Centrality of Events Scale), self‐consistency, and post‐traumatic stress symptoms (Impact of Events Scale—Revised, Centre for Epidemiological Studies—Depression Scale). Results: A significant positive correlation was found between trauma‐centred identity and post‐traumatic symptoms. However, self‐consistency was not related to post‐traumatic symptoms or trauma‐centred identity. Given the relationship between depressive symptoms and self‐consistency, the correlations were also conducted controlling for depression. When the effects of depressive symptoms were partialled out, both self‐consistency and trauma‐centred identity were positively correlated with intrusion symptoms. Discussion and Conclusion: The implications for PTSD models, which suggest self‐change is motivated by self‐consistency, are discussed and implications for clinical treatments are considered.