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

      1 , 1
      International Journal of Eating Disorders
      Wiley

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          Abstract

          Objective

          Future 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.

          Method

          Searches 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.

          Results

          Random‐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).

          Discussion

          Greater 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 Statement

          Higher 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.

          Resumen

          Objetivo

          Los futuros tratamientos para los trastornos de la conducta alimentaria (TCA) deben ser mejorados mediante la focalización en los mecanismos de mantenimiento. La literatura sugiere que la autocrítica y el perfeccionismo autocrítico actúan como mecanismos clave que exacerban los TCA, y que la autocompasión protege contra la autocrítica. Este meta‐análisis examina las asociaciones entre la autocrítica y el perfeccionismo autocrítico en la alimentación disfuncional (AD), y revisa cómo la autocompasión y la autocrítica se relacionan entre sí con respecto a la AD.

          Método

          Las búsquedas en tres bases de datos arrojaron 135 estudios con 42,952 participantes. Se analizaron la heterogeneidad, el sesgo de publicación y las evaluaciones de calidad. También se llevaron a cabo análisis de moderación entre las medidas de autocrítica, las medidas de autocompasión, entre muestras clínicas y no clínicas, y entre estudios transversales y experimentales.

          Resultados

          Los modelos de efectos aleatorios mostraron una asociación positiva media entre la autocrítica y la AD ( r = .37), y 10 subgrupos relacionados con diversas medidas de autocrítica utilizadas en la literatura mostraron asociaciones positivas pequeñas a grandes con la AD ( r = .20–.52). Además, evidencia preliminar sugiere relaciones negativas entre la autocompasión y la AD ( r = −0.40–−0.43) y relaciones negativas entre la autocompasión y la autocrítica ( r = −.04–−.88).

          Discusión

          Los niveles mayores de autocrítica están relacionados con mayores niveles de AD y niveles reducidos de autocompasión, lo que sugiere la necesidad de abordar la autocrítica y fomentar la autocompasión en los tratamientos estándar para los TCA. Comprender mejor estas interacciones en conjunto con estudios de intervención puede ayudar a desarrollar intervenciones más efectivas y eficientes dirigidas a la autocrítica y la autocompasión para personas con AD.

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          Most cited references217

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          Diagnostic and Statistical Manual of Mental Disorders

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            Quantifying heterogeneity in a meta-analysis.

            The extent of heterogeneity in a meta-analysis partly determines the difficulty in drawing overall conclusions. This extent may be measured by estimating a between-study variance, but interpretation is then specific to a particular treatment effect metric. A test for the existence of heterogeneity exists, but depends on the number of studies in the meta-analysis. We develop measures of the impact of heterogeneity on a meta-analysis, from mathematical criteria, that are independent of the number of studies and the treatment effect metric. We derive and propose three suitable statistics: H is the square root of the chi2 heterogeneity statistic divided by its degrees of freedom; R is the ratio of the standard error of the underlying mean from a random effects meta-analysis to the standard error of a fixed effect meta-analytic estimate, and I2 is a transformation of (H) that describes the proportion of total variation in study estimates that is due to heterogeneity. We discuss interpretation, interval estimates and other properties of these measures and examine them in five example data sets showing different amounts of heterogeneity. We conclude that H and I2, which can usually be calculated for published meta-analyses, are particularly useful summaries of the impact of heterogeneity. One or both should be presented in published meta-analyses in preference to the test for heterogeneity. Copyright 2002 John Wiley & Sons, Ltd.
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              Conducting Meta-Analyses inRwith themetaforPackage

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                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                International Journal of Eating Disorders
                Intl J Eating Disorders
                Wiley
                0276-3478
                1098-108X
                March 2024
                February 17 2024
                March 2024
                : 57
                : 3
                : 473-536
                Affiliations
                [1 ] Flinders University, Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing Adelaide South Australia Australia
                Article
                10.1002/eat.24166
                38366726
                f6c14150-2c44-4652-aa15-3e8401e40461
                © 2024

                http://creativecommons.org/licenses/by/4.0/

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