Self-criticism, low self-esteem, depressive symptoms, and over-evaluation of shape and weight in binge eating disorder patients

Department of Psychiatry, Yale University, New Haven, Connecticut, United States
Behaviour Research and Therapy (Impact Factor: 3.85). 02/2007; 45(1):139-49. DOI: 10.1016/j.brat.2006.01.017
Source: PubMed


Despite the fact that negative self-evaluations are widely considered to be prominent in eating disorders, the role of self-criticism has received little empirical attention. The vast majority of research on the construct of self-criticism has focused on its role as a specific personality vulnerability factor in depression-related phenomena. In this study of 236 patients with binge eating disorder, confirmatory factor analysis supported self-criticism, self-esteem, depressive symptoms, and over-evaluation of shape and weight as distinct, albeit related, constructs. Structural equation modeling demonstrated that the relation between self-criticism and over-evaluation of shape and weight was partly mediated or explained by low self-esteem and depressive symptoms. Continued efforts to understand the role of self-criticism in eating disorders appear warranted.

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Available from: David Dunkley, Jul 16, 2014
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    • "As these previous studies supported selfesteem only as a partial mediator in the relation between SC perfectionism and depressive symptoms, research is needed to establish which other maladaptive characteristics of SC perfectionism explain its unique association with depressive symptoms. SC perfectionism differs conceptually from low self-esteem as it involves a critical and harsh self-evaluation relating to feelings of failure to live up to one's own or others' expectations (Dunkley & Grilo, 2007). "
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    ABSTRACT: This study of community adults (N = 210) aimed to gain a better understanding of the links among self-critical (SC) perfectionism, self-esteem, experiential avoidance, and depressive symptoms. Participants completed self-report questionnaires assessing perfectionism dimensions, self-esteem, experiential avoidance, and depressive symptoms. Confirmatory factor analysis supported SC perfectionism, self-esteem, experiential avoidance, and depressive symptoms as distinct, but related, constructs. Structural equation modeling (SEM) demonstrated that the relation between SC perfectionism and depressive symptoms was mediated by lower self-esteem. SEM also showed that experiential avoidance independently mediated the relation between SC perfectionism and depressive symptoms, controlling for the effects of lower self-esteem. These results distinguish SC perfectionism from lower self-esteem by demonstrating that individuals with higher SC perfectionism have a unique propensity towards experiential avoidance, which, in turn, incrementally explains why they experience higher levels of depressive symptoms.
    Full-text · Article · Aug 2015 · Personality and Individual Differences
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    • "Negative self-evaluation and self-criticism are widely known to be key factors in depression-related symptoms. However, little research has focused on self-criticism and the relationship with critical inner voices (Dunkley & Grilo, 2007). Individuals with high self-criticism perceive negative outcomes solely as the result of their own deficits (Beck, 1976). "
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    ABSTRACT: Hilde Bruch (1978) was one of the first to describe the phenomenon of anorectic patients experiencing a critical inner voice. Although several qualitative studies regarding eating disorder patients report this experience, few quantitative studies have been conducted in which hearing voices was examined in eating disorder patients. This motivated us to investigate whether eating disorder patients (N = 74) experience critical inner voices significantly more often than a healthy control group (N = 58). Is voice hearing related to the severity of the eating disorder and to low self-esteem and high self-criticism? These questions will be addressed in this article.
    Full-text · Article · Mar 2014 · Eating disorders
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    • "Borderline traits are well-reported in adult patients with EDs, particularly those with bingepurge symptoms (Kleifield et al., 1994; Lilenfeld et al., 2000; Steiger & Seguin, 1999; Wonderlich, 2002). Selfdemeaning tendencies accord with long-standing theories and conceptualisations of EDs that note self-criticism and low self-esteem (Dunkley & Grilo, 2007; Fairburn et al., 2003). The cross-sectional design precludes causal inference about an aetiological association between personality and EDs. "
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    ABSTRACT: Background Among adults, personality traits have been implicated in the development and maintenance of eating disorders (EDs); whether these findings extend to youth is unknown. The aim of this study was to investigate personality traits of adolescents with EDs. MethodsA case-control approach was performed by comparing a clinical group of female adolescents with EDs (n = 23) to a control group of adolescents in the general community (n = 26) on personality traits of inhibited, self-demeaning, and borderline tendency. Controls were frequency-matched to cases on age and sex, were drawn from a similar geographic catchment area, and observed in the same year as clinical cases. ResultsThe clinical group demonstrated significantly higher scores on self-demeaning (F(1,47) = 41.39, p < .001, η2 = .075), borderline (F(1,47) = 24.50, p < .001, η2 = .093), and inhibited (F(1,47) = 13.33, p = .001, η2 = .014) personality styles. Adjustment for affective symptomatology diminished the strength of these relationships, but personality pathology still demarcated the group with clinical EDs. Conclusions The well-established link between personality pathology and EDs in adults generalised to adolescents.
    Full-text · Article · Nov 2013 · Clinical Psychologist
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