Academic journal article International Journal of Psychology and Psychological Therapy

Self-Criticism, Perfectionism and Eating Disorders: The Effect of Depression and Body Dissatisfaction

Academic journal article International Journal of Psychology and Psychological Therapy

Self-Criticism, Perfectionism and Eating Disorders: The Effect of Depression and Body Dissatisfaction

Article excerpt

Eating disorders are characterized by the over-evaluation of eating, shape and weight and their control in determining one's self-worth. In this sense, the hallmark of eating disorders is the intense drive to be thin and the morbid fear of losing control over eating and one's body image and shape (Fairburn, 2008). Even though eating disorders are not highly prevalent (with lifetime prevalence rates of anorexia nervosa and bulimia nervosa ranging from 0.3% to 4.2%), these are one of the most life-threatening psychopathological conditions. Nevertheless, the rates of subclinical disordered eating features seem to be significantly higher. In fact, approximately over 50% young women present great efforts in dieting and weight loss, as well as intense concerns about body image, weight and eating (APA Work Group on Eating Disorders, 2006). Furthermore, research show that women who present these subclinical behaviours are at higher risk of developing full syndrome eating disorders (for a review see Fairburn, 2008).

It is widely accepted that there are multiple risk pathways for the development of eating psychopathology (Stice, 2001). One component that is referred to as key to eating disorders' development is body image dissatisfaction (e.g., Mcknight, 2003; Stice, Marti, & Durant, 2011). Body image dissatisfaction often emerges as the result of the perceived sociocultural pressure to be thin and the internalization of the thin beauty ideal (Buote, Wilson, Strahan, Gazzola, & Papps, 2011). Moreover, body image dissatisfaction promotes unhealthy eating patterns, typified by negative affect and dieting, which may progress to eating psychopathology (Stice et al., 2011).

Theoretical and empirical accounts suggest that alongside the overvaluation of eating and body image, patients with eating disorders tend to compare themselves negatively with others (Ferreira, Pinto-Gouveia, & Duarte, 2011). Also, they often are oversensitive regarding how others view them, assuming that others' evaluations towards them are negative and condemning. In this sense, in order to feel safer and to increase a sense of belonging to the social group, avoiding rejection and criticism, these individuals tend to adopt a series of defensive strategies, such as self-criticism and the drive to meet excessively high levels of performance and to be perfect, (Gilbert, Durrant, & McEwan, 2006; Gilbert & Procter, 2006). Self-criticism refers to a type of negative self-judgment and self-scrutiny where one displays a punitive response in face of one's errors, faults or attributes (e.g., physical appearance) that may cause social disapproval or rejection. Self-criticism may then be understood as a strategy to cope with shortcomings of an inadequate or inferior perceived self (Gilbert, Clarke, Hempel, Miles, & Irons, 2004). However, this constant and cruel self-to-self harassment is highly linked to psychopathology, namely depressive symptoms (Dunckley, Zuroff, & Blankstein, 2003;Gilbert et al., 2004; Gilbert et al., 2006). Recent research has gathered evidence showing the important role of self-criticism in eating-related symptoms (e.g., binge eating; Dunckley & Grilo, 2007). Particularly, self-criticism has been considered a potent maladaptive emotional regulation process that, by fueling a sense of being an inferior or flawed self in comparison to others, predicts increased drive for thinness (Pinto-Gouveia, Ferreira, & Duarte, 2012).

A critical self-to-self-relationship has also been associated with striving to achieve flawlessness, which is defined as perfectionism (Flett & Hewitt, 2002; Frost, Martin, Faliart, & Rosenblate, 1990; Gilbert et al., 2006; Hewitt & Flett, 1991). Perfectionism has long been pointed out as a core feature of patients with eating disorders (patent in these patients intense drive to reach "perfection" regarding their weight or body shape) that has an important impact in the onset, development, treatment and recovery from these disorders (for a review see B ardone-Cone et al . …

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