Feasibility and pilot study of a brief self-compassion intervention addressing body image distress in breast cancer survivors

Angela Mifsud; Melissa J Pehlivan; Paul Fam; Maddison O'Grady; Annamiek van Steensel; Elisabeth Elder; Jenny Gilchrist; Kerry A Sherman

doi:10.1080/21642850.2021.1929236

Feasibility and pilot study of a brief self-compassion intervention addressing body image distress in breast cancer survivors

Health Psychol Behav Med. 2021 May 21;9(1):498-526. doi: 10.1080/21642850.2021.1929236.

Authors

Angela Mifsud¹, Melissa J Pehlivan¹, Paul Fam¹, Maddison O'Grady¹, Annamiek van Steensel¹, Elisabeth Elder², Jenny Gilchrist³, Kerry A Sherman¹

Affiliations

¹ Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
² Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia.
³ Macquarie University Hospital, Sydney, Australia.

Abstract

Background: The majority of breast cancer survivors (BCSs) experience body image concerns following treatment. Body Image distress (BID) is associated with psychological distress and diminished quality of life. A web-based self-compassion focused writing activity (My Changed Body - MyCB) reduces BID in BCSs, yet limited research exists on participant characteristics associated with such intervention adherence. Self-compassion-based meditations are also efficacious in reducing BID in non-BCS populations. This parallel, double-blind pilot randomised controlled trial aimed to assess the feasibility and acceptability of MyCB, with and without an additional meditation component, on BID and related psychological outcomes in BCSs. The trial was registered with the Australian and New Zealand Clinical Trials Registry (#ACTRN12619001693112).

Methods: BCSs were randomly allocated to MyCB (n = 39), MyCB + Meditation (MyCB + M) (n = 17) or an expressive writing (EW) active control arm (n = 23). The primary outcome was BID. Secondary outcomes were body appreciation, affect (positive and negative), psychological distress (depression, anxiety and stress) and self-compassion (state and trait). Assessments were completed online at baseline, post-intervention and 1-month.

Results: Adherence to the MyCB writing (45%) and meditation (50%) was modest, and acceptability was high for both MyCB and MyCB + M. Intent to treat linear mixed model analyses indicated: Post-intervention - state self-compassion and positive affect increased for MyCB compared to EW; 1-month: BID scores decreased across all conditions; trait self-compassion increased and anxiety decreased for MyCB + M compared to MyCB and EW.

Conclusion: These findings provide preliminary evidence for the efficacy and potential clinical use of the MyCB brief web-based self-compassion intervention alone and with the addition of meditation, to increase self-compassion and psychological wellbeing in BCSs.

Keywords: Breast cancer; body image; e-health intervention; feasibility; self-compassion.