14,135 research outputs found

    Identifizierung prädiktiver und prognostischer Biomarker in unterschiedlichen Tumorkompartimenten des ösophagealen Adenokarzinoms

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    Das ösophageale Adenokarzinom zeigt eine global steigende Inzidenz und hat mit einer 5-Jahres-Überlebensrate von weniger als 25% eine schlechte Prognose. Personalisierte Therapieansätze sind selten und prognostische/prädiktive Biomarker des Tumormikromilieus sind unzureichend charakterisiert. Die kumulative Promotion nähert sich dieser Problematik in drei unterschiedlichen Schwerpunkten. 1. Zur Identifizierung Kompartiment-spezifischer Biomarker wurde eine Methode entwickelt, welche als kostengünstige Alternative zum sc-Seq Expressionsprofile individueller Zelltypen generiert. Dabei erfolgt die Extraktion der RNA nicht aus Einzelzellen, sondern aus flowzytometrisch-getrennten Zellkompartimenten. Die Separation der Proben in Epithelzellen, Immunzellen und Fibroblasten wurde durch verschiedene Verfahren validiert und eine suffiziente Ausbeute an RNA auch für kleine Gewebemengen gezeigt. 2. Biomarker des Immunzellkompartiments als therapeutische Angriffspunkte wurden in einem Patientenkollektiv von bis zu 551 Patienten auf ihre Bedeutung beim EAC überprüft. Es zeigte sich eine Expression der Immuncheckpoints LAG3, VISTA und IDO auf TILs durch IHC und RNA-Sonden basierte Verfahren in einem relevanten Anteil (LAG3: 11,4%, VISTA: 29%, IDO: 52,6%). Es konnte eine prognostisch günstige Bedeutung der VISTA, LAG3 und IDO Expression gezeigt werden. Durch den Vergleich von Genexpressionsprofilen aus therapienaiven und vorbehandelten Tumoren konnte zudem ein immunsuppressiver Effekt von neoadjuvanten Therapiekonzepten auf das Tumormikromilieu des EACs gezeigt werden. Dabei kam es zur verminderten Expression von Checkpoints und Anzahl TILs nach (Radio-) Chemotherapie. 3. Im Tumorzellkompartiment wurde die Rolle von Amplifikationen in ErbB-Rezeptor abhängigen Signalwegen durch FISH-Technik und Immunhistochemie evaluiert. Es fanden sich KRAS Amplifikationen in 17,1%, PIK3CA Amplifikationen in 5% sowie eine HER2/neu-Überexpression in 14,9% der untersuchten Tumore

    Computertomographie-basierte Bestimmung von Aortenklappenkalk und seine Assoziation mit Komplikationen nach interventioneller Aortenklappenimplantation (TAVI)

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    Background: Severe aortic valve calcification (AVC) has generally been recognized as a key factor in the occurrence of adverse events after transcatheter aortic valve implantation (TAVI). To date, however, a consensus on a standardized calcium detection threshold for aortic valve calcium quantification in contrast-enhanced computed tomography angiography (CTA) is still lacking. The present thesis aimed at comparing two different approaches for quantifying AVC in CTA scans based on their predictive power for adverse events and survival after a TAVI procedure.   Methods: The extensive dataset of this study included 198 characteristics for each of the 965 prospectively included patients who had undergone TAVI between November 2012 and December 2019 at the German Heart Center Berlin (DHZB). AVC quantification in CTA scans was performed at a fixed Hounsfield Unit (HU) threshold of 850 HU (HU 850 approach) and at a patient-specific threshold, where the HU threshold was set by multiplying the mean luminal attenuation of the ascending aorta by 2 (+100 % HUAorta approach). The primary endpoint of this study consisted of a combination of post-TAVI outcomes (paravalvular leak ≥ mild, implant-related conduction disturbances, 30-day mortality, post-procedural stroke, annulus rupture, and device migration). The Akaike information criterion was used to select variables for the multivariable regression model. Multivariable analysis was carried out to determine the predictive power of the investigated approaches.   Results: Multivariable analyses showed that a fixed threshold of 850 HU (calcium volume cut-off 146 mm3) was unable to predict the composite clinical endpoint post-TAVI (OR=1.13, 95 % CI 0.87 to 1.48, p=0.35). In contrast, the +100 % HUAorta approach (calcium volume cut-off 1421 mm3) enabled independent prediction of the composite clinical endpoint post-TAVI (OR=2, 95 % CI 1.52 to 2.64, p=9.2x10-7). No significant difference in the Kaplan-Meier survival analysis was observed for either of the approaches.   Conclusions: The patient-specific calcium detection threshold +100 % HUAorta is more predictive of post-TAVI adverse events included in the combined clinical endpoint than the fixed HU 850 approach. For the +100 % HUAorta approach, a calcium volume cut-off of 1421 mm3 of the aortic valve had the highest predictive value.Hintergrund: Ein wichtiger Auslöser von Komplikationen nach einer Transkatheter-Aortenklappen-Implantation (TAVI) sind ausgeprägte Kalkablagerung an der Aortenklappe. Dennoch erfolgte bisher keine Einigung auf ein standardisiertes Messverfahren zur Quantifizierung der Kalklast der Aortenklappe in einer kontrastverstärkten dynamischen computertomographischen Angiographie (CTA). Die vorliegende Dissertation untersucht, inwieweit die Wahl des Analyseverfahrens zur Quantifizierung von Kalkablagerungen in der Aortenklappe die Prognose von Komplikationen und der Überlebensdauer nach einer TAVI beeinflusst.   Methodik: Der Untersuchung liegt ein umfangreicher Datensatz von 965 Patienten mit 198 Merkmalen pro Patienten zugrunde, welche sich zwischen 2012 und 2019 am Deutschen Herzzentrum Berlin einer TAVI unterzogen haben. Die Quantifizierung der Kalkablagerung an der Aortenklappe mittels CTA wurde einerseits mit einem starren Grenzwert von 850 Hounsfield Einheiten (HU) (HU 850 Verfahren) und andererseits anhand eines individuellen Grenzwertes bemessen. Letzterer ergibt sich aus der HU-Dämpfung in dem Lumen der Aorta ascendens multipliziert mit 2 (+100 % HUAorta Verfahren). Der primäre klinische Endpunkt dieser Dissertation besteht aus einem aus sechs Variablen zusammengesetzten klinischen Endpunkt, welcher ungewünschte Ereignisse nach einer TAVI abbildet (paravalvuläre Leckage ≥mild, Herzrhythmusstörungen nach einer TAVI, Tod innerhalb von 30 Tagen, post-TAVI Schlaganfall, Ruptur des Annulus und Prothesendislokation). Mögliche Störfaktoren, die auf das Eintreten der Komplikationen nach TAVI Einfluss haben, wurden durch den Einsatz des Akaike Informationskriterium ermittelt. Um die Vorhersagekraft von Komplikationen nach einer TAVI durch beide Verfahren zu ermitteln, wurde eine multivariate Regressionsanalyse durchgeführt.   Ergebnisse: Die multivariaten logistischen Regressionen zeigen, dass die Messung der Kalkablagerungen anhand der HU 850 Messung (Kalklast Grenzwert von 146 mm3) die Komplikationen und die Überlebensdauer nicht vorhersagen konnten (OR=1.13, 95 % CI 0.87 bis 1.48, p=0.35). Die nach dem +100 % HUAorta Verfahren (Kalklast Grenzwert von 1421 mm3) individualisierte Kalkmessung erwies sich hingegen als sehr aussagekräftig, da hiermit Komplikationen nach einer TAVI signifikant vorhergesagt werden konnten (OR=2, 95 % CI 1.52 bis 2.64, p=9.2x10-7). In Hinblick auf die postoperative Kaplan-Meier Überlebenszeitanalyse kann auch mit dem +100 % HUAorta Verfahren keine Vorhersage getroffen werden.   Fazit: Aus der Dissertation ergibt sich die Empfehlung, die Messung von Kalkablagerungen nach dem +100 % HUAorta Verfahren vorzunehmen, da Komplikationen wesentlich besser und zuverlässiger als nach der gängigen HU 850 Messmethode vorhergesagt werden können. Für das +100 % HUAorta Verfahren lag der optimale Kalklast Grenzwert bei 1421 mm3

    Examples of works to practice staccato technique in clarinet instrument

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    Klarnetin staccato tekniğini güçlendirme aşamaları eser çalışmalarıyla uygulanmıştır. Staccato geçişlerini hızlandıracak ritim ve nüans çalışmalarına yer verilmiştir. Çalışmanın en önemli amacı sadece staccato çalışması değil parmak-dilin eş zamanlı uyumunun hassasiyeti üzerinde de durulmasıdır. Staccato çalışmalarını daha verimli hale getirmek için eser çalışmasının içinde etüt çalışmasına da yer verilmiştir. Çalışmaların üzerinde titizlikle durulması staccato çalışmasının ilham verici etkisi ile müzikal kimliğe yeni bir boyut kazandırmıştır. Sekiz özgün eser çalışmasının her aşaması anlatılmıştır. Her aşamanın bir sonraki performans ve tekniği güçlendirmesi esas alınmıştır. Bu çalışmada staccato tekniğinin hangi alanlarda kullanıldığı, nasıl sonuçlar elde edildiği bilgisine yer verilmiştir. Notaların parmak ve dil uyumu ile nasıl şekilleneceği ve nasıl bir çalışma disiplini içinde gerçekleşeceği planlanmıştır. Kamış-nota-diyafram-parmak-dil-nüans ve disiplin kavramlarının staccato tekniğinde ayrılmaz bir bütün olduğu saptanmıştır. Araştırmada literatür taraması yapılarak staccato ile ilgili çalışmalar taranmıştır. Tarama sonucunda klarnet tekniğin de kullanılan staccato eser çalışmasının az olduğu tespit edilmiştir. Metot taramasında da etüt çalışmasının daha çok olduğu saptanmıştır. Böylelikle klarnetin staccato tekniğini hızlandırma ve güçlendirme çalışmaları sunulmuştur. Staccato etüt çalışmaları yapılırken, araya eser çalışmasının girmesi beyni rahatlattığı ve istekliliği daha arttırdığı gözlemlenmiştir. Staccato çalışmasını yaparken doğru bir kamış seçimi üzerinde de durulmuştur. Staccato tekniğini doğru çalışmak için doğru bir kamışın dil hızını arttırdığı saptanmıştır. Doğru bir kamış seçimi kamıştan rahat ses çıkmasına bağlıdır. Kamış, dil atma gücünü vermiyorsa daha doğru bir kamış seçiminin yapılması gerekliliği vurgulanmıştır. Staccato çalışmalarında baştan sona bir eseri yorumlamak zor olabilir. Bu açıdan çalışma, verilen müzikal nüanslara uymanın, dil atış performansını rahatlattığını ortaya koymuştur. Gelecek nesillere edinilen bilgi ve birikimlerin aktarılması ve geliştirici olması teşvik edilmiştir. Çıkacak eserlerin nasıl çözüleceği, staccato tekniğinin nasıl üstesinden gelinebileceği anlatılmıştır. Staccato tekniğinin daha kısa sürede çözüme kavuşturulması amaç edinilmiştir. Parmakların yerlerini öğrettiğimiz kadar belleğimize de çalışmaların kaydedilmesi önemlidir. Gösterilen azmin ve sabrın sonucu olarak ortaya çıkan yapıt başarıyı daha da yukarı seviyelere çıkaracaktır

    TOWARDS AN UNDERSTANDING OF EFFORTFUL FUNDRAISING EXPERIENCES: USING INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS IN FUNDRAISING RESEARCH

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    Physical-activity oriented community fundraising has experienced an exponential growth in popularity over the past 15 years. The aim of this study was to explore the value of effortful fundraising experiences, from the point of view of participants, and explore the impact that these experiences have on people’s lives. This study used an IPA approach to interview 23 individuals, recognising the role of participants as proxy (nonprofessional) fundraisers for charitable organisations, and the unique organisation donor dynamic that this creates. It also bought together relevant psychological theory related to physical activity fundraising experiences (through a narrative literature review) and used primary interview data to substantiate these. Effortful fundraising experiences are examined in detail to understand their significance to participants, and how such experiences influence their connection with a charity or cause. This was done with an idiographic focus at first, before examining convergences and divergences across the sample. This study found that effortful fundraising experiences can have a profound positive impact upon community fundraisers in both the short and the long term. Additionally, it found that these experiences can be opportunities for charitable organisations to create lasting meaningful relationships with participants, and foster mutually beneficial lifetime relationships with them. Further research is needed to test specific psychological theory in this context, including self-esteem theory, self determination theory, and the martyrdom effect (among others)

    Pupillometry and the vigilance decrement: Task‐evoked but not baseline pupil measures reflect declining performance in visual vigilance tasks

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    Baseline and task-evoked pupil measures are known to reflect the activity of the nervous system's central arousal mechanisms. With the increasing availability, affordability and flexibility of video-based eye tracking hardware, these measures may one day find practical application in real-time biobehavioural monitoring systems to assess performance or fitness for duty in tasks requiring vigilant attention. But real-world vigilance tasks are predominantly visual in their nature and most research in this area has taken place in the auditory domain. Here, we explore the relationship between pupil size—both baseline and task-evoked—and behavioural performance measures in two novel vigilance tasks requiring visual target detection: (1) a traditional vigilance task involving prolonged, continuous and uninterrupted performance (n = 28) and (2) a psychomotor vigilance task (n = 25). In both tasks, behavioural performance and task-evoked pupil responses declined as time spent on task increased, corroborating previous reports in the literature of a vigilance decrement with a corresponding reduction in task-evoked pupil measures. Also in line with previous findings, baseline pupil size did not show a consistent relationship with performance measures. Our data offer novel insights into the complex interplay of brain systems involved in vigilant attention and question the validity of the assumption that baseline (prestimulus) pupil size and task-evoked (poststimulus) pupil measures reflect the tonic and phasic firing modes of the locus coeruleus

    Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study

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    Background: We primarily aimed to explore the associations between duration of untreated illness (DUI), treatment response, and functioning in a cohort of patients with bipolar disorder (BD). Methods: 261 participants with BD were recruited. DUI was defined as months from the first affective episode to the start of a mood-stabilizer. The functioning assessment short test (FAST) scores and treatment response scores for lithium, valproate, or lamotrigine according to the Alda Scale Total Score (TS) were compared between patients with short (<24 months) or long DUI. Differences in FAST scores among good (GR; TS≥7), poor (PR; TS=2-6), or non-responders (NR; TS<2) to each mood-stabilizer were analyzed. Linear regression was computed using the FAST global score as the dependent variable. Results: DUI and FAST scores showed no statistically significant correlation. Patients with a longer DUI showed poorer response to lithium (Z=-3.196; p<0.001), but not to valproate or lamotrigine. Response to lithium (β=-1.814; p<0.001), number of hospitalizations (β=0.237; p<0.001), and illness duration (β=0.160; p=0.028) were associated with FAST total scores. GR to lithium was associated with better global functioning compared to PR or NR [H=27.631; p<0.001]. Limitations: The retrospective design could expose our data to a recall bias. Also, only few patients were on valproate or lamotrigine treatment. Conclusions: Poor functioning in BD could be the result of multiple affective relapses, rather than a direct effect of DUI. A timely diagnosis with subsequent effective prophylactic treatment, such as lithium, may prevent poor functional outcomes in real-world patients with BD

    Sexual violence as a form of social control : the role of hostile and benevolent sexism

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    This thesis examines the feminist hypothesis that rape functions as a tool of social control through which women are kept in subordinate social positions (Brownmiller, 1975). In examining this hypothesis, the current thesis explores the role of benevolent and hostile sexism in accounting for people's responses to different types of rape (i.e. stranger vs. acquaintance rape). An examination of the literature suggests that there are general societal beliefs in the distinction between "good" and "bad" rape victims (Pollard, 1992). Interestingly, researchers have observed that benevolent sexism (BS) is related to the idealisation of women in traditional gender roles (i.e. "good" women; Glick et aI., 2000). It is, therefore, argued that individuals who idealise women in traditional roles (i.e. high BS individuals) are more likely to negatively evaluate rape victims who can be perceived as violating these norms. Nine empirical studies are presented in this thesis. Study 1 examines the potential role of BS in accounting for previously observed differences in the amount of blame attributed to stranger and acquaintance rape victims (e.g. Pollard, 1992). Studies 2 and 3 examine the psychological mechanisms that underlie the relationship between BS and victim blame in acquaintance rape situations. Studies 2 and 4 also explore the psychological mechanisms that underlie the relationship between hostile sexism (HS) and self reported rape proclivity in acquaintance rape situations (c.f. Viki, 2000). In Study 5, the relationship between BS and paternalistic chivalry (attitudes that are simultaneously courteous and restrictive to women) is examined. Studies 6 and 7 examine the role of BS in accounting for participants' responses to stranger vs. acquaintance rape perpetrators. The last two studies (Studies 8 and 9) examine the potential role of legal verdicts in moderating the relationship between BS and victim blame in acquaintance rape cases. Taken together, the results support the argument that BS provides a psychological mechanism through which differences in the amount of blame attributed to stranger and acquaintance rape victims can be explained. In contrast, HS provides a mechanism for explaining differences in self-reported proclivity to commit stranger and acquaintance rape. The thesis concludes with a summary of the findings, a discussion of the methodological limitations of the studies and suggestions of directions for future research

    Development and evaluation of a treatment package for men with an intellectual disability who sexually offend

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    Sex offending in the general population has been a focus of interest for some time due to the damaging nature of the behaviour, and the need to reduce recidivism. Theoretical and clinical advances (Finke1hor, 1986; HM Prison Service, 1996; Marshall, Anderson, & Fernandez, 1999; Serran & Marshall, 2010) in treatment for sex offenders in the general population have been extended to men with an intellectual disability at risk of sexual offending (Lindsay, 2009). The purpose of this project is to develop and evaluate the SOTSEC-ID version cftrus model. Participants are adult males from 15 different locations across England and Wales, with an intellectual disability or borderline cognitive functioning and who have committed sexual offences. A pilot study clarified assessments and procedures, and individual data over several years is presented. A qualitative study using Interpretive Phenomenological Analysis (JP A) illustrates the 'meaning making' of participants' treatment experience through six major themes. A reliability and validity study assesses the four main quantitative measures, QACSO, SAKA, SOSAS, and VESA, finding limited support for criterion validity for the SOSAS and SAKA, excellent inter-rater reli"ability for all four main measures, and good to excellent inter-rater reliability on all but the SAKA Finally, a quantitative study, in collaboration with the wider SOTSEC-ID group, uses a repeated measures design to compare the QACSO, SOSAS and SAKA across pre-group, post-group and follow. up. Significant main effects and post-hoc comparisons were in the predicted direction for all measures. A range of information on demographic, clinical and criminogenic factors including offending during treatment or follow-up are also presented. A recidivism rate of 12.3% over a year was calculated for the sample. The treatment model and collaborative framework is recommended for wider adoption

    Exploring the effects of spinal cord stimulation for freezing of gait in parkinsonian patients

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    Dopaminergic replacement therapies (e.g. levodopa) provide limited to no response for axial motor symptoms including gait dysfunction and freezing of gait (FOG) in Parkinson’s disease (PD) and Richardson’s syndrome progressive supranuclear palsy (PSP-RS) patients. Dopaminergic-resistant FOG may be a sensorimotor processing issue that does not involve basal ganglia (nigrostriatal) impairment. Recent studies suggest that spinal cord stimulation (SCS) has positive yet variable effects for dopaminergic-resistant gait and FOG in parkinsonian patients. Further studies investigating the mechanism of SCS, optimal stimulation parameters, and longevity of effects for alleviating FOG are warranted. The hypothesis of the research described in this thesis is that mid-thoracic, dorsal SCS effectively reduces FOG by modulating the sensory processing system in gait and may have a dopaminergic effect in individuals with FOG. The primary objective was to understand the relationship between FOG reduction, improvements in upper limb visual-motor performance, modulation of cortical activity and striatal dopaminergic innervation in 7 PD participants. FOG reduction was associated with changes in upper limb reaction time, speed and accuracy measured using robotic target reaching choice tasks. Modulation of resting-state, sensorimotor cortical activity, recorded using electroencephalography, was significantly associated with FOG reduction while participants were OFF-levodopa. Thus, SCS may alleviate FOG by modulating cortical activity associated with motor planning and sensory perception. Changes to striatal dopaminergic innervation, measured using a dopamine transporter marker, were associated with visual-motor performance improvements. Axial and appendicular motor features may be mediated by non-dopaminergic and dopaminergic pathways, respectively. The secondary objective was to demonstrate the short- and long-term effects of SCS for alleviating dopaminergic-resistant FOG and gait dysfunction in 5 PD and 3 PSP-RS participants without back/leg pain. SCS programming was individualized based on which setting best improved gait and/or FOG responses per participant using objective gait analysis. Significant improvements in stride velocity, step length and reduced FOG frequency were observed in all PD participants with up to 3-years of SCS. Similar gait and FOG improvements were observed in all PSP-RS participants up to 6-months. SCS is a promising therapeutic option for parkinsonian patients with FOG by possibly influencing cortical and subcortical structures involved in locomotion physiology

    Examination of a Brief, Self-Paced Online Self-Compassion Intervention Targeting Intuitive Eating and Body Image Outcomes among Men and Women

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    Ideals for appearance and body image are pervasive in Western culture in which men and women are portrayed with unrealistic and often unattainable standards (Ferguson, 2013; Martin, 2010). Exposure and reinforcement have created a culture of social acceptance and internalization of these ideals, contributing to pervasive body image disturbance (i.e., body dissatisfaction; Fallon et al., 2014; Stice, 2001; Thompson & Stice, 2001; Thompson et al., 1999). Research has suggested that body dissatisfaction is expressed differently across sexes (Grossbard et al., 2008), with attention to thin ideals among women and muscular ideals among men. Body dissatisfaction has been linked to numerous poor outcomes, including dieting, unhealthy weight control behaviors, disordered eating, and increased psychopathology. Although dieting is one of the primary mechanisms employed to reduce body dissatisfaction (Thompson & Stice, 2001), research has shown that such efforts are contraindicated as dieting predicts weight gain over time (Pietiläinen et al., 2012) as well as preoccupation with food, disordered eating, eating disorders, emotional distress, and higher body dissatisfaction (Grabe et al., 2007; Johnson & Wardle, 2005; Neumark- Sztianer et al., 2006; Paxton et al., 2006; Tiggemann, 2005). Restrictive dietary behaviors suppress physiological cues to eat (e.g., hunger) that presents a vulnerability to eating in response to alternative cues, both internal (e.g., emotions) and external (e.g., availability of food). Intuitive eating is a non-restrictive approach to eating that encourages adherence to internal physiological cues to indicate when, what, and how much to eat (Tylka, 2006) and has demonstrated an inverse relationship with disordered eating, restrained eating, food preoccupation, dieting, body dissatisfaction, and negative affect (Bruce & Ricciardelli, 2016). Self-compassion, relating to oneself in a caring and supportive manner (Neff, 2003a), has been proposed as a pathway to increase intuitive eating and reduce body dissatisfaction (Neff & Knox, 2017; Schoenefeld & Webb, 2013; Webb & Hardin, 2016). Research has highlighted the efficacy of self-compassion interventions in addressing weight-related concerns (Rahimi-Ardabili et al., 2018) as well as brief experiential exercises for reducing body dissatisfaction (Moffitt et al., 2018). Additionally, there is a growing body of evidence supporting the efficacy of internet-based self-compassion interventions (Mak et al., 2018; Kelman et al., 2018; Nadeau et al., 2020). The purpose of the current study was to examine the effectiveness of a brief, self-paced online self-compassion intervention targeting body image and adaptive eating behaviors and potential mechanisms of change (e.g., self-compassion and psychological flexibility) among undergraduate men and women. This study also examined outcomes among men and women in the area of self-compassion, body dissatisfaction, and intuitive eating as research has highlighted the need to determine who benefits more from self-compassion interventions (Rahimi-Ardabili et al., 2018). The study compared a one-hour, self-guided online self-compassion intervention to an active control condition. The intervention was comprised of psychoeducation, experiential exercises, and mindfulness practice designed to increase self-compassion surrounding body image and eating behaviors. In contrast, the active control condition consisted of self-care recommendations and self-assessments for nutrition, exercise, and sleep. The study was administered over three parts (e.g., baseline, intervention, and follow-up) in which variables of interest were assessed at each time point. Outcome variables included self-compassion, intuitive eating, disordered eating, body appreciation, muscle dysmorphia, internalized weight bias, fear of self-compassion, and psychological inflexibility. Participants were randomized on a 2:1 intervention to control ratio at the second time point in order to make comparisons between groups while simultaneously having sufficient power for examining mediation and moderation within the treatment condition. Overall, 1023 individuals (64% women, Mage = 18.9, 67.4% white) signed informed consent and participated in at least one part of the study whereas 101 participants (71% women, Mage = 19.3, 71% white) completed all three study portions. As predicted, self-compassion was correlated with all variables of interest, and all study variables were correlated with each other (p < .01). In contrast to hypothesized outcomes, the self-compassion condition failed to demonstrate improvements across time or between conditions on all study outcomes. These results persisted when participants were screened for levels of intuitive eating as well. Contrary to prediction, internalized weight bias, muscle dysmorphia, and fear of self-compassion demonstrated increased levels within the intervention condition and decreases in the control condition. There were significant gender differences on multiple outcome variables, with men demonstrating higher levels of self-compassion and body appreciation whereas women endorsed higher levels of disordered eating, internalized weight bias, muscle dysmorphia, and psychological inflexibility. Additionally, there were significant gender interactions for internalized weight bias, body appreciation, and muscle dysmorphia. The interactions existed such that men demonstrated increased internalized weight bias and muscle dysmorphia across time whereas women displayed decreased weight bias and muscle dysmorphia. The opposite pattern was found within body appreciation; women demonstrated increased body appreciation across time while men reported decreased levels of body appreciation. Despite this study’s intent to examine underlying mechanisms of change, the condition in which participants were randomly selected did not have any relationship, positive or negative, with the outcome variables of interest. As such, mediation within the current study was not conducted as it would violate statistical assumptions required to examine this hypothesis. Finally, upon examining the moderating relationship of fear of self-compassion between self-compassion and outcome variables, there were main effects for self-compassion on intuitive eating, emotional eating, internalized weight bias, body appreciation, and psychological inflexibility as well as main effects of fear of self-compassion on psychological inflexibility. There were significant interactions for intuitive eating and emotional eating, such that as fear of self-compassion increased, the effect of self-compassion on intuitive eating decreased, and the effect of self-compassion on reducing emotional eating behaviors decreased. Overall, the brief, self-paced online intervention delivered in the current study did not prove to be an effective means for improving self-compassion, intuitive eating, body appreciation, disordered eating, muscle dysmorphia, and psychological inflexibility. Nevertheless, the relationships between self-compassion and outcome variables of interest throughout the study mirror that of the existing literature. Findings from this study, in general, were also consistent with differences between men and women despite a gap in the research for intervention outcomes. Although fear of self-compassion demonstrated a moderating effect on the relationship between self-compassion and intuitive eating as well as emotional eating, this does not account for the lack of significant findings. The context surrounding this study, such as the COVID-19 pandemic, provided a considerable challenge to examining the efficacy of the current intervention. However, the findings of this study suggest future research will likely need to identify ways to enhance the delivery of experiential exercises that encourage engagement, provide a safe and warm environment for participants, and create flexibility and willingness surrounding painful and difficult experiences in order to undermine internalized and socially accepted beliefs about body image and eating behaviors
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