• The dark side of competition: How competitive behaviour and striving to avoid inferiority are linked to depression, anxiety, stress and self-harm.

      Gilbert, Paul; McEwan, Kirsten; Bellew, Rebecca; Mills, Alison; Gale, Corinne; University of Derby (British Psychological Society, 2009-06)
      This study was guided by the social rank theory of depression and aimed to explore the relationship between depression, anxiety, stress and self‐harm with striving to avoid inferiority, feelings of shame and styles of attachment. Participants diagnosed with depression (n=62) completed a series of questionnaires measuring striving to avoid inferiority, fears of missing out, being overlooked and active rejection, attachment, social rank and psychopathologies. Striving to avoid inferiority was significantly linked to social rank variables and anxious attachment. Mediator analyses revealed that the relationship between striving to avoid inferiority and depression was mediated by the social rank variable of external shame, and also anxious attachment. These findings suggest that elevated competitive behaviour can have a ‘dark side’. When people feel insecure in their social environments, it can focus them on a hierarchical view of themselves and others, with a fear of rejection if they feel they have become too inferior or subordinate. This may increase vulnerability to depression, anxiety and stress.
    • Development of a striving to avoid inferiority scale.

      Gilbert, Paul; Broomhead, Claire; Irons, Christopher Paul; McEwan, Kirsten; Bellew, Rebecca; Mills, Alison; Gale, Corinne; Knibb, Rebecca C.; University of Derby; Kingsway Hospital (British Psychological Society, 2007-09)
      Social rank theory suggests that mood variation is linked to the security a person feels in his/her social domain and the extent to which they are sensitive to involuntary subordination (e.g. feeling defeated and feeling inferior). Previous studies looking at rank‐related and competitive behaviour have often focused on striving for dominance, whereas social rank theory has focused on striving to avoid inferiority. This study set out to develop a measure of ‘Striving to Avoid Inferiority’ (SAIS) and assess its relationship to other rank and mood‐related variables. We hypothesized two factors: one we called insecure striving, relating to fear of rejection/criticism for ‘not keeping up’, and the second we called secure non‐striving, relating to feeling socially acceptable and valued regardless of whether one succeeds or not. This scale was given to 207 undergraduates. The SAIS had good psychometric properties, with the two factors of insecure striving and secure non‐striving strongly supported by exploratory factor analysis. Both factors were significantly (though contrastingly) related to various fears of rejection, need for validation, hypercompetitive attitudes, feeling inferior to others, submissive behaviour and indicators of stress, anxiety and depression. Striving to avoid inferiority was a significant predictor of psychopathologies, especially where individuals perceived themselves to have low social rank.
    • ‘Do you practice what you preach?’ A qualitative exploration of therapists' personal practice of compassion focused therapy.

      Gale, Corinne; Schröder, Thomas; Gilbert, Paul; University of Nottingham; University of Derby; Trent Doctorate in Clinical Psychology; University of Nottingham; UK; Trent Doctorate in Clinical Psychology; University of Nottingham; UK; Derbyshire Healthcare NHS Foundation Trust; UK (Wiley, 2015-12-21)
      Background Therapists' personal practice of therapy techniques can impact on a range of areas, including: empathy for the client, therapeutic understanding, therapist skills and self-awareness. Compassion Focused Therapy (CFT) draws extensively on personal practice during training, and on-going personal practice is encouraged. However, the impact of this has not been examined.
    • Eating attitudes and striving to avoid inferiority.

      Bellew, Rebecca; Gilbert, Paul; Mills, Alison; McEwan, Kirsten; Gale, Corinne; Kingsway Hospital; University of Derby (Taylor and Francis, 2006-09-22)
      Vulnerability to some psychopathologies may be related to feeling the need to compete, strive, and achieve in order to avoid inferiority and rejection. This study explored “insecure striving”, (relating to a perceived need to strive to avoid inferiority and its consequence, rejection) in relationship to eating attitudes and appearance anxiety in students. Eating attitudes and appearance anxiety were associated with judgments of inferiority, insecure striving to avoid inferiority, and fear of losing out and were negatively associated to secure non-striving (social acceptance). Further work exploring the way people understand and react to the competitive dynamics of their social groups may illuminate important processes linked to eating disorders.
    • An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders

      Gale, Corinne; Gilbert, Paul; Read, Natalie; Goss, Ken; Kingsway Hospital; University of Derby; Coventry Eating Disorder Service; Mental Health Research Unit; Kingsway Derby UK; Mental Health Research Unit; Kingsway Derby UK; Coventry Eating Disorders Service; Coventry UK; et al. (Wiley, 2012-06-28)
      Objective This study explored the outcome of introducing Compassion Focused Therapy (CFT) into a standard treatment programme for people with eating disorders. In particular, the aim was to evaluate the principle that CFT can be used with people with eating disorders and improve eating disorder symptomatology. Method Routinely collected questionnaire data were used to assess cognitive and behavioural aspects of eating disorders and social functioning/well being (n = 99). Results There were significant improvements on all questionnaire measures during the programme. An analysis by diagnosis found that people with bulimia nervosa improved significantly more than people with anorexia nervosa on most of the subscales. Also, in terms of clinical significance, 73% of those with bulimia nervosa were considered to have made clinically reliable and significant improvements at the end of treatment (compared with 21% of people with anorexia nervosa and 30% of people with atypical eating disorders). Conclusion This study demonstrates the potential benefits of using CFT with people with eating disorders and highlights the need for further research on this new approach. Copyright © 2012 John Wiley & Sons, Ltd.
    • An exploration of different types of positive affect in students and patients with bipolar disorder.

      Gilbert, Paul; McEwan, Kirsten; Mitra, Ranjana; Richter, Anne; Franks, Leigh; Mills, Alison; Bellew, Rebecca; Gale, Corinne; Kingsway Hospital; University of Derby (Giovanni Fioriti Editore, 2009-08)
      Objective: Depue and Morrone-Strupinsky (2005) distinguished between two different types of positive affect regulation system: 1. relates to activated positive affects such as excitement, joy and vitality; and 2. relates to positive affects associated with peacefulness, contentment and well-being, and is linked to the experience of attachment and social safeness. In addition, people can derive positive feelings from doing social things (e.g. enjoying being with friends), and non-social things (e.g. watching a sunset). The first aim of this study was to develop two scales to assess the enjoyment of social and non-social events and to explore how these relate to the two types of affect regulation. In addition, we explore how these two types of positive affect regulation system are related to measures of affective temperament linked to mood disorders. The second aim was to explore these dimensions in people who have a bipolar disorder. Method: Students (n=202) and patients with bipolar disorder (n=49) completed a set of self-report scales measuring: social and non-social positive affect; different types of positive affect; social rank; current affective temperament and mood. Results: Our data showed that, in both patient and student groups, non-social positive affect has few correlations with other types of positive affect and affective temperament. In contrast, the pleasures derived from social relationships are significantly related to other types of positive affect and mood linked affective temperaments. Conclusions: Social and non-social positive affect seem to operate quite differently. It is the positive affects that we receive from our social relationships that are most significantly linked to affective temperament and social rank variables. This finding may have implications for pharmacological, psychological and social therapies.
    • The impact of self-criticism and self-reassurance on weight-related affect and well-being in participants of a commercial weight management programme.

      Duarte, Cristiana; Stubbs, James; Pinto-Gouveia, José; Matos, Marcela; Gale, Corinne; Morris, Liam; Gilbert, Paul; University of Coimbra; University of Leeds; Slimming World; et al. (Karger, 2017-04-04)
      Objective: Certain psychological and emotional factors can undermine attempts at weight management. Previously we have found that shame and self-criticism were significantly associated with disinhibition and perceived hunger in 2,236 participants of a weight management programme. This effect was fully mediated through weight-related negative affect. The present study examined the impact of self-criticism and self-reassurance on well-being and whether it was mediated by weight-related affect in the same population. Methods: Participants completed an online survey of measures of self-criticism and self-reassurance, and negative and positive affect associated with weight and well-being. Results: Path analysis suggested that self-criticism was significantly associated with decreased well-being, both directly and indirectly, mediated by increased negative and decreased positive weight-related affect. Self-reassurance had a stronger association with increased well-being by predicting lower negative and increased positive weight-related affect. All effects were significant at p < 0.001. Conclusion: Self-criticism and self-reassurance were related to well-being in participants attempting to manage their weight, both directly and through their impact on weight-related affect. The positive association between self-reassurance and well-being was stronger than the negative association between self-criticism and well-being. Supporting the development of self-reassuring competencies in weight management programmes may improve weight-related affect and well-being.
    • The impact of shame, self-criticism and social rank on eating behaviours in overweight and obese women participating in a weight management programme

      Duarte, Cristiana; Matos, Marcela; Stubbs, James; Gale, Corinne; Morris, Liam; Gouveia, Jose Pinto; Gilbert, Paul; University of Coimbra; University of Derby; Slimming World; et al. (Public Library of Science (PLOS), 2017-01-20)
      Recent research has suggested that obesity is a stigmatised condition. Concerns with personal inferiority (social rank), shame and self-criticism may impact on weight management behaviours. The current study examined associations between social comparison (shame, self-criticism), negative affect and eating behaviours in women attending a community based weight management programme focused on behaviour change. 2,236 participants of the programme completed an online survey using measures of shame, self-criticism, social comparison, and weight-related affect, which were adapted to specifically address eating behaviour, weight and body shape perceptions. Correlation analyses showed that shame, self-criticism and social comparison were associated with negative affect. All of these variables were related to eating regulation and weight control (p < 0.001). Path analysis revealed that the association of shame, hated-self, and low self-reassurance on disinhibition and susceptibility to hunger was fully mediated by weight-related negative affect, even when controlling for the effect of depressive symptoms (p < 0.050 to p < 0.010). In addition, feelings of inadequacy and unfavourable social comparisons were associated with higher disinhibition and susceptibility to hunger, partially mediated through weight-related negative affect (p = 0.001). These variables were negatively associated with extent of weight loss during programme attendance prior to the survey, while self-reassurance and positive social comparisons were positively associated with the extent of weight loss prior to the survey (p < .050). Shame, self-criticism, and perceptions of inferiority may play a significant role in self-regulation of eating behaviour in overweight people trying to manage their weight.
    • Paranoid beliefs and self-criticism in students.

      Mills, Alison; Gilbert, Paul; Bellew, Rebecca; McEwan, Kirsten; Gale, Corinne; University of Derby; Kingsway Hospital (Wiley, 2007-09)
      Paranoid beliefs are associated with negative and malevolent views of others. This study, however, explored hostile and compassionate self‐to‐self relating in regard to paranoid beliefs. A total of 131 students were given a series of scales measuring paranoid ideation, forms and functions of self‐criticism, self‐reassurance, self‐compassion and depression. Test scores were subjected to correlation and hierarchical regression analyses to explore the relative contribution of study variables to paranoid beliefs. In this population, paranoid beliefs were associated with forms and functions of self‐criticism, especially self‐hating and self‐persecution. Paranoid beliefs were negatively correlated with self‐kindness and abilities to be self‐reassuring. These variables were also associated with depression (as were paranoid beliefs). A hierarchical regression found that self‐hatred remained a predictor of paranoid ideation even after controlling for depression and self‐reassurance. Paranoid beliefs seem to be associated with a critical and even hating experience of self. These inner experiences of self may be profitable targets for therapeutic interventions. 
    • Practical compassions: repertoires of practice and compassion talk in acute mental healthcare

      Brown, Brian; Crawford, Paul; Gilbert, Paul; Gilbert, Jean; Gale, Corinne; DeMontfort University; Nottingham University; University of Derby; Faculty of Health and Life Sciences; De Montfort University; Leicester UK; Division of Nursing; Nottingham University; Nottingham UK; et al. (Wiley, 2013-10-11)
      This article reports an exploratory study of the concept of compassion in the work of 20 mental health practitioners in a UK Midlands facility. Using notions of practice derived from phenomenology and Bourdieusian sociology and notions of emotional labour we identify two contrasting interpretive repertoires in discussions of compassion. The first, the practical compassion repertoire, evokes the practical, physical and bodily aspects of compassion. It involves organising being with patients, playing games, anticipating disruption and taking them outside for cigarettes. Practitioners described being aware that these practical, bodily activities could lead to patients ‘opening up’, disclosing their interior concerns and enabling practical, compassionate mental health work to take place. In contrast, the second, organisational repertoire, concerns organisational constraints on compassionate practice. The shortage of staff, the record-keeping and internal processes of quality control were seen as time-greedy and apt to detract from contact with patients. The findings are discussed in relation to Bourdieu and Merleau-Ponty's phenomenological accounts of practice and habit and set in context in the growing interest in placing compassion centrally in healthcare. We also explore how the exercise of compassion in the way our participants describe it can afford the more effective exercise of medical power.
    • A qualitative study of the understanding and use of ‘compassion focused coping strategies’ in people who suffer from serious weight difficulties.

      Gilbert, Jean; Stubbs, James; Gale, Corinne; Gilbert, Paul; Dunk, Laura; Thomson, Louise; Derbyshire Healthcare NHS Trust; Slimming World; University of Derby; University of Nottingham (Biomed Central, 2014-11-11)
      Abstract Background The physical and psychological health problems associated with obesity are now well documented, as is the urgency for addressing them. In addition, associations between quality of life, depression, self-esteem, self-criticism, and obesity are now established indicating a need for a better understanding of the links between self-evaluation, affect-regulation and eating behaviours. Methods Compassion has now been identified as a major source of resilience, helpful self-relating and affect regulation. Thus this study used semi-structured interviews to explore the understanding and experiences of compassion in 2 overweight men and 10 women seeking help for weight problems. The interviews examined people's understandings of compassion, their recall of experiences of compassion in childhood, their current experiences of receiving compassion from others, being compassionate to others, being self-compassionate, and whether they would be compassionate or self-critical for relapses in overeating. Interviews were transcribed and analysed using thematic analysis (Qual Res Psychol, 3: 77-101, 2006). Results Participants saw compassion as related to ‘caring’ and being ‘listened to’. However, their recall of earlier experiences of compassion was of primarily practical help rather than emotional engagement. Typically their response to their own relapse and setbacks were self-criticism, self-disgust and even self-hatred rather than self-caring or understanding. Self-critical/hating responses tend to be associated with poor weight regulation. Conclusions When people with weight problems relapse, or struggle to control their eating, they can become quite self-critical, even self-hating, which may increase difficulties with emotionally coping and maintaining healthy lifestyles and eating habits. Although turning to others for support and compassion, and becoming self-compassionate are antidotes to self-criticism, and are associated with better coping and mental health, many participants did not utilise compassionate strategies – often the opposite. It is possible that interventions that include mindfulness and compassion training could be helpful for these difficulties.