The phenomenology of self-critical thinking in people with depression, eating disorders, and in healthy individuals.
Thew GR., Gregory JD., Roberts K., Rimes KA.
OBJECTIVES: To explore the phenomenology of self-criticism, and the relationship with constructs such as rumination and perfectionism. DESIGN: The study followed a three-group (Depression, n = 26; Eating Disorder, n = 26; Non-clinical, n = 26) mixed methods design. METHOD: Participants completed a set of questionnaires and were interviewed about the occurrence, impact, and content of self-critical thinking, along with their beliefs about self-criticism. RESULTS: Both clinical groups reported more frequent, persistent, and less controllable self-criticism compared to controls, present on average 50-60% of the time. They reported a negative impact on mood, and a moderately severe impact on daily activities. They indicated greater desire to change self-criticism whilst judging it more difficult to reduce. Habitual self-criticism was highly correlated with lower self-esteem, lower self-compassion, greater rumination, and greater negative perfectionism. Compared to those with depression, the eating disorder group reported harsher self-criticism, felt it was more part of their personality, and was more beneficial. CONCLUSIONS: The findings highlight the importance of exploring people's beliefs about their self-criticism, and imply that treatment for self-criticism may be more challenging with people with eating disorders than people with depression. PRACTITIONER POINTS: This study highlights that self-criticism is common in depression and eating disorders and that some people find this a significant problem in its own right. Careful assessment of self-criticism is recommended when working with these clinical presentations, which should include the perceived positive consequences and desire to change.