title: Self-compassion directly and indirectly predicts dietary adherence and quality of life among adults with celiac disease.
abstract: Strict adherence to a gluten-free diet (GFD) is the only treatment for preventing both short- and long-term consequences of celiac disease. Given that following a strict GFD can be difficult, evidence-based strategies are needed to improve the psychological experience of living with celiac disease and following the GFD. Self-compassion appears to be an important component of effectively self-regulating one's behavior to cope with a chronic disease. The main goal of this study was to examine the relationships between self-compassion and management of celiac disease as assessed by (a) adherence to a strict GFD and (b) celiac-specific quality of life (CQoL). The secondary goal of this study was to explore self-regulatory efficacy (i.e., confidence in one's ability to self-manage behavior to follow a strict GFD) and concurrent self-regulatory efficacy (i.e., one's confidence to self-manage other valued life goals while following a strict GFD) as mediators of the relationship between self-compassion and the primary outcomes (adherence and CQoL). In this prospective study, 200 North American adults diagnosed with celiac disease completed online questionnaires at two time points (baseline and 1 month later). Self-compassion at baseline directly predicted stricter adherence (at Time 2; b = -0.63, p = 0.006) and enhanced CQoL (at Time 2; b = -0.50, p = 0.001). Further, self-compassion (at Time 1) also indirectly predicted stricter Time 2 adherence through self-regulatory efficacy (at Time 1; b = -0.26, 95% CI [-0.58, -0.04], R2= 0.29) and enhanced Time 2 CQoL through concurrent self-regulatory efficacy (at Time 1; b = -0.07, 95% CI [-0.14, -0.03], R2= 0.33). This was the first study to assess the effects of self-compassion in relation to the psychological experience of coping with celiac disease and following a GFD. The findings indicate that self-compassion, self-regulatory efficacy and concurrent self-regulatory efficacy are important cognitions in understanding adherence to a GFD and CQoL among adults with celiac disease.
authors.affiliation: The University of British Columbia, School of Health and Exercise Sciences, 3333 University Way, Kelowna, BC V1V 1V7, Canada. Electronic address: jdowd@ucalgary.ca.
authors.forename: A Justine
authors.initials: AJ
authors.lastname: Dowd
authors.affiliation: The University of British Columbia, School of Health and Exercise Sciences, 3333 University Way, Kelowna, BC V1V 1V7, Canada. Electronic address: mary.jung@ubc.ca.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Jung
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002446:Celiac Disease / Q000178:diet therapy / Q000523:psychology*; D055050:Diet, Gluten-Free / Q000523:psychology*; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D020377:Self Efficacy; D011795:Surveys and Questionnaires
keywords: Adherence behavior; Celiac disease; Gluten-free diet; Quality of life; Self-compassion; Self-regulation