Macquarie University
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My changed body: breast cancer, body image, distress and self-compassion

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posted on 2022-03-28, 10:33 authored by Astrid Przezdziecki
Negative alteration to a woman’s body image is a common consequence of breast cancer diagnosis, associated medical intervention and treatment side-effects. Despite the inevitable occurrence of adverse side-effects and the distress it causes for some women, body image difficulties for a subset of breast cancer survivors are not always adequately addressed. Self-compassion is a novel psychological approach that has been used in non-oncology contexts to assist with distress and body image disturbance. However, such an approach has not been applied to difficulties experienced by breast cancer survivors, and hence constitutes a gap in the psycho-oncology research literature. The overall aim of this thesis was to explore the utilization of a self-compassion-based intervention to address body image disturbance in this population, using a series of four studies. An initial cross-sectional exploratory study (Study I) investigated the relevance of self-compassionate approaches to body image and its possible relationship to psychological distress. It was found that self-compassion was a significant factor in the relationship between body image disturbance and subsequent psychological distress in breast cancer survivors, with evidence of self-compassion acting as a mediator of this relationship. A proof-of-concept pilot study (Study II) was then undertaken to investigate the acceptability and feasibility of a self-compassion focused writing activity to assist with body image difficulties in breast cancer survivors, the “My Changed Body” intervention. It was demonstrated that self-compassionate writing produced immediate reduction in negative affect and enhancement in self-compassionate outlook, compared with individuals in the expressive writing only control group. Given the promising outcomes from this research, a third study (Study III) was undertaken to investigate the potential acceptability of an online version of the My Changed Body self-compassion based writing intervention amongst breast cancer consumers and breast cancer-related health professionals. This development study indicated moderate to high acceptability for an online self-compassion based writing intervention. The final study (Study IV) investigated, in a randomised controlled trial, the effectiveness of the online self-compassion writing intervention on negative affect and self-compassion. A total of 206 breast cancer survivors were randomized to receive either the self-compassion online intervention or an active control condition (i.e., unstructured expressive writing). It was found that women assigned to the structured self-compassion writing intervention exhibited significant less negative affect, particularly for younger women. Moreover, older women receiving the My Changed Body intervention had a significant enhancement of self-compassion. In sum, the findings from this thesis have important implications for researchers, health professionals and breast cancer survivors. This research has been the first to investigate and apply self-compassion as a possible intervention for adverse body image changes in breast cancer, hence addressing a current knowledge gap. The research findings have been translated to create and evaluate a user-friendly, accessible online intervention that is simple for health professionals to administer. Finally, and most importantly, female breast cancer survivors have been provided with a novel, evidence-based, effective approach that can, depending on their age, decrease negative affect related to adverse bodily changes and improve their levels of self-compassion.


Table of Contents

Part One. Background and review of relevant literature. Chapter One. Breast cancer and body image Chapter Two. Self-compassion Chapter Three. Therapeutic writing and research development -- Part Two. Empirical studies of self-compassion in breast cancer survivors. Chapter Four. Empirical study I Chapter Five. Empirical study II Chapter Six. Empirical study III Chapter Seven. Empirical study IV Chapter Eight. Overview and closing comments -- References -- Appendices.


Bibliography: pages 221-252 Thesis by publication.

Awarding Institution

Macquarie University

Degree Type

Thesis PhD


PhD, Macquarie University, Faculty of Human Sciences, Department of Psychology

Department, Centre or School

Department of Psychology

Year of Award


Principal Supervisor

Kerry Sherman

Additional Supervisor 1

Andrew James Baillie


Copyright Astrid Przezdziecki 2017. Copyright disclaimer:




1 online resource (389 pages) colour illustrations

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