Exercise & Physical Activity in Middle-Aged Women: The Role of Self-Compassion DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Michelle Susan Thall, M.S. Graduate Program in Education The Ohio State University 2014 Dissertation Committee: Professor Janet Buckworth, Advisor Professor Diane Habash Professor Maryanna Klatt i i Abstract Americans do not engage in sufficient physical activity and exercise (PA/Ex). PA/Ex declines with age and women are less active than men. Research suggests a focus on immediate benefits of PA/Ex may increase PA/Ex motivation. Self-compassion, a psychological construct comprised of self-kindness, mindfulness and common humanity, is correlated with several indicators of acute positive affect. In the last four years, 10 published studies have explored the relationship between self-compassion, body image and exercise in youth or young-adult populations. This study’s purpose was to contribute to such research by investigating self-compassion’s influence on body image, exercise motivation and PA/Ex in middle-aged women. Women were eligible for this study if they were 35-60 years of age, not pregnant (or within one year postpartum), and able to be physically active. Participants were recruited from the ResearchMatch database and completed a survey developed using Qualtrics Research Suite. In September 2013, 1,303 participants accessed the on-line survey. After allowing for individuals who did not consent to take the survey, data errors, and treatment for missing values and outliers, 1,213 complete cases were available for data analysis. Of these, 1,122 non-African American participants were initially analyzed as the literature indicated African American women may differ significantly from other ethnic groups in perceptions of body image. ii Average age and BMI of the1,122 women participants were 48, and 28 kg/m2, respectively. Seventy-one percent of the participants met or exceeded the 150-minute recommended level of moderate aerobic activity per week, as compared to 50% of women aged 35-64 in the 2011 Behavioral Risk Factor Surveillance System. A confirmatory factor analysis conducted within structural equation modeling (SEM) using LISREL indicated appearance evaluation, health/fitness evaluation, health/fitness orientation, and body appreciation were significant dimensions of body image (p < .001, in all cases), while amotivation, extrinsic motivation, identified motivation, and intrinsic motivation were significant aspects of exercise motivation (p < .001, in all cases) Appearance orientation and introjected motivation were not significant dimensions of body image (p = .136) and exercise motivation (p = .646), respectively. The final structural equation model indicated that in this population of middle- aged women, self-compassion positively predicts body image, which in turn predicts autonomous exercise motivation and consequently, higher levels of PA/Ex participation (SRMR = .05, and GFI = .952). Further, contrary to hypotheses based upon the literature, Body Mass Index (BMI) and age were not significant predictors of PA/Ex participation in this sample of women, though BMI and age were both significantly and positively correlated with self-compassion levels. In depth analysis of the relationship between self-compassion and body image suggests self-compassion might be viable as a coping mechanism to relieve negative repercussions of poor body image, encourage body appreciation and ultimately lead to increases in PA/Ex levels in the population of middle-aged women. Future research iii should focus on examining commonalities between self-compassion and distinct aspects of body image and how increases in levels of self-compassion and body appreciation can increase the likelihood that middle-aged women will autonomously adopt and maintain more active lifestyles. iv Acknowledgements I acknowledge the help of all mentors, colleagues, co-workers, friends and family who have made this research and this document possible. To those few who I am certain I will forget to mention by name, I am eternally grateful regardless. First to my amazing dissertation committee, Dr. Janet Buckworth, Dr. Diane Habash and Dr. Maryanna Klatt, thank you for your brilliance, knowledge, common sense and unlimited supply of patience. A special thanks to Dr. Richard Lomax and Dr. Joseph Gliem for their statistical wizardry, analytical guidance and general geek support. I also want to acknowledge the incomparable guidance of Rose Hallern and CCTS in recruiting my sample. Without her assistance I could not have even begun my study. And finally to two special friends who have taught me to put my head down, barrel through and “git-er-done,” John Borowski and Dr. Chris Hearon. Thanks for always getting my back! I cannot imagine weathering graduate studies without the camaraderie of colleagues and co-workers who made the Fish Bowl come to life. You know who you are, no names will be dropped. You made life fun, interesting, bizarre, and sometimes, just bearable. To a special group of women who supported me through laughter and tears, I express the utmost in gratitude, and I support you right back. To Liz Balk, who v could always put a smile on my face, regardless of the situation, and to Chris Wilks for reminding me to silence the committee in my head, thank you, thank you, thank you. Coming to the OSU and successfully navigating a new city, a new home, a new job, a new academic program and a traumatic car accident wasn’t easy. But it wasn’t impossible because of two great people, my mom, and my friend Vikkie. My mom supported me financially, medically, logistically and emotionally; she is the best mom I know and put up with me even when I was beyond impossible. Vikkie rose to all occasions, from taking care of my dog after my accident, to welcoming me into her home, her family and her life. I was never alone because she shared so much with me. And finally a big thanks to the following: My next-door neighbor Jed for …too many things to say and count. My daddy for looking in on me from time to time. My dog Eppy for being exactly as she is. My friend Ayla for cluing me in to the “blue hairs,” and keeping me safe. The universal subconscious mind for the Law of Attraction. I’d also like to acknowledge the groundbreaking work of several scholars without whom I would never have gotten here: Kristin Neff, Naomi Wolf, Edward Deci and Richard Ryan, again, my amazing advisor, Janet Buckworth, Chris Germer, John Kabat Zinn and Jay Kimiecik. It’s been an honor to immerse myself in your knowledge and develop my research study on the backbone of your findings. With gratitude, peace and humility, M- vi Vita 1985 ………………. B.S. Accountancy, University of Illinois 2005 ……….……… M.S. Exercise Science, Northeastern Illinois University 2005-2009 ………... Instructor, Northeastern Illinois University 2009-2013 …............. Graduate Teaching Associate, PAES, The Ohio State University Publications Buckworth,J, & Thall, M., (2012). Increasing and maintaining physical activity in clinical populations: Update. In J.A. Trafton & W. P. Gordon (Eds.), Best practices in the behavioral management of chronic disease. (3rd ed). Los Altos, CA: Institute for Disease Management. Fields of Study Major Field: Education vii Table of Contents Abstract ............................................................................................................................... ii Acknowledgements ............................................................................................................. v Vita .................................................................................................................................... vii Chapter 1 - Introduction ...................................................................................................... 1 Significance..................................................................................................................... 4 Statement of Purpose ...................................................................................................... 6 Hypotheses ...................................................................................................................... 6 Definition of Terms......................................................................................................... 9 Assumptions .................................................................................................................. 13 Limitations .................................................................................................................... 13 Chapter 2 – Literature Review .......................................................................................... 14 Organization .................................................................................................................. 14 Self-Compassion – Overview ....................................................................................... 14 Historical perspectives and a contemporary construct. ............................................. 15 Self-compassion research.......................................................................................... 18 Discussion. ................................................................................................................ 20 Self-Determination Theory & Motivation .................................................................... 22 Self-Compassion