Self-compassion directly and indirectly predicts dietary adherence and quality of life among adults with celiac disease

Appetite. 2017 Jun 1;113:293-300. doi: 10.1016/j.appet.2017.02.023. Epub 2017 Feb 20.


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.

Keywords: Adherence behavior; Celiac disease; Gluten-free diet; Quality of life; Self-compassion; Self-regulation.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Celiac Disease / diet therapy
  • Celiac Disease / psychology*
  • Diet, Gluten-Free / psychology*
  • Empathy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology
  • Prospective Studies
  • Quality of Life*
  • Self Efficacy*
  • Surveys and Questionnaires