Effect of writing based on self-compassion on body image and psychological distress among women with systemic lupus erythematosus: a randomized clinical trial

Women with systemic lupus erythematosus (SLE) are at risk for body image (BI) disturbances and its resultant psychological distress (PD). The aim of this study was to examine the effects of self-compassion (SC)-based writing on BI and PD among women with SLE.

In this randomized clinical trial, which was done in 2022–2023, 86 women with SLE were selected and randomly allocated to an intervention group (IG) and a control group (CG). Participants in the IG were instructed to engage in SC-based writing that emphasized the concepts of common humanity, mindfulness, and self-kindness. Six blank pages were provided, each featuring a question related to self-compassion for participants to address. Conversely, the CG was also provided with papers and asked to respond to questions that were unrelated to SC. Data were collected before, immediately after, and one month after the intervention (T1–T3) using a demographic and clinical characteristics questionnaire, the SLE Disease Activity Index, the Body Image Lupus Scale(BILS), the Depression Anxiety Stress Scale, the Self-Compassion Scale, and the Body Image Quality of Life Inventory(BIQLI). The SPSS software (v. 22.0) was employed for data analysis.

Groups did not significantly differ from each other respecting baseline demographic and clinical characteristics and baseline mean scores of the main study outcomes. However, there were significant between-group differences respecting the mean scores of BI (P = 0.028), stress (P = 0.003), anxiety (P = 0.003), and SC (P < 0.001) at T2 and the mean scores of stress (P = 0.023), anxiety (P = 0.029), and SC (P < 0.001) at T3. Moreover, between-group differences respecting the other study outcomes at T2 and T3 were insignificant (P > 0.05).

SC-based writing significantly increases SC among women with SLE. Patients may be encouraged to engage in SC-based writing through education about this technique. Investigating alternative strategies or implementing the intervention at different time intervals may be beneficial for improving the BILS, PD, and BIQLI.

This study was registered in the Iranian Registry of Clinical Trials in February 14, 2022 (code: IRCT20220107053656N1).