A qualitative investigation of the experience of self-criticism in a student population

Abstract

Objectives
Self-criticism is a trans-diagnostic construct that has been receiving considerable research and clinical attention. The purpose of this systematic review was to explore whether there is evidence from prospective studies that self-criticism is significantly associated with subsequent symptoms of psychopathology in students.
Methods
To identify studies for inclusion in this systematic review, searches were carried out in four electronic databases: PsychInfo, Embase, Medline and The Web of Science Core Collection. Inclusion criteria specified a prospective design, a student sample, valid and reliable measurement of self-criticism and symptoms of a common mental health disorder and publication in a peer-reviewed journal. The methodological quality of the included studies was assessed and data was extracted and synthesised.
Results
Sixteen studies were identified, twelve of which explored the relationship between self-criticism and subsequent depressive symptomatology. The remaining studies investigated social anxiety (n=1), depression and anxiety (n=2) and depression and terrorism-related perceived stress (n=1). In terms of depression, all identified studies found a significant relationship, with moderate to strong effect sizes, between self-criticism and subsequent symptoms. Eight (of the twelve studies that tested this) observed self-criticism, with weak to moderate effect sizes, to significantly predict an increase in symptoms over time. In terms of anxiety, all three studies found a significant relationship, with weak to moderate effect sizes, between self-criticism and subsequent symptoms, while none observed an increase in symptoms. The one study of terrorism-related perceived stress found a significant relationship and an increase in symptoms, with weak effect sizes, between self-criticism and subsequent psychopathology. The methodological quality of studies ranged from fair to good, with study attrition, and its subsequent consideration in the analysis process, being a primary methodological flaw. The use of the Depressive Experiences Questionnaire (DEQ) to
measure self-criticism was also problematic as this scale was designed to measure self-critical depression and includes items about depression.
Conclusions
This systematic review provides some evidence that there is a significant prospective relationship between self-criticism and symptoms of psychopathology amongst a student sample, with the strongest evidence for depression. Recommendations were made to carry out prospective research exploring the effects of self-criticism on symptoms of other mental health problems in students, to consider alternative measures of self-criticism and to improve the methodological quality of studies especially in terms of study attrition.

Date of Award	2017
Original language	English
Awarding Institution	King's College London
Supervisor	Katharine Rimes (Supervisor) & Patrick Smith (Supervisor)