Body-Related Shame and Guilt Predict Physical Activity in Breast Cancer Survivors Over Time

Andrée L. Castonguay, PhD; Carsten Wrosch, PhD; Eva Pila, MSc; Catherine M. Sabiston, PhD


Purpose/Objectives: To test body-related shame and guilt as predictors of breast cancer survivors’ (BCS’) moderate to vigorous intensity physical activity (MVPA) during six months and to examine motivational regulations as mediators of this association.

Design: Prospective study.

Setting: Survivors were recruited through advertisements and oncologist referrals from medical clinics and hospitals in Montreal, Quebec, Canada.

Sample: 149 female BCS.

Methods: Self-reports of body-related shame and guilt, motivational regulations, and MVPA were measured among BCS at baseline. MVPA was assessed a second time six months later. Residual change scores were used.

Main Research Variables: Body-related shame and guilt; external, introjected, and autonomous (identified and intrinsic) motivational regulations; MVPA.

Findings: In the multiple mediation models, body-related shame was associated with low levels of MVPA, as well as external, introjected, and autonomous motivational regulations. Guilt was related to high levels of MVPA and introjected and autonomous motivational regulations. Indirect effects linked shame, guilt, and MVPA via autonomous motivation. Only body-related shame was a significant predictor of six-month changes in MVPA.

Conclusions: Based on these results, the specific emotions of shame and guilt contextualized to the body differentially predict BCS’ health motivations and behavior over time.

Implications for Nursing: Survivorship programs may benefit from integrating intervention strategies aimed at reducing body-related shame and helping women manage feelings of guilt to improve physical activity.

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