PAPER Self‐compassion and hope in the context of body image disturbance and distress in breast cancer survivors Natasha Todorov 1 | Kerry A. Sherman 2 | Christopher J. Kilby 2 | Breast Cancer Network Australia 1 Department of Psychology, Macquarie University, Sydney, Australia 2 Centre for Emotional Health Department of Psychology, Macquarie University, Sydney, Australia Correspondence Natasha Todorov, Department of Psychology, Macquarie University, Sydney, NSW, Australia. Email: natasha.todorov@mq.edu.au Funding information Macquarie University Department of Psychol- ogy Strategic Research Grant Fund Abstract Objective: Greater hope and self‐compassion have individually been associated with lower psychological distress in women with breast cancer. Self‐compassion is also associated with lower body image distress in this population, yet it is unknown whether hope also has this association. This study aimed to investigate the extent to which hope accounts for body image distress and psychological distress in breast cancer survivors alone, and in direct comparison to self‐compassion. Method: A total of 195 women were recruited from the Breast Cancer Network Australia and completed a cross‐sectional online anonymous questionnaire containing self‐report measures of body image (Body Image Scale), self‐compassion (Self Com- passion Scale‐SF), hope (State Hope Scale), psychological distress (depression, anxi- ety, stress; DASS), and demographic/medical questions. Results: Self‐compassion and hope were inversely correlated with all outcomes. Hierarchical linear regression analyses indicated that self‐compassion and hope uniquely explained variance in all outcomes with different magnitudes of strength. Comparison of standardised betas indicated (a) Body image distress—self‐ compassion (B std = -.355) vs hope (B std = -.161); (b) Stress—self‐compassion (B std = -.562) vs hope (B std = -.287); (c) Depression—hope (B std = -.447) vs self‐ compassion (B std = -.374); (d) Anxiety—hope (B std = -.406) vs self‐compassion (B std = -.249). Conclusion: The unique contribution of self‐compassion and hope in explaining body image distress and psychological distress suggests that combined, hope‐ focused components of therapy may be suitable additions to the growing array of self‐compassion–based psychosocial interventions to address body image and psy- chological distress concerns of women with breast cancer. KEYWORDS body image, breast cancer, cancer, hope, oncology, psychology, self‐compassion, survivor 1 | INTRODUCTION Body image disturbance is commonly experienced at some time during the cancer trajectory by the majority of women diagnosed with breast cancer. 1-6 This body image distress stems largely from the visible (eg, breast loss) and nonvisible (eg, hot flushes) changes to a woman's body arising during active treatment for breast cancer and into the post- treatment period. 2-6 Of those experiencing body image concerns, Received: 27 March 2019 Revised: 23 July 2019 Accepted: 25 July 2019 DOI: 10.1002/pon.5187 Psycho‐Oncology. 2019;28:2025–2032. © 2019 John Wiley & Sons, Ltd. wileyonlinelibrary.com/journal/pon 2025