Protection or Vulnerability? A Meta-Analysis of the Relations Between the Positive and Negative Components of Self-Compassion and Psychopathology

Does self-compassion buffer the detrimental effect of body shame on depressive symptoms?

Researchers have identified that experiences of body-related shame significantly contribute to heightened depressive symptoms, and therefore it is valuable to identify and understand potential factors that buffer this relationship. The present study examined the cross-sectional relationship between body-related shame and depressive symptoms separately among women and men, and tested self-compassion as a potential moderator. Data from a sample of 520 adults (42.3 % women; M_age = 35.43, SD = 10.09 years) recruited through MTurk were analyzed using moderated regression analysis. Results indicated that body-related shame was positively and significantly associated with frequency of depressive symptoms. Additionally, self-compassion moderated the relationship between body-related shame and depression among women, but not men, even after controlling for self-esteem. Specifically, women with lower levels of self-compassion reported a significantly stronger relationship between body-related shame and depressive symptoms, and at higher levels of self-compassion, there was no relationship between body shame and depressive symptoms. These findings have practical implications and suggest that low levels of self-compassion may increase the risk of depressive symptoms, and high levels of self-compassion may be protective among women that experience body-related shame.

Psychometric validity of the Compassionate Engagement and Action Scale for Adolescents: a Swedish version

BACKGROUND

There is increasing evidence that compassion is linked to mental health and well-being while difficulties in receiving and expressing compassion to self and others is associated with mental health and social difficulties. For the most part the self-report scales that measure these processes have been developed for adults and little is known how they function in adolescents. This study investigates a Swedish adaption for adolescents of the Compassionate Engagement and Action Scales (CEAS), developed by Gilbert et al. (2017) for adults. This assesses different competencies associated with being compassionate to others, the experience receiving compassion from others, and being compassionate with one-self.

OBJECTIVE

To evaluate the psychometric properties and gender differences of CEAS for Youths - Swedish version (CEASY-SE), in a school-sample of adolescents (n = 316) aged 15-20 years.

METHOD

The Compassionate Engagement and Action Scales were translated into Swedish. A back-translation method was used. It was then adapted for adolescents with age-appropriate language. Adolescents were recruited by research assistants at two public high schools.

RESULTS

After removing one item of each subscale, the dimensionalities of the three scales were good. Confirmatory factor analysis showed that engagement and action constituted different dimensions in each scale. Internal consistency was good to excellent in all three sub-scales (α from 0.74 to 0.92). Intra Class Correlations demonstrated good to excellent test-retest reliability over a period of three weeks (0.67 to 0.85). Convergent and divergent validity were as expected, except for Compassion for others, which did not correlate with anxiety and depression symptoms as expected. Girls showed less self-compassion compared to boys and more compassion for others.

CONCLUSIONS

Present study suggests that CEASY-SE has good to excellent psychometric properties and further study is needed for more definite establishment of the psychometric properties. Girls and boys have different patterns of compassion.

Understanding the Relation Between Self-Compassion and Suicide Risk Among Adolescents in a Post-disaster Context: Mediating Roles of Gratitude and Posttraumatic Stress Disorder

Background

The suicide risk among adolescents post-earthquake remains an important issue in trauma psychology. While existing studies and theories suggest that factors such as self-compassion, gratitude, and posttraumatic stress disorder (PTSD) play roles in the risk of suicide, few studies have combined these factors to explore the relationship between them.

Objective

This study examined the mediating roles of gratitude and PTSD in the relationship between self-compassion and suicide risk among Chinese adolescents after the Ya’an earthquake.

Methods

Four and a half years after the Ya’an earthquake, 499 middle school students in Lushan County were assessed using the following systems: Measures of Self-Compassion Scale, Gratitude Questionnaire, PTSD Checklist for DSM-5, and Child Behavior Problems Questionnaire.

Results

When we controlled for gender, age, and traumatic exposure, in the direct effect model, positive self-compassion had a negative effect on suicide risk, and negative self-compassion had a positive effect on suicide risk. In the indirect effects model, both positive self-compassion and negative self-compassion had no significant direct effect on suicide risk. Moreover, we found an indirect and negative effect of positive self-compassion on suicide risk via gratitude and PTSD, as well as via an indirect path from gratitude to PTSD. On the other hand, we also found an indirect and positive effect of negative self-compassion on suicide risk via gratitude and PTSD, as well as via an indirect path from gratitude to PTSD.

Conclusion

Positive self-compassion reduces the risk of suicide, while negative self-compassion increases the risk of suicide. Gratitude and PTSD play significant mediating role between self-compassion and suicide risk.

Anxiety, Self-Compassion, Gender Differences and COVID-19: Predicting Self-Care Behaviors and Fear of COVID-19 Based on Anxiety and Self-Compassion with an Emphasis on Gender Differences

Objective: The outbreak of COVID-19 has different effects on people's psychological and social aspects. This study aimed to investigate the relationship between anxiety, self-compassion, and gender differences with self-care behaviors and fear of COVID-19 in Kermanshah. Method : In the cross-sectional study, 403 people answered online questions on the Generalized Anxiety Disorder 7-Item (GAD-7) Scale, Self-Compassion Scale (SCS), Fear of COVID-19 Scale (FCV-19S), and a questionnaire focusing on COVID-19-related behavior. Pearson correlation coefficient and regression analysis were used for data analysis. Results: There was a significant relationship between social distance and gender, and people who observed social distancing reported higher levels of fear of COVID-19 (p < 0.001). No significant relationship was found between handwashing behaviour and gender variables, marital status, and education (p > 0.05). There was a significant difference between those who answered yes to self-care behaviours related to washing and those who answered no in terms of variables of fear of COVID-19, the overall score of compassion, and subscales of compassion, including self-kindness and isolation (p < 0.05). In relation to fear of COVID-19, married status, anxiety, and common humanity had a positive relationship with fear of COVID-19. However, self-judgment was negatively related to fear of COVID-19 (p < 0.05). Conclusion: According to the findings of the present study, men and people who are less afraid of COVID-19 are more likely not to observe self-care behaviors. Therefore, providing training about treatment protocols is necessary for these people. To reduce the fear of this disease in people with high levels of fear, psychologists, psychiatrists, and other medical staff can implement protocols to increase compassion.

Is self-compassion relevant to the pathology and treatment of eating and body image concerns? A systematic review and meta-analysis

Eating disorders are severe mental health conditions, with substantial consequences for health and quality of life. Such disorders are strongly associated with body image concerns. It is important to consider treatments that might enhance our ability to treat such cases. Recently, there has been a growing body of research on self-compassion in relation to such problems. However, we are not yet clear about the extent of such effects, given the range of studies and methodologies used. Therefore, a systematic literature review was carried out using four key databases. Meta-analysis was used to reach conclusions about the size of the effects and moderators. Random-effects meta-analyses were conducted with 59 studies. Higher self-compassion was associated with lower eating pathology, reduced body image concerns, and greater positive body image, with medium to strong effect sizes (respectively, r = -0.34, r = -0.45, r = 0.52). Furthermore, self-compassion interventions for eating pathology and body image were effective, and superior to control groups (respectively, g = 0.58, g = 0.39). These findings support the role of self-compassion in understanding and addressing eating and body image concerns. Self-compassion appears to be an adaptive emotion regulation strategy in eating disorders and body image.

Self-criticism, self-compassion, and perceived health: moderating effect of ethnicity

A caring and compassionate attitude toward the self (i.e., self-compassion) has been linked to various mental and physical health benefits. The Self-Compassion Scale (SCS) is widely used in psychology literature in order to assess global self-compassion. However, recent evidence suggests that the single factor model comprising positive and negative items of the SCS in fact measures two distinct constructs (i.e., self-criticism/self-coldness and self-compassion) with different psychological correlates. Given these recent findings, in addition to other research that highlights cultural differences in self-conceptualizations and self-evaluations, the present study examined potential ethnic differences in the relationships between self-criticism, self-compassion, and perceived health. Participants included 728 college students (141 Asian American, 449 European American, and 138 Hispanic/Latinx individuals) attending a university in the northeast United States. Results indicated that the relationship between self-criticism and self-compassion was significantly different across ethnicity. In addition, the relationships between these two constructs (i.e., self-criticism and self-compassion) and perceived health were moderated by ethnicity. Our findings suggest that focusing on global self-compassion scores (i.e., total SCS scores) may miss some of the important cultural or ethnic differences in the relationships between self-criticism, self-compassion, and perceived health.

The development of the Japanese version of the compassionate engagement and action scales

The last few years have seen increasing research on self-report measures of compassion. The Compassionate Engagement and Action Scale (CEAS) is rooted in an evolutionary approach to compassion, which focuses on the competencies of compassion those are engagement with distress or suffering, and taking action to alleviate and prevent it. This study sought to validate the CEAS in a Japanese population using a cross-sectional design. A total of 279 students (82 males, 191 females, 6 unknown) answered self-report questionnaires, including the Japanese version of CEAS. We found single-factor structures for compassion for others scales, compassion from others scales, and compassion for self scales. All scales were found to have acceptable internal consistency, test-retest reliability, content validity, and construct validity. Even though some limitations, these results indicate that the Japanese version of CEAS is an adequately constructed and useful measure to assess compassionate engagement and action toward others, from others, and for the self with Japanese population.

Effects of self-compassion and self-focus on sleep disturbances among psychiatric nurses

PURPOSE

Previous research has demonstrated that self-compassion improved sleep in geriatric samples. However, this may be due to an uncontrolled influence from self-focus, or interaction between self-compassion and self-focus. This study examines whether these findings apply to psychiatric nurses.

DESIGN AND METHODS

Demographics, sleep disturbances, self-compassion, and self-focus of 404 psychiatric nurses were assessed. Hierarchical multiple regression was used to predict sleep disturbances.

FINDINGS

Analyzes revealed that working more night shifts, less self-compassion, and rumination predicted worse sleep quality; however, the effect of self-compassion was not significant when controlling for self-focus.

PRACTICE IMPLICATIONS

An association between sleep quality and self-compassion was observed, but not when controlling for self-focus. Rumination may have an impact on sleep, and reducing it may improve sleep in psychiatric nurses.

Development and Validation of the Self-Compassion Scale for Youth

We present a series of studies on the development and validation of the Self-Compassion Scale-Youth version (SCS-Y), which is intended for use with early adolescents in middle school. Study 1 (N = 279, M_age = 12.17) describes the selection of 17 items out of a pool of 36 potential items, with three items each representing the subscales of self-kindness, mindfulness, common humanity, self-judgment, isolation, and two items representing over-identification. Using state-of-the-art psychometric analyses ideal for examining multidimensional constructs like self-compassion-bifactor exploratory structural equation modeling (bifactor-ESEM)-findings supported the use of a general self-compassion score and six subscale scores. Study 2 cross-validated the factor structure of the SCS-Y with a second sample of youths (N = 402, M_age = 12.43). Study 3 found support for the test-retest reliability of the SCS-Y (N = 102, M_age = 12.52). Study 4 (N = 212, M_age = 12.18) established construct validity for the SCS-Y by demonstrating that SCS-Y scores were significantly associated with mindfulness, happiness, life-satisfaction, depression, resilience, and achievement goal orientation in expected directions. Overall, findings suggest that the SCS-Y is a reliable and valid measure of self-compassion for use with youths.

Different patterns of perceived barriers to psychological treatment among Chinese depressed college students: Preliminary findings

OBJECTIVES

This study aimed to (a) identify the different patterns of perceived barriers to psychological treatment in Chinese college students with depression and (b) determine whether self-compassion and depression severity distinguished individuals with different patterns.

METHODS

This study included 338 college students with depression. The perceived barriers to psychological treatment scale were used. Latent profile analysis (LPA) was performed to identify the differential patterns.

RESULTS

Results of LPA indicated four patterns of perceived barriers, which differed with respect to levels and patterns, namely, "low barriers" (31%, n = 105), "moderate barriers" (45%, n = 153), "attitudinal and availability barriers" (18%, n = 61), and "high barriers" (6%, n = 19). Self-compassion (particularly, negative self-compassion) and depression severity distinguished participants with the four patterns.

CONCLUSIONS

A small number of participants reporting high levels across different types of barriers deserve special attention because they would be less likely to seek professional help.

The effect of four Immeasurables meditations on depressive symptoms: A systematic review and meta-analysis

The Four Immeasurables Meditations (FIM) intervention have been shown as a promising intervention for reducing depressive symptoms. The current study is a systematic review of FIM intervention effects on depressive symptoms. Among 192 empirical research articles on FIM published before May 2019, 40 independent trials from 35 records measured depressive symptoms. The meta-analysis included 21 randomized controlled trials (RCT; n = 1468) and 16 uncontrolled trials (n = 376). The results supported overall effectiveness of FIM on depressive symptoms (d = 0.38 for RCT and d = 0.87 for uncontrolled trials). Moderator analysis indicated the effects differed across protocols, and effects were smaller in RCT using active control groups. No significant differences were observed for participant type, measures, intervention length, or intervention components. Individual studies found no direct association between meditation practice time and effects, and mindfulness and self-compassion were widely supported as mechanisms of change. Current evidence supports FIM as an effective intervention for reducing depressive symptoms, but additional studies with more rigorous designs using active control groups are needed. Further investigation should be encouraged regarding specific protocols and participants, the contribution of meditation practice, and other mechanisms such as positive emotions.

Family Strain Predicts Subsequent Depressive Symptoms in Middle-aged Adults: Hope Mediates and Self-compassion Moderates the Relation

Introduction

Interpersonal strain is linked with depressive symptoms in middle-aged adults. One possible mechanism accounting for this relation is a reduction in hope, defined as the belief in one's capacity both to reach and to generate a variety of ways to obtain goals. The strength of the strain-depressive symptoms relation is not uniform across individuals, however, pointing to the likelihood that individual differences in the ability to successfully navigate relationship strain play a role in mitigating its negative effects. One potential moderator of the strain - depressive symptoms relation is self-compassion, which encompasses the capacity to respond to one's own negative thoughts and experiences in a kind and nonjudgmental way. Although theory and empirical evidence suggest that self-compassion is protective against the impact of stress on mental health outcomes, little research has investigated how self-compassion operates in the context of relationship strain. In addition, few studies have examined psychological mechanisms by which self-compassion protects against mental health outcomes, depression in particular. Thus, this study examined 1) the extent to which hope mediates the relation between family strain and depressive symptoms, and 2) whether these indirect effects are conditional on self-compassion in a community sample of middle-aged adults.

Methods

Self-reported family strain, self-compassion, hope, and depressive symptoms were assessed in a community sample of 762 middle-aged adults aged 40-65. Follow-up measures of depressive symptoms were assessed approximately 20 months later.

Results

Results from structural equation models indicated that hope mediated the relation between family strain and depressive symptoms and the indirect effect was conditional on levels of self-compassion. For individuals high versus low in self-compassion, strain-related declines in hope predicted smaller increases in depressive symptoms.

Discussion

Taken together, the findings suggest that family strain may lead individuals to experience less hope and subsequent increases in depressive symptoms. However, a self-compassionate attitude may serve as a resilience resource, weakening the hope - depressive symptoms relation, a finding that holds promise for future research on the development and refinement of self-compassion interventions.

Self-Compassion Buffers the Adverse Mental Health Impacts of COVID-19-Related Threats: Results From a Cross-Sectional Survey at the First Peak of Hong Kong's Outbreak

COVID-19 has brought tremendous and abrupt threats to various aspects of our daily lives, from school and work to interpersonal relationships. Self-compassion is put forth as a salutogenic perspective on oneself that buffers the adverse mental health impacts of these threats. During the peak of a local outbreak in Hong Kong in Spring 2020, 761 participants completed questionnaires on self-compassion, perceived threats, as well as perceived benefits and psychological distress. Controlling for demographic variables, negative indicators of self-compassion (aka self-coldness) was found to intensify the impacts of threats on psychological distress. The positive indicators of self-compassion also moderated the link between threats and perceived benefits, such that perceived benefits tend to be less related to threats in participants with higher self-compassion. Our findings highlight the impacts of both positive and negative indicators of self-compassion on the adjustment to such unprecedented challenges, and point to the possibility of enhancing people's resilience through fostering self-compassion and alleviating self-coldness.

The Independent Relationships of Metacognition, Mindfulness, and Cognitive Insight to Self-Compassion in Schizophrenia

The debilitating nature of psychosis may be exacerbated by societal stigma and feelings of social isolation over and above positive (e.g., hallucinations) and negative (e.g., flat affect) symptoms. Thus, recovery may be facilitated by increasing self-compassion, the ability to respond with a nonjudgmental attitude of kindness toward oneself as a result of connecting with one's own inadequacies and suffering. We conducted a stepwise regression in individuals with schizophrenia-spectrum disorders (n = 92) to determine the unique contributions of cognitive variables in predicting self-compassion, such as metacognition (the ability to form complex and integrated ideas about oneself and others), mindfulness, and cognitive insight. Results indicated that increased metacognitive awareness of others and mindfulness uniquely predicted greater self-compassion (i.e., self-kindness), whereas increased cognitive insight predicted greater lack of self-compassion (i.e., self-judgment). These findings suggest the potential for mindfulness and metacognitive interventions to increase positive self-compassion and promote recovery in psychosis.

The role of self-compassion in the relationship between attachment, depression, and quality of life

BACKGROUND

Self-compassion may be shaped by early attachment experiences, and has been linked to mental health and well-being. This study examined the role of two distinct features of self-compassion, self-warmth and self-coldness, in the relationship between attachment insecurity and depression as well as quality of life in a general population sample in Germany.

METHODS

Participants (N = 2,253; 53.4% female, M_age 50 years) completed the Self-Compassion Scale (SCS), Adult Attachment Scale (AAS), Beck Depression Inventory-Fast Screen (BDI-FS), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Mediation analysis was used to examine whether insecure attachment predicted increased symptoms of depression and decreased quality of life through decreased self-warmth and increased self-coldness.

RESULTS

Attachment-related anxiety and avoidance had a significant direct effect on depressive symptoms and significant indirect effect via self-warmth and self-coldness. The indirect effect via self-warmth appears to be of negligible magnitude. Attachment-related anxiety and avoidance had a significant direct effect on quality of life, and significant indirect effect via self-coldness. The indirect effect via self-warmth was not statistically significant, speaking against self-warmth as a relevant mediator.

LIMITATIONS

Causal conclusions cannot be drawn based on cross-sectional research design. All measures were based on participant self-report.

CONCLUSIONS

This study contributes to a more differentiated understanding of how attachment insecurity and self-compassion may contribute to affective disorders. Findings suggest that self-coldness may be particularly relevant in affective disorders and when addressing relational struggles, with both theoretical and clinical implications for psychotherapy and future research.

Self-compassion, physical health, and health behaviour: a meta-analysis

This meta-analysis investigated relationships between self-compassion and (1) physical health and (2) health-promoting behaviour in a large pooled sample (N = 29,588) sourced from 94 peer-reviewed articles. As hypothesised, omnibus analyses revealed positive associations between self-compassion and both physical health (r = .18) and health behaviour (r = .26). Moderation analyses using 290 effects found that both associations varied according to health domain, participant age, intervention duration, and self-compassion measure. Self-compassion predicted outcomes in most health domains, with the strongest effects observed on global physical health, functional immunity, composite health behaviour, sleep, and danger avoidance. It did not predict frailty, maladaptive bodily routines, and substance abuse. Multi-session interventions designed to boost self-compassion predicted increased physical health and health behaviour, thereby supporting causal links between self-compassion and health outcomes. The effects of single-session inductions were non-significant. The mean effect of self-compassion on physical health was non-significant for young participants (12.00-19.99) and its effect on health behaviour was weakest among older participants (40.00+). Results support the proposition that self-compassion can promote better physical health. Practical implications of these findings are discussed.

Systematic Review and Meta-Analysis of Correlates of FFMQ Mindfulness Facets

Background: A number of meta-analyses of mindfulness have been performed, but few distinguished between different facets of mindfulness, despite it being known that facets of mindfulness behave differently in different populations; and most studied the outcome of interventions, which tend to involve additional ingredients besides mindfulness. Furthermore, there has recently been some concern regarding possible publication bias in mindfulness research. Objective: Systematic review and meta-analysis of the relationship of different facets of mindfulness with various outcomes, taking into account possible moderators, and controlling for publication bias using a method appropriate given the substantial heterogeneity present. Methods: Random effects meta-analysis with a number of robustness checks and estimation of the possible impact of publication bias on the results. Included are all studies that report correlations of outcomes with all five FFMQ facets, in English, French, German, or Spanish. Study Registration: PROSPERO International prospective register of systematic reviews http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016041863. Results: For the designated primary measure (SWLS) estimated correlations were: 0.15 [0.07, 0.22] for the Observing facet, 0.31 [0.27, 0.36] for Describing, 0.35 [0.31, 0.38] for Acting-with-Awareness, 0.30 [0.10, 0.47] for Non-judging and 0.28 [0.18, 0.37] for Non-reacting. Grouping all desirable outcomes together, Describing has the highest zero-order (though not partial) correlation; Non-judging the highest effect on avoiding undesirable outcomes. Results seem to be reasonably robust even to severe publication bias.

The link between self-compassion and psychotic-like experiences: A matter of distress?

OBJECTIVES

Self-shaming and self-criticism have been shown to contribute to the emergence of distressing psychotic symptoms and psychotic-like experiences (PLEs). In contrast, a self-compassionate mindset may protect against negative evaluations in response to PLEs leading to less distress. This study explores the association between self-compassion, the frequency of PLEs, and their associated distress.

DESIGN

The study used a correlational, cross-sectional design on a German community sample.

METHODS

A total of 234 participants completed the self-compassion scale (SCS), the Peters' Delusions Inventory, and a modified version of the Launay-Slade Hallucination Scale that measures frequency and distress of hallucinatory experiences. Pearson correlations between SCS and frequency of PLEs as well as between SCS and PLE-distress were compared. Additionally, network analyses of SCS and PLE-measures were calculated.

RESULTS

Self-compassion was associated with less-frequent PLEs and with less PLE-distress, with stronger correlations between self-compassion and PLE-distress. The network analysis showed the self-compassion facets isolation and overidentification to be the closest links to PLE-distress.

CONCLUSIONS

Self-compassion is associated with less PLE related distress. Prevention programmes and interventions that target the negative facets associated with lack of self-compassion may be promising. However, future studies need to explore the causal role of self-compassion facets in the formation of PLE-distress.

PRACTITIONER POINTS

Low levels of self-compassion are associated with being more distressed by psychotic experiences. As the self-compassion facets isolation and overidentification are most strongly related to distress, prevention and intervention programmes may benefit from focusing on these negative facets.

Self-reassurance, not self-esteem, serves as a buffer between self-criticism and depressive symptoms

OBJECTIVES

Several studies suggest that self-criticism and self-reassurance operate through different mechanisms and might interact with each other. This study examined the hypothesis that self-reassurance serves as a buffer between self-criticism and depressive symptoms in a way that self-esteem, which is rooted in a different motivational system, may not.

DESIGN

We hypothesized that self-criticism would be correlated with high levels of depressive symptoms, but that this association would be weaker at higher levels of self-reassurance abilities. We also hypothesized that self-esteem, a self-relating process based on feeling able and competent to achieve life goals, would not buffer the relationship between self-criticism and depression.

METHODS

Self-criticism, self-reassurance, depressive symptoms, and self-esteem were assessed in a sample of 419 participants (66% females; M_age  = 33.40, SD = 11.13).

RESULTS

At higher levels of self-reassurance, the relationship between self-criticism and depressive symptoms became non-significant, supporting the buffering hypothesis of self-reassurance. Despite the high correlation between self-esteem and self-reassurance, self-esteem did not moderate the relationship between self-criticism and depressive symptoms.

CONCLUSIONS

Results support the growing evidence that not all positive self-relating processes exert the same protective function against psychopathological consequences of self-criticism. Implications for psychotherapy and the validity of using compassion-focused interventions with clients with self-critical issues are discussed.

PRACTITIONER POINTS

Self-reassurance and self-criticism are distinct processes and they should not be considered positive and negative variations of a single dimension Different types of positive self-relating do not show the same correlation with depressive symptoms. The ability to be self-reassuring protects against the psychopathological correlates of self-criticism while having high self-esteem does not. Compassion-focused interventions are promising avenues to help clients counteract the negative impact of self-criticism on mood.

Examining psychometric properties and measurement invariance of a Chinese version of the Self-Compassion Scale - Short Form (SCS-SF) in nursing students and medical workers

BACKGROUND

Self-compassion has been regarded as a key psychological construct and a protective factor of mental health status. The focus of the present study was to adapt the Self-Compassion Scale (SCS) into Chinese, assess the validity and reliability of the measure and test measurement invariance (MI) across nursing students and medical workers.

METHODS

The current study assessed the psychometric properties and invariance of the SCS-Short Form (SCS-SF) in two samples of 2676 from nursing students and medical workers. For construct validity, confirmatory and exploratory factor analyses (CFAs and EFAs) were conducted. Using Perceived Stress Questionnaire , Short Form-8 Health Survey (SF-8) and Goldberg Anxiety and Depression Scale, we evaluated concurrent validity and convergent/divergent validity. For reliability, internal consistency and test-retest analysis were employed. Multi-group analyses were conducted to examine MI of the different SCS-models across populations.

RESULTS

CFA showed that the proposed six-factor second-order model could not be replicated and the six-factor first-order model was a reasonable to mediocre fitting model in both samples. EFA supported a three-factor structure which consisted of one positive and two negative factors. CFA confirmed that the hypothesized three-factor structure with 10 items ultimately was considered as the optimal model on the fitted results. The SCS-SF-10 (10 items form) also demonstrated acceptable internal consistency and test-retest reliability, as well as strong concurrent validity with measures of stress perception, health status, anxious and depressive symptoms. Convergent/divergent validity was not satisfactory. Multi-group CFAs provided support for the validity of the established models.

CONCLUSION

The Chinese version of the SCS-SF-10 has sound psychometric properties and can be applied to efficiently assess self-compassion in Chinese-speaking populations. The current study contributes to the identification and measurement of self-compassion after adversities.

The predictive role of self-compassion in cancer patients' symptoms of depression, anxiety, and fatigue: A longitudinal study

Objective Self-compassion is consistently found to be related to better psychological outcomes. As most studies were cross-sectional, little is known about the predictive role of self-compassion for future psychological outcomes. This longitudinal study in cancer patients investigated the predictive role of self-compassion at the time of cancer diagnosis for the course of symptoms of depression, anxiety, and fatigue in the period of receiving cancer treatment.

METHODS

This longitudinal study was conducted at the Shaanxi Provincial Tumour Hospital in Xi'an, China. A total of 153 heterogeneous cancer patients were assessed within 1 week after cancer diagnosis (T1) as well as at the start (T2) and the end (T3) of medical treatment. Hierarchical linear regression analyses were conducted to examine the research questions.

RESULTS

Cross-sectional regression analyses at T1 showed that a self-compassion total score and negative self-compassion (and to a lesser extent positive self-compassion) were significantly related to symptoms of depression, anxiety, and fatigue. When controlling for symptoms at T1, positive self-compassion significantly predicted all three outcomes at T3. A self-compassion total score only predicted symptoms of anxiety at T2, controlling for T1 symptoms. In contrast, we found no significant predictive value of negative self-compassion.

CONCLUSIONS

This study suggests that the positive aspects of self-compassion are beneficial for cancer patients for their future functioning, in terms of fewer symptoms of depression, anxiety, and fatigue over time. Future interventions should test how and to what extent self-compassion can be cultivated and whether increases in self-compassion are associated with better outcomes.

Self-compassion, self-forgiveness, suicidal ideation, and self-harm: A systematic review

Self-compassion has been implicated in the aetiology and course of mental health with evidence suggesting an association between greater self-compassion and lower emotional distress. However, our understanding of the nature and extent of the relationship between self-compassion and self-harm (self-injury regardless of suicidal intent) or suicidal ideation remains unclear. This review, therefore, aimed to critically evaluate the extant literature investigating this relationship. To do so, a systematic search, including terms synonymous with self-compassion, was conducted on three main psychological and medical databases (Web of Science, PsycINFO, and Medline). Only studies investigating self-compassion or self-forgiveness and self-harm or suicidal ideation were found to be relevant to the review. Eighteen studies were included in the final narrative synthesis. Heterogeneity of studies was high, and the majority of studies were quantitative and cross-sectional (n = 16) in design. All studies reported significant associations between higher levels of self-forgiveness or self-compassion and lower levels of self-harm or suicidal ideation. Several studies suggested that self-compassion or self-forgiveness may weaken the relationship between negative life events and self-harm. In conclusion, this review highlights the potential importance of self-compassion in the aetiology of suicidal thoughts and self-harm. We discuss the clinical and research implications.

An integrative perspective on the interplay between early maladaptive schemas and mental health: The role of self-compassion and emotion regulation

OBJECTIVES

We aimed to test whether negative emotion regulation difficulties and self-compassion mediate the relationship between early maladaptive schemas (EMSs) and symptoms of psychopathology and life satisfaction.

METHODS

Data were collected from 296 adults (179 females, 117 males), whose age ranged from 17 to 52 years. The mediating roles of self-compassion and negative emotion regulation were examined via Hayes' procedure (PROCESS) for multiple mediation.

RESULTS

Negative emotion regulation was the only mediator to psychopathological symptoms, with no additional role for self-compassion, whereas self-compassion mediated only to life satisfaction, with no additional role for negative emotion regulation.

CONCLUSIONS

The results provide evidence for unique mediating roles of negative emotion regulation and self-compassion, depending on the outcome variable. That helps to understand how problems that may be identified in terms of positive and negative domains are related to EMSs, and allows to put forward potential strategies within the frame of schema therapy.

Which aspects of mindfulness are important to include in adolescent interventions?

AIM

Despite widespread enthusiasm to adopt universal mindfulness-based interventions (MBIs) for youth, high-quality evidence is still lacking. It remains unknown how best to modify the successful adult curricula to render them accessible for young people but still effective. Specifically, it is unclear whether particular elements of mindfulness are key ingredients. The aim of this research was to identify the relation between aspects of baseline mindfulness and longitudinal trajectories related to well-being in adolescence.

METHOD

We examined associations between eight aspects of mindfulness at baseline and longitudinal trajectories of depression, anxiety, well-being, weight concern and shape concern over a 12-month period in early adolescents (N = 499; 46% female; M_age at baseline 13.45 years; SD = .33).

RESULTS

We found a transdiagnostic protective effect for those high in Accepting and Nonjudgmental Orientation, Decentering and Nonreactivity and Acting with Awareness, with effect sizes across the variables ranging from small to large (Cohen's d = .29-1.26) although this benefit reduced over time, especially for weight and shape concerns in girls.

CONCLUSION

This natural but waning protective effect strengthens the case for MBIs in youth. The isolation of three key elements is an important preliminary step in identifying ways to improve the effectiveness of current adolescent curricula. Of the three, the current study suggests that teaching young adolescents to respond to their mistakes with kindness and non-judgement should be a prime focus.

The Intermediary Role of Burnout in the Relationship Between Self-Compassion and Job Satisfaction Among Nurses

Background

Self-compassion is the process of treating oneself kindly especially when suffering. Self-compassion is associated with decreased symptoms of burnout in nurses such that those high in self-compassion are less likely to report emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment.

Objectives

The purpose of this study was to examine the relationships among self-compassion, burnout, job satisfaction, and sleep quality. Method and Participants: Recruited from MTurk, a final sample of 158 nurses living in the United States (57.6% female) completed indices of self-compassion, burnout, and outcomes of satisfaction and sleep via an online survey.

Results

Self-compassion was positively associated with satisfaction and sleep quality and negatively associated with burnout. In addition, increased burnout was associated with lower satisfaction and poorer sleep quality. Mediational models suggested that the relationships between self-compassion and outcomes were accounted for by the shared variance between self-compassion and burnout.

Conclusions

The results showed the predicted associations among self-compassion, burnout, and outcomes. Importantly, self-compassion was associated with lower burnout that, in turn, was associated with higher job satisfaction and better sleep. Despite the limitations of the study, these results add to the growing literature on the benefits of self-compassion for nurses for preventing and/or ameliorating symptoms of burnout.

Moral injury and suicidality among combat-wounded veterans: The moderating effects of social connectedness and self-compassion

OBJECTIVE

Among combat veterans, moral injury (i.e., the guilt, shame, inability to forgive one's self and others, and social withdrawal associated with one's involvement in events that occurred during war or other missions) is associated with a host of negative mental health symptoms, including suicide. To better inform and tailor prevention and treatment efforts among veterans, the present study examined several potential risk (i.e., overidentification and self-judgment) and protective (i.e., self-kindness, mindfulness, common humanity, and social connectedness) variables that may moderate the association between moral injury and suicidality.

METHOD

Participants were 189 combat wounded veterans (96.8% male; mean age = 43.14 years) who had experienced one or more deployments (defined as 90 days or more). Nearly all participants reported a service-connected disability (n = 176, 93.1%) and many had received a Purple Heart (n = 163, 86.2%).

RESULTS

Within a series of moderation models, we found 3 statistically significant moderation effects. Specifically, the association between self-directed moral injury and suicidality strengthened at higher levels of overidentification, that is, a tendency to overidentify with one's failings and shortcomings. In addition, the association between other-directed moral injury and suicidality weakened at higher levels of mindfulness and social connectedness.

CONCLUSIONS

These findings provide insight on risk and protective factors that strengthen (risk factor) or weaken (protective factor) the association between moral injury and suicidality in combat-wounded veterans. Taken together, mindfulness, social connectedness, and overidentification are relevant to understand the increased/decreased vulnerability of veterans to exhibit suicidality when experiencing moral injury. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Abuse, invalidation, and lack of early warmth show distinct relationships with self-criticism, self-compassion, and fear of self-compassion in personality disorder

BACKGROUND

Cultivating self-compassion is increasingly recognized as a powerful method to regulate hyperactive threat processes such as shame and self-criticism, but fear of self-compassion (FSC) can inhibit this. These difficulties are underexplored in personality disorder (PD) despite their prevalence. Furthermore, little evidence exists regarding how these factors relate to adverse childhood experiences (ACEs) and attachment.

METHOD

Fifty-three participants with a diagnosis of PD completed measures including childhood abuse/neglect, invalidation, early warmth, self-compassion, shame, self-criticism, FSC, and anxious/avoidant attachment.

RESULTS

Self-compassion was predicted uniquely by low early warmth; self-inadequacy by invalidation and abuse; and FSC by multiple ACEs. FSC and self-compassion were significantly correlated with self-criticism and shame, but not with one another.

CONCLUSIONS

Low self-compassion and high FSC appear to be distinct problems, substantiating physiological models proposing distinct threat and soothing systems. Results are consistent with theories positing that low self-compassion has distinct origins to shame, self-criticism, and FSC.

Mindfulness and self-compassion along the chronotype: a cross-sectional study

It is well established in the literature that morning-type individuals present better health indicators than evening-types. Mindfulness is considered an adaptive self-regulation skill associated with well-being and physical and mental health. However, there is scarce studies that relate chronotype and mindfulness. Thus, in this research, our aim was to study the relationship between chronotype and mindfulness-related variables. For this purpose, a sample composed of 483 participants from the community was recruited through an online survey and invited to fill out the Five Facet Mindfulness Questionnaire, the Self-Compassion Scale, and the Composite Morningness Scale. Regarding mindfulness measure, the results indicated that morning-types presented higher levels of "acting with awareness" than intermediate and evening-types. Additionally, as to self-compassion measure, morning-types presented higher levels of "mindfulness" and "overall self-compassion" than intermediate and evening-types. The remaining associations examined were not statistically significant. In sum, the morning-types showed higher scores in some of the mindfulness and self-compassion scales which seem to suggest that this morningness tendency may function as protective factor concerning eventual disorders´ development. Nonetheless, more systematic studies are needed to better understand this association and subsequently foster changes for psychological intervention.

Self-Compassion and Cultural Values: A Cross-Cultural Study of Self-Compassion Using a Multitrait-Multimethod (MTMM) Analytical Procedure

Self-compassion is natural, trainable and multi-faceted human capacity. To date there has been little research into the role of culture in influencing the conceptual structure of the underlying construct, the relative importance of different facets of self-compassion, nor its relationships to cultural values. This study employed a cross-cultural design, with 4,124 participants from 11 purposively sampled datasets drawn from different countries. We aimed to assess the relevance of positive and negative items when building the self-compassion construct, the convergence among the self-compassion components, and the possible influence of cultural values. Each dataset comprised undergraduate students who completed the “Self-Compassion Scale” (SCS). We used a confirmatory factor analysis (CFA) approach to the multitrait-multimethod (MTMM) model, separating the variability into self-compassion components (self-kindness, common humanity, mindfulness), method (positive and negative valence), and error (uniqueness). The normative scores of the Values Survey Module (VSM) in each country, according to the cultural dimensions of individualism, masculinity, power distance, long-term orientation, uncertainty avoidance, and indulgence, were considered. We used Spearman coefficients (r_s) to assess the degree of association between the cultural values and the variance coming from the positive and negative items to explain self-compassion traits, as well as the variance shared among the self-compassion traits, after removing the method effects produced by the item valence. The CFA applied to the MTMM model provided acceptable fit in all the samples. Positive items made a greater contribution to capturing the traits comprising self-compassion when the long-term orientation cultural value was higher (r_s = 0.62; p = 0.042). Negative items did not make significant contributions to building the construct when the individualism cultural value was higher, but moderate effects were found (r_s = 0.40; p = 0.228). The level of common variance among the self-compassion trait factors was inversely related to the indulgence cultural value (r_s = -0.65; p = 0.030). The extent to which the positive and negative items contribute to explain self-compassion, and that different self-compassion facets might be regarded as reflecting a broader construct, might differ across cultural backgrounds.

Two is more valid than one, but is six even better? The factor structure of the Self-Compassion Scale (SCS)

INTRODUCTION

Self-compassion refers to a non-evaluative, interconnected and mindful attitude towards oneself especially when facing difficulties or feelings of personal inadequacies. The Self-Compassion Scale (SCS) is a frequently used instrument designed to measure self-compassion either by using the six subscale scores, or by calculating a total score, averaged across all 26 items.

PURPOSE

The purpose of this study is to examine the factor structure of the Self-Compassion Scale, and in particular, whether the widely used six-factor model and the unidimensional model can be confirmed.

METHODS

The internal structure of the SCS was examined using confirmatory factor analysis (CFA). Six different models (a one-factor model, an oblique six-factor model, a higher-order model, an oblique two-factor model, a bi-factor model with one general factor (bifactor model) and a bi-factor model with two general factors, i.e. two-bifactor model) were tested in a sample of adolescents (n = 1725; 50.3% female; mean age = 16.56, SD = 1.95). All models were replicated using responses collected five months after the first data collection from 1497 students (W2), who were largely, but not completely, the same students involved in W1 data collection.

RESULTS

Fit indices for the two-factor model implied an acceptable fit, but none of the remaining models tested met the criteria for an adequate solution. Although the fit indices for the six-factor model suggested an acceptable fit to the data, in this model the negative components of the SCS were highly correlated with each other, especially with the over-identification factor.

CONCLUSION

The results of this study provide evidence to support the use of the separate self-compassion- and self-coldness -scores rather than the overall score of the SCS. Although the fit indices supported the six-factor model, the use of six subscale scores cannot be recommended on the basis of our results given the extremely high correlations within this model between some factors.

Physical symptom complaints, cognitive emotion regulation strategies, self-compassion and diabetes distress among adults with Type 2 diabetes

AIMS

Diabetes-related distress is common among adults with Type 2 diabetes and is consistently associated with poorer self-management and treatment outcomes. However, little is known about the psychological factors that may contribute to or protect against diabetes distress. This study examined illness burden, and positive and negative ways of thinking and relating to oneself in times of stress, as independent correlates of diabetes distress, cross sectionally and longitudinally.

METHOD

A total of 120 adults treated for Type 2 diabetes reported their physical symptom complaints, cognitive emotion regulation, self-compassion and diabetes distress at baseline; 110 completed a 3-month follow-up assessment of diabetes distress. Pearson correlations and multivariable linear regression tested baseline and longitudinal relationships.

RESULTS

Baseline diabetes distress was associated with greater use of negative cognitive emotion regulation strategies (r = 0.43, P < 0.01), greater tendency towards self-criticism, self-judgement and over-identification (r = 0.37, P < 0.01), and greater physical symptom burden (r = 0.50, P < 0.01). Baseline physical symptoms and negative cognitive emotion regulation were independently associated with baseline diabetes distress. Baseline physical symptoms and negative aspects of self-compassion significantly predicted diabetes distress over 3 months. Positive aspects of cognitive emotion regulation and self-compassion were not independently associated with diabetes distress cross sectionally or longitudinally.

CONCLUSION

Greater symptom burden along with the use of negative cognitive emotion regulation and negative aspects of self-compassion were independently associated with diabetes distress. If these relations are explained by causal influence, these modifiable factors could be fruitful targets for intervention research.

Effects of mindfulness-based cognitive therapy on shame, self-compassion and psychological distress in anxious and depressed patients: A pilot study

OBJECTIVES

The tendency to experience shame or guilt is associated differentially with anxiety and depression, with shame being associated with greater psychopathology. Correlational studies have shown self-compassion to be related to lower shame and rumination, and mindfulness-based interventions increase self-compassion. Therefore, mindfulness-based interventions may decrease shame. This pilot study aimed to assess the association of shame, rumination, self-compassion, and psychological distress and the effects of a mindfulness-based intervention on these measures in a clinical sample.

DESIGN

Single-group design with pre-test and post-test measures.

METHOD

Thirty-two service users who experienced clinically diagnosed depressive or anxiety disorders in a mindfulness-based cognitive therapy programme were assessed before and twenty-two after therapy with measures of shame-proneness, external shame, rumination, self-compassion, and psychological distress.

RESULTS

Shame-proneness and external shame were positively correlated with self-coldness, and external shame was positively correlated with stress and depressive symptoms. Self-compassion increased and self-coldness decreased, while shame-proneness, rumination, anxiety, and stress symptoms decreased from pre- to post-treatment. There was no significant reduction in depressive symptoms, guilt-proneness, or external shame.

CONCLUSION

Our preliminary findings suggest that mindfulness-based approaches may be helpful in increasing self-compassion and reducing shame-proneness in mixed groups of anxious and depressed patients. Controlled studies of the effects of mindfulness-based interventions on shame in clinical populations are warranted.

PRACTITIONER POINTS

Shame-proneness and external shame showed different patterns of relationship with depressive and stress symptoms and with self-compassion. Shame-proneness decreased to a greater extent than external shame decreased following participation in an MBCT group. Mindfulness-based interventions may benefit shame-proneness to a greater extent than external shame.

Differences in Compassion, Well-being, and Social Anxiety between Japan and the USA

Research has shown that self-compassion can improve individual well-being in many cultures; however, little research has examined cultural differences regarding compassion for others and individual well-being. Cross-cultural research has indicated that interdependent happiness and Taijin Kyofusho (TKS) (other-focused social anxiety) are aspects of well-being and psychopathology, respectively, related to interdependent (i.e., collectivistic) cultures such as Japan. First, we hypothesized that self-compassion would foster greater positive affect and satisfaction with life in the US than in Japan. Our second hypothesis was that the compassion for others would be association with greater interdependent happiness, and with less TKS symptoms in Japan than in the US. Through a web-based survey of Japanese and American adults, we found that self-compassion was related to positive and negative affect, SAD and TKS symptoms, and well-being in both countries. Compassion for others was found to be associated with increased positive affect and decreased TKS symptoms across both cultures. Simple slope tests revealed that self-compassion had a stronger relation with positive affect among U.S. adults than their Japanese counterparts, whereas compassion for others was related to interdependent happiness only in Japan. These findings suggest that the link between compassion, well-being, and psychopathology might be universal, although the effects of two types of compassion have different patterns between the two cultures.

Self-compassionate Aging: A Systematic Review

Abstract Background and Objectives

There is considerable heterogeneity in experiences of aging, with some experiencing greater well-being and adapting more successfully to the challenges of aging than others. Self-compassion is a modifiable psychological skill that might help explain individual differences in well-being and adjustment in later life. The aim of this study was to systematically review the literature on self-compassion and well-being outcomes in studies of older adults aged 65 and older.

Research Design and Methods

This systematic review was conducted according to PRISMA guidelines, using databases PsycINFO, Medline, and Embase. The search term self-compassion was paired with terms relating to well-being, psychological symptoms, and adjustment. Meta-analysis was used to synthesize results on the relationship between self-compassion and four outcomes including depression, anxiety, hedonic well-being, and eudaimonic well-being.

Results

Eleven studies met inclusion criteria for this review. Meta-analysis revealed that self-compassion was associated with lower levels of depression (r = −.58, 95% CI [−.66, −.48]) and anxiety (r = −.36, 95% CI [−.60, −.07]), and higher levels of hedonic (r = .41, 95% CI [.15, .62]) and eudaimonic (r = .49, 95% CI [.41, .57]) well-being. Further, three studies found self-compassion weakened the impact of physical symptoms on well-being outcomes.

Discussion and Implications

We found preliminary evidence that self-compassion is associated with well-being outcomes in older adults, and that self-compassion may buffer the psychological sequelae of health symptoms in later life. Higher quality studies with uniform outcome measures are needed to replicate and extend these results.

'Finding the person you really are … on the inside': Compassion focused therapy for adults with intellectual disabilities

This study utilized a mixed methods approach to examine the feasibility and acceptability of group compassion focused therapy for adults with intellectual disabilities (CFT-ID). Six participants with mild ID participated in six sessions of group CFT, specifically adapted for adults with ID. Session-by-session feasibility and acceptability measures suggested that participants understood the group content and process and experienced group sessions and experiential practices as helpful and enjoyable. Thematic analysis of focus groups identified three themes relating to (1) direct experiences of the group, (2) initial difficulties in being self-compassionate and (3) positive emotional changes. Pre- and post-group outcome measures indicated significant reductions in both self-criticism and unfavourable social comparisons. Results suggest that CFT can be adapted for individuals with ID and provide preliminary evidence that people with ID and psychological difficulties may experience a number of benefits from this group intervention.

Good and Bad Sides of Self-Compassion: A Face Validity Check of the Self-Compassion Scale and an Investigation of its Relations to Coping and Emotional Symptoms in Non-Clinical Adolescents

To demonstrate that the positive and negative subscales of Self-Compassion Scale (SCS) are very different in nature, we conducted a series of face validity checks on the items of this questionnaire among psychologists and psychology students (Study 1). Furthermore, a survey was administered to a convenience sample of non-clinical adolescents to examine the relations between various SCS subscales and symptoms of anxiety and depression as well as coping styles (Study 2). The results of the face validity checks revealed that the positive subscales seem to be well in line with the protective nature of self-compassion as they were mainly associated with cognitive coping and healthy functioning, whereas the negative subscales were chiefly associated with psychopathological symptoms and mental illness. The survey data demonstrated that the positive SCS subscales were positively correlated with adaptive coping (r's between .22 and .50) and negatively correlated with symptoms of anxiety and depression (r's between -.19 and -.53), while the negative subscales were positively correlated with symptoms (r's between .49 and .61) and maladaptive coping strategies such as passive reacting (r's between .53 and .56). Additional analyses indicated the negative subscales of the SCS accounted for a significant proportion of the variance in symptoms, whereas the unique contribution of the positive SCS subscales was fairly marginal. We caution to employ the total SCS score that includes the reversed negative subscales as such a procedure clearly inflates the relation between self-compassion and psychopathology.

Self-compassion in somatoform disorder

'Third wave' cognitive-behavioral therapies have given a boost to the study of resilience factors, such as self-compassion. To get an indication of the potential clinical relevance of self-compassion for somatoform disorder, this study examined whether self-compassion in patients with somatoform disorder is lower than in the general population, and whether self-compassion is associated with number of symptoms and health-related quality of life. Two-hundred-and-thirty-six participants with somatoform disorder and 236 subjects from the general population, matched on sex and age, filled out questionnaires regarding self-compassion (SCS), number of symptoms (PSC) and health-related quality of life (EQ-5D). The difference in self-compassion between the patient group (Mean 3.53, SD .96) and the general population (Mean 4.16, SD .98) was significant with a medium effect size (d = -.65). Multiple regression analyses showed that having a somatoform disorder and low self-compassion were independently associated with number of symptoms and reduced health-related quality of life. The lower level of self-compassion in somatoform disorder and its association with more physical symptoms and lower health-related quality of life, indicate that self-compassion is a potential clinically relevant factor that may influence therapy outcome and that can be a therapeutic target in patients with somatoform disorder.