Compassion: an evolutionary analysis and empirical review

Enriching sociocultural perspectives on the effects of idealized body norms: Integrating shame, positive body image, and self-compassion

Body image is an integral aspect of the psychology of the self. Idealized body images are ubiquitous in both traditional media forms (e.g., magazines, television) and social media (e.g., Facebook, Instagram). The classic sociocultural model of body image (i.e., the Tripartite Influence Model) emphasizes pathways between idealized body norms, appearance comparisons, internalization of body ideals, and body dissatisfaction and its outcomes. We summarize the model and identify some issues to be addressed in future work, particularly in light of the immense popularity of social media. We review three topics that are not included in the sociocultural model but that provide a more complete picture of the influence of societal body norms on body image: (1) body shame, (2) positive body image, and (3) self-compassion. Research on the nature, assessment, and relevance of these constructs is reviewed in detail. In terms of clinical applications of these areas of research for individuals at risk of body dissatisfaction, we suggest assessing for and targeting body shame, cultivating facets of positive body image, and teaching strategies for developing self-compassion.

Leading with a cool head and a warm heart: trait-based leadership resources linked to task performance, perceived stress, and work engagement

Leaders of today need to achieve well in terms of task performance, perceiving low stress, and having high levels of work engagement. One may ask whether trait-based leadership resource factors can be identified and how such resource factors might relate to task performance, perceived stress, and work engagement. Our aim was to test the hypothesis, derived from Hobfoll's motivational Conservation of Resources (COR) theory, that there are trait-based leadership resource factors, which are differentially correlated to the leaders' task performance, perceived stress, and work engagement. Leaders (N = 344) aged from 23 to 65 years (M = 49, SD = 8.6; 58% women) completed an online questionnaire including measures of task performance, perceived stress, work engagement, personality traits, trait emotional intelligence, empathy, performance-related self-esteem, compassionate and rational leadership competence, and coping resources for stress. Using exploratory factor analysis, we identified four trait-based leadership resource factors. With Bonferroni adjustment, and controlling for sex, age, number of years in the current managerial position, self-deceptive enhancement, and impression management, only Rational Mastery was significantly positively correlated with task performance. Rational Mastery, Efficient Coping, and Modesty were negatively correlated with perceived stress, and all factors except Modesty, but including the fourth (Good-Heartedness) were positively correlated with work engagement. Organizations striving for sustainable work conditions should support trait-based leadership, which depends not only on a task-oriented resource such as rational mastery, but also on human-oriented resources such as efficient coping, modesty, and good-heartedness, all of them being differentially related to task performance, perceived stress, and work engagement.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03767-8.

Epidemiology of compassion: A literature review

Psychology and neuroscience have contributed significantly to advances in understanding compassion. In contrast, little attention has been given to the epidemiology of compassion. The human experience of compassion is heterogeneous with respect to time, place, and person. Therefore, compassion has an epidemiology, although little is known about the factors that account for spatial or temporal clustering of compassion or how these factors might be harnessed to promote and realize a more compassionate world. We reviewed the scientific literature to describe what is known about “risk factors” for compassion towards others. Studies were included if they used quantitative methods, treated compassion as an outcome, and used measures of compassion that included elements of empathy and action to alleviate suffering. Eighty-two studies met the inclusion criteria; 89 potential risk factors were tested 418 times for association with compassion. Significant associations with compassion were found for individual demographic factors (e.g., gender, religious faith); personal characteristics (e.g., emotional intelligence, perspective-taking, secure attachment); personal experience (e.g., previous adversity); behaviors (e.g., church attendance); circumstantial factors during the compassion encounter (e.g., perceptions of suffering severity, relational proximity of the compassion-giver and -receiver, emotional state of the compassion-giver); and organizational features. Few studies explored the capacity to receive, rather than give, compassion. Definitions and measures of compassion varied widely across disciplines; 87% of studies used self-report measures and 39% used a cross-sectional design. Ten randomized clinical trials documented the effectiveness of compassion training. From an epidemiologic perspective, most studies treated compassion as an individual host factor rather than as transmissible or influenced by time or the environment. The causal pathways leading from suffering to a compassionate response appear to be non-linear and complex. A variety of factors (acting as effect modifiers) appear to be permissive of—or essential for—the arising of compassion in certain settings or specific populations. Future epidemiologic research on compassion should take into account contextual and environmental factors and should elucidate compassion-related dynamics within organizations and human systems. Such research should be informed by a range of epidemiologic tools and methods, as well as insights from other scientific disciplines and spiritual and religious traditions.

Compassion Fatigue and Coping Mechanisms of Laboratory Animal Professionals from Europe, China, and Japan

Laboratory animal professionals (LAP) may experience situations that contribute to compassion fatigue (CF). The goal of this research was to better understand CF in LAP in and across employment categories. Surveys were distributed through LAP organizational listservs in the European Union (EU), China, and Japan, and results were analyzed to identify CF prevalence, personal and work-related factors, coping mechanisms, and beneficial work-support programs. Independent χ²-tests compared personal and work-related factors and feelings of CF. Feelings of CF and coping mechanisms were compared with personality scores using independent sample t tests. There were 302 respondents from the EU, 39 from China, and 77 from Japan. Over half of respondents from the EU (52%) and China (56%) reported experiencing CF (52%), with fewer (32%) reporting CF in Japan. No major differences were found based on employer type. Personality scores were significantly related to feelings of CF and preferred coping mechanisms. Work-related factors that contributed to feelings of CF in over half of respondents included staffing levels, workplace relationships, and availability of programs geared to address CF. Across regions, talking to someone, physical activity, getting away from work, and self-care were effective coping mechanisms in over 50% of respondents. Fewer than 30% of respondents indicated that their place of employment had CF support programs, and even fewer (8% to 28%) indicated that these programs were helpful. The study results suggest that to be effective, employer CF programs for LAP should consider providing quiet places at work and programs for self-care, promoting physical and mental health and social support systems, and establishing opportunities to memorialize animals.

Dispositional Mindfulness and Self-Compassion Buffer the Effects of COVID-19 Stress on Depression and Anxiety Symptoms

Objectives

The COVID-19 pandemic has been associated with a dramatic rise in symptoms of depression and anxiety. Dispositional mindfulness (DM) and self-compassion (SC) have consistently been associated with psychological disorder symptoms and appear to buffer the effects of stress on depression and anxiety.

Methods

Across two studies (n = 888), we examined direct and indirect (moderation) relationships of DM, SC, COVID-19-related stress, and symptoms of depression and anxiety. We also examined the differential effects of several DM measures (FFMQ-15; FFMQ-39; MAAS) in the relationships of COVID-19 stress and psychological disorder symptoms. We recruited participants (Study 1 n = 350; 42.2% cis women; Study 2 n = 538; 44.3% cis women) online (MTurk) and examined associations of DM, SC, and COVID-19 stress, and emotional impact, and the moderating effect of DM and SC in the relationships of COVID-19-related fears, stress, emotional impacts, and psychological disorder symptoms.

Results

DM and SC were moderately and negatively correlated with COVID-19 fears and stress (correlations ranging r =  − .14 to r =  − .42) across studies. Study 1 moderation analyses demonstrated SC, but not DM (FFMQ-15), significantly moderated relationships of COVID-19 fears and emotional impacts with symptoms. Study 2 analyses demonstrated the FFMQ-39, but not the MAAS, significantly moderated relationships of COVID-19 stress and psychological disorder symptoms.

Conclusions

These results support the potential protective roles of DM and SC in disrupting pathological trajectories related to naturally elevated pandemic stress. Results also demonstrate the differential associations of several DM measures with COVID-19 stress. Future research should replicate such findings with more diverse samples and using various measures of self-compassion and risk metrics.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-022-02008-0.

Qualitative Analysis of Chair Tasks in Emotion-Focused Therapy Video Sessions

One of the key elements of Emotion-Focused Therapy (EFT) is decreasing self-criticism as a secondary, maladaptive emotion within two-chair interventions while simultaneously increasing self-compassion and self-protection as primary, adaptive emotions. Though the concepts of self-compassion, self-protection, and self-criticism are highly acknowledged within psychotherapy research, the verbal articulation of these constructs within therapy sessions is underinvestigated. Thus, this qualitative study aims to examine how self-criticism, self-protection, and self-compassion are articulated by clients in EFT video sessions. Consensual qualitative research was used for data analysis performed by two core team members and one auditor. Three similar domains were considered for all three concepts: behavioural, emotional, and cognitive aspects. The number of self-protection statements was the highest among the states. The behavioural aspect was the most dominant domain for self-protection with the major subdomain 'I tell you what I need'. For self-compassion, the cognitive aspect was the most significant domain containing eight subdomains, such as 'I see your bad circumstances'. The most frequent domain for self-criticism was the behavioural aspect consisting of the two subdomains 'I point out your wrong behaviours and I give you instructions'. The findings demonstrate the significance of promoting both self-compassion and self-protection to combat self-criticism. More studies of categorising a broader number of cases among various therapy approaches are necessary to develop a more detailed understanding of clients' verbalisation of self-compassion, self-protection, and self-criticism within therapy.

The missing construct: Impathy

This article is about impathy (introversive empathy), understood as the ability to share in and understand one’s own feelings, which is considered a critical psychological construct relevant for the recovery and maintenance of mental health. However, while the ability to empathize with oneself has received considerable attention from the clinical community, this has not been paralleled by the same scientific scrutiny, which was subject to the ability to empathize with others. Impathy has not yet been operationally defined and thus has remained relatively unexplored, both conceptually and empirically. This work describes an operational definition of impathy with four dimensions: Perceiving, Meta-Position, Accepting Attitude, and Understanding. Issues of differentiation from related constructs are discussed and avenues of clinical applicability are explored, suggesting that impathy exists as a distinct human capacity, which can be assessed and which has important clinical implications. The paper closes with future directions, including the assessment of impathy and possible research questions.

Bibliometric Analysis of the Scientific Production on Compassion Fatigue

Background: Compassion fatigue is a common phenomenon among healthcare professionals and includes several concepts that share a direct relationship with quality of life, with consequences on both physical and emotional well-being but also at the economic and organizational levels. Objectives: To analyze the profile of scientific publications on compassion fatigue, dissecting trends, and highlighting research opportunities. Method: Bibliometric analysis based on Donthu’s guidelines, data collection from Web of Science (Clarivate Analytics), and analytic techniques (performance analysis and science mapping) with VOSviewer^® and CiteSpace^®. Results: We obtained 1364 articles and found that the concept emerged in 1995 and is frequently associated with areas of general health. Through analysis, we identified the following research frontiers: “vicarious traumatization”, “working”, “survivor”, “mental health”, and “impact”. Conclusion: There has been a growing interest in this subject among researchers, with an increase in scientific production related to areas of health such as nursing, providing a solid starting point for further investigation. Registration number from the Open Science Framework: osf.io/b3du8.

Affective and cognitive brain-networks are differently integrated in women and men while experiencing compassion

Different theoretical models have proposed cognitive and affective components in empathy and moral judgments encompassing compassion. Furthermore, gender differences in psychological and neural functions involving empathic and moral processing, as well as compassionate experiences, have been reported. However, the neurobiological function regarding affective and cognitive integration underlying compassion and gender-associated differences has not been investigated. In this study, we aimed to examine the interaction between cognitive and emotional components through functional connectivity analyzes and to explore gender differences for the recruitment and interaction of these components. Thirty-six healthy participants (21–56 years; 21 women) were exposed to social images in an fMRI session to judge whether the stimuli elicited compassion. The results showed a different connectivity pattern for women and men of the insular cortex, the dorsomedial prefrontal cortex (dmPFC), the orbitofrontal cortex (OFC), and the cingulate cortex. The integration of affective and cognitive components follows a complex functional connectivity pattern that is different for both genders. These differences may indicate that men largely make compassionate judgments based on contextual information, while women tend to notably take internal and introspective processes into account. Women and men can use different affective and cognitive routes that could converge in similar learning of moral values, empathic experiences and compassionate acts.

Prevalence of compassion fatigue among helping professions and relationship to compassion for others, self-compassion and self-criticism

INTRODUCTION

Helping professionals are at high risk of being affected by the negative aspects of helping such as compassion fatigue. To date, no study has provided a comprehensive overview of compassion fatigue and compared the prevalence among different helping professions.

OBJECTIVES

The aim of this study was to explore the prevalence and differences in compassion fatigue among different helping professions. We also wanted to explore the relationship between compassion, self-compassion, self-criticism and compassion fatigue.

METHODS

Six hundred and seven participants working in the helping professions were recruited. The sample consisted of 102 nurses, 44 doctors, 57 paramedics, 39 home nurses, 66 teachers, 103 psychologists, 40 psychotherapists and coaches, 76 social workers, 39 priests and pastors and 41 police officers. The data were collected using an online questionnaire battery measuring levels of compassion, self-compassion, self-criticism, compassion fatigue and compassion satisfaction.

RESULTS

We found significant differences in compassion fatigue levels among various helping professions. No large differences were found in the compassion and self-compassion levels exhibited by professionals with medium versus low compassion fatigue scores. However, participants with higher levels of compassion fatigue scored higher in self-criticism. Self-criticism was found to be the best predictor of compassion fatigue. The effect of profession on compassion fatigue as mediated by self-criticism and self-compassion was significant.

CONCLUSIONS

Based on the results, we recommend designing programs to combat compassion fatigue that teach helping professionals to better manage their work time and workload (hours per week with clients/patients) and learn healthier inner talk (less self-critical and more self-compassionate).

The influence of signs of social class on compassionate responses to people in need

A field experiment (N = 4,536) examined how signs of social class influence compassionate responses to those in need. Pedestrians in two major cities in the United States were exposed to a confederate wearing symbols of relatively high or low social class who was requesting money to help the homeless. Compassionate responding was assessed by measuring the donation amount of the pedestrians walking past the target. Pedestrians gave more than twice (2.55 times) as much money to the confederate wearing higher-class symbols than they did to the one wearing lower-class symbols. A follow-up study (N = 504) exposed participants to images of the target wearing the same higher- or lower-class symbols and examined the antecedents of compassionate responding. Consistent with theorizing, higher-class symbols elicited perceptions of elevated competence, trustworthiness, similarity to the self, and perceived humanity compared to lower-class symbols. These results indicate that visible signs of social class influence judgments of others’ traits and attributes, as well as in decisions to respond compassionately to the needs of those who are suffering.

Disaster description vividness and intention to donate: The mediating role of sympathy

From the perspective of affective events theory, we examined how the vividness of a disaster description affects the public's willingness to donate money to victims of the disaster. We conducted three experimental studies (Studies 1–3) and a survey study (Study 4), and the findings show that the vividness of a disaster description was positively related to individuals' willingness to donate (Study 1), and that this result was maintained when participants' affect and demographic variables were taken into consideration (Study 2). Further, sympathy mediated the effect of vivid descriptions of a disaster on the public's intention to donate money (Studies 3 and 4). We have provided a new understanding of the relationship between the vividness of a disaster description and the public's intention to donate money.

More than a feeling? What does compassion in healthcare 'look like' to patients?

OBJECTIVE

Compassion is important to patients and their families, predicts positive patient and practitioner outcomes, and is a professional requirement of physicians around the globe. Yet, despite the value placed on compassion, the empirical study of compassion remains in its infancy and little is known regarding what compassion 'looks like' to patients. The current study addresses limitations in prior work by asking patients what physicians do that helps them feel cared for.

METHODS

Topic modelling analysis was employed to identify empirical commonalities in the text responses of 767 patients describing physician behaviours that led to their feeling cared for.

RESULTS

Descriptively, seven meaningful groupings of physician actions experienced as compassion emerged: listening and paying attention (71% of responses), following-up and running tests (11%), continuity and holistic care (8%), respecting preferences (4%), genuine understanding (2%), body language and empathy (2%) and counselling and advocacy (1%).

CONCLUSION

These findings supplement prior work by identifying concrete actions that are experienced as caring by patients. These early data may provide clinicians with useful information to enhance their ability to customize care, strengthen patient-physician relationships and, ultimately, practice medicine in a way that is experienced as compassionate by patients.

PUBLIC CONTRIBUTION

This study involves the analysis of data provided by a diverse sample of patients from the general community population of New Zealand.

Mental Wellbeing of Indonesian Students: Mean Comparison with UK Students and Relationships with Self-Compassion and Academic Engagement

The number of Indonesian students in higher education has been increasing rapidly. However, many Indonesian university students report experiencing mental distress. Research on student wellbeing found that self-compassion (i.e., being kind towards oneself in challenging times) and academic engagement (i.e., a commitment and purposeful effort toward study) are essential to students’ mental wellbeing. With the present study, we aimed to assess the mental wellbeing of Indonesian students. A convenience sample of 156 Indonesian students completed self-report measures on mental wellbeing, self-compassion and academic engagement (consisting of vigour, dedication and absorption). To contextualise their mental wellbeing, data from Indonesian students were compared with those from 145 UK students using Welch t-tests. Correlation, regression and mediation analyses were then performed to examine the relationships among these variables. Indonesian students had higher levels of self-compassion and absorption and a lower level of dedication than UK students. Self-compassion and academic engagement explained 36% of variance in mental wellbeing. Self-compassion and vigour were identified as significant predictors of mental wellbeing, whereas self-compassion was the strongest predictor. Lastly, vigour did not mediate the pathway from self-compassion to mental wellbeing. Interventions to support self-compassion and academic engagement, especially vigour, in Indonesian students are recommended to support their mental wellbeing.

Compassionate Discourses: A Qualitative Study Exploring How Compassion Can Transform Healthcare for 2SLGBTQ+ People

Compassion can be seen as a necessary, but often lacking, concept and practice in healthcare. Due to the cis-heteronormative nature of societies, people who identify as Two-Spirit, lesbian, gay, bisexual, transgender, queer (2SLGBTQ+) often experience health disparities and disparities in accessing compassionate healthcare. We aimed to explore the meanings of compassion in healthcare for Canadian 2SLGBTQ+ people. Using a poststructuralist framework, 20 self-identifying 2SLGBTQ+ participants were interviewed. Data was analyzed through discourse analysis. Three main discursive considerations are discussed, including (1) meanings and expectations of compassion in healthcare, (2) compassionate healthcare is not guaranteed, and (3) prescription for care: self-compassion for healing and health. The results provide insights into how compassionate healthcare is framed for 2SLGBTQ+ participants and how compassion is often lacking for them due to discourses of cis-heteronormativity and healthism.

Effects of a compassion-based program on the grief experienced by caregivers of people suffering from dementia: a randomized controlled clinical trial

BACKGROUND

Dementia is a syndrome that reduces the cognitive and functional abilities of the brain increasing the need for care. The caregivers of these patients are mostly their family members. The great care burden causes devastating effects on the health of family caregivers and the grief experienced by these family caregivers is considerable. This study was conducted to investigate the effects of a compassion-based program on the grief experienced by caregivers of people suffering from dementia.

METHOD

The present study was a randomized controlled clinical trial in which 70 family caregivers of people suffering from dementia were sampled through the block method and they were divided into experimental and control groups. The data collection tools included demographic information questionnaire and grief inventory that was completed before, a week and a month after the implementation of the compassion-based program in five sessions virtually by sending offline content to the experimental group. The obtained data were analyzed by SPSS 22 software using the repeated measures analysis of variance.

RESULTS

The mean comparison of scores of the grief experienced in the experimental group between pretest and posttest and follow-up, unlike the control group, showed a significant difference (p < 0.001). The mean scores of the experimental and the control groups were significantly different in terms of experiencing mourning and all of its fields (p < 0.001). The mean comparison of post-test and follow-up showed that the effect of a compassion-based program at the follow-up stage has been mitigated.

CONCLUSIONS

According to the study results, the compassion-based program reduced the grief experienced by the family caregivers of people suffering from dementia. Nevertheless, the effect of a compassion-based program has been reduced over time. This program can be a good guide for providing society-oriented services to the health team.

TRIAL REGISTRATION

This study is registered by Iranian Registry of Clinical Trials with decree code: IRCT20190712044181N4  on 02/06/2020.

Association of compassion and empathy with prosocial health behaviors and attitudes in a pandemic

This investigation examined how dispositional compassion and empathy were associated with prosocial behaviors and attitudes in the SARS-CoV-2 pandemic. Every two weeks from March 22 to June 15, 2020, we fielded a survey to a new cohort of adults in the U.S. Compassion related to whether one stayed home to protect others, more hours spent staying home and distancing from others, and more frequent mask wearing in public, in the past two weeks. Compassion also related to greater perceived ability to help others who were negatively affected. Empathy related to more endorsement of understanding others' fear of COVID-19, and less endorsement of the view that others were overreacting to COVID-19. There was an interaction between empathy and political ideology, suggesting that empathy may matter for understanding others' fear among those with more conservative-leaning beliefs. Empathy also related to greater understanding that sheltering-in-place helps prevent the spread of COVID-19. Findings suggest that messaging and interventions to increase compassion and empathy may promote public health behaviors during a pandemic regardless of political orientation. Targeting empathy may be one way to reach individuals with more conservative political beliefs, and it is important to use an evidence-based approach accounting for political party differences in motivated reasoning.

Compassion Focused Group Therapy for People With a Diagnosis of Bipolar Affective Disorder: A Feasibility Study

Background

Compassion focused therapy (CFT) is an evolutionary informed, biopsychosocial approach to mental health problems and therapy. It suggests that evolved motives (e.g., for caring, cooperating, competing) are major sources for the organisation of psychophysiological processes which underpin mental health problems. Hence, evolved motives can be targets for psychotherapy. People with certain types of depression are psychophysiologically orientated towards social competition and concerned with social status and social rank. These can give rise to down rank-focused forms of social comparison, sense of inferiority, worthlessness, lowered confidence, submissive behaviour, shame proneness and self-criticism. People with bipolar disorders also experience elevated aspects of competitiveness and up rank status evaluation. These shift processing to a sense of superiority, elevated confidence, energised behaviour, positive affect and social dominance. This is the first study to explore the feasibility of a 12 module CFT group, tailored to helping people with a diagnosis of bipolar disorder understand the impact of evolved competitive, status-regulating motivation on their mental states and the value of cultivating caring and compassion motives and their psychophysiological regulators.

Methods

Six participants with a history of bipolar disorder took part in a CFT group consisting of 12 modules (over 25 sessions) as co-collaborators to explore their personal experiences of CFT and potential processes of change. Assessment of change was measured via self-report, heart rate variability (HRV) and focus groups over three time points.

Results

Although changes in self-report scales between participants and across time were uneven, four of the six participants consistently showed improvements across the majority of self-report measures. Heart rate variability measures revealed significant improvement over the course of the therapy. Qualitative data from three focus groups revealed participants found CFT gave them helpful insight into: how evolution has given rise to a number of difficult problems for emotion regulation (called tricky brain) which is not one's fault; an evolutionary understanding of the nature of bipolar disorders; development of a compassionate mind and practices of compassion focused visualisations, styles of thinking and behaviours; addressing issues of self-criticism; and building a sense of a compassionate identity as a means of coping with life difficulties. These impacted their emotional regulation and social relationships.

Conclusion

Although small, the study provides evidence of feasibility, acceptability and engagement with CFT. Focus group analysis revealed that participants were able to switch from competitive focused to compassion focused processing with consequent improvements in mental states and social behaviour. Participants indicated a journey over time from 'intellectually' understanding the process of building a compassionate mind to experiencing a more embodied sense of compassion that had significant impacts on their orientation to (and working with) the psychophysiological processes of bipolar disorder.

Emotion Work in Tabligh Jama’at Texts

This study examines the emotional dynamics of the written and oral texts of Tabligh Jama’at—respectively, Faza’il-e-A’maal (Virtues of Good Deeds) and bayan (religious sermon). In them, the study identifies emotion work—the attempt to generate certain emotions. The study discusses how the texts’ emotion work relates to Tablighi discursive ideology (framing) and also posits several emotions that the emotion work might generate. From these findings, the study offers the idea that Tablighi emotion work contributes to transforming Muslims’ emotional sphere by attaching them emotionally to ultimate religious concerns. By enchanting Muslims’ emotional sphere and attaching Muslims to Islamic social actors, values, practices, and Islamic revivalist goals, Tablighi emotion work contributes to the social transformation of individuals and society.

Further Validation of a Dutch Translation of the Sussex Oxford Compassion for the Self Scale in Samples of Crisis Line Volunteers, Military Personnel and Nursing Students

Self-compassion is considered an important, transdiagnostic factor for mental health. The Sussex Oxford Compassion for the Self Scale (SOCS-S) is a recently developed comprehensive measure of self-compassion, that was found to have promising psychometric properties among health care staff and university students in the initial validation study. The aim of this study is the further psychometric evaluation of a Dutch translation of the SOCS-S in different populations and settings. The SOCS-S was administered in three different Dutch samples [crisis line volunteers (n = 560), military personnel (n = 244) and nursing students (n = 255)]. The results confirm the five-factor structure of the SOCS-S and its reliability and criterion and convergent validity across the samples. Measurement invariance was demonstrated for gender in two samples and for age in all three samples, but not across professions. Finally, the SOCS-S was found to explain additional variance in mental health in comparison to a widely used self-compassion measure (SCS-SF).

What is the Most Valid and Reliable Compassion Measure in Healthcare? An Updated Comprehensive and Critical Review

Our previous review of compassion measures in healthcare between 1985 and 2016 concluded that no available measure assessed compassion in healthcare in a comprehensive or methodologically rigorous fashion. The present study provided a comparative review of the design and psychometric properties of recently updated or newly published compassion measures. The search strategy of our previous review was replicated. PubMed, MEDLINE, CINAHL, and PsycINFO databases and grey literature were searched to identify studies that reported information on instruments that measure compassion or compassionate care in clinicians, physicians, nurses, healthcare students, and patients. Textual qualitative descriptions of included studies were prepared. Instruments were evaluated using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. Measures that underwent additional testing since our last review included the Compassion Competence Scale (CCS), the Compassionate Care Assessment Tool (CCAT)^©, and the Schwartz Center Compassionate Care Scale (SCCCS)™. New compassion measures included the Sussex-Oxford Compassion for Others Scale (SOCS-O), a self-report measure of compassion for others; the Bolton Compassion Strengths Indicators (BSCI), a self-report measure of the characteristics (strengths) associated with a compassionate nurse; a five-item Tool to Measure Patient Assessment of Clinician Compassion (TMPACC); and the Sinclair Compassion Questionnaire (SCQ). The SCQ was the only measure that adhered to measure development guidelines, established initial construct validity by first defining the concept of interest, and included the patient perspective across all stages of development. The SCQ had the highest EMPRO overall score at 58.1, almost 9 points higher than any other compassion measure, and achieved perfect EMPRO subscale scores for internal consistency, reliability, validity, and respondent burden, which were up to 43 points higher than any other compassion measure. These findings establish the SCQ as the ‘gold standard’ compassion measure, providing an empirical basis for evaluations of compassion in routine care.

A Deep Dive Into Compassion

Abstract. The present multi-sample study ( N = 723) explores in depth the construct of dispositional compassion and its assessment, relying on two recent multidimensional scales: the Sussex-Oxford Compassion Scale – toward Others (SOCS-O; Gu et al., 2020 ) and the Compassion Scale (CS; Pommier et al., 2020 ). First, we validated the two scales in Italian, finding substantial support for their original factor structures and second-order solutions aggregating first-order factors into a general dispositional compassion factor. Second, we tested the simultaneous links between SOCS-O and CS facets via network analysis to identify which facets stand at the core of dispositional compassion or are more distal. Kindness (CS) and Feeling (SOCS-O) facets were more central components of compassion, leaning on the ability to tune in to (CS Mindfulness) and understand others’ pain (SOCS-O Universality) and connected to the urge to alleviate that pain (SOCS-O Acting). Third, we explored the nomological net of correlates of dispositional compassion and examined the differences between the SOCS-O and the CS in their relationship with the correlates. Results supported the convergent and discriminant validity of the scales and showed that the SOCS-O, compared to the CS, may capture some emotionally aversive sides of compassion.

"Today I Can Look in the Mirror and Like Myself": Effects of a Trauma-Informed Mindful Recovery Program on Self-Compassion

Background

Opioid-related deaths continue to rise. Psychological trauma is commonly comorbid with Opioid Use Disorder (OUD). Adverse childhood experiences can disrupt the development of emotion regulation, increasing risk of substance use. Self-compassion may reduce OUD risk and outcomes by facilitating emotion regulation, decreasing the toxicity of shame, and reducing internalized stigma that can hinder recovery. Mindfulness practice enhances self-compassion.

Methods

This study is part of a pilot (N = 18) of the Mindful Recovery OUD Care Continuum (M-ROCC) during buprenorphine office-based opioid treatment (OBOT). The present study was conducted to gain a deeper understanding of the intervention’s effects on self-compassion development, and to explore differential changes in self-compassion during the intervention among participants with varying intensity of trauma exposure measured by high levels of childhood adversity (defined by 4+ adverse childhood experiences (ACEs) at baseline). We conducted secondary analyses of a subset of qualitative interview data (N = 11 unique participants) collected for the pilot study (weeks 4 and 24, 14 total interviews) to elaborate upon changes in Self-Compassion Scale (SCS-SF) scores.

Results

In the primary pilot study, participants’ mean SCS-SF scores shifted significantly from baseline to week 24, β = 0.22, p = 0.028. This change is elaborated upon through interviews. Despite pervasive challenges to becoming more self-compassionate (e.g., trauma histories and substance use), participants reported increased compassionate self-responding and decreased uncompassionate self-responding. Mindfulness training was identified as the primary mechanism underlying the shift. Kindness to self and others and—to a lesser extent an increased sense of common humanity—were also identified as key to overall self-compassion. Compared to those in the lower ACEs group, participants in the higher ACEs group tended to have lower baseline self-compassion scores (d = 1.09, p = 0.055).

Conclusion

M-ROCC may increase self-compassion among patients with OUD during OBOT by increasing compassionate, and decreasing uncompassionate, self-responding. Patients with OUD with greater childhood adversity tended to have lower levels of self-compassion, which improved with M-ROCC. Future trials with larger samples are needed to confirm these potential outcomes, mechanisms, and differential impacts between ACEs subgroups.

The Mediating Role of Compassion between Social Job Resources, and Healthy Healthcare Professionals: A Cross-Sectional Study with Gender Perspective

The aim of this study is to examine the role of Compassion towards others as a mediator between Social Job Resources (social support climate, coordination, and positive leadership), Healthy Employees (psychological well-being such as resilience, engagement, and optimism) and Healthy Organisational Outcomes (in-role performance, extra-role performance and commitment) from a gender perspective in healthcare professionals. Through the multiple analyses of variance, structural equation models, and multiple-group analyses in a sample of 1420 healthcare professionals from different public and private hospitals in Spain, this study proved the existence of gender differences, with women perceiving higher levels of Compassion. Moreover, this study shows that Compassion partially mediates the relationship between Social Job Resources and Healthy Employees. In addition, Compassion partially mediates the relationship between Social Job Resources and Healthy Organisational Outcomes. Finally, Healthy Employees mediate the positive relationship between Social Job Resources and Healthy Organisational Outcomes. This is an innovative contribution to the limited research examining Compassion towards others as a personal resource that can have a positive impact in the workplace. The results also propose a way to develop and conduct interventions in order to increase Compassion towards others in the healthcare context.

The Impact of Gratitude on Connection With Nature: The Mediating Role of Positive Emotions of Self-Transcendence

Gratitude, as one of the positive emotions associated with self-transcendence, is also a moral and pro-social emotion with a pro-social nature. Therefore, in order to verify whether gratitude has the same effect as pro-social in promoting connection with nature, this study (N = 890) divided subjects into three groups (gratitude, recreation, and control) and used a questionnaire to explore the effects of gratitude on positive emotions of self-transcendence, connection with nature, and pro-environmental tendencies (willingness to participate in environmental protection, willingness to sacrifice for the environment). The results found that (1) positive emotions of self-transcendence partially mediated the effect of the gratitude condition on connection to nature, and (2) positive emotions of self-transcendence and connection to nature were fully and continuously mediated, suggesting that the gratitude condition had an indirect effect on both (a) willingness to participate in environmental protection and (b) willingness to sacrifice for the environment. These findings imply that we may need to pay more attention to the connection between gratitude and nature to promote a harmonious relationship between humans and nature.

Interconnectedness Is Associated with a Greater Sense of Civic Duty and Collective Action Participation through Transcendental Awareness and Compassion during COVID-19

The COVID-19 pandemic has a unprecedented impact on the way individuals make sense of the interconnected nature of themselves in relation to the world. This study investigated the mediating role of transcendental awareness and compassion in the association of interconnectedness with a sense of civic duty and collective action participation during COVID-19 using a longitudinal design. A total of 336 young adult participants were recruited at baseline and were asked to complete measures of interconnectedness, transcendental awareness, compassion, civic duty, and collective action participation at three time points over a 6-month period. Path analysis was used to test the hypothesized mediation model. The results showed that compassion fully mediated the positive association between interconnectedness and collective action participation and partially mediated the positive association between interconnectedness and civic duty. Transcendental awareness also partially mediated the positive association between interconnectedness and civic duty but not collective action participation. This study highlighted the potential of interconnectedness in promoting civic duty and engagement in collective action through transcendental awareness and compassion during the COVID-19 pandemic.

Times Are Harsh, Be Kind to Yourself! Anxiety, Life Satisfaction, and the Mediating Role of Self-Compassion

The present research aimed to explore the indirect effect of self-compassion on the relationship between two dimensions of intolerance of uncertainty (i.e., prospective and inhibitory anxiety) and life satisfaction. One hundred sixty-four Romanian adult participants formed our sample from the country's eastern side. Their ages ranged between 18 and 61 (M = 23.45, SD = 7.70, 72% females). The study was conducted in 2021, when the Delta wave of COVID-19 was at its peak. Our findings suggested significant negative associations between prospective anxiety, self-compassion, and life satisfaction. A similar negative significant association was suggested between inhibitory anxiety and self-compassion. Age did not significantly correlate with any of our primary variables. Mediation analyses indicated a total mediating effect of self-compassion on the relationship between participants' prospective and inhibitory anxiety and their life satisfaction. We discuss the implications of our findings, considering their relevance for therapeutical interventions aimed to promote psychological wellbeing when facing adversity.

Empathy, Defending, and Functional Connectivity While Witnessing Social Exclusion

Peers are present for most bullying episodes. Peers who witness bullying can play an important role in either stopping or perpetuating the behaviour. Defending can greatly benefit victimized peers. Empathy is strongly associated with defending. Yet, less is known about defenders' neural response to witnessing social distress, and how this response may relate to the link between empathy and defending. Forty-six first-year undergraduate students (M_age = 17.7; 37 women), with varied history of peer defending, underwent fMRI scanning while witnessing a depiction of social exclusion. Functional connectivity analysis was performed across brain regions that are involved in cognitive empathy, empathetic distress, and compassion. History of defending was positively associated with functional connectivity (Exclusion > Inclusion) between the left orbitofrontal cortex (OFC) - medial prefrontal cortex (MPFC), and right OFC - left and right amygdalae. Defending was negatively associated with functional connectivity between the left OFC - anterior cingulate cortex. The relationship between history of defending and empathy (specifically, empathetic perspective taking) was moderated by functional connectivity of the right OFC - left amygdala. These findings suggest that coactivation of brain regions involved in compassionate emotion regulation and empathetic distress play a role in the relationship between empathy and peer defending.

Moderating the work distress experience among inpatient hospice staff: a qualitative study

Background: Palliative and hospice care health professionals may be at risk of poorer psychological outcomes. It is unclear what specific stressors are experienced by staff and what impact they have on their psychological wellbeing. Aims: To identify stressors experienced when working in an adult hospice inpatient unit environment and how these are managed. Methods: Individual interviews were conducted with healthcare professionals working in a hospice adult inpatient unit. Findings: A total of 19 staff were interviewed. Six themes were constructed, with four related to stressors experienced: unrealistic workload, patient care, managing relationships, and work culture. Two themes concerned strategies for managing stressors were identified: peer support and time out. Conclusion: Changes within hospice care provision are placing demands on staff and reducing the amount of available resources. This may be alleviated by a move towards more compassionate workplaces. There is a need for further research to identify how distress can best be managed and how hospice organisations can best support healthcare staff.

People from lower social classes elicit greater prosociality: Compassion and deservingness matter

People are quick to form impressions of others’ social class, and likely adjust their behavior accordingly. If social class is linked to prosociality, as literature suggests, then an interaction partner’s class should affect prosocial behavior, especially when costs or investments are low. We test this expectation using social mindfulness (SoMi) and dictator games (DG) as complementary measures of prosociality. We manipulate target class by providing information regarding a target’s (a) position on a social class ladder, and (b) family background. Three studies using laboratory and online approaches ( Noverall = 557) in two nations (the Netherlands [NL], the UK), featuring actual and hypothetical exchanges, reveal that lower class targets are met with greater prosociality than higher class targets, even when based on information about the targets’ parents (Study 3). The effect of target class was partially mediated by compassion (Studies 2 and 3) and perceived deservingness of the target (Study 3). Implications and limitations are discussed.

How emotions, relationships, and culture constitute each other: advances in social functionalist theory

Social Functionalist Theory (SFT) emerged 20 years ago to orient emotion science to the social nature of emotion. Here we expand upon SFT and make the case for how emotions, relationships, and culture constitute one another. First, we posit that emotions enable the individual to meet six "relational needs" within social interactions: security, commitment, status, trust, fairness, and belongingness. Building upon this new theorising, we detail four principles concerning emotional experience, cognition, expression, and the cultural archiving of emotion. We conclude by considering the bidirectional influences between culture, relationships, and emotion, outlining areas of future inquiry.

Relationship between Compassion and Spiritual Care among Nurses in Turkey

The aim of this study was to determine the effect of the compassion level of nurses on the frequency of their provision of spiritual care therapeutics to patients. The research was conducted as a correlational descriptive study and included 253 nurses working in a university hospital in Turkey between October and December 2020. The data were collected via an online survey using psychometrically valid scales to assess the nurses' compassion and provision of spiritual care therapeutics. The nurses had a high compassion level and a medium level of spiritual care therapeutics. Compassion level explained 31% of the frequency of spiritual care therapeutics. As nurses' compassion levels increased, the frequency of their provision of spiritual care therapeutics to patients also increased.

Retracted: 'We were on our knees long before COVID': How healthcare workers experienced the compassionate care model during COVID-19

Aim

This qualitative study aimed to explore the impact of a novel compassion‐based intervention on healthcare workers during a pandemic.

Sample

Participants were N  = 10 healthcare workers (HCW) recruited from a healthcare organisation in Northern Ireland, including nurses, allied health professionals, managerial staff and administrative staff. The sample was 80% female with an average age of 45.1 years.

Intervention

All participants engaged in a compassion‐based staff support psychological intervention. The ‘compassionate care’ intervention was based on the compassion‐focussed staff support model. Modalities included face‐to‐face, remote, individual and group intervention, offered by clinical psychologists and psychotherapists.

Method

Ethical approval was obtained through the researcher’s academic institution. After obtaining informed consent, participants completed individual interviews, analysed using reflexive thematic analysis.

Results

Findings highlighted model appropriateness and feasibility, detailing post‐intervention changes. Three themes were generated. The first two, Preparing for war: A threat without boundary and Masking the pain: Externalising resistance to compassion, describe the transition from an initial burnout state to a state of derealisation via avoidance coping. The final theme, Reconnection: Returning to compassion, highlights how participants rehabilitated via the intervention, reconnecting with relationships and personal values.

Conclusion

Participants reported personal and professional experiential changes relating to compassion and resilience, while noting organisational blocks to compassion. The model appears appropriate across a variety of presentations and levels of chronicity of distress, across age, disciplines and gender groups, and for both managers and non‐managerial staff. Participants reported its usefulness in clinical and administrative settings, as well as application of the skills gained to settings outside work.

A longitudinal study of dispositional compassion in Syrian origin young adults resettling in the Netherlands

Background

Dispositional compassion is regarded as a facet of Agreeableness, an emotional driver of prosociality, and a primary marker of adjustment. We examined changes in dispositional compassion in Syrian young adults resettling in the Netherlands, as well as the role of migration-related and demographic variables in this change.

Methods

We analyzed data from a 4-wave (T1-T4), 13-month longitudinal study ( N = 168; T1 Mage = 28.1 years, 70% male) using Latent Growth Curve Modelling (LGCM) in Mplus.

Results

Bivariate correlations indicated moderate test-retest correlations across the four waves of dispositional compassion and several correlations with the migration-related and demographic variables. A LGCM indicated a high initial level and small linear decrease in compassion over the four waves. Except for a link between pre-migration adversity and the intercept, the migration-related and demographic variables were not related to either the intercept of the slope of dispositional compassion.

Conclusion

Results suggest that high levels of dispositional compassion may be common for Syrian young adults with refugee backgrounds, but on average, slowly decreases over time. The cross-sectional associations between migration-related and demographic variables and dispositional compassion in the absence of a prospective one emphasize the importance of longitudinal research for understanding trajectories of adjustment.

Danger appraisal and pathogen-avoidance mechanisms in stigma towards severe mental illness: the mediating role of affective responses

BACKGROUND

Stereotypes of dangerousness are common predictors of stigmatising attitudes towards Severe Mental Illness (SMI). However less is known about pathogen avoidance mechanisms underlying stigma towards SMI, specially in samples of non-industrialised societies of Latin America and the Caribbean. The primary aim of this study was to examine pathogen-disgust sensitivity and danger appraisal mechanisms in responses of stigma towards SMI.

METHODS

Cross-sectional design with convenience sampling. Using an online survey, volunteers at the Universidad del Norte in Colombia (N = 271) provided their sociodemographic data and completed the Three-Domain Disgust Scale (TDDS). Participants were randomised to different descriptions of someone with SMI that varied in terms of aggressiveness (with and without danger) and causes of the SMI. Then, following the attribution questionnaire (AQ-27), respondents reported affective and discriminatory responses to the person in the description.

RESULTS

Increased disgust sensitivity to pathogen stimuli resulted in stronger reports of anger (β = .14; p = .03), and fear (β = 0.27; p < 0.001). The relationship between disgust sensitivity and discriminatory responses was indirectly mediated by fear towards SMI (Bootstrapped CI =-.04,-.009). Dangerousness attributions in the description of SMI predicted stronger feelings of anger (β = .23; p = 0.001) and fear (β = .40; p < .001), as well increased support for coercion-segregation of SMI (β = .34; p = 0.04), but less intentions to help (β = -.26; p = 0.003). The relationship between dangerousness and support for coercion was mediated by fear (Bootstrapped CI = .72, 1.37) and anger (Bootstrapped CI = .06, .44), whereas pity (Bootstrapped CI = .03, .38) and fear (Bootstrapped CI = -1.39, -.69) mediated responses of support for coercion-segregation of SMI. Attributions about causes and personal responsibility were not significantly linked to stigma towards SMI (p > 0.05).

CONCLUSIONS

Findings suggested that pathogen avoidance and danger appraisal systems interplay in the generation of discriminatory behaviour towards SMI. Anti-stigma programs and policy makers would benefit from introducing strategies that challenge stereotypes of dangerousness and unpredictability by promoting positive contact with people with SMI.

Compassion satisfaction and compassion fatigue in haematology cancer nurses: A cross‐sectional survey

Aim

This study aimed to investigate compassion satisfaction (CS) and compassion fatigue (CF) in haematology nurses and their associated factors.

Design

A cross‐sectional survey.

Methods

The survey was conducted on 336 haematology nurses from 21 hospitals in Sichuan, China. The CS and CF were assessed by the Professional Quality of Life Scale version 5. The CF was determined by burnout and secondary traumatic stress.

Results

Haematology nurses in China had moderate levels of CS and moderate‐to‐low CF. Better nursing competence of teaching/consultation and communication/coordination and the percentage of critically ill patients >60% predicted higher CS. The permanent nurse, better nursing competence of communication/coordination and specialized clinical practice predicted less burnout, while working >40 hr per week or more nurse‐patient conflict events predicted more burnout. In addition, working >40 hr per week, more nurse‐patient conflict events and having the need of psychological support predicted higher secondary traumatic stress.

The Role of English as a Foreign Language Teachers' Mindfulness and Compassion in Fostering Students' Foreign Language Enjoyment

With the popularity of positive psychology in English as a Foreign Language (EFL) teaching and learning, learners' positive emotions have attracted great academic attention. Foreign language enjoyment (FLE) is regarded as a constructive emotion and key component for learners' academic engagement that is affected by educators' emotions and psychological attributes. Earlier studies have proved the positive role of educators' mindfulness and compassion in reducing learners' negative feelings, boosting their positive emotions and building a harmonious teacher-student rapport. Through mindful and compassionate training, EFL teachers are skilled at creating a joyful learning atmosphere, showing understanding and support toward learners, as well as inspiring learners with enthusiasm and joy. The present review makes efforts to emphasize the significant effect of EFL teachers' mindfulness and compassion on fostering students' FLE. Moreover, a number of practical implications are provided for EFL teachers, teacher educators, school managers, and future directions are offered for enthusiastic researchers to conduct similar and complementary research in the field of foreign language education.