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Navarrete J, Fontana-McNally M, Colomer-Carbonell A, Sanabria-Mazo JP, Pinazo D, Silvestre-López AJ, Lau M, Tanay G, García-Campayo J, Demarzo M, Soler J, Cebolla A, Feliu-Soler A, Luciano JV. The Toronto Mindfulness Scale and the State Mindfulness Scale: psychometric properties of the Spanish versions. Front Psychol 2023; 14:1212036. [PMID: 37484107 PMCID: PMC10359483 DOI: 10.3389/fpsyg.2023.1212036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives The Toronto Mindfulness Scale (TMS) and the State Mindfulness Scale (SMS) are two relevant self-report measures of state mindfulness. The purpose of this study was to examine the internal structure and to offer evidence of the reliability and validity of the Spanish versions of the TMS and SMS. Methods Data from six distinct non-clinical samples in Spain were obtained. They responded to the TMS (n = 119), SMS (n = 223), and measures of trait mindfulness, decentering, non-attachment, depression, anxiety, stress, positive and negative affect, self-criticism, and self-reassurance. The internal structure of the TMS and SMS was analyzed through confirmatory factor analysis. Reliability, construct validity, and sensitivity to change analyses were performed. Results The correlated two-factor structure (curiosity and decentering) was the best-fitting model for the TMS (CFI = 0.932; TLI = 0.913; RMSEA = 0.100 [0.077-0.123]; WRMR = 0.908). The bifactor structure (general factor, mindfulness of body, and mindfulness of mind) was the best-fitting model for the SMS (CFI = 0.961; TLI = 0.950; RMSEA = 0.096 [0.086-0.106]; WRMR = 0.993). Adequate reliability was found for both measures. The reliability of the SMS specific factors was very poor when controlling for the general factor. The patterns of correlations were mainly as expected and according to previous literature. The TMS and SMS have been able to detect state mindfulness changes after different meditation practices. Conclusion Validity evidence is provided to support the use of the TMS and SMS in Spanish populations, though the reliability of the SMS specific factors merit revision.
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Affiliation(s)
- Jaime Navarrete
- Institut De Recerca Sant Joan De Déu, Esplugues De Llobregat, Spain
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu, Sant Boi De Llobregat, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marta Fontana-McNally
- Institut De Recerca Sant Joan De Déu, Esplugues De Llobregat, Spain
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu, Sant Boi De Llobregat, Spain
| | - Ariadna Colomer-Carbonell
- Institut De Recerca Sant Joan De Déu, Esplugues De Llobregat, Spain
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu, Sant Boi De Llobregat, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Juan P. Sanabria-Mazo
- Institut De Recerca Sant Joan De Déu, Esplugues De Llobregat, Spain
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu, Sant Boi De Llobregat, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Daniel Pinazo
- Department of Evolutionary, Educational and Social Psychology and Methodology, Universitat Jaume I, Castellón de la Plana, Spain
| | | | - Mark Lau
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Galia Tanay
- Observing Minds Lab, School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Universidad de Zaragoza, Zaragoza, Spain
| | - Marcelo Demarzo
- Mente Aberta - the Brazilian Center for Mindfulness and Health Promotion- Universidade Federal de São Paulo- UNIFESP, São Paulo, Brazil
| | - Joaquim Soler
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER of Mental Health (CIBERSAM), Madrid, Spain
| | - Ausiàs Cebolla
- Department of Personality, Evaluation and Psychological Treatments, University of Valencia, Valencia, Spain
- CIBER of Obesity and Nutrition (CIBEROBN), Madrid, Spain
| | - Albert Feliu-Soler
- Department of Clinical & Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
| | - Juan V. Luciano
- Institut De Recerca Sant Joan De Déu, Esplugues De Llobregat, Spain
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu, Sant Boi De Llobregat, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Clinical & Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
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Lau-Zhu A, Williams F, Steel C. Attachment patterns and autobiographical episodic memory functioning: A systemic review of adult studies to advance clinical psychological science. Clin Psychol Rev 2023; 101:102254. [PMID: 36804184 DOI: 10.1016/j.cpr.2023.102254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
Patterns of insecure attachment are associated with psychopathology but the mechanisms involved remain poorly understood. Cognitive science proposes that attachment patterns are influenced by the autobiographical memory system and in turn influence its ongoing functioning. Disturbances in autobiographical memory represent cognitive risks for later emotional difficulties. We systemically reviewed 33 studies (in 28 articles) examining the association between attachment patterns and autobiographical episodic memory (AEM) in individuals from the age of 16 (i.e., from young to older adulthood). Attachment patterns were associated with key areas of AEM phenomenology, including intensity and arousal; detail, specificity, and vividness; coherence and fragmentation; and accuracy and latency. These associations appeared to be moderated by contextual and individual factors; mediated by emotional regulation and schema-based processing; linked to mental health outcomes. Attachment patterns may also influence the impact of certain AEM-based manipulations. We conclude by providing a critical discussion and a research agenda for bringing together attachment, memory, and emotion, with a view to promote mechanism-driven treatment innovation in clinical psychology.
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Affiliation(s)
- A Lau-Zhu
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, United Kingdom; Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom.
| | - F Williams
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - C Steel
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
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Naismith I, Otto Scheiber CS, Gonzalez Rodriguez D, Petrocchi N. Physiological response to self-compassion versus relaxation in a clinical population. PLoS One 2023; 18:e0272198. [PMID: 36749746 PMCID: PMC9904495 DOI: 10.1371/journal.pone.0272198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 07/12/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Compassion-focused imagery (CFI) can be an effective emotion-regulation technique but can create threat-focused responses in some individuals. However, these findings have been based on tasks involving receiving compassion from others. AIMS This study sought to compare responses CFI involving self-compassion to relaxation and a control task, and to see whether any threat-responses to self-compassion and relaxation decrease with practice. METHOD 25 participants with depression/anxiety symptoms and high self-criticism and/or low self-compassion engaged in three tasks (control task, relaxation imagery, and CFI) at three or four separate testing sessions, every three days. Heart-rate variability (HRV) was used to explore group-level differences between tasks. Additionally, we identified how many individuals showed a clinically significant change in HRV in response to compassion (compared to baseline) and how many showed such a change during relaxation (compared to baseline). RESULTS During session 1, more individuals had a clinically significant increase in HRV in response to CFI (56%) than in response to relaxation (44%), and fewer had a clinically significant decrease in HRV during CFI (16%) than during relaxation (28%). Comparing the group as a whole, no significant differences between tasks were seen. Repeated sessions led to fewer positive responses to CFI, perhaps reflecting habituation/boredom. CONCLUSIONS These preliminary findings suggest that in high self-critics (those most likely to find self-compassion difficult), self-compassionate imagery is no more challenging than standard relaxation tasks. For both compassion and relaxation, some individuals respond positively and others negatively. For those who are not benefiting, practice alone is not sufficient to improve response. Effects may differ for other compassion tasks. TRIAL REGISTRATION Trial number: NCT04647318.
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Affiliation(s)
- Iona Naismith
- Department of Psychology, University of the Andes, Bogota, Colombia
- * E-mail:
| | | | | | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, Rome, Italy
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Exploring the Relationship Between Compassion and Attachment in Individuals with Mental Health Difficulties: A Systematic Review. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2022. [DOI: 10.1007/s10879-022-09573-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AbstractThe objective of the review was to explore the relevance of the relationship of compassion and attachment to mental health. APAPsycInfo, APAPsycArticles, CINAHL, MEDLINE, Social Science Database, Sociology Database, PTSDpubs, Pubmed, and Web of Science were searched from their inception until November 9, 2021. Peer-reviewed empirical studies exploring the compassion–attachment relationship in individuals with mental health difficulties through outcome measures were included. Studies were excluded if non-empirical, with non-clinical/subclinical samples, in a language other than English and if they did not consider the compassion–attachment relationship. Risk of bias was assessed through The Newcastle–Ottawa Scale and the Downs and Black Checklist. Seven eligible studies comprising 4839 participants were identified, with low to moderate risk of overall bias. Findings indicated a more straightforward relationship between self-compassion and secure attachment and confirmed the relevance of compassion and attachment to psychological functioning. Limitations concerned study design, the use of self-report measures, and low generalisability. While suggesting mechanisms underpinning compassion and attachment, the review corroborates the role of secure attachment and self-compassion as therapeutic targets against mental health difficulties. This study is registered on PROSPERO number CRD42021296279.
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Lucre K, Clapton N. The Compassionate Kitbag: A creative and integrative approach to compassion-focused therapy. Psychol Psychother 2021; 94 Suppl 2:497-516. [PMID: 32639097 DOI: 10.1111/papt.12291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/28/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE This paper outlines the concept of the 'Compassionate Kitbag', a novel multi-sensory-based means of helping draw together the various elements of compassionate mind training and processes within compassion-focused therapy (CFT), to help clients cultivate and facilitate their capacities for compassion. Building on the work of Lucre and Corten (2013, Psychology and Psychotherapy: Theory, Research and Practice, 86, 387), this is the first published work exploring this concept and the theoretical underpinnings, with a specific focus on how this can be used to support people with attachment and relational trauma. METHODS A narrative review of the literature on multi-sensory stimulation in facilitating people's capacities for compassion was conducted, coupled with a review of the literature of the use of non-human and transitional objects as explained by attachment theory and the broader scientific research underpinning the CFT model. RESULTS Clinical examples of how to use the Compassionate Kitbag to help stimulate compassionate therapeutic processes demonstrate the benefits of and how to begin utilizing this approach in compassion-focused work with clients with complex needs. CONCLUSIONS The Compassionate Kitbag's potential therapeutic value lies in offering multifarious creative and tangible means of accessing compassion to a wide range of individuals whom are typically fearful of, blocked, and/or resistant to compassion. Further research into the wider application of the concept of the Compassionate Kitbag is needed. PRACTITIONER POINTS Many patients with ruptured and/or traumatized early attachment relationships can find more traditional talking therapies difficult to access. Compassion-focused therapy (CFT) can offer an evolutionary-based understanding of interpersonal difficulties which can be helpful for such patients. Creatively harnessing and utilizing multi-sensory and non-linguistic social signals in CFT is key to exercising the care-giving and care-receiving social mentalities that facilitate compassionate flow. There is considerable evidence to support the use of a multi-sensory component to the therapeutic work to help patients cultivate and facilitate their capacities for compassion. The Compassionate Kitbag can be a way of supporting patients to create concrete representations of compassion in the context of the compassionate mind training component of the therapeutic work. Some of these objects can become transitional objects which can aid the therapeutic work.
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Affiliation(s)
| | - Neil Clapton
- Avon and Wiltshire Mental Health Partnership NHS Trust, Swindon, UK
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Bennett-Levy J, Roxburgh N, Hibner L, Bala S, Edwards S, Lucre K, Cohen G, O'Connor D, Keogh S, Gilbert P. Arts-Based Compassion Skills Training (ABCST): Channelling Compassion Focused Therapy Through Visual Arts for Australia's Indigenous Peoples. Front Psychol 2021; 11:568561. [PMID: 33391084 PMCID: PMC7772135 DOI: 10.3389/fpsyg.2020.568561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/11/2020] [Indexed: 01/27/2023] Open
Abstract
The last 20 years have seen the development of a new form of therapy, compassion focused therapy (CFT). Although CFT has a growing evidence base, there have been few studies of CFT outside of an Anglo-European cultural context. In this paper, we ask: Might a CFT-based approach be of value for Indigenous Australians? If so, what kind of cultural adaptations might be needed? We report the findings from a pilot study of an arts-based compassion skills training (ABCST) group, in which usual CFT group processes were significantly adapted to meet the needs of Indigenous Australians. At face value, CFT appeared to be a promising approach to enhancing the social and emotional wellbeing of Australia’s Indigenous peoples. However, despite initial consultations with Indigenous health professionals, the first attempts to offer a more conventional group-based CFT to Indigenous clients were largely unsuccessful. Following a review and advice from two Indigenous clients, we combined elements of CFT with visual arts to develop a new approach, “arts-based compassion skills training” (ABCST). This paper reports an evaluation of this pilot ABCST group. The group had 6 × 4 h sessions of ABCST, facilitated by two psychologists (1 Indigenous, 1 non-Indigenous) and two artists (1 Indigenous, 1 non-Indigenous). There were 10 participants, who attended between 2 and 6 sessions: five were clients, five were health professionals. Between 1 and 3 months later, six of the participants (2 clients, 4 health professionals) were interviewed. Qualitative analysis of interview data identified that two key processes—creating a positive group atmosphere and channeling compassion skills training through the medium of visual arts—led to four positive outcomes for participants: planting the seeds of new understandings, embodying the skills of compassion, strengthening relationships with others, and evolving a more self-compassionate relationship. We suggest that the preliminary results are sufficiently encouraging to warrant further development of ABCST in Indigenous communities.
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Affiliation(s)
- James Bennett-Levy
- University Centre for Rural Health, The University of Sydney, Lismore, NSW, Australia
| | - Natalie Roxburgh
- University Centre for Rural Health, The University of Sydney, Lismore, NSW, Australia
| | - Lia Hibner
- University Centre for Rural Health, The University of Sydney, Lismore, NSW, Australia
| | | | - Stacey Edwards
- Department of Psychology, Charles Sturt University, Bathurst, NSW, Australia
| | - Kate Lucre
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | | | | | | | - Paul Gilbert
- Centre for Compassion Research and Training, University of Derby, Derby, United Kingdom
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Naismith I, Kerr S, Mwale A, Feigenbaum J. A thematic analysis of compassion‐focused imagery for people with personality disorder: Inhibitors, facilitators and clinical recommendations. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12180] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Iona Naismith
- Department of Psychology, Universidad de Los Andes, Bogota, Colombia,
| | - Shelley Kerr
- North East London NHS Foundation Trust, London, UK,
| | - Amanda Mwale
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK,
| | - Janet Feigenbaum
- North East London NHS Foundation Trust, London, UK,
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK,
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Naismith I, Ferro CD, Ingram G, Leal WJ. Compassion-focused imagery reduces shame and is moderated by shame, self-reassurance and multisensory imagery vividness. RESEARCH IN PSYCHOTHERAPY (MILANO) 2019; 22:329. [PMID: 32913776 PMCID: PMC7451339 DOI: 10.4081/ripppo.2019.329] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/07/2018] [Indexed: 12/03/2022]
Abstract
Compassion-focused imagery (CFI) is an emotion-regulation technique involving visualization of a person, animal or object offering one compassion, to generate feelings of safeness. It is proven to increase self-compassion and reduce negative affect. This study explores two hypotheses not previously investigated: i) which sensory modalities can stimulate compassionate affect; and ii) whether presentation of pictorial stimuli can enhance CFI. Additionally, we examine iii) whether CFI can reduce shame and iv) whether self-criticism inhibits CFI, since previous studies have involved small samples or methodological limitations. After completing measures of self-criticism, selfreassurance and imagery abilities in five sensory modalities, participants (n=160) were randomly assigned to look at compassionate images during CFI (visual input), compassionate images before CFI (priming), or abstract images (control). Participants trialled CFI then rated compassionate affect and completed open-response questions. Before and after CFI, participants recalled a shame-based memory and rated state shame. Correlational analyses explored whether self-criticism, self-reassurance, and multisensory imagery abilities moderated outcomes. CFI significantly reduced shame regarding a recalled memory, particularly for those high in shame. Compassionate affect was predicted by imagery vividness in visual and bodily-sensation modalities. Self-criticism predicted poorer CFI In multiple regressions, self-reassurance predicted poorer CFI outcomes but self-criticism did not. Between-group effects did not emerge. Qualitative data suggested that pictures helped some participants but hindered others. CFI is a promising technique for shame-prone clients, but may be challenging for those with low imagery abilities or unfamiliar with self-reassurance. Multiple senses should be engaged.
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Naismith I, Zarate Guerrero S, Feigenbaum J. Abuse, invalidation, and lack of early warmth show distinct relationships with self-criticism, self-compassion, and fear of self-compassion in personality disorder. Clin Psychol Psychother 2019; 26:350-361. [PMID: 30715768 DOI: 10.1002/cpp.2357] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 11/30/2018] [Accepted: 12/03/2018] [Indexed: 11/07/2022]
Abstract
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.
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Affiliation(s)
- Iona Naismith
- Department of Psychology, Universidad de los Andes, Bogota, Colombia
| | | | - Janet Feigenbaum
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Abstract
Mental imagery refers to the experience of perception in the absence of external sensory input. Deficits in the ability to generate mental imagery or to distinguish it from actual sensory perception are linked to neurocognitive conditions such as dementia and schizophrenia, respectively. However, the importance of mental imagery to psychiatry extends beyond neurocognitive impairment. Mental imagery has a stronger link to emotion than verbal-linguistic cognition, serving to maintain and amplify emotional states, with downstream impacts on motivation and behavior. As a result, anomalies in the occurrence of emotion-laden mental imagery has transdiagnostic significance for emotion, motivation, and behavioral dysfunction across mental disorders. This review aims to demonstrate the conceptual and clinical significance of mental imagery in psychiatry through examples of mood and anxiety disorders, self-harm and suicidality, and addiction. We contend that focusing on mental imagery assessment in research and clinical practice can increase our understanding of the cognitive basis of psychopathology in mental disorders, with the potential to drive the development of algorithms to aid treatment decision-making and inform transdiagnostic treatment innovation.
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