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Davis HA, Patarinski AGG, Hahn SL, Kesselring-Dacey D, Smith GT. A longitudinal test of problematic alcohol use and binge eating among college women: The moderating role of shame. Alcohol 2024; 118:65-73. [PMID: 37952786 PMCID: PMC11150035 DOI: 10.1016/j.alcohol.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
Problematic alcohol use and binge eating frequently co-occur. High levels of negative affect, negative urgency, and/or shame may increase the likelihood that problematic alcohol use and binge eating co-occur over time. OBJECTIVE Examine 1) the temporal relationship between problematic alcohol use and binge eating among college women, who are at high risk for both, and 2) the additive and moderating effects of shared, emotion-based risk factors in models involving both problematic alcohol use and binge eating. METHOD In n = 302 college women assessed at two time points across 8 months, we used hierarchical linear regression to invstigate our objectives. RESULTS Baseline problematic alcohol use and baseline shame independently predicted increases in follow-up binge eating, controlling for baseline binge eating. In addition, the interaction between problematic alcohol use and shame accounted for further variance in subsequent binge eating (the influence of baseline problematic alcohol use on follow-up binge eating was stronger at higher levels of baseline shame). The reciprocal relationship was not significant: baseline binge eating did not predict follow-up problematic alcohol use independently or in conjunction with risk factors. Neither negative affect nor negative urgency showed predictive effects beyond prior behavior and shame. Results support 1) problematic alcohol use as a prospective risk factor for binge eating, 2) shame as an additive predictor of binge eating, and 3) shame as a positive moderator of binge eating prediction from problem drinking. CONCLUSION Addressing shame and problematic alcohol use may be warranted in binge eating interventions for college women.
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Affiliation(s)
- Heather A Davis
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States.
| | - Anna Gabrielle G Patarinski
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Samantha L Hahn
- College of Medicine, Central Michigan University, Mount Pleasant, MI, United States
| | - Denise Kesselring-Dacey
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Gregory T Smith
- Department of Psychology, University of Kentucky, Lexington, KY, United States
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2
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Veilleux JC, Clift JB, Brott KH, Warner EA, Schreiber RE, Henderson HM, Shelton DK. "I'm so dumb and worthless right now": factors associated with heightened momentary self-criticism in daily life. Cogn Emot 2024; 38:492-507. [PMID: 38241697 DOI: 10.1080/02699931.2024.2305400] [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: 05/05/2023] [Accepted: 11/02/2023] [Indexed: 01/21/2024]
Abstract
Self-criticism is a trait associated with increased psychopathology, but self-criticism is also a personality state reflecting an action that people do in moments of time. In the current study, we explored factors associated with heightened self-criticism in daily life. Participants (N = 197) received five random prompts per day for one week on their mobile phones, where they reported their current affect (negative and positive affect), willpower self-efficacy, distress intolerance, degree of support and criticism from others, current context (location, activity, hunger, tiredness) and momentary self-criticism. We first demonstrated that self-criticism varies over time and across contexts, and is associated with heightened trait self-criticism. Then, using multilevel modelling, we explored the contextual factors associated with greater self-criticism. We found that self-criticism was higher when people were at home, and more tired. We also found higher self-criticism to be associated with greater negative and lower positive affect, greater distress intolerance, lower willpower and greater perceived criticism from others. In addition, self-criticism predicted subsequent distress intolerance, willpower and positive affect in lagged analyses. This study provides evidence that both environmental and psychological factors are associated with the dynamics of self-critical thoughts.
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Affiliation(s)
- Jennifer C Veilleux
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Jeremy B Clift
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Katherine Hyde Brott
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Elise A Warner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Regina E Schreiber
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Hannah M Henderson
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Dylan K Shelton
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
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Gilbert P. Threat, safety, safeness and social safeness 30 years on: Fundamental dimensions and distinctions for mental health and well-being. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024. [PMID: 38698734 DOI: 10.1111/bjc.12466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/18/2024] [Indexed: 05/05/2024]
Abstract
In 1993, the British Journal of Clinical Psychology published my paper titled 'Defence and safety: Their function in social behaviour and psychopathology'. The paper highlights that to understand people's sensitivity to threat, we also need to understand their ability to identify what is safe. This paper offers an update on these concepts, highlighting distinctions that were implicit but not clearly defined at the time. Hence, the paper seeks to clarify distinctions between: (i) threat detection and response, (ii) safety and safety seeking, (iii) safeness and (iv) their social and non-social functions and forms. Threat detection and response are to prevent or minimize harm (e.g., run from a predator or fire). Safety checking relates to monitoring for the absence and avoidance of threat, while safety seeking links to the destination of the defensive behaviour (e.g., running home). Safety seeking also relates to maintaining vigilance to the appearance of potential harms and doing things believed to avoid harm. Threat-defending and safety checking and seeking are regulated primarily through evolved threat processing systems that monitor the nature, presence, controllability and/or absence of threat (e.g., amygdala and sympathetic nervous system). Safeness uses different monitoring systems via different psychophysiological systems (e.g., prefrontal cortex, parasympathetic system) for the presence of internal and external resources that support threat-coping, risk-taking, resource exploration. Creating brain states that recruit safeness processing can impact how standard evidence-based therapies (e.g., exposure, distress tolerance and reappraisal) are experienced and produce long-term change.
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Affiliation(s)
- Paul Gilbert
- Centre of Compassion Research and Training, College of Health and Social Care Research Centre, University of Derby, Derby, UK
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4
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Boring BL, Walsh KT, Ng BW, Schlegel RJ, Mathur VA. Experiencing Pain Invalidation is Associated with Under-Reporting of Pain: A Social Psychological Perspective on Acute Pain Communication. THE JOURNAL OF PAIN 2024; 25:104428. [PMID: 37984509 DOI: 10.1016/j.jpain.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/16/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023]
Abstract
Pain invalidation involves the dismissal or lack of understanding of another's pain, undermining their subjective experience. Frequent exposure to invalidation negatively impacts mental and physical health as well as pain-related behaviors, potentially leading people to conceal their pain from others in the future and/or withdraw from potential sources of support. It is therefore possible that experiencing pain invalidation may also impact pain-reporting behavior in clinical settings. Across 2 separate samples of emerging adults, we examined whether exposure to invalidation of one's pain was associated with cognizant modulation of one's subjective acute pain ratings within routine medical and dental settings. Drawing upon social psychological theories of impression management and self-presentation, we hypothesized that exposure to pain invalidation would be associated with the under-rating of one's pain. In Study 1, previous experiences of invalidation were associated with under-rating of one's pain when visiting the doctor and the dentist. Study 2 found that invalidation from family and medical professionals-but not from friends-was associated with under-rating pain in both settings. Findings provide further evidence for the harmful effects of pain invalidation, particularly for emerging adults, as the dismissal of one's subjective experience may sow self-doubt while reinforcing cultural stigmas against pain, leading to alterations in pain communication that ultimately creates barriers to efficacious clinical treatment and care and increase pain-related suffering. PERSPECTIVE: Pain invalidation imparts harm to those who already suffer from pain, be it mentally, physically, and/or behaviorally. We show that people who have encountered invalidation are more likely to under-rate their pain when seeking care, impeding assessment and treatment, and further highlighting the importance of clinical validation of pain experiences.
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Affiliation(s)
- Brandon L Boring
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | - Kaitlyn T Walsh
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | - Brandon W Ng
- Department of Psychology, University of Richmond, Richmond, Virginia
| | - Rebecca J Schlegel
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, College Station, Texas
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Lucre K, Ashworth F, Copello A, Jones C, Gilbert P. Compassion Focused Group Psychotherapy for attachment and relational trauma: Engaging people with a diagnosis of personality disorder. Psychol Psychother 2024. [PMID: 38305507 DOI: 10.1111/papt.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES The research aimed to evaluate an exploratory Compassion Focused Group Psychotherapy Programme and the impact on participants' experiences of self-criticism, usage of services and general wellbeing. Participants included patients with a history of complex attachment and relational trauma (A&RT), who might attract a diagnosis of personality disorder. DESIGN This study utilised a quasi-experimental non-randomised within subject controlled design for the evaluation of the efficacy of the programme. METHODS Participants were recruited from tertiary care services. The programme consisted of a 12-week Preparation and Engagement intervention (PEG) which was Compassionate Mind Training and Psychoeducation, followed by a 40-week Compassion Focused Trauma Group intervention. The cohort was then followed up after 12 months during which period they received treatment as usual. A comprehensive selection of self-report measures was administered at various points during the therapeutic process and following completion of the group interventions. RESULTS The results of the research showed that the provision of a long-term, slow-paced, Compassion Focused Group Psychotherapy intervention, resulted in significant changes across all measures which were maintained at 12-month follow-up. These significant results were maintained following intention to treat and reliable change analyses. These data were supported by a significant reduction in service usage and a significant increase in engagement in employment and education. CONCLUSIONS This study has identified that within Compassion Focused Group Psychotherapy, there is a therapeutic process of establishing group-based safeness as a necessary precursor to cultivating compassion and reworking early shame-based trauma memories.
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Affiliation(s)
- Kate Lucre
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | | | - Alex Copello
- School of Psychology University of Birmingham & Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
| | - Chris Jones
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Paul Gilbert
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, UK
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6
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Neshat Z, Farah Bijari A, Dehshiri G. The relationship between perfectionism and interpersonal sensitivity with self-compassion in university students: the mediation of repetitive negative thinking. Cogn Process 2024; 25:107-120. [PMID: 37803210 DOI: 10.1007/s10339-023-01163-z] [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: 12/03/2022] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
Self-compassion is a construct of positive psychology related to personality and cognitive factors. Perfectionism and interpersonal sensitivity are prevalent personality traits among university students and are associated with low self-compassion. Further research is required to comprehend how these mechanisms work in creating self-compassion. Consequently, the current study investigated the direct and indirect relationship between perfectionism and interpersonal sensitivity with self-compassion via repetitive negative thinking. To this end, a sample of 450 students studying in Tehran during the 2022 academic year was selected as the study sample. The results indicated that perfectionism and interpersonal sensitivity demonstrate a negative direct relationship with self-compassion, while perfectionism and interpersonal sensitivity exhibit an indirect relationship with self-compassion via repetitive negative thinking. Based on the findings, it can be concluded that the relationship between perfectionism and interpersonal sensitivity with self-compassion is not straightforward and that repetitive negative thinking can mediate this relationship. The results can be used to improve methods for increasing self-compassion and paying attention to personality, and cognitive factors can be an important step toward more effective self-compassion interventions.
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Affiliation(s)
- Zahra Neshat
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran.
| | - Azam Farah Bijari
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Gholamreza Dehshiri
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
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7
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Pol SM, de Jong A, Trompetter H, Bohlmeijer ET, Chakhssi F. Effectiveness of compassion-focused therapy for self-criticism in patients with personality disorders: a multiple baseline case series study. Personal Ment Health 2024; 18:69-79. [PMID: 37942561 DOI: 10.1002/pmh.1597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/22/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Targeting self-criticism, the tendency to negatively evaluate and judge aspects of oneself, may improve treatment efficacy for personality disorders (PDs). This study aimed to test whether adding 12-week group compassion-focused therapy (CFT) that explicitly targets self-criticism to treatment as usual (TAU) would reduce self-criticism in patients with PDs. METHOD Twelve patients with PDs participated in a multiple baseline study, randomly allocated to different baseline lengths. The primary outcome was twice-weekly assessed self-critical beliefs during baseline, treatment, and follow-up phases. Secondary outcomes were self-criticism, self-compassion, and PD severity at the end of CFT and follow-up (trial registered: NL8131). Nine participants completed the intervention. No significant changes were observed during CFT, but at follow-up significant decrease in self-critical beliefs (Cohen's d = -0.43; 95% CI = -0.73 to -0.12) was reported compared to baseline. On secondary outcomes, most participants showed reliable improvement on self-reported criticism (66.7%) and self-compassion (55.6%), and a minority of patients showed reliable improvement in PD severity (33.3%). CONCLUSIONS This study seems to provide preliminary evidence for the effectiveness of 12-week CFT for self-critical beliefs in patients with PDs compared to TAU. CFT for self-criticism in PDs may complement treatment offerings and warrant further research.
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Affiliation(s)
- Silvia M Pol
- GGNet Group for Mental Health Care in East-Gelderland and Zutphen, Scelta, Zutphen, The Netherlands
| | - Audrey de Jong
- GGNet Group for Mental Health Care in East-Gelderland and Zutphen, Scelta, Zutphen, The Netherlands
| | - Hester Trompetter
- Department of Medical and Clinical Psychology, Tilburg University Tilburg School of Social and Behavioral Sciences, Tilburg, The Netherlands
| | - Ernst T Bohlmeijer
- Psychology, Health & Technology, University of Twente Faculty of Behaviourial, Management and Social sciences, Enschede, The Netherlands
| | - Farid Chakhssi
- GGNet Group for Mental Health Care in East-Gelderland and Zutphen, Scelta, Zutphen, The Netherlands
- Dimence Groep, Deventer, The Netherlands
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Sajadian M, Younesi SJ, Jafari P, Azkhosh M, Yarandi RB, Kordbagheri M. Shame, fear of compassion, self-criticism, and self-reassurance mediate the effect of early life events on emotional disorders among male prisoners: A structural equation modeling analysis. Acta Psychol (Amst) 2024; 242:104116. [PMID: 38113609 DOI: 10.1016/j.actpsy.2023.104116] [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: 10/06/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Early negative experiences in childhood are potent predictors of criminal behavior in youth and adulthood. This study aimed to identify the mediation effects of Shame, Fear of Compassion, Self-criticism, and Self-reassurance on the effect of Early Life Events on Emotional Disorders. METHOD This cross-sectional study was conducted among 368 male prisoners (Mean age: 33.26 ± 8.41 years) with convenient sampling method, from Ilam, Iran. A set of self-reported instruments were used for data collection. The ultimate model was constructed using structural equation modeling after confirming the construct validity of the measures via confirmatory factor analysis. RESULTS Shame, fear of compassion, self-criticism, and self-reassurance significantly mediated the relationship between Early Life Events and emotional disorders. The mediating effect accounted for 77 % of the total effect in the mediating model. According to Pearson's correlation, a positive and significant relationship existed between early life events and self-criticism, shame, fear of compassion and emotional disorders (P < .001). In conclusion, the presented model has an appropriate and acceptable fit, as evidenced by the results of the chi-square test (χ2 = 48.067, p < .001) and other relevant fit indices. However, self-reassurance's mediating role was insignificant (P > .05). CONCLUSIONS The present results showed that shame, fear of compassion, and self-criticism are important mediators in the relationship between early life events and emotional disorders among male prisoners. So, it is necessary to develop related protocols to increase the mental health of prisoners.
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Affiliation(s)
- Maryam Sajadian
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Jalal Younesi
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Parvin Jafari
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Manouchehr Azkhosh
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Razieh Bidhendi Yarandi
- Epidemiology and Biostatistics Department, University of social welfare and rehabilitation sciences, Tehran, Iran
| | - Mohammadreza Kordbagheri
- Department of Statistics, Faculty of Mathematical Sciences, Shahid Beheshti University, Tehran, Iran
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Welch K, Brott KH, Veilleux JC. Hovering or invalidating? Examining nuances in the associations between controlling parents and problematic outcomes for college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-13. [PMID: 37216586 DOI: 10.1080/07448481.2023.2209197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 04/03/2023] [Accepted: 04/23/2023] [Indexed: 05/24/2023]
Abstract
Objective: The purpose of these studies was to examine whether college students' beliefs about themselves (i.e., self-compassion and beliefs about emotions) could be mechanisms explaining the relationship between problematic parenting behaviors (helicopter parenting and parental invalidation) and outcomes including perfectionism, affective distress, locus of control, and distress tolerance. Participants: Respondents included 255 (Study 1) and 277 (Study 2) college undergraduates. Methods: Simultaneous regressions and separate path analyses with helicopter parenting and parental invalidation as predictors, with self-compassion and emotion beliefs as mediators. Results: Across both studies, parental invalidation predicted perfectionism, affective distress, distress tolerance, and locus of control, and these links were often mediated by self-compassion. Self-compassion emerged as the most consistent and strongest link between parental invalidation and negative outcomes. Conclusion: People who internalize their parents' criticism and invalidation such that they hold negative beliefs about themselves (i.e., low self-compassion) may be vulnerable to negative psychosocial outcomes.
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Affiliation(s)
- Katie Welch
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - Katherine Hyde Brott
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - Jennifer C Veilleux
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
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10
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Zhang H, Li J, Sun B, Wei Q. Effects of Childhood Maltreatment on Self-Compassion: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:873-885. [PMID: 34510982 DOI: 10.1177/15248380211043825] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND This systematic review aims to estimate the extent to which childhood maltreatment influences self-compassion in later life. METHOD Four English databases (Web of Science, PsycINFO, PubMed, and PsycARTICLES) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and Weipu) were systematically searched. We extracted data related to the associations between child maltreatment and self-compassion and pooled them using random effect models. FINDINGS A total of 20 eligible studies were included involving 6,877 participants in the analyses. Overall child maltreatment was negatively related to self-compassion (r = -.28, p < .001); emotional abuse and neglect were negatively related to self-compassion (r = -.28, p < .01; r = -.31, p < .01, respectively) at a moderate level; and physical abuse, sexual abuse, and physical neglect were negatively related to self-compassion (r = -.12, p < .01; r = -.10, p < .01; and r = -.22, p < .001, respectively) at a small level. CONCLUSION The results indicate that overall and subtypes of maltreatment are associated with decreased self-compassion, and child intervention programs focused on self-compassion should be designed to protect the well-being of individuals with a history of childhood maltreatment.
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Affiliation(s)
- Huiping Zhang
- Center for Studies of Sociology Theory and Method, Renmin University of China, Beijing, China
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Jiming Li
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Bingyi Sun
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Qingong Wei
- National Academy of Development and Strategy, Renmin University of China, Beijing, China
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Ortiz R, Zhao S, Kline DM, Brock G, Carroll JE, Seeman TE, Jaffee SR, Berger JS, Golden SH, Carnethon MR, Joseph JJ. Childhood environment early life stress, caregiver warmth, and associations with the cortisol diurnal curve in adulthood: The coronary artery risk development in young adults (CARDIA) study. Psychoneuroendocrinology 2023; 149:106008. [PMID: 36599226 PMCID: PMC10029914 DOI: 10.1016/j.psyneuen.2022.106008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Early life stress (ELS) is associated with increased morbidity and mortality across the lifecourse. Studies observing a relationship between ELS and stress physiology (cortisol), may help explain the connection to poor health outcomes, but have been limited by cortisol measures used. PURPOSE We examined the association between ELS measured by a Risky Family (RF) environment questionnaire, and adult diurnal cortisol profile inclusive of multiple cortisol measures. METHODS RF and cortisol were collected from Coronary Artery Risk Development in Young Adults Study participants at follow-up (Year 15). Complete case (n = 672) data were included in multi-variable regression analyses with log transformed cortisol measures (outcomes) including wake-up cortisol, cortisol awakening response [CAR], AUC and five other cortisol diurnal curve measures. RESULTS Participants were age 39.9 + /- 3.7 years and 51.6% Black. For every 1 unit increase in RF, there was a 1.4% greater wake-up cortisol and flatter CAR after adjustment for age, sex, income, and smoking (B=0.014, p = 0.023; B=-0.014, p = 0.028, respectively). Each unit increase in caregiver warmth/affection was associated with a 6.9% higher (steeper) CAR (B=0.069, p = 0.03). Results remained significant after adjusting for other covariates except social support in adulthood. An interaction between child abuse and caregiver warmth was nearly significant (p = 0.068), such that for those with exposure to the greatest caregiver warmth and lowest child abuse, CAR was steepest CONCLUSIONS: We demonstrate that ELS is associated with altered cortisol regulation in adulthood. However, further research is needed to assess how healthy relationships throughout the life course may modulate cortisol regulation in adulthood.
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Affiliation(s)
- Robin Ortiz
- Institute for Excellence in Health Equity, New York University Langone Health, New York, NY, USA; Departments of Pediatrics and Population Health, New York University, Grossman School of Medicine, New York, NY, USA.
| | - Songzhu Zhao
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - David M Kline
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Guy Brock
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Judith E Carroll
- The University of California, Los Angeles, David Geffen School of Medicine, Jane and Terri Semel Institute for Neuroscience and Human Behavior, Cousins Center for Psychoneuroimmunology, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA, USA
| | - Teresa E Seeman
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Sara R Jaffee
- Department of Psychology, The University of Pennsylvania, Philadelphia, PA, USA
| | - Jeffrey S Berger
- Departments of Medicine and Surgery, New York University, Grossman School of Medicine, New York, NY, USA; Center for the Prevention of Cardiovascular Disease, Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Sherita H Golden
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Joshua J Joseph
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, OH, USA
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12
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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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13
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Tavares LR, Vagos P, Xavier A. The role of self-compassion in the psychological (mal)adjustment of older adults: A repeated-measures study protocol. Psychol Psychother 2022; 95:990-1002. [PMID: 35833498 DOI: 10.1111/papt.12414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/25/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Self-compassion is associated with healthy ageing and may be a protection factor of older adults' mental health in face of negative life events and other factors such as insecure attachment. However, fear of self-compassion may constitute an obstacle to promoting self-compassion. The role of self-compassion on the psychological (mal)adjustment of older adults requires further research with robust designs, and fear of self-compassion has not been studied in this population. We will test the moderator and mediator role, respectively, of self-compassion and fear of self-compassion, and we will analyse the longitudinal developmental trajectories of these variables. METHODS A repeated-measures design with three data collection moments across 6 months, using a sample (180-200 participants) of community residents aged ≥65 years. Data will be collected using traditional (i.e. pencil-and-paper questionnaires) and online (i.e. Google Forms) methods. Path analyses will be conducted to test moderation and mediation models. Latent growth curve analyses will be conducted to study the within-person change and between-person differences in change over time of self-compassion and fear of self-compassion. CONCLUSIONS We expect that participants with higher self-compassion will show better psychological adjustment, regardless of attachment quality and negative life events. We expect that insecure attachment and more negative life events will increase the participants' fear of self-compassion, which will decrease their psychological adjustment. Additionally, we expect that self-compassion and fear of self-compassion will show stable developmental trajectories during 6 months. Our results will contribute to better understand protection factors of older adults' mental health, which may guide future psychological interventions.
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Affiliation(s)
- Lúcia Rafaela Tavares
- Instituto de Desenvolvimento Humano Portucalense, Universidade Portucalense Infante D. Henrique, Porto, Portugal
| | - Paula Vagos
- Centro de Investigação em Neuropsicologia e Intervenção Cognitivo-Comportamental da Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra, Instituto de Desenvolvimento Humano Portucalense, Universidade Portucalense Infante D. Henrique, Porto, Portugal
| | - Ana Xavier
- Instituto de Desenvolvimento Humano Portucalense, Universidade Portucalense Infante D. Henrique, Porto, Portugal
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14
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Chasson M, Taubman – Ben-Ari O. The contribution of childhood experiences, maternal disintegrative responses, and self-compassion to maternal self-efficacy and role satisfaction: a prospective study. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04085-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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15
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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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16
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Talmon A, Cohen N, Raif Y, Ginzburg K. Sense of mastery among older adults and its relation to invalidating childhood experiences. Aging Ment Health 2022; 26:2186-2194. [PMID: 34669542 DOI: 10.1080/13607863.2021.1993130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
ObjectivesSense of mastery, a well-recognized resource for older adults, has been shown to be related to early life experiences, especially parent-child interactions. Yet while there are indications that a reduced sense of mastery is related to early experiences of child maltreatment, this association has not been studied among older adults. The aim of this study was to examine the relation between experiences of childhood parental invalidation and sense of mastery among older adults, through the mediation of self-objectification and perceived disrupted body boundaries.Methods: Three-hundred-and-sixteen older adults (Mean = 72.24; SD = 8.12 years; range: 60-94) filled out a battery of questionnaires assessing their levels of exposure to childhood parental invalidation experiences, sense of self-objectification, disrupted body boundaries, and sense of masteryResults: A structural equation modeling (SEM) analysis supported the hypothesized research model. More specifically, two significant indirect effects were observed, according to which the association between invalidating childhood experiences and sense of mastery was mediated by both self-objectification and by disrupted body boundaries.Conclusion: As these results suggest that early life experiences continue to affect individuals' sense of self in older age, they should be considered an important factor for evaluation and intervention.
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Affiliation(s)
- Anat Talmon
- Psychology Department, Stanford University, Stanford, CA, USA
| | - Noa Cohen
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Yael Raif
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Karni Ginzburg
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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17
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Pfeiffer S, Peixoto Pereira N, Saraiva de Macedo Lisboa C. Fears of Compassion Scales: Cross-Cultural Adaptation and Validity Evidence for Use in Brazil. TRENDS IN PSYCHOLOGY 2022. [PMCID: PMC9360723 DOI: 10.1007/s43076-022-00220-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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Fagan S, Hodge S, Morris C. Experiences of Compassion in Adults With a Diagnosis of Borderline Personality Disorder: An Interpretative Phenomenological Analysis. Psychol Rep 2022; 125:1326-1347. [PMID: 33730923 PMCID: PMC9136373 DOI: 10.1177/00332941211000661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study explored experiences of compassion in adults with a diagnosis of Borderline Personality Disorder (BPD) to further the development of the construct of compassion in relation to BPD. Interpretative Phenomenological Analysis was used to develop themes from the narratives of six adults with a diagnosis of BPD. Five themes emerged: Emotional Connection to Suffering, Empathic Understanding, Prioritisation of Needs, A Model of Genuine Compassion and Developing Acceptance and Worth. Participants described the role of compassion in their difficulties, including the adverse impact of experiences of incompassion upon their sense of self. The themes were integrated into a model that highlighted a process of recovery through therapeutic encounters with others in which genuine compassion was modelled. In addition, barriers to compassion and factors facilitating the development of compassion emerged from the analysis and have implications for clinical practice.
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Affiliation(s)
- Stephanie Fagan
- Primary/Intermediate Mental Health Team, 1756Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - Suzanne Hodge
- Division of Health Research, 4396Lancaster University, Lancaster, UK
| | - Charlotte Morris
- Recovery Team, North West Boroughs Healthcare NHS Trust, Warrington, UK
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19
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Zhang S, Guo M, Wang J, Lin L. The Relationship Between Fears of Compassion, Emotion Regulation Difficulties, and Emotional Eating in College Students: A Moderated Mediation Model. Front Psychol 2022; 12:780144. [PMID: 35035369 PMCID: PMC8755638 DOI: 10.3389/fpsyg.2021.780144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
Although previous research has found the impact of fears of compassion on eating disorders, the mechanism underlying the relationship between fears of compassion and emotional eating remains to be examined. This study aimed to examine the mediating role of emotion regulation difficulties in the relationships between fears of compassion and emotional eating in college students, as well as the gender difference in the mediation model. The Fears of Compassion Scale, Difficulties in Emotion Regulation Scale, and Dutch Eating Behavior Questionnaire were completed by 673 college students in Fujian Province, China. Structural Equation Modeling was primarily employed to analyze the data. The results showed that both fear of compassion for self and fear of compassion from others were positively associated with emotion regulation difficulties, which in turn were related to emotional eating for female college students. Emotion regulation difficulties played a significant mediating effect in the relationship between fears of compassion and emotional eating. Comparatively, for male college students, only fear of compassion for self was positively associated with emotion regulation difficulties, but emotion regulation difficulties were not related to emotion eating. Moreover, the mediating effect of emotion regulation difficulties was not significant in the relationship between fears of compassion and emotion eating for male college students. The findings suggest that it is important to improve individuals' fears of compassion to reduce emotional eating, particularly for female college students.
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Affiliation(s)
- Shuwei Zhang
- School of Health, Fujian Medical University, Fuzhou, China
| | - Mingchun Guo
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Jingyun Wang
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Lihua Lin
- School of Health, Fujian Medical University, Fuzhou, China
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20
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Chi X, Jiang W, Guo T, Hall DL, Luberto CM, Zou L. Relationship between adverse childhood experiences and anxiety symptoms among Chinese adolescents: The role of self-compassion and social support. CURRENT PSYCHOLOGY 2022; 42:1-13. [PMID: 35035184 PMCID: PMC8741560 DOI: 10.1007/s12144-021-02534-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/16/2022]
Abstract
Previous studies have revealed that adverse childhood experiences (ACEs) create a significant and lasting effect of increased anxiety. However, few studies have examined the mediating and moderating mechanisms underlying this relation. The present study aimed to explore the mediating role of self-compassion and moderating role of social support in ACEs-anxiety relationship among Chinese adolescents. In this cross-sectional study, 1,764 middle school students completed questionnaires measuring their levels of ACEs, anxiety, self-compassion (SC), and social support. Correlations of variables were computed using Pearson's r. Mediation and moderated mediation models were tested using PROCESS macro with the regression bootstrapping method. After covariates (age and gender) were controlled, results showed that: (1) ACEs were positively associated with anxiety symptoms; (2) self-compassion partially mediated the ACEs-anxiety association; (3) both ACEs-anxiety and SC-anxiety relationships were moderated by social support. Specifically, social support was associated with lower anxiety, particularly among students with fewer ACEs or lower level of self-compassion. Reducing possible adversities existing in environment may help to reduce risk of anxiety for adolescents. Cultivating self-compassion is crucial for adolescents' mental health, since it may play a role in ACEs-anxiety relationship. Social support would operate as a buffer to ACEs in the relation with anxiety, under the circumstances of mild adversities, and a promoter to self-compassion in the relation with anxiety, under the circumstances of low self-compassion.
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Affiliation(s)
- Xinli Chi
- Exercise Psychophysiology Laboratory, Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen, 518060 China
| | - Weiwei Jiang
- Exercise Psychophysiology Laboratory, Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen, 518060 China
| | - Tianyou Guo
- Exercise Psychophysiology Laboratory, Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen, 518060 China
| | - Daniel L. Hall
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, MA Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, 02114 USA
| | - Christina M. Luberto
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, MA Boston, USA
- Department of Psychiatry, Harvard Medical School, Boston, 02114 USA
| | - Liye Zou
- Exercise Psychophysiology Laboratory, Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen, 518060 China
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21
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Boring BL, Walsh KT, Nanavaty N, Mathur VA. Shame Mediates the Relationship Between Pain Invalidation and Depression. Front Psychol 2021; 12:743584. [PMID: 34925146 PMCID: PMC8677820 DOI: 10.3389/fpsyg.2021.743584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022] Open
Abstract
The experience of pain is subjective, yet many people have their pain invalidated or not believed. Pain invalidation is associated with poor mental health, including depression and lower well-being. Qualitative investigations of invalidating experiences identify themes of depression, but also social withdrawal, self-criticism, and lower self-worth, all of which are core components of shame. Despite this, no studies have quantitatively assessed the interrelationship between pain invalidation, shame, and depression. To explore this relationship, participants recounted the frequency of experienced pain invalidation from family, friends, and medical professionals, as well as their feelings of internalized shame and depressive symptoms. As shame has been shown to be a precursor for depression, we further explored the role of shame as a mediator between pain invalidation and depressive symptoms. All sources of pain invalidation were positively associated with shame and depressive symptoms, and shame fully mediated the relationship between each source of pain invalidation and depression. Relative to other sources, pain invalidation from family was most closely tied to shame and depression. Overall, findings indicate that one mechanism by which pain invalidation may facilitate depression is via the experience of shame. Future research may explore shame as a potential upstream precursor to depression in the context of pain. Findings provide more insight into the harmful influence of pain invalidation on mental health and highlight the impact of interpersonal treatment on the experiences of people in pain.
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Affiliation(s)
- Brandon L Boring
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Kaitlyn T Walsh
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Namrata Nanavaty
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States.,Texas A&M Institute for Neuroscience, College Station, TX, United States
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22
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Wakelin KE, Perman G, Simonds LM. Effectiveness of self-compassion-related interventions for reducing self-criticism: A systematic review and meta-analysis. Clin Psychol Psychother 2021; 29:1-25. [PMID: 33749936 DOI: 10.1002/cpp.2586] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/16/2021] [Indexed: 11/09/2022]
Abstract
Self-criticism is the process of negative self-evaluation. High levels are associated with psychopathology and poorer therapeutic outcomes. Self-compassion interventions were developed to explicitly target self-criticism. The aim of this review was to estimate the overall effect of self-compassion-related interventions on self-criticism outcomes and investigate potential moderating variables. A systematic search of the literature identified 20 randomized controlled trials (RCTs) that met the inclusion criteria. Nineteen papers, involving 1350 participants, had sufficient data to be included in the meta-analysis. Pre- and post-data points were extracted for the compassion and control groups. Study quality was assessed using an adapted version of the Cochrane Collaboration's risk of bias tool, which concluded that studies were of moderate quality. Meta-analysis findings indicated that self-compassion-related interventions produce a significant, medium reduction in self-criticism in comparison with control groups (Hedges' g = 0.51, 95% CI [0.33-0.69]). Moderator analysis found greater reductions in self-criticism when self-compassion-related interventions were longer and compared with passive controls rather than active. The remaining moderators of forms of self-criticism, sample type, intervention delivery, intervention setting and risk of bias ratings were insignificant. Overall, the review provides promising evidence of the effectiveness of self-compassion-related interventions for reducing self-criticism. However, results are limited by moderate quality studies with high heterogeneity. Directions for future research indicate that more RCTs with active controls, follow-ups, consistent use and reporting of measures and diverse samples are needed.
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Affiliation(s)
| | - Gemma Perman
- School of Psychology, University of Surrey, Guildford, UK
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23
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Chio FHN, Mak WWS, Yu BCL. Meta-analytic review on the differential effects of self-compassion components on well-being and psychological distress: The moderating role of dialecticism on self-compassion. Clin Psychol Rev 2021; 85:101986. [PMID: 33667941 DOI: 10.1016/j.cpr.2021.101986] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 12/18/2020] [Accepted: 02/08/2021] [Indexed: 12/20/2022]
Abstract
Although self-compassion has been extensively studied in the recent decades, the representation of self-compassion as a unitary measure or the presence of self-warmth (i.e., presence of the positive components: self-kindness, common humanity, and mindfulness) and self-coldness (i.e., presence of the negative components: self-judgment, isolation, and mindfulness) remains controversial. Moreover, the differential effects of the six components of self-compassion on mental well-being and psychological distress have not been systematically investigated. To synthesize the differential effects of the six components of self-compassion and to examine how people in different cultures may associate the positive and negative components of self-compassion differentially, the present meta-analysis synthesized 183 effect sizes across 27 cultures. Results showed that the negative components of self-compassion (rs = 0.44 to 0.45) showed greater effect sizes with psychological distress than the positive counterparts (rs = -0.17 to -0.29) whereas the positive components of SCS (rs = 0.29 to.39) showed greater effect sizes with mental well-being than the negative counterparts (rs = -0.29 to -0.36), with the exception of common humanity and isolation (r = 0.29 and - 0.36). Cultural orientation of dialecticism moderated the association between the positive and the negative components of self-compassion, with dialectical cultures showing lower associations between the two opposing components. Findings have implications on the design and implementation of self-compassion interventions cross-culturally.
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Affiliation(s)
- Floria H N Chio
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
| | - Ben C L Yu
- Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
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24
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Petrocchi N, Cosentino T, Pellegrini V, Femia G, D'Innocenzo A, Mancini F. Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design. Front Psychol 2021; 11:594277. [PMID: 33510677 PMCID: PMC7835278 DOI: 10.3389/fpsyg.2020.594277] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/08/2020] [Indexed: 11/13/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder that can easily become a treatment-resistant condition. Although effective therapies exist, only about half of the patients seem to benefit from them when we consider treatment refusal, dropout rates, and residual symptoms. Thus, providing effective augmentation to standard therapies could improve existing treatments. Group compassion-focused interventions have shown promise for reducing depression, anxiety, and avoidance related to various clinical problems, but this approach has never been evaluated for OCD individuals. However, cultivating compassion for self and others seems crucial for OCD patients, given the accumulating research suggesting that fear of guilt, along with isolation and self-criticism, can strongly contribute to the development and maintenance of OCD. The primary aim of this pilot study was to evaluate the acceptability, tolerability, and effectiveness of an 8-week group compassion-focused intervention for reducing OCD symptoms, depression, fear of guilt and self-criticism, and increasing common humanity and compassionate self-reassuring skills in treatment-resistant OCD patients. Using a multiple baseline experimental design, the intervention was evaluated in a sample of OCD patients (N = 8) who had completed at least 6 months of CBT treatment for OCD, but who continued to suffer from significant symptoms. Participants were randomized to different baseline assessment lengths; they then received 8 weekly, 120-min group sessions of compassion-focused therapy for OCD (CFT-OCD), and then were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances (post-treatment and follow-up data collection were carried out, respectively, at the beginning and in the middle of the Italian lockdown due to the COVID-19 pandemic), by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments.
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Affiliation(s)
- Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, Rome, Italy.,Compassionate Mind Italia, Rome, Italy
| | | | - Valerio Pellegrini
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Antonella D'Innocenzo
- Compassionate Mind Italia, Rome, Italy.,Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy
| | - Francesco Mancini
- Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy.,Department of Psychological Sciences, Guglielmo Marconi University, Rome, Italy
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25
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Can compassion-focused imagery be used as an attention bias modification treatment? CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01241-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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26
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Guo T, Huang L, Hall DL, Jiao C, Chen ST, Yu Q, Yeung A, Chi X, Zou L. The relationship between childhood adversities and complex posttraumatic stress symptoms: a multiple mediation model. Eur J Psychotraumatol 2021; 12:1936921. [PMID: 34249246 PMCID: PMC8245101 DOI: 10.1080/20008198.2021.1936921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: There is a growing research literature on complex posttraumatic stress disorder (CPTSD), yet studies that focused on Chinese populations are still limited. Accumulating evidence showed that adverse childhood experiences (ACEs) are associated with a higher likelihood of CPTSD symptoms, but potential mediating roles of self-kindness and self-judgement on the ACEs-CPTSD relationship remain understudied. Objective: The purpose of this study was to first examine the relationship between ACEs and CPTSD among Chinese college students, and then to test the mediating role of self-kindness and self-judgement on the ACEs-CPTSD relationship. Method: The study included 1361 college students for an online survey in May 2020. Demographic variables (e.g. age, gender, having sibling[s] or not, residence, family structure, and subjective socioeconomic status), ACEs, self-compassion (self-kindness and self-judgement subscales), and CPTSD symptoms were assessed. After controlling for demographic variables, a series of structural equation models tested the mediation hypothesis: indirect effects of self-kindness and self-judgement on the relationship between ACEs and CPTSD symptom. Results: ACEs of College students were positively associated with more severe CPTSD symptoms (posttraumatic stress disorder and disturbances in self-organization symptoms). Furthermore, these direct pathways were mediated by decreased self-kindness and increased self-judgement. Conclusions: Findings have substantial theoretical and treatment implications, including the two critical targets (i.e. lowering self-judgement and raising self-kindness) when treating complex PTSD.
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Affiliation(s)
- Tianyou Guo
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Liuyue Huang
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Daniel L Hall
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Health Promotion and Resiliency Intervention Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Can Jiao
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Qian Yu
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Xinli Chi
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
| | - Liye Zou
- Institute of Collaborative Innovation, Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen, P.R.China
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27
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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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28
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Pohl S, Steuwe C, Mainz V, Driessen M, Beblo T. Borderline personality disorder and childhood trauma: Exploring the buffering role of self-compassion and self-esteem. J Clin Psychol 2020; 77:837-845. [PMID: 33037647 DOI: 10.1002/jclp.23070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/28/2020] [Accepted: 09/19/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate whether patients with borderline personality disorder (BPD) show lower self-compassion and self-esteem than healthy controls and whether patients' self-compassion and self-esteem moderate the association between childhood trauma and the severity of their BPD symptoms. METHOD Self-reported self-compassion, self-esteem, and the current severity of BPD symptoms were assessed in 35 female patients with BPD and 35 age-matched control participants. Further, traumatic childhood experiences were recorded in the patient group. RESULTS Patients with BPD reported significantly lower self-compassion and self-esteem compared to healthy controls. In addition, self-compassion but not self-esteem moderated the positive correlation between childhood trauma and the severity of BPD symptoms. DISCUSSION Self-compassion appears to buffer the negative consequences of childhood traumatization. Therefore, cultivating self-compassion may be an important therapeutic aim for patients with BPD.
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Affiliation(s)
- Sina Pohl
- Department of Research, Evaluation and Documentation, Clinic of Psychiatry and Psychotherapy, Evangelical Hospital Bethel, Bielefeld, Germany
| | - Carolin Steuwe
- Department of Research, Evaluation and Documentation, Clinic of Psychiatry and Psychotherapy, Evangelical Hospital Bethel, Bielefeld, Germany
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, University Hospital of the RWTH Aachen University, Aachen, Germany
| | - Martin Driessen
- Department of Research, Evaluation and Documentation, Clinic of Psychiatry and Psychotherapy, Evangelical Hospital Bethel, Bielefeld, Germany
| | - Thomas Beblo
- Department of Research, Evaluation and Documentation, Clinic of Psychiatry and Psychotherapy, Evangelical Hospital Bethel, Bielefeld, Germany
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Haeyen S, Heijman J. Compassion Focused Art Therapy for people diagnosed with a cluster B/C personality disorder: An intervention mapping study. ARTS IN PSYCHOTHERAPY 2020. [DOI: 10.1016/j.aip.2020.101663] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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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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