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Irwin L, Berry K, Bell T, Carter LA, Udachina A. Momentary displays of compassion and the relationship between psychosis, mood and risk incidents on inpatient wards: An experience sampling study. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024. [PMID: 39233367 DOI: 10.1111/bjc.12496] [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: 11/06/2023] [Accepted: 07/23/2024] [Indexed: 09/06/2024]
Abstract
OBJECTIVES Psychosis can be thought of as a threat-based experience. Compassion has been shown to be effective in reducing threat, although highly distressed individuals may struggle to be self-compassionate. This study explored the effects of compassionate interactions with staff on inpatients with psychosis. METHOD Experience Sampling Method (ESM) was used to investigate the relationships between compassion from staff and paranoia, voice hearing, distress related to psychosis experiences, affect and risk incidents in daily life. Twenty-two service users residing on inpatient mental health wards took part. Baseline measures of compassion, fears of compassion and affect were taken. Participants completed ESM assessments 10 times per day, over 6 days. RESULTS Compassion from staff was associated with a small increase in voice hearing, but was not associated with paranoia, paranoia-related distress, voice-related distress, negative affect, positive affect, or risk incidents in daily life. Baseline fears of compassion moderated the relationships between compassion from staff and some of the service user outcomes. For inpatients scoring low on fears of compassion, compassionate interactions were associated with increased positive affect and lower paranoia. However, for those scoring high on fears of compassion, this relationship was reversed, and compassionate interactions were associated with higher paranoia and lower positive affect. CONCLUSION People with psychosis who have fears of compassion may benefit from receiving support to address these fears in order to experience the benefit from the compassion of staff. The results should be interpreted with caution due to the low number of observations and limited statistical power.
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Affiliation(s)
- Leanne Irwin
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Royal Infirmary, Manchester, UK
| | - Tobyn Bell
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
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Wooldridge JS, Soriano E, Filip TF, Moore RC, Eyler LT, Herbert MS. Compassion Dynamics in Medical Students: An Ecological Momentary Assessment Study. J Clin Psychol Med Settings 2024:10.1007/s10880-024-10003-x. [PMID: 38402300 DOI: 10.1007/s10880-024-10003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 02/26/2024]
Abstract
Effective interventions to support compassionate patient- and self-care requires an understanding of how to best assess compassion. Micro-ecological momentary assessment (micro-EMA), a method in which participants provide brief responses in real-time within their own environments, can capture changes in compassion across time and contexts. This study examined a micro-EMA approach for measuring the temporal dynamics of compassion in medical students during the COVID-19 pandemic. Medical students (N = 47) completed demographic information and self-report questionnaires assessing empathy and compassion for self and others. Participants then completed six bursts of micro-EMA smartphone-delivered surveys. Each burst was 14 days, with 28 days between bursts. During each burst, participants received four daily micro-EMA surveys assessing compassion, stress, positive affect, and negative affect. Dynamic structural equation modeling was used to examine micro-EMA responses. The overall micro-EMA response rate was 83.75%. On average, daily compassion did not significantly change across the academic year. However, there was significant within-person variability in medical students' compassion trajectories over the training year (b = 0.027, p < .01). At concurrent timepoints, micro-EMA assessed compassion was associated with greater happiness (b = 0.142, p < .001) and lower stress (b = -0.052, p < .05) but was not associated with sadness. In lagged analyses, higher micro-EMA assessed compassion predicted higher next day happiness (b = 0.116, p < .01) and vice versa (b = 0.185, p < .01). Results suggest it is feasible to use micro-EMA to assess daily levels of compassion among medical students. Additionally, there is wide variability in day-to-day fluctuations in compassion levels among medical students, with some students showing substantial increases in daily compassion across the training year and others showing decreases. Positive affect as opposed to negative affect may have particularly strong associations with compassion. Further examination of antecedents and consequences of fluctuations in daily compassion could inform potent intervention targets.
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Affiliation(s)
- Jennalee S Wooldridge
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, USA
| | - Emily Soriano
- Scripps Whittier Diabetes Institute, San Diego, CA, USA
| | - Tess F Filip
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Desert-Pacific Mental Illness Research, Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
| | - Matthew S Herbert
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA.
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
- Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, USA.
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Andorfer A, Kraler S, Kaufmann P, Pollheimer E, Spah C, Fuchshuber J, Rominger C, Traunmüller C, Schwerdtfeger A, Unterrainer HF. Psychophysiological stress response after a 6-week Mindful Self-Compassion training in psychiatric rehabilitation inpatients: a randomized post-test only study. Front Psychiatry 2023; 14:1098122. [PMID: 37533890 PMCID: PMC10391549 DOI: 10.3389/fpsyt.2023.1098122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/30/2023] [Indexed: 08/04/2023] Open
Abstract
Objectives Mindfulness-based interventions (including self-compassion interventions) are effective in improving stress management at psychological and physical levels. Mindful Self-Compassion (MSC) is a newly developed program particularly aimed at increasing self-compassion. The main objective of this study was to determine whether the psychophysiological stress response during a social-evaluative speaking task differs in inpatients participating in the MSC or the Progressive Muscle Relaxation (PMR) program at the end of their 6-week psychiatric rehabilitation stay (i.e., post-test only design). Method Data from 50 inpatients (25 MSC, 25 PMR, 35 female) aged 19 to 76 years (M = 47.22, SD = 12.44) were analyzed in terms of psychophysiological stress response. For this purpose, heart rate variability, heart rate, and blood pressure were assessed together with several psychometric variables: positive and negative affect (PANAS), subjective stress perception (Visual Analog Scale), self-compassion (Self-Compassion Scale), cognitive reappraisal and suppression (Emotion Regulation Questionnaire), psychological distress (Brief Symptom Inventory-18), and appraisal and rumination (selected items). Results After correction for alpha inflation no differences in the psychophysiological stress response and psychometric parameters between the MSC and PMR group were found. Discussion In general, our results indicate that MSC is not superior to PMR training. However, more research with clinical randomized controlled trials investigating larger samples are needed to further affirm these initial findings.
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Affiliation(s)
- Andrea Andorfer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- CIAR: Center for Integrative Addiction Research, Grüner Kreis Society, Vienna, Austria
| | - Sabina Kraler
- Institute of Psychology, University of Graz, Graz, Austria
| | - Paul Kaufmann
- Center for Psychosocial Health, Sonnenpark Neusiedlersee, Rust, Austria
| | - Ewald Pollheimer
- Center for Psychosocial Health, Sonnenpark Neusiedlersee, Rust, Austria
| | - Christoph Spah
- Center for Psychosocial Health, Sonnenpark Neusiedlersee, Rust, Austria
| | - Jürgen Fuchshuber
- CIAR: Center for Integrative Addiction Research, Grüner Kreis Society, Vienna, Austria
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Human-Friedrich Unterrainer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- CIAR: Center for Integrative Addiction Research, Grüner Kreis Society, Vienna, Austria
- Institute of Psychology, University of Graz, Graz, Austria
- Department of Religious Studies, University of Vienna, Vienna, Austria
- Faculty of Psychotherapy Science, Sigmund Freud University, Vienna, Austria
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Matos M, McEwan K, Kanovský M, Halamová J, Steindl SR, Ferreira N, Linharelhos M, Rijo D, Asano K, Vilas SP, Márquez MG, Gregório S, Brito-Pons G, Lucena-Santos P, da Silva Oliveira M, de Souza EL, Llobenes L, Gumiy N, Costa MI, Habib N, Hakem R, Khrad H, Alzahrani A, Cheli S, Petrocchi N, Tholouli E, Issari P, Simos G, Lunding-Gregersen V, Elklit A, Kolts R, Kelly AC, Bortolon C, Delamillieure P, Paucsik M, Wahl JE, Zieba M, Zatorski M, Komendziński T, Zhang S, Basran J, Kagialis A, Kirby J, Gilbert P. Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1845. [PMID: 36767212 PMCID: PMC9915071 DOI: 10.3390/ijerph20031845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.
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Affiliation(s)
- Marcela Matos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
| | - Kirsten McEwan
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby DE22 1G, UK
| | - Martin Kanovský
- Institute of Social Anthropology, Faculty of Social and Economic Sciences, Comenius University, 814 99 Bratislava, Slovakia
| | - Júlia Halamová
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University, 814 99 Bratislava, Slovakia
| | - Stanley R. Steindl
- Compassionate Mind Research Group, School of Psychology, University of Queensland, Brisbane 4072, Australia
| | - Nuno Ferreira
- Department of Social Sciences, University of Nicosia, Nicosia 2417, Cyprus
| | - Mariana Linharelhos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
| | - Daniel Rijo
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
| | - Kenichi Asano
- Department of Psychological Counseling, Faculty of Psychology, Mejiro University, Tokyo 161-0032, Japan
| | - Sara P. Vilas
- Behavior, Emotions, and Health Research Group, Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Margarita G. Márquez
- Behavior, Emotions, and Health Research Group, Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Sónia Gregório
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
- Behavior, Emotions, and Health Research Group, Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Gonzalo Brito-Pons
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Paola Lucena-Santos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
| | - Margareth da Silva Oliveira
- Evaluation and Treatment in Cognitive and Behavioral Psychotherapies—Research Group (GAAPCC), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil
| | | | | | - Natali Gumiy
- Motivación Compasiva, Buenos Aires C1001, Argentina
| | | | - Noor Habib
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 11564, Saudi Arabia
| | - Reham Hakem
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 11564, Saudi Arabia
| | - Hussain Khrad
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 11564, Saudi Arabia
| | - Ahmad Alzahrani
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 11564, Saudi Arabia
| | - Simone Cheli
- School of Human Health Sciences, University of Florence, 50121 Florence, Italy
| | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, 00165 Rome, Italy
| | - Elli Tholouli
- Center for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Philia Issari
- Center for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Gregoris Simos
- Department of Educational and Social Policy, University of Macedonia, 546 36 Thessaloniki, Greece
| | | | - Ask Elklit
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
| | - Russell Kolts
- Department of Psychology, Eastern Washington University, Cheney, WA 99004, USA
| | - Allison C. Kelly
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Catherine Bortolon
- Laboratoire Inter-Universitaire de Psychologie: Personnalité, Cognition et Changement Social, Grenoble Alpes University, 38400 Grenoble, France
- Centre Hospitalier Alpes Isère, C3R—Réhabilitation Psychosociale et Remédiation Cognitive, 38100 Grenoble, France
| | - Pascal Delamillieure
- CHU de Caen, Service de Psychiatrie Adulte, 14000 Caen, France
- UNICAEN, ISTS, GIP Cyceron, University of Normandy, 76000 Caen, France
| | - Marine Paucsik
- Laboratoire Inter-Universitaire de Psychologie: Personnalité, Cognition et Changement Social, Grenoble Alpes University, 38400 Grenoble, France
| | - Julia E. Wahl
- The Mind Institute Poland, 33-332 Warsaw, Poland
- Institute of Psychology, Department of General Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland
| | - Mariusz Zieba
- Institute of Psychology, Department of General Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland
| | - Mateusz Zatorski
- Institute of Psychology, Department of General Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland
| | - Tomasz Komendziński
- Department of Cognitive Science, Nicolaus Copernicus University, 87-100 Torún, Poland
- Neurocognitive Laboratory, Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, 87-100 Torún, Poland
| | - Shuge Zhang
- School of Human Sciences, University of Derby, Derby DE22 1G, UK
| | - Jaskaran Basran
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby DE22 1G, UK
| | - Antonios Kagialis
- Department of Social Sciences, University of Nicosia, Nicosia 2417, Cyprus
| | - James Kirby
- Compassionate Mind Research Group, School of Psychology, University of Queensland, Brisbane 4072, Australia
| | - Paul Gilbert
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby DE22 1G, UK
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7
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Förster K, Kurtz M, Konrad A, Kanske P. Emotional Reactivity, Emotion Regulation, and Social Emotions in Affective Disorders. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2022. [DOI: 10.1026/1616-3443/a000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract. Affective disorders, specifically Major Depressive Disorder and Bipolar Disorders, show high prevalence, relapse rates, and a high likelihood to develop a chronic course. For the past two decades, research has investigated the neural correlates of emotion processing and emotion regulation in patients with affective disorders. Putative underlying causal mechanisms of dysregulated affect have been informed by knowledge from the intersection of neuroimaging and clinical psychology. More recent investigations also consider processing the role of mostly negative, self-blaming social emotions, which have been linked to treatment resistance and, hence, provide a prolific target for intervention. Several psychotherapeutic treatment approaches already focus on emotion, and here specific knowledge about the mechanisms underlying persistent changes in affect bears the potential to improve the treatment of affective disorders. In this narrative review, we delineate why and how our insights into the neural correlates of emotion processing and regulation can be applied to the treatment of patients with affective disorders.
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Affiliation(s)
- Katharina Förster
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden (TU Dresden), Germany
| | - Marcel Kurtz
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden (TU Dresden), Germany
- Social Psychology, Faculty of Psychology, Technische Universität Dresden (TU Dresden), Germany
| | - Annika Konrad
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden (TU Dresden), Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden (TU Dresden), Germany
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