Compassion: an evolutionary analysis and empirical review

Neuroception of psychological safety scale (NPSS): validation with a UK based adult community sample

Background: Psychological safety plays a vital role in rest, recovery, and fostering social connections. However, a history of trauma can predispose individuals to perceive heightened levels of threat and danger. Research suggests that a lack of psychological safety may be a defining biopsychosocial characteristic of posttraumatic stress disorder (PTSD). Persistent feelings of threat and danger are associated with a lack of psychological safety and may be predictive of PTSD. Our pioneering work reported on the development of the neuroception of psychological safety (NPSS), rooted in polyvagal theory, and consists of social engagement, compassion, and body sensations dimensions. Understanding more about the dimensionality of the NPSS and further establishing its psychometric properties was our priority.Objective: Our current research aimed to validate and test the reliability and dimensionality of the NPSS, using a large community sample (n = 2035) of adult residents in the UKMethod: We examined the internal and test-retest reliability, convergent, discriminant, and concurrent validity as well as dimensionality of the NPSS.Results: The 3-factor structure of the NPSS was replicated with regard to the absolute fit indices. Internal consistencies ranged from acceptable to excellent across the NPSS's subscales. Providing support for the validity of the NPSS, scores were predictably related to team psychological safety, wellbeing, post-traumatic stress, burnout, body awareness, and personality, with effect sizes typically in the high to medium range. Scores on the NPSS were found to show good test-retest reliability.Conclusions: This study demonstrates the validity, reliability and dimensionality of the NPSS with an adult sample. Further work is underway to support and enhance understandings of psychological safety with diverse clinical populations impacted by trauma. The NPSS has applicability across a range of health and social care contexts, such as shaping new approaches to evaluating trauma treatments and enhancing trauma informed care.

Mental health, self-compassion, and compassion fatigue in physicians: a cross-sectional study

The mental health of physicians has been neglected for a long time. This study investigated the association between Mental Health, Self-Compassion, and Compassion Fatigue in physicians. This was a cross-sectional study that was conducted among 315 physicians. In the study, a Sociodemographic Data Form, Self-Compassion Scale-Short Form, Compassion Fatigue Scale-Short Form, and Patient Health Questionnaire-4 were applied to the participants. 58.7% of the participants are between 25 and 35 years old and 51.4% are female. The mean scores of SC-SF and CF-SF were 33.2 (SD = 8.49) and 61.8 (SD = 26.2), respectively. The physicians had poor mental health, with 36.8% reporting anxiety and 41.9% reporting depression. A negative and moderate-level significant relationship was found between SC-SF and CF-SF (R = - 0.596, p < 0.001). Physicians should receive expert support and regular training on specific topics such as awareness-based self-compassion methods, recognizing and managing psychiatric symptoms, and coping with compassion fatigue and stress. The positive mental health of physicians, who hold a leading position in healthcare services, will have a favourable impact on the health system and public health.

Behavioral manifestations and neural mechanisms of empathic pain

Empathy is an important trait that allows individuals to comprehend and share the emotions and sentiments of others. It not only facilitates effective interpersonal communication, but also helps in establishing meaningful connections and fostering trust and understanding. Impaired empathy development can manifest as excessive self-centeredness, extreme egoism, and antisocial behaviors. Many psychiatric disorders, such as autism, narcissistic personality disorder, and schizophrenia, are often accompanied by empathy disorders. Pain empathy, which is a common behavioral paradigm of empathic behavior, is not only observed in humans but also in animals. By delving into the study of pain empathy, we can gain a deeper understanding of empathy itself. This understanding not only contributes to the advancement of scientific, clinical, and social fields, but also promotes the cultivation of emotional resonance and social harmony among humans, with profound significance and impact. This article provides a brief overview of the current understanding and mechanistic studies of pain empathy, as well as suggests future research directions.

From disconnection to compassion: a phenomenological exploration of embodied empathy in a face-to-face interaction

Background

Research has advanced in revealing psychological and brain mechanisms in empathy-compassion experience. However, much of this research has been constrained by using non-ecologically valid, non-interactive experimental paradigms, as well as a lack of in-depth investigation into participants' subjective experiences.

Objective

This study aims to bridge these gaps by examining subjective experiences within an interactive setting.

Methods

Forty-two participants engaged in a 90-s, face-to-face interaction with an actor simulating a person with (Alzheimer's) dementia. The actor's performance in the interaction followed a validated emotion-inducing narrative about his fear of forgetting their family memories. Subsequently, micro-phenomenological interviews explored participants' embodied experiences. Data underwent iterative inter-coder processing, and both qualitative and quantitative analyses were conducted. Qualitative analysis focused on temporal dynamics and multilayered dimensions (bodily, affective, attentional, motivational, and relational), while quantitative analysis assessed Bayes's correlation between phenomenological dimensions and structures of experience, alongside exploratory correlations with empathy-compassion trait questionnaires.

Results

The participants initially connect with the actor's suffering in their own bodies, leading to an intensified sensation of anguish as the actor vividly describes the fear of forgetting his wife. After, four main experiential ways of navigating the anguish were identified: (1) Relational Disengagement, characterized by detachment from others' suffering, reduced anguish intensity, and a cold interaffective space; (2) Persistent Angst, characterized by ongoing distress; (3) Anguish Anchoring, characterized by a reactive willingness to alleviate suffering, intense bodily sensations, fluctuating presence, and a less warm, more distant interaffective space; and (4) Compassionate Balanced Support, characterized by a felt presence within a warm interaffective space, motivating balanced support for others. These graded experiences were positively correlated with the 'empathic concern' trait assessed by the Interpersonal Reactivity Index scale.

Conclusion

This study suggests a shift in empathy research by proposing moving from a traditional binary view (distress and compassion) to a nuanced framework identifying four distinct and holistic embodied experiences.

Compassionate care in the emergency department: A narrative review and blueprint for future inquiry

While compassion has long been accepted conceptually as a vital part of patient care, few rigorous studies have focused on its provenance or impact until quite recently. A growing body of literature gives early evidence that compassion can substantially impact health outcomes, and critically, that compassionate behaviors may be fostered by didactics or clinical environment. Only a few studies have yet addressed compassion in the emergency department (ED) setting, but there are already indications that the perception of compassionate care during medical emergencies can have a meaningful and enduring impact on health. This review aims to assess the current research on compassion as it relates to ED care and proposes a framework for future inquiry. In particular, we assess the current evidence surrounding 1) measurement of compassion, 2) the impact of compassion on patient outcomes, and 3) the efficacy of compassion education for providers. We also highlight several understudied areas in the compassion literature, including potential effect on overall cost of care, how delivery of compassionate care might influence provider burnout, and how social determinants of health, race, gender, and other factors mediate either the provision of or the perception of compassionate care. In an era of competing demands on emergency providers' time, it is vitally important to better understand both the teaching of compassion and its myriad potential impacts if we are to make informed decisions about how to prioritize this aspect of medical care.

A neuroscience perspective on the plasticity of the social and relational brain

Over the past two decades, the fields of social and contemplative neurosciences have made significant strides. Initial research utilizing fMRI identified neuronal networks involved in empathy, mentalizing, and compassion, as well as complex interactions among these networks. Subsequent studies shifted to testing the plasticity of these social skills via different types of mindfulness- or compassion-based mental training programs, demonstrating brain plasticity, enhanced social capacities and motivation, as well as improved mental health and overall well-being. Next, researchers developed scalable evidence-based online mental training programs to address the growing levels of mental health problems and loneliness, both exacerbated by the COVID-19 pandemic. Innovative approaches, such as novel relational partner-based practices and online app-based dyadic training programs, offer scalable solutions to counteract ongoing societal and mental health deterioration. Current studies are now applying the above findings to support resilience building within diverse domains of society and professional populations-such as healthcare workers and teachers-at high risk of burn-out. Future research should explore the broader impact of such training-related individual changes on larger systems, potentially leading to the development of a translational social neuroscience approach that leverages insights from social brain plasticity research to support societal needs, thereby enhancing resilience, mental health, and social cohesion.

Integration of negative emotions, empathy, and support for conciliatory policies in intractable conflicts

Adaptive regulation of intense negative emotions appears crucial for reconciliation, as negative emotions often impede the resolution of intractable intergroup conflicts. Integrative emotion regulation (IER; actively taking an interest in one's own negative emotions) appears promising in this context, given previous findings of its links to empathy and support for conciliatory policies in the context of the Middle East conflict. However, prior work did not test whether these links hold when negative emotions related to the conflict (e.g. anger and fear) are elicited. We conducted two studies with Jewish-Israelis to test these links, focusing on participants' reactions to innocent Palestinians. In both studies, we measured IER, empathy (sympathy, perspective-taking), and support for conciliatory policies (humanitarian aid) and compared a negative emotion condition (Study 1: fear, N = 240; Study 2: anger, N = 293) to a neutral control condition. Our findings replicated the positive relations between IER, empathy, and support for conciliatory policies even when negative emotions were elicited. These findings are discussed in relation to prior research on emotion regulation in group contexts, including applications to conflict resolution.

The effects of social mindfulness and online interpersonal trust on college students' online prosocial behavior

Introduction

With the widespread adoption of the internet and social media, adolescents' social interactions through online platforms have increasingly expanded. Adolescents' prosocial activities in cyberspace not only serve as important indications of their socialization but also show how the internet and technology impact the new generation's psychological adjustment and social integration patterns. Our study aimed to construct a moderated mediation model to explore the impact of social mindfulness on online prosocial behavior, as well as the mediating role of perceived prosocial impact and the moderating role of online interpersonal trust. Three experiments were designed based on the model to verify the applicability of the previously constructed model in real-world contexts.

Methods

In Study 1, a cross-sectional study was conducted at a college in China, recruiting 328 college students using self-report questionnaires. The Social Mindfulness Self-Report Scale, the Online Prosocial Behavior Extension Scale (Chinese Version), the Perceived Social Impact Scale, and the Online Interpersonal Trust Scale were used. This study explored the relationship between social mindfulness and online prosocial behavior, the mediating effect of perceived prosocial impact, and the moderating role of online interpersonal trust. In Study 2, we adopted experimental research among 60 Chinese college students to explore the prosocial behavior of participants with different levels of social mindfulness in online contexts with varying levels of credibility.

Results

(1) Social mindfulness positively predicted online prosocial behavior, with perceived prosocial impact serving as a partial mediator. Online interpersonal trust moderated the latter part of the mediation model. (2) Social mindfulness and contextual credibility positively predicted college students' online prosocial behavior.

Experience of compassionate care in mental health and community-based services for children and young people: facilitators of, and barriers to compassionate care- a systematic review

Compassion and compassionate care for children and young people (CYP) encompass a variety of emotions, including sympathy, empathy, and sadness for their suffering, alongside actions intended to alleviate their distress. While compassion is a well-recognised concept in health and social care, literature has identified various barriers and facilitators that affect the delivery of compassionate care. These include compassion fatigue, time limitations, organisational and clinical culture, insufficient resources or support, technological advancements, and burdensome administrative tasks. Despite being viewed as essential in health care, the concept of compassionate care remains poorly defined and expressed, particularly in the context of mental health services for CYP. This review explored the perspectives of CYPs, their parents, and staff regarding the compassionate care provided in community services. Additionally, it aimed to identify factors that facilitate or obstruct compassionate care for CYPs in both mental health and community settings services. From June to August 2024, a search was carried out for peer-reviewed articles and grey literature, with additional searches conducted in October 2024. The initial search produced 7,461 articles, with 23 selected for this review. A thematic synthesis organised the studies based on the main themes identified: 'Compassionate care is all about humanity' and 'the complex interplay of facilitators and barriers to compassionate care'. The identified articles highlighted the increasing need for compassionate care in community-based services for CYP, along with the range of facilitators and barriers to providing this care. Lastly, we propose an alternative definition of compassionate care tailored to these services.

Regulation of Stress Physiology While Parenting: a Randomized Micro-trial of Loving-Kindness Meditation on Parenting and Salivary Alpha Amylase

Sensitive parenting early in life sets children up for healthy development, and this type of parenting draws on the parent's compassion and physiological regulation. Loving-kindness meditations (LKM) increase compassion and reduce physiological responses to stressors and so may support sensitive parenting. The current study tested the effects of a LKM on parent sensitivity and salivary alpha amylase (sAA) during a parent-child interaction. One hundred and thirty-six parents (114 mothers, 22 fathers) of toddlers (18-36 months, M = 28.85 months, SD = 5.13) participated in an online survey and were randomly assigned to listen to either a LKM, focused-imagery audio, or podcast during a video call before engaging in a play-based interaction with their toddler. Parent sAA was collected from parents at five points throughout the video call. LKM did not significantly increase parent sensitivity (B = 0.06, p = 0.86); however, there was limited variability in sensitivity in this sample (M = 6.01, SD = 0.89). The LKM did affect sAA activity (B =  - 0.66, p < 0.05) such that parents in the LKM group gradually decreased sympathetic activity across the research session, whereas the podcast group increased sAA levels after the parent-child interaction. Overall, these findings suggest that engaging in compassion and self-compassion can change the pattern of stress physiology in parents of toddlers while parenting.

The ripple effect of compassion on psychosocial flourishing: A mediational model of individual and organizational factors in Indian public sector

The study draws insights from the ethos of Buddhism and underpinnings of positive activity model to investigate the mediational role of individual emotions and organizational support in the relationship between workplace compassion and psychosocial flourishing. Data were collected from the employees of a public sector organization in India who were selected using purposive sampling technique. An exploratory sequential mixed method approach was followed, that includes qualitative phase of focus group studies involving 42 participants to identify the main themes of the study, and a theoretical model is proposed following thematic literature review. Quantitative survey responses from 218 employees were used to conduct further statistical analysis. The authors tested the proposed model and hypothesis through parallel mediation analysis using structural equation modelling. Results showed that workplace compassion significantly influences psychosocial flourishing of the compassion givers, positive and negative emotions as well as perceived organizational support significantly and positively mediate compassion and flourishing relationship. Advocating the idea of productive paradox wherein compassion for others leads to utmost self-benefit, the study highlights the reciprocal gains of well-being and fulfillment to compassion giving employees at service-centered workplaces.

The relationship between compassion competence, satisfaction, and professional commitment levels

BackgroundThe compassionate presentation of caregiving skills, which constitute the building block of nursing care, directly affects the quality of health services. It is extremely important for the future of the nursing profession to develop compassion competence and satisfaction in students who are candidates for the nursing profession and to reveal their level of commitment to the profession.Research aimThis study examined the correlation between compassion competence, compassion satisfaction, and professional commitment levels of nursing students.Research designThe study was conducted as a descriptive-correlational research.Participants and research contextThe study was conducted between 01.05.2023 and 01.10.2024 with nursing students continuing their education in the Nursing Department of state universities in Gaziantep. The research sample consisted of 280 nursing students. A convenience sampling method was used in this study. Nursing students who met the inclusion criteria and voluntarily agreed to participate were included in the sample. Personal Information Form, Compassion Competence Scale, Compassion Satisfaction Scale, and Nursing Professional Commitment Scale were used as data collection tools. SPSS package program, t-test, ANOVA, and Pearson correlation analyses were used to analyze the data.Ethical considerationsEthical approval for the study was received from the Non-Interventional Clinical Research Ethics Committee. The study was conducted following the Declaration of Helsinki.ResultsNursing students' total score on the Compassion Competence Scale was 3.86 ± 0.04. The mean total score of the Compassion Satisfaction Scale was 50.37 ± 0.58. It was determined that the mean total score of the Nursing Professional Commitment Scale was 72.98 ± 0.77. A weak, positive, statistically significant relationship was found between compassion competence and professional commitment (r: 0.288, p < .05). A moderate, positive, statistically significant relationship was found between compassion satisfaction and professional commitment (r: 0.403, p < .05).ConclusionA positive correlation was found between compassion competence, compassion satisfaction, and professional commitment among nursing students. It is recommended to increase studies on developing empathy, compassion, and emotional resilience skills in nursing education programs. In addition, these findings emphasize that a compassion-oriented approach should be adopted to improve quality in the nursing profession.

The Lived Experience of Participating in Online Peer-To-Peer Groups After Acquired Brain Injury: Phenomenological Study

BACKGROUND

Stroke and other acquired brain injuries (ABIs) can present challenging experiences for individuals, both in recovery of functions affected by visible or invisible impairments and in learning to live with the new situation. Research has shown that sharing experiences face-to-face in peer groups can be beneficial during recovery. However, there is limited knowledge about the lived experiences of people with ABI who participate in online peer-to-peer groups.

OBJECTIVE

The aim of our study was to explore the lived experiences of participating in online peer-to-peer groups for people with ABI, where participants themselves set the agenda.

METHODS

Members of 2 Facebook groups (FBGs) for people with ABI were invited to participate in this study, and 20 individuals were included (14 women and 6 men; age range 24-74 years). One FBG focused on stroke and the other on fatigue caused by ABI. One group was private, and the other group was public. Data were collected through semistructured interviews, in which participants were encouraged to describe their experiences of engaging in FBGs in detail. The interviews were conducted over telephone or Zoom and digitally recorded. The audio recordings were then transcribed verbatim, resulting in 224 pages of text, and analyzed using the empirical phenomenological psychological method.

RESULTS

The analysis presented a common meaning structure with 1 main characteristic that is, "validating self," common for all 20 participants, and 3 subcharacteristics, that is, "learning-having one's own experiences confirmed," "adjusting self-building competence and self-compassion," and "supporting others-becoming a valued lived-experience expert/authority." Together, the subcharacteristics reflected a process of validating self from newcomer to lived-experience expert or authority. In this process, members of FBGs moved from being newcomers with pronounced needs for support and to learn and to have their experiences confirmed by others with similar experiences. Thus, participants were building competence and developing self-compassion. Gradually, they assumed the role of advisors, mentors, or coaches, acknowledging their experiences and competence as valuable to others, thereby validating themselves as compassionate lived-experience experts or authorities in supporting others.

CONCLUSIONS

Participation in online peer-to-peer groups can offer unique opportunities for individuals with ABI to validate self through processes that involve learning, developing self-compassion and compassion for others, and offering support to others with similar experiences. Given that rehabilitation after an ABI is often of limited duration and that positive experiences can be achieved over time through involvement in digital peer-to-peer support, health care professionals should assist patients by providing information and directing them to digital networks for people with ABI. However, when recommending the use of online peer-to-peer support, impairments and insufficient digital competence that may complicate or prevent the use of social media should be assessed and support provided when relevant.

Compassionate Behavior of Clinical Faculty: Associations with Role Modelling and Gender Specific Differences

Introduction

For future doctors, learning compassion skills is heavily dependent on female and male faculty's role modelling in practice. As such, more insight into the relationships between faculty's compassionate behavior, faculty gender and role modelling is needed.

Methods

In this cross-sectional survey, we analyzed 12416 resident evaluations of 2399 faculty members across 22 Dutch hospitals. The predictor variables were: observed compassionate behavior, faculty gender (reference category: female), and an interaction term between those two. Our outcome variables were: person, teacher and physician role model. All variables, except for faculty gender, were scored on a 7-point Likert scale ranging from 1 "totally disagree" to 7 "totally agree".

Results

Female faculty scored slightly but significantly higher (M = 6.2, SD = 0.7) than male faculty (M = 5.9, SD = 0.6) on observed compassionate behavior. Observed compassionate behavior was significantly positively associated with being seen as a role model teacher (b = 0.695; 95% CI = 0.623 - 0.767), physician (b = 0.657; 95% CI = 0.598 - 0.716) and person (b = 0.714; 95% CI = 0.653 - 0.775). Male gender showed significant negative associations with role model teacher (b = -0.847; 95% CI = -1.431 - -0.262), physician (b = -0.630, 95% CI = -1.111 - -0.149) and person (b = -0.601, 95% CI = -1.099 - -0.103). The interaction term showed positive significant associations with role model teacher (b = 0.157, 95% CI = 0.061 - 0.767), physician (b = 0.116, 95% CI = 0.037 - 0.194) and person (b = 0.102, 95% CI = 0.021 - 0.183).

Discussion

Dutch residents, in general, observed their faculty to be compassionate towards patients and families and faculty's observed compassionate behavior is related to being seen as a role model. However, male faculty benefit more from demonstrating compassion, as it has a greater positive influence on their perceived role model status compared to female faculty.

Severity of Adversity Predicts Lower Costly Helping

Nascent research has found that adversity severity predicts helping behavior. A quasi-experimental, moderation-of-process design was employed to examine whether individuals who have experienced more severe adverse life events will engage more in altruistically motivated helping behaviors. In a virtual setting, participants were offered the opportunity to switch places with an ostensible participant who was visibly distressed by an unpleasant task. Participants were randomized to an easy escape or difficult escape condition. There was no support for this hypothesis, as severity of adversity experienced at the time the adverse events occurred was not associated with helping in an altruistic (or any) context. Instead, the current emotional impact of prior adverse life events (irrespective of when they occurred) was negatively associated with helping behavior. Discussion focuses on the temporal framing of severity of adversity measures and the feasibility of studying altruistic responsiveness in virtual social interactions.

Developing the Good Physician: The Influence of Role Models in the Development of Virtues and Flourishing in Medical Students

OBJECTIVES

A virtues-based model of character development for training future physicians may lead to increased flourishing in medical students through the influence of exemplary role models. This study aimed to analyze the association between caring virtues and measures of flourishing and to identify facilitators of physician flourishing.

METHODS

The authors used data from a 2011 nationally representative sample of 605 US medical students in which caring virtues (mindfulness, empathic compassion, and generosity) were measured using scales at two time points during the students' clinical years. Hypothesizing a mediated influence of role models in students' generosity and flourishing, the authors explored the interrelationship between measures of mindfulness, empathic compassion, and generosity, using latent variables within a structural equation model. Built into the model were paths to determine mechanisms by which virtues and flourishing are facilitated and/or inhibited.

RESULTS

Analyses supported the interrelationship between physician-specific measures of mindfulness, empathic compassion, and generosity. Findings were generally consistent with the hypothesized direction of relationships between these virtues of medical care and the effect of role models on student generosity and sense of calling. Experiences of positive character feedback from a supervisor did not directly predict the generous behavior of medical students as hypothesized, but there appeared to be an indirect effect on generosity through increased vocational satisfaction. When moral elevation was added to the structural model, data offered further support for mentors inspiring caring behavior. Findings from this study provide continued evidence in support of a virtues-based model of character education in medicine that theorizes the influence of role modeling on virtues development and flourishing, including evidence for moral elevation as a potential psychological mechanism.

CONCLUSIONS

Medical schools may consider adopting a virtues-based model of character education in which supervisors are selected based on their capacity to exemplify virtuous care in their professional life.

Neural correlates and plasticity of explicit emotion regulation following the experience of trauma

Experiencing trauma or other adverse life events is highly prevalent and poses a significant risk for the development of mental disorders. Understanding the underlying mechanisms and neural processes involved in trauma processing is crucial for both prevention and targeting symptoms. Especially, difficulties in emotion regulation emerge as one key mechanism implicated in the development of conditions such as post-traumatic stress disorder (PTSD) following traumatic experiences. However, neural correlates of explicit emotion regulation among individuals who have undergone trauma have not received much attention. Understanding the neural basis of dysregulated emotion following trauma could reveal important details about how trauma interferes with emotional regulation systems, informing the development of more specific intervention approaches. Therefore, this mini review summarizes current research, and identifies relevant gaps in the literature and challenges for future studies. Specifically, it provides an overview of the neural dysregulation associated with explicit emotion regulation strategies such as reappraisal or suppression. Finally, it highlights promising findings from intervention studies targeting emotion regulation, such as trauma-focused exposure therapy and neurofeedback, indicating neural plasticity in individuals with traumatic experiences. Hereby, this review aims to bridge the gap between fundamental and intervention research and highlights future directions for translational research.

The effect of self-compassion versus mindfulness interventions on autonomic responses to stress in generalized anxiety disorders

Objective

Although research on psychological interventions in generalized anxiety disorder (GAD) has provided evidence of their effectiveness regarding self-reported outcomes, few studies have examined their psychophysiological effects. Heart rate is emerging as a potential biomarker of efficacy in anxiety disorders. This study aimed to investigate the effects of a self-compassion intervention versus a mindfulness intervention on physiological arousal in response to induced stress.

Methods

Forty-seven patients with GAD had heart rate data collected during a stress task before and after a 2-week pharmacological treatment (known as treatment as usual, TAU), a self-compassion intervention + TAU or a mindfulness intervention + TAU. They also reported state anxiety, positive affect, and negative affect at pre- and post- intervention before the stress task. ANOVAs were conducted to analyze the effects on electrocardiogram data self-reported measurements.

Results

Self-compassion intervention uniquely decreased heart rate response to a stressor whereas mindfulness intervention did not. Both treatments decreased state anxiety and negative affect to a stressor, while increased positive affect in this context. We also demonstrated a significant correlation between decreased heart rate response and less negative emotions.

Conclusion

The Findings provides novel physiological evidence that self-compassion interventions buffer stress reactivity in individuals with GAD. Attention shall be paid to the limitations in small and unequal sample size and a non-randomized study design.

Narrative approach to understanding compassion: a mixed methods study in a Polish sample

Objectives

This study investigates the relationship between compassion, defined by Gilbert as "a sensitivity to suffering in self and others, with a commitment to try to alleviate and prevent it" and narrative identity. We explored whether individuals with high and low levels of compassion differ in narrative characteristics such as affective tone, agency, and communion themes, as well as the use of redemption or contamination sequences in stressful life event narratives.

Methods

A mixed-method study was conducted with Polish adult participants (N = 63), half of whom had low and the other half high levels of compassion. Participants completed several questionnaires, including the Compassion Action and Engagement Scale. A few weeks later, they participated in individual interviews where they narrated several key life events. The interviews were recorded, transcribed, and coded by an individual blind to the participants' compassion levels and other identifying information. The self-narratives were analyzed for affective tone, agency and communion themes, and redemption and contamination sequences. Differences in these elements between individuals with low and high compassion were analyzed using t-tests.

Results

Our findings indicate that individuals with higher compassion more frequently incorporate themes of agency and communion in their narratives, particularly in stories of failure and the past year's most difficult event. The narrative identity of a highly compassionate person includes more content related to seeing oneself as sensitive to suffering and actively working to reduce or prevent it.

Conclusions

This study highlights how individuals with varying levels of compassion construct narratives about significant life events. Narrative approaches can foster compassionate engagements and actions, potentially improving therapeutic practices and personal development strategies. The results underscore the importance of narrative analysis in understanding compassion and suggest that compassion levels may influence how individuals interpret and narrate their life experiences, offering valuable insights for future research.

Streaming to Connect: Exploring How Social Connectedness Relates to Empathy Types and Physiological States in Remote Virtual Audiences

Examining remote virtual audiences is a vital part of understanding social experiences in modern human-computer interaction contexts. Doing so raises intriguing questions about how these mediated connections relate to emotional and physiological states. The vagus nerve is central to socioemotional processing and physiological well-being, with its activation represented as vagally mediated heart rate variability (vmHRV). We examine how participants' social connectedness to virtual partners relates to their experience of socioemotional competences and psychophysiological states while observing streamed gameplay. In this experimental study with 48 participants, we compared self-reported empathy, empathic concern, and continuously measured vmHRV (from a PPG sensor) during different types of gameplay. The results revealed that viewers who felt greater social connectedness to remote partners also felt more empathic concern (quantitative detail) and had significantly heightened vmHRV (quant detail) across all conditions compared to those who felt lower connectedness. These findings reveal that stronger feelings of connectedness to remote partners are associated with enhanced socioemotional competences and physiological well-being. This research highlights the intertwined nature of social connectedness, empathy, and physiological health, providing valuable insights for designing virtual platforms that foster deeper interpersonal connections and promote well-being.

Visual Art and Medical Narratives as Universal Connectors in Health Communication: An Exploratory Study

Health-related information can often be overwhelming for consumers resulting in difficulty in interpretation and application. Historically, art and narratives have played key roles in communication within diverse populations however collectively have received little recognition as a means to enable health literacy. This study aims to investigate patient/caregiver narratives and visual art as a modality to improve knowledge translation and health literacy in the wider community. Nine recently discharged patients and 1 caregiver from a regional hospital were paired with 10 tertiary visual arts students for interview. Each narrative was transformed into visual art and exhibited at a community art gallery and to high school art students. Self-reported questionnaires generated data in subjective experience and learning outcomes. Health literacy was evaluated via voluntary gallery viewer and school student response surveys post-exhibition exposure. Exhibition surveys revealed 96.9% of gallery observers had learnt something new about illness or injury. High school students found the activity had improved (42%) or somewhat improved (38%) their understanding of illness and injury. Our findings suggest patient/caregiver narratives and visual art are equitable and effectual modalities for health service organizations to facilitate, affective and experiential learning, and improve health literacy within the community.

The Mediating Role of Compassion in the Relationship Between Nurses' Ethnocultural Empathy and Cultural Sensitivity: Structural Equation Model Analysis

INTRODUCTION

Nurses must possess the capacity for compassionate care and exhibit empathy to promote culturally competent care. This research investigated the mediating role of compassion in the relationship between ethnocultural empathy and intercultural sensitivity among nurses.

METHOD

The study was conducted at a hospital that provides health care services to refugees. In total, 125 nurses were recruited through the simple random sampling technique. Data were collected using a personal form and three scales. Statistical analysis was performed using SPSS23 and AMOS24.

RESULTS

Nurses' cultural sensitivity positively influenced their compassion competence and ethnocultural empathy. Compassion competence did not function as a full mediator in the relationship between intercultural sensitivity and ethnocultural empathy.

DISCUSSION

This study revealed that exposure to different cultures contributed to compassion competence, ethnocultural empathy, and cultural sensitivity skills in nurses. Cultural competence is a critical component of nursing care; therefore, it should be developed through curriculum revisions and a sensitive and supportive discussion of experiences.

Having a More Compassionate Doctor Does Not Mean Patients Will Feel More Cared for: An Empirical Study

BACKGROUND

Compassion is central to healthcare. It is valued by both patients and physicians and predicts better outcomes for patients, physicians, and healthcare organisations. Whilst most studies to date have focused on providers' expression of compassion, the current report was designed to focus on the patient, specifically identifying patient and physician variables predicting the patient experience of compassion from physicians.

OBJECTIVES

To identify the predictors of patient experience of compassion.

DESIGN

An anonymous cross-sectional online survey study conducted in Aotearoa New Zealand.

PARTICIPANTS

One thousand sixty-five patients were recruited from the community, followed by the recruitment of 219 physicians based on patients' referrals.

MAIN MEASURE

Patient experience of physician compassion.

KEY RESULTS

Patient-level predictors only explained 1.7% and physician-level 2.9% of the variance in patient experience of compassion (PEC). Patient age (β = 0.08, p < 0.05) and being diagnosed with serious chronic illness (β = 0.08, p < 0.05) predicted reports of greater compassion from physicians, whereas better self-reported health (β = - 0.12, p < 0.01) predicted less. Patients reported experiencing greater compassion when physicians were younger (β = - 0.15, p < 0.05), but physician trait compassion was unrelated (p > 0.05) and reports of physician behaviours that should signal compassion were only marginally significant (p = 0.06).

CONCLUSIONS

Our data highlight how little is known about the patient experience of compassion and imply that the patient experience of compassion may or may not be related to physician compassion. Consequently, we need to supplement our ongoing study of the origins and determinants of compassion in healthcare providers with an equally systematic, rigorous, and empirically based study of the patient experience of compassion from providers.

Stimulation-based compassion mapping to assess risk of insular resection for surgical epilepsy management: illustrative case

BACKGROUND

The insula is a central node in network models of compassion and empathy. Because of this, resection of the insula for the treatment of drug-resistant epilepsy can change an individual's level of compassion.

OBSERVATIONS

Here, the authors present the clinical case of a woman with drug-resistant epilepsy localized to the nondominant insula. Because of the widespread literature implicating insular function in empathy and compassion, including lesion studies, her primary concern was changes in her compassion level after insular resection. In this case, the authors performed a novel compassion mapping paradigm before resection, using 30-second video clips to elicit compassion. This showed no changes in compassion with electrical stimulation of sites spanning the anterior insula, providing some reassurance that resection would not affect her compassion. Consistent with this, pre- and postresection testing, along with informal subjective reports by the patient, demonstrated no change in compassion or subcomponents of compassion (sadness and empathy) after right insular resection.

LESSONS

While resection of the nondominant insular cortex warrants caution, this case illustrates a compassion mapping paradigm that reassured the clinical team and the patient that her compassion would not be affected and formal postoperative testing that was consistent with this. https://thejns.org/doi/10.3171/CASE24339.

Efficacy of Compassion-Based Interventions in Breast Cancer Patients and Survivors: A Systematic Review of Randomized Controlled Trials

Breast cancer patients and survivors deal with physical and psychological challenges due to oncological treatments. The existing literature highlights the importance of compassion in reducing the main cancer-related effects in terms of emotions, quality of life, and dysfunctional coping skills. Over the past few years, compassion-based interventions (CBIs) have been considered an interesting approach to reduce anxiety and depression symptoms and improve quality of life and well-being. However, there have not been many studies that show the benefits of these interventions in breast cancer patients and survivors. The primary objective of this systematic review is to provide evidence of the impact of CBIs on specific variables identified in the literature as affected by this pathology. The variables that will be studied are (a) emotional issues (e.g., anxiety, stress, and depression symptoms); (b) quality of life; and (c) positive coping skills. A systematic search during the previous 10 years up to November 2023 was conducted following the PRISMA guidelines across multiple databases, such as PubMed, Web of Science, PsycINFO, and Scopus. Nine eligible randomized controlled trials were included in this article, with a total of 813 breast cancer patients and survivors. Findings show that CBIs increased compassion, mindful observation, and acting with awareness skills, leading to a significant reduction of anxiety and stress levels, depression, and negative affect. Additionally, less body image distress and greater body appreciation were reported as a consequence of the interventions. This review shows the CBI's efficacy on emotions, positive coping skills, and quality of life in breast cancer patients and survivors. Guidelines for future studies are listed to promote CBIs as a clinically useful intervention for breast cancer patients and survivors.

The Relationship Between Self-Compassion and Resilience in the General Population: Protocol for a Systematic Review and Meta-Analysis

BACKGROUND

Resilience can protect individuals from the negative impact of adversity, facilitating a swift recovery. The exploration of protective factors contributing to resilience has been a central focus of research. Self-compassion, a positive psychological construct that involves treating oneself with kindness, holds the potential to bolster resilience. Although several studies have indicated an association between self-compassion and resilience, there is a lack of systematic reviews and meta-analyses examining this relationship and the potential moderators and mechanisms.

OBJECTIVE

This study aimed to systematically review the literature on the relationship between self-compassion and resilience in the general population, perform a meta-analysis to quantify the effect size of their association, and explore potential moderators (eg, age, gender, culture, and health status) and mediators.

METHODS

We will search the Web of Science, PsycINFO, MEDLINE, Scopus, CINAHL, and CNKI databases for peer-reviewed studies (including observational and experimental studies) that examined the relationship between self-compassion and resilience, with no language restrictions. There are no restrictions regarding participants' age, gender, culture, or health status. Qualitative studies, conference abstracts, review articles, case reports, and editorials will be excluded. Two reviewers (XL and JH) will independently screen the literature, extract data, and assess the quality of the eligible studies. If possible, the pooled effect size between self-compassion and resilience will be meta-analyzed using a random-effect model. Meta-regression and subgroup analysis will be conducted to examine the moderating roles of age, gender, culture, health status, and other potential moderators. The characteristics and main findings of eligible studies will be summarized in tables and narrative descriptions. Results from the meta-analysis, meta-regression, and subgroup analysis will be presented quantitatively.

RESULTS

We registered our protocol with PROSPERO, conducted the search, and initiated the screening in April 2024. We expect to start data analysis in October 2024 and finalize the review by March 2025.

CONCLUSIONS

The systematic review and meta-analysis will provide evidence on the protective role of self-compassion in resilience under adversity. Our investigation into potential moderators will highlight the contexts and groups where the benefits of self-compassion can be maximized. The findings are expected to provide valuable insights for health care professionals and stakeholders, informing the development of interventions aimed at enhancing resilience by fostering self-compassion.

TRIAL REGISTRATION

PROSPERO CRD42024534390; https://tinyurl.com/3j3rmcja.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/60154.

Associations of lipids in adolescence and adulthood with self- and other-directed compassion in adulthood

Self- and other-directed compassion have been linked with better mental and physical health but research on factors contributing to their development is scarce. Previous studies indicate a possible causal relationship of lipids with personality and socioemotional functioning. As an extension to earlier research, in the present study we examine whether lipids assessed in adolescence and adulthood are associated with self-compassion and other-directed compassion in adulthood. The study utilizes data on lipids from two follow-ups in the Northern Finland Birth Cohort 1986 at ages 15-16 and 33-35. In the latter follow-up also self-compassion and other-directed compassion were assessed with the self-compassion scale - short form and the subscale for compassion in the dispositional positive emotions scale, respectively. The sample for the cross-sectional associations of lipids in adulthood with the compassion variables in adulthood includes 1,459 participants, whereas the sample for the longitudinal associations of lipids in adolescence and the compassion variables in adulthood consists of 1,509 participants. The associations were examined with hierarchical linear regression (lipids as continuous variables) and univariate general linear model (lipids as categorical variables). The results suggest that in women, high-density lipoprotein (HDL) cholesterol in adolescence is associated with high empathic concern (a component of other-directed compassion) in adulthood. The results show further that, in women, an HDL cholesterol level above 1.2 mmol/L in adulthood is associated with high other-directed compassion and empathic concern in adulthood. The present study provides tentative evidence that biological factors such as lipids might play a role in the development of empathic concern and other-directed compassion.

Are prosocial tendencies relevant for developmental psychopathology? The relations of prosocial behavior and empathy-related responding to externalizing problems, internalizing problems, and autism spectrum disorder

The field of developmental psychopathology tends to focus on the negative aspects of functioning. However, prosocial behavior and empathy-related responding - positive aspects of functioning- might relate to some aspects of psychopathology in meaningful ways. In this article, we review research on the relations of three types of developmental psychopathology- externalizing problems (EPs), internalizing problems (IPs), and Autism Spectrum Disorder (ASD) - to empathy-related responding (e.g., affective and cognitive empathy, sympathy, personal distress) and prosocial behavior. Empathy-related responding and prosocial behavior generally have been inversely related to EPs, although findings are sometimes reversed for young children and, for empathy, weak for reactive aggression. Some research indicates that children's empathy (often measured as emotional contagion) and personal distress are positively related to IPs, suggesting that strong sensitivity to others' emotions is harmful to some children. In contrast, prosocial behaviors are more consistently negatively related to IPs, although findings likely vary depending on the motivation for prosocial behavior and the recipient. Children with ASD are capable of prosocially and empathy-related responding, although parents report somewhat lower levels of these characteristics for ASD children compared to neurotypical peers. Issues in regard to measurement, motivation for prosociality, causal relations, and moderating and mediating factors are discussed.

Considering distinct positive emotions in psychedelic science

In this review, we discuss psychedelics' acute subjective and persisting therapeutic effects, outline the science of positive emotions, and highlight the value in considering distinct positive emotions in psychedelic science. Psychedelics produce a wide variety of acute subjective effects (i.e. the 'trip'), including positive emotions and affective states such as awe and joy. However, despite a rich literature on distinct emotions and their different correlates and sequelae, distinct emotions in psychedelic science remain understudied. Insofar as psychedelics' acute subjective effects may play a role in their downstream therapeutic effects (e.g. decreased depression, anxiety, and substance misuse), considering the role of distinct positive emotions in psychedelic experiences has the potential to yield more precise statements about psychedelic-related subjective processes and outcomes. We propose here that understanding the role of positive emotions within the context of psychedelic experiences could help elucidate the connection between psychedelics' acute subjective effects and therapeutic outcomes.

Intersections of Compassion, Science, and Spiritual Care in Global Health for Public Health Benefits

Across the globe, spiritual care is offered by individuals, healthcare chaplains, and humanitarian, social and related spiritual groups on account of zeal, voluntary and paid services. Sometimes, services are provided without understanding the connectivity of compassion, spiritual care, and scientific protocols. There are instances where health professionals and managers disagree with spiritual caregivers or reject spiritual services because of poor service deliveries in conflict with healthcare protocols. Against this background, this article focuses on how spiritual care services can be provided scientifically to improve service delivery. It presents leading questions to link the scientific and compassionate approach to spiritual care. These include-What is science? What is compassion? What is spiritual care? What makes compassion and spiritual care scientific? Are there tenets of compassion in religions? How are compassion, science and spiritual care linked? What are the implications of the intersections for public health and safety? Hopefully, the provided answers may improve the service delivery performance of spiritual caregivers and their collaboration with healthcare professionals, social workers, and related groups.

Impact of interprofessional education on empathy of pre-licensure healthcare students: A mixed-studies systematic review

BACKGROUND

In the age of automation and technology, incorporating empathy in pre-licensure healthcare education is essential in providing empathic care to patients and co-workers. This can be achieved through interprofessional education (IPE).

OBJECTIVE

To consolidate evidence to evaluate interprofessional education's impact on pre-licensure healthcare students' empathy levels.

DESIGN

A mixed-studies systematic review following a convergent segregated approach.

METHODS

Ten electronic databases were searched from their inception until 30 November 2023. Quantitative, qualitative, and mixed-method studies that explored the impact of IPE on the change in empathy level in pre-licensure healthcare students were reviewed. The methodological quality of the included studies was assessed using the Mixed-Method Appraisal Tool. Findings from the qualitative and quantitative aspects were analysed and synthesized separately using thematic and narrative synthesis. The findings were integrated by convergent synthesis.

RESULTS

A total of 36 studies involving 3887 participants were included in this review, consisting of five quantitative, 14 qualitative and 17 mixed-methods studies. This review found that IPE enhanced the empathy level of students by improving their understanding of empathy and various empathic responses. Through IPE activities, students demonstrated empathy towards both patients and interprofessional peers. Three themes were generated through the synthesis of qualitative and quantitative results: (1) Empathy Awareness, (2) Internal Empathic Processes, and (3) Intentional Actions. The results showed that healthcare students exhibited empathic care behaviours towards patients and their interprofessional peers.

CONCLUSION

The findings of this review suggested that IPE was effective in improving awareness and knowledge of empathy and in providing empathy care to patients and interprofessional peers. This review encourages educators to implement IPE to pre-licensure healthcare students to increase their knowledge of the importance of providing empathic patient care and interprofessional empathy. Future research could explore more on the processes of interprofessional empathy in students.

Harnessing Virtual Reality to Influence Attitudes Toward Beef Consumption: The Role of Empathy in Dietary Interventions

The excessive consumption of red meat, such as beef, is a growing global health concern linked to increased risks of cancer and cardiovascular diseases. The health consequences associated with red meat consumption were estimated to cost USD 285 billion globally in 2020, accounting for approximately 0.3% of total health expenditures that year. Understanding the psychological mechanisms behind food choices is crucial for changing consumption habits, fostering healthy behaviors, and achieving sustainable dietary patterns. To address these challenges, this study utilizes virtual reality (VR) as a persuasive tool to examine how empathy, as a psychological mechanism, influences the intention to reduce beef consumption and its impact on dietary attitudes. Using an experimental design with 142 participants, the study found that in the VR context, individuals with higher empathy scores experienced a stronger sense of presence, significantly influencing their attitudes toward beef consumption, mediated by the change in anti-beef-eating attitude (p = 0.029). This suggests that VR can serve as an effective medium to reduce individuals' willingness to consume beef and consequently prevent health risks associated with excessive meat intake. This study also highlights the importance of considering individual empathy levels when designing VR interventions to maximize their effectiveness and promote healthier dietary habits, ultimately improving public health. However, one limitation of this study is that it only assessed short-term changes in attitudes following the VR intervention, without incorporating long-term follow-ups to determine if these changes are sustained over time.

Developing a compassionate university: Insights from a longitudinal process evaluation

Compassionate communities are gaining momentum as a new public health approach emphasizing community support during times of serious illness, death, and bereavement. However, evidence on their development, particularly in higher education, is limited. This study investigates the development of a Compassionate University, examining the underlying processes and contextual factors shaping its development. A longitudinal process evaluation was conducted, using field notes right-now surveys, individual interviews, focus groups, and strategic learning debriefs. Factors that facilitated the development process included leadership support, the establishment of the Compassionate Schools Learning Network, and alignment with existing university programs. Barriers were the lack of guiding examples, the fragmented university environment, resource constraints, and limited prioritization. Cognitive and social processes that supported the work involved recognizing the value of Compassionate University and adapting implementation strategies based on empirical feedback. However, challenges such as building coherence, engaging stakeholders, and assessing the work hampered the development process.

Revisiting Compassion and Job Performance: A Constructive Study in South Korean Public Art Institutions

This study empirically examines how employee compassion relates to job performance. Specifically, this study is a constructive replication and expansion of a previous study on the relationship between compassion and job performance using multiple sources of measurement. It investigates unexplored pathways within the public art sector in South Korea. Focusing on the mediating roles of positive work-related identity (PWRI) and positive psychological capital, we collected data from public art institutions in Korea, including galleries and museums, using a survey method. We tested the hypotheses using structural equation modeling and the PROCESS bootstrapping method. Our findings demonstrate a positive association between compassion and job performance, serially mediated by PWRI and positive psychological capital. Theoretically, by constructively replicating and expanding the previous findings, our study contributes to a robust understanding of how compassion could enhance employee performance. Practically, this study reinforces the value of fostering compassion and positive psychological resources to improve job performance, particularly within the public art sector.

Peer support provider and recipients' perspectives on compassion in virtual peer support stroke programs: "You can't really be supportive without compassion"

BACKGROUND

Peer support programs demonstrate numerous benefits, including emotional, instrumental, informational, and affirmational social support. Since the COVID-19 pandemic, many peer support stroke programs in Canada have been delivered virtually. Compassion must be consistently applied to build meaningful interactions, but the shift to virtual services may have changed the quality of interaction and compassion in virtual services. While compassion is recommended in health and social services to improve outcomes, satisfaction, and service quality, compassion in virtual peer support stroke programs remains understudied. We aimed to describe compassionate support in virtual peer support stroke programs from peer support providers' and recipients' perspectives.

METHODS

This qualitative descriptive study was guided by Sinclair & colleagues' model of compassion. Peer support recipients or peer support providers participated in interviews transcribed and analyzed using a hybrid thematic analysis.

RESULTS

Sixteen were peer support recipients, six were peer support providers, and two were both peer support providers and recipients. Participants agreed that compassion was essential in these programs. Participants perceived compassion to be a result of the virtues of compassionate facilitators (i.e., genuineness, passion, and empathy), relational space, and communication within the virtual peer support stroke program (e.g., sense of awareness or intuition of compassion, aspects of engaged peer support provision), virtuous response (e.g., knowing the person and actions that made the peer support recipient feel like a priority). Compassion was facilitated by listening and understanding peer support recipients' needs as they relate to stroke (i.e., seeking to understand peer support recipients and their needs), attending to peer support recipients' needs (e.g., timely actions to address their needs), and achieving compassion-related program outcomes (e.g., alleviating challenges and enhancing wellbeing). The absence of these components (e.g., lacking genuineness, passion and empathy) was a barrier to compassion in virtual peer support stroke programs.

CONCLUSIONS

Study findings describe facilitators and barriers to perceived compassion in virtual peer support stroke programs and provide practical recommendations that can be adapted into programs to improve program quality.

Dispositional compassion shifts social preferences in systematic ways

INTRODUCTION

How people attach value to the outcomes of self and other-social preferences-is central to social behavior. Recently, how dispositional and state emotion shape such social preferences has received researchers' attention.

METHOD

The present investigation asked whether and to what extent dispositional and state compassion predict shifts in social preferences across 4 samples: two correlational samples (final ns 153 & 368, study 1a and 1b) and two experimental samples (final ns: 430 & 530, studies 2 and 3).

RESULTS

In keeping with recent accounts of compassion, dispositional compassion predicted general preference for equality, expressed as dispreference for both monetary advantage over another (interaction βs = -0.36, -0.33, -0.25, -0.22; all p < 0.001) and monetary disadvantage relative to others (βs: 0.26, 0.27, 0.28, 0.17; all p < 0.01; positive coefficients imply dispreference). This dispositional effect persisted when controlling for prosociality, positivity, agreeableness, and respectfulness. Furthermore, these dispositional compassion effects were relatively unchanged by experimental emotion inductions in studies 3 and 4. The experimental inductions of state compassion and state pride showed little evidence of systematic effects on social preferences relative to each other or a neutral condition.

DISCUSSION

Discussion focused on individual differences in emotion and social preferences.

System circumvention: Dishonest-illegal transgressions are perceived as justified in non-meritocratic societies

Does believing that "effort doesn't pay" in society shape how people view dishonest-illegal transgressions? Across five studies, we show that when people view societal success as non-meritocratic-that is, more dependent on luck and circumstances than on hard work-they are more lenient in their moral judgements of dishonest-illegal transgressions. Perceiving society as non-meritocratic predicted greater justifiability of dishonest-illegal transgressions in the United States (Study 2), and across 42 countries (N = 49,574; Study 1). And inducing participants to view society as non-meritocratic increased justifiability of others' dishonest-illegal transgressions, via greater feelings of sympathy (Studies 3 and 4). Next, we investigated the contours of these effects. Perceiving societal success as non-meritocratic rather than based on hard work causes people to view dishonest-illegal transgressions as more justifiable if they are perpetrated by the poor, but not the rich (Study 4), and if the dishonest-illegal transgressions are related to economic striving, such as money laundering and dealing illegal drugs (Study 5). In sum, when people see a social system as unfair, they show greater tolerance for dishonest-illegal transgressions perpetrated to circumvent the system.

Xenophobia and Xenophilia, the Bright and Dark Sides of Attitude Towards Foreigners: A Self-Determination Theory Approach

Introduction: The intensification of the migration phenomenon led to a growing interest in the public domain about the attitudes towards foreigners. Xenophobia and xenophilia are two opposite orientations towards foreigners, that could be considered the consequences of the interaction between several factors. Based on the self-determination theory, this study aims to verify that a bright pathway composed by intrinsic goal, needs satisfaction and altruism could explain xenophilia, whereas a dark pathway composed by extrinsic goal, needs frustration, and egoism could explain xenophobia in a group of Italian emerging adult. Methods: A group of 306 Italian emerging adults (aged 18-24), completed questionnaires and structural equation modelling was used to test the hypothesized model. Results: The results showed a relation between intrinsic goals and needs satisfaction, conversely needs satisfaction was related to altruism, moreover altruism was related to xenophilia. On the other hand, extrinsic goals were related to need frustration; moreover, need frustration was related to egoism and egoism was related to xenophobia. Discussion: These results were discussed within the Italian context for a better general comprehension of both xenophobia and xenophilia in a SDT framework.

Perceived social support and prosocial behavior in medical students: Mediating effect of empathy and moderating role of moral identity

BACKGROUND

Prosocial behavior is essential for effective patient communication and building a positive doctor-patient relationship in medical students. Research on the factors influencing prosocial behavior in medical students is limited. This research aims to examine how perceived social support influences prosocial behavior among medical students, focusing on the mediating role of empathy and the moderating role of moral identity.

METHODS

This cross-sectional study included 2425 medical students from central and southern Jiangsu province. Participants were assessed using the Prosocial Behavior Scale, Interpersonal Response Index Scale, Moral Identity Scale, and Perceived Social Support Scale, with data collected through via an online questionnaire. SPSS PROCESS macro model 4.1 was used to examine the mediating effect and the moderating effect.

RESULTS

Perceived social support showed a significant positive correlation with prosocial behavior among medical students. The indirect effects of perceived social support on prosocial behavior through perspective taking (βindirect = 0.11, 95% Boot CI [0.09, 0.13]) and empathic concern (βindirect = 0.08, 95% Boot CI [0.06, 0.10]) confirmed the mediating roles of these variables, accounting for 32.05% and 23.82% of the total effect, respectively. However, personal distress did not mediate this relationship (βindirect = -0.004, 95% Boot CI [-0.01, 0.005]). Moral identity significantly moderated the effect of perceived social support on perspective taking (β = 0.05, p < 0.01) and the relationship between perspective taking and prosocial behavior (β = 0.12, p < 0.001). Additionally, moral identity also moderated the relationships between perceived social support and empathic concern (β = -0.05, p < 0.01) and between empathic concern and prosocial behavior (β = 0.08, p < 0.001). While the interaction between perceived social support and moral identity predicted personal distress (β = 0.04, p < 0.05), moral identity did not moderate the relationship between personal distress and prosocial behavior (β = 0.03, p = 0.12).

CONCLUSION

This study underscores the link between perceived social support and prosocial behavior, highlighting the significant roles of perspective taking, empathic concern, and moral identity in this relationship. These findings underscore the potential of cultivating these psychological mechanisms to foster caring and prosocial behaviors among medical students, providing important references for future educational interventions and policy formulation.

A call to action: Re-activating the latent human factor for achieving the UN SDGs-cultivating courageous partnerships and compassionate human systems

The raison d'être for psychotherapy1 is to address individual suffering and distress. The sustainable development goals address suffering and distress on a global scale in the context of threats to the survival of our communities and planet.

OBJECTIVE

We propose scaling up therapeutic principles for collective impact and nurturing therapist commitment beyond the therapy room, to activate and sustain compassion-in-action at the community system level.

DESIGN

The SDGs represent the strength of collective human concern and action coming together. At the half-way point, we are falling dangerously short of our targets, requiring an urgent response. The tenet of this paper is that the weakest link in our journey is not technical capability or finances, or even the impact of multiple intersecting crises, but our ability to collaborate for sustained action-it is the human factor-hence, we need a psychologically informed response.

METHOD

Notably, least 'visible' is SDG17, the umbrella goal designated means of implementation, through partnership. Partnership has been treated as a transactional element of SDG projects, rather than the vital heartbeat connecting daily actions to the 2030 vision. Partnership is about investing in relationships and a commitment to working together with a common purpose-the bailiwick of psychological therapists.

RESULTS

We propose an architecture to support the development of courageous partnerships and compassionate systems.

CONCLUSION

Compassion uniquely potentiates global action on wicked problems.

Sexual Assault Labels, Compassion for Others, Self-Compassion, and Victim Blaming

Two studies examined whether label preferences (survivor, victim, neither/other/both) and past assault experience (assaulted or not assaulted) are related to compassion for others, self-compassion, rape myth acceptance, and cognitive distortions surrounding rape. Findings indicate that a preference for a victim label is related to more negative outcomes (e.g., propensity to victim-blame, less compassion for others) compared to those advocating for a survivor label or falling into a neither/other/both category. Furthermore, those who experienced sexual assault have significantly lower self-compassion compared to those who do not experience sexual assault. Implications for the impact of labels are discussed.

Schadenfreude or empathy? Children's emotional responses to the physical pain and pleasure of prosocial and antisocial others

Adults' emotional reactions to the pain and pleasure of others are influenced by the moral character of those individuals. However, it remains unclear whether children's emotional responses also show such selectivity. To investigate this, we compared 4- to 8-year-old children's emotional responses to the physical pain and pleasure of prosocial versus antisocial puppets. In Study 1, children reported unhappiness after witnessing the pain of the prosocial and antisocial puppets but reported less unhappiness after witnessing the pain of the antisocial puppet. In Study 2, children reported happiness after witnessing the pleasure of both puppets but reported being less happy for the antisocial puppet. These results suggest that children are less likely to empathize with antisocial individuals. Meanwhile, children did not display Schadenfreude (pleasure at others' pain) or Gluckschmerz (displeasure at others' pleasure) toward antisocial individuals in our studies. Moreover, the selectivity of children's emotional responses disappeared after we manipulated the physical competence rather than the moral character of the puppets in Study 3. Our findings help to reveal the moral selectivity of emotional responses to others' pleasure and pain during early childhood.

Heartfelt ventures: The power of empathy in driving social entrepreneurial

Although the notion of social entrepreneurship is not new to us today, it has not yet gained widespread acceptance and development in Vietnam. Although there are numerous study publications on the relationship between empathy and social entrepreneurial intentions, this problem has yet to be studied much in the context of Vietnam's, particularly among youth. The goal of this study is to see if young empathy is linked to their desire to start a social enterprise. Reliability analysis using PLS-SEM software and a binary regression model will be used to examine data obtained from 339 university students in Vietnam. According to the findings, as well as the theory of planned behavior and the theory of action phases, (1) empathy does not directly affect social business intention, but rather indirectly through two mechanisms, social worth and social entrepreneurial self-efficacy, and (2) individuals who are confident in their own abilities have more social entrepreneurship intentions. We provide recommendations based on these findings to inspire young people to pursue social entrepreneurship, contribute to the development of a sustainable economy, and contribute positive values to society.

Preconsultation compassion video to reduce anxiety among patients referred to a cancer centre: a randomised control trial

Objective

Anxiety is common among patients attending an initial oncology consultation. The objective of this trial was to test if an enhanced compassion video emailed to patients prior to their initial oncology consultation reduces anxiety compared with being sent an information-only introduction video.

Methods and analysis

We conducted a randomised control trial at a single university-based cancer centre between May 2021 and October 2023. We enrolled adult patients scheduled for an initial cancer consultation. Subjects underwent simple 1:1 randomisation to receive either a standard introduction video or an enhanced compassion video via email. Investigators and subjects were blinded to allocation. The primary outcome was degree of anxiety on arrival to the initial oncology consultation, measured using the Hospital Anxiety and Depression scale (HADS).

Results

Of 1005 subjects randomised to the standard video and 1038 to the enhanced compassion video, 183 and 179 subjects completed the HADS-anxiety in each group, respectively. Only 25% reported watching their assigned video. There was no difference in degree of anxiety between the standard or compassion video groups using intention to treat analysis (median (IQR) 7 (4-10) vs 7 (4-10), p value=0.473)) or per-protocol analysis (limited to subjects who reported watching the video) (median (IQR) 7 (4-10) (n=45) vs 7 (5-10) (n=46), p value=0.997).

Conclusion

Receiving an enhanced compassion video did not reduce anxiety compared with a standard introduction video. Given 25% of subjects reported watching their assigned video, future research should focus on identifying interventions at the point-of-care to reduce anxiety.

Trial registration number

NCT04503681.

Patient and Provider Experiences With Compassionate Care in Virtual Physiatry: Qualitative Study

BACKGROUND

Telemedicine in the realm of rehabilitation includes the remote delivery of rehabilitation services using communication technologies (eg, telephone, emails, and video). The widespread application of virtual care grants a suitable time to explore the intersection of compassion and telemedicine, especially due to the impact of COVID-19 and how it greatly influenced the delivery of health care universally.

OBJECTIVE

The purpose of this study was to explore how compassionate care is understood and experienced by physiatrists and patients engaged in telemedicine.

METHODS

We used a qualitative descriptive approach to conduct interviews with patients and physiatrists between June 2021 and March 2022. Patients were recruited across Canada from social media and from a single hospital network in Toronto, Ontario. Physiatrists were recruited across Canada through social media and the Canadian Association for Physical Medicine and Rehabilitation (CAPM&R) email listserve. Interviews were recorded and transcribed. Data were analyzed thematically.

RESULTS

A total of 19 participants were interviewed-8 physiatrists and 11 patients. Two themes capturing physiatrists' and patients' experiences with delivering and receiving compassionate care, especially in the context of virtual care were identified: (1) compassionate care is inherently rooted in health care providers' inner intentions and are, therefore, expressed as caring behaviors and (2) virtual elements impact the delivery and receipt of compassionate care.

CONCLUSIONS

Compassionate care stemmed from physiatrists' caring attitudes which then manifest as caring behaviors. In turn, these caring attitudes and behaviors enable individualized care and the establishment of a safe space for patients. Moreover, the virtual care modality both positively and negatively influenced how compassion is enacted by physiatrists and received by patients. Notably, there was large ambiguity around the norms and etiquette surrounding virtual care. Nonetheless, the flexibility and person-centeredness of virtual care cause it to be useful in health care settings.

Social media emotions annotation guide (SMEmo): Development and initial validity

The proper measurement of emotion is vital to understanding the relationship between emotional expression in social media and other factors, such as online information sharing. This work develops a standardized annotation scheme for quantifying emotions in social media using recent emotion theory and research. Human annotators assessed both social media posts and their own reactions to the posts' content on scales of 0 to 100 for each of 20 (Study 1) and 23 (Study 2) emotions. For Study 1, we analyzed English-language posts from Twitter (N = 244) and YouTube (N = 50). Associations between emotion ratings and text-based measures (LIWC, VADER, EmoLex, NRC-EIL, Emotionality) demonstrated convergent and discriminant validity. In Study 2, we tested an expanded version of the scheme in-country, in-language, on Polish (N = 3648) and Lithuanian (N = 1934) multimedia Facebook posts. While the correlations were lower than with English, patterns of convergent and discriminant validity with EmoLex and NRC-EIL still held. Coder reliability was strong across samples, with intraclass correlations of .80 or higher for 10 different emotions in Study 1 and 16 different emotions in Study 2. This research improves the measurement of emotions in social media to include more dimensions, multimedia, and context compared to prior schemes.

Attachment and propensity for reporting compassionate opportunities and behavior in everyday life

Introduction

Researchers have identified links between anxious and avoidant attachments and difficulties with self-compassion, giving others compassion, and receiving compassion. However, while compassion requires both awareness of opportunities for compassion and compassionate action, little is known about attachment-related differences in reporting compassionate opportunities. Further, most research relies on retrospective-reports that may not accurately assess compassionate behaviors in everyday life.

Method

Consequently, we collected 2,757 experience sampling survey responses from 125 participants (95 women, 27 men, 3 non-binary, M age = 18.74, SD age = 1.66) to investigate whether attachment anxiety, avoidance, or their interaction were associated with differences in propensity for reporting compassionate opportunities, actions, and emotional responses to opportunities in everyday life across self-compassion, giving compassion, and receiving compassion.

Results

Anxiety was associated with greater likelihood of reporting all types of compassionate opportunities and less positive responses to opportunities to receive compassion. Avoidance was associated with less likelihood of reporting opportunities to give and receive compassion and less positive responses to opportunities to give compassion. Those high in anxiety but simultaneously low in avoidance reported fewer self-compassionate actions, but we identified no further differences in compassionate action.

Discussion

This study highlights the potential role of awareness of compassionate opportunities in attachment-related differences in compassion.

Personality factors and pandemic-related behaviors

Purpose

The purpose of the current study was to determine whether there are personality differences (the HEXACO model, narcissism, sadism, compassion for others) in mask-wearing, social distancing, and hoarding.

Findings

Those who always wore masks were significantly higher in compassion for others and significantly lower in sadism compared to those who did not always wear masks. Those who always socially distanced (compared to those who did not) were significantly higher in openness, compassion for others, and conscientiousness. Those who hoarded were significantly lower in agreeableness than those who did not hoard.

Conclusion

Perhaps physicians may use information to boost states of altruistic-type traits (agreeableness, compassion for others) while educating patients during visits in order to increase the likelihood of receiving vaccinations or booster shots.

Basal parasympathetic deficits in C9orf72 hexanucleotide repeat expansion carriers relate to smaller frontoinsula and thalamus volume and lower empathy

Diminished basal parasympathetic nervous system activity is a feature of frontotemporal dementia that relates to left frontoinsula dysfunction and empathy impairment. Individuals with a pathogenic expansion of the hexanucleotide repeat in chromosome 9 open reading frame 72 (C9orf72), the most common genetic cause of frontotemporal dementia and amyotrophic lateral sclerosis, provide a unique opportunity to examine whether parasympathetic activity is disrupted in genetic forms of frontotemporal dementia and to investigate when parasympathetic deficits manifest in the pathophysiological cascade. We measured baseline respiratory sinus arrhythmia, a parasympathetic measure of heart rate variability, over two minutes in a sample of 102 participants that included 19 asymptomatic expansion carriers (C9+ asymp), 14 expansion carriers with mild cognitive impairment (C9+ MCI), 16 symptomatic expansion carriers with frontotemporal dementia (C9+ FTD), and 53 expansion-negative healthy controls (C9- HC) who also underwent structural magnetic resonance imaging. In follow-up analyses, we compared baseline respiratory sinus arrhythmia in the C9+ FTD group with an independent age-, sex-, and clinical severity-matched group of 26 people with sporadic behavioral variant frontotemporal dementia. The Frontotemporal Lobar Degeneration-modified Clinical Dementia Rating-Sum of Boxes score was used to quantify behavioral symptom severity, and informant ratings on the Interpersonal Reactivity Index provided measures of participants' current emotional (empathic concern) and cognitive (perspective-taking) empathy. Results indicated that the C9+ FTD group had lower baseline respiratory sinus arrhythmia than the C9+ MCI, C9+ asymp, and C9- HC groups, a deficit that was comparable to that of sporadic behavioral variant frontotemporal dementia. Linear regression analyses indicated that lower baseline respiratory sinus arrhythmia was associated with worse behavioral symptom severity and lower empathic concern and perspective-taking across the C9orf72 expansion carrier clinical spectrum. Whole-brain voxel-based morphometry analyses in participants with C9orf72 pathogenic expansions found that lower baseline respiratory sinus arrhythmia correlated with smaller gray matter volume in the left frontoinsula and bilateral thalamus, key structures that support parasympathetic function, and in the bilateral parietal lobes, occipital lobes, and cerebellum, regions that are also vulnerable in individuals with C9orf72 expansions. This study provides novel evidence that basal parasympathetic functioning is diminished in FTD due to C9orf72 expansions and suggests that baseline respiratory sinus arrhythmia may be a potential non-invasive biomarker that is sensitive to behavioral symptoms in the early stages of disease.

Compassionate care through the eyes of patients and physicians: An interview study

BACKGROUND

Although compassion is a crucial element of physicians' professional performance and high-quality care, research shows it often remains an unmet need of patients. Understanding patients' and physicians' perspectives on compassionate care may provide insights that can be used to foster physicians' ability to respond to patients' compassion needs. Therefore, this study aims to understand how both patients and physicians experience the concept and practice of compassionate care.

METHODS

We conducted semi-structured interviews with eight patients and ten resident physicians at a University Medical Center in the Netherlands. Using thematic analysis, we separately coded patient and resident transcripts to identify themes capturing their experiences of compassionate care. This study was part of a larger project to develop an educational intervention to improve compassion in residents.

RESULTS

For both patients and residents, we identified four themes encompassing compassionate care: being there, empathizing, actions to relieve patients' suffering, and connection. For residents, a fifth theme was professional fulfillment (resulting from compassionate care). Although patients and residents both emphasized the importance of compassionate care, patients did not always perceive the physician-patient encounter as compassionate. According to residents, high workloads and time pressures hindered their ability to provide compassionate care.

DISCUSSION AND CONCLUSION

Patients and residents have similar and varying understandings of compassionate care at the same time. Understanding these differences can aid compassion in medical practice. Based on the findings, three topics are suggested to improve compassion in residents: (1) train residents how to ask for patients' compassion needs, (2) address residents' limiting beliefs about the concept and practice of compassion, and (3) acknowledge the art and science of medicine cannot be separated.