Development and Validation of the Self-Compassion Scale for Youth

The Prevalence and Benefits of Self-Compassion Among Professional Caregivers

OBJECTIVE

Self-compassion is a healthy way of responding to challenges that may help long-term care professional caregivers (ie, nursing assistants and personal care aides) cope with stress, but its use may vary in important ways. This study explored the relationships between self-compassion and caregiver demographic characteristics, anxiety and depressive symptoms, and job satisfaction in a large racially/ethnically diverse sample of professional caregivers.

DESIGN

Cross-sectional self-report questionnaire.

SETTING AND PARTICIPANTS

A total of 391 professional caregivers, including nursing assistants and personal care aides from 10 nursing homes and 3 assisted living communities in New York, California, and North Carolina.

METHODS

Professional caregivers were invited to complete an online questionnaire regarding stress and coping. Self-compassion was measured using the Self-Compassion for Youth Scale; anxiety and depressive symptoms were assessed using standardized screeners; and job satisfaction was assessed via an item used in a national survey. Self-compassion scores were represented by total scores and individual subscale scores. Analysis of variance was used to examine differences in self-compassion scores based on demographic characteristics, and correlation coefficients were used to explore relationships between self-compassion and mental health symptoms and job satisfaction.

RESULTS

Significant differences were found in self-compassion based on age, race/ethnicity, place of birth, and education. In general, older caregivers, caregivers with higher education, and caregivers born outside the United States had the highest self-compassion, whereas White caregivers had the lowest self-compassion. Self-compassion was negatively associated with anxiety and depressive symptoms and positively associated with job satisfaction.

CONCLUSION AND IMPLICATIONS

Professional caregivers' use of self-compassion to cope with challenges may depend on characteristics and life experiences influenced by their sociocultural background. Given the link between self-compassion and lower mental health symptoms and higher job satisfaction, it may be helpful to design and implement interventions with these differences in mind.

Age-varying associations of parent-adolescent relationship and school connectedness with adolescent self-compassion: Differences by gender

INTRODUCTION

Parent-adolescent relationships and school connectedness are critical promotive factors for adolescent self-compassion. However, little is known about how the magnitude of the associations between these protective factors and self-compassion changes across continuous age groups and whether gender differences exist in the age-varying associations. This study aims to investigate (1) the age-varying associations of parent-adolescent relationships and school connectedness with self-compassion using time-varying effect modeling and (2) how their age-varying associations may differ by gender.

METHODS

A total of 14,776 adolescents aged 10-18 (mean age = 13.53 ± 2.08, 52.3% males) from Shenzhen, China participated in this study. All adolescents completed the online questionnaires in the school computer rooms.

RESULTS

The results showed that both parent-adolescent relationships and school connectedness were positively associated with adolescent self-compassion, and the magnitudes fluctuated with age. Specifically, the association between parent-adolescent relationships and self-compassion peaked for adolescents in early adolescence, with the key timing for girls (age group of 10 years old) being slightly earlier than boys (age group of 11 years old). The association between school connectedness and self-compassion was stronger for boys in the early years of adolescence (in the age group of 12.7 years), while stronger for girls during middle adolescence (in the age group of 14.0 years). Overall, girls were more sensitive to connections with parents and schools than boys during most age groups.

CONCLUSIONS

The findings demonstrated differential key timing for boys and girls regarding family- and school-based intervention to cultivate self-compassion and highlighted the importance of maintaining strong connections with families and schools for cultivating adolescent self-compassion, particularly for girls.

A pre-post evaluation of the impact of the Embrace Kids film on children's and adults' body image and self-compassion

Given the prevalence of body dissatisfaction among young people, which tends to persist into adulthood, a need exists for large-scale interventions that address this problem. Film has been identified as a resource that is well-suited to large-scale dissemination, which can achieve broad impact and reach. Embrace Kids, a film aimed at improving young people's body image, is one such resource. To evaluate the film's impact on body image, 55 children (M = 10.59, SD = 1.49) and 47 adults (M = 43.75, SD = 8.54) were recruited from the Australian general public to complete a brief survey before and after viewing the film. After viewing the film, significant increases in state body appreciation, state functionality appreciation and state self-compassion were reported for children (d = 0.46 - 0.61) and adults (d = 0.88 - 1.08). They supported the safety of the film by indicating that it did not make them more concerned about their appearance. Findings provide initial support for the film as a scalable intervention that can be safely task-shifted to non-professional audiences. Future research directions include comparing the effect of Embrace Kids against a control film, and testing the longitudinal impact of the film on trait body image.

On the Edge of Psychopathology: Strong Relations Between Reversed Self-compassion and Symptoms of Anxiety and Depression in Young People

Self-compassion is assumed to have a protective role in the etiology of emotional problems in adolescents. This assumption is primarily based on correlational data revealing negative correlations between the total score on the Self-Compassion Scale (SCS) and symptom measures of anxiety and depression. Recently, however, the SCS has been criticized because this scale not only consists of items measuring compassionate self-responding (i.e., self-kindness, common humanity, and mindfulness), but also includes 'reversed' items measuring uncompassionate self-responding (i.e., self-criticism, isolation, and overidentification), which would undermine the validity of the scale as an index of a protective construct. The present article used two methods to demonstrate that compassionate (positive) and uncompassionate (negative) self-responding have differential effects on emotional problems in youths. In the first part, a meta-analysis based on 16 relevant studies demonstrated a modest protective effect of positive self-compassion on anxiety/depression and a large (and significantly stronger) vulnerability effect of negative self-compassion on such emotional symptoms. In the second part, network analyses were conducted on three previously collected data sets and these analyses again showed that negative self-compassion is more closely connected to young people's symptoms of anxiety and depression than positive self-compassion. It is argued that the observed differential effects should not be discarded as a subversive fallacy, but rather offer an opportunity for studying the role of self-compassion in adolescents' emotional psychopathology in a more sophisticated way, taking into account both protection and vulnerability.

The relationship between acceptance, self-compassion and hope in infertile women: a structural equation analysis

OBJECTIVE

This study aimed to determine the relationship between psychological acceptance, self-compassion and hope in infertile women.

BACKGROUND

Infertility distress can make women more vulnerable than men. Acceptance, self-compassion and hope can help infertile women to alleviate their distresses and to peruse the medical treatments.

METHODS

This study was performed using a cross-sectional descriptive correlational design; A total of 346 women with primary infertility referred to infertility centres of Yazd, Isfahan and Kerman provinces, Iran, participated in the study by completing the self-compassion scale, hope scale and Acceptance and Action Questionnaire-II (AAQ-II). Data were analysed using structural equation analysis.

RESULTS

The results of structural equation analysis showed that the path coefficient of self-compassion on acceptance (r = .69, p < .01) and hope (r = .29, p < .05) in infertile women was direct and significant. Acceptance also had a direct effect on hope in infertile women (r = .31, p < .05) and played a significant mediating role in the relationship between self-compassion and hope in infertile women.

CONCLUSIONS

The findings suggest that self-compassion is likely to be an important strategic intervention alongside medical treatments for infertile women, because it leads to problem acceptance and then increases hope in them.

Teaching Adolescents With Type 1 Diabetes Self-Compassion (TADS) to Reduce Diabetes Distress: Protocol for a Randomized Controlled Trial

BACKGROUND

Adolescents living with type 1 diabetes (T1D) often experience diabetes distress (DD), a construct distinct from depression or anxiety that refers to the negative emotions that arise from living with and managing diabetes. Self-compassion, which involves being open to one's own suffering and treating oneself with the same care one would show to loved ones, is associated with better psychological and clinical outcomes among individuals with T1D. Self-compassion is a skill that can be taught and therefore represents an opportunity for intervention.

OBJECTIVE

The overall aim of this study is to assess the effectiveness of a web-based mindful self-compassion for teens (MSC-T) intervention on improving DD, anxiety, depression, diabetes-related disordered eating, and suicidal ideation experienced by youth with T1D (aged between 12 and 17 years) compared with a waitlist control group (standard of care). We will also explore (1) if the effect of the MSC-T intervention changes over time, (2) if the MSC-T intervention has a positive impact on measures of glycemic control, and (3) if the effect of the MSC-T intervention differs based on self-reported gender.

METHODS

We will conduct a single-center, parallel-group randomized controlled trial of 140 adolescents with T1D followed for 12 months. Participants will be randomly allocated (using hidden allocation) in a 1:1 ratio to either the MSC-T intervention or the waitlist control group. Our primary outcome is DD, as measured by the Problem Areas in Diabetes-Teen (PAID-T) version at 3 months. Secondary outcomes, assessed at 3 and 12 months, include anxiety (Generalized Anxiety Disorder 7-item [GAD-7] scale), depression (Patient Health Questionnaire-9 [PHQ-9]), diabetes-related disordered eating (Diabetes Eating Problem Survey-Revised [DEPS-R] version), and suicidal ideation (using 1 question from the PHQ-9).

RESULTS

Study recruitment began in October 2022 and was completed in March 2023, with a total of 141 participants enrolling. Data collection will be ongoing until March 2024. The first results are expected in June 2024.

CONCLUSIONS

This study will be the first randomized trial to assess the effectiveness of the web-based MSC-T intervention on adolescents with T1D. Given that adolescence is a period where individuals are typically required to assume more responsibility for their diabetes care, providing adolescents with the tools they need to better manage the stress that often accompanies T1D management is paramount.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05463874; https://clinicaltrials.gov/study/NCT05463874.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/53935.

A scoping review of the self-reported compassion measurement tools

BACKGROUND

Compassion is closely linked to psychological well-being, and several assessment tools have been developed and studied to assess the level of compassion in different populations and for more precise measurement. There is currently a scarcity of comprehensive knowledge about compassion-related assessment tools, and our research provides an overview of these tools.

AIMS

To identify scales used to measure compassion from different flows, and to assess their measurement properties and quality.

METHODS

Focusing on compassion assessment tools, the authors conducted a thorough search of 10 Chinese and English databases from their establishment until August 14, 2022. Data extracted included the author, year, country, objectives, target population, as well as the primary evaluation content. Using the COSMIN checklist, the methodological quality and measurement properties of the included studies were appraised. This scoping review was registered with the Open Science Framework and followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist.

RESULTS

There were 15,965 papers searched, and 36 compassion-related measurement tools were identified in this study. None of the 36 studies provided possessed all nine psychometric properties, as outlined by the COSMIN criteria. On the basis of a systematic evaluation of quality, measurement qualities were ranked. The results for internal consistency and content validity were relatively favorable, whereas the results for structural validity were variable and the results for the remaining attributes were either uncertain or negative. A Venn diagram was used to illustrate the overlapping groups of compassion measurement tools based on the three-way flow of compassion. An overview of the reference instrument and theoretical basis for the included studies was provided, and half of them did not contain any theoretical or scale-based evidence.

CONCLUSION

In this study, 36 compassion-related measuring instruments were identified, and the methodological quality and measurement properties of the included studies were acceptable. The included measurements were consistent with flows of compassion. A further focus of further research should be on developing theories in the compassion domain and developing instruments for measuring compassion that are multidimensional, multi-populations, and culturally relevant.

Protocol of a cluster randomised trial of BodyKind: a school-based body image programme for adolescents

BACKGROUND

Poor body image is prevalent among adolescents and associated with several negative outcomes for their physical and psychological health. There is a pressing need to address this growing public health concern, yet there are few evidence-informed universal programmes for older adolescents that address contemporary body image concerns (i.e., social media). BodyKind is a four lesson, school-based, teacher led, universal body image programme that incorporates empirically supported principles of cognitive dissonance, self-compassion, compassion for others and social activism, to support positive body image development. Building on previous pilot trials in the USA, this paper outlines the protocol for a cluster randomised control trial (cRCT) and implementation evaluation of the BodyKind programme which was culturally adapted for the Irish cultural context.

METHODS

We aim to recruit 600 students aged 15-17 years in Transition Year (4th year) across 26 second-level schools in Ireland. Using minimisation, schools will be randomly assigned to receive BodyKind (intervention condition, n=300) or classes as usual (waitlist control, n=300). Teachers in intervention groups will receive training and deliver the programme to students over four weeks, at a rate of one lesson per week. Primary outcomes of body appreciation, body dissatisfaction and psychological wellbeing and secondary outcomes of self-compassion, compassion for others, body ideal internalisation, social justice motives and appearance-based social media use will be assessed at pre-, post- and 2 month follow up. Mediation and moderation analyses will be conducted to identify how and for whom the intervention works best. An implementation evaluation will assess the quality of programme implementation across schools and how this may influence intervention outcomes. Waitlist control schools will receive the programme after the 2-month follow up.

CONCLUSION

This study will be the first to implement a cRCT and an implementation evaluation to assess the impact of this multicomponent school-based body image programme designed to support healthy body image development. If shown to be effective, BodyKind will have the potential to improve adolescent body image and wellbeing and inform efforts to implement sustainable and scalable programmes in schools.

TRIAL REGISTRATION

The trial was retrospectively registered on 10/10/2023 on ClinicalTrials.gov NCT06076993 .

Toward Strengthening the Capacity of the Health System: A Cross-Sectional Study of Factors Predicting Quality of Life in 545 Nigerian Children Exposed to Sexual Abuse

In Nigeria, the predictors of quality of life among children exposed to sexual abuse are unknown. Addressing this gap may strengthen the capacity of the health system to care for this population. Thus, this cross-sectional study selected 545 (mean age = 14.4 ± 1.4 years) Nigerian children exposed to sexual abuse. Results show that self-compassion, resilience, and meaning in life jointly predicted quality of life and explained 39% variance. The independent prediction of each predictor variable shows that self-compassion, resilience, and meaning in life have significant independent predictions, with self-compassion showing the greatest independent prediction, followed by resilience and meaning in life. Sex, age, and how long ago respondents were exposed to sexual abuse jointly predicted quality of life and explained 6% variance. However, how long ago respondents were exposed to sexual abuse shows a significant independent prediction. Results offer clinical implications that may strengthen the capacity of the health system to care for this population.

Self-Compassion and Anxiety in Adolescents with and without Anxiety Disorder

Previous studies have linked self-compassion to mental health, specifically anxiety, in non-clinical adolescents, suggesting that self-compassion can be a protective factor against anxiety. This study compared the overall level of self-compassion and (un)compassionate self-responding in adolescents with and without an anxiety disorder and assessed the association between self-compassion and anxiety. This cross-sectional study included adolescents (12-19 years) with an anxiety disorder (N = 23) and a reference group (N = 28). Participants completed the Self-Compassion Scale (SCS) and State Trait Anxiety Inventory (STAI). Results showed that overall self-compassion and uncompassionate self-responding were significantly lower and higher in the clinical than the reference group, respectively, while compassionate self-responding did not differ between groups. In the clinical group, only uncompassionate self-responding was significantly associated with higher anxiety. In the reference group, uncompassionate self-responding showed a significant positive association with anxiety, and compassionate self-responding showed a significant negative association with anxiety. Although the results suggest that low uncompassionate self-responding may buffer against anxiety, the role of compassionate and uncompassionate self-responding remains unclear. An alternative explanation is that the uncompassionate self-responding items measure the presence of psychopathology in adolescents with an anxiety disorder. More research on the construct validity of the SCS uncompassionate self-responding scale is needed.

A classroom-based pilot of a self-compassion intervention to increase wellbeing in early adolescents

A Classroom-Based Pilot of a Self-Compassion Intervention to Increase Wellbeing in Early adolescents Abstract Objective:  Our first aim was to examine the effect of a 4-week self-compassion-based intervention on emotional well-being in a school classroom of early adolescents. The second aim was to evaluate feasibility and acceptability of the program within a classroom setting.  Design:  This study was a pre-post pilot design utilizing paired sample  t -tests to examine within-person changes in the outcome measures prior to, and following, the intervention. Bivariate correlations were also used to assess covariation between the pre-to-post change scores in self-compassion and the pre-to-post change scores in the outcome measures.

SETTING

 The intervention was conducted during a wellbeing class at a culturally diverse secondary school.

PARTICIPANTS

 The sample comprised 18 students aged 12- to 14-years old ( M age  = 12.44,  SD  = 0.61).  Intervention:  A brief self-compassion-based program, Be Kind to Yourself, Inspire Others, was developed specifically for early adolescents and delivered across four 70- minute lessons.

MAIN OUTCOME MEASURES

The outcome measures were self-compassion, resilience, perceived stress, social and general anxiety, and peer and school connectedness.

RESULTS

 Findings revealed significant increases in self-compassion, resilience, and peer connectedness, and significant decreases in social and general anxiety at posttest, with small to medium effect sizes (Hedges'  g =  0.30-0.67). No significant differences were found for perceived stress and school connectedness. Pre-to-post changes in self-compassion covaried with pre-to-post changes in resilience and peer connectedness. Feasibility and acceptability were high. Findings suggest that a brief, classroom-based self-compassion intervention may be feasible and effective in improving indicators of emotional well-being among early adolescents.

Warm and Harsh Parenting, Self-Kindness and Self-Judgment, and Well-Being: An Examination of Developmental Differences in a Large Sample of Adolescents

Objectives: This study aimed to examine the associations between warm and harsh parenting and adolescent well-being, and the mediating effects of self-kindness and self-judgment, in relationships. Moreover, this study investigated developmental differences across three adolescence stages (early, middle, and late). Methods: In total, 14,776 Chinese adolescents (mean age = 13.53 ± 2.08, 52.3% males), including individuals in early (10-12 years old, N = 5055), middle (13-15 years old, N = 6714), and late adolescence (16-18 years old, N = 3007) participated in this study. All the adolescents rated their levels of warm and harsh parenting, self-kindness and self-judgment, and well-being. Structural equation modeling (SEM) was adopted to examine the mediation model. Multi-group analysis was conducted to investigate differences in the mediation model across the different developmental stages. Results: Both warm and harsh parenting were related to adolescent well-being through the mediating effects of self-kindness and self-judgment. However, warm parenting exerted a more substantial impact on adolescent well-being. Self-kindness had a more robust mediating effect than self-judgment in relationships. Moreover, harsh parenting had a weaker impact on adolescent well-being in late adolescence than in early and middle adolescence. Warm parenting had a more significant impact on adolescent well-being in early adolescence than in middle and late adolescence. Conclusions: Overall, warm parenting had a more substantial effect than harsh parenting on adolescent well-being. The findings also highlighted the crucial mediating effect of self-kindness in the relationships between parenting and well-being. Moreover, this study also indicated the importance of warm parenting in early adolescence. Intervention programs should focus on enhancing the level of warm parenting to promote self-kindness in adolescents, in order to improve their well-being.

Self-Compassion: Theory, Method, Research, and Intervention

Self-compassion refers to being supportive toward oneself when experiencing suffering or pain-be it caused by personal mistakes and inadequacies or external life challenges. This review presents my theoretical model of self-compassion as comprised of six different elements: increased self-kindness, common humanity, and mindfulness as well as reduced self-judgment, isolation, and overidentification. It discusses the methodology of self-compassion research and reviews the increasingly large number of empirical studies that indicate self-compassion is a productive way of approaching distressing thoughts and emotions that engenders mental and physical well-being. It also reviews research that dispels common myths about self-compassion (e.g., that it is weak, selfish, self-indulgent or undermines motivation). Interventions designed to increase self-compassion, such as compassion-focused therapy and mindful self-compassion, are discussed. Finally, the review considers problematic issues in the field, such as the differential effects fallacy, and considers limitations and future research directions in the field of self-compassion research.

Characteristics of Mindfulness-Based Interventions in Schools: a Systematic Review in School Psychology Journals

Mindfulness-based interventions (MBIs) have been evaluated in terms of efficacy; however, little is known about implementation factors of MBIs in schools. The purpose of the current study was to systematically review MBI studies published in school psychology journals. This systematic review examined peer-reviewed MBI literature in nine school psychology journals from 2006 to 2020 to examine prevalence of MBI intervention studies, specific techniques taught in MBIs, if and how fidelity of MBI implementation was evaluated, and how mindfulness skills were measured for youth participating in MBIs. A total of 46 articles (out of 4415) were related to mindfulness and 23 articles (0.52%) focused on the implementation of MBIs in schools. Nine different mindfulness techniques were implemented as part of MBIs in studies with some of the most common including awareness, breathing, and meditation. This study also found scarce evidence of implementation fidelity, and limited use of mindfulness measures within MBI studies. Future research and limitations are also discussed.

Self-Compassion Correlates of Anxiety and Depression Symptoms in Youth: A Comparison of Two Self-Compassion Measures

BACKGROUND AND PURPOSE

Self-compassion is considered as a protective psychological construct that would shield against the development of emotional problems. The aim of the present study was to compare the 'protective nature' of two measures of self-compassion: the Self-Compassion Scale for Youth (SCS-Y) and the Sussex-Oxford Compassion for the Self Scale (SOCS-S).

METHODS

Eighty-seven adolescents aged 12 to 18 years completed both self-compassion measures as well as scales of anxiety and depression symptoms.

RESULTS

SCS-Y and SOCS-S scores were positively correlated, and for both measures it was generally found that higher levels of self-compassion were associated with lower levels of emotional symptoms. However, the uncompassionate self-responding scales of the SCS-Y correlated positively with anxiety and depression symptoms and hence can better be seen as indices of vulnerability. Regression analyses suggested that a positive attitude toward oneself, as measured by the self-kindness scale of the SCS or its SOCS-S equivalent 'feeling for the person suffering' is particularly relevant as a buffer against emotional problems.

CONCLUSION

The protective nature of self-compassion can be established by both measures. Caution is advised with the use of the uncompassionate self-responding scales included in the SCS-Y as they appear to measure vulnerability rather than protection.

Mobile Health-Supported Virtual Reality and Group Problem Management Plus: Protocol for a Cluster Randomized Trial Among Urban Refugee and Displaced Youth in Kampala, Uganda (Tushirikiane4MH, Supporting Each Other for Mental Health)

BACKGROUND

Although mental health challenges disproportionately affect people in humanitarian contexts, most refugee youth do not receive the mental health support needed. Uganda is the largest refugee-hosting nation in Africa, hosting over 1.58 million refugees in 2022, with more than 111,000 living in the city of Kampala. There is limited information about effective and feasible interventions to improve mental health outcomes and mental health literacy, and to reduce mental health stigma among urban refugee adolescents and youth in low- and middle-income countries (LMICs). Virtual reality (VR) is a promising approach to reduce stigma and improve mental health and coping, yet such interventions have not yet been tested in LMICs where most forcibly displaced people reside. Group Problem Management Plus (GPM+) is a scalable brief psychological transdiagnostic intervention for people experiencing a range of adversities, but has not been tested with adolescents and youth to date. Further, mobile health (mHealth) strategies have demonstrated promise in promoting mental health literacy.

OBJECTIVE

The aim of this study is to evaluate the feasibility and effectiveness of two youth-tailored mental health interventions (VR alone and VR combined with GMP+) in comparison with the standard of care in improving mental health outcomes among refugee and displaced youth aged 16-24 years in Kampala, Uganda.

METHODS

A three-arm cluster randomized controlled trial will be implemented across five informal settlements grouped into three sites, based on proximity, and randomized in a 1:1:1 design. Approximately 330 adolescents (110 per cluster) are enrolled and will be followed for approximately 16 weeks. Data will be collected at three time points: baseline enrollment, 8 weeks following enrollment, and 16 weeks after enrollment. Primary (depression) and secondary outcomes (mental health literacy, attitudes toward mental help-seeking, adaptive coping, mental health stigma, mental well-being, level of functioning) will be evaluated.

RESULTS

The study will be conducted in accordance with CONSORT (Consolidated Standards of Reporting Trials) guidelines. The study has received ethical approval from the University of Toronto (#40965; May 12, 2021), Mildmay Uganda Research Ethics Committee (MUREC-2021-41; June 24, 2021), and Uganda National Council for Science & Technology (SS1021ES; January 1, 2022). A qualitative formative phase was conducted using focus groups and in-depth, semistructured key informant interviews to understand contextual factors influencing mental well-being among urban refugee and displaced youth. Qualitative findings will inform the VR intervention, SMS text check-in messages, and the adaptation of GPM+. Intervention development was conducted in collaboration with refugee youth peer navigators. The trial launched in June 2022 and the final follow-up survey will be conducted in November 2022.

CONCLUSIONS

This study will contribute to the knowledge of youth-tailored mental health intervention strategies for urban refugee and displaced youth living in informal settlements in LMIC contexts. Findings will be shared in peer-reviewed publications, conference presentations, and with community dissemination.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05187689; https://clinicaltrials.gov/ct2/show/NCT05187689.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/42342.

Self-Compassion and Authentic-Durable Happiness During COVID-19 Pandemic: The Mediating Role of Meaning of Life and the Moderating Role of COVID-19 Burnout

BACKGROUNDS AND AIMS

Self-compassion is important for authentic-durable happiness, particularly during the COVID-19 pandemic. To better understand the potential complexity of effects, this study sought to explore (a) the mediating role of meaning of life in the association between self-compassion and authentic-durable happiness and (b) the moderating role of COVID-19 burnout in the relationship between self-compassion and meaning of life.

METHODS

We conducted a cross-sectional online survey study in China from February 1 to 14, 2021. Online survey questionnaire technique and convenience sampling method were used for data collection. Participants anonymously completed the measures of self-compassion scale short form, COVID-19 burnout scale, meaning in life questionnaire, and subjective authentic-durable happiness scale. The data were examined utilizing Pearson's r correlations and moderated mediation analysis.

RESULTS

This study included 1165 Chinese college students (Mage = 19.68 years, SD = 1.37). Self-compassion (M = 3.39, SD = 0.49) was significantly positively associated with authentic-durable happiness (M = 3.82, SD = 0.66) (r = 0.45, p < 0.001), and mediation analyses indicated that meaning of life (M = 4.65, SD = 0.86) partially mediated this association (indirect effect = 0.103, SE = 0.016, 95% CI = [0.073, 0.135]). Moderated mediation analysis further revealed that COVID-19 burnout (M = 1.87, SD = 0.72) buffered the relation between self-compassion and meaning of life (β = -0.05, p < 0.033).

DISCUSSION AND CONCLUSION

Findings of this study shed light on a correlation between self-compassion and authentic-durable happiness. In addition, this study underlines the importance of intervening in COVID-19 burnout among college students and enhancing the meaning of life in order to promote and safeguard authentic-durable happiness in the setting of COVID-19.

Bifactor exploratory structural equation modeling: A meta-analytic review of model fit

Multivariate behavioral research often focuses on latent constructs—such as motivation, self-concept, or wellbeing—that cannot be directly observed. Typically, these latent constructs are measured with items in standardized instruments. To test the factorial structure and multidimensionality of latent constructs in educational and psychological research, Morin et al. (2016a) proposed bifactor exploratory structural equation modeling (B-ESEM). This meta-analytic review (158 studies, k = 308, N = 778,624) aimed to estimate the extent to which B-ESEM model fit differs from other model representations, including confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), hierarchical CFA, hierarchical ESEM, and bifactor-CFA. The study domains included learning and instruction, motivation and emotion, self and identity, depression and wellbeing, and interpersonal relations. The meta-analyzed fit indices were the χ²/df ratio, the comparative fit index (CFI), the Tucker-Lewis index (TLI), the root mean square error of approximation (RMSEA), and the standardized root mean squared residual (SRMR). The findings of this meta-analytic review indicate that the B-ESEM model fit is superior to the fit of reference models. Furthermore, the results suggest that model fit is sensitive to sample size, item number, and the number of specific and general factors in a model.

Narcissistic traits and compassion: Embracing oneself while devoiding others

Grandiose narcissistic traits refer to exploitative and arrogant attitudes, while vulnerable narcissistic traits entail hypersensitivity to judgment and low self-esteem. Little is known about how individuals with narcissistic traits can improve their attitudes toward themselves and others. The current research puts self- and other compassion forward as possible targets to alleviate some of destructive patterns of narcissism. Generally, self-compassion (SC) has previously been associated with beneficial effects on psychological wellbeing, while other compassion (OC) is advantageous for interpersonal relationships. This study explored the relationship between narcissistic traits and the efficacy of experimental compassion inductions. Student and community participants (N = 230, M age = 27.41, 65.2% female) completed grandiose and vulnerable narcissistic trait, SC and OC state questionnaires, and either an SC or OC induction. It was expected that individuals with higher narcissistic traits (particularly grandiose traits) would benefit from the inductions and show higher SC after but would have greater difficulty showing meaningful increases in OC (especially OC directed at the general population). The results indicated that individual differences in grandiose and vulnerable narcissistic traits are related to the magnitude of improvements following the inductions: the theorized lack of SC in individuals with vulnerable oversensitivity to judgment traits seems possible to be counteracted through different types of compassion exercises. Moreover, higher grandiose exploitativeness-entitlement and global vulnerable narcissistic traits related to less increases than others. However, directly inducing OC in individuals with these traits was linked to greater OC improvements than improvements after inducing SC. Overall, the present findings suggest that self-compassionate behavior can be improved in individuals with high oversensitivity and that other compassionate behavior could potentially be increased if, specifically, other compassion exercises are utilized when higher levels of certain narcissistic traits are present.

The Spanish Version of the State Self-Compassion Scale-Long Form (SSCS-L): A Study of Its Validity and Reliability in a Sample of Nursing Students

BACKGROUND

In nurses, self-compassion mitigates the effects of stress, burnout and compassion fatigue, and enhances empathy, compassion and well-being and quality of life. The Self-Compassion Scale is the most-used instrument. The aim of this study is to validate the Spanish version of the new developed State Self-Compassion Scale-Long (SSCS-L).

METHODS

Students of the first year of the Nursing Degree were surveyed online. Together with the SSCS-L, their levels of positive and negative affect was reported. Analyses included descriptive statistics, competitive confirmatory factor analysis, evidence on criterion-related validity and estimates of reliability.

RESULTS

The best fitting model for the SSCS-L was the one hypothesizing six-correlated factors of self-compassion: self-kindness, common humanity, mindfulness, self-judgement, isolation, and over-identification. Positive relations between the positive dimensions of self-compassion and positive affect were found, whereas there were negative relations between the positive poles of self-compassion and negative affect. Estimates of reliability were adequate, except for the dimension of over-identification.

CONCLUSIONS

Self-compassion has become a key competency for nurses. The SSCS-L is an appropriate tool to allow an adequate assessment of self-compassion in experimental contexts.

The Correlation Between Self-Compassion and Life Satisfaction Varies Across Societal Individualism-Collectivism: A Three-Level Meta-Analysis

Self-compassion is positively correlated with life satisfaction. However, no previous work examined the cross-cultural difference regarding the effect size of this correlation. Using 79 independent samples ( N = 23,976) from 26 countries/regions, this three-level meta-analysis synthesized the effect sizes of their correlation, partitioned the between-study heterogeneity into the within- and between-country levels, and examined the moderating role of national culture according to the revised Minkov-Hofstede model. Results indicated that self-compassion was positively correlated with life satisfaction, with a moderate-to-large effect size (.40 ≤  r ≤ .47); 33.66% and 35.73% of the effect size variance could be attributed to the within-country and between-country heterogeneities; this correlation was stronger in samples collected from more individualistic societies. This study highlights that self-compassion may fit differently into different cultural realities and the importance of raising cultural awareness in future self-compassion research.

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

Background

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

Methods

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

Results

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

Conclusion

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

Self-Compassion Scale for Youth: Turkish Adaptation and Exploration of the Relationship with Resilience, Depression, and Well-being

Self-compassion refers to being kind, understanding, and accepting toward oneself in times of failure, frustration, or negative feelings. Since self-compassion is related to both physical and psychological well-being, measuring and understanding self-compassion in different populations carries importance for their mental well-being and life satisfaction outcomes. One such group is the youth, who experience unique developmental challenges. For this purpose, a Self-Compassion Scale for Youth (SCS-Y) was developed (Neff et al., 2021) and this paper presents its Turkish adaptation. The Turkish translation of SCS-Y was tested on a sample of Turkish youth (N = 450, 61.8% female, M _age= 13.09 ± 1.59, range = 11-15) and was found to have acceptable reliability. The scale showed a similar structure to the original testing on American youth with a bifactor model of a general self-compassion score and six subscale scores, and a two-bifactor model where negative and positive aspects are grouped together. Self-compassion was positively related to resilience and well-being, and negatively related to depression. A serial mediation analysis showed self-compassion to have a direct and positive effect on resilience, and to have an indirect effect on well-being mediated by resilience and depression. Given that the trainable skill of self-compassion is associated with higher resilience, lower depression, and better well-being, the value of this scale and its different adaptations becomes evident, as they enable measuring self-compassion in youth in various populations such as the present Turkish one and guiding the design of future interventions to increase self-compassion, targeted for the specific concerns of the youth.

Self-Compassion Moderates the Association Between Body Dissatisfaction and Suicidal Ideation in Adolescents: A Cross-Sectional Study

Identifying risk and protective factors for suicidal ideation during adolescence is essential for suicide prevention. One potential risk factor is body dissatisfaction which appears to peak during adolescence. The present study investigated the self-compassion buffering effects in the relationship between body dissatisfaction and suicidal ideation. A convenience sample comprising 580 adolescents (mean age 16.35 years; SD = .87; range 14-18 years) was recruited from public schools. The results indicated a strong positive association between body dissatisfaction and suicidal ideation (Cohen's f 2 = .25). The association was significantly moderated by the self-compassion (β =  - .16, SE = .04, p = .01, t  = 2.4.34, .95% CI [- .16, - .01]). Structural equation modeling analysis showed that the lack of self-kindness was associated with a moderate suicidal ideation level (Cohen's f 2 = .14). Also, higher levels of self-judgment predicted suicidal ideation with a moderate to large effect size (Cohen's f 2 = .28). The findings suggest that therapeutic programs designed to develop self-compassion should be implemented to reduce the risk of suicidal ideation among adolescents with body dissatisfaction. The findings empirically show that a higher degree of self-judgment is strongly associated with suicidal thoughts among adolescents, which must be systematically addressed in clinical studies on suicidal risk.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11469-021-00727-4.

Psychometric Validation of the Persian Self-Compassion Scale Youth Version

Objectives

Empirical research investigating self-compassion is a rapidly developing field, and it is potentially crucial in early adolescence. The primary aim of the present study was to psychometrically evaluate the Persian translation of the Self-Compassion Scale Youth version (SCS-Y) and evaluate its factor structure among young adolescents. The second aim was to explore the buffering effect of self-compassion against the negative effect of difficulties in emotion regulation on COVID-19-related anxiety.

Methods

A sample of young students (n = 532; mean age 13.57 years) completed an online survey, which included the SCS-Y, Patient Health Questionnaire, Difficulties In Emotion Regulation Scale, Coronavirus Anxiety Scale, Youth Life Orientation Test, Brief Resilience Scale, and Brief 10-Item Big Five Inventory. First-order (six-factor) confirmatory factor analysis (CFA) and bi-factor exploratory structural equation modeling (ESEM) analysis were used to evaluate the factor structure of the SCS-Y.

Results

Results showed that the SCS-Y had very good internal consistency (Cronbach's alpha coefficient: 0.88; McDonald's omega coefficient: 0.90), composite reliability (0.87), and adequate test-retest reliability after 4 weeks (0.60). The first-order (six-factor) CFA and bi-factor ESEM analysis demonstrated the SCS-Y had excellent dimensionality. Further analysis found negative associations between self-compassion with both depression and neuroticism, and positive associations between self-compassion with both resilience and optimism. Moreover, self-compassion moderated the association between emotion dysregulation and anxiety generated by the COVID-19. Overall, the findings indicated that the SCS-Y had acceptable criterion-related validity, convergent validity, and discriminant validity.

Conclusions

The findings provide evidence that the SCS-Y is a reliable and valid instrument for assessing the six factors of self-compassion among younger adolescents. Based on the study's findings, self-compassion appears to be a protective factor against mental health problems during the COVID-19 pandemic for younger adolescents.

Improving Mental Health Among Transgender Adolescents: Implementing Mindful Self-Compassion for Teens

The purpose of this study was to investigate the feasibility, acceptability, and preliminary outcomes of an online self-compassion intervention for transgender adolescents, with the aim of improving mental health. Participants identified as transgender or gender expansive, were between the ages of 13 and 17, and lived in the U.S. or Canada. The empirically-based self-compassion program, Mindful Self-Compassion for Teens (formerly Making Friends with Yourself) was implemented in eight 1.5 hour sessions on the Zoom platform by two trained instructors. Surveys were administered pre-, post-intervention, and at 3 months follow-up, and qualitative data were collected through end-of-program interviews and open-ended questions on the post-survey. All protocols were approved by the university IRB. Quantitative data analysis included repeated measures ANOVAs, and qualitative data were analyzed via both inductive and deductive methods. Results indicated that all but one psychosocial measure significantly improved from pre- to post-intervention, which then significantly improved at 3-month follow-up; most other improvements were maintained at follow-up. Four themes emerged from the qualitative data: virtual safe space; connection to body; personal growth; and recommended course changes and are discussed. Results suggest that self-compassion interventions can be incorporated into therapy programs to support and improve mental health for transgender adolescents.

The role of parenting, self-compassion and friendships in depressive symptoms among young people in the UK and China

Self-compassion, being kind to oneself in difficult times, is a way of relating to oneself that promotes better mental health, but little is known about how self-compassion affects interpersonal relationships. The current study examined the association between self-compassion and adolescent depressive symptoms from an interpersonal perspective in different cultural contexts. Adolescents (N = 422/570, Mean age = 14.44/13.41, UK/China) completed questionnaires about their perceptions of their parents' behaviour towards them, self-compassion, friendships and depressive symptoms. Structural equation modelling revealed that positive parenting was positively associated with higher self-compassion, positive friendship quality, and with fewer depressive symptoms in both samples. Additionally, we confirmed a negative association between self-compassion and depressive symptoms. The pathway from positive parenting to lower depressive symptoms via higher self-compassion was also corroborated in both cultures. Contrary to our hypothesis, positive quality of friendship was associated with higher depressive symptoms in both countries. Conflicts were associated with more depressive symptoms in the Chinese sample only. There was evidence of a negative association between self-compassion and conflicts in the Chinese sample only. Finally, the direct association between self-compassion and depressive symptoms was greater in the UK sample, whereas in the Chinese sample, interpersonal factors were more strongly associated with self-compassion and depressive symptoms. Our findings suggest that self-compassion may be a useful therapeutic target to improve social functioning and mental health among adolescents and that it may be necessary to account for cross-cultural differences in interpersonal factors when designing psychological interventions.

Emotion-focused group therapy among women with premenstrual dysphoric disorder: A randomized clinical trial

OBJECTIVE

Premenstrual Dysphoric Disorder (PMDD) contributes to couple burnout, reduced quality of life, sexual dysfunction, and social isolation. The present study aimed to investigate the effectiveness of emotion-focused group therapy (EFGT) in pain perception, self-compassion, sexual function, and couple burnout in women with PMDD. Method: Among married females with PMDD, 72 participants were selected and randomly assigned to experimental and waitlist control groups. EFGT was performed in 10 sessions for the subjects in the experimental groups. The McGill Pain Questionnaire, Self-Compassion Scale, Female Sexual Function Index and Couple Burnout Measure were used to collect data in the pre-test and post-test. To analyze the data, an analysis of covariance test was applied. Results: The findings demonstrated that EFGT was effective in pain perception (p < .001, η²=.80), self-compassion (p < .001, η²= .86), sexual function (p < .001, η²= .38), and couple burnout (p < .001, η²= .70). Participants of EFGT improved well, were satisfied with treatment, and had a good therapeutic relationship. Conclusion: Implementing EFGT increased the components of self-compassion and sexual function, and reduced the components of pain perception and couple burnout. It seems that EFGT could be effective in women with PMDD.

Self-compassion training for certified nurse assistants in nursing homes

BACKGROUND/OBJECTIVES

Certified nursing assistants (CNAs) who work in nursing homes (NHs) face significant work and personal stress. Self-compassion training has been shown to decrease stress postintervention in previous studies among healthcare providers and those in helping professions. This study examines the feasibility, acceptability, and preliminary outcomes of self-compassion training to address CNA stress and well-being.

DESIGN

Pre-post intervention.

SETTING

Three mid-size, nonprofit NHs in North Carolina.

PARTICIPANTS

Thirty CNAs, with a mean age of 49, 96% of whom were female, and 83% black/African American.

INTERVENTION

In one NH, participants received an 8-week, 2.5-h/session (20 h total) group intervention. At the time of recruitment for NHs 2 and 3, a briefer format (6-week, 1-h/session; 6 h total) became available and was preferred by CNAs, thus both NHs 2 and 3 participants received a 6-h group intervention. All interventions occurred in meeting rooms within participating NHs during shift changes.

MEASUREMENTS

Intervention attendance, retention, and acceptability; self-compassion, stress, burnout, depression, and attitudes toward residents with dementia, and job satisfaction pre-, post-, 3-month post-, and 6-month postintervention were assessed.

RESULTS

Attendance and program satisfaction were high, and attrition was low for both training formats. Self-compassion was significantly improved at all time periods (p < 0.001), and stress and depression improved significantly through 3 months (p < 0.05), but not 6 months. No statistically significant change in job satisfaction was noted.

CONCLUSION

Self-compassion interventions are feasible and acceptable for CNAs working in NHs and show promise for managing stress and improving well-being and compassion toward residents. The briefer 6-h format may maximize participation, while still providing benefits.

Parent Self-Compassion and Supportive Responses to Child Difficult Emotion: An Intergenerational Theoretical Model Rooted in Attachment

Self-compassion is an adaptive way of self-relating that entails tending to one's emotional pain with understanding and care. In this paper, we propose an intergenerational model explaining how self-compassion develops within the context of the parent-child relationship. Specifically, we posit that parents who have had supportive experiences with their own childhood caregivers develop a secure attachment and a high level of self-compassion. In turn, we propose that high self-compassion in parents promotes the parents' capacity to support their child when he or she experiences difficult emotions (e.g., anger, sadness). These responses promote the child's secure attachment, high self-compassion development and positive behavioral outcomes. A key area for future research is examining the potential link between parent self-compassion and responses to difficult emotions in the child. Given self-compassion can be enhanced through intervention, support for this model will have broad implications for interrupting intergenerational cycles of dysfunction caused by insecure attachment.