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The role of self-compassion in chronic illness care
Abstract
Objective: To present current research and theory on the potential of self-compassion as a clinical concept for improving health-related outcomes in chronic illness, and make recommendations for the application of self-compassion interventions in clinical care to improve well-being and facilitate self-management of health for this group.
Methods: Narrative review of the literature.
Results: Current theory indicates that the self-kindness, common humanity, and mindfulness components of self-compassion can foster adaptive responses to the perceived setbacks and shortcomings that people experience in the context of living with a chronic illness. Research on self-compassion in relation to health has been examined primarily within non-medical populations. Cross-sectional and experimental studies have demonstrated clear links between self-compassion and lower levels of both perceived stress and physiological indictors of stress. A growing evidence base also indicates that self-compassion is associated with more frequent practice of health-promoting behaviours in healthy populations. Research on self-compassion with chronic illness populations is limited, but has demonstrated cross-sectional links to adaptive coping, lower stress and distress, and the practice of important health behaviours. There are several interventions for increasing self-compassion in clinical settings, with limited data suggesting beneficial effects for clinical populations.
Conclusion: Self-compassion holds promise as an important quality to cultivate to enhance health-related outcomes in those with chronic health conditions. Further systematic and rigorous research evaluating the effectiveness of self-compassion interventions in chronic illness populations is warranted to fully understand the role of this quality for chronic illness care.
... Self-compassion training has recently emerged as a promising approach to help individuals cope with chronic physical health conditions (Sirois & Rowse, 2016). Selfcompassion refers to treating oneself in a kind and nonjudgmental way in the presence of suffering (Neff, 2003a). ...
... Existing cross-sectional research suggests that self-compassion is well suited to address both mental and physical health outcomes in chronic illness (Sirois & Rowse, 2016;Sirois et al., 2015;Terry & Leary, 2011). Trait self-compassion has been associated with better adjustment to chronic illness (Pinto-Gouveia et al., 2014;Sirois et al., 2015). ...
... Moreover, cross-sectional studies have found that higher trait self-compassion buffers the relation between negative beliefs about illness and anxiety among cancer patients (Gillanders et al., 2015) and is associated with better pain coping among those with persistent pain and obesity (Wren et al., 2012). Theories have proposed that self-compassion yields benefits because it is an effective way to regulate emotions and behaviors in those with chronic illness by promoting changes in affect, attention, and self-efficacy (Sirois, 2015;Sirois & Hirsch, 2019;Sirois & Rowse, 2016;Terry & Leary, 2011). ...
Objectives
Self-compassion interventions are increasingly used to address mental and physical health outcomes in individuals with chronic illness. This review integrates the available evidence to (1) determine the extent to which self-compassion interventions improve mental and physical health among adults with chronic illness, (2) investigate moderators of effect size, and (3) situate the current findings in the context of current practice of evidence-based approaches.Methods
Randomized and non-randomized clinical trials (RCTs) that evaluated self-compassion interventions among samples of adults with chronic illness (N = 21) were included in a meta-analysis that employed random effects models. Outcomes included depressive symptoms, anxiety symptoms, pain, quality of life, and self-compassion.ResultsOverall, the studies included in the review were of low quality. Findings provided evidence that self-compassion interventions improved all within-person outcomes from pre- to post-intervention. In addition, self-compassion interventions had small effects on improvement in self-compassion compared to controls. Initial results showed small effects on improvement in depressive symptoms compared to controls, which became nonsignificant after trim-and-fill analyses. Length of intervention was a moderator of within-subject depressive symptoms and type of control condition and age were moderators of within-subject self-compassion.Conclusions
Compared to current evidence-based approaches, self-compassion interventions have small effects on improved self-compassion in individuals with chronic illness. However, more rigorous RCTs that include follow-up assessments are needed prior to determining whether self-compassion interventions are an effective treatment for co-morbid mental and physical health challenges among adults with chronic illness.
... Some resources may always be beneficial and directly related to psychological functioning (regardless of the presence of stress), whereas others may be particularly important in stressful circumstances (so-called buffer effect). Mindfulness and self-compassion have been related to psychological well-being and can be regarded as personal resources (Keng et al. 2011;Macbeth and Gumley 2012;Sirois and Rowse 2016). As personal resources, they have the ability to influence (i.e., moderate) the way in which stressors are perceived and coped with. ...
... So far, several studies have shown that certain facets of mindfulness and self-compassion are more strongly associated with health outcomes than others (Bränström et al. 2011;Cash and Whittingham 2010;Christopher et al. 2012;Garland et al. 2013a;Körner et al. 2015;Pinto-Gouveia et al. 2014;Sirois and Rowse 2016). Evidence from intervention research is mixed regarding which facets are cultivated and most strongly related to improved outcomes (Bränström et al. 2010;Takahashi et al. 2019;Witek-Janusek et al. 2019). ...
... Our results add to the recent body of knowledge that the negative self-compassion factor is in general more strongly related to negative indicators of psychological functioning and the positive factor of selfcompassion to positive indicators (López et al. 2015;Muris and Petrocchi 2017). Regarding the six facets of self-compassion, depressive symptoms were significantly associated with higher levels of Isolation and reduced levels of Mindfulness which is in line with research among the general population (Körner et al. 2015), whereas for chronically ill patients, only the latter may foster adaptive responses to adverse events (Sirois and Rowse 2016). ...
Objectives
Mindfulness and self-compassion are related to psychological well-being and can be regarded as personal resources. It is, however, unclear whether these resources are always beneficial (direct effect) or only in stressful circumstances (buffer effect). We therefore examined whether mindfulness and self-compassion are equally or more strongly related to depressive symptoms and affect in cancer patients, compared to healthy controls.
Methods
Using a case-control design, 245 cancer patients were matched to 245 healthy controls (without chronic somatic comorbidities). Both groups filled out questionnaires concerning mindfulness (Five Facet Mindfulness Questionnaire), self-compassion (Self-Compassion Scale), depressive symptoms (Center for Epidemiologic Studies Depression Scale), and affect (Positive and Negative Affect Scale). Using correlation and regression analyses, we examined within both groups the associations for mindfulness (i.e., total score and five facets) and self-compassion (i.e., total score, two factors and six facets) with depressive symptoms and affect.
Results
Mindfulness and self-compassion were equally strongly related to depressive symptoms and affect in cancer patients versus healthy controls. Mindfulness facets Act with awareness and Non-judgment were strongly related to depressive symptoms, negative affect, and the negative self-compassion factor. In contrast, mindfulness facets Describe and Observe were strongly related to positive affect and the positive self-compassion factor. When distinguishing the six self-compassion facets, Isolation and Mindfulness were strongly related to depressive symptoms, Over-identification to negative affect, and Mindfulness to positive affect.
Conclusions
Results suggest that mindfulness and self-compassion are basic human personal resources associated with psychological functioning, regardless of the presence or absence of stressful life experiences.
... Summarising the associations this way also permitted a probing, through moderator analyses, of the contextual factors of health status (i.e., student, community adult, or medical sample), age and sex as suggested by the Cognitive Process Model [23], that might attenuate or amplify the magnitude of the proposed associations across different samples. Because research indicates that self-compassion may be particularly beneficial for health among individuals who have existing health problems [42], it was expected that the effects garnered from the chronic illness samples would be the largest relative to the community adult and student samples. The influence of sex and age on the associations of self-compassion with SRH were also examined in moderator analyses as both have been found to moderate the link between personality and health [23,43]. ...
... However, the subgroup analyses revealed that the type of sample, which was used as a proxy for health status, did not significantly affect the size of the associations garnered across samples. Previous research indicates that selfcompassion may be particularly beneficial for health among individuals who have chronic health problems [42]. However, as there were only 4 chronic illness samples included in the analyses, the current findings need to be interpreted with caution as subgroup analyses tend to become less reliable as the subgroup size becomes smaller [55]. ...
... Given this, such training programs might be especially important for individuals living with chronic health conditions to improve their subjective evaluations of their health. This in turn could foster greater engagement with health maintaining behaviours such as medical adherence, as well as self-care behaviours including managing stress, following appropriate dietary and exercise recommendations [42], all of which can contribute to improvements in objective health status and overall quality of life [63]. Although the unadjusted effects were small to moderate, and the adjusted effects were small in magnitude, even small increases in SRH as a result of self-compassion training can still be considered important when viewed from a public health perspective that highlights the benefits of small changes over large numbers of individuals [64]. ...
Background: Although there is growing evidence of the relevance of self-compassion for understanding health outcomes, few studies have examined self-compassion in relation to self-reported physical health status, also known as self-rated health (SRH). This study addressed this gap by examining the associations between self-compassion and SRH across multiple samples and after accounting for the contributions of positive and negative affect.
Methods: Data from 26 samples (total N = 6,127), comprised of 6 university student, 16 community adult, and 4 chronic illness samples, were included in the current analyses. Participants in each sample completed a survey including measures of self-compassion and SRH. Thirteen samples also completed a measure of positive and negative affect. The associations between self-compassion and SRH were statistically meta-analysed. Moderator analyses were conducted to test whether the associations varied as a function of sample type, age or participant sex. Semipartial correlations were calculated controlling for positive and negative affect in 13 samples and meta-analysed.
Results: Findings indicated that self-compassion was significantly associated with higher SRH across the 26 samples (ravg = .25; CI: .22, .28). The associations did not however vary significantly across samples, or as a function of participant sex or age. The meta-analyses of the adjusted effects found that self-compassion remained significantly associated with higher SRH after accounting the contributions of positive (sravg = .11; CI: .07, .15) and negative (sravg = .25; CI: .06, .15) affect.
Conclusions: The current study demonstrated that self-compassion is robustly associated with higher SRH across 26 samples and that this association remained significant after adjusting for the influence of positive and negative affect in 13 samples. this research Further longitudinal and experimental research is needed to verify the causal direction between self-compassion and SRH suggested by theory and the current findings.
... However, for individuals living with long-term conditions that require ongoing medical care and monitoring, engaging in health-promoting behaviours are especially important for the maintenance of health. Accordingly, it has been noted that self-compassion could be particularly beneficial for promoting the self-regulation of health behaviours in the context of chronic health conditions (Sirois and Rowse 2016). Consonant with this view, self-compassion may be beneficial for facilitating patient adherence to medical recommendations. ...
... Self-compassion includes a focus on mindful acceptance of personal failure and maintaining emotional balance rather than over-identifying with the negative feelings that arise from personal failures (Neff 2003b), such as lapses in self-care and disease management. In this respect, self-compassion may reduce not only the stress of the daily challenges of living with a long-term health condition, but also the collateral stress that can arise when attempts at self-care and following medical regimens fail (Sirois and Rowse 2016). ...
... Overall, our findings demonstrate that self-compassion is associated with better medical adherence among people with fibromyalgia, chronic fatigue syndrome, and cancer, due in part to lower stress. This research contributes to a growing evidence base indicating the value of self-compassion for health-related behaviours and outcomes in a variety of medical populations (Sirois and Rowse 2016). Further work is needed to gain a more nuanced perspective on how each of the components of self-compassion may be beneficial for adherence across different medical populations and doctorrecommended behaviours and to test other potential explanatory pathways beyond stress. ...
Emerging evidence indicates self-compassion can be beneficial for medical populations and for medical adherence, yet research to date has not fully examined the reasons for this association. This study examined the association of dispositional self-compassion to adherence across five medical samples, and tested the extent to which perceived stress accounted for this association. Five medical samples (total N = 709), including fibromyalgia, chronic fatigue syndrome, and cancer patients, recruited from various sources, completed online surveys. Self-compassion was positively associated with adherence in all five samples. A meta-analysis of the associations revealed a small average effect size (average r = .22, [.15, .29]) of self-compassion and adherence, and non-significant heterogeneity among the effects, Q (4) = 3.15, p = .532. A meta-analysis of the kappa2 values from the indirect effects of self-compassion on adherence, revealed that on average, 10 percent of the variance in medical adherence that was explained by self-compassion could be attributed to lower perceived stress. Overall, findings demonstrate that dispositional self-compassion is associated with better medical adherence among people with fibromyalgia, chronic fatigue syndrome, and cancer, due in part to lower stress. This research contributes to a growing evidence base indicating the value of self-compassion for health-related behaviours in a variety of medical populations.
... People also must cope with the emotional reactions related to their diagnosis along with any physical limitations (e.g., weakness; de Ridder et al., 2008). The experience of unpleasant emotions may prevent an individual from effectively monitoring their behavior (Luu et al., 2000) or may thwart effective self-regulation in other ways such as by promoting procrastination (Sirois & Rowse, 2016) and reducing goal directed behavior (Eben et al., 2020). For instance, individuals who were presented with estimates of their risk of a future heart attack and/or stroke reported feeling anxious and worried which negatively affected their ability to engage in health behaviors (Nolan et al., 2015). ...
... Research has shown that chronic disease management is not solely about focusing on health behavior engagement but also about managing the emotional outcomes of living with a chronic disease (Dekker & de Groot, 2018). Sirois and Rowse (2016) called for more systematic approaches to establish how SC could help individuals diagnosed with a chronic disease manage their health behaviors. ...
Objectives
Health behavior engagement reduces adverse events associated with chronic disease. Self-regulating health behaviors is challenging; individuals are further at a disadvantage due to the experience of unpleasant affective states after chronic disease diagnosis. Self-compassion (SC)—an orientation to care for oneself during challenging times—may reduce the experience of difficult affective states and facilitate health behavior self-regulation. This study’s aim was to systematically explore SC’s relationship with affective states, health behavior engagement, and self-regulation among individuals living with a chronic disease.
Methods
We conducted a scoping review from six databases. Eligible studies included adults diagnosed with cancer, diabetes, cardiovascular disease (CVD), or respiratory disease; utilized a SC intervention, prospective or cross-sectional design; were written in English; investigated affective states, health behaviors, and/or self-regulation; and used a validated SC scale.
Results
Thirty-seven articles (N = 7,141 participants) were included in the review. SC was positively associated with health behavior engagement and adaptive cognitive emotional regulation in all included chronic diseases (except respiratory disease). SC was negatively associated with unpleasant affective states in the context of all included chronic diseases. Preliminary results indicate SC interventions may lead to decreases in unpleasant affective states among individuals diagnosed with cancer, diabetes, and CVD. No research has examined SC and behavior self-regulation.
Conclusions
This review highlights the potential psychological and physical benefits of SC for individuals diagnosed with a chronic disease. More research is needed to understand the role of SC among individuals diagnosed with a chronic disease.
... Self-compassion has been associated with engagement in a variety of health-promoting behaviours in the general population (10,32), among people engaging in health risk behaviours, such as smoking (57), and among other chronic diseased populations (27,53). However, we identified only 3 studies (2 crosssectional and 1 qualitative) that assessed self-compassion and its association with engagement in health-promoting behaviours among people with diabetes (type 1, type 2 and gestational diabetes). ...
... The qualitative findings aligned with this because mindfulness and self-kindness helped participants acknowledge their need to improve their diet and exercise (15). Research in other populations has similarly shown that selfcompassion may help people engage in health-promoting behaviours by mitigating negative affective reactions that can undermine self-regulation (31,53) and by promoting a proactive health focus that allows people to do good for themselves. Indeed, people with high levels of self-compassion are motivated to improve their shortcomings (58). ...
Engaging in health-promoting behaviours has health benefits for people with prediabetes or diabetes. People experience negative affect after diagnoses which can impede self-regulation of health behaviours. Self-compassion, extending care to oneself in difficult times, can mitigate negative affect and promote self-regulation. This scoping review explored the relationship between self-compassion and adaptive affect, self-regulation and engagement in health-promoting/management behaviours among people with prediabetes or diabetes.
We conducted a scoping literature search from six databases for studies and conference abstracts. Randomized control trials, cross-sectional, longitudinal, observational and qualitative designs focused on self-compassion were included. Eligible studies included adults with diabetes (prediabetes, type 1, type 2 and gestational), measured self-compassion using a validated self-compassion scale (quantitative) or included the 3 components (qualitative) and investigated: negative affect, health promoting/management behaviours, and/or self-regulation.
After de-duplication, 5338 quantitative and 953 qualitative abstracts, and 18 conference proceedings were screened leaving 35 articles. Full-text screening retained 11 eligible studies (6 cross-sectional, 2 randomized control trials, 2 longitudinal, 1 qualitative). Higher self-compassion associated with decreased negative affect in nine studies and positively associated with well-being in one cross-sectional study. Self-compassion led to decreased negative affect and improved blood glucose in two interventions. Five studies found positive associations between self-compassion and health-promoting/management behaviours. One qualitative study found self-compassion to benefit affective reactions, health-promoting behaviours and self-regulation.
This review shows that self-compassion is linked to adaptive behavioural and affective responding among people with prediabetes and diabetes, as well as the need for more research on self-compassion and self-regulation in these populations.
... Recentemente a autocompaixão tem sido identificada como um processo fundamental na melhoria do bemestar e na redução do stress em pessoas com um diagnóstico de doença crónica (Sirois & Rowse, 2016). A autocompaixão engloba uma atitude de compreensão, calor e bondade para consigo mesmo, a capacidade de estar no momento presente, e o reconhecimento da humanidade comum da própria experiência (Neff, 2003). ...
... Os valores a negrito indicam a existência de significância estatística. depressão, ansiedade e stress (Leaviss & Uttley, 2014), promovendo o bem-estar e a diminuição dos níveis de stress em pessoas com doença crónica (Sirois & Rowse, 2016). De acrescentar que, para além da TFC se mostrar eficaz na redução de sintomas psicopatológicos, há a referir que um dos mecanismos associados a esta redução é precisamente o da diminuição dos níveis de autocriticismo (Cuppage et al., 2018). ...
Objetivo: O presente estudo, de carácter exploratório, teve como principal objetivo examinar o papel preditor de processos relacionados com a regulação emocional (fusão cognitiva, evitamento experiencial, autocompaixão e autojulgamento) e da vergonha associada à doença nos sintomas psicopatológicos de depressão, ansiedade e stress em pacientes com diagnóstico de doença celíaca. Método: Através de uma associação de pacientes, foram recrutados 67 sujeitos com diagnóstico de doença celíaca autorreportado, os quais completaram online um questionário sociodemográfico e clínico e um conjunto de instrumentos de autorresposta, mais precisamente as Escalas de Ansiedade, Depressão e Stress – 21 (EADS-21), o Cognitive Fusion Questionnaire – Chronic Illness (CFQ-CI), o Acceptance and Action Questionnaire-II (AAQ-II), a Self-Compassion Scale (SCS), e a Chronic Illness-related Shame Scale (CISS). O papel mediador dos processos relacionados com a regulação emocional e da vergonha associada à doença crónica foi analisado através do cálculo de regressões lineares múltiplas hierárquicas. Resultados: O índice compósito de autojulgamento (autocriticismo, isolamento e sobreidentificação) revelou-se como o único preditor significativo dos sintomas de depressão, ansiedade e stress em pessoas com doença celíaca. Conclusões: Nas intervenções psicológicas dirigidas a pacientes com doença celíaca a avaliação e integração do autojulgamento enquanto processo de regulação emocional poderá ser relevante para a obtenção de ganhos terapêuticos no que se refere aos sintomas emocionais negativos de depressão, ansiedade e stress.
... L'efficacité de la thérapie fondée sur la compassion (compassion-focused therapy, TFC) proposée par Gilbert [4], a été également très peu étudiée auprès de cette population. Pourtant, quelques travaux [5] ont montré les bienfaits de cette psychothérapie comportementale et cognitive (TCC) de dernière génération sur la gestion du stress et l'amélioration de la qualité de vie des patients porteurs de maladies chroniques. C'est à partir de ce constat que ces auteurs [6] ont récemment publié une étude comparative, contrôlée et randomisée auprès d'un échantillon de 34 sujets souffrants de céphalées de tension primaires. ...
... Dans le groupe TFC, 51 % de l'effet retrouvé sur la durée des céphalées serait imputable à la TFC, contre 35 % pour l'effet retrouvé sur l'intensité des céphalées. Ces résultats confirment et complètent ceux de travaux antérieurs [5,7,8]. Cependant, ils doivent être interprétés avec prudence en particulier devant la petite taille des deux échantillons, leur description trop succincte et l'absence d'évaluation en post-suivi. ...
... Taking a compassionate perspective toward oneself in response to adversity has been consistently associated with many and varied indicators of positive psychological functioning and mental health (MacBeth & Gumley, 2012;Zessin, Dickhäuser, & Garbade, 2015). Although less extensive, a growing literature suggests that the benefits of self-compassion may extend to better physical health (Friis, Consedine, & Johnson, 2015;Sirois & Rowse, 2016) and greater engagement in health-promoting behaviour (Rahimi-Ardabili, Reynolds, Vartanian, McLeod, & Zwar, 2018;Sirois & Hirsch, 2019;Sirois, Kitner, & Hirsch, 2015). To fully appreciate and appropriately apply self-compassion in the health context, there is a need to quantify, classify, and consolidate current knowledge of this research area. ...
... Compared to individuals with low self-compassion, highly self-compassionate individuals have reported better physical health in several areas, including physical fitness (Arts-de Jong et al., 2018), few symptoms of illness (Hall, Row, Wuensch, & Godley, 2013), low pain intensity (Allen, Gold- wasser, & Leary, 2012), and adaptive physiological responses to stress (Breines et al., 2014). Self-compassion may influence physical health by alleviating stress (Homan & Sirois, 2017) and by fostering resilience (Neff, Kirkpatrick, & Rude, 2007), adaptive coping (Allen & Leary, 2010), adaptive emotions ( Sirois et al., 2015), and health-promoting behaviour (Sirois & Rowse, 2016). Cognitive variables, like perceived stress, are important mediators of the relationship between self-compassion and physical health, but health behaviour arguably represents the most important mechanism because it has been identified as a stronger (Delahanty et al., 2013;Vingilis, Wade, & Seeley, 2002) and more proximal (Lodi-Smith et al., 2010;O'Leary, 1992) predictor of health outcomes. ...
This meta-analysis investigated relationships between self-compassion and 1) physical health and 2) health-promoting behaviour in a large pooled sample (N = 29,588) sourced from 94 peer-reviewed articles. As hypothesised, omnibus analyses revealed positive associations between self-compassion and both physical health (r = .18) and health behaviour (r = .26). Moderation analyses using 290 effects found that both associations varied according to health domain, participant age, intervention duration, and self-compassion measure. Self-compassion predicted outcomes in most health domains, with the strongest effects observed on global physical health, functional immunity, composite health behaviour, sleep, and danger avoidance. It did not predict frailty, maladaptive bodily routines, and substance abuse. Multi-session interventions designed to boost self-compassion predicted increased physical health and health behaviour, thereby supporting causal links between self-compassion and health outcomes. The effects of single-session inductions were non-significant. The mean effect of self-compassion on physical health was non-significant for young participants (12.00 to 19.99) and its effect on health behaviour was weakest among older participants (40.00+). Results support the proposition that self-compassion can promote better physical health. Practical implications of these findings are discussed.
... Vasta literatura tem vindo a enfatizar o papel da autocompaixão enquanto estratégia de regulação emocional particularmente útil, sublinhando o seu papel protetor na saúde mental (e.g., associando-se à diminuição dos sintomas psicopatológicos) e qualidade de vida, tanto em amostras de doentes crónicos (Pinto-Gouveia, Duarte, Matos, & Fráguas, 2013;Sirois & Hirsch, 2019;Sirois & Rowse, 2016) como em amostras da população geral (e.g., Körner et al., 2015;Neff, 2003b). A autocompaixão pode ser compreendida como a capacidade do indivíduo de ser compreensivo e caloroso relativamente a experiências e aspetos do eu percecionados como indesejáveis ou negativos, os quais são percecionados como parte da experiência humana comum e numa atitude mindful (Neff, 2003b). ...
... Por outro lado, a literatura parece demonstrar que menores níveis de autocompaixão constituem um fator de vulnerabilidade para o desenvolvimento e manutenção de sintomas psicopatológicos, nomeadamente de sintomatologia depressiva (e.g., Körner et al., 2015;Krieger, Altenstein, Baetting, Doering, & Holtforth, 2013). Ainda, em estudos com amostras de doentes crónicos, a autocompaixão é apontada como tendo um papel fundamental na promoção de comportamentos de saúde (Sirois & Hirsch, 2019;Sirois & Rowse, 2016). ...
Objetivo: O presente estudo teve como objetivo testar o potencial efeito mediador da autocompaixão e da ação comprometida na relação entre vergonha e sintomatologia depressiva, em pessoas sem e com diagnóstico de doença física crónica. Adicionalmente, foram exploradas as diferenças em relação a essas variáveis entre os dois grupos.
Métodos: A amostra foi constituída por 453 participantes (223 com e 230 sem diagnóstico de doença física crónica), os quais responderam numa plataforma online a um protocolo de medidas de autorrelato de vergonha, autocompaixão, ação comprometida e sintomas depressivos.
Resultados: Os participantes com diagnóstico de doença crónica apresentaram níveis significativamente (p < 0,05) superiores de vergonha e sintomatologia depressiva, e níveis inferiores de ação comprometida, comparativamente aos participantes sem doença física crónica. Contudo, não foram encontradas diferenças significativas entre os dois grupos relativamente às competências autocompassivas. As análises de correlação revelaram que a vergonha se associa negativamente à autocompaixão e ação comprometida e positivamente á sintomatologia depressiva, tanto no grupo sem como no grupo com diagnóstico de doença física crónica. Os resultados da path analysis indicaram que sentimentos de vergonha têm um impacto significativo, explicando 41% da variância da sintomatologia depressiva, parcialmente via menores níveis de autocompaixão e de ação comprometida. Os resultados da análise multigrupos demonstraram que o modelo testado é plausível nos dois grupos em estudo.
Conclusões: Este estudo parece fornecer importantes contributos para a compreensão do impacto protetor das competências autocompassivas e da adoção de ações comprometidas para a saúde mental, tanto para pessoas sem como com diagnóstico de doença física crónica. De facto, os resultados sugerem que estes processos de regulação emocional são importantes mecanismos mediadores da relação entre vergonha e sintomas depressivos. Finalmente, estes dados parecem suportar o desenvolvimento de abordagens mais eficazes para a promoção da saúde psicológica para pessoas sem e com doença crónica.
... Interestingly, this relationship was not found in controls, and therefore may be specific to people with epilepsy, PNES and/or other chronic illnesses, possibly because such individuals have a greater number of daily stressors to cope with. This provides support for the suggestion that the protective role of self-compassion is explained primarily by the set of coping strategies self-compassionate people use to deal with challenging circumstances (Sirois & Rowse, 2017). ...
... Our findings match those of previous studies which show that the presence of stress in other chronic illnesses (e.g. arthritis) is associated with low self-compassion (Sirois & Rowse, 2017;Sirois et al., 2015). Our correlational findings also match those from previous studies in patients with other chronic disorders. ...
Purpose. Self-compassion has been associated with a set of adaptive coping strategies, which in turn explain better adjustment in individuals with chronic illnesses such as inflammatory bowel disease and arthritis. The aim of this study was to investigate whether self-compassion is associated with adjustment in people with epilepsy (PWE) and people with psychogenic non-epileptic seizures (PWPNES). Adjustment was measured via coping efficacy, quality of life (QoL), anxiety, and depression.
Method. A cross-sectional questionnaire design was employed. PWE (N = 74), PWPNES (N
= 46), and controls (N = 89), recruited from outpatient seizure clinics and online, completed questionnaires about their self-compassion, coping efficacy, QoL, anxiety and depression levels.
Results. Overall, self-compassion was associated with adjustment in PWE and PWPNES.
Self-compassion was negatively related to anxiety and depression in PWE, PWPNES and
controls; and positively related to coping efficacy in PWE and PWPNES. Self-compassion
was also positively related to QoL in PWE and controls; however, this relationship was not
significant in PWPNES.
Conclusion. Self-compassion is associated with better adjustment in PWE and PWPNES.
Implications of these findings for psychotherapeutic interventions for individuals with seizure disorders and future research are discussed.
... Also, self-compassion has been associated with positive outcomes in these samples, such as well-being and QoL (Hughes et al., 2021;Kirby et al., 2017;MacBeth & Gumley, 2012). The development of self-compassion thus seems to be an important therapeutic goal to consider when intervening in chronic patient populations (Sirois & Rowse, 2016). ...
The current study aimed at examining the potential role of self-compassion and self-judgment components on depressive symptomatology and psychological health in people with a diagnosis of chronic physical disease. The sample included 223 participants with a diagnosis of chronic physical disease, aged between 18 and 45 years, who completed an online survey. The tested model showed an excellent fit to the empirical data and path analysis results indicated that mindfulness, self-judgment, and isolation have a significant impact on depressive symptomatology (explaining 40% of its variance) and also on psychological health (explaining 45% of its variance). This study shed some light on the role of both self-compassion and self-judgment components, suggesting the importance of the promotion of mindfulness skills and the reduction of self-judgment and feelings of isolation in people with chronic physical disease. These findings seem to support the development of more effective interventions for the promotion of psychological health and reduction of depressive symptoms in people diagnosed with a chronic physical disease.
... Self-compassion is associated with increased resilience and optimism and decreased perceived stress, through which nursing and medical students are protected from depressive disorders. Enhancing mindfulness and kindness toward oneself and others can cultivate and improve self-compassion [49]. Thus, arranging appropriate community activities in certain courses for students to offer help to people in need, as volunteers, may help develop their loving kindness for others and for themselves. ...
Background
Nursing and medical students are suffering from high rates of depressive symptoms. Mental health benefits students’ learning, growth and professional development. Exploring psychological resources to prevent depression is emphasized recently, and self-compassion is shown to be inversely associated with depressive symptoms. However, the mechanism through which self-compassion contributes to decreased depressive symptoms is limited. Therefore, this study aimed to explore and examine a model detailing the potential paths between self-compassion and depressive symptoms.
Methods
A cross-sectional study was conducted and convenient sampling was used. Among the 1800 nursing and medical students targeted from two universities in East and North China, 1341 completed the questionnaires, and 1127 valid questionnaires were analyzed comprising 566 and 561 from medical and nursing students, respectively. Data in May 2020 and July 2020 were collected through Patient Health Questionnaire, self-compassion scale, resilience scale, Life Orientation Test and Perceived Stress Scale. Then, path model analysis was conducted to analyze the data.
Results
Finally, this study included 1125 valid questionnaires after excluding two extremes of study variables. Participants consisted of 50.2% medical students and 49.8% nursing students. The model showed an acceptable fit to the data. After controlling for the demographics, self-compassion was directly and indirectly associated with decreased depressive symptoms by increasing resilience and optimism and reducing perceived stress among nursing and medical students. Resilience and optimism were directly and indirectly associated with decreased depressive symptoms by reducing perceived stress among nursing students and indirectly associated with decreased depressive symptoms among medical students.
Conclusions
The study provides evidence that self-compassion significantly influences the decrease in depressive symptoms by increasing resilience and optimism and reducing perceived stress. These findings suggested that programs enhancing students’ self-compassion, resilience, and optimism simultaneously can help decrease depressive symptoms and improve mental health in education and healthcare institutes. These findings may facilitate the designing of educational programs for preventing depressive symptoms and promoting mental health among nursing and medical students.
... Given that endometriosis is associated with an increased level of psychological distress and reduced quality of life (Sullivan-Myers et al., 2021), and that self-compassion has been proposed as a protective factor in chronic health issues (Sirois and Rowse, 2016), it may provide a potential treatment pathway for women with endometriosis. Terry and Leary (2011) theorized that self-compassion may function by enhancing emotion regulation, thereby facilitating a kinder and less reactive stance toward the self when facing the difficulties of illness. ...
Abstract
Study Question: What is the relationship between self-compassion, endometriosis-related symptoms, and psychological health in women with symptomatic endometriosis?
Summary Answer: Decreased self-compassion is associated with increased psychological distress, extended diagnostic delay, and varies according to individual endometriosis-symptom profile.
What is Known Already: Existing research indicates that endometriosis is associated with reduced psychological health and varied endometriosis-related symptom profiles. Examining the level of self-compassion reported by women with endometriosis is important as greater self-compassion has been found to improve psychological well-being in several chronic health populations.
Study Design, Size, Duration: This study utilised a cross-sectional survey design to explore the relationship between self-compassion, psychological health, and endometriosis-related symptoms (n=318).
Participants/Materials, Setting, Methods: Women with a self-reported diagnosis of endometriosis were recruited via online advertising through social media platforms. Demographic and endometriosis-specific information (e.g., disease stage, diagnostic delay, symptom experience) was collected in addition to psychological health and self-compassion. Psychological health was measured by the PROMIS Emotional Distress (PED) and Anxiety (PAS) short forms and the Patient Health Questionnaire (PHQ-15). Self-compassion was measured by the Self-Compassion Scale (26-item). Independent t-tests, bivariate correlations and linear regression analyses explored the relationship between specific endometriosis-related symptoms, psychological health, and self-compassion.
Main Results and the Role of Chance: Hierarchical multiple regression indicated that psychological symptoms accounted for the greatest variance in levels of self-compassion in the current sample. Depression and anxiety were found to be significant negative predictors of self-compassion. Notable symptoms that were significant in the final model were the presence of dysmenorrhea, lower back pain, dyspareunia, pain after sexual intercourse, fatigue, and nausea.
Limitations, Reasons for Caution: The cross-sectional nature of the findings prevents direct findings of causality. The information pertaining to endometriosis was self-report in nature and was not medically verified.
Wider Implications of the Findings: These preliminary findings indicate the importance of clinical interventions aimed at enhancing self-compassion and the importance of individual case conceptualisation and treatment planning based on endometriosis-related symptomatic profiles.
... Accordingly, studies show that experiencing positive emotions would not only increase thought-action repertoires (e.g., Fredrickson & Branigan, 2005), or undo lingering negative emotions (Fredrickson et al., 2000), but also increase psychological flexibility and personal resources (Tugade & Fredrickson, 2004), which would also be associated with better outcomes for patients with chronic physical health conditions (Pressman et al., 2019). Increased self-compassion through self-kindness, common humanity, and mindfulness is associated with higher levels of positive affect (e.g., Wren et al., 2012) and with the use of more adaptive and problem-focused coping techniques like seeking social support or using positive reframing (Allen & Leary, 2010), which can lead to better outcomes in CPHCs (Sirois & Rowse, 2016), including decreased stress. Individuals with high levels of self-compassion show more adaptive responses, which may include increased health-promoting behaviors (Sirois, 2014) such as controlling their diet, exercising, or attending regular check-ups, each one a potentially important part of managing a CPHC. ...
Background
Innovations in virtual reality (VR) technologies have improved the adaptability of its use in therapeutic settings, and VR has shown to be a promising treatment for fear of medical procedures, with research increasing in this area in recent years.
Purpose
This review aims to collate evidence for the impact of VR on fear of medical procedures.
Methods
CENTRAL (Cochrane), MEDLINE, EMBASE, and PsychINFO databases were searched up to October 2020. A mix of experimental and case–control studies were included for review, which evaluated the effectiveness of VR for fear, anxiety, and pain of medical procedures for people with needle phobia, dental phobia, claustrophobia of medical scans, and burn wound care anxiety. Risk of bias (RoB) was assessed by Cochrane and ROBINS-I tools.
Results
Twenty-eight studies were selected. Some studies included mixed participant groups of young people adults. The interventions varied, with VR used for distraction, hypnosis, or exposure. These were shown to be effective for reducing fear of medical procedures. However, effectiveness for blood-injection-injury phobias and burn wound care patients was unclear.
Conclusions
Evidence on the effectiveness of VR suggests that it does decrease fear of medical procedures in some situations. However, the RoB assessment illustrated a poor quality of studies across those included in this review, limiting the ability to draw firm general conclusions from the study findings. There is a need for further research exploring the use of VR technologies in the management of anxiety in physical health care settings.
... (Kremer et al., 2013). Other research on healthy behaviors (Sirois, 2015) and chronic diseases (Sirois & Rowse, 2016) have highlighted the importance of self-love in self-care behaviors. ...
Psychological factors are important for the prevention of disease. This study aims to identify the psychological perceptions of people who are ignoring the warnings of novel COVID-19 infection. A qualitative content analysis was carried out from May to July 2020. The interviewees were selected purposefully from Isfahan, Iran. The saturation point was achieved in 20 semi-structured interviews. The thematic analysis approach was used to analyze the transcribed documents using MAXQDA software (version 12).The results revealed 2 themes and 6 sub-themes related to the psychological beliefs of individuals with no attention to corona alerts. Themes and sub-themes included Biased cognitive processing (biased beliefs, attention biases, metacognitive beliefs and Depressogenic schemata), low compassion, and empathy for oneself and others (Negative Emotions towards Oneself, low altruism). To ensure a positive attitude towards precautionary measures in society, the thoughts, perceptions, and behaviors of people who ignore coronavirus alerts need to be changed. This is achieved through the use of mass media and virtual networks, by encouraging people to change their negative attitude towards the use of preventive measures, individual and social protection campaigns, and by fostering a sense of responsibility.
... MacBeth and Gumley 2012; Wood et al. 2010) and samples with chronic health conditions (e.g. Sirois and Rowse 2016;Sirois and Wood 2017). Such results highlight the importance of these constructs for mental health and wellbeing within a tinnitus sample, which has important implications for models of and treatments for tinnitus. ...
Objectives
There is evidence to suggest that mindfulness-based treatments are effective at reducing tinnitus distress by changing the way individuals respond to their tinnitus. Further research is required to assess the impact of factors associated with mindfulness-based treatments on tinnitus distress. This study examines whether dispositional mindfulness, gratitude and self-compassion are associated with psychological and tinnitus distress.Methods
In this cross-sectional study, 182 participants with tinnitus completed online questionnaires. Measures for dispositional mindfulness, gratitude, self-compassion, tinnitus distress, psychological distress and cognitions about tinnitus were completed.ResultsMore dispositional mindfulness, gratitude and self-compassion were associated with lower tinnitus distress and psychological distress. More negative cognitions and fewer positive cognitions about tinnitus were associated with more tinnitus and psychological distress.Conclusions
Dispositional mindfulness, gratitude and self-compassion are associated with the experience of distress in people with tinnitus. Future research should continue to explore the contribution of these qualities in developing a cognitive style that helps protect against distress, and whether interventions that enhance these qualities lead to better clinical outcomes.
... Self-compassion can foster adaptive coping and, therefore, resilience to illness-related stressors. Indeed, self-compassion was associated with health-promoting behaviours in one meta-analysis 116 , and some evidence suggests an association between self-compassion and lower levels of depression among populations with chronic illness, particularly cancer [127][128][129] . Similarly, psychological flexibility (the capacity to adapt to situational demands and shift perspectives) may protect from depression. ...
Depression is one of the most common comorbidities of many chronic medical diseases including cancer and cardiovascular, metabolic, inflammatory and neurological disorders. Indeed, the prevalence of depression in these patient groups is often substantially higher than in the general population, and depression accounts for a substantial part of the psychosocial burden of these disorders. Many factors can contribute to the occurrence of comorbid depression, such as shared genetic factors, converging biological pathways, social factors, health behaviours and psychological factors. Diagnosis of depression in patients with a medical disorder can be particularly challenging owing to symptomatic overlap. Although pharmacological and psychological treatments can be effective, adjustments may need to be made for patients with a comorbid medical disorder. In addition, symptoms or treatments of medical disorders may interfere with the treatment of depression. Conversely, symptoms of depression may decrease adherence to treatment of both disorders. Thus, comprehensive treatment plans are necessary to optimize care. Major depressive disorder is common in patients with medical diseases and accounts for a substantial part of the psychosocial burden of these diseases. This Primer discusses the epidemiology, mechanisms, diagnosis and treatment of comorbid depression in patients with medical diseases.
... Accordingly, studies show that experiencing positive emotions would not only increase thought-action repertoires (e.g., Fredrickson & Branigan, 2005), or undo lingering negative emotions (Fredrickson et al., 2000), but also increase psychological flexibility and personal resources (Tugade & Fredrickson, 2004), which would also be associated with better outcomes for patients with chronic physical health conditions (Pressman et al., 2019). Increased self-compassion through self-kindness, common humanity, and mindfulness is associated with higher levels of positive affect (e.g., Wren et al., 2012) and with the use of more adaptive and problem-focused coping techniques like seeking social support or using positive reframing (Allen & Leary, 2010), which can lead to better outcomes in CPHCs (Sirois & Rowse, 2016), including decreased stress. Individuals with high levels of self-compassion show more adaptive responses, which may include increased health-promoting behaviors (Sirois, 2014) such as controlling their diet, exercising, or attending regular check-ups, each one a potentially important part of managing a CPHC. ...
Self-compassion, defined as a mindful way of coping with pain and suffering by showing kindness, care, and concern towards the self, may improve psychological adjustment in people living with a chronic physical health condition (CPHC). Various studies illustrate that self-compassion is associated with positive outcomes in general. The aim of this systematic review is to establish the effect of compassion-related therapies on self-compassion specifically in people with CPHCs. Secondary aims are to; i) establish the effect on other psychological and physiological outcomes and; ii) explore the relative effectiveness of different therapy types among those identified. Cochrane, Embase, Medline, PsychInfo, and CINAHL databases were searched using “compassion” AND “chronic disease” AND “psychological outcomes” and their synonyms, from 2004 to March 2019. Eligible studies had an experimental design using a self-compassion scale with an adult population. Risk of bias (RoB) was assessed using the Cochrane RoB tool. Effect sizes were calculated for study outcomes. Fifteen studies, including a total of 1190 participants, seven different CPHCs, and eleven types of therapies, were included in the review. Nearly all included therapies significantly increased self-compassion with medium to large effect sizes, and reported positive outcomes, such as decreased depression. None of the therapy types appeared clearly superior to the others. Findings from this review show that included therapies increased self-compassion and improved various outcomes, which may represent clinically significant benefits for patients. However, there is a need to further understand how self-compassion exerts its benefits and determine the best methods to increase self-compassion.
... Although the role of self-compassion in improving the quality of life of other diseases such as celiac disease [31], cancer [32], HIV [33], persistent musculoskeletal pain [34] and chronic disease management [35] has been acknowledged, but as confirmed in cancer patients [18], religious implications can be added to increase the effectiveness of self-compassion intervention, especially in a country, such as Iran, with a religious cultural background. ...
Background Anxiety is one of the common psychological problems among infertile women, which affects their quality of life. The purpose of this study was to determine the effect of self-compassion intervention based on religious perspective on the anxiety and quality of life of infertile women.
Methods A qusai-experimental design with experimental and control groups was used. 24 women who lived in Maybod city, Iran, and were referred to Yazd reproductive sciences institute selected by available sampling and randomly assigned to experimental and control groups. The participants of experimental group received 8 sessions self-compassion focused intervention based on religious instructions and control group was put on the waiting list. Data were collected using Quality of Life Questionnaire in Infertile Couples Questionnaire (QOLICQ) and Beck anxiety inventory (BDI) in pretest and posttest phase and then analyzed using multivariate analysis covariance (MANCOVA).
Results The results showed as compared to control group at the post-test phase, the quality of life (p< .001) and anxiety (p< .001) of infertile women increased and decreased, respectively, in the experimental group.
Conclusion Infertility medical centers can use self-compassion intervention based on a religious approach as a complementary psychological intervention, alongside with medical interventions, to improve the quality of life and reduce anxiety in infertile women.
... Pinto-Gouveia et al., 2014) and are known to interfere with self-regulation (Gilbert et al., 2010;Gross, 2002) including engagement in health-promoting behaviors (Sirois, 2015b;Sirois and Hirsch, 2019). With these types of emotional reactions mitigated or managed, women who relate to themselves with self-compassion should be well positioned to deal with the stress of their health risk (Sirois and Rowse, 2016), to be proactive in managing their disease risk (Terry and Leary, 2011) and resilient in the face of the setbacks that accompany behavior change efforts (Biber and Ellis, 2019). Although self-compassion was associated with less emotional reactions, overall, the women in our sample reported relatively low levels of emotional reactions immediately after receiving the CVD risk information. ...
The aim of this study was to determine whether self-compassion—orientation to care for oneself during challenges—helps people at risk of cardiovascular disease deal with emotional reactions and assist with self-regulating health behaviors. This observational study recruited women ( N = 102) who attended three research visits over 3 weeks to gather information on emotions, intentions, and engagement in health behaviors after women received news they were at risk of cardiovascular disease. Self-compassion negatively associated with emotional responses and associated with intentions and engagement in health behaviors after receiving news of their cardiovascular disease risk. Self-compassion was associated with adaptive lifestyle behaviors.
... This has been demonstrated in a study of patients with IBD and arthritis, where self-compassion was found to predict adaptive coping, which in turn was associated with enhanced coping efficacy and reductions in perceived stress [55,56]. Additionally, self-compassion may play a role in quality of life in individuals with CMCs as it is associated with increased engagement in health-promoting behaviours [57]. ...
Background: Chronic medical conditions affect up to 35% of children and adolescents. Youth with chronic medical conditions are at an increased risk of psychological distress and reduced health-related quality of life, and report rates of mental illness up to double that of their physically healthy peers. Accessible, evidence-based interventions for young people with chronic illness are urgently required to improve their mental health and daily functioning.
Self-compassion shares strong associations with mental health outcomes among young people, and preliminary work indicates that interventions that build self-compassion have the potential to substantially improve the mental health of this high-risk group. Self-compassion involves taking a mindful, accepting approach to difficult experiences, being aware that one is not alone in one’s suffering, and being kind and understanding with oneself during challenging times. While face-to-face self-compassion training is available, there are several barriers to access for youth with chronic illness. Online self-compassion training offers an accessible alternative, with preliminary evidence indicating improvements in self-compassion, emotion regulation, and mental health.
Methods: Self-Compassion Online (SCO) is a self-compassion program that has been tested with a non-clinical adult group. For the proposed trial, a reference group of youth (16-25 years) with chronic medical conditions reviewed the program and proposed adaptations to improve its suitability for youth with chronic illness. In alignment with the SPIRIT Checklist, this paper outlines the protocol for a CONSORT-compliant, single-blind randomised controlled trial to test the efficacy of the adapted program, relative to a waitlist control, for improving mental health and quality of life among young Australians with chronic medical conditions. Mechanisms of action and feasibility of SCO will also be analysed using quantitative data and participant interviews, respectively. Finally, cost-utility will be analysed using health-related quality of life data.
Discussion: The SCO program for young people with chronic medical conditions could provide a scalable solution for improving mental health and quality of life among this sizeable population. The proposed trial will be the first to determine its efficacy for improving these outcomes, relative to waitlist control.
... Other studies conducted on cancer patients demonstrated that higher levels of self-compassion had significant relationships with lower depressive and stress symptoms (17)(18)(19), higher mental health and quality of life (18,19), and higher resilience to breast cancer (14). According to a literature review by Sirois and Rowse, self-compassion is in connection with adaptive coping, lower stress and distress, and the practice of important health behaviors in chronic illness populations (20). Arambasic et al. in their study concluded that self-compassion training may be useful for enhancing psychological adjustment in long-term breast cancer survivors (21). ...
W ostatnich dwudziestu latach widzimy znaczny wzrost zainteresowania współczuciem dla samego siebie (z ang. self-compassion) w wielu dziedzinach nauk, także w psychologii, pedagogice czy medycynie. Celem publikacji jest przedstawienie procesu polskiej adaptacji Skali Współczucia dla Samego Siebie (Self Compassion Scale) autorstwa Kristin Neff. Adaptacja przebiegła w dwóch etapach. Walidacja kulturowa skali polegała na tłumaczeniu skali na język angielski, a następnie tłumaczenia zwrotnego – z języka angielskiego na polski oraz zadbaniu o równoważność fasadową oraz funkcjonalną testu zgodnie z przyjętymi zasadami adaptacji kulturowej skal. Drugim etapem była walidacja psychometryczna skali w oparciu o przeprowadzone badania z udziałem 645 badanych z wykorzystaniem Skali Współczucia dla Samego Siebie (SCS- PL) oraz Metryczki uwzględniającej dane demograficzne badanych takie jak wiek, płeć, miejsce zamieszkania, wykształcenie oraz romantyczne związki. Przeprowadzone badania i uzyskane wyniki pozwalają stwierdzić, że polska wersja SCS jest wiarygodną i miarą samowspółczucia. SCS-PL uzyskała w badaniach zadowalające wyniki rzetelności i trafności. Skala może być stosowana do oceny współczucia wobec siebie oraz jego komponentów, zarówno w warunkach klinicznych jak i badawczych
Objective:
People affected by chronic skin conditions suffer from elevated levels of psychological distress. There is a need for evidence-based treatments that integrate medical care. Mindfulness and Self-compassion programs (MCBPs) have proven effective in chronic diseases. This systematic review aims to narratively synthesize the literature on mindfulness and self-compassion as traits and interventions in chronic skin conditions.
Design:
We searched four electronic databases for mindfulness and self-compassion trials and correlational studies in chronic skin conditions. We narratively synthetized results regarding the effects of mindfulness and self-compassion, both as traits and as interventions, on psychological and disease outcomes.
Results:
Thirteen studies were included in our review. Evidence from cross-sectional studies suggest that mindfulness and self-compassion are linked to lower psychological distress and better adjustment to the disease. MCBPs appear feasible for this population and can lower psychological distress, reduce disease severity and improve quality of life. Methodological issues limit conclusions on MCBP efficacy. Based on our analysis, we propose possible mechanisms that future research could explore.
Conclusions:
The integration of MCBPs in the care process of chronic skin conditions appears promising. Definitive conclusions cannot be drawn due to a lack of strong evidence. Further studies with high methodological standards are needed.
This study explores the relationship between self-compassion, or treating oneself with kindness and acceptance, using the Self-Compassion Scale, and health-promoting behaviors, using the Health-Promoting Lifestyle Profile II, among a community sample. Canonical correlation results indicate self-compassion and health-promoting behaviors share 76 percent of the variance within the data set. The positive components of self-compassion are strongly positively correlated with health-promoting behaviors, and the negative components of self-compassion are strongly negatively correlated with health-promoting behaviors. Hierarchical linear regression results indicate self-kindness and mindfulness are significant predictors of health-promoting behaviors after controlling for demographics.
Research suggests that maladaptive perfectionism impedes the development of self-compassion, a self-attitude with numerous biopsychosocial benefits. The precise relationship between these constructs remains unclear, but accurate modeling could foster an understanding of the barriers that perfectionists experience to self-compassion, enabling focused interventions to be developed. This study used structural equation modeling within a convenience-sampled, general, population (n = 428; X‾ age = 34.3 yrs, SD = 12.1) to analyze how multidimensional perfectionism related to multidimensional self-compassion. The maladaptive perfectionism dimensions (Concern over Mistakes; Discrepancy) predicted lower levels of self-compassion and its positive dimensions (Self-kindness; Common Humanity; Mindfulness). Adaptive perfectionism also predicted higher levels of Self-judgment. Findings were discussed theoretically, and their utility for developing population-tailored, dual-focused, interventions aimed at reducing perfectionism and increasing self-compassion was explored.
Prediabetes, a condition characterised by impaired glucose regulation, is on the rise worldwide. This condition puts people at risk for cardiovascular disease, and 50% of people with prediabetes will develop type 2 diabetes (T2D). People with prediabetes can reduce their risk of developing T2D through lifestyle changes such as regular physical activity and healthy eating. However, the experience of health risks can be associated with negative reactions that can undermine people's ability to self-regulate the health behaviours that would reduce such risk. Self-compassion, or treating oneself kindly in the face of challenge, is known to help people manage negative emotions and facilitate self-regulation. Therefore, self-compassion may be helpful for people with prediabetes who have to manage their health behaviours in the context of a health threat. The purpose of this study was to explore how people, from a small Canadian city who learn that they have prediabetes, react emotionally to their prediabetes diagnosis. We also explored participants' receptivity to applying self-compassion in the context of their prediabetes. Twenty-one adults, recently notified by their doctors as having HbA1c scores indicative of prediabetes (Mage = 57.76, SD = 5.43), engaged in a semi-structured interview between June 2017 and January 2018. Inductive thematic analysis was used to analyse the data and four themes emerged. Participants' reactions to learning that they had prediabetes were characterised by (a) distress and concern, (b) downplay of T2D risks, (c) guilt and shame, and participants were receptive to (d) self-compassion as a beneficial approach to take in relation to their prediabetes. Findings suggest that people experience negative reactions to their prediabetes diagnosis yet are receptive to self-compassion, which could mitigate these reactions. These findings can inform lifestyle behaviour change programmes for individuals living with prediabetes by providing a better understanding of their perspectives of disease diagnosis.
Recently, the Self-Compassion Scale (SCS) has been criticized for problems with psychometric validity. Further, the use of an overall self-compassion score that includes items representing the lack of self-compassion has been called into question. I argue that the SCS is consistent with my definition of self-compassion, which I see as a dynamic balance between the compassionate versus uncompassionate ways that individuals emotionally respond to pain and failure (with kindness or judgment), cognitively understand their predicament (as part of the human experience or as isolating), and pay attention to suffering (in a mindful or over-identified manner). A summary of new empirical evidence is provided using a bi-factor analysis, which indicates that at least 90 % of the reliable variance in SCS scores can be explained by an overall self-compassion factor in five different populations, justifying the use of a total scale score. Support for a six-factor structure to the SCS was also found; however, suggesting the scale can be used in a flexible manner depending on the interests of researchers. I also discuss the issue of whether a two-factor model of the SCS—which collapses self-kindness, common humanity, and mindfulness items into a “self-compassion” factor and self-judgment, isolation, and over-identification items into a “self-criticism” factor—makes theoretical sense. Finally, I present new data showing that self-compassion training increases scores on the positive SCS subscales and decreases scores on the negative subscales, supporting the idea that self-compassion represents more compassionate and fewer uncompassionate responses to suffering.
Objective: This study tested a Self-Regulation Resource Model (SRRM) of self-compassion and health-promoting behavior intentions in emerging adults. The SRRM posits that positive and negative affect in conjunction with health self-efficacy serve as valuable self-regulation resources to promote health behaviors.
Methods: An online survey was completed by 403 emerging adults recruited from the community and a Canadian University in late 2008. Multiple meditation analyses with bootstrapping controlling for demographics and current health behaviors tested the proposed explanatory role of the self-regulation resource variables (affect and self-efficacy) in linking self-compassion to health behavior intentions.
Results: Self-compassion was positively associated with intentions to engage in health-promoting behaviours. The multiple mediation model explained 23 percent of the variance in health behavior intentions, with significant indirect effects through health self-efficacy and low negative affect.
Conclusion: Interventions aimed at increasing self-compassion in emerging adults may help promote positive health behaviours, perhaps through increasing self-regulation resources.
A recent review suggested that self-compassion promotes use of adaptive rather than maladaptive coping. Less is known about how self-compassion is linked to stress and coping in the context of a chronic stressor. Across two primarily female chronic illness samples, inflammatory bowel disease (N = 155) and arthritis (N = 164), a model linking self-compassion to lower stress through coping styles and coping efficacy was tested. Path analyses revealed significant indirect effects for adaptive coping styles (active, positive reframing, and acceptance), and negatively for maladaptive coping styles (behavioral disengagement and self-blame) in both samples. Findings suggest that the relative balance of adaptive and maladaptive coping strategies used by self-compassionate people is associated with better coping outcomes in the context of chronic illness.
Objective: Emerging theory and research suggests that self-compassion promotes the practice of health behaviors, and implicates self-regulation as an explanatory factor. However, previous investigations focused only on behavior intentions or health risk behaviors, and did not investigate the role of emotions. This study expands on this research using a small scale meta-analysis approach with our own data sets to examine the associations of self-compassion with a set of health-promoting behaviors, and test the roles of high positive affect and low negative affect as potential explanatory mechanisms.
Methods: Fifteen independent samples (N = 3,252) with correlations of self-compassion with the frequency of self-reported health-promoting behaviors (eating habits, exercise, sleep behaviors, and stress management) were meta-analyzed. Eight of these samples completed measures of positive and negative affect.
Results: Self-compassion was positively associated with the practice of health-promoting behaviors across all fifteen samples. The meta-analysis revealed a small effect size (average r = .25; p < .001) of self-compassion and health behaviors, with low variability. Tests of the indirect effects of self-compassion on health behaviors through positive and negative affect with multiple mediator analyses revealed small effects for each. Separate meta-analyses of the indirect effects (IE) were significant for positive (average IE = .08; p < .001) and negative affect (average IE = .06; p < .001), and their combined indirect effects (average IE = .15; p < .0001).
Conclusions: Self-compassion may be an important quality to cultivate for promoting positive health behaviors, due in part to its association with adaptive emotions.
Problems of quality and safety persist in health systems worldwide. We conducted a large research programme to examine culture and behaviour in the English National Health Service (NHS).
Mixed-methods study involving collection and triangulation of data from multiple sources, including interviews, surveys, ethnographic case studies, board minutes and publicly available datasets. We narratively synthesised data across the studies to produce a holistic picture and in this paper present a high-level summary.
We found an almost universal desire to provide the best quality of care. We identified many 'bright spots' of excellent caring and practice and high-quality innovation across the NHS, but also considerable inconsistency. Consistent achievement of high-quality care was challenged by unclear goals, overlapping priorities that distracted attention, and compliance-oriented bureaucratised management. The institutional and regulatory environment was populated by multiple external bodies serving different but overlapping functions. Some organisations found it difficult to obtain valid insights into the quality of the care they provided. Poor organisational and information systems sometimes left staff struggling to deliver care effectively and disempowered them from initiating improvement. Good staff support and management were also highly variable, though they were fundamental to culture and were directly related to patient experience, safety and quality of care.
Our results highlight the importance of clear, challenging goals for high-quality care. Organisations need to put the patient at the centre of all they do, get smart intelligence, focus on improving organisational systems, and nurture caring cultures by ensuring that staff feel valued, respected, engaged and supported.
Shame and self-criticism are transdiagnostic problems. People who experience them may struggle to feel relieved, reassured or safe. Research suggests that a specialised affect regulation sys tem (or systems) underpins feelings of reassurance, safeness and well-being. It is believed to have evolved with attachment systems and, in particular, the ability to register and respond with calming and a sense of well-being to being cared for. In compassion-focused therapy it is hypothesised that this affect regulation system is poorly accessible in people with high shame and self-criticism, in whom the 'threat' affect regulation system dominates orientation to their inner and outer worlds. Compassion-focused therapy is an integrated and multimodal approach that draws from evolutionary, social, developmental and Buddhist psychology, and neuro science. One of its key concerns is to use compassionate mind training to help people develop and work with experiences of inner warmth, safeness and soothing, via compassion and self-compassion.
Although previous research has demonstrated that procrastinators experience high levels of stress, less is known about the internal sources of stress associated with this behavioural style. This study is the first to investigate low self-compassion as a source of procrastinators’ self-generated stress. Across four samples (145 undergraduates, 339, undergraduates, 190 undergraduates, and 94 community adults) trait procrastination was associated with low self-compassion and high stress. A meta-analysis of these effects revealed a moderately strong negative association of procrastination with self-compassion. In all four samples bootstrapping tests found that low self-compassion explained the stress associated with procrastination. These findings suggest that low self-compassion is a source of stress for procrastinators and interventions that promote self-compassion may be beneficial for these individuals.
Self-compassion—treating oneself with kindness, care, and concern in the face of negative life events—may promote the successful self-regulation of health-related behaviors. Self-compassion can promote self-regulation by lowering defensiveness, reducing the emotional states and self-blame that interfere with self-regulation, and increasing compliance with medical recommendations. Furthermore, because they cope better with stressful events, people high in self-compassion may be less depleted by illness and injury and, thus, have greater self-regulatory resources to devote to self-care. Framing medical problems and their treatment in ways that foster self-compassion may enhance people's ability to manage their health-related behavior and deal with medical problems.
Adjustment to chronic pain is examined within the context of a model that emphasizes goal-centered self-regulatory processing. Individual differences in adjustment to chronic illness have typically been examined from within the framework of stressful person–environment transactions. However, it may be useful to examine a broader array of person–environment transactions encountered in the context of working toward personal goals. Self-regulation may be especially challenging for people with chronic pain because of the link between pain and emotion. Consistent with this perspective, we will focus on the role of emotion as an energizing force in self-regulation and discuss the implications for managing pain. We will suggest that pain and concomitant negative emotion pervasively bias information processing, constrain the selection of goals, and the ongoing process of self-regulation.
It is unclear whether psychological stress contributes to the inflammatory process in the inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn's disease (CD). This review assesses the epidemiological evidence regarding a causal link between stress and gut inflammation in IBD.
A Medline search identified prospective studies of the effects of stress on subsequent disease activity and randomized controlled studies of the effects of psychological interventions on disease course in IBD. Controlled retrospective studies were included in the review of aspects of the stress-inflammatory relationship for which few prospective studies are available (e.g. the link between stress and disease onset). Studies were assessed qualitatively.
Among 9 longitudinal studies of stress or depression and disease course, a significant stress-inflammation relationship has been found when UC and CD are studied independently (4 of 4 studies positive) but studies of mixed samples of CD and UC have mostly had negative results (1 of 5 studies positive). Evidence of a contribution of stress to disease onset is very weak. The results of 5 studies of psychological interventions in IBD have been negative or modestly supportive of benefit. Confidence in therapeutic benefits of psychological interventions results is limited by methodological weaknesses in these studies.
There is consistent evidence for a contribution of psychological factors to IBD disease course, especially stress in UC and depressive symptoms in CD. More rigorous tests of psychological interventions in IBD are needed.
Two studies are presented to examine the relation of self-compassion to psychological health. Self-compassion entails being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical; perceiving one’s experiences as part of the larger human experience rather than seeing them as isolating; and holding painful thoughts and feelings in mindful awareness rather than over-identifying with them. Study 1 found that self-compassion (unlike self-esteem) helps buffer against anxiety when faced with an ego-threat in a laboratory setting. Self-compassion was also linked to connected versus separate language use when writing about weaknesses. Study 2 found that increases in self-compassion occurring over a one-month interval were associated with increased psychological well-being, and that therapist ratings of self-compassion were significantly correlated with self-reports of self-compassion. Self-compassion is a potentially important, measurable quality that offers a conceptual alternative to Western, more egocentric concepts of self-related processes and feelings.
S. C. Roesch and B. Weiner's (2001) theoretical model of adjustment to chronic illness was adapted to examine the role of attributions, avoidant coping strategies, and disease severity in the psychological adjustment of people with inflammatory bowel disease (IBD). RESEARCH METHOD AND DESIGN: People with IBD (N = 259) completed an online survey including measures of health-related self-blame and responsibility attributions, disease severity, avoidant coping strategies, and psychological adjustment indexes (coping efficacy, acceptance, and helplessness).
Structural equation modeling revealed that avoidant coping mediated the relationship between attributions and psychological adjustment. Attributions of self-blame were directly related to increased avoidant coping, which was in turn associated with poor adjustment. Beliefs about responsibility were associated with decreased use of avoidant coping strategies and subsequently improved psychological adjustment. Higher scores on disease severity were linked to the use of avoidant coping strategies and poor psychological adjustment.
Distinguishing between self-blame and responsibility attributions has important implications for understanding the psychological adjustment of individuals with IBD and may be useful for creating intervention strategies aimed at enhancing the psychological functioning of people with IBD.
Objective: Kindness-based meditation (KBM) is a rubric covering meditation techniques developed to elicit kindness in a conscious way. Some techniques, for example, loving-kindness meditation and compassion meditation, have been included in programs aimed at improving health and well-being. Our aim was to systematically review and meta-analyze the evidence available from randomized controlled trials (RCTs) comparing the effects of KBM on health and well-being against passive and active control groups in patients and the general population. Method: Searches were completed in March 2013. Two reviewers applied predetermined eligibility criteria (RCTs, peer-reviewed publications, theses or conference proceedings, adult participants, KBM interventions) and extracted the data. Meta-analyses used random-effects models. Results: Twenty-two studies were included. KBM was moderately effective in decreasing self-reported depression (standard mean difference [Hedges’s g] = −0.61, 95% confidence interval [CI] [−1.08, −0.14]) and increasing mindfulness (Hedges’s g = 0.63, 95% CI [0.22, 1.05]), compassion (Hedges’s g = 0.61, 95% CI [0.24, 0.99]) and self-compassion (Hedges’s g = 0.45, 95% CI [0.15, 0.75]) against passive controls. Positive emotions were increased (Hedges’s g = 0.42, 95% CI [0.10, 0.75]) against progressive relaxation. Exposure to KBM may initially be challenging for some people. Results were inconclusive for some outcomes, in particular against active controls. The methodological quality of the reports was low to moderate. Results suffered from imprecision due to wide CIs deriving from small studies. Conclusions: KBM showed evidence of benefits for the health of individuals and communities through its effects on well-being and social interaction. Further research including well-conducted large RCTs is warranted.
Emerging research suggests that procrastination may be an important epidemiological factor for understanding the development and management of not only acute but also chronic health issues, due in part to its links with stress and poor health behaviors. In this chapter, I present and review current evidence for the procrastination-health model and then outline a temporal extension of this model that can serve as a guiding conceptual lens from which to better understand how procrastination may create vulnerability for chronic illness. Temporal myopia is presented as a key concept that characterizes procrastination and contributes to a pattern of reacting and behaving that creates vulnerability for both short- and long-term health consequences. I then review evidence suggesting how these characteristic ways of responding can further compromise healthy adjustment and disease management in individuals already living with chronic disease, and the subsequent downstream effects on health and well-being. The chapter concludes with a discussion of potentially fruitful areas of research to better understand and address the long-term health consequences of chronic procrastination.
To test the hypothesis that self-compassion predicts better physical health and that this is partially mediated through health-promoting behaviours, 147 adults completed self-report measures of self-compassion, health-promoting behaviours and physical health. Self-compassion and health-promoting behaviours were negatively associated with physical symptom scores. Self-compassion was positively associated with health-promoting behaviours. A bootstrapped mediation model confirmed a significant direct effect of self-compassion on physical health through health-promoting behaviours (R(2) = 0.13, b = -8.98, p = 0.015), which was partially mediated through health-promoting behaviours (R(2) = 0.06, b = -3.16, 95 per cent confidence interval [-6.78, -0.86]). Findings underscore the potential health-promoting benefits of self-compassion.
Why do some people report more personal improvement from their regret experiences than others? Three studies examined whether self-compassion promotes personal improvement derived from recalled regret experiences. In Study 1, we coded anonymous regret descriptions posted on a blog website. People who spontaneously described their regret with greater self-compassion were also judged as having expressed more personal improvement. In Study 2, higher trait self-compassion predicted greater self-reported and observer-rated personal improvement derived from recalled regret experiences. In Study 3, people induced to take a self-compassionate perspective toward a recalled regret experience reported greater acceptance, forgiveness, and personal improvement. A multiple mediation analysis comparing acceptance and forgiveness showed self-compassion led to greater personal improvement, in part, through heightened acceptance. Furthermore, self-compassion's effects on personal improvement were distinct from self-esteem and were not explained by adaptive emotional responses. Overall, the results suggest that self-compassion spurs positive adjustment in the face of regrets.
Personality is an important epidemiological factor for understanding health outcomes. This study investigated the associations of trait procrastination with hypertension and cardiovascular disease (HT/CVD) and maladaptive coping by testing an extension of the procrastination-health model among individuals with and without HT/CVD. Individuals with self-reported HT/CVD (N = 182) and healthy controls (N = 564), from a community sample, completed an online survey including measures of personality, coping, and health outcomes. Logistic regression analysis controlling for demographic and higher order personality factors found that older age, lower education level and higher procrastination scores were associated with HT/CVD. Moderated mediation analyses with bootstrapping revealed that procrastination was more strongly associated with maladaptive coping behaviours in participants with HT/CVD than the healthy controls, and the indirect effects on stress through maladaptive coping were larger for the HT/CVD sample. Results suggest procrastination is a vulnerability factor for poor adjustment to and management of HT/CVD.
A growing body of research has revealed that social evaluative stressors trigger biological and psychological responses that in chronic forms have been linked to aging and disease. Recent research suggests that self-compassion may protect the self from typical defensive responses to evaluation. We investigated whether brief training in self-compassion moderated biopsychological responses to the Trier Social Stress Test (TSST) in women. Compared to attention (placebo) and no-training control conditions, brief self-compassion training diminished sympathetic (salivary alpha-amylase), cardiac parasympathetic, and subjective anxiety responses, though not HPA-axis (salivary cortisol) responses to the TSST. Self-compassion training also led to greater self-compassion under threat relative to the control groups. In that social stress pervades modern life, self-compassion represents a promising approach to diminishing its potentially negative psychological and biological effects.
We examined the hypothesis that self-compassion is associated with lower levels of stress-induced inflammation. On two consecutive days, plasma concentrations of interleukin-6 (IL-6) were assessed at baseline and at 30 and 120 minutes following exposure to a standardized laboratory stressor in a sample of 41 healthy young adults. Participants who were higher in self-compassion exhibited significantly lower day 1 IL-6 responses, even when controlling for self-esteem, depressive symptoms, demographic factors, and distress. Self-compassion was not related to day 2 IL-6 response but was inversely related to day 2 baseline IL-6 levels, and to increase in baseline IL-6 from day 1 to day 2. These findings suggest that self-compassion may serve as a protective factor against stress-induced inflammation and inflammation-related disease.
The relation of self-compassion to physical and psychological well-being was investigated among 182 college students. The self-compassion scale was delineated into three composites, following the proposition by Neff that self-compassion consists of three main components: self-judgment versus self-kindness (SJ-SK), a sense of isolation versus common humanity (I-CH), and over-identification versus mindfulness (OI-M). Findings support the association between self-compassion and psychological and physical well-being, but the composites demonstrate different influences. SJ-SK and I-CH were predictive of both depressive symptomatology and physical well-being, and SJ-SK and OI-M were predictive of managing life stressors. The results of this study support and expand prior research on self-compassion.
Both stressors and stress vulnerability factors together with immune and hypothalamus-pituitary-adrenal (HPA) axis activity components have been considered to contribute to disease fluctuations of chronic inflammatory diseases, such as rheumatoid arthritis (RA). The aim of the present study was to investigate whether daily stressors and worrying as stress vulnerability factor as well as immune and HPA axis activity markers predict short-term disease activity and symptom fluctuations in patients with RA.
In a prospective design, daily stressors, worrying, HPA axis (cortisol) and immune system (interleukin (IL)-1β, IL-6, IL-8, interferon (IFN)-γ, tumour necrosis factor α) markers, clinical and self-reported disease activity (disease activity score in 28 joints, RA disease activity index), and physical symptoms of pain and fatigue were monitored monthly during 6 months in 80 RA patients.
Multilevel modelling indicated that daily stressors predicted increased fatigue in the next month and that worrying predicted increased self-reported disease activity, swollen joint count and pain in the next month. In addition, specific cytokines of IL-1β and IFN-γ predicted increased fatigue 1 month later. Overall, relationships remained relatively unchanged after controlling for medication use, disease duration and demographic variables. No evidence was found for immune and HPA axis activity markers as mediators of the stress-disease relationship.
Daily stressors and the stress-vulnerability factor worrying predict indicators of the short-term course of RA disease activity and fatigue and pain, while specific cytokines predict short-term fluctuations of fatigue. These stress-related variables and immune markers seem to affect different aspects of disease activity or symptom fluctuations independently in RA.
Self-compassion is an adaptive way of relating to the self when considering personal inadequacies or difficult life circumstances. However, prior research has only examined self-compassion among adults. The current study examined self-compassion among adolescents (N = 235; Mage = 15.2) and included a sample of young adults as a comparison group (N = 287; Mage = 21.1). Results indicated that self-compassion was strongly associated with well-being among adolescents as well as adults. In addition, family and cognitive factors were identified as predictors of individual differences in self-compassion. Finally, self-compassion was found to partially mediate the link between family/cognitive factors and well-being. Findings suggest that self-compassion may be an effective intervention target for teens suffering from negative self-views.
This article defines and examines the construct of self-compassion. Self-compassion entails three main components: (a) self-kindness—being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical, (b) common humanity—perceiving one's experiences as part of the larger human experience rather than seeing them as separating and isolating, and (c) mindfulness—holding painful thoughts and feelings in balanced awareness rather than over-identifying with them. Self-compassion is an emotionally positive self-attitude that should protect against the negative consequences of self-judgment, isolation, and rumination (such as depression). Because of its non-evaluative and interconnected nature, it should also counter the tendencies towards narcissism, self-centeredness, and downward social comparison that have been associated with attempts to maintain self-esteem. The relation of self-compassion to other psychological constructs is examined, its links to psychological functioning are explored, and potential group differences in self-compassion are discussed.
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The importance of self-compassion in the context of medical problems has been highlighted in previous research. Its role in the psychological adjustment of cancer patients, however, has remained unexplored. The current study aimed at examining whether self-compassion and self-critical judgement would distinctively predict general psychopathological symptoms and quality of life in three distinct groups: a mixed sample of cancer patients (n = 63), patients with chronic illnesses (n = 68) and healthy subjects (n = 71). Correlation analyses revealed significant associations between lower self-compassion and increased depressive and stress symptoms, and lower scores in quality of life dimensions in the patients' samples. The opposite correlational pattern was found regarding self-critical judgement. In the case of healthy subjects, these correlations were weaker or nonsignificant. Regression analyses revealed that in patients with chronic illnesses, self-critical judgement emerged as the best predictor of depressive and stress symptoms, and quality of life dimensions. In patients with cancer, however, it was the affiliate dimension of self-compassion that was found to significantly predict lower levels of depressive and stress symptoms, and increased quality of life. These findings have important clinical implications by suggesting the relevance of nurturing a caring and kind relation with oneself in the face of challenging medical conditions, particularly in patients with cancer.
Key practitioner message:
The link between self-compassion and psychopathology and quality of life was examined in a mixed sample of cancer patients, in chronic patients, and in healthy subjects. Self-compassion is associated with decreased psychopathological symptoms of stress and depression, and better quality of life in patients with chronic illnesses, and especially in patients with cancer. Psychological supportive interventions targeting the development of self-compassionate attributes and skills may have beneficial effects in the psychological adjustment of medically ill patients, namely patients with cancer.
To test the hypothesis that self-compassion buffers people against the emotional impact of illness and is associated with medical adherence, 187 HIV-infected individuals completed a measure of self-compassion and answered questions about their emotional and behavioral reactions to living with HIV. Self-compassion was related to better adjustment, including lower stress, anxiety, and shame. Participants higher in self-compassion were more likely to disclose their HIV status to others and indicated that shame had less of an effect on their willingness to practice safe sex and seek medical care. In general, self-compassion was associated with notably more adaptive reactions to having HIV.
Background:
Bodily changes after breast cancer treatment can lead to long-term distress. Self-compassion, the ability to be kind to oneself, is an internal resource that may enhance a woman's ability to adjust to cancer-related bodily changes. The aim of the present study was to test the hypothesis that self-compassion mediates the relationship between body image and distress, controlling for alternate plausible mediators.
Methods:
Members of a nationwide breast cancer consumer network were invited to participate. A total of 279 women who had finished active cancer treatment completed the online survey. Assessments included the Body Image Scale; Self-compassion Scale; Depression, Anxiety and Stress Scale and items measuring perceived normative pressure and comfort with one's weight. Possible mediating effects of proposed variables on the body image-distress relationship were assessed.
Results:
Tests using a bootstrapping approach with multiple mediators were significant for self-compassion on distress. Body image disturbance was indirectly associated with distress through low self-compassion.
Conclusions:
Body image disturbance and lower self-compassion were associated with increased psychological distress among these breast cancer survivors. This study provides preliminary evidence for a mediating role of self-compassion between body image disturbance and psychological distress, suggesting a potentially protective effect of higher levels of self-compassion for women at risk of experiencing body image disturbance.
reviewed the evidence suggesting that control is not always desirable and discussed some implications of these findings for interventions in health care settings
factors that influence the effects of control / effort and attention / amount of control / lack of information / perferred coping styles / unsuccessful control attempts / disconfirmations of control / unresolved questions
preferences for no control
practical implications for health settings / the effects of failure / circumstances in which control is offered / individual preferences for control (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Objectives: The authors test hypotheses derived from current models of growth following adversity in a sample of people with tinnitus. These models assume a process whereby adversity or trauma threatens major assumptions, which, in turn, promotes a search for meaning in the adversity and subsequently growth. Method: Data from a sample of 315 people with tinnitus who completed an online survey were used to assess the relations of reports of negative changes to asking "Why me?" and answering the Why me? question with reports of growth, acceptance, and well-being. Results: indicate that reports of negative changes in goals and philosophy of life predict a search for meaning and that finding meaning is associated with perceived growth. Those who report never searching for meaning are less likely to report growth but report better adjustment and acceptance of their tinnitus than those who have searched for meaning. Discussion: The data are consistent with models of growth that give a central role to meaning-making processes, but they also suggest that a significant minority of people with tinnitus do not report searching for meaning or perceiving growth--yet appear to be coping well. Acceptance of tinnitus is identified as a key construct for future research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The aim of these two studies was to evaluate the effectiveness of the Mindful Self-Compassion (MSC) program, an 8-week workshop designed to train people to be more self-compassionate.
Study 1 was a pilot study that examined change scores in self-compassion, mindfulness, and various wellbeing outcomes among community adults (N = 21; mean [M] age = 51.26, 95% female). Study 2 was a randomized controlled trial that compared a treatment group (N = 25; M age = 51.21; 78% female) with a waitlist control group (N = 27; M age = 49.11; 82% female).
Study 1 found significant pre/post gains in self-compassion, mindfulness, and various wellbeing outcomes. Study 2 found that compared with the control group, intervention participants reported significantly larger increases in self-compassion, mindfulness, and wellbeing. Gains were maintained at 6-month and 1-year follow-ups.
The MSC program appears to be effective at enhancing self-compassion, mindfulness, and wellbeing.
Compassionate mind training (CMT) was developed for people with high shame and self-criticism, whose problems tend to be chronic, and who find self-warmth and self-acceptance difficult and/or frightening. This paper offers a short overview of the role of shame and self-criticism in psychological difficulties, the importance of considering different types of affect system (activating versus soothing) and the theory and therapy process of CMT. The paper explores patient acceptability, understanding, abilities to utilize and practice compassion focused processes and the effectiveness of CMT from an uncontrolled trial. Six patients attending a cognitive–behavioural-based day centre for chronic difficulties completed 12 two-hour sessions in compassionate mind training. They were advised that this was part of a research programme to look at the process and effectiveness of CMT and to become active collaborators, advising the researchers on what was helpful and what was not. Results showed significant reductions in depression, anxiety, self-criticism, shame, inferiority and submissive behaviour. There was also a significant increase in the participants' ability to be self-soothing and focus on feelings of warmth and reassurance for the self. Compassionate mind training may be a useful addition for some patients with chronic difficulties, especially those from traumatic backgrounds, who may lack a sense of inner warmth or abilities to be self-soothing. Copyright © 2006 John Wiley & Sons, Ltd.
This article focuses on the construct of self-compassion and how it differs from self-esteem. First, it discusses the fact that while self-esteem is related to psychological well-being, the pursuit of high self-esteem can be problematic. Next it presents another way to feel good about oneself: self-compassion. Self-compassion entails treating oneself with kindness, recognizing one’s shared humanity, and being mindful when considering negative aspects of oneself. Finally, this article suggests that self-compassion may offer similar mental health benefits as self-esteem, but with fewer downsides. Research is presented which shows that self-compassion provides greater emotional resilience and stability than self-esteem, but involves less self-evaluation, ego-defensiveness, and self-enhancement than self-esteem. Whereas self-esteem entails evaluating oneself positively and often involves the need to be special and above average, self-compassion does not entail self-evaluation or comparisons with others. Rather, it is a kind, connected, and clear-sighted way of relating to ourselves even in instances of failure, perceived inadequacy, and imperfection.
Can treating oneself with compassion after making a mistake increase self-improvement motivation? In four experiments, the authors examined the hypothesis that self-compassion motivates people to improve personal weaknesses, moral transgressions, and test performance. Participants in a self-compassion condition, compared to a self-esteem control condition and either no intervention or a positive distraction control condition, expressed greater incremental beliefs about a personal weakness (Experiment 1); reported greater motivation to make amends and avoid repeating a recent moral transgression (Experiment 2); spent more time studying for a difficult test following an initial failure (Experiment 3); exhibited a preference for upward social comparison after reflecting on a personal weakness (Experiment 4); and reported greater motivation to change the weakness (Experiment 4). These findings suggest that, somewhat paradoxically, taking an accepting approach to personal failure may make people more motivated to improve themselves.
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2012. The new recommendations are: (1) use of home blood pressure monitoring to confirm a diagnosis of white coat syndrome; (2) mineralocorticoid receptor antagonists may be used in selected patients with hypertension and systolic heart failure; (3) a history of atrial fibrillation in patients with hypertension should not be a factor in deciding to prescribe an angiotensin-receptor blocker for the treatment of hypertension; and (4) the blood pressure target for patients with nondiabetic chronic kidney disease has now been changed to < 140/90 mm Hg from < 130/80 mm Hg. We also reviewed the recent evidence on blood pressure targets for patients with hypertension and diabetes and continue to recommend a blood pressure target of less than 130/80 mm Hg.
There has been limited characterization of the burden of anxiety and depression, especially the former, among US adults with arthritis in the general population. The study objective was to estimate the prevalence and correlates of anxiety and depression among US adults with doctor-diagnosed arthritis.
The study sample comprised US adults ages ≥ 45 years with doctor-diagnosed arthritis (n = 1,793) from the Arthritis Conditions Health Effects Survey (a cross-sectional, population-based, random-digit-dialed telephone interview survey). Anxiety and depression were measured using separate and validated subscales of the Arthritis Impact Measurement Scales. Prevalence was estimated for the sample overall and stratified by subgroups. Associations between correlates and each condition were estimated with prevalence ratios and 95% confidence intervals using logistic regression models.
Anxiety was more common than depression (31% and 18%, respectively); overall, one-third of respondents reported at least 1 of the 2 conditions. Most (84%) of those with depression also had anxiety. Multivariable logistic regression modeling failed to identify a distinct profile of characteristics of those with anxiety and/or depression. Only half of the respondents with anxiety and/or depression had sought help for their mental health condition in the past year.
Despite the clinical focus on depression among people with arthritis, anxiety was almost twice as common as depression. Given their high prevalence, their profound impact on quality of life, and the range of effective treatments available, we encourage health care providers to screen all people with arthritis for both anxiety and depression.
Mindfulness-based meditation interventions have become increasingly popular in contemporary psychology. Other closely related meditation practices include loving-kindness meditation (LKM) and compassion meditation (CM), exercises oriented toward enhancing unconditional, positive emotional states of kindness and compassion. This article provides a review of the background, the techniques, and the empirical contemporary literature of LKM and CM. The literature suggests that LKM and CM are associated with an increase in positive affect and a decrease in negative affect. Preliminary findings from neuroendocrine studies indicate that CM may reduce stress-induced subjective distress and immune response. Neuroimaging studies suggest that LKM and CM may enhance activation of brain areas that are involved in emotional processing and empathy. Finally, preliminary intervention studies support application of these strategies in clinical populations. It is concluded that, when combined with empirically supported treatments, such as cognitive-behavioral therapy, LKM and CM may provide potentially useful strategies for targeting a variety of different psychological problems that involve interpersonal processes, such as depression, social anxiety, marital conflict, anger, and coping with the strains of long-term caregiving.
Chronic Fatigue Syndrome (CFS) is a highly disabling disorder that is part of a broader spectrum of chronic pain and fatigue disorders. Although the etiology and pathogenesis of CFS largely remain unclear, there is increasing evidence that CFS shares important pathophysiological disturbances with mood disorders in terms of disturbances in the stress response and the stress system. From a psycho-dynamic perspective, self-critical perfectionism and related personality factors are hypothesized to explain in part impairments of the stress response in both depression and CFS. Yet, although there is ample evidence that high levels of self-critical perfectionism are associated with stress generation and increased stress sensitivity in depression, evidence supporting this hypothesis in CFS is currently lacking. This study therefore set out to investigate the relationship between self-critical perfectionism, the active generation of stress, stress sensitivity, and levels of depression in a sample of 57 patients diagnosed with CFS using an ecological momentary assessment approach. Results showed, congruent with theoretical assumptions, that self-critical perfectionism was associated with the generation of daily hassles, which in turn predicted higher levels of depression. Moreover, multilevel analyses showed that self-critical perfectionism was related to increased stress sensitivity in CFS patients over a 14-day period, and that increased stress sensitivity in turn was related to increased levels of depression. The implications of these findings for future research and particularly for the development of psychodynamic treatment approaches of CFS and related conditions are discussed.
This pilot study examined loving-kindness meditation (LKM) with 18 participants with schizophrenia-spectrum disorders and significant negative symptoms. Findings indicate that the intervention was feasible and associated with decreased negative symptoms and increased positive emotions and psychological recovery.
Psychosocial factors are independently associated with increased risk of cardiovascular disease (CVD) morbidity and mortality, but the effects of psychosocial factor intervention on CVD are uncertain. We performed a randomized controlled clinical trial of cognitive behavioral therapy (CBT) to measure its effects on CVD recurrence.
The study included 362 women and men 75 years or younger who were discharged from the hospital after a coronary heart disease event within the past 12 months. Patients were randomized to receive traditional care (reference group, 170 patients) or traditional care plus a CBT program (intervention group, 192 patients), focused on stress management, with 20 two-hour sessions during 1 year. Median attendance at each CBT session was 85%. Outcome variables were all-cause mortality, hospital admission for recurrent CVD, and recurrent acute myocardial infarction.
During a mean 94 months of follow-up, the intervention group had a 41% lower rate of fatal and nonfatal first recurrent CVD events (hazard ratio [95% confidence interval], 0.59 [0.42-0.83]; P = .002), 45% fewer recurrent acute myocardial infarctions (0.55 [0.36-0.85]; P = .007), and a nonsignificant 28% lower all-cause mortality (0.72 [0.40-1.30]; P = .28) than the reference group after adjustment for other outcome-affecting variables. In the CBT group there was a strong dose-response effect between intervention group attendance and outcome. During the first 2 years of follow-up, there were no significant group differences in traditional risk factors.
A CBT intervention program decreases the risk of recurrent CVD and recurrent acute myocardial infarction. This may have implications for secondary preventive programs in patients with coronary heart disease. Trial Registration clinicaltrials.gov Identifier: NCT00888485.
Manipulated perceptions of the portion size of food influence subsequent eating by restrained and unrestrained eaters. In the present study, all participants were served a same-sized slice of pizza. For one-third of participants, their slice appeared larger than the slice being served to another ostensible participant, another third perceived their slice as smaller, and the final third did not see a second slice. All participants then proceeded to "taste and rate" cookies in an ad lib eating opportunity. A significant interaction reflected the fact that when the pizza slice was perceived as large, restrained eaters tended to eat more cookies whereas unrestrained eaters tended to eat less cookies. Emotion data suggest that the differential responses of restrained and unrestrained eaters to the belief that they have overeaten relative to another eater influenced their subsequent dissimilar ad lib eating behavior.
People who are high in self-compassion treat themselves with kindness and concern when they experience negative events. The present article examines the construct of self-compassion from the standpoint of research on coping in an effort to understand the ways in which people who are high in self-compassion cope with stressful events. Self-compassionate people tend to rely heavily on positive cognitive restructuring but do not appear to differ from less self-compassionate people in the degree to which they cope through problem-solving and distraction. Existing evidence does not show clear differences in the degree to which people who are low vs. high in self-compassion seek support as a coping strategy, but more research is needed.
The objective of this study was to examine the effectiveness of mindfulness-based stress reduction (MBSR) on depression, anxiety and psychological distress across populations with different chronic somatic diseases.
A systematic review and meta-analysis were performed to examine the effects of MBSR on depression, anxiety, and psychological distress. The influence of quality of studies on the effects of MBSR was analyzed.
Eight published, randomized controlled outcome studies were included. An overall effect size on depression of 0.26 was found, indicating a small effect of MBSR on depression. The effect size for anxiety was 0.47. However, quality of the studies was found to moderate this effect size. When the studies of lower quality were excluded, an effect size of 0.24 on anxiety was found. A small effect size (0.32) was also found for psychological distress.
It can be concluded that MBSR has small effects on depression, anxiety and psychological distress in people with chronic somatic diseases. Integrating MBSR in behavioral therapy may enhance the efficacy of mindfulness based interventions.
Evidence suggests that stressful experiences might affect diabetes, in terms of both its onset and its exacerbation. In this article, the authors review some of this evidence and consider ways in which stress might affect diabetes, both through physiological mechanisms and via behavior. They also discuss the implications of this for clinical practice and care.