Compassionate and self-image goals as interpersonal maintenance factors in clinical depression and anxiety

Time for you and for me: compassionate goals predict greater psychological well-being via the perception of time as nonzero-sum resources

An experience sampling survey showed that when people seek to support others' well-being in a given interaction, they experience greater life satisfaction, fulfillment of psychological needs, and lower time pressure through the perception that time spent on others is also time spent on themselves (i.e., nonzero-sum perception of time). In contrast, interpersonal goals to appear competent showed weaker positive indirect effects on psychological well-being, while goals to appear likable showed no significant indirect effects, and goals to avoid an undesirable self-image showed negative indirect effects. Spending time on others feels fulfilling rather than depleting when people have compassionate goals.

Concurrent Validity of PROMIS and LD-SRS Scores in Pediatric Patients With Lower Limb Differences

BACKGROUND

We sought to assess the concurrent validity of select Patient Reported Outcomes Measurement Information System (PROMIS) domains and Limb Deformity-Scoliosis Research Society (LD-SRS) scores.

METHODS

We prospectively administered PROMIS - 25 (including anxiety, depression, fatigue, pain interference, peer relationships, and physical function) and LD-SRS questionnaires to 46 consecutive pediatric patients with lower limb differences, presenting to a single surgeon for reconstruction. Concurrent validity between various subdomains of the 2 outcome measures was assessed through Pearson's correlation, with significance defined as P <0.05. The strength of correlation was interpreted by Evans criteria: absolute r value <0.20 indicating very weak correlation; 0.20 to 0.39, weak; 0.40 to 0.59, moderate; 0.60 to 0.79, strong; and 0.8 or greater indicating very strong correlation.

RESULTS

The LD-SRS Pain, Function, and Mental Health domains most strongly correlated with the PROMIS pain interference ( r =-0.79, P <0.001), physical function ( r =0.74, P <0.001), and anxiety ( r =-0.68, P <0.001) domains, respectively. In addition, LD-SRS pain strongly correlated with PROMIS physical function ( r =0.61, P <0.001) and LD-SRS function with PROMIS pain interference ( r =-0.72, P <0.001). All PROMIS domains significantly correlated with total LD-SRS scores. PROMIS pain interference ( r =-0.79, P <0.001), physical function ( r =0.67, P <0.001), and fatigue ( r =-0.60, P <0.001) domains demonstrated the strongest correlations with the total LD-SRS score.

CONCLUSIONS

The significant concurrent validity between LD-SRS and multiple PROMIS domains suggests considerable overlap, and perhaps redundancy, between these 2 outcome measures. Given the high degree of concordance and the advantage of computer adaptive testing (CAT) in mitigating administrative burden and survey fatigue, along with the ability to compare outcomes across a wider group of children with a variety of underlying diagnoses, select PROMIS domains may be a viable alternative to LD-SRS score for assessing patient-reported outcomes when treating pediatric patients with lower limb deformities. A larger, multi-center study including pediatric patients with lower limb differences from a diverse background, including age, etiology, native language, and ethnicity, would be helpful to externally validate our findings.

LEVEL OF EVIDENCE

Level-I.

Examining the Effects of a Brief, Fully Self-Guided Mindfulness Ecological Momentary Intervention on Empathy and Theory-of-Mind for Generalized Anxiety Disorder: Randomized Controlled Trial

BACKGROUND

The utility of brief mindfulness ecological momentary interventions (EMIs) to improve empathy and theory-of-mind has been underinvestigated, particularly in generalized anxiety disorder (GAD).

OBJECTIVE

In this randomized controlled trial, we aimed to examine the efficacy of a 14-day, fully self-guided, mindfulness EMI on the empathy and theory-of-mind domains for GAD.

METHODS

Adults (aged ≥18 y) diagnosed with GAD were randomized to a mindfulness EMI (68/110, 61.8%) or self-monitoring app (42/110, 38.2%) arm. They completed the Interpersonal Reactivity Index self-report empathy measure and theory-of-mind test (Bell-Lysaker Emotion Recognition Task) at prerandomization, postintervention, and 1-month follow-up (1MFU) time points. Hierarchical linear modeling was conducted with the intent-to-treat principle to determine prerandomization to postintervention (pre-post intervention) and prerandomization to 1MFU (pre-1MFU) changes, comparing the mindfulness EMI to self-monitoring.

RESULTS

Observed effects were generally stronger from pre-1MFU than from pre-post intervention time points. From pre-post intervention time points, the mindfulness EMI was more efficacious than the self-monitoring app on fantasy (the ability to imagine being in others' shoes; between-intervention effect size: Cohen d=0.26, P=.007; within-intervention effect size: Cohen d=0.22, P=.02 for the mindfulness EMI and Cohen d=-0.16, P=.10 for the self-monitoring app). From pre-1MFU time points, the mindfulness EMI, but not the self-monitoring app, improved theory-of-mind (a window into others' thoughts and intentions through abstract, propositional knowledge about their mental states, encompassing the ability to decipher social cues) and the fantasy, personal distress (stress when witnessing others' negative experiences), and perspective-taking (understanding others' perspective) empathy domains. The effect sizes were small to moderate (Cohen d=0.15-0.36; P<.001 to P=.01) for significant between-intervention effects from pre-1MFU time points. Furthermore, the within-intervention effect sizes for these significant outcomes were stronger for the mindfulness EMI (Cohen d=0.30-0.43; P<.001 to P=.03) than the self-monitoring app (Cohen d=-0.12 to 0.21; P=.001 to P>.99) from pre-1MFU time points. No between-intervention and within-intervention effects on empathic concern (feeling affection, compassion, and care when observing others in distress, primarily attending to their emotional well-being) were observed from pre-post intervention and pre-1MFU time points.

CONCLUSIONS

The brief mindfulness EMI improved specific domains of empathy (eg, fantasy, personal distress, and perspective-taking) and theory-of-mind with small to moderate effect sizes in persons with GAD. Higher-intensity, self-guided or coach-facilitated, multicomponent mindfulness EMIs targeting the optimization of social relationships are likely necessary to improve the empathic concern domain in this population.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04846777; https://clinicaltrials.gov/study/NCT04846777.

Motivation and empathic accuracy during conflict interactions in couples: it's complicated!

The aim of this study was to broadly investigate the role of relationship-, self-, and partner-serving motivation in empathic accuracy in couples' conflict interactions. To this end, a laboratory study was set up in which couples (n = 172) participated in a conflict interaction task, followed immediately by a video-review task during which they reported their own feelings and thoughts and inferred those of their partner to assess empathic accuracy. We used both trait and state measures of relationship-, self-, and partner-serving motivation, and we experimentally induced these three categories of motivation. Relationship-serving state motivation predicted greater empathic accuracy. In contrast, experimentally induced partner-serving motivation resulted in less empathic accuracy for men. Self-serving motivation was not found to be associated with empathic accuracy, nor were any of the trait measures. These findings underscore the complexity of the association between motivation and empathic accuracy in partners' conflict interactions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11031-022-09982-x.

Childhood Emotional Maltreatment and Romantic Relationships: The Role of Compassionate Goals

Past research indicates that childhood emotional maltreatment (CEM) undermines the quality of adult romantic relationships by fostering negative characteristics in survivors. Two longitudinal studies investigated the hypothesis that decreased compassionate goals toward partners over time explain the association between CEM and declining relationship quality. In Study 1, CEM predicted decreased compassionate goals over time, which in turn predicted decreased relationship quality in individuals in romantic relationships. Study 2 replicated this effect in romantically involved couples and showed that partners' high compassionate goals attenuated the decline in compassionate goals associated with reported CEM. These results point to the importance of examining how CEM may affect positive relationship processes and the protective roles of partners' compassionate goals.

Big five traits and interpersonal goals during stressors as predictors of hair cortisol

Background

Hair cortisol concentrations (HCC) provide a biomarker for stress adaptation, which has downstream health consequences. Personality traits (e.g., neuroticism) and social processes (e.g., chronic interpersonal goals) may confer risk or buffer against dysregulated cortisol secretion. However, few studies have examined personality or interpersonal factors predicting hair cortisol, which estimates longer-term secretion and therefore provides a potential biomarker for studying trait-like psychological processes. The present study investigated effects of personality traits and daily interpersonal goals during stressors on HCC.

Method

Participants (N = 90) reported Big Five traits at baseline, recorded interpersonal (self-image and compassionate) goals pursued during their worst psychosocial stressors for 4–5 weeks (1,949 entries), then provided a hair sample to estimate cortisol secretion over the past two months.

Results

As hypothesized, neuroticism predicted higher HCC, beyond other Big Five traits (b = 7.45, SE = 3.36, p = .029). Moreover, this effect was greater for those chronically striving to promote/protect one’s self-image during psychosocial stressors (b = 14.53, SE = 4.72, p = .003), and for those low in conscientiousness (b = 14.84, SE = 4.83, p = .003). Moderate extraversion was associated with higher HCC. Striving to support others (compassionate goals) exerted no direct or interactive effect on HCC, contrary to hypotheses.

Conclusions

Results support the relevance of neuroticism and maladaptive interpersonal strivings to longer-term neuroendocrine responses, suggesting hair cortisol as a potential method for studying links of trait-like psychological and HPA processes.

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Trait neuroticism uniquely predicted higher hair cortisol concentration.

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Interpersonal goals during chronic social stressors amplified effects of neuroticism.

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Trait conscientiousness blunted the effect of neuroticism on hair cortisol.

Disgust uniquely predicts coping and interpersonal processes beyond anxiety and dysphoria in the context of naturalistic stressors

BACKGROUND

Disgust is theorized to serve a unique function of motivating avoidance of noxious stimuli and setting interpersonal boundaries to prevent contamination. Research has established the relevance of disgust to OCD, posttraumatic stress, and phobias, suggesting transdiagnostic features. However, research has not always accounted for overlap of disgust with other negative emotions, obscuring unique contributions. Moreover, studies have not disentangled between-person (mean levels) and within-person (state) effects. The present study examined within- and between-person relationships of disgust, anxiety, and dysphoria with responses to daily social stressors. We expected disgust would uniquely predict cognitive avoidance and boundary-setting interpersonal behavior.

METHOD

Individuals (N = 159) meeting ADIS-V anxiety/depressive disorder criteria (n = 55) and healthy controls (n = 104) completed online journals about naturalistic social stressors over five weeks (1,923 records), reporting disgust, anxiety, dysphoria, and responses to social stressors.

RESULTS

As expected, disgust uniquely predicted lower acceptance, greater thought suppression, greater self-assertion, and less prosocial behavior, above and beyond anxiety and dysphoria. Several disgust effects were present at both between- and within-person levels, suggesting the relevance of both mean disgust and state fluctuations.

CONCLUSIONS

Results demonstrate unique relevance of disgust for how individuals respond to social stressors.

The Role of Compassionate and Self-Image Goals in Predicting Psychological Controlling and Facilitative Parenting Styles

People enter into parental roles with a range of different motivations for parenting. To date, however, there is limited research assessing maternal motivations, concerns, and anxieties in their parenting styles. While some mothers are confident and child focused, others have concerns with performing parenting behaviors, and can be self-focused, shame prone, and self-judgmental. Two studies explored these two dimensions in relation to degree of controlling and facilitative parenting styles in the mothers of 3-9-year-old children. In study one, 151 mothers took part in an online survey measuring these two dimensions using the compassionate goals and self-image goals scales (Crocker and Canevello, 2008), in relation to facilitative and controlling parenting styles. As predicted, after controlling for child behavior, parental mental health, and parental self-efficacy, self-focused and shame avoidant concerns were associated with greater psychologically controlling parenting. In contrast a compassionate focused orientation was associated with greater facilitative parenting. In study two, 198 mothers were randomly assigned to either compassion focused goals, self-image goals, or control condition, which was manipulated by varying the instructions provided to participants. Emotional responses (e.g., angry, sad, and shame) to difficult parenting scenarios did not differ depending on whether participants were prompted with compassionate goal, self-image goal, or control condition instructions. The findings from study 1 demonstrate how goal motivation can influence parenting style, with the results from study 2 suggesting that instruction alone is insufficient to shift goal orientation.

Compassionate Goals Predict Social Support and PTSD Symptoms Following a University Shooting: A Moderated Mediation Analysis

Introduction: Social support is known to buffer posttraumatic stress disorder (PTSD) symptoms, but the stress-buffering properties of striving to help and support others (compassionate goals) have received less attention. Recent research suggests that compassionate goals shape social support processes and dampen stress responses following social threat, but their relevance to trauma have not been examined. The present study tested whether, in the aftermath of a university mass shooting, compassionate goals concurrently and prospectively predicted lower PTSD symptoms indirectly via higher social support, and whether this mediation would be stronger with higher proximity to the trauma.

Method: Participants (N = 369) completed measures four months post-shooting (Time 1), and a subset (n = 85) repeated outcome variables at eight months (Time 2).

Results: As hypothesized, there was a significant moderated mediation, with trauma proximity moderating the indirect effect of compassionate goals on PTSD symptoms at Time 1 (B = −0.88, SE = 0.28, 95% CI [−1.47, −0.37]) and prospectively at Time 2 (B = −1.12, SE = 0.77, 95% CI [−3.16, −0.03]), although not when controlling for Time 1 symptoms. The indirect effects were greatest for those with higher trauma proximity, suggesting particular relevance for individuals most at risk for trauma-related difficulties.

Discussion: These findings suggest the need for further research into compassionate goals and strategies for fostering them, particularly in the context of social or community traumas.