Making Friends With Yourself: A Mixed Methods Pilot Study of a Mindful Self-Compassion Program for Adolescents

Exploring the Effects of Mindfulness on Adolescent Depression-Findings from a Longitudinal Study

Background/Objectives: Adolescence is a critical period for mental health, with depression increasing rapidly and often leading to lifelong consequences. In recent decades, the prevalence of elevated depressive symptoms among adolescents has steadily risen, making it a significant public health concern. While research supports the benefits of mindfulness-based practices in reducing adolescent depressive symptoms, the role of trait mindfulness remains underexplored. Although some studies suggest a link between trait mindfulness and lower depressive symptomatology, a longitudinal perspective could provide deeper insights into this relationship. Given adolescents' heightened vulnerability to mental health issues, understanding the potential causal link between trait mindfulness and depression is crucial for both prevention and intervention efforts. Methods: This study examines the relationship between mindfulness and depression in a three-wave longitudinal study of 1618 secondary school students (Males: N = 671, M = 16.4 years, SD = 0.60; Females: N = 947, M = 16.3 years, SD = 0.65) using a random intercept cross-lagged panel model. Results: Findings indicate that mindfulness and depression share a substantial proportion of variance (r = 0.48) at the stable trait level, suggesting that sustained attentional focus, a hallmark of mindfulness, is consistently associated with fewer depressive symptoms. At the within-person level, momentary deviations from stable mindfulness levels in the first and second waves were linked to lower depressive symptoms in subsequent waves (β = -0.21, p = 0.016; β = -0.44, p = 0.03, respectively). These findings suggest that even temporary increases in mindfulness may provide additional protection against depression. Conclusions: Overall, the results suggest that trait mindfulness is associated with a reduced risk of developing depressive symptoms at both the between-person and within-person levels. Specifically, adolescents with higher stable levels of mindfulness tend to report fewer depressive symptoms over time, and even momentary increases in mindfulness beyond an individual's typical level are linked to reductions in subsequent depressive symptoms. These findings highlight the potential of mindfulness-based interventions in mitigating adolescent depression and underscore the importance of cultivating mindfulness as a protective factor during this critical stage of development.

Internet-based group compassion-focused therapy for Swedish young people with stress, anxiety and depression: a pilot waitlist randomized controlled trial

Introduction

Compassion-focused therapy (CFT) has shown promising outcomes for young people, but research on CFT for this population remains limited. This study aims to evaluate the feasibility and acceptability of a seven-session, therapist-led, internet-based group CFT for young people, and to investigate its preliminary effects.

Methods

A two-arm pilot randomized controlled trial (RCT) was conducted. The study included 42 participants (aged 15-20), experiencing mild to moderate stress, anxiety, or depression, most of whom (90%) were female. In the intervention group, 22 participants were included in the intention-to-treat (ITT) analysis. The trial was registered at ClinicalTrials.gov (NCT05448014).

Results

The intervention group had low attrition and moderate attendance, with 77% completing four or more modules. No adverse events were reported, and participants generally expressed satisfaction with the intervention. Linear regression models showed preliminary between-group differences in two variables. Depressive symptoms increased post-intervention for individuals in the intervention group compared to the waitlist (WL) group (p = 0.002). Self-compassion improved in the intervention group (p = 0.023). These patterns were consistent among participants who completed more than two sessions. Within-group analyses indicated moderate, significant improvements in stress, self-compassion and compassion from others.

Discussion

These preliminary results suggest that CFT is feasible and acceptable and may offer benefits for young people, particularly by enhancing self-compassion and compassion for others. The observed increase in depressive symptoms in the intervention group, despite improvements in self-compassion, warrants further investigation. Larger studies are needed to confirm these preliminary results and to better understand the underlying mechanisms.

Exposure to Traumatic Events and Shame in Adolescent Surf Lifesavers: An Australian Perspective

Emergency service personnel experience high levels of psychological distress, with increasing evidence of associations with shame and trauma. Additionally, adolescence is a critical time in social and cognitive development, in which shame plays an important role. In Australia, adolescent volunteer surf lifesavers (SLS) are particularly vulnerable due to exposure to potentially traumatic experiences (PTEs) such as rescues and resuscitation of human lives. The aim of this study was to investigate the association between direct or indirect PTEs, and the relationship PTSS and shame may have in adolescent surf lifesavers. This cross-sectional study surveyed patrolling adolescent SLS, aged 13-17 years, recruited via internal communications and social media groups. Complete responses from patrolling adolescents (n = 118; 59% female; mean age 15.4 years) were used to determine exposure to PTEs across global, direct, and within SLS trauma domains. Associations between demographics, PTEs, post-traumatic stress symptoms (PTSS), with shame as a moderator were assessed for each trauma domain. PTEs and PTSS were positively associated across trauma domains. Shame was identified as a significant predictor of PTSS and as an important moderator of PTSS for experiences within SLSA, but not global or direct trauma. By exploring links between PTEs, PTSS, and shame, these findings contribute to the development of strategies and interventions for adolescents during stressful times. Responsiveness to adolescents via feedback and genuine, reassuring relationships that acknowledge the complexity of coping with stressful situations, may be potentially effective approaches to support coping with experiences of shame following PTE's in adolescent surf lifesavers.

Neural correlates of reduction in self-judgment after mindful self-compassion training: A pilot study with resting state fMRI

Self-judgment is a trans-diagnostic symptom among various psychological disorders, therefore can be a therapeutic target for many common psychiatric conditions. Self-judgment often arises among those who experienced childhood maltreatment, which increases the risk for developing comorbid psychiatric disorders that are resistant to traditional pharmacological and psychological interventions. Understanding the neural correlates of the therapeutic effect of behavioral interventions for reducing self-judgment is key for developing and refining evidence-based intervention programs. This single arm pilot study (N = 24) explored the neural correlates of reduction in self-judgment after an eight-week mindful self-compassion (MSC) intervention program for a sample of adult patients with either anxiety or depressive disorders, with 83 % having more than one diagnoses. The results demonstrated significant reduction of self-judgment after the intervention (p < 0.001, d = -1.04) along with increased self-compassion (p < 0.001, d =1.20); in particular, participants with above median score on the Childhood Trauma Questionnaire had significantly more improvement than those with below median scores (p < 0.05). Resting state fMRI was used to study neural correlates and showed that reduced self-judgment was associated with increased posterior cingulate cortex functional connectivity with dorsal lateral prefrontal cortex, inferior frontal gyrus, and dorsal medial prefrontal cortex, accompanied by reduced posterior cingulate cortex functional connectivity with the amygdala-hippocampal complex. These findings suggest reduced self-judgment after MSC training was substantiated by reduced fear circuitry influences on self-referential processes along with enhanced frontal regulation from the executive network and language network.

Starting well, staying well: randomised controlled trial of "Whitu - seven ways in seven days," a well-being app for university students

OBJECTIVES

Digitally native university students face challenges to their well-being and up to a third develop mental health problems. "Whitu: seven ways in seven days" is an app based on positive psychology, cognitive behaviour therapy (CBT) and psychoeducation principles.

METHODS

Ninety-first year university students (45 per arm) participated in a randomised controlled trial of Whitu against a university self-help website ("Be Well"). Primary outcomes were changes in well-being on the World Health Organisation 5-item well-being index (WHO-5) and the short Warwick-Edinburgh mental well-being scale (SWEMWBS). Secondary outcomes were changes in depression, anxiety, self-compassion, stress, sleep and self-reported acceptability of the app.

RESULTS

At 4 weeks (primary endpoint), participants in the intervention group experienced significantly higher mental well-being (mean difference: 2.53 (95%CI: 0.53, 4.52); p = 0.013) and significantly lower depression (-4.23 (-8.32, -0.15); p = 0.042), compared to controls. Emotional well-being was greater in the intervention group at 3 months (12.23 (3.93, 20.54; p = 0.004). Other outcomes were similar between groups. User feedback was positive, with 88% saying they would recommend the app to a friend.

CONCLUSIONS

Whitu is an acceptable, effective, scalable and multi-modal means of improving some aspects of well-being and mental health among university students.

TRIAL REGISTRATION

This study was registered with the Australian New Zealand Clinical Trials Network Registry: ACTRN12622000053729.

Bidirectional relationship between self-compassion and psychological richness: A two-wave longitudinal study

Previous research has found that self-compassion enhances well-being outcomes such as happiness and meaning in life. However, little is known about the link between self-compassion and psychological richness, a recently introduced concept of well-being. Thus, an exploration of the relationship between self-compassion and psychological richness is necessary to gain a comprehensive understanding of the association between self-compassion and well-being. To address this issue, this study investigated the temporal directionality of their relationship within a cohort of Chinese college students, utilizing a two-wave longitudinal approach. Using a cross-lagged model, the results revealed that the self-compassion could predict psychological richness 3 months later, and conversely, psychological richness could also predict subsequent self-compassion. This research provides new insights into the bidirectional relationship between self-compassion and psychological richness, broadening our understanding of the association between self-compassion and well-being. Future interventions should focus on the important effect of self-compassion interventions in the development of psychological richness. In addition, future research could consider interventions on increasing psychological richness to improve the level of self-compassion among college students.

Interventions to modify the habituation of biological responses to repeated stress in healthy adults: a randomized controlled trial

BACKGROUND

Changes in response patterns of biological stress systems, including responses of the sympathetic nervous system (SNS) and the hypothalamus-pituitary-adrenal (HPA) axis to repeated stress, can promote the development and progression of chronic diseases via changes in downstream inflammatory processes. The aim of this project is thus to investigate, whether habituation of biological stress system activity including responses of the inflammatory system can be modified. Aiming to test for possible paths of action, a randomized controlled study with two intervention programs designed to manipulate cognitive coping strategies will be carried out. By increasing either ruminative or self-compassionate thoughts among healthy young adults, the intervention programs are expected to affect the regulation of occurring emotions as expressed by the responsiveness of biological systems during repeated stress exposure.

METHODS

In this study, a total of 120 healthy adults will complete the Trier Social Stress Test (TSST) on two consecutive days. Immediately after the first stress induction, participants will be randomly assigned to two experimental conditions designed to manipulate cognitive coping strategies (rumination vs. self-compassion) or a control condition. Measures of HPA axis (salivary cortisol) and autonomic activity (salivary alpha amylase, heart rate, heart rate variability) as well as inflammatory markers (plasma interleukin(IL)-6, expression rates of pro- and anti-inflammatory cytokine genes) will be repeatedly assessed throughout the experimental sessions. Response and habituation indices of these measures will be calculated and compared between the experimental conditions and the control condition.

DISCUSSION

The results should provide insight into whether modifying response patterns of biological stress systems could reverse a significant biological mechanism in the development of stress-related diseases.

TRIAL REGISTRATION

German Clinical Trials Register (DKRS), DRKS00034790. Registered on August 12, 2024,  https://www.drks.de/DRKS00034790 .

Strategies to overcome mental health stigma: Insights and recommendations from young people with major depressive disorder (MDD)

BACKGROUND

Young people with depression are met with stigma related to their mental health, which exacerbates loneliness, social isolation, and depression symptoms. While disclosing depression could improve one's mental health, stigma can also make social interactions more challenging and reduce the likelihood of receiving treatment. This research explored young people's experiences with stigma and recommendations for addressing it.

METHODS

Semi-structured interviews conducted with N = 35 young people aged 18-25 years (Mage = 20.09) were analyzed with thematic analysis. Participants met the criteria for clinical depression using the Mood and Feelings Questionnaire (score >27) or had recently obtained a medical diagnosis (N = 18) of depression by a medical professional.

RESULTS

Participants faced stigma when deciding to disclose their depression, which fed into a vicious cycle influencing feelings of loneliness, social isolation, and withdrawal. Their recommendations for others to avoid this cycle can be summarized under three main themes: (1) Social affirmation: identify allies and build meaningful connections; (2) Self-affirmation: build a constructive relationship with the self; and (3) Societal affirmation: structural changes are needed.

CONCLUSIONS

The current research indicates that social, self-, and societal affirmation are considered important for reducing the detrimental impacts of stigma. Policies and programs are needed that provide mental health support to young people, and public awareness campaigns that guide young people to appropriate resources (i.e., support and intervention) via governmental public health bodies.

The Effect of a Mindful Self-Compassion Intervention on Burden, Express Emotion and Mental Well-Being in Family Caregivers of Patients with Schizophrenia: A Randomized Controlled Trial

The objective of this randomized controlled trial was to examine the impact of a mindful self-compassion intervention on burden, express emotion, and mental well-being in family caregivers of patients with schizophrenia. Standardized measures, including the ZARIT Caregiving Burden Scale, Expressed Emotion Scale and Warwick-Edinburgh Mental Well-Being Scale, were administered at baseline, post-intervention. Statistical analysis was conducted to assess differences between the two groups. Significant reductions in caregiver burden, expressed emotion, and enhanced mental well-being in the intervention group compared to the control group at post-intervention. The results of this randomized controlled trial indicate that the mindful self-compassion intervention significantly reduces caregiver burden, expressed emotion, and improves mental well-being in family caregivers of patients with schizophrenia. These findings underscore the potential utility of mindful self-compassion interventions as effective support for this population, highlighting the importance of integrating such interventions into caregiver support programs.

Boabom: A Feasible and Acceptable Approach to Helping College Students Manage Stress

Objective: College students in the United States report high rates of psychological health concerns. Psychological and physical complementary health approaches have been found to be protective for college students. The aims of this study were to assess the feasibility and acceptability of Boabom, a martial art, with college students and to explore any changes in psychosocial outcomes. Participants: Twenty-six college students (25 females; mean age 21.73 years) participated in an 8-week Boabom intervention. Methods: Feasibility measures were attendance and retention of participants; acceptability was based on participants' cognitive and emotional responses to Boabom and was determined through analysis of focus group data. Psychosocial outcomes were assessed through analyses of pre- and postintervention measures of mindfulness, perceived stress, anxiety, depression, resilience, perceived health, and life satisfaction. Results: The Boabom intervention was feasible as 23 of 26 participants attended at least six of eight classes, and 22 participants attended the last class. Students found the intervention acceptable, with three themes emerging from the focus group data to describe the participants' experience with Boabom: (1) disengaging from constant, daily stress and breathing and moving as a group leads to sense of calm, (2) empowerment through incremental mastery of skills, and (3) recognition of the value of health benefits to be gained. Participants reported positive changes in mindfulness, perceived stress, anxiety, depression, resilience, perceived health, and life satisfaction from pre- to postintervention. Conclusions: Boabom may be a feasible and acceptable offering for college students; still, further piloting with other college student populations is recommended.

Daily micropractice can augment single-session interventions: A randomized controlled trial of self-compassionate touch and examining their associations with habit formation in US college students

In this pre-registered study, we evaluated the effects of a single-session, self-guided intervention, leveraging daily micropractice (≤20 seconds/day practice) of self-compassionate touch to enhance self-compassion. We randomly assigned undergraduates (N = 135) to one of two conditions: a single-session intervention in which they were taught self-compassionate touch or a finger-tapping active control. Then, we instructed them to practice for 20 seconds/day for one month. At baseline (T1) and one-month follow-up (T2), participants completed assessments of self-compassion, growth mindset, positive affect, stress, psychopathology, habit formation, and more. In confirmatory, intention-to-treat analyses (N = 135), we found no significant effects on these outcomes. However, in confirmatory, per-protocol analyses (comparing the subsets from each condition who practiced>28 times, N = 45), self-compassionate touch, relative to active control, predicted T1-to-T2 increases in self-compassion (β = 0.71, p = .025), and reductions in stress (β = -0.62, p = .047) and psychopathology (β = -0.61, p = .046). In exploratory intention-to-treat analyses (N = 135), we found the same pattern of effects as in the per-protocol analyses among those who practiced self-compassionate touch more frequently relative to active control. We discuss factors associated with habit formation of daily practice. Daily micropractices have the potential for augmenting single-session interventions and for offering help when more time-intensive approaches may be less accessible. CLINICAL TRIAL REGISTRATION NUMBER: NCT05199779.

Feasibility, acceptability, and depression outcomes of a randomized controlled trial of Mindful Self-Compassion for Teens (MSC-T) for adolescents with subsyndromal depression

INTRODUCTION

Adolescents are experiencing high rates of depressive symptoms, with negative consequences to their long-term health. Group-based, mindful self-compassion programs show promise in mitigating the development of more significant depression in at-risk adolescents. However, the lack of well-designed, active control conditions has limited the ability to examine the efficacy of such interventions.

METHODS

Fifty-nine adolescents (Mage  = 15.81, 70% female) with subsyndromal depressive symptoms from the Southeastern US were randomized to group-based Mindful Self-Compassion for Teens (N = 30) or a newly developed active control Healthy Lifestyles group (N = 29) during 2018 and 2019. Participants attended 8 weekly "main" sessions followed by 6 monthly continuation sessions. The feasibility and acceptability of participation in both groups were measured using attrition, attendance, credibility, and satisfaction data. Depression scores were collected weekly, and self-compassion scores were collected five times across 36 weeks.

RESULTS

Both groups were equally feasible and acceptable during the 8-week program period; however, monthly continuation sessions were poorly attended in both groups. The risk of developing clinically significant depression was 2.6 times higher in the control group compared with the self-compassion group (p = .037) across 36 weeks. Depression significantly decreased in the self-compassion group, while it significantly increased in the control group. Both groups increased significantly in reports of self-compassion. These findings are on par with results noting the efficacy of cognitive-based interventions for high-risk adolescents; follow-up studies with larger sample sizes should be conducted to confirm these findings.

CONCLUSIONS

Initial examination suggests Mindful Self-Compassion for Teens programming is feasible, acceptable, and efficacious in preventing the development of clinically significant depression in adolescents with subsyndromal depression. Future studies may benefit from refinements to the self-compassion measurement and/or the attention control condition; moreover, larger sample sizes are needed to confirm results.

Self-Compassion, Anxiety and Depression Symptoms; the Mediation of Shame and Guilt

Self-compassion is related to psychological well-being and can improve mental health problems. The present study aimed to examine the relationship of self-compassion with anxiety and depression symptoms considering the mediating effects of shame and guilt. Two hundred forty-three participants in Iran completed the measures of Depression, Anxiety, Stress Scale (DASS), self-compassion Scale-Short Form (SCS-SF), and personal feelings questionnaire-2 (PFQ-2 Brief). The result showed that there was a significant negative correlation between self-compassion and shame, guilt, depression, and anxiety. The correlation between shame and guilt with depression and anxiety was also positive and significant. Mediation analysis was used to examine whether self-compassion predicted decreased symptoms of depression and anxiety through decreased shame and guilt. The results showed that self-compassion has a negative direct effect on depression symptoms. The direct effect of self-compassion on anxiety symptoms was not significant. Moreover, we found that shame and guilt mediate the relationship between self-compassion and depressive symptoms. However, the indirect effect of guilt on anxiety symptoms was not significant. The findings of the current study demonstrate that Self-compassion is linked to more psychological strengths and efficient emotional regulations, leading to less self-conscious emotions (shame and guilt) and decreased depression and anxiety symptoms.

Pilot feasibility and acceptability trial of BE REAL's BodyKind: A universal school-based body image intervention for adolescents

Body dissatisfaction is prevalent among adolescents and a primary risk factor for eating disorders, yet there are few body image interventions for older adolescents that support development of positive body image. Therefore, we assessed the feasibility, acceptability and preliminary effectiveness of BodyKind, a four-lesson, mixed gender, teacher-led, school-based curriculum for older adolescents, that combines principles of self-compassion, compassion for others, cognitive dissonance, and social activism to address contemporary adolescent body image concerns (i.e., appearance bias, comparisons on social media) and strengthen positive body image development. The sample contained 147 adolescents, predominantly racial/ethnic minorities (>95%), 54.8% male, 41.5% female and 4.1% gender-minority students aged 15-18 years (M=16.24, SD=.96) from a low-income, inner-city high school in the Midwestern US. Two teachers received training and delivered the curriculum to students. This single arm, mixed methods trial assessed student and teacher acceptability, teacher fidelity and student intervention outcomes. Despite reasonable teacher fidelity, recruitment/attendance rates, post-intervention data loss (35% attrition) limited evaluations of program effectiveness and study feasibility. Important learnings regarding study feasibility will inform optimisation for future school-based trials. Findings demonstrate high acceptability of BodyKind among teachers and adolescents in a lower socioeconomic school setting, and further randomized controlled effectiveness trials are required.

Self-compassion and avoidant coping as mediators of the relationship between childhood maltreatment and mental health and alcohol use in young adulthood

BACKGROUND

Exposure to childhood maltreatment increases the risk of mental health and substance use problems. Understanding the mechanisms linking maltreatment to these problems is critical for prevention.

OBJECTIVE

To examine whether self-compassion and avoidant coping mediate the relationship between childhood maltreatment and mental ill-health and alcohol use.

PARTICIPANTS AND SETTING

Australians aged 18-20 years at baseline were recruited through social media and professional networks.

METHODS

Participants (n = 568) completed an online survey, and were followed up annually for two subsequent surveys. Mediation models were conducted with the SPSS PROCESS macro. Maltreatment was the predictor; Wave 2 self-compassion and avoidant coping as mediators; Wave 3 mental health and alcohol use as outcomes.

RESULTS

Childhood maltreatment predicted greater mental health symptoms (b = 0.253, 95 % CI = 0.128-0.378), and alcohol use (b = 0.057, 95 % CI = 0.008-0.107). Both self-compassion (b = 0.056, 95 % CI = 0.019-0.093) and avoidant coping (b = 0.103, 95 % CI = 0.024-0.181) mediated the relationship between maltreatment and mental health. Additionally, avoidant coping, but not self-compassion, mediated the relationship (b = 0.040, 95 % CI 0.020-0.061) with alcohol use. However, when controlling for pre-existing mental health and substance use, neither self-compassion nor avoidant coping mediated the relationship with mental health. Only avoidant coping mediated the link with alcohol use (b = 0.010, 95 % CI = 0.001-0.020).

CONCLUSIONS

Findings suggests that by adulthood, self-compassion and avoidant coping may not explain future change in mental health symptoms; however, avoidant coping accounts for change in alcohol use across early adulthood. Reducing avoidant coping may prevent hazardous alcohol use across young adulthood among people exposed to childhood maltreatment.

The Me and the Us of Emotions: a cluster-randomized controlled trial of the feasibility and efficacy of a compassion-based social-emotional learning program for children

There are well-established benefits of social and emotional learning (SEL) programs for children within educational contexts. Combining social-emotional skills and compassion abilities has been seldomly done, and it may be valuable at individual and societal levels, for resilient, empathetic, and inclusive societies. This study explored the feasibility and efficacy of a program designed to promote socioemotional and compassion skills in children attending the 3rd and 4th grades, by using in-class dynamics complemented with serious games. This program, named "The Me and the Us of Emotions," is part of the Gulbenkian Knowledge Academies 2020 and consists of 10 group sessions embedded in the school curriculum. Using a cluster-randomized controlled trial design, school classes were allocated to intervention (classes, n = 8; children, n = 163) and control groups (classes, n = 6; children, n = 132). During the program, facilitators assessed adherence to the sessions' plan, attendance, dosage (i.e., how many sessions were delivered), and participant responsiveness. Children completed self-report measures of social-emotional skills and emotional climate at pre-, post-intervention, 3-month, and 6-month follow-ups. Results indicate that the program is feasible, with high adherence, high attendance rate, and participant responsiveness. Results also indicate empathy, soothing, and drive feelings to change from pre-intervention to all other assessment moments, for the intervention group only. Moreover, cooperation and threat changed over time for participants in both the control and the intervention groups. The current study offers empirical support for the feasibility and utility of a compassion-based social-emotional learning program on promoting children's empathy, and emotions of soothing and vitality in the school context. Thus, these findings contribute to recent research on the potential added value of compassion practices within an SEL program.

Self-compassion and neural activity during self-appraisals in depressed and healthy adolescents

BACKGROUND

Depression is one of the most concerning mental disorders in youth. Because atypical excessive neural activity during self-referential processing is often implicated in depression, identifying psychological factors that link to lower depression and less excessive neural activity during self-referential processing is critical for treatment development. This study examined the relationship between self-compassion - a protective factor of youth depression - and neural activity during self-appraisals, a well-established experimental paradigm for studying self-referential processing, and their associations with depression severity in depressed and healthy youth.

METHODS

The sample consisted of 115 youth (79 met the clinical diagnosis of depression; 36 were matched healthy controls) aged from 11 to 17 years (68 females). Self-compassion and depression severity were measured with self-reported scales. In the scanner, participants were asked to judge whether the phrases they heard described them from four perspectives (self, mother, classmate, and best friend).

RESULTS

Higher self-compassion was associated with lower PCC/precuneus activity especially during negatively-valenced self-appraisals and explained its association with reduced depression severity. In depressed youth, higher self-compassion was associated with lower superior temporal gyrus/operculum/postcentral gyrus/insula activity especially during positively-valenced self-appraisals. In healthy youth, higher self-compassion was associated with higher activity in these regions.

CONCLUSIONS

Self-compassion was associated with less excessive experiential immersion and/or autobiographical memory retrieval during negative self-appraisals. Neural stimulation interventions targeting PCC/precuneus activity during negative self-appraisals combined with behavioral interventions targeting self-compassion could be a promising approach to youth depression treatment.

Harsh Childhood Discipline and Developmental Changes in Adolescent Aggressive Behavior: The Mediating Role of Self-Compassion

Harsh discipline during childhood (psychological aggression and corporal punishment) has been found to be an early risk factor for adolescent aggressive behavior. However, previous studies have mainly examined the relationship between harsh discipline as a whole and the level of adolescent aggressive behavior. This study investigates the effects of childhood psychological aggression and corporal punishment on the initial levels and rate of change in adolescent aggressive behavior, as well as the mediating role of self-compassion in this relationship. Using cluster sampling, a three-wave follow-up assessment was conducted on 1214 high-school students (60.7% boys; mean age at Wave 1 = 15.46 ± 0.71). The results showed that childhood psychological aggression and corporal punishment had a positive predictive effect on the development level of adolescent aggressive behavior. However, only childhood psychological aggression significantly directly attenuated the decline rate of adolescent aggressive behavior. In addition, both childhood psychological aggression and corporal punishment indirectly affected the initial levels and growth rate of adolescent aggressive behavior through self-compassion. These findings could provide potential targets for prevention and intervention programs aimed at improving aggressive behavior in Chinese adolescents.

The Effects of Self-Criticism and Self-Compassion on Adolescents' Depressive Symptoms and Nonsuicidal Self-Injury

Purpose

Symptoms of depression increase during adolescence as do nonsuicidal self-injurious behaviors (NSSI). The present study aimed to investigate how self-criticism interacted with the effects of stressful life events on depressive symptoms and NSSI and whether self-compassion would buffer these negative effects.

Methods

A total of 908 Chinese adolescents (Mage = 13.46, SD = 0.57) completed a cross-sectional survey. The main and interacted effects of stressful life events, self-criticism, self-compassion on depressive symptoms and NSSI were examined respectively.

Results

The results showed that self-criticism significantly moderated the relationships between stressful events and depression and NSSI. Self-compassion could buffer the negative impacts of stressful events and self-criticism on NSSI but not on depression. High self-compassion significantly reduced the magnitude of the association between stressful life events and NSSI in adolescents with low self-criticism but not in those with high self-criticism.

Conclusion

Self-criticism exacerbated the negative impacts of stressful life events on both depressive symptoms and NSSI, but self-compassion only buffered the impact of stressful life events on NSSI. Interventions designed to reduce NSSI risk of Chinese adolescents may benefit from training them to improve self-compassion abilities and to be less self-critical.

The effect of brief digital mindfulness-based interventions on increasing online charitable behavior in Chinese adolescents

Digital mindfulness-based interventions (d-MBIs) have garnered significant research interest in recent years due to their psychological benefits. However, little is known about their impact on prosocial behaviors. This study investigates how d-MBIs impact prosocial behaviors where time spent is money, with Chinese adolescents as the subjects, through an online charity task (www.freerice.com). 119 students from a high school in China, who were inexperienced with mindfulness meditation, participated in this randomized controlled trial. The d-MBI group (N = 39) received online MBI guidance, while the face-to-face mindfulness-based intervention (f-MBI, N = 43) group underwent mindfulness intervention under personal tutors. The active control group (N = 37) completed a crossword task. Data analysis first involved repeated measures variance analysis, including pre-and post-intervention assessments. Subsequently, a two-way variance analysis was performed, with gender (female and male) and group (d-MBI, f-MBI, active control) as independent variables and the number of grains as dependent variables for the three groups of participants. Results showed that d-MBIs effectively improved empathy and compassion in Chinese adolescents, leading to increased rice donations to the United Nations World Food Program. These results underscore the positive effect of d-MBIs on prosociality and suggest their applicability in beneficial real-world situations involving prosocial behaviors, extending beyond previous research primarily conducted in artificial and hypothetical scenarios.

Resilience and Enhancement in Sport, Exercise, & Training (RESET): A brief self-compassion intervention with NCAA student-athletes

Athletes often believe that self-criticism is necessary to avoid complacency, but this attitude can lead to anxiety and stress. Research shows that self-compassion is an adaptive way to relate to mistakes and challenges. Although there are many benefits of self-compassion, fear that self-compassion harms performance may discourage athletes from adopting this approach. This study developed and tested an online self-compassion intervention for athletes called RESET (Resilience and Enhancement in Sport, Exercise, & Training), adapted from the Mindful Self-Compassion program. Between-group analyses (multilevel modeling; MLM) and within-group analyses (paired t-tests) were used to assess the effectiveness of the intervention on athletes' ability to respond compassionately to failure, improve well-being, and increase perceived sport performance. Compared to the waitlist control (n = 102, 71% women), the intervention group (n = 148, 90% women) experienced greater increases in self-compassion, decreases in self-criticism and fear of self-compassion, and greater improvements in perceived performance. In general, the intervention was more effective for those who had the most room for growth. Within-group analyses supported the MLM findings while also showing that athletes who participated in the RESET program experienced reduced levels of depression, anxiety, and stress. Program evaluation measures, including participant testimonials, extend the quantitative findings and demonstrate that RESET was engaging, well-liked, and effective.

Effects of Self-Compassion Interventions on Reducing Depressive Symptoms, Anxiety, and Stress: A Meta-Analysis

Objectives

A growing body of evidence shows self-compassion can play a key role in alleviating depressive symptoms, anxiety, and stress in various populations. Interventions fostering self-compassion have recently received increased attention. This meta-analysis aimed to identify studies that measured effects of self-compassion focused interventions on reducing depressive symptoms, anxiety, and stress.

Methods

A comprehensive search was conducted within four databases to identify relevant randomized controlled trials (RCTs). The quality of the included RCTs was assessed using the Cochrane Collaboration risk-of-bias tool. Either a random-effects model or fixed-effects model was used. Subgroup analyses were conducted according to types of control groups, intervention delivery modes, and the involvement of directly targeted populations with psychological distress symptoms.

Results

Fifty-six RCTs met the eligibility criteria. Meta-analyses showed self-compassion focused interventions had small to medium effects on reducing depressive symptoms, anxiety, and stress at the immediate posttest and small effects on reducing depressive symptoms and stress at follow-up compared to control conditions. The overall risk of bias across included RCTs was high.

Conclusions

Fewer studies were conducted to compare effects of self-compassion interventions to active control conditions. Also, fewer studies involved online self-compassion interventions than in-person interventions and directly targeted people with distress symptoms. Further high-quality studies are needed to verify effects of self-compassion interventions on depressive symptoms, anxiety, and stress. As more studies are implemented, future meta-analyses of self-compassion interventions may consider conducting subgroup analyses according to intervention doses, specific self-compassion intervention techniques involved, and specific comparison or control groups.

Preregistration

This study is not preregistered.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-023-02148-x.

Mindfulness-based programs and school adjustment: A systematic review and meta-analysis

Mindfulness-based programs (MBPs) are increasingly used in educational institutions to enhance students' mental health and resilience. However, reviews of the literature suggest this use may have outpaced the evidence base and further research is needed to better understand the mechanisms underlying these programs' effectiveness and which outcomes are being affected. The purpose of this meta-analysis was to investigate the strength of MBPs' effects on school adjustment and mindfulness outcomes while also considering the potential influence of study and program characteristics, including the role of comparison groups, students' educational level, the type of program being used, and the facilitator's training and previous mindfulness experience. Following a systematic review of five databases, 46 studies using a randomized controlled design with students from preschool to undergraduate levels were selected. At post-program, the effect of MBPs compared to control groups was (a) small for overall school adjustment outcomes, academic performance, and impulsivity; (b) small to moderate for attention; and (c) moderate for mindfulness. No differences emerged for interpersonal skills, school functioning, or student behaviour. The effects of MBPs on overall school adjustment and mindfulness differed based on students' educational level and the type of program being delivered. Moreover, only MBPs delivered by outside facilitators with previous experience of mindfulness had significant effects on either school adjustment or mindfulness. This meta-analysis provides promising evidence of the effectiveness of MBPs in educational contexts to improve students' school adjustment outcomes beyond typically assessed psychological benefits, even when using randomized controlled designs.

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

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

SETTING

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

PARTICIPANTS

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

MAIN OUTCOME MEASURES

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

RESULTS

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

Cultivating Compassion for Self and Others: A School-Based Pilot Study for Peer-Nominated Caring Adolescents

Many have called for school-based student programs that teach skills related to self-care and caring for others. Here, such a program for peer-nominated adolescents was developed and piloted virtually at one high school during the COVID-19 pandemic. Results of a longitudinal, quasi-experimental evaluation of the program showed high-quality program implementation and promising program impacts. Effect sizes indicated moderate to large program impacts on improvements in adolescents' self-compassion, sense of interdependence, and perspective-taking, and female adolescents' interoceptive awareness, compared to controls. No group differences in compassion for others were found. The need for more research on programs that help adolescents balance compassion for the self and for others is discussed.

The effect of explicit and implicit online self-compassion interventions on sleep quality among Chinese adults: A longitudinal and diary study

Objective

This study aimed to investigate the effects of explicit and implicit online intervention methods for self-compassion on improving sleep quality among Chinese adults.

Methods

A total of 328 adult participants were recruited to complete the Pittsburgh Sleep Quality Questionnaire and Self-compassion Scale, and 168 participants were randomly assigned to one of three different conditions: two self-compassion intervention groups (self-compassion writing intervention asked participants to write several sentences with self-compassion, and self-compassion combination intervention asked participants to combine words into complete sentences with self-compassion) and one control group. After 1 week of online self-compassion intervention with daily sleep quality measured simultaneously, 150 participants completed the posttest of the Pittsburgh Sleep Quality Questionnaire and Self-Compassion Scale.

Results

The pretest and posttests results showed that the self-compassion level and sleep quality of the self-compassion writing intervention group were significantly better than those of the control group. However, there was no significant difference between the self-compassion combination intervention group and the control group. For the diary tracking results, sleep quality was significantly better for both the self-compassion writing intervention group and self-compassion combination intervention group than the control group, however, the self-compassion writing intervention group showed great improvements.

Conclusion

Both self-compassion writing and combination interventions were effective in improving sleep quality, and the effect of self-compassion writing was more stable.

A Self-Compassion Chatbot to Improve the Wellbeing of Adolescents with Type 1 Diabetes During the COVID-19 Pandemic: What do Adolescents and their Healthcare Professionals Want?

BACKGROUND

Prior to the coronavirus (COVID-19) pandemic, adolescents with type 1 diabetes (T1D) already experienced far greater rates of psychological distress than their peers. With the pandemic further challenging mental health and increasing the barriers to maintaining optimal diabetes self-management, it is vital this population has access to remotely deliverable, evidence-based interventions to improve psychological and diabetes outcomes. Chatbots, defined as digital conversational agents, offer these unique advantages, as well as the ability to engage in empathetic and personalized conversations 24/7. Building on previous work developing a self-compassion program for adolescents with T1D, a self-compassion chatbot was developed for adolescents with T1D to address these concerns. However, the acceptability and potential clinical usability of a chatbot to deliver self-compassion coping tools to adolescents with T1D remained unknown.

OBJECTIVE

This qualitative study was designed to evaluate the acceptability and potential clinical utility of a novel self-compassion chatbot (called 'COMPASS') among adolescents aged 12 to 16 years with T1D and their diabetes healthcare professionals.

METHODS

Potential adolescent participants were recruited from previous participant lists, and online and in-clinic study flyers, whereas healthcare professionals were recruited from clinic emails and diabetes research special interest groups. Qualitative Zoom interviews exploring views on a newly developed self-compassion chatbot were conducted with 19 adolescents (in 4 focus groups), and 11 diabetes healthcare professionals (in 2 focus groups and 6 individual interviews), from March to April 2022. Transcripts were analyzed using directed content analysis to examine the features and content of greatest importance to both groups.

RESULTS

Adolescents were broadly representation of the youth population living with T1D in Aotearoa (58% female, 68% Aotearoa New Zealand European, 11% Māori). Healthcare professionals represented a range of disciplines including Diabetes Nurse Specialists (n = 3), Health Psychologists (n = 3), Dieticians (n = 3), and Endocrinologists (n = 2). Findings offer early insight into what adolescents with T1D and their healthcare professionals see as shared advantages of COMPASS and desired future additions, such as personalization (mentioned by all 19 adolescents), self-management support (mentioned by 13 of 19 adolescents), clinical utility (mentioned by all 11 healthcare professionals), and breadth and flexibility of tools (mentioned by 10 of 11 healthcare professionals).

CONCLUSIONS

Early data suggest that a self-compassion chatbot for adolescents with T1D is acceptable, relevant to common difficulties, and offers clinical utility during the COVID-19 pandemic. However, shared desired features amongst both groups, including problem-solving and integration with diabetes technology to support self-management, creating a safe peer-to-peer sense of community, and broadening the representation of different cultures, lived experience stories, and diabetes challenges, could further improve the potential of the chatbot. Based on these findings, the COMPASS chatbot is currently being improved to be tested in a future feasibility study.

CLINICALTRIAL

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

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

Feasibility and acceptability of implementing the Making Friends with Yourself intervention on a college campus

Objective: To assess the feasibility and acceptability of Making Friends with Yourself (MFY): A Mindful Self-Compassion Program for Teens and Young Adults with a sample of college students. A secondary objective was to explore changes in psychosocial outcomes. Participants: Twenty-five students (23 females; mean age 20.35 years) enrolled in the 8-week intervention. Methods: Feasibility was measured by attendance and retention of participants; acceptability was determined through analysis of focus group data. Psychosocial outcomes were assessed through analyses of pre- and post-intervention measures. Results: The intervention was feasible as 20 students attended at least seven of eight classes, and 21 completed the program. Students found the intervention acceptable and reported significant increases in mindfulness and self-compassion and decreased perceived stress from pre- to post-intervention. However, academic stress increased. Conclusions: MFY may be a feasible and acceptable program to offer to college students. Further piloting in college student populations is recommended.

Pilot trial of a self-compassion intervention to address adolescents' social media-related body image concerns

Introduction: Self-compassion interventions reduce body dissatisfaction in adults but have not been extensively investigated in adolescents. A novel 5-week Digital Social Media Adolescent Resilience Training intervention grounded in Gilbert's (2010) Compassionate Mind Training was adapted to address adolescent's social media-related body image concerns. Method: A convenience sample of 102 adolescents, 54 girls (53%), 48 boys (47%), aged 15-17 years (M=15.6, SD=0.46) were recruited from four mixed gender Irish Secondary Schools. Due to data loss because of Covid-19, analyses were conducted on data from 80 participants (24 boys, 56 girls). A mixed methods quasi-experimental design was used. Primary outcomes of self-compassion, self-criticism, social media comparisons and body image perceptions were quantitatively assessed at pre, post-intervention and 3-month follow up, while post-intervention focus groups qualitatively documented adolescents' responses to the programme. Results: Qualitative data indicated that the programme was feasible and acceptable. Analyses revealed significant increases in body appreciation and body satisfaction in the experimental group from pre- to post-intervention. Girls exhibited significant increases in body appreciation and reductions in self-criticism, while boys exhibited increases in body satisfaction. Improvements in body satisfaction were observed at 3-month follow up. Conclusions: Findings indicate that self-compassion has potential to improve adolescent's body image perceptions, but further research is warranted.

Self-compassion training for individuals with social anxiety disorder: a preliminary randomized controlled trial

Self-compassion is the ability to offer oneself kindness and compassion in response to failure, suffering, or insecurity. Learning how to be self-compassionate through self-compassion training appears effective for improving psychological well-being in community samples and promising for clinical populations. The current randomized controlled trial was designed to (a) examine the effectiveness of a self-guided self-compassion training program; and (b) determine whether self-compassion training can help mitigate social anxiety disorder (SAD) symptoms. Adults with SAD (n = 63; Mage = 34.3, SD = 11.4; 67.8% female; 84.7% Caucasian) were randomized to a waitlist control condition, a self-guided self-compassion training condition, or a self-guided applied relaxation training condition for six weeks. Outcome measures of SAD symptoms and self-compassion were completed pre-, mid-, and post-treatment, as well as at 3-months follow-up. Multilevel linear modelling results suggested the self-compassion training program was statistically superior at improving outcome measures relative to the waitlist control condition (ps < .05; η²_ps = .12-.33), but not relative to the applied relaxation training condition (ps > .05; η²_ps = .01-.05). Self-compassion training produced greater clinically significant gains in self-compassion and reductions in fear of self-compassion compared to both the waitlist condition and applied relaxation training. The current trial provides preliminary evidence for the effectiveness of a self-help self-compassion training program and provides evidence that self-compassion training may be beneficial for managing clinically significant SAD symptoms.

In the shadow of COVID-19: A randomized controlled online ACT trial promoting adolescent psychological flexibility and self-compassion

Background

Although some adolescents managed to cope well with the challenges brought on by the COVID-19 pandemic, the well-being of many was adversely affected due to school closures, distance education, restrictions on gathering with friends, and limited access to mental health services. Many adolescents reported increased anxiety and depression as well as decreased psychological wellbeing due to the pandemic. Consequently, there is a need for psychological support that exceeds the strained resources available to schools to support young people during times of crisis and societal pressure.

Objective

The present study aimed to explore the effects of an online-delivered ACT intervention to promote adolescent psychological flexibility and self-compassion and decrease psychological distress during the second wave of COVID-19 in the fall of 2020.

Methods

A total of 348 adolescents aged 15-16 were randomly divided into three equal groups: 1) the iACT student coach + virtual coach group, n = 116; 2) the iACT virtual coach group, n = 116; and 3) the control group with no intervention, n = 116). Among these adolescents, 234 participated in a pre-measurement (iACT, n = 154; control, n = 80; intent-to-treat) and completed measures of psychological flexibility, self-compassion, anxiety, and depression.

Results

An investigation of all the adolescents who participated in the pre-measurement (intent-to-treat analysis, n = 234) revealed no significant differences between the three groups with regard to psychological flexibility, self-compassion, and symptoms of anxiety and depression. However, upon combining the two intervention groups and examining the adolescents who completed at least 30% of the Youth Compass program (per-protocol analysis, n = 137), small but significant differences between the iACT intervention and control groups were found regarding the psychological flexibility subscale valued action, self-compassion, and anxiety in favor of the intervention group.

Conclusions

Active use of an ACT-based online intervention under adverse circumstances may decrease symptoms of anxiety and increase psychological flexibility skills in adolescents.

Gender Felt Pressure, Affective Domains, and Mental Health Outcomes among Transgender and Gender Diverse (TGD) Children and Adolescents: A Systematic Review with Developmental and Clinical Implications

Although capable of mobilizing significant resilience factors to face stigma and discrimination, transgender and gender diverse (TGD) children and adolescents tend to suffer from more adverse mental health outcomes compared to their cisgender counterparts. The minority stressors that this population faces are mainly due to the gender-based pressure to conform to their assigned gender. This systematic review was aimed at assessing the potential mental health issues that affect the TGD population. The literature search was conducted in three databases; namely, Scopus, PubMed, and Web of Science, based on the PRISMA guidelines. The 33 articles included in the systematic review pointed out how TGD children and adolescents experience high levels of anxiety and depression, as well as other emotional and behavioral problems, such as eating disorders and substance use. Resilience factors have been also pointed out, which aid this population in facing these negative mental health outcomes. The literature review highlighted that, on the one hand, TGD individuals appear to exhibit high levels of resilience; nonetheless, health disparities exist for TGD individuals compared with the general population, which are mainly attributable to the societal gender pressure to conform to their assigned gender. Considerations for research and clinical practice are provided.

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

BACKGROUND AND PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

What helps distressed Australian adolescents impacted by cancer? Mechanisms of improvement of the PEER program

PEER is a four-day residential program for adolescents impacted by their own or a relative's cancer, with both psychosocial (acceptance and commitment therapy, self-compassion) and recreational components. This study aimed to determine whether previously observed improvements in quality of life amongst highly distressed participants were mediated by improvements in processes targeted by psychotherapeutic elements of the program (psychological flexibility, mindfulness, self-compassion, peer support, distress). Adolescents attending PEER completed surveys assessing the quality of life and proposed mediator variables at pre-program, post-program and two-month follow-up. Adolescents experiencing high/very high levels of baseline distress (n = 52; 5 patients/survivors, 31 siblings/offspring, 13 bereaved siblings/offspring) were previously identified as experiencing clinically significant improvements in psychosocial well-being; here, mediation analyses explored whether these improvements were associated with improvements in process variables. Findings evidenced improvements in quality of life amongst distressed PEER participants, mediated by increases in psychological flexibility and self-compassion, and reductions in distress. Peer support and mindfulness were not significant mediators. Together, this suggests that the psychosocial benefits of PEER observed for highly distressed adolescents are linked to the specific therapeutic approaches used in the program, rather than being non-specific effects of peer connection or recreation. Findings from this evaluation provide further evidence for the efficacy and mechanisms of the effect of PEER for supporting distressed adolescents impacted by cancer. The study also demonstrates the viability and utility of the therapeutic approaches (acceptance and commitment therapy, self-compassion) used, showing that they have psychosocial benefits for this population.

Feasibility and acceptability of video-based microinterventions for eating disorder prevention among adolescents in secondary schools

OBJECTIVE

Eating disorders (EDs) often emerge in late adolescence. Schools are ideal settings for prevention programs; however, cost and time limit implementation. Microinterventions may overcome these challenges. This study adapted two microinterventions (cognitive dissonance, self-compassion) and assessed feasibility and acceptability among mid-adolescents to provide proof-of-concept for further investigation.

METHOD

Feedback from staff (n = 5) and student (n = 15) focus groups contributed iteratively to the adaptation of intervention materials. Students in Grade 10 and 11 (N = 101, M_age  = 15.80, SD = 0.68) were then randomly allocated by class to a 20-min video-based cognitive-dissonance or self-compassion intervention, accessed on their school devices. ED risk and protective factors were assessed at baseline, immediate postintervention (state outcomes), and 1-week follow-up (trait outcomes). Acceptability items were included at both timepoints.

RESULTS

Implementation was deemed feasible. Girls generally reported greater acceptability than boys. Among girls, the self-compassion intervention demonstrated greater acceptability. Among boys, some aspects of acceptability (e.g., lesson endorsement, utilization of techniques) were rated higher in the cognitive dissonance group whereas other aspects (e.g., understanding, interest) were greater in the self-compassion group. All groups exhibited favorable changes in most state outcomes, however trait outcome change was varied.

DISCUSSION

Microinterventions provide a feasible way of implementing prevention strategies in a time-poor educational context. Future large-scale evaluation is warranted to determine efficacy, following modifications based on current findings.

PUBLIC SIGNIFICANCE

This study shows promising feasibility and acceptability of two brief, self-guided video-based lessons (microinterventions) for adolescents in school classrooms, that use psychological techniques to target appearance pressures as a key risk factor for eating disorders. Such interventions are easier to implement in school settings than longer, facilitator-led interventions, to encourage greater uptake and ongoing use. Findings support further research to evaluate effectiveness, to ultimately provide accessible and gender-inclusive tools for busy schools.

Childhood emotional abuse and adolescent flourishing: A moderated mediation model of self-compassion and curiosity

BACKGROUND

Resilience and positive mental health may be negatively influenced by childhood maltreatment. While many scholars have noted that adolescents exposed to childhood emotional abuse could meet the criteria for flourishing, little research has investigated the mediating effect of self-compassion and the moderating effect of curiosity on the relationship between childhood emotional abuse and adolescent flourishing.

OBJECTIVE

This study proposed and tested a moderated mediation model that attempted to explain the pathway from childhood emotional abuse to adolescent flourishing.

PARTICIPANTS AND SETTING

The sample consisted of 315 female students (mean age 12.81 years, range 12-14 years) in a girls' secondary school in Hong Kong, China.

METHODS

We conducted a three-wave study with six-month intervals. The participants completed self-administered questionnaires at school under the guidance of trained research assistants.

RESULTS

Self-compassion at Time 2 mediated the relationship between childhood emotional abuse at Time 1 and adolescent flourishing at Time 3. Furthermore, the mediating effect was moderated by adolescent curiosity at Time 1 and Time 2.

CONCLUSIONS

The findings of this study suggested that although childhood emotional abuse may hinder the development of self-compassion, reduced levels of self-compassion and curiosity (especially the stretch dimension of curiosity) could work together to promote flourishing in adolescents with a history of childhood emotional abuse. The results lent further support to the developmental psychopathology and resilience perspectives in explaining the relationship between childhood trauma and positive developmental outcomes.

The association between gender, sexual harassment, and self-compassion on depressive symptoms in adolescents

AIM

The study aims to identify the prevalence of bullying and sexual harassment as well as possible risk and protective factors for depression among adolescents. We focus on the association of different types of sexual harassment, gender, bullying, and self-compassion to depression criteria according to DSM 4.

METHODS

This cross-sectional study included 318 adolescents aged 15-20 years, from Sweden. Participants answered the self-assessment scales Reynolds Adolescent Depression Scale, Second Edition, and Compassionate Engagement and Action Scales for Youth, as well as questions about sexual harassment and bullying. Regression analyses were conducted to examine the association between bullying, sexual harassment, self-compassion, and gender with depressive symptoms.

RESULTS

Few students had been subjected to bullying, whereas sexual harassment was more common. About 32.7% of students had been subjected to verbal harassment and girls were more frequently exposed. Both bullying and sexual harassment were associated with depressive symptoms, and gender patterns were observed. For boys, verbal harassment and bullying correlated with negative self-evaluation and somatic complaints. For girls, bullying correlated with all depressive symptoms. Higher levels of self-compassion were associated with less depression, and the correlation was especially strong among boys.

CONCLUSION

Boys and girls express different types of depressive symptoms when subjected to bullying and sexual harassment. Not asking boys about negative self-evaluation or somatic complaints could lead to missing depression. However, for girls, all four symptoms are equally important to inquire about. Self-compassion is a possible protective factor against depression and future studies will show if teaching this to adolescents could lead to less depression.

Effectiveness and mechanism of a 4-week online self-help mindfulness intervention among individuals with emotional distress during COVID-19 in China

Background

Many people suffered from emotional distress especially during the COVID-19 pandemic. In order to alleviate emotional distress, more accessible psychological intervention programs, such as online intervention programs, are needed. The study aimed to investigate the efficacy and the potential mechanism of a 4-week, online, self-help mindfulness-based intervention to manage emotional distress during the COVID-19 pandemic between February 3 and May 20, 2020.

Methods

A total of 302 individuals with high emotional distress completed a self-help mindfulness course, which lasted 30–60 min per day for 28 consecutive days. Participants who registered in the program later were included in the analyses as the control group (n = 315). Levels of mindfulness, perceived stress, emotional distress, anxiety and depression were assessed at baseline(T1), week 1(T2), week 2(T3), week 3(T4) and week 4(T5).

Results

Significant Group by Time interaction effects were found on mindfulness, perceived stress, emotional distress, anxiety and depression (p < 0.001). Compared to the control group, the intervention group had a greater increase in changes of all outcome variables (p < 0.001). Random intercept cross-lagged analyses showed that compared with control group, mindfulness at T2 and T4 negatively predicted stress at T3 and T5, and mindfulness at T2 and T4 negatively predicted depression at T3 and T5 while depression at T3 predicted mindfulness at T4 in the mindfulness group.

Conclusions

The results suggest that a 4-week self-help online mindfulness intervention improved mindfulness and reduced stress, emotional distress, anxiety and depression symptoms. Compared to the control group, changes in mindfulness preceded changes in stress, and mindfulness and depression reciprocally influenced each other during the intervention.

Trial registration Chinese Clinical Trial Registry: ChiCTR2000034539. Registered 9 July 2020—Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=55721&htm=4.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00831-7.

Well-being app to support young people during the COVID-19 pandemic: randomised controlled trial

OBJECTIVES

To evaluate the efficacy and acceptability of 'Whitu: seven ways in seven days', a well-being application (app) for young people.

DESIGN

Prospective randomised controlled trial of Whitu against waitlist control, with 45 participants in each arm.

PARTICIPANTS

90 New Zealand young people aged 16-30 recruited via a social media advertising campaign.

SETTING

Participants' homes.

INTERVENTIONS

Developed during the COVID-19 pandemic, and refined from a prototype version that was evaluated during a smaller qualitative study, 'Whitu: seven ways in seven days' is a well-being app that, as its name suggests, contains seven modules to help young people (1) recognise and rate emotions, (2) learn relaxation and mindfulness, (3) practice self-compassion and (4) gratitude, (5) connect with others, (6) care for their physical health and (7) engage in goal-setting. It can be completed within a week or as desired.

MAIN OUTCOME MEASURES

Primary outcomes were changes in well-being on the WHO 5-item Well-Being Index and Short Warwick-Edinburgh Mental Well-Being Scale. Secondary outcomes were changes in depression on the Centre for Epidemiological Studies Depression Scale, anxiety on the Generalised Anxiety Disorder 7-item Scale, self-compassion on the Self Compassion Scale-Short Form, stress on the 10-item Perceived Stress Scale, sleep on the single-item Sleep Quality Scale and user engagement on the end-user version of the Mobile Application Rating Scale and via qualitative feedback during an online survey. Outcomes were evaluated at baseline, 4 weeks (primary study endpoint) and 3 months, and analysed using linear mixed models with group, time and a group-time interaction.

RESULTS

At 4 weeks, participants in the Whitu group experienced significantly higher emotional (Mean difference (md) 13.19 (3.96 to 22.42); p=0.005) and mental (md 2.44 (0.27 to 4.61); p=0.027) well-being, self-compassion (md 0.56 (0.28 to 0.83); p<0.001) and sleep (md 1.13 (0.24 to 2.02); p=0.018), and significantly lower stress (md -4.69 (-7.61 to -1.76); p=0.002) and depression (md -5.34 (-10.14 to -0.53); p=0.030), compared with the waitlist controls. Group differences remained statistically significant at 3 months for all outcomes. Symptoms of anxiety were also lower in the intervention group at 4 weeks (p=0.096), with statistically significant differences at 3 months (md -2.31 (-4.54 to -0.08); p=0.042). Usability of Whitu was high (subjective ratings of 4.45 (0.72) and 4.38 (0.79) out of 5 at 4 weeks and 3 months, respectively) and qualitative feedback indicated individual and cultural acceptability of the app.

CONCLUSIONS

Given the evolving psychological burden of the COVID-19 pandemic, Whitu could provide a clinically effective and scalable means of improving the well-being, mental health and resilience of young people. Replication of current findings with younger individuals and in other settings is planned.

TRIAL REGISTRATION NUMBER

Australian New Zealand Clinical Trials Registry (ACTRN12620000516987).

A Review of Self-Compassion as an Active Ingredient in the Prevention and Treatment of Anxiety and Depression in Young People

Previous meta-analyses have found higher self-compassion is associated with lower anxiety and depression. The aim of this study was to investigate the efficacy of self-compassion as an active ingredient in the treatment and prevention of anxiety and depression in youth. This was conducted through (i) a systematic review of the literature and (ii) qualitative consultation with young people and researchers in self-compassion. Fifty studies met our inclusion criteria. Eight studies evaluated self-compassion interventions among youth aged 14-24, and the remaining studies measured the association between self-compassion and anxiety, and/or depression among this age group. Qualitative interviews were conducted with four self-compassion researchers. Interviews were also conducted in two rounds of consultation with 20 young people (M age = 18.85 years, age range 14-24 years). Higher self-compassion was related to lower symptoms of anxiety, r =  - 0.49, 95% CI (- 0.57, - 0.42), and depression, r =  - 0.50, 95% CI (- 0.53, - 0.47). There was evidence for self-compassion interventions in decreasing anxiety and depression in young people. Consultation with young people indicated they were interested in self-compassion interventions; however, treatment should be available in a range of formats and tailored to address diversity. Self-compassion experts emphasised the importance of decreasing self-criticism as a reason why self-compassion interventions work. The importance of targeting self-criticism is supported by the preferences of young people who said they would be more likely to engage in a treatment reducing self-criticism than increasing self-kindness. Future research is required to add to the emerging evidence for self-compassion interventions decreasing symptoms of anxiety and depression in young people.

The association between carer self-compassion, expressed emotion, quality of life, and paediatric eating disorder symptoms

OBJECTIVE

The aim of this study was to investigate carer variables on paediatric eating disorders. We examined whether carer self-compassion, the tendency to treat oneself with kindness during distress and disappointments, was associated with lower carer expressed emotion, and, in turn, whether lower carer expressed emotion would be associated with both higher carer quality of life and lower eating disorder symptoms in young people. Further, we examined whether higher carer quality of life was associated with lower adolescent eating disorder symptoms.

METHOD

Data were extracted from the Helping out Paediatric Eating Disorders (HOPE) project database. Participants included children and adolescents diagnosed with a DSM5 eating disorder and their primary carer (N of dyads = 359). Primary carers completed the Self-Compassion Scale-Short Form (SCS-SF), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF), and the Family Questionnaire-Expressed Emotion (FQ-EE). Children and adolescents completed an adapted version of the Eating Disorder Examination (EDE).

RESULTS

As hypothesised, structural equation modelling (SEM) revealed a direct relationship between higher carer self-compassion and lower expressed emotion, and between lower expressed emotion and both higher carer quality of life and lower eating disorder symptoms. However, contrary to our hypothesis, carer quality of life was not significantly associated with paediatric eating disorder symptoms. Expressed emotion carried significant indirect effects between carer self-compassion and (a) paediatric eating disorder symptoms and (b) carer quality of life.

DISCUSSION

The results highlight the importance of further research to determine whether targeting carer self-compassion is helpful in the treatment of eating disorders in young people.

Self-compassion and dorsolateral prefrontal cortex activity during sad self-face recognition in depressed adolescents

BACKGROUND

Given the prevalence of adolescent depression and the modest effects of current treatments, research ought to inform development of effective intervention strategies. Self-compassion is inversely associated with depression, and self-compassion interventions have demonstrated promising effects on reducing depression. However, little is known about the neural mechanisms underlying that relationship. Maladaptive self-processing is a characteristic of depression that contributes to the onset and chronicity of depression. Because our own face is an automatic and direct cue for self-processing, this study investigated whether self-compassion was associated with neural responses during sad v. neutral self-face recognition and explore their relationship with depression severity in depressed adolescents and healthy controls (HCs).

METHODS

During functional magnetic resonance imaging, 81 depressed youth and 37 HCs were instructed to identify whether morphed self or other faces with sad, happy, or neutral expressions resembled their own.

RESULTS

Self-compassion correlated negatively with activity during sad v. neutral self-face recognition in the dorsal anterior cingulate cortex in the total sample, and in the right posterior cingulate cortex/precuneus in HCs, respectively. In depressed adolescents, higher self-compassion correlated with lower activity during sad v. neutral self-face recognition in the right dorsolateral prefrontal cortex (DLPFC), implying that less cognitive effort might be needed to avoid dwelling on sad self-faces and/or regulate negative affect induced by them. Moreover, higher self-compassion mediated the relationship between lower DLPFC activity and reduced depression severity.

CONCLUSIONS

Our findings imply that DLPFC activity might be a biological marker of a successful self-compassion intervention as potential treatment for adolescent depression.

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) in Portugal: Feasibility Study Results

The Unified Protocol for Children (UP-C) is a transdiagnostic Cognitive-Behavioral Therapy group intervention for children and caregivers targeting the treatment of children’s emotional disorders (EDs). The present study aims to assess the feasibility and acceptability of the UP-C in the Portuguese population using a single-armed design. The participants were 32 children (6–12 years of age) with an ED (anxiety and/or depressive disorder) as a main diagnosis and their parents. All participants received the UP-C intervention and were assessed at pretreatment, midtreatment, posttreatment, and 3 months posttreatment. Children, parents, the clinicians, and an external observer completed questionnaires to assess the feasibility and acceptability of the UP-C (e.g., satisfaction, motivation, and adherence). Children and parents also completed self-report measures assessing the children’s anxiety and depression and its interference and severity. The results of the present study support the feasibility and acceptability of the UP-C in Portugal; low dropout rates, high adherence rates, and high levels of child and parent satisfaction and motivation were observed. Moreover, significant reductions over time in children’s levels of anxiety and/or depression and of its interference and severity were found and were maintained after 3 months of follow-up. These results are promising and warrant a subsequent randomized controlled trial (RCT).

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

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

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

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

Testing the Efficacy of ‘Unlearning’, a Mindfulness and Compassion-Based Programme for Cultivating Nonviolence in Teenagers: A Randomised Controlled Trial

Background: Most programmes developed to reduce aggressive attitudes among teenagers are based on cultivating nonviolence, a construct that has been related to compassion and, more indirectly, mindfulness. This study aims at testing the efficacy of ‘Unlearning’, a mindfulness and compassion-based programme, for reducing aggressive attitudes in adolescents.

Method: A sample of 164 students from three high schools in Zaragoza (Spain) participated in the study. They were randomly assigned to (1) ‘Unlearning’, or (2) relaxation programme. Three assessment points were established: baseline, post-treatment and a 4-month follow-up. The outcome variables were the subscales of the ‘Attitudes Toward Social Aggression Scale’. Mindfulness and compassion were assessed as secondary outcomes.

Results: ‘Unlearning’ did not produce changes in the primary outcomes, but significant effects were observed post-treatment in self-compassion; and in the follow-up, in self-compassion and mindfulness. The control group did not experience any change post-treatment, but a significant effect in mindfulness was observed in the follow-up. The intergroup analyses indicated that ‘Unlearning’ improved self-compassion, both post-treatment (t = −2.48, p = 0.014) and after 4-months (t = −2.03, p = 0.044), although these results were not statistically significant after correcting for multiple comparisons.

Conclusion: ‘Unlearning’ did not produce significant reductions in aggressive attitudes compared to the control group. The low baseline levels may have hindered the efficacy of the interventions. ‘Unlearning’ showed potential to improve self-compassion, which is related to nonviolence, and this may have positive implications for the adolescents. Future interventions should include teachers and families to enhance the effectiveness of the programmes.

Mindful self-compassion for nurses: a systematic review

This article details a systematic review that aimed to synthesise and analyse the published research on the effects of mindful self-compassion interventions on stress in nurses. Five studies were identified that met the inclusion criteria and were analysed in terms of sample characteristics, intervention, measurement of self-compassion, additional psychosocial outcome measures, intervention duration and adherence, intervention outcomes and effect size and follow-up. The review found that mindful self-compassion interventions had medium-to-large effect sizes for self-compassion, traumatic stress, burnout, stress and compassion satisfaction. There was also high intervention adherence (mean=86%) in the included studies. Since these interventions can improve self-compassion and compassion in nurses, they have the potential to enhance the quality of compassionate care provided by nurses who undergo training in mindful self-compassion.

Pilot study of a well-being app to support New Zealand young people during the COVID-19 pandemic

BACKGROUND

Well-being apps represent a promising and scalable approach for improving mental health outcomes in youth, especially during a global pandemic when access to face-to-face interventions may be limited. Whitu (meaning 7 in the New Zealand Māori language Te Reo) is a newly developed well-being app with 7 modules that support young people to learn and practice evidence-based coping skills, including relaxation, mindfulness, self-compassion, and goal-setting.

OBJECTIVE

During this pilot, we explored the acceptability, usability, and preliminary efficacy of Whitu before refining the app for a randomized controlled trial (RCT).

METHODS

We recruited 20 New Zealand young people aged 16-25 years via social media to trial the first prototype of the Whitu app over 6 weeks. Within-group differences from baseline to 2- and 6-weeks post intervention in self-reported well-being, depression, anxiety, stress, self-compassion, optimism and sleep quality were evaluated using repeated-measures ANOVA. A further 21 participants aged 16-30 years were recruited to participate in 4 focus groups to give feedback on the app's usability and cultural acceptability. Feedback was analysed using directed content analysis.

RESULTS

Statistically significant improvements in anxiety (p = 0.024) and stress (p = 0.017) were observed from baseline to 2-weeks post intervention. Improvements in well-being (p = 0.021), depression (p = 0.031), anxiety (p = 0.005), and stress (p = 0.004) were also observed from baseline to 6-weeks. No statistically significant changes were seen in self-compassion, optimism, or sleep quality. Effect sizes (partial η2s) ranged from 0.25 (depression) to 0.42 (stress). Qualitative feedback comprised of five key themes, namely: factors affecting engagement, issues with functionality, preferences regarding aesthetics, effectiveness and adverse effects, and cultural acceptability.

CONCLUSIONS

Our preliminary results suggest that Whitu may be an effective app for improving multiple dimensions of young people's well-being. Modifications to the look and feel, cultural content, and onboarding have been undertaken based on the qualitative feedback, and an RCT is currently underway.

The Effects of the Positive Psychology-Based Online Group Counselling Program on Mothers Having Children with Intellectual Disabilities

The purpose of the current study is to examine the effects of the Positive Psychology-Based Online Group Counselling Program (PPBOGCP) on the psychological well-being, self-compassion and hope levels of the mothers having children with intellectual disabilities. The current study is a mixed-design research having quantitative and qualitative dimensions. The quantitative dimension of the study was designed in a quasi-experimental design based on the experimental, placebo and control group pre-test, post-test and follow-up test model. The study group is comprised of a total of 35 participants. While in the experimental group, the 10-session PPBOGCP developed by the researcher was implemented, a 10-session group counselling was conducted in the placebo group. No study was conducted with the individuals in the control group. As the data collection tools, the Psychological Well-Being Scale, Self-Compassion Scale and Dispositional Hope Scale were used in the current study. The quantitative analyses were conducted in SPSS 17 program package while the qualitative data were analyzed with the content analysis technique. According to the findings of the current study, the PPBOGCP created significant differences in the psychological well-being, self-compassion and hope levels of the mothers having children with intellectual disabilities according to the intervention time effect (p < 0.05). It was observed that the data obtained in the individual interviews were collected around the categories of "Learning how to cope with, recognizing the sources of support, perceiving positively-acceptance, empathy and development".