Clarifying the Relationship Between Self-Compassion and Mindfulness: an Ecological Momentary Assessment Study

Compassion Dynamics in Medical Students: An Ecological Momentary Assessment Study

Effective interventions to support compassionate patient- and self-care requires an understanding of how to best assess compassion. Micro-ecological momentary assessment (micro-EMA), a method in which participants provide brief responses in real-time within their own environments, can capture changes in compassion across time and contexts. This study examined a micro-EMA approach for measuring the temporal dynamics of compassion in medical students during the COVID-19 pandemic. Medical students (N = 47) completed demographic information and self-report questionnaires assessing empathy and compassion for self and others. Participants then completed six bursts of micro-EMA smartphone-delivered surveys. Each burst was 14 days, with 28 days between bursts. During each burst, participants received four daily micro-EMA surveys assessing compassion, stress, positive affect, and negative affect. Dynamic structural equation modeling was used to examine micro-EMA responses. The overall micro-EMA response rate was 83.75%. On average, daily compassion did not significantly change across the academic year. However, there was significant within-person variability in medical students' compassion trajectories over the training year (b = 0.027, p < .01). At concurrent timepoints, micro-EMA assessed compassion was associated with greater happiness (b = 0.142, p < .001) and lower stress (b = -0.052, p < .05) but was not associated with sadness. In lagged analyses, higher micro-EMA assessed compassion predicted higher next day happiness (b = 0.116, p < .01) and vice versa (b = 0.185, p < .01). Results suggest it is feasible to use micro-EMA to assess daily levels of compassion among medical students. Additionally, there is wide variability in day-to-day fluctuations in compassion levels among medical students, with some students showing substantial increases in daily compassion across the training year and others showing decreases. Positive affect as opposed to negative affect may have particularly strong associations with compassion. Further examination of antecedents and consequences of fluctuations in daily compassion could inform potent intervention targets.

Validation of the factor structure of the Experiences Questionnaire using Exploratory Graph Analysis

Introduction

Decentering describes the ability to shift the focus away from one's subjective experience onto the experience itself. The Experiences Questionnaire (EQ) is a self-report measure that was developed to systematically assess changes in Decentering ability. Although several studies show the validity of the questionnaire, there are discrepancies between the factorial structure of the Decentering scale of the EQ (EQ-D) found in the initial study (one factor) and other studies (two factors). Therefore, the current study aimed to assess the dimensionality of the EQ-D using Exploratory Graph Analysis (EGA).

Methods

In total, 1,100 participants were recruited online (790 female, 307 male, 3 non-binary; age 18 to 65 years). Participants completed the EQ and the Rosenberg Self-esteem scale (RSES).

Results

The bootstrapped EGA results revealed a two-dimensional structure of the EQ-D (Factor 1: Distanced Perspective, DP; Factor 2: Accepting Self-perception, AS) with high structural and item stability (all items > 0.70). The two dimensions of the EQ-D showed a high internal consistency (DP: ω = 0.74; AS: ω = 0.86) and discriminant validity with the rumination items of the EQ. Furthermore, a high convergent validity of the EQ was established, as the AS factor exhibited a significantly stronger correlation with self-esteem than the DP factor (z = 7.98, p < 0.001), which aligns with theoretical considerations suggesting that the AS factor encompasses aspects of self-compassion alongside decentering. We also found measurement invariance of the DP and AS factor across age, gender and country but not for education.

Discussion

These results support the EQ's validity, demonstrated in a larger sample with a new methodology, aligning with existing two-factor decentering models literature.

Decentering from Emotions in Daily Life: Dynamic Associations with Affect, Symptoms, and Wellbeing

Decentering is thought to be protective against a range of psychological symptoms, but little is known about the outcomes of decentering as a momentary state in daily life. We used ecological momentary assessment (42 reports across one week) to examine the temporal ordering of the associations of decentering with affect, dysphoria, participant-specific idiographic symptoms, and wellbeing. We also hypothesized that greater decentering predicts less inertia (persistence) of each variable, and weakens the association of affect with dysphoria, idiographic symptoms, and wellbeing. Results in 345 community participants indicated that decentering and these variables were mutually reinforcing over time, and that greater decentering was associated with less inertia of negative affect and dysphoria. Decentering generally predicted reduced impact of positive and negative affect on dysphoria symptoms, but results were mixed when predicting idiographic symptoms or wellbeing. Clinical implications and refinements for theory on decentering are discussed.

Accepting Things as They Are: Dispositional Mindfulness, Decentering, Self-Compassion, and the Impact of Stuttering on Adults Who Stutter

PURPOSE

Mindfulness is defined as intentional, present-moment, nonjudgmental awareness. Previous studies have proposed that mindfulness practice may benefit people who stutter. This study aimed to test the relationship between levels of dispositional mindfulness in people who stutter and the impact of stuttering and whether self-compassion and the metacognitive ability of shifting to an objective perspective (decentering) mediate this relationship. It is hypothesized that greater dispositional mindfulness is associated with attenuated negative impact of stuttering on a person's life through a higher capability to shift into an objective and compassionate perspective.

METHOD

A total of 150 Israeli adults who stutter completed a full online survey in Hebrew to assess their levels of dispositional mindfulness, self-compassion, decentering capability, and impact of stuttering on their lives. The relationships between constructs were assessed using Pearson's correlation and mediation analysis.

RESULTS

The adverse impact of stuttering was negatively and moderately associated with dispositional mindfulness, such that individuals with greater self-reported dispositional mindfulness reported fewer reactions to stuttering, difficulty in communication, and higher quality of life. This relationship was fully and sequentially mediated via decentering and self-compassion, which were also negatively and moderately associated with the impact of stuttering.

CONCLUSIONS

People who stutter with greater dispositional mindfulness have an increased ability to view their experiences in a more objective and compassionate manner, which is associated with an attenuated impact of stuttering on their lives. As these capabilities can be cultivated through practice, this study proposes mindfulness practice as an additional beneficial tool for people who stutter.

Assessing Decentering Capacity in Athletes: A Moderated Mediation Model

Decentering has received more attention in sports literature as a self-regulating skill capable of significantly limiting episodes of mental block in competitive situations. This contribution depicts a comparative study conducted with 375 Italian national and international athletes. The objective was to evaluate athletes' decentralization skills across different sports and levels of competition and test a mediation model of decentering in sports with coping and emotional balance variables. Pearson bivariate correlations, linear hierarchical regression, and simple mediation analysis were conducted for all main measures (The Decentering Sport Scale, The Emotion Regulation Questionnaire, and The Coping Orientations to Problems Experienced). Outputs reported significant associations with emotional regulation and coping styles. Mediation analysis confirmed the central mediating role of decentering capacity which has indirect effects on both the coping ability of problem solving (z-value = 2.986; p = 0.003) and cognitive reappraisal (z-value = 2.779; p = 0.005). Decentering acts as a mediator between an athlete's positive attitude, problem-orientation ability, and management of emotions in competition through cognitive reappraisal. The study highlights the significance of evaluating and enhancing decentralization skills in order to establish specific action mechanisms, which are crucial for both peak performance and the athlete's health.

A negative body image contextualization of the self-compassion scale

Self-compassion, a style of responding to oneself in times of suffering, is typically measured as a general tendency for how one normally responds using the Self-Compassion Scale (SCS; Neff, 2003). A contextualized adaptation to the SCS could provide a new understanding of how one responds to suffering by providing a standard frame of reference, is more likely to be more predictive of context outcomes, and reduces intraindividual variance (Baird & Lucas, 2011). How a contextualized assessment of self-compassion compares to the original assessment using parallel measures is unknown. The purpose of this study was to explore the use of a modified SCS adapted for the context of responding to the experience of negative body image (BI-SCS). There were 468 participants who completed the SCS and then wrote about a specific negative body image experience (to prime a negative body image experience) before they completed a modified SCS and related constructs. Confirmatory Factor Analysis supported a bi-factor structure consistent with SCS. Correlations with body image outcomes were stronger for the majority of BI-SCS scores compared to the SCS. Unique explained variance of the BI-SCS supported incremental validity. Results show promising initial evidence supporting the use of the BI-SCS for body-related outcomes.