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

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

What if parental love is conditional …? Children's self-esteem profiles and their relationship with parental conditional regard and self-kindness

BACKGROUND

Numerous studies have demonstrated that low, unstable, or contingent self-esteem negatively affects youth development and is linked to adolescent psychopathology. However, most previous studies have applied variable-oriented approaches, and less is known about the natural combination of self-esteem facets in school-aged adolescents, how parental conditional regard affects self-esteem profiles, and how these profiles relate to self-kindness, self-judgement, and life satisfaction.

METHODS

By employing a longitudinal person-oriented approach (i.e., latent profile analysis and latent transition analysis) on two-wave longitudinal data from 587 German secondary school students (52.3% female, Mage=13.52 years), this study aims to (1) identify adolescents' self-esteem profiles based on the level, stability, and contingency of self-esteem; (2) examine the impact of parental conditional regard on the self-esteem profiles explained using self-determination theory; and (3) examine these profiles' relationship with self-kindness, self-judgement, and life satisfaction.

RESULTS

Four self-esteem profiles were derived: optimal-secure (~ 8%), good (~ 18%), average (~ 36%), and low-insecure (~ 38%). The results reveal a concerningly high proportion as well as a high stability of low-insecure self-esteem (~ 98%) and indicate the strong negative influence of parental conditional regard on the development of optimal-secure self-esteem. Furthermore, the results demonstrate strong correlations between optimal-secure self-esteem, highly developed self-kindness, and high life satisfaction.

CONCLUSIONS

Using a longitudinal person-oriented approach, it was possible to identify a group with highly vulnerable self-esteem, characterised by particularly low self-kindness, strong self-judgment, and lower life satisfaction. The findings of this study support the need for prevention and intervention targeting adolescents with low-insecure self-esteem.

Does loving-kindness meditation elicit empathic emotions? The moderating role of self-discrepancy and self-esteem on guilt

Our understanding of the emotions elicited by loving-kindness meditation (LKM) at early stages of practice is limited, despite the influence that these emotions may have on later engagement. Past work suggests that LKM may elicit emotional ambivalence at early stages of the practice, but it is still unclear whether the content of LKM activates this ambivalence and who is more likely to experience it. Given the specific content of LKM, we defend that this meditation is likely to elicit empathetic emotions, both positive (compassion and gratitude) and negative (guilt), to a greater extent than an active control. Guilt is likely to be elicited by memories of incidents where naïve meditators were not able to experience compassion and/or by the difficulties in sending compassionate love to disliked others during the meditation. Furthermore, individuals with greater self-discrepancy and lower self-esteem are more likely to experience guilt. These hypotheses were tested in two experimental studies with community and student samples (n = 55 and n = 33, respectively) and using a brief intervention. The results support the hypotheses. These findings have implications for instructors of LKM, especially when organizing meditation practices with naïve meditators who should be aware of the potential negative emotions elicited by this meditation.

How do aspects of selfhood relate to depression and anxiety among youth? A meta-analysis

Adolescents' sense of self has important implications for their mental health. Despite more than two decades of work, scholars have yet to amass evidence across studies to elucidate the role of selfhood in the mental health of adolescents. Underpinned by the conceptual model of selfhood, this meta-analytic review investigated the strength of associations of different facets of selfhood and their associated traits with depression and anxiety, moderating factors that attenuate or exacerbate these associations, and their causal influences. Using mixed-effects modeling, which included 558 effect sizes from 298 studies and 274 370 adolescents from 39 countries, our findings revealed that adolescents' self-esteem/self-concept [r = -0.518, p < 0.0001; (95% CI -0.49 to -0.547)] and self-compassion [r = -0.455, p < 0.0001; (95% CI -0.568 to -0.343)] demonstrating largest effect sizes in their associations with depression. Self-esteem/self-concept, self-compassion, self-awareness, self-efficacy, and self-regulation had similar moderate negative associations with anxiety. Meta-regressions revealed that adolescent age and type of informants (parents v. adolescents) were important moderators. Findings on causal influences indicated bidirectional causations, particularly low self-esteem/self-concept, self-awareness and self-efficacy drive higher depression and vice-versa. In contrast, the different self traits did not demonstrate specific causal direction with anxiety. These results pinpoint self traits that are pivotal in relating to adolescent mental health functioning. We discussed the theoretical implications of our findings in terms of how they advance theory of selfhood for adolescent mental health, and the practical implications of building selfhood as cultivating psychological skills for mental health.

Risk and protective factors in suicidal behaviour among young people in Hong Kong: A comparison study between children and adolescents✰

Suicide is the leading cause of death among young people worldwide. Few studies examined the factors of childhood suicidality and compared them with adolescent suicidality to meet their age-specific needs. We examined the similarities and differences in risk and protective factors of children and adolescent suicidality in Hong Kong. A school-based survey with 541 students in grades 4-6 and 3,061 students in grades 7-11 from 15 schools was conducted. We measured the demographic, familial, school, mental health, and psychological factors of suicidality. Hierarchical binary logistic regressions were performed to examine the association between correlates and child and youth suicidality, and the interaction effects of these factors and school-age groups. Approximately 17.51% and 7.84% of secondary school respondents and 15.76% and 8.17% of primary school respondents reported suicidal ideation and attempt, respectively. Common correlates for suicidal ideation were depression, bullying, loneliness, self-compassion, and growth mindset, while those for suicide attempt were depression and bullying. Secondary school respondents with higher life satisfaction reported less suicidal ideation, while primary school respondents with higher self-control reported fewer suicide attempts. In conclusion, we recommended recognizing the factors of suicidal ideation and attempt in children and adolescents to tailor preventive strategies in a culturally sensitive manner.

The role of self-compassion in the psychological (mal)adjustment of older adults: A repeated-measures study protocol

PURPOSE

Self-compassion is associated with healthy ageing and may be a protection factor of older adults' mental health in face of negative life events and other factors such as insecure attachment. However, fear of self-compassion may constitute an obstacle to promoting self-compassion. The role of self-compassion on the psychological (mal)adjustment of older adults requires further research with robust designs, and fear of self-compassion has not been studied in this population. We will test the moderator and mediator role, respectively, of self-compassion and fear of self-compassion, and we will analyse the longitudinal developmental trajectories of these variables.

METHODS

A repeated-measures design with three data collection moments across 6 months, using a sample (180-200 participants) of community residents aged ≥65 years. Data will be collected using traditional (i.e. pencil-and-paper questionnaires) and online (i.e. Google Forms) methods. Path analyses will be conducted to test moderation and mediation models. Latent growth curve analyses will be conducted to study the within-person change and between-person differences in change over time of self-compassion and fear of self-compassion.

CONCLUSIONS

We expect that participants with higher self-compassion will show better psychological adjustment, regardless of attachment quality and negative life events. We expect that insecure attachment and more negative life events will increase the participants' fear of self-compassion, which will decrease their psychological adjustment. Additionally, we expect that self-compassion and fear of self-compassion will show stable developmental trajectories during 6 months. Our results will contribute to better understand protection factors of older adults' mental health, which may guide future psychological interventions.

The impact of session-introducing mindfulness and relaxation interventions in individual psychotherapy for children and adolescents: a randomized controlled trial (MARS-CA)

Background

The investigation of mindfulness-based interventions (MBIs) in cognitive-behavioral therapy has greatly increased over the past years. However, most MBI research with youth focuses on structured, manualized group programs, conducted in school settings. Knowledge about the implementation and effects of MBIs in individual psychotherapy with children and adolescents is scarce. To fill this research gap, the “Mindfulness and Relaxation Study – Children and Adolescents” (MARS-CA) is designed. It aims to assess the effects of short session-introducing interventions with mindfulness elements on juvenile patients’ symptomatic outcome and therapeutic alliance in individual child and adolescent psychotherapy.

Methods

MARS-CA is conducted at a university outpatient training center for cognitive-behavior therapy. Short session-introducing interventions with mindfulness elements will be compared to short session-introducing relaxation interventions and no session-introducing intervention to explore their effects on symptomatic outcome and therapeutic alliance. The session-introducing interventions will take place at the beginning of 24 subsequent therapy sessions. We hypothesize that patients’ symptomatic outcome and therapeutic alliance improve more strongly in the mindfulness condition than in the other two conditions and that the mindfulness condition moderates the relationship between therapeutic alliance and symptomatic outcome. Patients and their trainee therapists will be randomized to one of the three treatment arms. Participants aged between 11 and 19 years and having a primary diagnosis of either a depressive disorder, an anxiety disorder, or a hyperkinetic disorder will be included. Therapeutic alliance will be assessed after every therapy session (therapy session 1 to therapy session 24), symptomatic outcome will be assessed before the start of treatment (pre), after the 3rd, the 10th, and the 17th therapy sessions, at the end of treatment (24th therapy session, post), and at a 6-month follow-up. Additionally, mindfulness and mindfulness-related measures as well as demographic data, adherence, allegiance, and therapeutic techniques will be assessed. It is our aim to assess a sample of 135 patients. We will conduct multilevel modeling to address the nested data structure.

Discussion

The study can provide information about how add-on MBIs, conducted by trainee therapists, influence therapeutic alliance and symptomatic outcome in individual psychotherapy in children and adolescents.

Trial registration

ClinicalTrials.gov NCT04034576. Registered on July 17, 2019

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

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

Meta-analytic review on the differential effects of self-compassion components on well-being and psychological distress: The moderating role of dialecticism on self-compassion

Although self-compassion has been extensively studied in the recent decades, the representation of self-compassion as a unitary measure or the presence of self-warmth (i.e., presence of the positive components: self-kindness, common humanity, and mindfulness) and self-coldness (i.e., presence of the negative components: self-judgment, isolation, and mindfulness) remains controversial. Moreover, the differential effects of the six components of self-compassion on mental well-being and psychological distress have not been systematically investigated. To synthesize the differential effects of the six components of self-compassion and to examine how people in different cultures may associate the positive and negative components of self-compassion differentially, the present meta-analysis synthesized 183 effect sizes across 27 cultures. Results showed that the negative components of self-compassion (rs = 0.44 to 0.45) showed greater effect sizes with psychological distress than the positive counterparts (rs = -0.17 to -0.29) whereas the positive components of SCS (rs = 0.29 to.39) showed greater effect sizes with mental well-being than the negative counterparts (rs = -0.29 to -0.36), with the exception of common humanity and isolation (r = 0.29 and - 0.36). Cultural orientation of dialecticism moderated the association between the positive and the negative components of self-compassion, with dialectical cultures showing lower associations between the two opposing components. Findings have implications on the design and implementation of self-compassion interventions cross-culturally.

A Preliminary Investigation Into the Relationship Between Autistic Traits and Self-Compassion

Self-compassion refers to the extension of kindness to oneself when faced with feelings of inadequacies, shortcomings or failures. It is possible that individuals high in autistic traits may encounter difficulties with self-compassion, and this could be particularly pronounced due to the social challenges they might face. To explore this potential relationship, we recruited university students and members of the general population to an online survey (n = 176). Participants completed measures on demographics, autistic traits, and self-compassion. We found that autistic traits were indeed negatively correlated with self-compassion in both males and females. Interestingly, a comparison of the slopes showed significantly stronger relationships in males compared to females for the negative (but not the positive) subscales of the self-compassion scale. Although speculative at this point, it is possible that self-compassion acts as a mediator between autistic traits and psychopathology. With this in mind, further work is warranted to determine whether self-compassion could be a target for therapeutic intervention.

Effects of a Self-Compassion Break Induction on Self-Reported Stress, Self-Compassion, and Depressed Mood

INTRODUCTION

The objective of the study was to determine whether practicing a self-compassion induction would reduce self-reported stress, depressed mood, and increase self-compassion in a randomized controlled study measuring variables of interest at two time points spanning three weeks.

METHOD

Participants were 129 students (91 females and 38 males, M_age = 19.47, SD = 3.20) divided into three groups: Self-compassion Break, Time Management Control Group, and a No-Induction Control Group. Participants were part of the general student body and were not diagnosed or screened for clinical depression. Self-compassion, stress, and depressed mood were assessed at baseline and follow-up. Participants practiced their respective inductions over three weeks after being guided through their respective inductions at Time 1.

RESULTS

There were no significant differences between groups in outcome variables. Results of this study may indicate the importance of weekly group check-in meetings to facilitate positive change as findings in this study did not mirror those of similar studies using frequent meetings.

A systematic review of the relation between self-compassion and depressive symptoms in adolescents

Research on self-compassion and depressive symptoms is growing at an exponential pace. This systematic review provides an in-depth exploration of the relation between self-compassion and depressive symptoms in adolescents. In accordance with PRISMA guidelines, MEDLINE, CINAHL, and PsycINFO databases were systematically searched and 18 studies were identified. Results demonstrate the potentially pertinent role that self-compassion may play in the development, maintenance, and treatment of depression in adolescents, yet reflect on the paucity of research on this topic with respect to mechanisms of change. These studies further highlight how the impact of self-compassion may differ according to gender and age and underscore the need to account for other diversity-related variables, such as ethnic-racial group, socioeconomic status, and sexual orientation. Despite such limitations in the literature, the current findings extend research in adults by providing support for the relevance of self-compassion in adolescence, particularly with respect to the prevention of depressive symptoms.

Self-Evaluation and Depressive Symptoms: A Latent Variable Analysis of Self-esteem, Shame-proneness, and Self-criticism

This paper examined the unique associations of latent self-esteem with symptoms of depression, over-and-above latent shame-proneness (study 1) and latent self-criticism (study 2), among two samples of undergraduate students. In study 1, confirmatory factor analysis (CFA) showed convergent and discriminant validity for most measures of shame-proneness and self-esteem. Shame-proneness and self-esteem (taken separately) were strongly related to depressive symptoms. Controlling for each other, self-esteem but not shame-proneness remained associated with depressive symptoms. In study 2, CFA showed convergent validity but not discriminant validity for measures of self-criticism and low self-esteem. Self-esteem and self-criticism (taken separately) were strongly related to depressive symptoms. Controlling for each other, however, neither construct was significantly associated with depressive symptoms. Findings suggest that (a) self-esteem and shame-proneness have good discriminant validity, (b) self-esteem is uniquely related to depressive symptoms above and beyond shame-proneness, and (c) self-report measures of self-criticism and self-esteem have poor discriminant validity.

Self-compassion and Psychological Distress in Adolescents-a Meta-analysis

Research indicates that self-compassion is relevant to adolescents' psychological well-being, and may inform the development of mental health and well-being interventions for youth. This meta-analysis synthesises the existing literature to estimate the magnitude of effect for the association between self-compassion and psychological distress in adolescents. Our search identified 19 relevant studies of adolescents (10-19 years; N = 7049) for inclusion. A large effect size was found for an inverse relationship between self-compassion and psychological distress indexed by anxiety, depression, and stress (r = - 0.55; 95% CI  - 0.61 to - 0.47). The identified studies were highly heterogeneous, however sensitivity analyses indicated that correction for publication bias did not significantly alter the pattern of results. These findings replicate those in adult samples, suggesting that lack of self-compassion may play a significant role in causing and/or maintaining emotional difficulties in adolescents. We conclude that self-compassion may be an important factor to target in psychological distress and well-being interventions for youth.