Nicola Petrocchi

Protection or Vulnerability? : A Meta-Analysis of the Relations Between the Positive and Negative Components of Self-Compassion and Psychopathology

Self-compassion is increasingly explored as a protective factor in relation to psychopathology. The Self-Compassion Scale (SCS) and its Short Form variant (SCS-SF) are the most widely used instruments for measuring this psychological construct, and previous studies have indeed shown that the total score of this scale is negatively associated with psychopathology. In this article, we point out that half of the items of the SCS and SCS-SF are positive indicators of self-compassion and directly refer to the three key components of self-kindness, common humanity and mindfulness, while the other half of the items are negative indicators of the construct and reflect the precise opposite of the key components, namely self-judgment, isolation and over-identification. A meta-analysis was conducted including 18 studies that reported on the positive and negative indicators of self-compassion as indexed by the SCS/SCS-SF and their relations to various types of psychopathology. Results showed that positive indicators of self-compassion were negatively associated with psychopathology, which confirms their hypothesized protective influence. However, the negative indicators were positively linked to psychopathology, suggesting that these scales tap increased vulnerability to mental health problems. Moreover, tests comparing the strength of the relations between various SCS/SCS-SF counterparts (i.e., self-kindness versus self-judgment, common humanity versus isolation and mindfulness versus over-identification) and psychopathology showed that the negative indicators were significantly stronger linked to mental health problems than the positive indicators. This provides support for the idea that the use of a total self-compassion score of the SCS or SCS-SF, which typically includes the reversely scored negative subscales, will probably result in an inflated relationship with symptoms of psychopathology. Copyright

Dimensionality of self-compassion: translation and construct validation of the self-compassion scale in an Italian sample

Abstract Background: The construct of self-compassion is receiving increased attention due to its strong link to mental health. Nonetheless, many questions concerning its dimensionality and construct validity remain open. Aims: The purpose of this study was to evaluate the factorial structure and construct validity of the Self-Compassion Scale (SCS) in a sample of 424 Italian participants ranging in age from 17 to 65 years. Method: SCS was translated with a back-translation procedure and then administered through an on-line survey, along with measures of self-blame, subjective loneliness, emotion regulation, depression and anxiety. Results: Confirmatory factor analysis (CFA) confirmed the six-factor model both in the overall sample and in gender and age subgroups. CFA did not support the single higher-order factor of self-compassion, originally found by the author of the scale. Negative associations of Self-Kindness, Common Humanity and Mindfulness subscales with anxiety and depression were confirmed. Moreover, negative correlations of these subscales with self-blame, positive correlations with reappraisal and non-significant associations with expressive suppression and subjective loneliness were found, unveiling aspects of the construct not fully investigated in empirical research. Conclusions: Findings suggest that the SCS is a reliable tool but its dimensionality may vary according to different cultural contexts.

Intrapsychic and interpersonal guilt: a critical review of the recent literature.

Various authors hold that some emotions (i.e., moral emotions) have the function of orienting people toward ethical actions. In addition to embarrassment, shame and pride, the moral emotion of guilt is believed to affect humans’ behavior when they carry out transgressions that violate social and cultural standards. Over the past century, many studies (including controversial ones) have been conducted on guilt. In this study, we analyzed and summarized mainly the most recent literature on this emotion. On one side, the destructiveness of guilt is emphasized. It inflicts punishment and pain on individuals for their errors and can lead to psychopathology (e.g., depression). On the other side, it is described as a “friendly” emotion that motivates behavior adapted to social and cultural rules. How can this asymmetry be explained? Different existing views on guilt are presented and discussed, together with recent proposals, supported by research data. Finally, we discussed some systematic models that try to incorporate these different views in a single framework that could facilitate future researches.

The current and future role of heart rate variability for assessing and training compassion

The evolution of mammalian caregiving involving hormones, such as oxytocin, vasopressin, and the myelinated vagal nerve as part of the ventral parasympathetic system, enables humans to connect, co-regulate each other’s emotions and create prosociality. Compassion-based interventions draw upon a number of specific exercises and strategies to stimulate these physiological processes and create conditions of “interpersonal safeness,” thereby helping people engage with, alleviate, and prevent suffering. Hence, compassion-based approaches are connected with our evolved caring motivation and attachment and our general affiliative systems that help regulate distress. Physiologically, they are connected to activity of the vagus nerve and corresponding adaptive heart rate variability (HRV). HRV is an important physiological marker for overall health, and the body–mind connection. Therefore, there is significant value of training compassion to increase HRV and training HRV to facilitate compassion. Despite the significance of compassion in alleviating and preventing suffering, there remain difficulties in its precise assessment. HRV offers a useful form of measurement to assess and train compassion. Specific examples of what exercises can facilitate HRV and how to measure HRV will be described. This paper argues that the field of compassion science needs to move toward including HRV as a primary outcome measure in its future assessment and training, due to its connection to vagal regulatory activity, and its link to overall health and well-being.

Compassion at the mirror: Exposure to a mirror increases the efficacy of a self-compassion manipulation in enhancing soothing positive affect and heart rate variability

Abstract We tested whether a mirror could enhance the efficacy of a self-compassion manipulation in increasing soothing positive affect and heart rate variability (HRV). Eighty-six participants generated four phrases they would use to soothe and encourage their best friend. Second, they described an episode where they criticized themselves and were assigned to one of three conditions: (a) repeat the four phrases to themselves while looking at the mirror; (b) repeat the four phrases to themselves without the mirror; (c) look at themselves in the mirror without repeating the phrases. Participants in condition (a) reported higher levels of ‘soothing’ positive affect and HRV compared to participants in conditions (b) and (c). The effect of the ‘phrases at the mirror’ manipulation on soothing affect was mediated by increased common humanity. The mirror enhances the efficacy of this self-compassion manipulation in activating the soothing affect system connected with parasympathetic nervous system activity.

The impact of gratitude on depression and anxiety: the mediating role of criticizing, attacking, and reassuring the self

Abstract Gratitude significantly predicts less depression and anxiety symptoms in general population. Three types of self-relating processes as possible mediators of this relationship were evaluated. Trait gratitude, depression, anxiety, and three forms of self-relating (criticizing, attacking, and reassuring the self) were assessed in 410 Italian participants. Gratitude predicted less depression and anxiety symptoms, and the three forms of self-relating partially mediated the impact of gratitude on both depression and anxiety. Self-reassuring had a stronger mediation power than self-attacking in the prediction of anxiety symptoms. Gratitude is a protective factor against psychopathology not only due to its association with improved relationships with others, but also because it is connected to a less critical, less punishing, and more compassionate relationship with the self.

Compassion-Based Therapy for Trauma-Related Shame and Posttraumatic Stress: Initial Evaluation Using a Multiple Baseline Design

Accumulating research suggests that shame can strongly contribute to the development and maintenance of posttraumatic stress disorder (PTSD). Interventions that promote self-compassion have shown promise for reducing shame related to various clinical problems, but this approach has not been systematically evaluated for traumatized individuals. The aim of this study was to develop a brief compassion-based therapy and assess its efficacy for reducing trauma-related shame and PTSD symptoms. Using a multiple baseline experimental design, the intervention was evaluated in a community sample of trauma-exposed adults (N=10) with elevated trauma-related shame and PTSD symptoms. Participants completed weekly assessments during a 2-, 4-, or 6-week baseline phase and a 6-week treatment phase, and at 2 and 4weeks after the intervention. By the end of treatment, 9 of 10 participants demonstrated reliable decreases in PTSD symptom severity, while 8 of 10 participants showed reliable reductions in shame. These improvements were maintained at 2- and 4-week follow-up. The intervention was also associated with improvements in self-compassion and self-blame. Participants reported high levels of satisfaction with the intervention. Results suggest that the intervention may be useful as either a stand-alone treatment or as a supplement to other treatments.

Transcranial direct current stimulation enhances soothing positive affect and vagal tone

ABSTRACT Transcranial Direct Current Stimulation (tDCS) is a promising tool for the treatment of depression and the dorsolateral prefrontal cortex (dlPFC) is often targeted when exploring tDCS effects on mood. However, the basic effects of tDCS on momentary emotions are inconsistent. We tested whether a single‐session of anodal tDCS over the left temporal lobe (T3), topographically closer to the insular cortex than dlPFC, had effects on both vagally‐mediated heart rate variability (HRV) and momentary affect in healthy participants. Thirty‐four subjects underwent both sham and active tDCS in a counterbalanced random order. ECG was continuously recorded to derive both time and frequency domain HRV indexes. Before and after the tDCS protocol, participants completed momentary affect assessments. Results showed that HRV and soothing positive affectivity were both enhanced after a single‐session of tDCS over T3, while negative and activating positive affect were not modulated by the stimulation. After controlling for sex, age, and levels of anxiety and depression a significant association emerged between increases in soothing positive affect and concomitant increases in vagally‐mediated HRV. Deficits in soothing positive emotions have consistently been associated with psychopathology and psychotherapeutic approaches aimed to develop this type of emotionality have shown to improve psychological well‐being. Thus, present exploratory results may impact future research investigating potential moderators (site of stimulation) and mediators (specificity for a determined type of momentary affect) of the effects of tDCS on psychopathological conditions such as depression. HIGHLIGHTSThe basic effects of tDCS on momentary emotions are inconsistent.A single‐session anodal tDCS over T3 increased HRV and soothing positive affect.Increases in soothing positive affect were associated with increases in HRV.Results suggest moderators and mediators of the effects of tDCS on depression.

Positive Social Interactions in a Lifespan Perspective with a focus on Opioidergic and Oxytocinergic systems: Implications for Neuroprotection.

In recent years, a growing interest has emerged in the beneficial effects of positive social interactions on health. The present work aims to review animal and human studies linking social interactions and health throughout the lifespan, with a focus on current knowledge of the possible mediating role of opioids and oxytocin. During the prenatal period, a positive social environment contributes to regulating maternal stress response and protecting the fetus from exposure to maternal active glucocorticoids. Throughout development, positive social contact with the caregiver acts as a “hidden regulator” and promotes infant neuroaffective development. Postnatal social neuroprotection interventions involving caregiver–infant physical contact seem to be crucial for rescuing preterm infants at risk for neurodevelopmental disorders. Attachment figures and friendships in adulthood continue to have a protective role for health and brain functioning, counteracting brain aging. In humans, implementation of meditative practices that promote compassionate motivation and prosocial behavior appears beneficial for health in adolescents and adults. Human and animal studies suggest the oxytocinergic and opioidergic systems are important mediators of the effects of social interactions. However, most of the studies focus on a specific phase of life (i.e., adulthood). Future studies should focus on the role of opioids and oxytocin in positive social interactions adopting a lifespan perspective.

A tailored compassion-focused therapy program for sexual minority young adults with depressive symotomatology: study protocol for a randomized controlled trial

BackgroundLesbian, gay, and bisexual (LGB) men and women represent one of the highest-risk populations for depressive symptomatology and disorders, with young LGB adults being at greatest risk. To date, there have been no randomized controlled trials (RCT) to specifically target depressive symptoms in young LGB adults. This is despite research highlighting unique predictors of depressive symptomatology in this population. Here we outline a protocol for an RCT that will test the preliminary efficacy of a tailored compassion-focused therapy (CFT) intervention for young LGB adults compared with a self-directed cognitive behavioral therapy (CBT) program with no specific tailoring for LGB individuals.MethodsThe CFT intervention consists of 8 units with self-directed reading and activities tailored to LGB young adults, and 8 x weekly 1-hour consultations with a therapist. The CBT intervention consists of 8 units with self-guided reading and activities, with 1 x 1-hour session with a therapist at the mid-point of therapy. Fifty LGB individuals with scores of 13 or above on the Beck Depression Inventory-II will be randomized to either the CFT or CBT condition. The primary outcome measure is depressive symptomatology. Secondary outcome measures are symptoms of anxiety, suicidal ideation, internalized homophobia, self-compassion, and shame and guilt proneness. Assessments will occur at pre-intervention, post-intervention, and at 3-month post-intervention.DiscussionThis study is an RCT to test the preliminary efficacy of an LGB-tailored compassion-focused intervention for young LGB adults with depressive symptomatology. If this intervention is efficacious, this could begin to address the substantial mental health disparities amongst sexual minorities.Trial registrationACTRN12616001018404. Prospective registration, registered 02/08/2016.