Top

Gepubliceerd in:

24-09-2021 | REVIEW

Investigating the Influence of Self-Compassion-Focused Interventions on Posttraumatic Stress: A Systematic Review and Meta-Analysis

Auteurs: Xi Luo, Xianwei Che, Yi Lei, Hong Li

Gepubliceerd in: Mindfulness | Uitgave 12/2021

Abstract

Objectives

Self-compassion-focused interventions may be able to decrease posttraumatic stress symptoms. However, previous studies demonstrated mixed effects in which a series of confounders were not systematically quantified. In this study, a systematic review with meta-analysis was conducted to quantify the effects of self-compassion-focused therapies on posttraumatic stress disorder.

Methods

Twelve eligible studies were included after a systematic search of databases. Outcome measures were extracted for posttraumatic stress disorder.

Results

Our data indicated a medium protective effect on posttraumatic stress symptoms (SMD = − 0.65), with most of the studies (8/12) coming from clinical settings. More importantly, longer interventions were associated with better posttraumatic stress outcomes (p < 0.001). Baseline or changes in self-compassion scores were not associated with posttraumatic stress outcomes post-interventions.

Conclusions

Overall, findings from this meta-analysis quantified the complex influence of self-compassion-focused interventions on posttraumatic stress symptoms and may provide insights for optimizing intervention strategies.

Systematic Review and Meta-analysis Registration: PROSPERO CRD42020208663.

vorige artikel Effects of Mindfulness-Based Parallel-Group Interventions on Family Functioning and Child and Parent Mental Health: a Systematic Review and Meta-analysis

volgende artikel Psychobiological Mechanisms Underlying the Mental Health Benefits of Yoga-Based Interventions: a Narrative Review

Alleen toegankelijk voor geautoriseerde gebruikers

Allen, A. B., & Leary, M. R. (2010). Self-compassion, stress, and coping. Social and Personality Psychology Compass, 4(2), 107–118. https://doi.org/10.1111/j.1751-9004.2009.00246.xCrossRefPubMedPubMedCentral

Amstadter, A. B., & Vernon, L. L. (2008). Emotional reactions during and after trauma: A comparison of trauma types. Journal of Aggression, Maltreatment & Trauma, 16(4), 391–408. https://doi.org/10.1080/10926770801926492CrossRef

Association Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Au, T. M., Sauer-Zavala, S., King, M. W., Petrocchi, N., Barlow, D. H., & Litz, B. T. (2017). Compassion-based therapy for trauma-related shame and posttraumatic stress: Initial evaluation using a multiple baseline design. Behavior Therapy, 48(2), 207–221. https://doi.org/10.1016/j.beth.2016.11.012CrossRefPubMed

Barlow, M. R., Turow, R. E. G., & Gerhart, J. (2017). Trauma appraisals, emotion regulation difficulties, and self-compassion predict posttraumatic stress symptoms following childhood abuse. Child Abuse & Neglect, 65, 37–47. https://doi.org/10.1016/j.chiabu.2017.01.006CrossRef

Bax, L. (2011). MIX 2.0. Professional software for meta-analysis in excel. Available at: https://www.meta-analysis-made-easy.com/

Begg, C. B., & Mazumdar, M. (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics, 50(4), 1088–1101. https://doi.org/10.2307/2533446CrossRefPubMed

Bistricky, S. L., Gallagher, M. W., Roberts, C. M., Ferris, L., Gonzalez, A. J., & Wetterneck, C. T. (2017). Frequency of interpersonal trauma types, avoidant attachment, self-compassion, and interpersonal competence: A model of persisting posttraumatic symptoms. Journal of Aggression, Maltreatment & Trauma, 26(6), 608–625. https://doi.org/10.1080/10926771.2017.1322657CrossRef

Breslau, N., Kessler, R. C., Chilcoat, H. D., Schultz, L. R., Davis, G. C., & Andreski, P. (1998). Trauma and posttraumatic stress disorder in the community: The 1996 Detroit area survey of trauma. Archives of General Psychiatry, 55(7), 626–632. https://doi.org/10.1001/archpsyc.55.7.626CrossRefPubMed

Cȃndea, D.-M., & Szentágotai-Tătar, A. (2018). The impact of self-compassion on shame-proneness in social anxiety. Mindfulness, 9(6), 1816–1824. https://doi.org/10.1007/s12671-018-0924-1CrossRef

Che, X., Cash, R., Chung, S., Fitzgerald, P. B., & Fitzgibbon, B. M. (2018). Investigating the influence of social support on experimental pain and related physiological arousal: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 92, 437–452. https://doi.org/10.1016/j.neubiorev.2018.07.005CrossRef

Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Earlbam Associates.

Diedrich, A., Burger, J., Kirchner, M., & Berking, M. (2017). Adaptive emotion regulation mediates the relationship between self-compassion and depression in individuals with unipolar depression. Psychology and Psychotherapy: Theory, Research and Practice, 90(3), 247–263. https://doi.org/10.1111/papt.12107CrossRef

Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. Bmj-British Medical Journal, 315(7109), 629–634. https://doi.org/10.1136/bmj.315.7109.629CrossRefPubMedCentral

Evans, A. P., Mascaro, J. S., Kohn, J. N., Dobrusin, A., Darcher, A., Starr, S. D., Craighead, L. W., & Negi, L. T. (2019). Compassion meditation training for emotional numbing symptoms among veterans with post-traumatic stress disorder. The Journal of Alternative and Complementary Medicine, 25(4), 441–443. https://doi.org/10.1089/acm.2018.0425CrossRefPubMed

Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness, 10(8), 1455–1473. https://doi.org/10.1007/s12671-019-01134-6CrossRef

Galili-Weinstock, L., Chen, R., Atzil-Slonim, D., Bar-Kalifa, E., Peri, T., & Rafaeli, E. (2018). The association between self-compassion and treatment outcomes: Session-level and treatment-level effects. Journal of Clinical Psychology, 74(6), 849–866. https://doi.org/10.1002/jclp.22569CrossRefPubMed

González-García, M., Álvarez, J. C., Pérez, E. Z., Fernandez-Carriba, S., & López, J. G. (2021). Feasibility of a brief online mindfulness and compassion-based intervention to promote mental health among university students during the COVID-19 pandemic. Mindfulness, 12(7), 1685–1695. https://doi.org/10.1007/s12671-021-01632-6CrossRef

Grodin, J., Clark, J. L., Kolts, R., & Lovejoy, T. I. (2019). Compassion focused therapy for anger: A pilot study of a group intervention for veterans with PTSD. Journal of Contextual Behavioral Science, 13, 27–33. https://doi.org/10.1016/j.jcbs.2019.06.004CrossRef

Guan, M., & Vandekerckhove, J. (2016). A Bayesian approach to mitigation of publication bias. Psychonomic Bulletin & Review, 23(1), 74–86. https://doi.org/10.3758/s13423-015-0868-6CrossRef

Hamrick, L. A., & Owens, G. P. (2019). Exploring the mediating role of self-blame and coping in the relationships between self-compassion and distress in females following the sexual assault. Journal of Clinical Psychology, 75(4), 766–779. https://doi.org/10.1002/jclp.22730CrossRefPubMed

Hedges, L., & Olkin, I. (2014). Statistical methods for meta-analysis. Academic.

Held, P., & Owens, G. P. (2015). Effects of self-compassion workbook training on trauma-related guilt in a sample of homeless veterans: A pilot study. Journal of Clinical Psychology, 71(6), 513–526. https://doi.org/10.1002/jclp.22170CrossRefPubMed

Held, P., Owens, G. P., Thomas, E. A., White, B. A., & Anderson, S. E. (2018). A pilot study of brief selfcompassion training with individuals in substance use disorder treatment. Traumatology, 24(3), 219. https://doi.org/10.1037/trm0000146

Higgins, J., & Wells, G. (2011). Cochrane handbook for systematic reviews of interventions. Version 5.1.0. The Cochrane Collaboration. http://www.cochrane-handbook.org.

Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. Bmj-British Medical Journal, 327(7414), 557–560. https://doi.org/10.1136/bmj.327.7414.557CrossRefPubMedCentral

Hoffart, A., Øktedalen, T., & Langkaas, T. F. (2015). Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: A study of within-person processes. Frontiers in Psychology, 6, 1273. https://doi.org/10.3389/fpsyg.2015.01273CrossRefPubMedPubMedCentral

Huwaldt, J. A. (2010). Open Source Software. Available at. http://plotdigitizer.sourceforge.net/

Hwang, W.-C., & Chan, C. P. (2019). Compassionate meditation to heal from race-related stress: A pilot study with Asian Americans. American Journal of Orthopsychiatry, 89(4), 482. https://doi.org/10.1037/ort0000372CrossRef

Inwood, E., & Ferrari, M. (2018). Mechanisms of change in the relationship between self-compassion, emotion regulation, and mental health: A systematic review. Applied Psychology: Health and Well-Being, 10(2), 215–235. https://doi.org/10.1111/aphw.12127CrossRef

Kearney, D. J., Malte, C. A., McManus, C., Martinez, M. E., Felleman, B., & Simpson, T. L. (2013). Loving-kindness meditation for posttraumatic stress disorder: A pilot study. Journal of Traumatic Stress, 26(4), 426–434. https://doi.org/10.1002/jts.21832CrossRefPubMed

Kirby, J. N., & Gilbert, P. (2019). Commentary regarding Wilson et al.(2018)“Effectiveness of ‘self-compassion’ related therapies: A systematic review and meta-analysis.” All is not as it seems. Mindfulness, 10(6), 1006–1016. https://doi.org/10.1007/s12671-018-1088-8CrossRef

Kok, B. E., Coffey, K. A., Cohn, M. A., Catalino, L. I., Vacharkulksemsuk, T., Algoe, S. B., Brantley, M., & Fredrickson, B. L. (2013). How positive emotions build physical health: Perceived positive social connections account for the upward spiral between positive emotions and vagal tone. Psychological Science, 24(7), 1123–1132. https://doi.org/10.1177/0956797612470827CrossRefPubMed

Lang, A. J., Malaktaris, A. L., Casmar, P., Baca, S. A., Golshan, S., Harrison, T., & Negi, L. (2019). Compassion meditation for posttraumatic stress disorder in veterans: A randomized proof of concept study. Journal of Traumatic Stress, 32(2), 299–309. https://doi.org/10.1002/jts.22397CrossRefPubMed

Lang, A. J., Casmar, P., Hurst, S., Harrison, T., Golshan, S., Good, R., Essex, M., & Negi, L. (2020). Compassion meditation for veterans with posttraumatic stress disorder (PTSD): A nonrandomized study. Mindfulness, 11(1), 63–74. https://doi.org/10.1007/s12671-017-0866-zCrossRefPubMed

Lawrence, V. A., & Lee, D. (2014). An exploration of people’s experiences of compassion-focused therapy for trauma, using interpretative phenomenological analysis. Clinical Psychology & Psychotherapy, 21(6), 495–507. https://doi.org/10.1002/cpp.1854CrossRef

Lee, D. A., & James, S. (2013). The compassionate-mind guide to recovering from trauma and PTSD: Using compassion-focused therapy to overcome flashbacks, shame, guilt, and fear. New Harbinger Publications.

Lee, M. Y., Zaharlick, A., & Akers, D. (2017). Impact of meditation on mental health outcomes of female trauma survivors of interpersonal violence with co-occurring disorders: A randomized controlled trial. Journal of Interpersonal Violence, 32(14), 2139–2165. https://doi.org/10.1177/0886260515591277CrossRefPubMed

Lenferink, L. I., Eisma, M. C., de Keijser, J., & Boelen, P. A. (2017). Grief rumination mediates the association between self-compassion and psychopathology in relatives of missing persons. European Journal of Psychotraumatology, 8(sup6), 1378052. https://doi.org/10.1080/20008198.2017.1378052CrossRefPubMedPubMedCentral

Li, Y., Hu, Y., Yang, W., & Wang, Y. (2021). Daily interventions and assessments: The effect of online self-compassion meditation on psychological health. Applied Psychology: Health and Well-Being, 00, 1–16. https://doi.org/10.1111/aphw.12278CrossRef

Litz, B., & Carney, J. R. (2018). Employing loving-kindness meditation to promote self-and other-compassion among war veterans with posttraumatic stress disorder. Spirituality in Clinical Practice, 5(3), 201. https://doi.org/10.1037/scp0000174CrossRef

Liu, G., Zhang, N., Teoh, J. Y., Egan, C., Zeffiro, T. A., Davidson, R. J., & Quevedo, K. (2020). Self-compassion and dorsolateral prefrontal cortex activity during sad self-face recognition in depressed adolescents. Psychological Medicine, 1–10.https://doi.org/10.1017/S0033291720002482

Luo, X., Qiao, L., & Che, X. (2018). Self-compassion modulates heart rate variability and negative affect to experimentally induced stress. Mindfulness, 9(5), 1522–1528. https://doi.org/10.1007/s12671-018-0900-9CrossRef

Luo, X., Liu, J., & Che, X. (2020). Investigating the influence and a potential mechanism of self-compassion on experimental pain: Evidence from a compassionate self-talk protocol and heart rate variability. The Journal of Pain, 21(7–8), 790–797. https://doi.org/10.1016/j.jpain.2019.11.006CrossRefPubMed

Lutz, J., Berry, M. P., Napadow, V., Germer, C., Pollak, S., Gardiner, P., Edwards, R. R., Desbordes, G., & Schuman-Olivier, Z. (2020). Neural activations during self-related processing in patients with chronic pain and effects of a brief self-compassion training–a pilot study. Psychiatry Research: Neuroimaging, 304, 111155. https://doi.org/10.1016/j.pscychresns.2020.111155CrossRefPubMed

MacBeth, A., & Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32(6), 545–552. https://doi.org/10.1016/j.cpr.2012.06.003CrossRefPubMed

Maheux, A., & Price, M. (2015). Investigation of the relation between PTSD symptoms and self-compassion: Comparison across DSM IV and DSM 5 PTSD symptom clusters. Self and Identity, 14(6), 627–637. https://doi.org/10.1080/15298868.2015.1037791CrossRef

Maheux, A., & Price, M. (2016). The indirect effect of social support on post-trauma psychopathology via self-compassion. Personality and Individual Differences, 88, 102–107. https://doi.org/10.1016/j.paid.2015.08.051CrossRef

Mitchell, A. E., Whittingham, K., Steindl, S., & Kirby, J. (2018). Feasibility and acceptability of a brief online self-compassion intervention for mothers of infants. Archives of Women’s Mental Health, 21(5), 553–561. https://doi.org/10.1007/s00737-018-0829-yCrossRefPubMed

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Meddicne, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097CrossRef

Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860309027CrossRef

Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28–44. https://doi.org/10.1002/jclp.21923CrossRefPubMed

Phillips, W. J., & Hine, D. W. (2019). Self-compassion, physical health, and health behaviour: A meta-analysis. Health Psychology Review, 127.https://doi.org/10.1080/17437199.2019.1705872

Rockliff, H., Gilbert, P., McEwan, K., Lightman, S., & Glover, D. (2008). A pilot exploration of heart rate variability and salivary cortisol responses to compassion-focused imagery. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 5(3), 132–139.

Scoglio, A. A., Rudat, D. A., Garvert, D., Jarmolowski, M., Jackson, C., & Herman, J. L. (2018). Self-compassion and responses to trauma: The role of emotion regulation. Journal of Interpersonal Violence, 33(13), 2016–2036. https://doi.org/10.1177/0886260515622296CrossRefPubMed

Serpa, J. G., Bourey, C. P., Adjaoute, G. N., & Pieczynski, J. M. (2021). Mindful self-compassion (MSC) with veterans: A program evaluation. Mindfulness, 12(1), 153–161. https://doi.org/10.1007/s12671-020-01508-1CrossRef

Sirois, F. M., Molnar, D. S., & Hirsch, J. K. (2015). Self-compassion, stress, and coping in the context of chronic illness. Self and Identity, 14(3), 334–347. https://doi.org/10.1080/15298868.2014.996249CrossRef

Thomas, B., Ciliska, D., Dobbins, M., & Micucci, S. (2004). A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Worldviews on Evidence-Based Nursing, 1(3), 176–184. https://doi.org/10.1111/j.1524-475X.2004.04006.xCrossRefPubMed

Thompson, S. G. (1994). Systematic review: Why sources of heterogeneity in meta-analysis should be investigated. Bmj-British Medical Journal, 309(6965), 1351–1355. https://doi.org/10.1136/bmj.309.6965.1351CrossRefPubMedCentral

Thompson, B. L., & Waltz, J. (2008). Self-compassion and PTSD symptom severity. Journal of Traumatic Stress: Official Publication of the International Society for Traumatic Stress Studies, 21(6), 556–558. https://doi.org/10.1002/jts.20374CrossRef

Turk, F., & Waller, G. (2020). Is self-compassion relevant to the pathology and treatment of eating and body image concerns? A systematic review and meta-analysis. Clinical Psychology Review, 101856.https://doi.org/10.1016/j.cpr.2020.101856

Valdez, C. E., & Lilly, M. M. (2016). Self-compassion and trauma processing outcomes among victims of violence. Mindfulness, 7(2), 329–339. https://doi.org/10.1007/s12671-015-0442-3CrossRef

Valenstein-Mah, H., Simpson, T. L., Bowen, S., Enkema, M. C., Bird, E. R., Cho, H. I., & Larimer, M. E. (2019). Feasibility pilot of a brief mindfulness intervention for college students with posttraumatic stress symptoms and problem drinking. Mindfulness, 10(7), 1255–1268. https://doi.org/10.1007/s12671-018-1077-yCrossRefPubMedPubMedCentral

Wakelin, K. E., Perman, G., & Simonds, L. M. (2021). Effectiveness of self‐compassion related interventions for reducing self‐criticism: A systematic review and meta‐analysis. Clinical Psychology & Psychotherapy, 1–25. https://doi.org/10.1002/cpp.2586

Winders, S. J., Murphy, O., Looney, K., & O’Reilly, G. (2020). Self-compassion, trauma, and posttraumatic stress disorder: A systematic review. Clinical Psychology & Psychotherapy, 27(3), 300–329. https://doi.org/10.1002/cpp.2429CrossRef

Zeller, M., Yuval, K., Nitzan-Assayag, Y., & Bernstein, A. (2015). Self-compassion in recovery following potentially traumatic stress: Longitudinal study of at-risk youth. Journal of Abnormal Child Psychology, 43(4), 645–653. https://doi.org/10.1007/s10802-014-9937-y

Titel: Investigating the Influence of Self-Compassion-Focused Interventions on Posttraumatic Stress: A Systematic Review and Meta-Analysis
Auteurs: Xi Luo
Xianwei Che
Yi Lei
Hong Li
Publicatiedatum: 24-09-2021
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness / Uitgave 12/2021
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-021-01732-3

Andere artikelen Uitgave 12/2021

Negative Mood and Food Craving Strength Among Women with Overweight: Implications for Targeting Mechanisms Using a Mindful Eating Intervention

ORIGINAL PAPER

Correction to: Overcoming Automaticity Through Meditation

Correction

Mindfulness-Based Intervention for Children with Mental Health Problems: a 2-Year Follow-up Randomized Controlled Study

Open Access
ORIGINAL PAPER

Family Mindfulness Training for Childhood ADHD: Short- and Long-Term Effects on Children, Fathers and Mothers

Open Access
ORIGINAL PAPER

Enhancing Cognition in Older Persons with Depression or Anxiety with a Combination of Mindfulness-Based Stress Reduction (MBSR) and Transcranial Direct Current Stimulation (tDCS): Results of a Pilot Randomized Clinical Trial

ORIGINAL PAPER

EEG Characteristics During Mindfulness Meditation Among Buddhist Monks in a Sri Lankan Forest Monastery

ORIGINAL PAPER