• Ability to receive compassion from others buffers the depressogenic effect of self-criticism: A cross-cultural multi-study analysis

      Hermanto, Nicola; Zuroff, David C.; Kopala-Sibley, Daniel C.; Kelly, Allison C.; Matos, Marcela; Gilbert, Paul; Koestner, Richard; McGill University; University of Waterloo; University of Coimbra; et al. (Elsevier, 2016-04-29)
      Self-criticism has been shown to be a vulnerability factor that can lead to and maintain depression. We examined the moderating effect of fear of receiving compassion from others on the positive association between self-criticism and depression. Self-report measures were administered to four separate samples (total N = 701) varying in age (students and community adults) and cultural context (Canada, England, and Portugal). Two different measures of self-criticism and of depression were administered to investigate the generalizability of results. Self-criticism, depression, and fear of compassion from others were positively related to one another in all samples. As predicted, fear of compassion from others exerted a moderating effect on the relationship between self-criticism and depression. Low fear of compassion from others weakened the depressogenic effect of self-criticism, while high fear of compassion from others exacerbated the effect. Thus, a self-critic's ability to be open and responsive to care and support from others protected against depression. The aggregate moderating effect across the four studies was of medium size (d + = .53) and highly significant, indicating a robust phenomenon. Implications for working with self-critical depressed patients are discussed.
    • Affiliative and prosocial motives and emotions in mental health

      Gilbert, Paul; University of Derby (Servier Research Group, 2015)
      This paper argues that studies of mental health and wellbeing can be contextualized within an evolutionary approach that highlights the coregulating processes of emotions and motives. In particular, it suggests that, although many mental health symptoms are commonly linked to threat processing, attention also needs to be directed to the major regulators of threat processing, ie, prosocial and affiliative interactions with self and others. Given that human sociality has been a central driver for a whole range of human adaptations, a better understanding of the effects of prosocial interactions on health is required, and should be integrated into psychiatric formulations and interventions. Insight into the coregulating processes of motives and emotions, especially prosocial ones, offers improved ways of understanding mental health difficulties and their prevention and relief.
    • Attitudes towards mental health problems scale: Confirmatory factor analysis and validation in the Portuguese population.

      Cabral Master, Joana Moura; Barreto Carvalho, Célia Maria de Oliveira; Motta, Carolina Dall’Antonia; Sousa, Marina Correia; Gilbert, Paul; University of Azores; University of Derby (Taylor and Francis, 2016-08-19)
      Several studies about stigmatization and shame toward mental health problems have contributed to minimizing the impact of these negative attitudes on people diagnosed with mental illnesses, on their families and on their communities. The Attitudes Towards Mental Health Problems Scale (ATMHP) is a self-report scale aimed at the assessment of attitudes toward mental health that involve several factors relating to attitudes and shame (internal, external, and reflected shame) when facing mental health problems. The goal of the current study was to translate, and to adapt this scale to the Portuguese population, and to study its psychometric properties in a sample of Azorean adults with and without psychiatric problems. The scale was administered to 411 participants with ages between 19 and 81 years. Confirmatory factor analysis was carried out on the initial model proposed by the authors of the ATMHP, and results showed a poor adjustment. An alternative model comprising an additional factor was tested and presented good model fit indices. Based on the alternative model, further analysis revealed that the scale has good psychometric properties.
    • Body dysmorphic disorder: The functional and evolutionary context in phenomenology and a compassionate mind.

      Veale, David; Gilbert, Paul; King's College London; University of Derby (Elsevier, 2013-11-26)
      BACKGROUND: Social wariness and anxiety can take different forms. Paranoid anxiety focuses on the malevolence of others, whereas social anxiety focuses on the inadequacies in the self in competing for social position and social acceptance. This study investigates whether shame and shame memories are differently associated with paranoid and social anxieties.
    • A brief outline of the evolutionary approach for compassion focused therapy.

      Gilbert, Paul; University of Derby (ECronicon, 2017-06-06)
      Abstract Humans are evolved animals set up to pursue various life tasks. This gives rise to different phenotypes some of which are conducive to well-being, while others are not. Compassion focused therapy seeks to harness the evolved importance of affiliative and caring motivational processing to help alleviate individuals who are caught in high levels of shame and self-criticism and conse
    • Comparing brief internet-based compassionate mind training and cognitive behavioral therapy for perinatal women: Study protocol for a randomized controlled trial.

      Kelman, Alex R; Stanley, Meagan L; Barrera, Alinne Z; Cree, Michelle; Heineberg, Yotam; Gilbert, Paul; Palo Alto University; i4health; Derbyshire Healthcare NHS Foundation Trust; University of Derby; et al. (JMIR Publications, 2016-04-15)
      Background Depression that occurs during the perinatal period has substantial costs for both the mother and her baby. Since in-person care often falls short of meeting the global need of perinatal women, Internet interventions may function as an alternate to help women who currently lack adequate access to face-to-face psychological resources. However, at present there are insufficient empirically supported Internet-based resources for perinatal women.
    • Compassion as a social mentality: An evolutionary approach

      Gilbert, Paul; Gilbert, Paul; University of Derby (Routledge, 2017)
    • Compassion focused therapy with children and adolescents

      Carona, Carlos; Rijo, Daniel; Salvador, Céu; Castilho, Paula; Gilbert, Paul; University of Coimbra; University of Derby (Royal College of Psychiatrists, 2017-07-03)
      Compassion-focused therapy (CFT) is embedded in an evolutionary, functional analysis of psychopathology, with a focus on affiliative, caring and compassion processes. CFT has been applied in a number of adult settings, but its clinical applications in child and adolescent psychopathology and psychotherapy have not been systematically explored. This article describes the applications of CFT in paediatric populations. Specifically, the following developmental considerations are discussed: the unique importance of parent–child and attachment relationships for the development of self-compassion, being open to compassion from others and being compassionate to others; the potential effect of compassion training on the maturing brain (affective regulation systems); and the therapeutic targeting of shame and self-criticism to alleviate psychological distress and enhance the effectiveness of cognitive–behavioural interventions.
    • Compassion motivations: Distinguishing submissive compassion from genuine compassion and its association with shame, submissive behavior, depression, anxiety and stress

      Catarino, Francisca; Gilbert, Paul; McEwan, Kirsten; Baião, Rita; Derbyshire Healthcare Foundation Trust; University of Coimbra; University of Derby; University of Cardiff (Guildford Press, 2014-05)
      Abstract Recent research has suggested that being compassionate and helpful to others is linked to well-being. However, people can pursue compassionate motives for different reasons, one of which may be to be liked or valued. Evolutionary theory suggests this form of helping may be related to submissive appeasing behavior and therefore could be negatively associated with well-being. To explore this possibility we developed a new scale called the submissive compassion scale and compared it to other established submissive and shame-based scales, along with measures of depression, anxiety and stress in a group of 192 students. As predicted, a submissive form of compassion (being caring in order to be liked) was associated with submissive behavior, shame-based caring, ego-goals and depression, anxiety, and stress. In contrast, compassionate goals and compassion for others were not. As research on compassion develops, new ways of understanding the complex and mixed motivations that can lie behind compassion are required. The desire to be helpful, kind, and compassionate, when it arises from fears of rejection and desires for acceptance, needs to be explored.
    • Compassion, fears, blocks and resistances: An evolutionary investigation.

      Gilbert, Paul; Mascaro, Jennifer; University of Derby; Emory University (Oxford University Press, 2017-11-16)
    • Compassion-focused therapy: Preface and introduction for special section.

      Gilbert, Paul; University of Derby; Mental Health Research Unit; Kingsway Hospital; Derby UK (Wiley, 2014-03)
    • Compassion: Concepts, research and applications.

      Gilbert, Paul; University of Derby (Routledge, 2017-05-04)
      Paul Gilbert brings together an international line-up of leading scholars and researchers in the field to provide a state-of-the-art exploration of key areas in compassion research and applications. Compassion can be seen as a core element of prosocial behaviour, and explorations of the concepts and value of compassion have been extended into different aspects of life including physical and psychological therapies, schools, leadership and business. While many animals share abilities to be distress sensitive and caring of others, it is our newly evolved socially intelligent abilities that make us capable of knowingly and deliberately helping others and purposely developing skills and wisdom to do so. This book generates many research questions whilst exploring the similarity and differences of human compassion to non-human caring and looks at how compassion changes the brain and body, affects genetic expression, manifests at a young age and is then cultivated (or not) by the social environment. Compassion: Concepts, Research and Applications will be essential reading for professionals, researchers and scholars interested in compassion and its applications in psychology and psychotherapy.
    • Compassion: Definitions and controversies

      Gilbert, Paul; Gilbert, Paul; University of Derby (Routledge, 2017)
    • Compassionate care: The theory and the reality.

      Cole-King, Alys; Gilbert, Paul; University of Derby (Routledge, 2014-07-08)
    • Compassionate mind coaching

      Anstiss, Tim; Gilbert, Paul; University of Derby (Kogan Page, 2014-09-03)
    • Cruelty, evolution, and religion: The challenge for the new spiritualities

      Gilbert, Paul; Gilbert, Hannah; University of Derby (Praeger, 2015-02-28)
    • Cultivating the compassionate self against depression: An exploration of processes of change.

      Matos, Marcela; Duarte, Joana; Duarte, Cristiana; Pinto-Gouveia, José; Gilbert, Paul; University of Coimbra; University of Derby (2017-04)
      Introduction Compassion and self-compassion can be protective factors against mental health difficulties, in particular depression. The cultivation of the compassionate self, associated with a range of practices such as slow and deeper breathing, compassionate voice tones and facial expressions, and compassionate focusing, is central to compassion focused therapy (Gilbert, 2010). However, no study has examined the processes of change that mediate the impact of compassionate self-cultivation practices on depressive symptoms. Aims The aim of this study is to investigate the impact of a brief compassionate self training (CST) intervention on depressive symptoms, and explore the psychological processes that mediate the change at post intervention. Methods Using a longitudinal design, participants (general population and college students) were randomly assigned to one of two conditions: Compassionate self training (n = 56) and wait-list control (n = 37). Participants in the CST condition were instructed to practice CST exercises for 15 minutes everyday or in moments of stress during two weeks. Self-report measures of depression, self-criticism, shame and compassion, were completed at pre and post in both conditions. Results Results showed that, at post-intervention, participants in the CST condition decreased depression, self-criticism and shame, and increased self-compassion and openness to receive compassion from others. Mediation analyses revealed that changes in depression from pre to post intervention were mediated by decreases in self-criticism and shame, and increases in self-compassion and openness to the compassion from others. Conclusions These findings support the efficacy of compassionate self training components on lessening depressive symptoms and promoting mental health.
    • Cultural differences in shame-focused attitudes towards mental health problems in Asian and Non-Asian student women.

      Gilbert, Paul; Bhundia, Rakhee; Mitra, Ranjana; McEwan, Kirsten; Irons, Christopher Paul; Sanghera, Jasvinder; University of Derby; Kingsway Hospital (Routledge, 2007-02-14)
      This study explored differences in shame-focused attitudes to mental health problems in Asian and non-Asian students. The ‘Attitudes Towards Mental Health Problems’ (ATMHP) is a self-report scale designed for this study to measure: external shame (beliefs that others will look down on self if one has mental health problems); internal shame (related to negative self-evaluations); and reflected shame (believing that one can bring shame to family/community). A second questionnaire was designed to measure concerns with confidentiality. Results suggest that Asian students have higher external shame and reflected shame, but not internal shame beliefs. Asian students were also more concerned with confidentiality when it comes to talking about personal feeling/anxieties.
    • The current and future role of heart rate variability for assessing and training compassion

      Kirby, James N.; Doty, James R.; Petrocchi, Nicola; Gilbert, Paul; Stanford University; University of Queensland; John Cabot University; University of Derby (Frontiers, 2017-03-08)
      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.
    • The dark side of competition: How competitive behaviour and striving to avoid inferiority are linked to depression, anxiety, stress and self-harm.

      Gilbert, Paul; McEwan, Kirsten; Bellew, Rebecca; Mills, Alison; Gale, Corinne; University of Derby (British Psychological Society, 2009-06)
      This study was guided by the social rank theory of depression and aimed to explore the relationship between depression, anxiety, stress and self‐harm with striving to avoid inferiority, feelings of shame and styles of attachment. Participants diagnosed with depression (n=62) completed a series of questionnaires measuring striving to avoid inferiority, fears of missing out, being overlooked and active rejection, attachment, social rank and psychopathologies. Striving to avoid inferiority was significantly linked to social rank variables and anxious attachment. Mediator analyses revealed that the relationship between striving to avoid inferiority and depression was mediated by the social rank variable of external shame, and also anxious attachment. These findings suggest that elevated competitive behaviour can have a ‘dark side’. When people feel insecure in their social environments, it can focus them on a hierarchical view of themselves and others, with a fear of rejection if they feel they have become too inferior or subordinate. This may increase vulnerability to depression, anxiety and stress.