• 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.
    • 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.
    • The development of compassionate engagement and action scales for self and others

      Gilbert, Paul; Catarino, Francisca; Duarte, Cristiana; Matos, Marcela; Kolts, Russell; Stubbs, James; Ceresatto, Laura; Duarte, Joana; Pinto-Gouveia, José; Basran, Jaskaran; et al. (Biomed Central, 2017-04-27)
      Background Studies of the value of compassion on physical and mental health and social relationships have proliferated in the last 25 years. Although, there are several conceptualisations and measures of compassion, this study develops three new measures of compassion competencies derived from an evolutionary, motivational approach. The scales assess 1. the compassion we experience for others, 2. the compassion we experience from others, and 3. self-compassion based on a standard definition of compassion as a ‘sensitivity to suffering in self and others with a commitment to try to alleviate and prevent it’. We explored these in relationship to other compassion scales, self-criticism, depression, anxiety, stress and well-being. Methods Participants from three different countries (UK, Portugal and USA) completed a range of scales including compassion for others, self-compassion, self-criticism, shame, depression, anxiety and stress with the newly developed ‘The Compassionate Engagement and Actions’ scale. Results All three scales have good validity. Interestingly, we found that the three orientations of compassion are only moderately correlated to one another (r < .5). We also found that some elements of self-compassion (e.g., being sensitive to, and moved by one’s suffering) have a complex relationship with other attributes of compassion (e.g., empathy), and with depression, anxiety and stress. A path-analysis showed that self-compassion is a significant mediator of the association between self-reassurance and well-being, while self-criticism has a direct effect on depressive symptoms, not mediated by self-compassion. Discussion Compassion evolved from caring motivation and in humans is associated with a range of different socially intelligent competencies. Understanding how these competencies can be inhibited and facilitated is an important research endeavour. These new scales were designed to assess these competencies. Conclusions This is the first study to measure the three orientations of compassion derived from an evolutionary model of caring motivation with specified competencies. Our three new measures of compassion further indicate important complex relationships between different potentiation’s of compassion, well-being, and vulnerability to psychopathologies.
    • The effect of shame and shame memories on paranoid ideation and social anxiety.

      Matos, Marcela; Pinto-Gouveia, José; Gilbert, Paul; University of Coimbra; University of Derby; Cognitive and Behavioural Research Centre (CINEICC); University of Coimbra; Coimbra; Portugal; Cognitive and Behavioural Research Centre (CINEICC); University of Coimbra; Coimbra; Portugal; Mental Health Research Unit; University of Derby; Derby; UK (Wiley, 2012-01-30)
      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. Method Shame, traumatic impact of shame memory, centrality of shame memory, paranoia and social anxiety were assessed using self-report questionnaires in 328 participants recruited from the general population. Results Results from path analyses show that external shame is specifically associated with paranoid anxiety. In contrast, internal shame is specifically associated with social anxiety. In addition, shame memories, which function like traumatic memories, or that are a central reference point to the individual's self-identity and life story, are significantly associated with paranoid anxiety, even when current external and internal shame are considered at the same time. Thus, traumatic impact of shame memory and centrality of shame memory predict paranoia (but not social anxiety) even when considering for current feelings of shame. Conclusion Our study supports the evolutionary model suggesting there are two different types of ‘conspecific’ anxiety, with different evolutionary histories, functions and psychological processes. Paranoia, but less so social anxiety, is associated with traumatic impact and the centrality of shame memories. Researchers and clinicians should distinguish between types of shame memory, particularly those where the self might have felt vulnerable and subordinate and perceived others as threatening and hostile, holding malevolent intentions towards the self.
    • Effects of intranasal oxytocin on compassion focused imagery.

      Rockliff, Helen; Karl, Anke; McEwan, Kirsten; Gilbert, Jean; Matos, Marcela; Gilbert, Paul; University of Bristol; University of Exeter; University of Derby; University of Coimbra (American Psychological Association, 2011-06-27)
      This study explored the effects of oxytocin on Compassion Focused Imagery (CFI), that is, imagining another “mind” being deeply compassionate to oneself, and the interaction of these effects with self-criticism and feeling socially safe with others. Forty-four healthy participants (29 men and 15 women) completed self-report measures of self-criticism, attachment style, and social safeness before taking part in a double-blind randomized placebo controlled study. They attended two imagery sessions, receiving oxytocin in one and a placebo in the other. Positive affect was measured before and after each imagery session, and “imagery experience” was assessed after each session. Overall, oxytocin increased the ease of imagining compassionate qualities but there were important individual differences in how CFI was experienced. Participants higher in self-criticism, lower in self-reassurance, social safeness, and attachment security had less positive experiences of CFI under oxytocin than placebo, indicating that the effects of oxytocin on affiliation may depend on attachment and self-evaluative styles.
    • Exploring the international utility of progressing compassionate mind training in school settings: a comparison of implementation effectiveness of the same curricula in the UK and Portugal

      Maratos, Frances A.; Matos, Marcela; Alberquerque, Isabel; Wood, Wendy; Palmeira, Lara; Cuna, Marina; Lima, Margarida; Gilbert, Paul; University of Derby; University of Coimbra (British Psychological Society, 2020-09-01)
      Given current retention and well-being crises within the teaching profession worldwide, this research sought to explore implementation efficacy of a Compassion Mind Training (CMT) programme in cross-cultural school-settings. A 6-module CMT curriculum was implemented in teaching staff of two primary schools in the UK (N=76) and one primary school in Portugal (N=41). Results revealed that high-quality implementation was achieved across the UK and Portuguese cohorts, with the majority of staff providing extremely positive ratings regarding all aspects of module content, delivery, and interest/relevance. Moreover, recommendation of the CMT to others was the modal response across cohorts. These findings indicate that CMT in school settings has international appeal and utility in helping educators manage educational-based stresses.
    • Fears of compassion and happiness in relation to alexithymia, mindfulness, and self-criticism.

      Gilbert, Paul; McEwan, Kirsten; Gibbons, L.; Duarte, Joana; Matos, Marcela; Kingsway Hospital, Derby; University of Coimbra (British Psychological Society, 2011-11-08)
      Background. Thereisincreasingresearchtosuggestthatfearsof,andresistancesto, affiliativeandpositiveemotionsarelinkedtoself-criticismandarangeofpsychopathologies.Itisunclearhowthesefearsandresistancesarelinkedtoeachotherandhowthese inturnarelinkedtopsychologicalprocesses,suchasabilitiestobemindfulandrecognize and describe emotions. Objectives. Thisresearchexplorestherelationshipbetweenfearsofcompassionand happinessingeneral,withcapacitiesforemotionalprocessing(alexithymia),capacitiesfor mindfulness, and empathic abilities. Toadvance this research, a new scale was developed to measure general fears of positive feelings – the Fear of Happiness Scale. Results. The results showed that fears of compassion for self, from others and in particular fear of happiness, were highly linked to different aspects of alexithymia, mindfulness, empathy, self-criticism and depression, anxiety and stress. Especially noteworthy was the very high correlation between fear of happiness and depression (r =.70). Conclusion. While the development of positive emotions, especially those linked to affiliation and connectedness are increasingly seen as important therapeutic targets, little research has focused on the blocks and fears to positive emotions. This study used newly developed fears of positive affect scales (e.g., compassion and happiness) to explore these aspects and found they were significantly linked to psychopathology variables self-criticism and difficulties such as alexithymia.
    • Fears of compassion: development of three self-report measures.

      Gilbert, Paul; McEwan, Kirsten; Matos, Marcela; Rivis, Amanda; Kingsway Hospital; University of Coimbra; University of Nottingham (British Psychological Society, 2011-04-13)
      Objectives. There is increasing evidence that helping people develop compassion for themselves and others has powerful impacts on negative affect and promotes positive affect. However, clinical observations suggest that some individuals, particularly those high in self-criticism, can find self-compassion and receiving compassion difficult and can befearfulofit.Thisstudythereforedevelopedmeasuresoffearof:compassionforothers, compassion from others, and compassion for self. We also explored the relationship of these fears with established compassion for self and compassion for others measures, self-criticism, attachment styles, and depression, anxiety, and stress. Method. Students (N = 222) and therapists (N = 53) completed measures of fears of compassion, self-compassion, compassion for others, self-criticism, adult attachment, and psychopathology. Results. Fear of compassion for self was linked to fear of compassion from others, and both were associated with self-coldness, self-criticism, insecure attachment, and depression, anxiety, and stress. In a multiple regression, self-criticism was the only significant predictor of depression. Conclusion. This study suggests the importance of exploring how and why some people may actively resist engaging in compassionate experiences or behaviours and be fearful of affiliative emotions in general. This has important implications for therapeutic interventions and the therapeutic relationship because affiliative emotions are major regulators of threat-based emotions.
    • The flows of compassion in adolescents as measured by the compassionate engagement and action scales

      Cunha, Marina; Galhardo, Ana; Gilbert, Paul; Rodrigues, Cátia; Matos, Marcela; University of Coimbra, Coimbra, Portugal; University of Derby (Springer Science and Business Media LLC, 2021-07-23)
      The development of self-report instruments assessing the different facets of compassion adapted for different age groups is crucial for research and clinical practice. This study examined the factor structure and psychometric properties of the adaptation to adolescents of the Compassionate Engagement and Action Scales (CEAS-A) in a sample of 674 Portuguese adolescents. Confirmatory factor analyses showed that the factor structure of the CEAS-A was similar to the one found in the adults’ version, with higher-order factor models encompassing two first/s-order factors in each scale (Engagement and Actions). The CEAS-A revealed good construct validity, reliability, and temporal stability. Gender differences were found in Self-compassion and Compassion for Other scales. Path analysis results indicated that self-criticism had a direct negative impact on adolescents’ life satisfaction, whereas the impact of self-reassurance on life satisfaction was partially mediated by self-compassion and compassion from others. The CEAS-A is the first self-report instrument that allows for the assessment of the three different flows of compassion in adolescents and may be an important and useful tool for research and clinical practice.
    • How one experiences and embodies compassionate mind training influences its effectiveness.

      Matos, Marcela; Duarte, Joana; Duarte, Cristiana; Gilbert, Paul; Pinto-Gouveia, José; University of Coimbra; University of Derby (Springer, 2017-12-02)
      This paper explores indicators of practice quality of a brief compassion mind training (CMT) intervention and their impact on the development of an inner sense of one’s compassionate self (CS) and a range of self-report measures. Participants were randomly assigned to one of two conditions: compassionate mind training (CMT; n = 77) and wait-list control. Participants in the CMT condition practiced a range of CMT practices during 2 weeks. Each week, participants completed a feedback questionnaire, measuring practice frequency, helpfulness and embodiment of the practices in everyday life. Self-report measures of compassion, positive affect, shame, self-criticism, fears of compassion and psychopathological symptoms were also completed at pre and post. Practice frequency was associated with the frequency and easiness of embodiment of the CS. Perceived helpfulness of the practices was related to greater embodiment of the CS and to increases in compassion, reassured self, relaxed and safe affect and decreases in self-criticism. The embodiment variables of the CS were associated with higher compassion for the self, for others and from others and with improvements in reassured self, safe affect and compassionate goals. Embodiment of the CS and perceived helpfulness of the practices predicted compassion for the self and experience of compassion from others at post-intervention. Perceiving compassion cultivation practices as helpful and being able to embody the CS in everyday life is key to foster self-compassion and the experience of receiving compassion from others, as well as to promote feelings of safeness, contentment and calmness.
    • The impact of self-criticism and self-reassurance on weight-related affect and well-being in participants of a commercial weight management programme.

      Duarte, Cristiana; Stubbs, James; Pinto-Gouveia, José; Matos, Marcela; Gale, Corinne; Morris, Liam; Gilbert, Paul; University of Coimbra; University of Leeds; Slimming World; et al. (Karger, 2017-04-04)
      Objective: Certain psychological and emotional factors can undermine attempts at weight management. Previously we have found that shame and self-criticism were significantly associated with disinhibition and perceived hunger in 2,236 participants of a weight management programme. This effect was fully mediated through weight-related negative affect. The present study examined the impact of self-criticism and self-reassurance on well-being and whether it was mediated by weight-related affect in the same population. Methods: Participants completed an online survey of measures of self-criticism and self-reassurance, and negative and positive affect associated with weight and well-being. Results: Path analysis suggested that self-criticism was significantly associated with decreased well-being, both directly and indirectly, mediated by increased negative and decreased positive weight-related affect. Self-reassurance had a stronger association with increased well-being by predicting lower negative and increased positive weight-related affect. All effects were significant at p < 0.001. Conclusion: Self-criticism and self-reassurance were related to well-being in participants attempting to manage their weight, both directly and through their impact on weight-related affect. The positive association between self-reassurance and well-being was stronger than the negative association between self-criticism and well-being. Supporting the development of self-reassuring competencies in weight management programmes may improve weight-related affect and well-being.
    • The impact of shame, self-criticism and social rank on eating behaviours in overweight and obese women participating in a weight management programme

      Duarte, Cristiana; Matos, Marcela; Stubbs, James; Gale, Corinne; Morris, Liam; Gouveia, Jose Pinto; Gilbert, Paul; University of Coimbra; University of Derby; Slimming World; et al. (Public Library of Science (PLOS), 2017-01-20)
      Recent research has suggested that obesity is a stigmatised condition. Concerns with personal inferiority (social rank), shame and self-criticism may impact on weight management behaviours. The current study examined associations between social comparison (shame, self-criticism), negative affect and eating behaviours in women attending a community based weight management programme focused on behaviour change. 2,236 participants of the programme completed an online survey using measures of shame, self-criticism, social comparison, and weight-related affect, which were adapted to specifically address eating behaviour, weight and body shape perceptions. Correlation analyses showed that shame, self-criticism and social comparison were associated with negative affect. All of these variables were related to eating regulation and weight control (p < 0.001). Path analysis revealed that the association of shame, hated-self, and low self-reassurance on disinhibition and susceptibility to hunger was fully mediated by weight-related negative affect, even when controlling for the effect of depressive symptoms (p < 0.050 to p < 0.010). In addition, feelings of inadequacy and unfavourable social comparisons were associated with higher disinhibition and susceptibility to hunger, partially mediated through weight-related negative affect (p = 0.001). These variables were negatively associated with extent of weight loss during programme attendance prior to the survey, while self-reassurance and positive social comparisons were positively associated with the extent of weight loss prior to the survey (p < .050). Shame, self-criticism, and perceptions of inferiority may play a significant role in self-regulation of eating behaviour in overweight people trying to manage their weight.
    • The Other as Shamer Scale – 2: Development and validation of a short version of a measure of external shame

      Matos, Marcela; Pinto-Gouveia, José; Gilbert, Paul; Duarte, Cristiana; Figueiredo, Cláudia; University of Coimbra; Kingsway Hospital; University of Aveiro (Elsevier, 2015-02)
      External shame arises from the perception of negative judgements about the self in the mind of others and is currently measured by Other As Shamer Scale (OAS). This scale has been used in numerous studies. This study sought to develop a valid and reliable shorter form of the scale, called OAS2, in an adult sample of 690 participants, using experts’ item ratings and Confirmatory Factor Analysis. The OAS2 consisted of 8 items, which replicated the unidimensional structure of the OAS (Matos et al., 2011) and revealed a good fit. The OAS2 had good internal consistency (.82), similar to the longer version. The OAS2 has good concurrent and divergent validity, being highly correlated with the OAS (r = .91). The OAS and OAS2 have very similar significant correlations with measures of internal shame, psychopathology and anger, with no significant difference between them. Our results, suggest that the OAS2 is an economic, valid and reliable measure of external shame.
    • Psychological and physiological effects of compassionate mind training: A pilot randomised controlled study

      Matos, Marcela; Duarte, Cristiana; Duarte, Joana; Pinto-Gouveia, José; Petrocchi, Nicola; Basran, Jaskaran; Gilbert, Paul; University of Coimbra; John Cabot University; University of Derby (Springer, 2017-06-08)
      The development of the compassionate self, associated with practices such as slow and deeper breathing, compassionate voice tones and facial expressions and compassionate focusing is central to Compassion Focused Therapy. This study explores the impact of a two-week Compassionate Mind Training (CMT) program on emotional, self-evaluative and psychopathology measures and on heart rate variability (HRV). Participants (general population and college students) were randomly assigned to one of two conditions: CMT (n=56) and Wait-List Control (n=37). Participants in the CMTcondition were instructed to practice CMT exercises during two weeks. Self-report measures of compassion, positive affect, fears of compassion, self-criticism, shame, depression, anxiety and stress, and HRV were collected at pre and post intervention in both conditions. Compared to the control group, the experimental group showed significant increases in positive emotions, associated with feeling relaxed and also safe and content, but not activated; and in self-compassion, compassion for others and compassion from others. There were significant reductions in shame, self-criticism, fears of compassion, and stress. Only the experimental group reported significant improvement in HRV. Developing awareness of the evolved nature and inherent difficulties of our minds allied with practicing CMT exercises has beneficial effects on participants' psychological and physiological well-being.