• 30 days wild and the relationships between engagement with nature’s beauty, nature connectedness and well-being.

      Richardson, Miles; McEwan, Kirsten; University of Derby (Frontiers, 2018-09-03)
      Recent research suggests that engagement with natural beauty (EWNB) is key to the well-being benefits of nature connectedness. The Wildlife Trust’s 30 Days Wild campaign provides a large-scale intervention for improving public engagement with nature and its beauty. The effect of 30 Days Wild participation on levels of EWNB and the relationship between EWNB, nature connectedness and happiness was evaluated during the 2017 campaign. Of the 49,000 people who signed up to the campaign, 308 people fully completed measures of EWNB, nature connection, health, happiness, and conservation behaviors at baseline, post-30 days and post-2 months. There were sustained and significant increases for scores in nature connection, health, happiness, and conservation behaviors. In addition, 30 Days Wild was the first intervention found to increase EWNB. Further, the significant increase in EWNB mediated the relationship between the increases in nature connectedness and happiness. In a supplementary study to understand the well-being benefits further (n = 153), emotional regulation was found to mediate the relationship between nature connectedness and happiness, but EWNB and emotional regulation were not related. The links between nature’s beauty, nature connectedness and well-being are discussed within an account of affect-regulation.
    • 30 days wild: who benefits most?

      Richardson, Miles; McEwan, Kirsten; Garip, Gulcan; University of Derby; Human Sciences Research Centre, University of Derby, Derby, UK; Human Sciences Research Centre, University of Derby, Derby, UK; Human Sciences Research Centre, University of Derby, Derby, UK (2018-09-17)
      There is a need to provide interventions to improve well-being that are accessible and cost-effective. Interventions to increase engagement with nature are coming to the fore. The Wildlife Trusts 30 Days Wild campaign shows promise as a large-scale intervention for improving public engagement with nature for well-being. The paper aims to discuss this issue. Design/methodology/approach In total, 273 people fully participated in a repeated measures evaluation comparing baseline measures of nature connection, health, happiness and conservation behaviours with measures post-30 days and 3 months. Findings There were sustained and significant increases for scores in nature connection, health, happiness and conservation behaviours. Those with lower scores at baseline in nature connection, conservation behaviours and happiness showed the most benefit. Older participants and those with higher baseline scores in conservation behaviours were the most likely to sustain their engagement with the campaign. Research limitations/implications Although the design and defined outcomes meet criteria for public health interventions, the self-reported measures, self-selecting sample and attrition are limitations. Originality/value The significant and sustained effects of the campaign on health, happiness and nature connection and conservation make this a promising intervention for improving human’s and nature’s well-being. The large community sample and naturalistic setting for the intervention make these data relevant to future interventions and policy.
    • Assessing the medium-term impact of a home-visiting programme on child maltreatment in England: protocol for a routine data linkage study.

      Ludd-Widger, Fiona V.; Cannings-John, Rebecca; Channon, Sue; Fitzsimmons, Deborah; Hood, Kerenza; Jones, Kerina H.; Kemp, Alison; Kenkre, Joyce; Longo, Mirella; McEwan, Kirsten; et al. (BMJ Publishing Group Ltd., 2017-05-03)
      ABSTRACT Introduction Child maltreatment involves acts of omission (neglect) or commission (abuse) often by caregivers that results in potential or actual harm to a child. The Building Blocks trial (ISRCTN23019866) assessed the short-term impact of an intensive programme of antenatal and postnatal visiting by specially trained nurses to support young pregnant women in England. The Building Blocks: 2–6 Study will assess the medium-term impacts of the programme for mothers and children (n=1562), through the linkage of routinely collected data to the trial data, with a particular emphasis on the programme’s impact on preventing child maltreatment. Methods and analysis We have developed a bespoke model of data linkage whereby outcome data for the trial cohort will be retrieved by linked anonymous data abstraction from NHS Digital, Office for National Statistics and the Department for Education’s National Pupil Database. Participants will be given reasonable opportunity to opt out of this study prior to data transfer. The information centres will match participants to the information held in their databases using standard identifiers and send extracts to a third-party safe haven. The study will have 80% power to detect a 4% difference (4%vs8%) for the binary primary outcome of child in need status (from birth to key stage 1) at a two-sided 5% alpha level by following up 602 children in each trial arm. Analysis will be by intention to treat using logistic multilevel modelling. A cost-and-consequences analysis will extend the time frame of the economic analysis from the original trial. Ethics and dissemination The study protocol has been approved by the National Health Service Wales Research Ethics Committee and the Health Research Authority’s Confidentiality Advisory Group. Methods of innovative study design and findings will be disseminated through peer-reviewed journals and conferences; results will be of interest to clinical and policy stakeholders in the UK.
    • Availability of breastfeeding peer-support in the UK: a cross-sectional survey.

      Grant, Aimee; McEwan, Kirsten; Tedstone, Sally; Greene, Giles; Copeland, Lauren; Hunter, Billie; Sanders, Julia; Phillips, Rhiannon; Brown, Amy; Robling, Mike; et al. (Wiley, 2017-07-07)
      Peer support is recommended by the World Health Organization for the initiation and continuation of breastfeeding, and this recommendation is included in United Kingdom (U.K.) guidance. There is a lack of information about how, when, and where breastfeeding peer support was provided in the U.K. We aimed to generate an overview of how peer support is delivered in the U.K. and to gain an understanding of challenges for implementation. We surveyed all U.K. infant feeding coordinators (n = 696) who were part of U.K.‐based National Infant Feeding Networks, covering 177 National Health Service (NHS) organisations. We received 136 responses (individual response rate 19.5%), covering 102 U.K. NHS organisations (organisational response rate 58%). We also searched NHS organisation websites to obtain data on the presence of breastfeeding peer support. Breastfeeding peer support was available in 56% of areas. However, coverage within areas was variable. The provision of training and ongoing supervision, and peer‐supporter roles, varied significantly between services. Around one third of respondents felt that breastfeeding peer‐support services were not well integrated with NHS health services. Financial issues were commonly reported to have a negative impact on service provision. One quarter of respondents stated that breastfeeding peer support was not accessed by mothers from poorer social backgrounds. Overall, there was marked variation in the provision of peer‐support services for breastfeeding in the U.K. A more robust evidence base is urgently needed to inform guidance on the structure and provision of breastfeeding peer‐support services.
    • 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.
    • Controlled antenatal thyroid screening II: Effect of treating maternal suboptimal thyroid function on child cognition.

      Hales, Charlotte; Taylor, Peter N.; Channon, Sue; Paradice, Ruth; McEwan, Kirsten; Zhang, Lei; Gyedu, Michael; Bakhsh, Ameen; Okosieme, Onyebuchi; Muller, Ilaria; et al. (Oxford Academic, 2018-01-15)
      Context and Objective The Controlled Antenatal Thyroid Screening (CATS) study investigated treatment of suboptimal gestational thyroid function (SGTF) on childhood cognition and found no difference in intelligence quotient (IQ) at 3 years between children of treated and untreated SGTF mothers. We have measured IQ in the same children at age 9.5 years and included children from normal gestational thyroid function (normal-GTF) mothers. Design, Setting, and Participants One examiner, blinded to participant group, assessed children’s IQ (Wechsler Intelligence Scale for Children, Fourth Edition UK), long-term memory, and motor function (Developmental Neuropsychological Assessment II) from children of 119 treated and 98 untreated SGTF mothers plus children of 232 mothers with normal-GTF. Logistic regression explored the odds and percentages of an IQ < 85 in the groups. Results There was no difference in IQ < 85 between children of mothers with normal-GTF and combined SGTF, i.e., treated and untreated (fully adjusted odds ratio [OR] = 1.15 [95% confidence interval (CI) 0.52, 2.51]; P = 0.731). Furthermore, there was no significant effect of treatment [untreated OR = 1.33 (95% CI 0.53, 3.34); treated OR = 0.75 (95% CI 0.27, 2.06) P = 0.576]. IQ < 85 was 6.03% in normal-GTF, 7.56% in treated, and 11.22% in untreated groups. Analyses accounting for treated-SGTF women with free thyroxine > 97.5th percentile of the entire CATS-I cohort revealed no significant effect on a child’s IQ < 85 in CATS-II. IQ at age 3 predicted IQ at age 9.5 (P < 0.0001) and accounted for 45% of the variation. Conclusions Maternal thyroxine during pregnancy did not improve child cognition at age 9.5 years. Our findings confirmed CATS-I and suggest that the lack of treatment effect may be a result of the similar proportion of IQ < 85 in children of women with normal-GTF and SGTF.
    • 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 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.
    • A descriptive study of feelings of arrested escape (entrapment) and arrested anger in people presenting to an emergency department following an episode of self-harm.

      Clarke, Martin; McEwan, Kirsten; Ness, Jennifer; Waters, Keith; Basran, Jaskaran; Gilbert, Paul; Derbyshire Healthcare NHS Foundation Trust; Nottinghamshire Healthcare NHS Foundation Trust; Cardiff University; University of Derby (Frontiers, 2016-09-14)
      To explore the role of elevated feelings of anger and desires to escape (fight/flight), which are experienced as inhibited, blocked, and arrested (i.e., arrested anger and arrested flight/escape leading to feelings of entrapment). This descriptive study developed measures of arrested anger and arrested flight and explored these in the context of a recent self-harm event in people presenting to a Hospital’s Emergency Department (ED).
    • Development of a striving to avoid inferiority scale.

      Gilbert, Paul; Broomhead, Claire; Irons, Christopher Paul; McEwan, Kirsten; Bellew, Rebecca; Mills, Alison; Gale, Corinne; Knibb, Rebecca C.; University of Derby; Kingsway Hospital (British Psychological Society, 2007-09)
      Social rank theory suggests that mood variation is linked to the security a person feels in his/her social domain and the extent to which they are sensitive to involuntary subordination (e.g. feeling defeated and feeling inferior). Previous studies looking at rank‐related and competitive behaviour have often focused on striving for dominance, whereas social rank theory has focused on striving to avoid inferiority. This study set out to develop a measure of ‘Striving to Avoid Inferiority’ (SAIS) and assess its relationship to other rank and mood‐related variables. We hypothesized two factors: one we called insecure striving, relating to fear of rejection/criticism for ‘not keeping up’, and the second we called secure non‐striving, relating to feeling socially acceptable and valued regardless of whether one succeeds or not. This scale was given to 207 undergraduates. The SAIS had good psychometric properties, with the two factors of insecure striving and secure non‐striving strongly supported by exploratory factor analysis. Both factors were significantly (though contrastingly) related to various fears of rejection, need for validation, hypercompetitive attitudes, feeling inferior to others, submissive behaviour and indicators of stress, anxiety and depression. Striving to avoid inferiority was a significant predictor of psychopathologies, especially where individuals perceived themselves to have low social rank.
    • Development of an early memories of warmth and safeness scale and its relationship to psychopathology.

      Richter, Anne; Gilbert, Paul; McEwan, Kirsten; Kingsway Hospital; University of Derby (British Psychological Society, 2009-06)
      Experiences of early childhood have a major impact on physiological, psychological, and social aspects of maturation and functioning. One avenue of work explores the recall and memory of positive or negative rearing experiences and their association with psychopathology measures. However, while many self‐report studies have focused on the recall of parental behaviours this study developed a new measure called the early memories of warmth and safeness scale (EMWSS), which focuses on recall of one's own inner positive feelings, emotions and experiences in childhood. Student participants (N=180) completed the new scale and a series of self‐report scales measuring different types of early recall, psychopathology, types of positive affect, and self‐criticism/reassurance. The EMWSS was found to have good psychometric properties and reliability. Recall of parental behaviour and recall of positive emotional memories were highly related, but recall of positive emotional memories was a better predictor of psychopathology, styles of self‐criticism/self‐reassurance and disposition to experience positive affect, than recall of parental behaviour.
    • Do therapeutic imagery practices affect physiological and emotional indicators of threat in high self-critics?

      Duarte, Joana; McEwan, Kirsten; Barnes, Christopher; Gilbert, Paul; Maratos, Frances A.; University of Coimbra; University of Derby; Cardiff University; Cognitive and Behavioural Centre for Research and Intervention; University of Coimbra; Portugal; Institute of Primary Care and Population Health; School of Medicine; Cardiff University; Wales UK; et al. (Wiley, 2015-09)
      Objectives: Imagery is known to be a powerful means of stimulating various physiological processes and is increasingly used within standard psychological therapies. Compassion-focused imagery (CFI) has been used to stimulate affiliative emotion in people with mental health problems. However, evidence suggests that self-critical individuals may have particular difficulties in this domain with single trials. The aim of the present study was to further investigate the role of self-criticism in responsiveness to CFI by specifically pre-selecting participants based on trait self-criticism. Design: Using the Forms of Self-Criticism/Self-Reassuring Scale, 29 individuals from a total sample of 139 were pre-selected to determine how self-criticism impacts upon an initial instance of imagery. Methods: All participants took part in three activities: a control imagery intervention (useable data N = 25), a standard CFI intervention (useable data N = 25), and a non-intervention control (useable data N = 24). Physiological measurements (alpha amylase) as well as questionnaire measures of emotional responding (i.e., the Positive and Negative Affect Schedule, the Types of Positive Affect Scale, and the State Adult Attachment Scale) were taken before and after the different interventions. Results: Following both imagery interventions, repeated measures analyses revealed that alpha amylase increased significantly for high self-critics compared with low self-critics. High self-critics (HSC) also reported greater insecurity on entering the imagery session and more negative CFI experiences compared with low self-critics. Practitioner Points: Data demonstrate that HSC respond negatively to imagery interventions in a single trial. This highlights that imagery focused therapies (e.g., CFI) need interventions that manage fears, blocks, and resistances to the techniques, particularly in HSC. An initial instance of imagery (e.g., CFI) can be frightening for people who have a tendency to be self-critical. This research provides examples of physiological and emotional responses to imagery type therapies in high and low self-critics, and associated clinical implications. Therapists may find it helpful to be mindful that when introducing imagery based therapies, highly self-critical patients need interventions that manage fears, blocks, and resistances to the techniques.
    • Eating attitudes and striving to avoid inferiority.

      Bellew, Rebecca; Gilbert, Paul; Mills, Alison; McEwan, Kirsten; Gale, Corinne; Kingsway Hospital; University of Derby (Taylor and Francis, 2006-09-22)
      Vulnerability to some psychopathologies may be related to feeling the need to compete, strive, and achieve in order to avoid inferiority and rejection. This study explored “insecure striving”, (relating to a perceived need to strive to avoid inferiority and its consequence, rejection) in relationship to eating attitudes and appearance anxiety in students. Eating attitudes and appearance anxiety were associated with judgments of inferiority, insecure striving to avoid inferiority, and fear of losing out and were negatively associated to secure non-striving (social acceptance). Further work exploring the way people understand and react to the competitive dynamics of their social groups may illuminate important processes linked to eating disorders.
    • 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.
    • Evaluation of a web-based self-compassion intervention to reduce student assessment anxiety.

      McEwan, Kirsten; Elander, James; Gilbert, Paul; University of Derby (Rivera Open, 2018-05-04)
      Assessment anxiety is associated with excessive worry and cognitive disruption which can contribute to academic failure. Compassion-focused interventions have previously been effective in reducing anxiety, stress and depression among the general population. Aims: This study extended this approach to students whose academic achievement is potentially compromised by assessment anxiety, by evaluating a web-based compassionate imagery intervention. Students (n=48) who self-identified as assessment anxious were randomised to practice either compassionate imagery exercises or to a control condition of practicing relaxation exercises. Students completed measures of test anxiety, mastery and performance learning goals, self-compassion, self-criticism/self-reassurance, depression, anxiety and stress, before and after the two-week intervention. The compassionate imagery exercises improved self-compassion more than the control condition of relaxation exercises did. Both tasks improved students’ wellbeing, and reduced assessment anxiety among those with higher baseline assessment anxiety. Web-based compassionate imagery and relaxation may offer cost-effective interventions for reducing assessment anxiety. More research is needed on the influence of self-compassion on learning processes and academic performance and achievement.
    • An exploration into depression-focused and anger-focused rumination in relation to depression in a student population.

      Gilbert, Paul; Cheung, Mimi; Irons, Christopher Paul; McEwan, Kirsten; Cardiff University; Kingsway Hospital; University of Derby (British Association for Behavioural and Cognitive Psychotherapies, 2005-07-01)
      Research has shown an important link between depression and rumination. This study set out to explore depression-focused rumination and anger-focused rumination in relation to shame and entrapment, and depression. 166 undergraduate students completed a battery of self-report questionnaires measuring current depression, rumination on depressive symptoms, rumination on anger, and the frequency of shame-focused and entrapment-focused thoughts. Both depression-focused and anger-focused rumination were related to depression, and to the frequency of shame and entrapment thoughts. In a mediational model, the link between depression-focused rumination and depression was partially mediated by feeling trapped by, and wanting to escape from, one's thoughts and feelings. Thus the link between rumination and depression is complex. Although rumination may contribute to depression by generating a spiral of negative thinking and negative feeling, feeling trapped and unable to control one's rumination, and being flight motivated, may add a further dimension to the depressogenic qualities of rumination.
    • An exploration of competitiveness and caring in relation to psychopathology.

      McEwan, Kirsten; Gilbert, Paul; Duarte, Joana; Kingsway Hospital, Derby; University of Coimbra (British Psychological Society, 2011-04-14)
      Objectives. Social mentality theory outlines how specialist systems have evolved to facilitate different types of social behaviour such as caring for offspring, forming alliances, and competing for resources. This research explored how different types of self-experiencearelinkedtothedifferentsocialmentalitiesofcompetitivesocialranking (focusingongaininganddefendingone’ssocialposition/status/rank)incontrasttocaring (being helpful to others). Perceived low social rank (with feelings of being inferior and unfavourable social comparison, SC) has been linked to depression, but a caring sense of self has less so. We hypothesized therefore that depression, in both clinical and nonclinical populations, would be primarily linked to competitive and rank focused sense of self rather than a caring sense of self. Method. Students (N=312) and patients with depression (N=48) completed selfreport scales measuring: self-experience related to competitiveness and caring; social rank; social safeness; and depression, anxiety, and stress. Results. The data suggest that in students, and particularly in patients, competitiveness (and feeling unsuccessful in competing for resources) is strongly associated with depression. Although caring shares a small correlation with depression in students, and with depression, anxiety, and stress in patients, when controlling for the rank variable of submissive behaviour this relationship ceases to be significant. Submissive behaviour was found to be a full mediator between caring and depression. We also found that how safe and comfortable one feels in one’s social relationships (social safeness), was a full mediator between competitiveness and depression. So, it is the feeling of being unable to compete where one does not feel secure in one’s social environment that is particularly linked to depression. Conclusion. The results of this study suggest that self-experience is complex and multifaceted and is linked to different social roles that are socially contextualized. In addition, perceived low social rank and perceived failures in being able to ‘attract’ others and compete for social resources, are strongly linked to depression, whereas experiencing oneself as caring and helpful is not when submissiveness is controlled for.
    • An exploration of different types of positive affect in students and patients with bipolar disorder.

      Gilbert, Paul; McEwan, Kirsten; Mitra, Ranjana; Richter, Anne; Franks, Leigh; Mills, Alison; Bellew, Rebecca; Gale, Corinne; Kingsway Hospital; University of Derby (Giovanni Fioriti Editore, 2009-08)
      Objective: Depue and Morrone-Strupinsky (2005) distinguished between two different types of positive affect regulation system: 1. relates to activated positive affects such as excitement, joy and vitality; and 2. relates to positive affects associated with peacefulness, contentment and well-being, and is linked to the experience of attachment and social safeness. In addition, people can derive positive feelings from doing social things (e.g. enjoying being with friends), and non-social things (e.g. watching a sunset). The first aim of this study was to develop two scales to assess the enjoyment of social and non-social events and to explore how these relate to the two types of affect regulation. In addition, we explore how these two types of positive affect regulation system are related to measures of affective temperament linked to mood disorders. The second aim was to explore these dimensions in people who have a bipolar disorder. Method: Students (n=202) and patients with bipolar disorder (n=49) completed a set of self-report scales measuring: social and non-social positive affect; different types of positive affect; social rank; current affective temperament and mood. Results: Our data showed that, in both patient and student groups, non-social positive affect has few correlations with other types of positive affect and affective temperament. In contrast, the pleasures derived from social relationships are significantly related to other types of positive affect and mood linked affective temperaments. Conclusions: Social and non-social positive affect seem to operate quite differently. It is the positive affects that we receive from our social relationships that are most significantly linked to affective temperament and social rank variables. This finding may have implications for pharmacological, psychological and social therapies.
    • An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team.

      Judge, Lorna; Cleghorn, Ailish; McEwan, Kirsten; Gilbert, Paul; Stobhill Hospital, Glasgow; Kingsway Hospital, Derby (Guilford Press, 2012-12)
      This study explored the benefits of a group-based compassion-focused therapy approach in a heterogeneous group of clients presenting with severe and enduring mental health difficulties to a community mental health team. Seven groups with an average of five clients per group were run over 12–14 weeks. The format of the group followed the procedures of explaining the evolutionary model, formulating client problems within the compassion-focused therapy model, introducing clients to the core practices of compassionate training, and using compassion based interventions to address core difficulties. Questionnaires were completed pre- and post intervention: Self-criticism, shame, depression, anxiety, and stress. Significant reductions were found for depression, anxiety, stress, self-criticism, shame, submissive behavior, and social comparison post intervention. Of importance, at pre-intervention the majority of patients were in the severe category of depression scores. At the end of therapy the majority were in the borderline category. A combination of self-report data and client feedback suggests that compassion focused therapy is easily understood, well-tolerated, seen as helpful and produces significant changes in objective measures of mental health difficulties in naturalistic settings.
    • Facial expressions depicting compassionate and critical emotions: the development and validation of a new emotional face stimulus set

      McEwan, Kirsten; Gilbert, Paul; Dandeneau, Stephane; Lipka, Sigrid; Maratos, Frances A.; Paterson, Kevin B.; Baldwin, Mark; University of Derby (2014-02-19)
      Attachment with altruistic others requires the ability to appropriately process affiliative and kind facial cues. Yet there is no stimulus set available to investigate such processes. Here, we developed a stimulus set depicting compassionate and critical facial expressions, and validated its effectiveness using well-established visual-probe methodology. In Study 1, 62 participants rated photographs of actors displaying compassionate/kind and critical faces on strength of emotion type. This produced a new stimulus set based on N = 31 actors, whose facial expressions were reliably distinguished as compassionate, critical and neutral. In Study 2, 70 participants completed a visual-probe task measuring attentional orientation to critical and compassionate/kind faces. This revealed that participants lower in self-criticism demonstrated enhanced attention to compassionate/kind faces whereas those higher in self-criticism showed no bias. To sum, the new stimulus set produced interpretable findings using visual-probe methodology and is the first to include higher order, complex positive affect displays.