Above and beyond emotional suffering: the unique contribution of compassionate and uncompassionate self-responding in chronic pain

Abstract

ObjectivesStudies have shown that self-compassion plays a protective role against depression in women with chronic pain (CP). However, the majority of studies in CP have used the total score of the self-compassion scale (SCS), which have raised concerns due to potential overlap, not only between the uncompassionate self-responding factors and psychopathology, but also between self-compassion as a whole and other well-known psychological processes (e.g., mindfulness, acceptance, psychological flexibility). This calls for a more nuanced understanding of which components of (un)compassionate self-responding adds to better mental health in CP.MethodsThis study explores the unique contribution of compassionate and uncompassionate self-responding to depressive symptoms in women with CP undergoing pain consultation (n = 49).ResultsCorrelation analyses suggest that compassionate self-responding only significantly correlates with progress in valued living, while the uncompassionate self-responding significantly correlates with pain fusion, pain avoidance, obstructions to valued living and depression. Multiple regression analysis showed that self-compassion contributes to depressive symptoms (R2 = 8%) above and beyond pain intensity and disability (R2 = 12%) and psychological (in) flexibility processes (R2 = 31%), and uncompassionate (but not compassionate) self-responding uniquely contributes to depressive symptoms (sr2 = 18%).ConclusionsFindings suggest that uncompassionate self-responding is a stronger contributor to depression in CP than compassionate self-responding. Clinical implications are further discussed.

On the Edge of Psychopathology: Strong Relations Between Reversed Self-compassion and Symptoms of Anxiety and Depression in Young People

“…In two separate samples of non-clinical youth, it was found that the total self-compassion score (as measured with either the full-length or the short form of the SCS) was significantly and substantially negatively correlated with symptom measures of anxiety and depression (all r ’s between -0.52 and -0.64), thus suggesting a clear-cut ‘protective effect.’ Yet, when analyzing the separate contributions of the positive and negative self-compassion components, the data convincingly showed that this observed ‘protective effect’ was driven by the reversed negative self-compassion components (i.e., vulnerability) and that the true shielding effect of the positive self-compassion components appeared to be very modest (when discarding the effect of the negative self-compassion components) or almost nonexistent (when controlling for other vulnerability and protective variables such as neuroticism, extraversion, and self-esteem). Similar findings have been documented in research studying the differential effects of positive and negative self-compassion components in adult populations suffering from depression (Körner et al, 2015 ), eating disorders (Bicaker & Racine, 2022 ), and chronic pain (Carvalho et al, 2020 ). Such findings again cast doubt on the protective shield that these positive self-compassion ought to have.…”

Self-compassion in Acceptance and Commitment Therapy for chronic pain: a pilot study

“…The current study is part of a larger one that focused on the relationship between self-compassion, pain, psychopathology, and psychological flexibility processes in CP. Specifically, the sample in the present clinical study (n=16) partly overlaps with the sample (n=49) of a published cross-sectional study [24] (which is composed of the baseline scores of the 16 participants who are part of the current study, as well as participants who were not able or interested to participate in the current clinical study, but who agreed to participate in the crosssectional study).…”

Особливості Психогенного Болю У Дітей

“…Все вище сказане складає таке проблемне «поле» для досліджень як «пам'ять про біль»: ця інформація закодована у вигляді структурних або функціональних змін у ноцицептивній системі та інших нейрональних структурах, що може призвести до змін у соматосенсорній обробці ноцицептивної інформації та нейроповедінкових змін у майбутньому. Складність діагностики при синдроми хронічного болю у дітей обумовлена ще й тим, що психогенний компонент хронічного больового синдрому може поєднуватися з соматичним (ноцицептивним або нейропатичним) [4].…”