The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults

Abstract

Little is known about the role of mindfulness and self-compassion in obsessive-compulsive disorder. This cross-sectional study examined associations of mindfulness and self-compassion with obsessive-compulsive disorder symptoms and with the obsessive beliefs and low distress tolerance thought to maintain them. Samples of treatment-seeking adults (N = 1871) and non-treatment-seeking adults (N = 540) completed mindfulness, self-compassion, obsessive-compulsive disorder, anxiety, depression, obsessive beliefs and distress tolerance questionnaires. Participants with clinically significant obsessivecompulsive disorder symptoms reported lower trait mindfulness and self-compassion compared to participants with clinically significant anxiety/depression and to non-clinical controls. Among the clinical sample, there were medium-large associations between mindfulness and self-compassion and obsessive-compulsive disorder symptoms, obsessive beliefs and distress tolerance. Mindfulness and self-compassion were unique predictors of obsessive-compulsive disorder symptoms, controlling for depression severity. Once effects of obsessive beliefs and distress tolerance were controlled, a small effect remained for mindfulness (facets) on obsessing symptoms and for self-compassion on washing and checking symptoms. Directions for future research and clinical implications are considered in conclusion. Keywords Obsessive-compulsive disorder • Mindfulness • Self-compassion • Obsessive beliefs • Distress tolerance Obsessive-compulsive disorder (OCD) is a debilitating mental health condition characterised by obsessions, i.e. persistent unwanted intrusive thoughts, images or urges that can cause significant distress, and compulsions, i.e. repetitive, ritualistic behaviours aimed at alleviating distress and/ or preventing negative outcomes (APA 2013). Obsessivecompulsive disorder is a heterogeneous disorder as obsessions can centre on contamination, harm, symmetry or taboo thoughts and compulsions include physical behaviours like Electronic supplementary material The online version of this article (

Self‐compassion and emotion regulation difficulties in obsessive–compulsive disorder

“…This finding supports the idea that emotion regulation deficits may play a relevant role for patients with OCD. Unlike the recently published study by Leeuwerik et al (2019), self‐compassion did not emerge as a significant predictor. The mediation analysis provides one explanation for this result as the self‐compassion–symptom severity relationship was found to be mediated by emotion regulation difficulties.…”

“…The hypotheses were largely supported by the data. As anticipated and in accordance with prior research (Berman et al, 2018;Fergus & Bardeen, 2014;Fernández de la Cruz et al, 2013;Leeuwerik et al, 2019;Wetterneck et al, 2013;Yap et al, 2018), symptom severity and obsessive beliefs were negatively correlated with self-compassion and positively associated with emotion regulation difficulties. In line with our expectation and previous studies (Finlay-Jones et al, 2015;Scoglio et al, 2018;Vettese et al, 2011), a strong and negative correlation between selfcompassion and difficulties in emotion regulation existed.…”

“…Fostering self‐compassion and improving emotion regulation skills might help patients with OCD to cope better with difficult inner experiences and to develop a more open and accepting stance towards intrusions and distressing emotions, which might in turn decrease the reliance on symptomatic behaviour (Berman, Shaw, & Wilhelm, 2018; Didonna et al, 2019; Key, Rowa, Bieling, McCabe, & Pawluk, 2017; Leeuwerik, Cavanagh, & Strauss, 2019). Therefore, these two constructs might be important in the maintenance of OCD as well as influencing factors during the treatment process and deserve further attention.…”

“…Using an online survey with participants who self‐reported suffering from OCD, Wetterneck, Lee, Smith, and Hart (2013) found a moderate negative correlation between self‐compassion and obsessive–compulsive symptom severity. In a recently published study, participants with clinically significant OCD symptoms reported lower trait mindfulness and self‐compassion compared with participants with anxiety or depression and to healthy controls (Leeuwerik et al, 2019). The authors found medium‐to‐large associations between mindfulness, self‐compassion, and obsessive–compulsive symptoms as well as obsessive beliefs.…”

Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design

“…Two recent studies on OCD patients demonstrated that self-compassion was correlated to reduced OCD symptoms and that this correlation was partially explained by lower emotion regulation difficulties ( Chase et al, 2019 ; Eichholz et al, 2020 ). Another recent cross-sectional study comparing treatment-seeking adults ( N = 1871) and non-treatment-seeking adults ( N = 540) found that participants with clinically significant OCD symptoms reported lower trait mindfulness and self-compassion compared to participants with clinically significant anxiety/depression and to non-clinical controls, with mindfulness and self-compassion as unique predictors of OCD symptoms, even when controlling for depression severity ( Leeuwerik et al, 2020 ).…”