Self-Compassion and Suicide Risk in Veterans: When the Going Gets Tough, Do the Tough Benefit More from Self-Compassion?

Abstract

Objectives

Veterans are at particular risk for suicide due to psychopathological, emotional, and interpersonal risk factors. However, the presence of individual-level protective factors, such as self-compassion, may reduce risk, becoming more salient at increasing levels of distress and psychopathology, per theory. We examined the relation between self-compassion and suicide risk, and the moderating effects of depression, PTSD symptoms, anger, shame, and thwarted interpersonal needs.

Methods

Our sample of US veterans (n = 541) in our cross-sectional study were mostly male (69.1%) with an average age of 49.90 (SD = 16.78), who completed online self-report measures: Suicidal Behaviors Questionnaire-Revised, Multidimensional Health Profile-Psychosocial Functioning Screening Tool, PTSD Checklist-Military Version, Differential Emotions Scale-IV, and the Interpersonal Needs Questionnaire.

Results

The linkage between self-compassion and suicidal behavior in our veteran sample was moderated by distress-evoking risk factors, including depression, anger, shame, and thwarted interpersonal needs, such that, as level of risk severity increases, the inverse association between self-compassion and suicidal behavior is strengthened.

Conclusions

Our findings highlight an emergent protective process that may prevent suicide in times of distress. Therapeutically bolstering the ability for self-compassion may provide a proactive coping strategy that can be brought to bear in times of crisis, reducing suicide risk for veterans.

Correction to: Parental Mindfulness and Preschool Children’s Emotion Regulation: the Role of Mindful Parenting and Secure Parent-Child Attachment The authors would like to correct some mistakes in Fig. 1. In Fig. 1b, the mediator should be “parent-child attachment” rather than “mindful parenting”. In both Fig. 1a and 1b, the path coefficients from the mediators (i.e., mindful parenting in Fig. 1a and parent-child attachment  in Fig. 1b) to preschool children's emotional lability/negativity should be negative.

Correction to: Principles for a Responsible Integration of Mindfulness in Individual Therapy The original version of this article was revised twice due to the following changes.

Christian U. Krägeloh, Marcus A. Henning, Oleg N. Medvedev, Xuan Joanna Feng, Fiona Moir, Rex Billington and Richard J. Siegert: Mindfulness-based Intervention Research: Characteristics, Approaches, and Developments . Routledge, New York, NY, 2019

The Relationship Between Adopting Mindfulness Practice and Reperceiving: a Qualitative Investigation of CARE for Teachers Abstract Objectives This study qualitatively examined the relationship between home practice and reperceiving for teachers who participated in the CARE program. We used distress tolerance, mindfulness, burnout, efficacy, compassion, and self-care as proxies for (or direct representations of) underlying components of reperceiving—awareness, emotion regulation, and compassion. Methods From a larger study of 224 elementary teachers in a large urban district, 16 teachers were purposively selected for semi-structured interviews. Selected teachers fit one of three profiles: no adopted mindfulness practice; no practice at baseline but practice at post and follow-up; practice at baseline, post, and follow-up. Four coders employed a directed content analysis to (1) investigate the outcomes discretely, examining their prevalence within the three practice groups; (2) analyze the relationships between outcomes and whether these differed across practice groups; and (3) examine teachers’ descriptions of how they used the practices. Results There were no differences between practice groups in teachers’ reported amounts of stress, but differences were found across outcomes, specifically mindfulness and efficacy. The no practice group engaged in more suppression and felt less capable of handling their stressors. Teachers who adopted practice described an emerging awareness of their negative emotions, more facility to let go of their stressors, and greater affirmation of the importance of self-care and use of strategies to promote it. Compassion lacked prevalence across practice groups. Conclusions Adoption of mindfulness practice may impact teachers’ capacity to reperceive through emotional awareness and self-regulation, but additional research is required to examine the role of compassion.

Evaluating the Factor Structure of Each Facet of the Five Facet Mindfulness Questionnaire Abstract Objective Nearly all studies treat the Five Facet Mindfulness Questionnaire as five independent scales (one measuring each of the five facets), yet almost no methodological work has examined the psychometric structure of the facets independently. We address this issue using factor analytic methods. Methods Exploratory and confirmatory factor models were fit to item response data from a sample of 522 adults recruited online. Findings were replicated in a sample of 454 adults receiving aftercare for substance use disorder. Results Parallel analysis suggested multiple factors for all five facets, in both samples. Exploratory factor models suggested the presence of method factors on the acting with awareness (items using the term “distraction”) and describing facets (items that were reverse-scored). Confirmatory factor models fit poorly for all facets, in both samples. In follow-up analyses, model fit improved substantially on the acting with awareness and describing facets when method factors were included in a bifactor model. Model fit was also better for the facets of FFMQ short forms than for the full-length facets. The short-form facets and original facets correlated similarly with external criteria in both samples. Conclusions None of the FFMQ facets fit a unidimensional factor model; yet, follow-up analyses suggested that each can be considered substantively unidimensional. Initial tests suggest that the facets’ multidimensionality did not materially impact their relation to other psychological constructs, suggesting that multidimensionality can be ignored for some purposes. The use of short-form facets or latent variable models (e.g., bifactor specifications) are both viable solutions for addressing multidimensionality when desired.

Negative Mood Reduces Negative False Memories After a Brief Mindfulness Exercise Abstract Objectives Research on the effect of mindfulness meditation on false memories has produced mixed findings. Seminal research on the topic suggested that a brief mindfulness meditation before encoding increases false memories. Subsequent researchers have found no effect or even a decrease in false memories as a result of brief mindfulness meditation. None of these studies have analyzed mood or stimuli valence as a factor. Methods One hundred and twenty-three introductory psychology undergraduate were assigned to one of four between-subject conditions. Depending on the condition to which they were assigned, participants either completed a brief mindfulness meditation exercise or were told to let think about whatever came to their mind (i.e., a control condition). In addition, half of the participants then received a negative mood induction while the other half did not. All participants completed a Deese-Roediger-McDermott false memory free recall and recognition procedure using both neutral and negative lists. Results The results showed that mindfulness and mood had little overall effect on false memory for neutral lures. Negative mood reduced the false recognition of negative lures only for those in the mindfulness condition. This pattern was more applicable to individuals with higher negative trait affect. Conclusions Mindfulness mediation reduced false memory only when a negative mood and negative lures were present. We discuss the results in terms of the source monitoring framework as well as encoding and retrieval processes. Further work is needed to clarify the specific instances when mindfulness impacts the occurrence of false memory.

A Randomized Trial of Mindfulness-Based Cognitive Therapy with Psoriasis Patients Abstract Objectives The objective of the present study was to investigate the effect of mindfulness-based cognitive therapy (MBCT) on psoriasis patients’ symptoms, anxiety, depression, and psychological well-being. The study also examined if MBCT significantly impacted the domain and mediating variables of a clinically modified Buddhist psychological model (CBPM), which are acceptance, mindfulness, self-compassion, aversion, non-attachment, attention, rumination, and worry. Methods One hundred and one participants were randomly allocated to MBCT (n = 51) or TAU (n = 50). Participants were measured pre-treatment, post-treatment, and after a 3-month follow-up period. Results Analyses revealed that when baseline variables were controlled, there was a significant reduction or increase in the hypothesized direction for each variable over time in the MBCT group, but not in the treatment as usual group. Conclusions The results suggest that MBCT may be a useful adjunct therapy for those suffering from psoriasis and the associated psychological symptoms relating to the condition.

Self-Compassion and Eating Pathology in Female Adolescents with Eating Disorders: The Mediating Role of Psychological Distress Abstract Objectives A burgeoning literature demonstrates that self-compassion has widespread implications for numerous mental health problems, with recent research highlighting the role of self-compassion in body dissatisfaction and eating pathology. The primary purpose of this study was to investigate the relations between self-compassion, psychological distress, and eating pathology in a clinical sample of female adolescents. In addition, this study examined whether psychological distress emerged as a cross-sectional mediator of the relation between self-compassion and eating pathology. Methods Fifty-eight female adolescents with eating disorders (Mage = 15.45; SD = 1.49) completed the Self-Compassion Scale (SCS), Hopkins Symptom Checklist (SCL-5), and Eating Disorder Examination Questionnaire - Adolescent Version (EDE-Q). Results The SCS positive items (referred to as self-compassion) were negatively associated with psychological distress and eating pathology. The SCS negative items (referred to as self-criticism) were positively associated with psychological distress and eating pathology (all ps < .001). Notably, psychological distress mediated the link between self-compassion and eating pathology (ab = − 0.39, 95% percentile bootstrap confidence interval (PB CI): −0.78 to −0.09). Psychological distress also mediated the relation between self-criticism and eating pathology (ab = 0.30, 95% PB CI: 0.05 to 0.68). Conclusions This study supports the notion that interventions focused on increasing self-compassion and decreasing psychological distress may have important implications for eating disorder recovery in youth.

Utilization and Perceived Effectiveness of Mindfulness Meditation in Veterans: Results from a National Survey Abstract Objectives Complementary and integrative health (CIH) approaches are increasingly utilized in health care, and mindfulness meditation is one such evidence-based CIH practice. More information is needed about veterans’ utilization of mindfulness to inform integration within the Veterans Health Administration (VHA). Methods This study involved secondary data analysis of a national survey to evaluate utilization and perceived effectiveness of mindfulness relative to other CIH approaches among military veterans. Military veterans (n = 1230) enrolled in VHA reported CIH utilization rates, reasons for use, perceived effectiveness, treatment barriers, and demographics. Results Approximately 18% of veterans reported using mindfulness meditation in the past year, exceeding the proportion using all other CIH approaches (p < .001), with the exception of massage and chiropractic care. Mindfulness was most commonly used for stress reduction and addressing symptoms of depression and anxiety. Among mindfulness users, veterans rated mindfulness with a mean score of 3.18 out of 5 (SD = 0.82) in terms of effectiveness, reflecting a response in the “somewhat helpful” to “moderately helpful” range. This was similar to ratings of other CIH approaches (mean = 3.20, p = .391). Of those who used mindfulness, nearly all (78%) reported only using it outside the VHA. Veterans identified not knowing if the VHA offered mindfulness as the most common reason for using mindfulness outside VHA. Conclusions In summary, veterans use mindfulness for a range of reasons and report receiving benefit from its use. Low awareness and potentially low availability of VHA’s mindfulness programs need to be addressed to increase access.