Mindfulness

, Volume 6, Issue 5, pp 1033–1041 | Cite as

Relations Among Self-Compassion, PTSD Symptoms, and Psychological Health in a Trauma-Exposed Sample

  • Antonia V. Seligowski
  • Lynsey R. Miron
  • Holly K. Orcutt
ORIGINAL PAPER

Abstract

Emerging literature on self-compassion suggests that establishing and maintaining a compassionate perspective toward oneself and one’s experiences may help buffer against the negative effects of trauma exposure, such as psychopathology and reduced quality of life. The goal of the current study was to examine relations among self-compassion, posttraumatic stress disorder (PTSD) symptom severity, and overall psychological health in a sample of trauma-exposed university students. Further, the current study explored these associations while controlling for a theoretically related construct, psychological inflexibility. Participants were 453 undergraduate students enrolled in an introductory psychology course at a large Midwestern University (M age = 19.75, SD = 3.07). A structural equation model (SEM) approach was used. Results indicated that a two-factor solution for the Self-Compassion Scale defined by subscale valence (i.e., positive and negative components) demonstrated improved fit over a single-factor model. The overall model demonstrated good fit: comparative fit index (CFI) = 0.96, Tucker-Lewis index (TLI) = 0.93, root-mean-square residual (RMSEA) = 0.08 (90 % confidence interval (CI) 0.07 to 0.09). The two observed factors of self-compassion emerged as strong predictors of variation in overall psychological health, even in the context of PTSD symptoms and psychological inflexibility. Additionally, the two self-compassion factors accounted for significant variance in psychological inflexibility, but not PTSD symptoms. Results demonstrate that increasing levels of self-compassion may represent an important area of intervention for trauma-exposed individuals.

Keywords

Self-compassion Trauma PTSD Psychological inflexibility Well-being Psychological health 

References

  1. Afifi, T. O., Enns, M. W., Cox, B. J., de Graaf, R., Have, M., & Sareen, J. (2007). Child abuse and health-related quality of life in adulthood. Journal of Nervous and Mental Disease, 195, 797–804. doi: 10.1097/NMD.0b013e3181567fdd.CrossRefPubMedGoogle Scholar
  2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.Google Scholar
  3. Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256, 174–186. doi: 10.1007/s00406-005-0624-4.PubMedCentralCrossRefPubMedGoogle Scholar
  4. Bandalos, D. L. (2008). Is item parceling really necessary? A comparison of results from item parceling and categorical variable methodology. Structural Equation Modeling: A Multidisciplinary Journal, 15, 211–240. doi: 10.1080/10705510801922340.CrossRefGoogle Scholar
  5. Barnard, L. K., & Curry, J. F. (2011). Self-compassion: conceptualizations, correlates, & interventions. Review of General Psychology, 15, 289–303. doi: 10.1037/a0025754.CrossRefGoogle Scholar
  6. Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676–688. doi: 10.1016/j.beth.2011.03.007.CrossRefPubMedGoogle Scholar
  7. Browne, M. W., & Cudeck, R. (1992). Alternative ways of assessing model fit. Sociological Methods & Research, 21, 230–258. doi: 10.1177/0049124192021002005.CrossRefGoogle Scholar
  8. Charney, M. E., & Marx, B. P. (2012). Promoting a positive quality of life posttrauma. In R. A. McMackin, E. Newman, J. M. Fogler, & T. M. Keane (Eds.), Trauma therapy in context: the science and craft of evidence-based practice (pp. 247–264). Washington DC: American Psychological Association.CrossRefGoogle Scholar
  9. Clark, D. B., & Kirisci, L. (1996). Posttraumatic stress disorder, depression, alcohol use disorders and quality of life in adolescents. Anxiety, 2, 226–233. doi: 10.1002/(SICI)1522-7154(1996)2:5<226::AID-ANXI4>3.0.CO;2-K.CrossRefPubMedGoogle Scholar
  10. Cohn, M. A., Fredrickson, B. L., Brown, S. L., Mikels, J. A., & Conway, A. M. (2009). Happiness unpacked: positive emotions increase life satisfaction by building resilience. Emotion, 9, 361–368. doi: 10.1037/a0015952.PubMedCentralCrossRefPubMedGoogle Scholar
  11. Costa, J., & Pinto-Gouveia, J. (2013). Experiential avoidance and self-compassion in chronic pain. Journal of Applied Social Psychology, 43, 1578–1591. doi: 10.1111/jasp.12107.CrossRefGoogle Scholar
  12. Doctor, J. N., Zoellner, L. A., & Feeny, N. C. (2011). Predictors of health-related quality-of-life utilities among persons with posttraumatic stress disorder. Psychiatric Services, 62, 272–277. doi: 10.1176/appi.ps.62.3.272.PubMedCentralCrossRefPubMedGoogle Scholar
  13. Fledderus, M., Bohlmeijer, E. T., & Pieterse, M. E. (2010). Does experiential avoidance mediate the effects of maladaptive coping styles on psychopathology and mental health? Behavior Modification, 34, 503–519. doi: 10.1177/0145445510378379.CrossRefPubMedGoogle Scholar
  14. Giacco, D., Matanov, A., & Priebe, S. (2013). Symptoms and subjective quality of life in post-traumatic stress disorder: a longitudinal study. PLoS ONE, 8, e60991. doi: 10.1371/journal.pone.0060991.PubMedCentralCrossRefPubMedGoogle Scholar
  15. Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, 15, 199–208. doi: 10.1192/apt.bp.107.005264.CrossRefGoogle Scholar
  16. Gilbert, P. (2010). Compassion focused therapy: distinctive features (CBT Distinctive Features Series). New York: Routledge.Google Scholar
  17. Goenjian, A. K., Roussos, A., Steinberg, A. M., Sotiropoulou, C., Walling, D., Kakaki, M., & Karagianni, S. (2011). Longitudinal study of PTSD, depression, and quality of life among adolescents after the Parnitha earthquake. Journal of Affective Disorders, 133, 509–515. doi: 10.1016/j.jad.2011.04.053.CrossRefPubMedGoogle Scholar
  18. Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford Press.Google Scholar
  19. Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., Polusny, M. A., Dykstra, T. A., Batten, S. V., Bergan, J., Stewart, S. H., Zvolensky, M. J., Eifert, G. H., Bond, F. W., Forsyth, J. P., Karekla, M., & McCurry, S. M. (2004). Measuring experiential avoidance: a preliminary test of a working model. The Psychological Record, 54, 553–578.Google Scholar
  20. Herrenkohl, T. I., Klika, J. B., Herrenkohl, R. C., Russo, M. J., & Dee, T. (2012). A prospective investigation of the relationship between child maltreatment and indicators of adult psychological well-being. Violence and Victims, 27, 764. doi:  10.1891/0886-6708.27.5.764.
  21. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. doi: 10.1080/10705519909540118.CrossRefGoogle Scholar
  22. IBM Corp. Released (2012) IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.Google Scholar
  23. Kashdan, T. B., Barrios, V., Forsyth, J. P., & Steger, M. F. (2006). Experiential avoidance as a generalized psychological vulnerability: comparisons with coping and emotion regulation strategies. Behavior Research and Therapy, 44, 1301–1320. doi: 10.1016/j.brat.2005.10.003.CrossRefGoogle Scholar
  24. Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060. doi: 10.1001/archpsyc.1995.03950240066012.CrossRefPubMedGoogle Scholar
  25. King, A. P., Erickson, T. M., Giardino, N. D., Favorite, T., Rauch, S. A., Robinson, E., Kulkarni, M., & Liberson, I. (2013). A pilot study of group mindfulness-based cognitive therapy (MBCT) for combat veterans with posttraumatic stress disorder (PTSD). Depression and Anxiety, 30, 638–645. doi: 10.1002/da.22104.PubMedCentralCrossRefPubMedGoogle Scholar
  26. Kubany, E. S. (2004). Traumatic Life Events Questionnaire (TLEQ). Los Angeles: Western Psychological Services.Google Scholar
  27. Kubany, E. S., Haynes, S. N., Leisen, M. B., Owens, J. A., Kaplan, A. S., Watson, S. B., & Burns, K. (2000). Development and preliminary validation of a brief broad- spectrum measure of trauma exposure: the Traumatic Life Events Questionnaire. Psychological Assessment, 12, 210–224. doi: 10.1037/1040-3590.12.2.210.CrossRefPubMedGoogle Scholar
  28. Kumpula, M. J., Orcutt, H. K., Bardeen, J. R., & Varkovitzky, R. L. (2011). Peritraumatic dissociation and experiential avoidance as prospective predictors of posttraumatic stress symptoms. Journal of Abnormal Psychology, 120, 617–627. doi: 10.1037/a0023927.PubMedCentralCrossRefPubMedGoogle Scholar
  29. Lang, A. J., Schnurr, P. P., Jain, S., Raman, R., Walser, R., Bolton, E., Chabot, A., & Benedek, D. (2012). Evaluating transdiagnostic treatment for distress and impairment in veterans: a multi-site randomized controlled trial of Acceptance and Commitment Therapy. Contemporary Clinical Trials, 33, 116–123. doi: 10.1016/j.cct.2011.08.007.CrossRefPubMedGoogle Scholar
  30. Leary, M. R., Tate, E. B., Adams, C. E., Allen, A. B., & Hancock, J. (2007). Self-compassion and reactions to unpleasant self-relevant events: the implications of treating oneself kindly. Journal of Personality and Social Psychology, 92(5), 887–904. doi: 10.1037/0022-3514.92.5.887.CrossRefPubMedGoogle Scholar
  31. Lyubomirsky, S., & Lepper, H. (1999). A measure of subjective happiness: preliminary reliability and construct validation. Social Indicators Research, 46, 137–155.CrossRefGoogle Scholar
  32. MacBeth, A., & Gumley, A. (2012). Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32, 545–552. doi: 10.1016/j.cpr.2012.06.003.CrossRefPubMedGoogle Scholar
  33. Marx, B. P., & Sloan, D. M. (2005). Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology. Behaviour Research and Therapy, 43, 569–583. doi: 10.1016/j.brat.2004.04.004.CrossRefPubMedGoogle Scholar
  34. Neely, M. E., Schallert, D. L., Mohammed, S. S., Roberts, R. M., & Chen, Y.-J. (2009). Self-kindness when facing stress: the role of self-compassion, goal regulation, and support in college students’ well-being. Motivation and Emotion, 33, 88–97. doi: 10.1007/s11031-008-9119-8.CrossRefGoogle Scholar
  35. Neff, K. D. (2003a). Self-compassion: an alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85–102. doi: 10.1080/15298860390129863.CrossRefGoogle Scholar
  36. Neff, K. D. (2003b). Development and validation of a scale to measure self-compassion. Self and Identity, 2, 223–250. doi: 10.1080/15298860390209035.CrossRefGoogle Scholar
  37. Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the Mindful Self-Compassion Program. Journal of Clinical Psychology, 69, 28–44. doi: 10.1002/jclp.21923.CrossRefPubMedGoogle Scholar
  38. Neff, K. D., & McGehee, P. (2010). Self-compassion and psychological resilience among adolescents and young adults. Self and Identity, 9, 225–240. doi: 10.1080/15298860902979307.CrossRefGoogle Scholar
  39. Neff, K. D., & Vonk, R. (2009). Self-compassion versus global self-esteem: two different ways of relating to oneself. Journal of Personality, 77(1), 23–50. doi: 10.1111/j.1467-6494.2008.00537.x.CrossRefPubMedGoogle Scholar
  40. Neff, K., Hsieh, Y., & Dejitterat, K. (2005). Self-compassion, achievement goals, and coping with academic failure. Self and Identity, 4, 263–287. doi: 10.1080/13576500444000317.CrossRefGoogle Scholar
  41. Neff, K. D., Kirkpatrick, K., & Rude, S. S. (2007). Self-compassion and adaptive psychological functioning. Journal of Research in Personality, 41, 139–154. doi: 10.1016/j.jrp.2006.03.004.CrossRefGoogle Scholar
  42. Orsillo, S. M., & Batten, S. V. (2005). Acceptance and commitment therapy in the treatment of posttraumatic stress disorder. Behavior Modification, 29, 95–129. doi: 10.1177/0145445504270876.CrossRefPubMedGoogle Scholar
  43. Royse, D., Rompf, B. L., Dhooper, S. S., Simon, N. M., Herlands, N. N., Marks, E. H., … Stein, M. B. (1991). Childhood trauma and adult life satisfaction in a random adult sample. Psychological Reports, 69(3 Pt 2), 1227–1231. doi: 10.2466/pr0.1991.69.3f.1227
  44. Sass, D. A., & Smith, P. L. (2006). The effects of parceling unidimensional scales on structural parameter estimates in structural equation modeling. Structural Equation Modeling: A Multidisciplinary Journal, 13, 566–586. doi: 10.1207/s15328007sem1304_4.CrossRefGoogle Scholar
  45. Schnurr, P. P., Friedman, M. J., Foy, D. W., Shea, M. T., Hsieh, F. Y., Lavori, P. W., Glynn, S. M., Wattenberg, M., & Bernardy, N. C. (2003). Randomized trial of trauma-focused group therapy for posttraumatic stress disorder: results from a Department of Veterans’ Affairs cooperative study. Archives of General Psychiatry, 60, 481–489. doi: 10.1001/archpsyc.60.5.481.CrossRefPubMedGoogle Scholar
  46. Stewart-Brown, S., Tennant, A., Tennant, R., Platt, S., Parkinson, J., & Weich, S. (2009). Internal construct validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS): a Rasch analysis using data from the Scottish Health Education Population Survey. Health and Quality of Life Outcomes, 7, 1–8. doi: 10.1186/1477-7525-7-15.CrossRefGoogle Scholar
  47. Taylor, S., Wald, J., & Asmundson, G. J. (2006). Factors associated with occupational impairment in people seeking treatment for posttraumatic stress disorder. Canadian Journal of Community Mental Health, 25, 289–301. Retrieved from http://www.cjcmh.com.CrossRefGoogle Scholar
  48. Tennant, R., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health and Quality of Life Outcomes, 5, 63–76. doi: 10.1186/1477-7525-5-63.PubMedCentralCrossRefPubMedGoogle Scholar
  49. Thompson, B. L., & Waltz, J. (2008). Self-compassion and PTSD symptom severity. Journal of Traumatic Stress, 21, 556–558. doi: 10.1002/jts.20374.CrossRefPubMedGoogle Scholar
  50. Ware, J. E., Jr., Kosinski, M., & Keller, S. D. (1996). A 12 item short form health survey: construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233. doi: 10.1097/00005650-199603000-00003.CrossRefPubMedGoogle Scholar
  51. Warshaw, M. G., Fierman, E., Pratt, L., Hunt, M., Yonkers, K. A., Massion, A. O., & Keller, M. B. (1993). Quality of life and dissociation in anxiety disorder patients with histories of trauma or PTSD. American Journal of Psychiatry, 150, 1512–1516.CrossRefPubMedGoogle Scholar
  52. Williams, M. J., Dalgleish, T., Karl, A., & Kuyken, W. (2014). Examining the factor structures of the Five Facet Mindfulness Questionnaire and the Self-Compassion Scale. Psychological Assessment, 26, 407–418. doi: 10.1037/a0035566.CrossRefPubMedGoogle Scholar
  53. Woodruff, S. C., Glass, C. R., Arnkoff, D. B., Crowley, K. J., Hindman, R. K., & Hirschhorn, E. W. (2013). Comparing self-compassion, mindfulness, and psychological inflexibility as predictors of psychological health. Mindfulness. doi: 10.1007/s12671-013-0195-9. Online First Publication.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Antonia V. Seligowski
    • 1
  • Lynsey R. Miron
    • 1
  • Holly K. Orcutt
    • 1
  1. 1.Department of PsychologyNorthern Illinois UniversityDeKalbUSA

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