For Whom Does Cognitively Based Compassion Training (CBCT) Work? An Analysis of Predictors and Moderators among African American Suicide Attempters

Abstract

Objectives

Both cognitively based compassion training (CBCT) and support-based group intervention have been found to be effective for African American suicide attempters in reducing suicidal ideation and depression, as well as enhancing self-compassion. This study aims to further our understanding of effective interventions by exploring participants’ responses to both interventions.

Methods

Exploratory analyses were conducted in a sample of low-income African Americans who had attempted suicide (n = 82) to determine how baseline demographic and psychological characteristics would (1) predict outcomes (i.e., suicidal ideation, depression, and self-compassion) regardless of intervention conditions and (2) moderate outcomes in interaction with intervention condition.

Results

Non-reactivity, a mindfulness facet, was identified as an intervention moderator for suicidal ideation and depressive symptoms, suggesting that CBCT outperformed the support group for African American suicide attempters who had low baseline non-reactivity (or high reactivity). Individuals who had high non-reactivity at baseline appeared to benefit more from both conditions in self-compassion as an outcome. There was a pattern that homeless individuals benefited less in terms of their levels of depressive symptoms and self-compassion as outcomes regardless of the assigned condition. When applying Bonferroni corrections, only non-reactivity as an intervention moderator for depressive symptoms was significant.

Conclusions

Findings reveal the relevance of mindfulness and to a lesser extent socioeconomic status in informing compassion-based intervention outcomes with this underserved population and the importance of intervention matching and tailoring to maximize treatment effects. Future large trials are needed to replicate findings and directions indicated from the current pilot study.

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Funding

This research was supported by grants from the Emory University Research Council (Group interventions for Suicidal African American men and women) awarded to the last author. Work by the first author was in part supported by the National Institute of Mental Health (T32MH078788).

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SS designed the study analysis, analyzed the data, and wrote the paper. AP assisted in data analysis and editing of the paper. SBG assisted in data analysis and editing of the paper. JB assisted in writing of the Methods. JKN and AEE assisted in data cleaning, literature review, and writing of the paper. BP collaborated in data collection and study design. NJK collaborated in data analysis, writing, and editing of the final manuscript.

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Correspondence to Nadine J. Kaslow.

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The authors declare that they have no conflict of interest.

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All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Emory University IRB provided approval for this study.

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Informed consent was obtained from all individual participants included in the study.

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Sun, S., Pickover, A.M., Goldberg, S.B. et al. For Whom Does Cognitively Based Compassion Training (CBCT) Work? An Analysis of Predictors and Moderators among African American Suicide Attempters. Mindfulness 10, 2327–2340 (2019). https://doi.org/10.1007/s12671-019-01207-6

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Keywords

  • Compassion
  • Mindfulness
  • Intervention moderators
  • African Americans
  • Suicide