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Objectives Growing research indicates that self-compassion is associated with key physical health outcomes in non-clinical adult populations. This systematic review was designed to characterize the mediators linking self-compassion to physical health outcomes, evaluate study quality and theoretical evidence, compare findings to the mental health literature, and provide directions for future research. Methods We searched Embase, Medline, APA PsycInfo, Scopus, AMED, and Web of Science for relevant articles (including the inclusion of formal statistical mediation tests) from 2003 to February 2022. Study quality was assessed with Downs and Black Checklist for Measuring Quality and Mediation Quality Checklist tools. Results We screened 6439 articles for title and abstracts, assessed 101 full texts for eligibility, and included 20 relevant articles. A range of mediators were categorized as testing psychological or behavioral factors. Perceived stress (n = 5), emotion regulation (n = 5), negative affect (n = 3), and coping strategies (n = 3) were the most frequently assessed mediators. In general, self-compassion had a significant indirect effect on physical health via negative affect and perceived stress (in the absence of overlapping affective mediators). Findings for emotion regulation and coping strategies were mixed. Conclusions The mediational evidence linking self-compassion to physical health via psychological and behavioral factors remains underdeveloped and focused on the measures of affect and emotion regulation. Future studies need to broaden the scope of mediators to include other self-regulatory factors indicated by theory (e.g., motivational and physiological indices) and implement designs other than cross-sectional/correlational. Protocol Registration PROSPERO CRD42021241915.

Stress has been linked to high-fat and high-sugar food consumption. Self-compassion is associated with better emotional and physiological responses to stress. The current study explored whether trait self-compassion or induced state self-compassion could improve dietary choice and food craving after a stress induction.Fifty-three university students completed an online survey assessing self-compassion, eating restraint, and general perceived stress before attending a laboratory visit. In the laboratory, participants were randomised to a neutral writing control or a self-compassion letter writing condition before a stress induction. Measures of heart rate, heart rate variability, state self-compassion, dietary choice, and state food cravings were taken.The brief self-compassion intervention did not sufficiently increase state self-compassion in the intervention group compared to the neutral writing condition. There was no effect of the written self-compassion intervention on heart rate, heart rate variability, dietary choice, or food craving. However, higher trait self-compassion was associated with healthier dietary choices (F(1, 49) = 5.35, p = .025, RResults suggest that higher trait self-compassion improved dietary choice after stress in a controlled environment in a university population. Further research is warranted to explore whether brief self-compassion interventions can improve state self-compassion and thereby influence dietary choices and food cravings after a stress induction.

Background: Despite being a mandated, foundational value in healthcare, research on compassion remains limited. Studying the individual, patient, clinical, and contextual factors that interfere with compassion—the “barriers”—may clarify our understanding of the origins of compassion and identify potential targets for improving patient-centred care. Studies of the related construct of empathy have suggested that medical students report declines with increasing clinical experience. In contrast, when comparing physicians with medical students, increased clinical experience predicts lower barriers to compassion. Whether—and how—a similar experience-related decline in the factors that interfere with compassion occurs across medical training remains unknown.Aims: To describe how the barriers to compassion vary across clinical training in medical students.Method: New Zealand medical students (N = 351) in their clinical years (Years 4–6) completed measures of the Barriers to Physician Compassion (BPCQ) and potential covariates such as demographics, work burden factors, and dispositional factors. The BPCQ indexes the extent to which barriers in four domains (individual, patient, clinical, and contextual) interfere with a physician/student’s compassion towards patients. Analyses of variance and regression analyses were used to explore the effect of year level on the four types of barriers.Results: Year 4 students reported slightly lower student-related, environmental and patient/family-related (but not clinical) barriers than Year 6 students (effect size: ɷ2 Conclusions: In extending studies of empathy decline, this report suggests that students experience higher barriers to compassion as clinical training progresses. This is in contrast to existing studies contrasting physicians with medical students, where greater experience was associated with lower perceived barriers to compassion. Self-compassion may offset increases in barriers to care.

Intuitive Eating (IE) is an approach to eating designed to facilitate a positive relationship with food. Its use in clinical settings and in the community is rapidly growing in popularity. The Intuitive Eating Scale 2 (IES-2) is a widely used measure that indexes intuitive eating motivations and behaviour, however evidence of its validity in populations with clinical eating disorders remains scarce. The objective of the proposed study was thus to evaluate the factor structure of the IES-2 in a large sample of individuals seeking treatment for eating disorders in private practice. Data collected from 569 women and men aged 12–68 years seeking treatment for an eating disorder in one of eight specialist private outpatient eating disorder clinics were examined using confirmatory factor analysis (CFA). Relationships between IES-2 scores and measures of psychopathology were also examined. Results were relatively consistent with the purported four-factor structure of the IES-2. The measure displayed strong construct validity and good internal consistency. Scores on the IES-2 were inversely associated with scores of depression, anxiety, and disordered eating, providing evidence for divergent validity of the measure. Clinical norms are provided for anorexia nervosa (AN) spectrum disorders and bulimia nervosa (BN) spectrum disorders, as well as for the clinical sample as a whole. Findings suggest that the IES-2 may be an appropriate measure for evaluating behaviours relating to IE in community outpatient eating disorder settings, and provide further evidence for the association between IE and positive health outcomes. III, evidence obtained from well-designed cohort or case–control analytic studies.

Background Compassion in healthcare provides measurable benefits to patients, physicians, and healthcare systems. However, data regarding the factors that predict care (and a lack of care) are scattered. This study systematically reviews biomedical literature within the Transactional Model of Physician Compassion and synthesizes evidence regarding the predictors of physician empathy, compassion, and related constructs (ECRC). Methods A systematic literature search was conducted in CENTRAL, MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, OvidJournals, ProQuest, Web of Science, and Scopus using search terms relating to ECRC and its predictors. Eligible studies included physicians as participants. Methodological quality was assessed based on the Cochrane Handbook, using ROBINS-I risk of bias tool for quantitative and CASP for qualitative studies. Confidence in findings was evaluated according to GRADE-CERQual approach. Results One hundred fifty-two included studies (74,866 physicians) highlighted the diversity of influences on compassion in healthcare (54 unique predictors). Physician-related predictors (88%) were gender, experience, values, emotions and coping strategies, quality of life, and burnout. Environmental predictors (38%) were organizational structure, resources, culture, and clinical environment and processes. Patient-related predictors (24%) were communication ease, and physicians’ perceptions of patients’ motives; compassion was also less forthcoming with lower SES and minority patients. Evidence related to clinical predictors (15%) was scarce; high acuity presentations predicted greater ECRC. Discussion The growth of evidence in the recent years reflects ECRC’s ongoing importance. However, evidence remains scattered, concentrates on physicians’ factors that may not be amenable to interventions, lacks designs permitting causal commentary, and is limited by self-reported outcomes. Inconsistent findings in the direction of the predictors’ effects indicate the need to study the relationships among predictors to better understand the mechanisms of ECRCs. The current review can guide future research and interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-07055-2.

Objectives Work stress is common in healthcare and reliably predicts negative outcomes, including burnout and lower quality of life (QOL). However, few studies have investigated factors that might attenuate the impact of stress on these negative outcomes. We investigated whether the tendency to be kind to the self during times of difficulty—self-compassion—might buffer the effect of work stress on outcomes. Methods Registered nurses (n = 801), physicians (n = 516), and medical students (n = 383) were recruited using convenience sampling in New Zealand. Following consent, participants (N = 1700) completed a survey including the Copenhagen Burnout Inventory, Satisfaction with Life Scale, and Self-Compassion Scale–Short Form. Results Across groups, greater work stress consistently predicted greater burnout and lower QOL, while greater self-compassion predicted lower burnout and better QOL. Self-compassion moderated the relationship between stress and burnout in nurses (albeit in the opposite direction to what had been predicted), but not in doctors or medical students. Conclusions While self-compassion predicted better outcomes (and may thus represent a target to enhance wellbeing), it strengthened the association between stress and burnout in nurses. How self-compassion impacts the experience of stress and its correlates and why it does so differently in different groups of professionals remains unclear.

Although the current randomized controlled trial has previously reported an effect of mindfulness-based stress reduction (MBSR) on improving disease activity in rheumatoid arthritis (RA), the possible mechanisms underlying this relationship remain unknown. This report presents secondary analyses examining anxiety and depression as potential mediators of the effect of MBSR on changes in RA disease activity. Fifty-one RA patients were randomized to either MBSR or to a wait-list control group. Depression and anxiety (Hospital and Anxiety Depression Scale) and RA disease activity (DAS28-CRP) were assessed at baseline (T1), post-treatment (T2), and at two (T3) and four (T4) months’ follow-up. Intention to treat (ITT) and per protocol (PP) analyses using multivariate analyses of variance showed that depression was lower in the MBSR than in the control group, post-treatment and at both follow-up time points. PP analyses suggested that anxiety was lower in the MBSR than in the control group post-treatment. In partial support of expectation, mediation analyses showed that a reduction in depression across the intervention (T2-T1) mediated the effect of MBSR on improvements in RA disease activity at both follow-up time points (T3-T1; T4-T1). This effect held across ITT and PP analyses. PP analyses also suggested an indirect effect of MBSR on RA disease activity via increased anxiety at T3, but not at T4. Together, findings suggest that improvements in depression (rather than anxiety) may mediate the effect of MBSR on RA disease activity. Screening for, and treating depression in RA with MBSR, may have downstream benefits for RA disease activity.

Emotional distress is common during chemotherapy, and supportive interventions during this time are often required. Mindfulness-based interventions appear promising amongst cancer survivors, but scant research has been conducted amongst patients undergoing acute treatment. This trial compared the efficacy of a brief mindfulness-based intervention (bMBT) with relaxation therapy on reducing distress amongst chemotherapy patients. Sixty-eight people receiving first-line chemotherapy at Auckland City Hospital were randomised to bMBT (n = 32) or relaxation training groups (n = 36). In both conditions, participants attended three 90-min weekly sessions. Overall distress (distress thermometer (DT); impact thermometer (IT)), cancer-related stress (Impact Events Scale–Cancer (IES-C)), cancer symptom distress (Memorial Symptom Assessment Scale–Short Form (MSAS-SF)) and social avoidance (SA) were assessed at enrolment, post-intervention and at 3-month follow-up. Both groups reported reductions in overall and cancer-related stress over time. Immediately post-intervention, however, bMBT (but not relaxation training) participants reported increased symptom distress, marginally increased social avoidance and decreased quality of life. So whilst overall distress and cancer distress declined in both groups, the mindfulness intervention was associated with increased symptom distress and social avoidance and reduced quality of life. This report presents a randomised controlled trial of a mindfulness-based intervention during chemotherapy and suggests that care is needed in employing mindfulness-based interventions in acute health treatment contexts.

Compassion is an essential component of medical practice but is difficult to sustain over time. This problem is increasingly recognized in medical curricula. Mindfulness-based interventions have the potential to enhance compassion in medicine but this has not yet been tested. This study evaluated whether a brief mindfulness induction increased compassionate responding to difficult patients among medical students and assessed whether trait self-compassion moderated the impact of this experimental manipulation. A sample of 83 medical students completed baseline questionnaires including trait self-compassion prior to a laboratory session. In the laboratory, participants were gender block-randomized to mindfulness or control conditions before completing tasks assessing compassionate behaviour and decision-making in difficult patient vignettes. Finally, a covert behavioural measure allowed direct observation of responses to a request for help. The induction elicited mindfulness as intended and equivalently at both high and low levels of self-compassion. ANCOVAs showed that mindfulness predicted greater patient “liking” and “caring” but only among persons lower in self-compassion. The mindfulness intervention predicted greater helping behaviour, but primarily among those with higher self-compassion. A brief mindfulness induction showed some promise in enhancing compassionate responses and behaviour among medical students. Mindfulness training may offer a means of sustaining and enhancing compassion among some medical professionals but further research is needed.

Dispositional self-compassion has been linked to better mood and better health behaviors in numerous studies, albeit in cross-sectional designs employing self-report measurement. This study (n = 42) experimentally evaluated how a self-compassion (versus self-criticism) manipulation impacted patterns of positive and negative emotion, tested whether it increased health behavior (flossing) and motivation to floss following negative feedback, and assessed whether changes in emotion predicted changes in behavior. As expected, there was greater positive and less negative mood following the self-compassion induction, but only temporarily; there were no buffering effects of the self-compassion intervention on mood after critical external feedback. In contrast to expectation, self-compassion predicted lower floss time and did not impact motivation to floss in future. These findings suggest that while being kind to oneself instead of self-critical may promote better mood, it may be less effective in motivating certain health behaviors like teeth flossing, at least in an experimental setting.

Background Despite considerable efforts to address practical barriers, colorectal cancer screening numbers are often low. People do not always act rationally, and investigating emotions may offer insight into the avoidance of screening. The current work assessed whether fear, embarrassment, and disgust predicted colorectal cancer screening avoidance. Methods A community sample (N = 306) aged 45+ completed a questionnaire assessing colorectal cancer screening history and the extent that perceptions of cancer risk, colorectal cancer knowledge, doctor discussions, and a specifically developed scale, the Emotional Barriers to Bowel Screening (EBBS), were associated with previous screening behaviours and anticipated bowel health decision-making. Results Step-wise logistic regression models revealed that a decision to delay seeking healthcare in the hypothetical presence of bowel symptoms was less likely in people who had discussed risk with their doctor, whereas greater colorectal cancer knowledge and greater fear of a negative outcome predicted greater likelihood of delay. Having previously provided a faecal sample was predicted by discussions about risk with a doctor, older age, and greater embarrassment, whereas perceptions of lower risk predicted a lower likelihood. Likewise, greater insertion disgust predicted a lower likelihood of having had an invasive bowel screening test in the previous 5 years. Conclusions Alongside medical and demographic factors, fear, embarrassment and disgust are worthy of consideration in colorectal cancer screening. Understanding how specific emotions impact screening decisions and behaviour is an important direction for future work and has potential to inform screening development and communications in bowel health.

In this experimental study, we evaluated whether manipulated disgust and mindfulness predicted social avoidance in bowel health contexts. Community participants (n = 101) were randomised to conditions in which disgust and/or state mindfulness were experimentally induced. Tasks assessing social avoidance and perceptions of available social networks in the context of bowel/health problems were conducted. Manipulation checks confirmed the elicitation of disgust and state mindfulness in the applicable conditions. As expected, persons in the disgust condition were more likely to exhibit immediate social avoidance (rejecting a glass of water). State disgust predicted greater socially avoidant decision-making, less decisional conflict, and smaller social network maps. State mindfulness predicted fewer names on inner network circles and amplified the effect of disgust on creating smaller social network maps. This report furthers understanding of disgust and avoidance in bowel health contexts, and suggests the need for caution in mindfulness interventions that raise awareness of emotion without also providing skills in emotional regulation.

Cancer screening disparities between black and white groupings are well-documented. Less is known regarding African-descent subpopulations despite elevated risk, distinct cultural backgrounds, and increasing numbers of Caribbean migrants. A systematic search of Medline, Web of Science, PubMed and SCOPUS databases (1980-2012) identified 53 studies reporting rates of breast, prostate, cervical, and colorectal screening behavior among immigrant and non-immigrant Caribbean groups. Few studies were conducted within the Caribbean itself; most work is US-based, and the majority stem from Brooklyn, New York. In general, African-descent Caribbean populations screen for breast, prostate, colorectal, and cervical cancers less frequently than US-born African-Americans and at lower rates than recommendations and guidelines. Haitian immigrants, in particular, screen at very low frequencies. Both immigrant and non-immigrant African-descent Caribbean groups participate in screening less frequently than recommended. Studying screening among specific Caribbean groups of African-descent may yield data that both clarifies health disparities between US-born African-Americans and whites and illuminates the specific subpopulations at risk in these growing immigrant communities.

Although mindfulness has been generally linked to superior emotional functioning, several areas remain unclear. In extending prior work, the current report evaluated the link between trait mindfulness and physiological patterns of recovery from negative emotion and investigated possible associations between trait mindfulness and emotion differentiation. After completing a trait mindfulness measure, 80 healthy volunteers were block-randomized (matched on gender and relatively high versus relatively low trait mindfulness) to complete either emotional (EN) or neutral (NE) writing tasks first. In the EN order, participants wrote about an upsetting experience and, in the NE order, about the events of an average day. In partial support of expectation, relatively more mindful men showed greater physiological reactivity to an emotional task followed by superior recovery, but only in the EN order; supplementary analyses suggest that greater non-reactivity scores among males may be involved in the physiological regulation of emotional stress. As expected, relatively more versus relatively less mindful participants also differentiated more among discrete negative emotions but, again, only in the EN order. Taken together, findings offer preliminary evidence that the more differentiated emotional responding associated with aspects of trait mindfulness may facilitate more adaptive responding under stress and contribute to superior mental and physical health.

Given global demand on health workforces, understanding student enrollment motivations are critical. Prior studies have concentrated on variation in career and lifestyle values; the current work evaluated the importance of disgust sensitivity in the prediction of health career interests. We argue that emotional proclivities may be important and that disgust sensitivity may help explain differential student interest in nursing, pharmacy, or medical careers. 303 first year students attending a required course in human behavior provided consent before completing questionnaires assessing: (1) demographics, (2) career intentions/interests, (3) traditional determinants of career intention/interest, and (4) dispositional disgust sensitivity. As expected, disgust sensitivity varied across the three majors, with those targeting medical careers being less sensitive than those interested in either nursing or pharmacy. As importantly, even when controlling for demographics and traditional career determinants, analyses showed that greater disgust sensitivity was associated with reduced odds of intended enrolment in pharmacy versus medicine or nursing but did not predict the distinction between nursing and medicine. The impact of disgust sensitivity on career interest was substantial and equivalent to established predictors of career intention. Disgust sensitivity may represent an important factor impacting the specific choices students make within the health professions, particular when students are choosing between careers involving greater and lesser degrees of exposure to the normative elicitors of disgust.

Disparities in breast screening are well documented. Less clear are differences within groups of immigrant and non-immigrant minority women or differences in adherence to mammography guidelines over time. A sample of 1,364 immigrant and non-immigrant women (African American, English Caribbean, Haitian, Dominican, Eastern European, and European American) were recruited using a stratified cluster-sampling plan. In addition to measuring established predictors of screening, women reported mammography frequency in the last 10 years and were (per ACS guidelines at the time) categorized as never, sub-optimal (

The purpose of the present study was to develop the later life attachment literature by providing data contrasting patterns of attachment among 616 older men and women (aged 50 to 70) from seven ethnic groups in the United States: African Americans, English-speaking Caribbeans, Haitians, Dominicans, Puerto Ricans, Eastern Europeans, and European Americans. A multivariate analysis of the variance with ethnicity, gender, and income as factors predicting four dimensional styles of attachment (secure, dismissive, preoccupied, and fearful avoidant) revealed numerous ethnic differences in attachment styles. Most notably, Haitians reported greater dismissiveness than all other groups, with Eastern Europeans reporting more than Dominicans, Puerto Ricans, European Americans and African Americans. Haitians also reported lower fearful avoidance than all other groups. Dominicans and Puerto Ricans reported greater preoccupation than Haitians, African Americans, and English-speaking Caribbeans. The most notable interactions with gender and income revealed that although preoccupation was lower among African American, English-speaking Caribbean, Haitian, and European American women versus men, it was greater among Dominican, Puerto Rican, and Eastern European women, and that whereas security was generally high among European Americans notwithstanding income, income strongly impacted attachment security in other groups. These differences are interpreted in light of ethnic differences in historical, familial, and religious contexts. This study provides a glimpse into the ethnic and cultural diversity in the ways in which older adults relate to significant others.

Although the aging process brings with it some common challenges to older men and women, there has been little attention to gender differences in patterns of socioemotional functioning or their links to adaptive outcome. In this paper we examine patterns of socioemotional functioning among 687 “younger” (65–73 years) and 426 “older” (74–86 years) men and women, describe sex differences in these patterns, and examine whether the same patterns are linked to physical resilience in the same ways across groups. Cluster analysis was applied to 11 measures of socioemotional functioning with ten qualitatively different patterns emerging. As expected, men and women from our two age groups were not equally distributed across the patterns. As expected, older men more frequently manifested patterns of adaptation characterized by inhibited emotion but, together with younger men, were less likely to be represented in patterns characterized by stress-buffering friend support networks. The patterns also showed predictable links to a measure of physical resiliency, which was predicted by participant sex, and both sex and age interacted with cluster membership in predicting resiliency. Taken together, these data underscore the complexity of adaptation to later life among men and women and highlight the possibility that the existence of particular patterns of later life adaptation may have differing late life consequences for older men and women. Implications for the continued study of sex differences in adaptation to later life and directions for future research are given.

It is an axiom of social gerontology that populations of older individuals become increasingly differentiated as they age. Adaptations to physical and social losses and the increased dependency that typically accompany greater age are likely to be similarly heterogeneous, with different individuals adjusting to the aging process in widely diverse ways. In this paper we consider how individuals with diverse emotional and regulatory profiles, different levels of religiosity, and varied patterns of social relatedness fare as they age. Specifically, we examine the relation between ethnicity and patterns of socioemotional adaptation in a large, ethnically diverse sample (N = 1118) of community-dwelling older adults. Cluster analysis was applied to 11 measures of socioemotional functioning. Ten qualitatively different profiles were extracted and then related to a measure of physical resiliency. Consistent with ethnographic and psychological theory, individuals from different ethnic backgrounds were unevenly distributed across the clusters. Resilient participants of African descent (African Americans, Jamaicans, Trinidadians, Barbadians) were more likely to manifest patterns of adaptation characterized by religious beliefs, while resilient US-born Whites and Immigrant Whites were more likely to be resilient as a result of non-religious social connectedness. Taken together, although these data underscore the diversity of adaptation to later life, we suggest that patterns of successful adaptation vary systematically across ethnic groups. Implications for the continued study of ethnicity in aging and directions for future research are given.

Consideration of the psychosocial contributions to cardiovascular disease (CVD) remains an ongoing focus of research in the behavioral sciences, with a particular emphasis on the role of hostility. There are, however, a number of inconsistent findings, and the generality of findings across genders remains a continuing concern. This article presents an emotions-theory perspective on the relation between personality and CVD and reports a test of the hypothesis that anxiety predicts CVD in women whereas hostility predicts CVD in men. Six hundred and eighty women and 415 men completed measures of traditional risk factors, emotion, and cardiovascular disease. Structural equation analyses supported our prediction. Data are interpreted in terms of their capacity to inform general psychosocial models of CVD, and implications for gender-specific intervention programs are discussed.

Emotions are central to contemporary theories of health, and a growing body of psychological research has shown emotion and emotion regulatory styles to be predictive of health outcomes. Yet despite these clear links and the fact that patterns of emotion and expression are partially a product of culture, there is a meager literature on the emotional characteristics of different ethnic groups. Even where ethnicity has been investigated in emotions research, it has typically been operationalized in such a way that within-group differences are obscured with most individuals assigned to broad ethnic categories, such as non-Hispanic White, or Black. In the present study we draw on data from a multi-ethnic sample of 755 community-dwelling older adults to parse a picture of the emotional characteristics of three of the largest and most culturally distinct ethnic groups in the Northeastern United States: African Americans, West Indians (Jamaicans), and Eastern Slavs (Russians and Ukrainians) from the former Soviet Republic, as well as a comparison group of US-born European Americans. As predicted, there were striking differences in nine of 10 trait emotions as well as in levels of emotion expressed during conflict. The findings are discussed in terms of emotion socialization and implications for prediction and intervention in psychosocial models of emotions, emotion regulation, and health in older ethnic populations.

Email: Nathan S Consedine* nconsedi@liu.edu; Brenda A Adjei brenda.adjei@liu.edu; David Horton dhorton79@gmail.com; Andrew K Joe akj3@columbia.edu; Luisa N Borrell lnb2@columbia.edu; Paul Michael Ramirez paul.ramirez@liu.edu; Tracey Ungar tracey.ungar@liu.edu; James M McKiernan jmm23@columbia.edu; Judith S Jacobson jsj4@columbia.edu; Carol Magai cmagai@liu.edu; Alfred I Neugut ain1@columbia.edu * Corresponding author

This study examined whether ethnic differences in insomnia symptoms are mediated by differences in repressive coping styles., Journal Article, info:eu-repo/semantics/published