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Athletes often believe that self-criticism is necessary to avoid complacency, but this attitude can lead to anxiety and stress. Research shows that self-compassion is an adaptive way to relate to mistakes and challenges. Although there are many benefits of self-compassion, fear that self-compassion harms performance may discourage athletes from adopting this approach. This study developed and tested an online self-compassion intervention for athletes called RESET (Resilience and Enhancement in Sport, Exercise, & Training), adapted from the Mindful Self-Compassion program. Between-group analyses (multilevel modeling; MLM) and within-group analyses (paired t-tests) were used to assess the effectiveness of the intervention on athletes' ability to respond compassionately to failure, improve well-being, and increase perceived sport performance. Compared to the waitlist control (n = 102, 71% women), the intervention group (n = 148, 90% women) experienced greater increases in self-compassion, decreases in self-criticism and fear of self-compassion, and greater improvements in perceived performance. In general, the intervention was more effective for those who had the most room for growth. Within-group analyses supported the MLM findings while also showing that athletes who participated in the RESET program experienced reduced levels of depression, anxiety, and stress. Program evaluation measures, including participant testimonials, extend the quantitative findings and demonstrate that RESET was engaging, well-liked, and effective., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Self-compassion refers to being supportive toward oneself when experiencing suffering or pain-be it caused by personal mistakes and inadequacies or external life challenges. This review presents my theoretical model of self-compassion as comprised of six different elements: increased self-kindness, common humanity, and mindfulness as well as reduced self-judgment, isolation, and overidentification. It discusses the methodology of self-compassion research and reviews the increasingly large number of empirical studies that indicate self-compassion is a productive way of approaching distressing thoughts and emotions that engenders mental and physical well-being. It also reviews research that dispels common myths about self-compassion (e.g., that it is weak, selfish, self-indulgent or undermines motivation). Interventions designed to increase self-compassion, such as compassion-focused therapy and mindful self-compassion, are discussed. Finally, the review considers problematic issues in the field, such as the differential effects fallacy, and considers limitations and future research directions in the field of self-compassion research.

The Self-Compassion Scale (SCS) is a widely used measure to assess the trait of self-compassion, and, so far, it has been implicitly assumed that it functions the same way across different groups. This assumption needs to be explicitly tested to ascertain that no measurement biases exist. To address this issue, the present study sought to systematically examine the generalizability of the bifactor exploratory structural equation modeling operationalization of the SCS via tests of measurement invariance across a wide range of populations, varying according to features such as student or community status, gender, age, and language. Secondary data were used for this purpose and included a total of 18 samples and 12 different languages ( N = 10,997). Multigroup analyses revealed evidence for the configural, weak, strong, strict, and latent variance-covariance of the bifactor exploratory structural equation modeling operationalization of the SCS across different groups. These findings suggest that the SCS provides an assessment of self-compassion that is psychometrically equivalent across groups. However, findings comparing latent mean invariance found that levels of self-compassion differed across groups.

We present a series of studies on the development and validation of the Self-Compassion Scale-Youth version (SCS-Y), which is intended for use with early adolescents in middle school. Study 1 ( N  = 279, M age = 12.17) describes the selection of 17 items out of a pool of 36 potential items, with three items each representing the subscales of self-kindness, mindfulness, common humanity, self-judgment, isolation, and two items representing over-identification. Using state-of-the-art psychometric analyses ideal for examining multidimensional constructs like self-compassion-bifactor exploratory structural equation modeling (bifactor-ESEM)-findings supported the use of a general self-compassion score and six subscale scores. Study 2 cross-validated the factor structure of the SCS-Y with a second sample of youths ( N  = 402, M age = 12.43). Study 3 found support for the test-retest reliability of the SCS-Y ( N  = 102, M age = 12.52). Study 4 ( N  = 212, M age = 12.18) established construct validity for the SCS-Y by demonstrating that SCS-Y scores were significantly associated with mindfulness, happiness, life-satisfaction, depression, resilience, and achievement goal orientation in expected directions. Overall, findings suggest that the SCS-Y is a reliable and valid measure of self-compassion for use with youths.

Objective: Two studies examined the efficacy of the Self-Compassion for Healthcare Communities (SCHC) program for enhancing wellbeing and reducing burnout among healthcare professionals., Method: Study 1 (N = 58) had a quasi-experimental design and compared wellbeing outcomes for the SCHC group compared to a waitlist control group. Study 2 (N = 23) did not include a control group and examined the effect of SCHC on burnout., Results: Study 1 found that SCHC significantly increased self-compassion and wellbeing. All gains were maintained for three months. Study 2 found that in addition to enhancing wellbeing, SCHC significantly reduced secondary traumatic stress and burnout. Changes in self-compassion explained gains in other outcomes, and initial levels of self-compassion moderated outcomes so that those initially low in self-compassion benefitted more., Conclusions: Findings suggest that the SCHC program may be an effective way to increase self-compassion, enhance wellbeing, and reduce burnout for healthcare professionals., (© 2020 Wiley Periodicals LLC.)

This article presents a measure of compassion for others called the Compassion Scale (CS), which is based on Neff's theoretical model of self-compassion. Compassion was operationalized as experiencing kindness, a sense of common humanity, mindfulness, and lessened indifference toward the suffering of others. Study 1 ( n = 465) describes the development of potential scale items and the final 16 CS items chosen based on results from analyses using bifactor exploratory structural equation modeling. Study 2 ( n = 510) cross-validates the CS in a second student sample. Study 3 ( n = 80) establishes test-retest reliability. Study 4 ( n = 1,394) replicates results with a community sample, while Study 5 ( n = 172) replicates results with a sample of meditators. Study 6 ( n = 913) examines the finalized version of the CS in a community sample. Evidence regarding reliability, discriminant, convergent, construct, and known-groups validity for the CS is provided.

This study examined the factor structure of the Self-Compassion Scale (SCS) using secondary data drawn from 20 samples (N = 11,685)-7 English and 13 non-English-including 10 community, 6 student, 1 mixed community/student, 1 meditator, and 2 clinical samples. Self-compassion is theorized to represent a system with 6 constituent components: self-kindness, common humanity, mindfulness and reduced self-judgment, isolation and overidentification. There has been controversy as to whether a total score on the SCS or if separate scores representing compassionate versus uncompassionate self-responding should be used. The current study examined the factor structure of the SCS using confirmatory factor analyses (CFA) and Exploratory Structural Equation Modeling (ESEM) to examine 5 distinct models: 1-factor, 2-factor correlated, 6-factor correlated, single-bifactor (1 general self-compassion factor and 6 group factors), and 2-bifactor models (2 correlated general factors each with 3 group factors representing compassionate or uncompassionate self-responding). Results indicated that a 1- and 2-factor solution to the SCS had inadequate fit in every sample examined using both CFA and ESEM, whereas fit was excellent using ESEM for the 6-factor correlated, single-bifactor and correlated 2-bifactor models. However, factor loadings for the correlated 2-bifactor models indicated that 2 separate factors were not well specified. A general factor explained 95% of the reliable item variance in the single-bifactor model. Results support use of the SCS to examine 6 subscale scores (representing the constituent components of self-compassion) or a total score (representing overall self-compassion), but not separate scores representing compassionate and uncompassionate self-responding. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

This study examined the factor structure of the Self-Compassion Scale (SCS) using a bifactor model, a higher order model, a 6-factor correlated model, a 2-factor correlated model, and a 1-factor model in 4 distinct populations: college undergraduates (N = 222), community adults (N = 1,394), individuals practicing Buddhist meditation (N = 215), and a clinical sample of individuals with a history of recurrent depression (N = 390). The 6-factor correlated model demonstrated the best fit across samples, whereas the 1- and 2-factor models had poor fit. The higher order model also showed relatively poor fit across samples, suggesting it is not representative of the relationship between subscale factors and a general self-compassion factor. The bifactor model, however, had acceptable fit in the student, community, and meditator samples. Although fit was suboptimal in the clinical sample, results suggested an overall self-compassion factor could still be interpreted with some confidence. Moreover, estimates suggested a general self-compassion factor accounted for at least 90% of the reliable variance in SCS scores across samples, and item factor loadings and intercepts were equivalent across samples. Results suggest that a total SCS score can be used as an overall mesure of self-compassion.

Mindfulness and self-compassion are overlapping, but distinct constructs that characterize how people relate to emotional distress. Both are associated with posttraumatic stress disorder (PTSD) and may be related to functional disability. Although self-compassion includes mindful awareness of emotional distress, it is a broader construct that also includes being kind and supportive to oneself and viewing suffering as part of the shared human experience--a potentially powerful way of dealing with distressing situations. We examined the association of mindfulness and self-compassion with PTSD symptom severity and functional disability in 115 trauma-exposed U.S. Iraq/Afghanistan war veterans. Mindfulness and self-compassion were each uniquely, negatively associated with PTSD symptom severity. After accounting for mindfulness, self-compassion accounted for unique variance in PTSD symptom severity (f(2) = .25; medium ES). After accounting for PTSD symptom severity, mindfulness and self-compassion were each uniquely negatively associated with functional disability. The combined association of mindfulness and self-compassion with disability over and above PTSD was large (f(2) = .41). After accounting for mindfulness, self-compassion accounted for unique variance in disability (f(2) = .13; small ES). These findings suggest that interventions aimed at increasing mindfulness and self-compassion could potentially decrease functional disability in returning veterans with PTSD symptoms., (Copyright © 2015 International Society for Traumatic Stress Studies.)

Self-compassion is conceptualized as containing 3 core components: self-kindness versus self-judgment, common humanity versus isolation, and mindfulness versus overidentification, when relating to painful experiences. Research evidence demonstrates that self-compassion is related to psychological flourishing and reduced psychopathology. Mindful Self-Compassion (MSC) is an 8-week training program, meeting 2.5 hours each week, designed to help participants cultivate self-compassion. MSC contains a variety of meditations (e.g., loving-kindness, affectionate breathing) as well as informal practices for use in daily life (e.g., soothing touch, self-compassionate letter writing). A detailed clinical case illustrates the journey of a client through the 8 weeks of MSC training, describing the key features of each session and the client's response., (© 2013 Wiley Periodicals, Inc.)

Objectives: The aim of these two studies was to evaluate the effectiveness of the Mindful Self-Compassion (MSC) program, an 8-week workshop designed to train people to be more self-compassionate., Methods: Study 1 was a pilot study that examined change scores in self-compassion, mindfulness, and various wellbeing outcomes among community adults (N = 21; mean [M] age = 51.26, 95% female). Study 2 was a randomized controlled trial that compared a treatment group (N = 25; M age = 51.21; 78% female) with a waitlist control group (N = 27; M age = 49.11; 82% female)., Results: Study 1 found significant pre/post gains in self-compassion, mindfulness, and various wellbeing outcomes. Study 2 found that compared with the control group, intervention participants reported significantly larger increases in self-compassion, mindfulness, and wellbeing. Gains were maintained at 6-month and 1-year follow-ups., Conclusions: The MSC program appears to be effective at enhancing self-compassion, mindfulness, and wellbeing., (© 2012 Wiley Periodicals, Inc.)

Purpose: To describe the systemic immunosuppression protocol used at the Cincinnati Eye Institute and University of Cincinnati, and to evaluate the success, tolerability, and side effects of systemic immunosuppression in patients undergoing ocular surface stem cell transplantation (OSST)., Methods: Retrospective study of all patients who had OSST from 1997 to 2007 and received follow-up for systemic immunosuppression at the Cincinnati Eye Institute. Patients were analyzed for demographics, systemic immunosuppression exposure, ocular surface stability, efficacy, and toxicity variables., Results: A total of 225 eyes from 136 patients with a mean age of 43.6 years (range, 8.9-80.6 years) underwent OSST with systemic immunosuppression. The most common systemic immunosuppression regimen consisted of tacrolimus, mycophenolate mofetil, and a short course (1-3 months) of prednisone (102/136 patients, 75%). Prophylactic valganciclovir and trimethoprim/sulfamethoxazole (dapsone if sulfa allergy was present) were also used. Mean duration of immunosuppression was 42.1 months (range, 3.6-128 months) and mean follow-up time after OSST was 53.9 months (range, 3.6-147.3 months). At the patients' final follow-up visit, 105/136 patients (77.2%) had a stable ocular surface. There were 3 severe adverse events in 2 patients (1.5%) and 21 minor adverse events in 19 patients (14.0%). Of the 21 patients with adverse events, 10 (47.6%) had systemic comorbidities at initial presentation., Conclusions: The prevention of graft rejection with the use of systemic immunosuppression after OSST is crucial and should be approached with the same rigor as in solid organ transplantation. With appropriate long-term monitoring by the cornea specialist and transplant physician, the risk of irreversible toxicity at current dosages of systemic immunosuppression in this population is minimal.

Purpose: To present the outcomes of Boston type I keratoprosthesis (KPro) implantation in combination with pars plana vitrectomy (PPV) and silicone oil for the treatment of hypotony in prephthisical eyes., Methods: Interventional case series. Thirteen eyes of 13 patients underwent Boston type I KPro implantation, pars plana vitrectomy, and silicone oil placement. Concurrent retinal detachment repair, membrane peel, or intraocular lens explantation were performed if necessary. Inclusion criteria for surgery were eyes with visual acuity worse than 20/400, previous failed penetrating keratoplasty, corneal opacification, visually significant or worsening hypotony, and visual acuity 20/200 or worse in the fellow eye. Outcome measures included Snellen best-corrected visual acuity, anatomic retinal attachment, and complications., Results: At the final follow-up (mean, 24 months; range, 5-66 months), visual acuity was improved in 10 of 13 eyes (77%), stable in 2 of 13 eyes (15%), and decreased in 1 of 13 eyes (8%). All eyes had attached retina with no progression to phthisis bulbi. No intraoperative complications occurred. Postoperative complications included retroprosthetic membrane (7 of 13), KPro melt (1 of 13), KPro leak (1 of 13), KPro infection (1 of 13), vitreous hemorrhage (1 of 13), and retinal detachment (1 of 13)., Conclusions: Boston type I KPro implantation in combination with pars plana vitrectomy and intraocular silicone oil fill can improve vision in most prephthisical eyes with hypotony. Structural findings can also improve.

Purpose: To explain our preferred technique and evaluate the success of ocular surface transplantation using a combined living-related conjunctival limbal allograft (lr-CLAL) and keratolimbal allograft (KLAL) in patients with severe ocular surface failure and conjunctival deficiency., Methods: Retrospective study of all patients undergoing combined lr-CLAL/KLAL at the Cincinnati Eye Institute/University of Cincinnati. Patients were retrospectively analyzed for demographics, immunosuppression exposure, ocular surface stability, and need for keratoplasty. Snellen best-corrected visual acuity was evaluated preoperatively and at final visit., Results: Nineteen patients (24 eyes) underwent combined lr-CLAL/KLAL. Mean follow-up was 43.4 months (range: 12.2 to 125.5 months). At the last recorded visit, the ocular surface was stable in 54.2% (13 of 24), improved in 33.3% (8 of 24), and failed in 12.5% (3 of 24) of eyes. 79.2% (19 of 24) of patients underwent staged keratoplasty. For the primary keratoplasty, 73.7% (14 of 19) of patients underwent penetrating keratoplasty, 21.1% of patients underwent Boston type I keratoprosthesis, and 5.2% of patients underwent deep anterior lamellar keratoplasty; 57.9% of patients required repeat keratoplasty. Preoperative best-corrected visual acuity was 20/400 or worse in 87.5% (21 of 24); 75% (18 of 24) of eyes had improvement in visual acuity at the last follow-up with 70.8% of patients (17 of 24) achieving 20/125 vision or better. Of patients with a Boston keratoprosthesis, 90.0% (9 of 10) had an improvement in vision with 70.0% achieving 20/125 vision or better at the last follow-up., Conclusions: Ocular surface transplantation with a combined lr-CLAL/KLAL and staged keratoplasty is an effective procedure to improve visual acuity in patients with severe ocular surface disease and conjunctival deficiency. Keratoprosthesis after limbal stem cell transplantation is an alternative to penetrating or lamellar keratoplasty in this patient population.

The objective of the present study was to construct and validate a short-form version of the Self-Compassion Scale (SCS). Two Dutch samples were used to construct and cross-validate the factorial structure of a 12-item Self-Compassion Scale-Short Form (SCS-SF). The SCS-SF was then validated in a third, English sample. The SCS-SF demonstrated adequate internal consistency (Cronbach's alpha ≥ 0.86 in all samples) and a near-perfect correlation with the long form SCS (r ≥ 0.97 all samples). Confirmatory factor analysis on the SCS-SF supported the same six-factor structure as found in the long form, as well as a single higher-order factor of self-compassion. The SCS-SF thus represents a reliable and valid alternative to the long-form SCS, especially when looking at overall self-compassion scores., (Copyright © 2010 John Wiley & Sons, Ltd.)

Purpose: To evaluate visual acuity outcomes after endothelial keratoplasty (EK) and describe the relationship to postoperative central corneal graft thickness as measured by anterior segment optical coherence tomography (AS-OCT)., Methods: A retrospective case series of 33 eyes in 28 patients undergoing routine EK using precut eye bank tissue was designed. All patients underwent serial central graft thickness measurements with AS-OCT. Based on the median central graft thickness of all patients, the eyes were divided into 2 groups: thin EK and thick EK. Differences between the groups were compared., Results: The median postoperative graft thickness of all eyes was 131 μm. The eyes were divided into 2 groups based on this median: thin EK (graft thickness: ≤ 131 μm; range: 77-131 μm; average: 109 μm) and thick EK (graft thickness: > 131 μm; range: 138-182 μm; average: 162 μm). There was no statistically significant difference in age, sex, or preoperative best spectacle-corrected visual acuity (BSCVA) between the 2 groups. Average postoperative follow-up was 12.8 months. The thin EK group showed better postoperative BSCVA compared with the thick EK group (P < 0.01). All thin EK eyes had BSCVA greater than or equal to 20/25 with 71% of eyes achieving BSCVA of 20/20. In contrast, only 50% of thick EK eyes reached BSCVA greater than or equal to 20/25 with 19% obtaining BSCVA of 20/20., Conclusions: Thin EK versus thick EK, as measured by AS-OCT in the postoperative period, showed a statistically significant improvement in BSCVA.

Purpose: To identify factors associated with intraoperative floppy iris syndrome (IFIS) in patients undergoing routine phacoemulsification., Design: Comparative case series., Participants: Analysis of 899 eyes of 660 patients undergoing routine cataract surgery., Methods: All routine cases of cataract extraction with posterior chamber intraocular lens implantation between September 1, 2005, and August 31, 2006, were documented. Pertinent patient information, including age, gender, race, medical history, and current medication use (including tamsulosin [Flomax, Boehringer-Ingelheim, Ingelheim, Germany], other alpha(1)-antagonists, angiotensin antagonists, anticholinergics, cholinergic agonists, muscle relaxants, nitric oxide donors, and saw palmetto), were collected at the time of surgery. A telephone survey was used to determine previous use of tamsulosin, other alpha(1)-antagonists, and saw palmetto. Cases were identified intraoperatively as IFIS or non-IFIS following the triad of criteria developed by Chang and Campbell., Main Outcome Measures: Presence of IFIS associated with medication use and medical history., Results: Analysis showed IFIS in 27 patients (4.1%) representing 33 eyes (3.7%). Tamsulosin use (P<0.001) and history of alpha(1)-antagonist use other than tamsulosin (P = 0.01) were shown to strongly correlate with IFIS in our study. Hypertension was noted to be a significant variable via multivariable generalized estimating equations analysis (P = 0.04) with a prevalence of 75.8% in patients with IFIS versus 56.4% in patients without IFIS. Saw palmetto showed a slight, but statistically insignificant, trend that current use or history of use may be associated with IFIS. There were no cases of posterior capsular rupture or vitreous loss., Conclusions: Exposure to tamsulosin highly correlates with IFIS. Use of other alpha(1)-antagonists is also associated with IFIS. Several patients in our series were identified to have IFIS with no history of alpha(1)-antagonist use, indicating that other etiologic factors, or a combination of factors, can also elicit this response. Multivariable regression analysis shows no proven relationship between IFIS and individual use of angiotensin antagonists, anticholinergics, cholinergic agonists, muscle relaxants, nitric oxide donors, or saw palmetto, and diabetes or congestive heart failure.

Purpose: To analyze the patient reported outcome of satisfaction after LASIK surgery., Design: Systematic review., Participants: Patient data from previously reported studies., Methods: A literature search conducted for the years 1988 to 2008 that included pertinent LASIK surgery information from the review of 2915 retrieved citations. All abstracts from these citations were reviewed and 1581 were deemed to be relevant for review. Complete copies of each of these relevant (1581) articles were obtained, and after thorough analysis each was rated based on the strength of the study design and weight of evidence. A level I rating was assigned to properly conducted, well-designed, randomized clinical trials; a level II rating to well-designed cohort and case-control studies; and a level III rating to case series, case reports, and poorly designed prospective and retrospective studies. Level I and II rated, peer-reviewed articles were entered into a database, and level III articles were eliminated. A total of 309 articles were incorporated into this database, representing level I and level II well-controlled studies of primary LASIK surgery., Main Outcome Measures: Patients' satisfaction rates and factors associated with dissatisfaction., Results: Nineteen of the 309 database articles (6.1%) reported on both patient quality of life and satisfaction and together encompassed a total of 2198 subjects. The procedures from these 19 articles took place between 1995 and 2003. The overall patient satisfaction rate after primary LASIK surgery was 95.4% (2097 of 2198 subjects; range of patient satisfaction for the 19 articles was 87.2%-100%). The patient satisfaction rate after myopic LASIK was 95.3% (1811 of 1901 patients), and after hyperopic LASIK was 96.3% (286 of 297 subjects)., Conclusions: Based on this review, worldwide, an average 95.4% of patients were satisfied with their outcome after LASIK surgery. With 16.3 million procedures performed worldwide, and more than a decade of clinical studies and technological innovation, LASIK surgery should be considered among the most successful elective procedures. LASIK surgery compares more favorably with other elective surgical procedures in terms of generally higher satisfaction rates.

This research examined self-compassion and self-esteem as they relate to various aspects of psychological functioning. Self-compassion entails treating oneself with kindness, recognizing one's shared humanity, and being mindful when considering negative aspects of oneself. Study 1 (N=2,187) compared self-compassion and global self-esteem as they relate to ego-focused reactivity. It was found that self-compassion predicted more stable feelings of self-worth than self-esteem and was less contingent on particular outcomes. Self-compassion also had a stronger negative association with social comparison, public self-consciousness, self-rumination, anger, and need for cognitive closure. Self-esteem (but not self-compassion) was positively associated with narcissism. Study 2 (N=165) compared global self-esteem and self-compassion with regard to positive mood states. It was found that the two constructs were statistically equivalent predictors of happiness, optimism, and positive affect. Results from these two studies suggest that self-compassion may be a useful alternative to global self-esteem when considering what constitutes a healthy self-stance.

The author examined relationship styles of self-focused autonomy (SFA), other-focused connection (OFC), and mutuality among 415 European and Mexican American young adults in 2 U.S. colleges. Mutuality was the most commonly reported style for both ethnic groups, although Mexican American men were more likely than the others to indicate that they had the SFA style. Mexican American participants perceived their fathers' styles as SFA more often than did the others regarding either of their parents' styles. Mutuality was associated with the best mental-health outcomes regardless of gender or ethnicity. The present results indicate that the cultural influences on autonomy and connection are complex and that collectivistic cultural contexts may sometimes promote autonomy concerns in men.

This study examined the moral reasoning of 36 young adults (M age = 20.8 yr., evenly divided by sex) about situations involving close interpersonal relationships: best friends, spouses, and parents or children. Participants were presented stories in which personal needs and desires were in conflict with interpersonal concerns. When asked how the conflicts should be resolved, the large majority of participants judged that personal desires should be subordinated to interpersonal concerns, justifying their judgments with reference to concern for others, relationship maintenance, or relationship responsibilities. No sex differences in judgments or justifications were found. In addition, most judged that the act of meeting another's needs in a close relationship was an obligatory responsibility and that such responsibilities generalized to people living in other societies. Thus, participants considered interpersonal responsibilities to be moral obligations that apply across cultural boundaries and did not consider them to be matters of personal choice.