Systematic review: Are Compassion-Focused Interventions Effective in Reducing Feelings of Shame, Negative Cognitions of the Self, and/or Post-traumatic Stress Symptoms in Adults with PTSD? Empirical paper: Immediate Psychophysiological Effects of Induced Self-compassion State on Experience of Shame Following a Psychosocial Stress Test.

Abstract

Systematic review: Background: Despite growing evidence showing links between Post Traumatic Stress Disorder (PTSD) and shame, and the protective role of self-compassion in relation to shame and self-criticism, there is no systematic review of the existing literature investigating whether Compassion Focused Interventions (CFI) reduce shame in people with PTSD. Objectives: This review addresses this gap and evaluates the research investigating the impact of CFIs on shame and negative cognitions of the self in adults with PTSD. Method: A systematic review, with no time restrictions, was completed using PsycINFO, Medline, Embase, Web of Science, Psychology & Behavioral Sciences Collection, PILOTS and PubMed. Additionally, relevant websites with articles by key authors in the field of interest were checked. References of included articles were screened to identify other relevant research studies. Results: In identifying only four articles, the review revealed research in this area is scarce. There is evidence that CFIs can lead to reductions in PTSD symptoms, shame and negative cognitions of the self (e.g., self-blame, guilt) in people with PTSD. However, due to a small number of studies included in this review, with mainly weak methodologies, it is impossible to reliably establish the effect of CFIs on people with PTSD. Conclusions: CFIs have a potential to reduce shame and negative cognitions of the self in adults with PTSD. However, due to limited research in this area and existing studies having weak methodologies, further research is needed with more studies incorporating stronger methodologies (e.g., Randomised Controlled Trials comparing CFIs with an active control group). Keywords: self-compassion, post-traumatic stress disorder, shame, negative cognitions, self-criticism Empirical paper: Despite emerging evidence indicating that self-compassion can have protective effects against shame and self-criticism, there is a lack of studies investigating direct effects of self-compassion on state shame and self-criticism when exposed to social stress. This study addressed this gap and investigated, in 62 healthy individuals, whether a brief Loving Kindness Meditation to self (LKM-S, n = 32), known to temporarily increase state self-compassion, can attenuate psychophysiological responses to a psychosocial stress test (Montreal Imaging Stress Task [MIST]) as compared to a neutral emotion induction (NEU, n = 30). An experimental design was used with self-report measures of shame, self-criticism and self-compassion as well as physiological measures of heart rate (HR), skin conductance level (SCL) and heart rate variability (HRV). It was investigated whether LKM-S has a protective effect in terms of reducing state shame and self-criticism when participants were exposed to MIST as compared to NEU. It was hypothesized that participants from LKM-S will have lower scores on state shame and self-criticism post MIST and higher self-compassion levels post MIST in LKM-S as compared to NEU. Additionally, the research used markers of sympathetic and parasympathetic variables to investigate whether LKM-S attenuated physiological responses to MIST. None of the described hypothesis were confirmed. The findings suggest that a brief one-off self-compassion intervention, although it temporarily increased self-reported self-compassion, is not sufficient to protect against shame and self-criticism in the context of a psychosocial stressor. Keywords: Self-compassion, shame, self-criticism, physiology, Heart Rate Variability, The Montreal Imaging Stress Task