Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology

Compassion has emerged as an important construct in studies of mental health and psychological therapy. Although an increasing number of studies have explored relationships between compassion and different facets of psychopathology there has as yet been no systematic review or synthesis of the empirical literature. We conducted a systematic search of the literature on compassion and mental health. We identified 20 samples from 14 eligible studies. All studies used the Neff Self Compassion Scale (Neff 2003, a). We employed meta-analysis to explore associations between self-compassion and psychopathology using random effects analyses of Fisher's Z correcting for attenuation arising from scale reliability. We found a large effect size for the relationship between compassion and psychopathology of r= -0.54 (95%CI = -0.57 to -0.51; Z=-34.02; p<.0001). Heterogeneity was significant in the analysis. There was no evidence of significant publication bias. Compassion is an important explanatory variable in understanding mental health and resilience. Future work is needed to develop the evidence base for compassion in psychopathology, and explore correlates of compassion and psychopathology

Somatization vs. Psychologization of Emotional Distress: A Paradigmatic Example for Cultural Psychopathology

This paper describes the developing area of cultural psychopathology, an interdisciplinary field of study focusing on the ways in which cultural factors contribute to the experience and expression of psychological distress. We begin by outlining two approaches, often competing, in order to provide a background to some of the issues that complicate the field. The main section of the paper is devoted to a discussion of depression in Chinese culture as an example of the types of questions that can be studied. Here, we start with a review of the epidemiological literature, suggesting low rates of depression in China, and move to the most commonly cited explanation, namely that Chinese individuals with depression present this distress in a physical way. Different explanations of this phenomenon, known as somatization, are explored and reconceptualized according to an increasingly important model for cross-cultural psychologists: the cultural constitution of the self. We close by discussing some of the contributions, both theoretical and methodological, that can be made by cross-cultural psychologists to researchers in cultural psychopathology

Cognitive psychopathology: The role of emotion

This paper examines the role of emotion in the understanding of psychopathology. The influential Cognitive Therapy model of Beck is briefly reviewed and a number of limitations are considered. Two particular weaknesses are highlighted in the understanding of cognitive psychopathology; namely, the importance of multi-level processing systems and the importance of emotion. The Power and Dalgleish (1997, 2008) SPAARS model is presented to show the advantages that arise from the inclusion of multilevel processes combined with a theoretical account of emotion. In order to illustrate the application of the SPAARS model to cognitive psychopathology, findings from a recent emotion profile analysis of clinical depression and anxiety are summarised. The analyses also illustrate the importance of shamerelated emotions in depression in contrast to the guiltrelated emotions that are highlighted in classification systems such as DSM-IV. ------ RESUMO ------ Neste artigo fazemos uma reflexão sobre o papel da emoção na compreensão da psicopatologia. Fazemos uma breve revisão e apontamos uma série de limitações. do influente modelo da Psicoterapia Cognitiva preconizado por Beck. Dois pontos particularmente fracos são destacados na compreensão da psicopatologia cognitiva; nomeadamente, a importância dos sistemas de processamento multi-nível e a importância das emoções. Apresentamos o modelo SPAARS de Power e Dalgleish (1997, 2008), para mostrar as vantagens que resultam da inclusão de processos de multi-nível combinados com uma teoria relacionada com as emoções. Com o objectivo de ilustrar a aplicação do modelo SPAARS à psicopatologia cognitiva. Referimos, de forma sucinta, o que foi observado numa recente analise sobre o perfil da depressão e ansiedade clínicas. Estas analises ilustram também a importância das emoções relacionadas com a vergonha na depressão, em contraste com as emoções relacionadas com a culpa que são destacadas em sistemas de classificação como o DSM-IV

A controlled study of hostile-helpless states of mind among borderline and dysthymic women

The aim of this study was to determine whether women with borderline personality disorder (BPD) are more likely than those with dysthymia to manifest contradictory Hostile-Helpless (HH) states of mind. A reliable rater blind to diagnosis evaluated features of such mental representations in transcripts of Adult Attachment Interviews from 12 women with BPD and 11 women with dysthymia of similar socioeconomic status (SES), all awaiting psychotherapy. In keeping with three hierarchical (non-independent) a priori predictions regarding the mental representations of women with BPD, the results were that (a) all those with BPD, compared with half the group with dysthymia, displayed HH states of mind; (b) those with BPD manifested a significantly higher frequency of globally devaluing representations; and (c) they exhibited a strong trend toward identifying with the devalued hostile caregiver (58% BPD vs. 18% dysthymic). In addition, significantly more BPD than dysthymic patients made reference to controlling behavior towards attachment figures in childhood. These findings offer fresh insights into the nature of BPD and extend previous evidence concerning affected individuals' patterns of thinking and feeling about childhood attachment figures

The Relationship between Personality Organization and Psychiatric Classification in Chronic Pain Patients

The assessment of PO is a crucial issue for diagnosis and treatment planning in CPPs, since it represents a measure of structural impairment that is to a considerable extent independent of axis I and II diagnoses. Moreover, the STIPO dimensional rating focuses on the most salient dysfunctions at a given time. Copyright (C) 2010 S. Karger AG, BaselBackground: The present study investigated the relationship between psychiatric classification and personality organization (PO) in a secondary/tertiary clinical sample of chronic pain patients (CPPs). Sampling and Methods: Forty-three patients were administered the Structured Clinical Interview for DSM-IV (SCID I+II) and the Structured Interview of Personality Organization (STIPO). The prevalence of axis I and axis II disorders was correlated with the STIPO level of PO. The STIPO dimensional ratings of patients without personality disorder (PD) were compared to those of patients diagnosed with one or more PDs. Results: Axis I comorbidity was high (93%), and 63% of the patients met the criteria for at least one axis II diagnosis. Twenty-five patients (58%) were diagnosed as borderline PO, with high-level impairments in the dimensions `coping/rigidity', `primitive defenses' and `identity'. Higher axis I and axis II comorbidity corresponded with greater severity of PO impairment. No difference was found between the dimensional ratings of patients without PD and those of patients with one or more PDs. Conclusions

Dissociation and interpersonal autonomic physiology in psychotherapy research: an integrative view encompassing psychodynamic and neuroscience theoretical frameworks

Interpersonal autonomic physiology is an interdisciplinary research field, assessing the relational interdependence of two (or more) interacting individual both at the behavioral and psychophysiological levels. Despite its quite long tradition, only eight studies since 1955 have focused on the interaction of psychotherapy dyads, and none of them have focused on the shared processual level, assessing dynamic phenomena such as dissociation. We longitudinally observed two brief psychodynamic psychotherapies, entirely audio and video-recorded (16 sessions, weekly frequency, 45 min.). Autonomic nervous system measures were continuously collected during each session. Personality, empathy, dissociative features and clinical progress measures were collected prior and post therapy, and after each clinical session. Two-independent judges, trained psychotherapist, codified the interactions\u2019 micro-processes. Time-series based analyses were performed to assess interpersonal synchronization and de-synchronization in patient\u2019s and therapist\u2019s physiological activity. Psychophysiological synchrony revealed a clear association with empathic attunement, while desynchronization phases (range of length 30-150 sec.) showed a linkage with dissociative processes, usually associated to the patient\u2019s narrative core relational trauma. Our findings are discussed under the perspective of psychodynamic models of Stern (\u201cpresent moment\u201d), Sander, Beebe and Lachmann (dyad system model of interaction), Lanius (Trauma model), and the neuroscientific frameworks proposed by Thayer (neurovisceral integration model), and Porges (polyvagal theory). The collected data allows to attempt an integration of these theoretical approaches under the light of Complex Dynamic Systems. The rich theoretical work and the encouraging clinical results might represents a new fascinating frontier of research in psychotherapy

Altered intrinsic functional connectivity in language-related brain regions in association with verbal memory performance in euthymic bipolar patients

Potential abnormalities in the structure and function of the temporal lobes have been studied much less in bipolar disorder than in schizophrenia. This may not be justified because language-related symptoms, such as pressured speech and flight of ideas, and cognitive deficits in the domain of verbal memory are amongst the hallmark of bipolar disorder (BD), and contribution of temporal lobe dysfunction is therefore likely. In the current study, we examined resting-state functional connectivity (FC) between the auditory cortex (Heschl’s gyrus [HG], planum temporale [PT]) and whole brain using seed correlation analysis in n = 21 BD euthymic patients and n = 20 matched healthy controls and associated it with verbal memory performance. In comparison to controls BD patients showed decreased functional connectivity between Heschl’s gyrus and planum temporale and the left superior and middle temporal gyrus. Additionally, fronto-temporal functional connectivity with the right inferior frontal/precentral gyrus and the insula was increased in patients. Verbal episodic memory deficits in the investigated sample of BD patients and language-related symptoms might therefore be associated with a diminished FC within the auditory/temporal gyrus and a compensatory fronto-temporal pathway