Self‐criticism is the process of negative self‐evaluation. High levels are associated with psychopathology and poorer therapeutic outcomes. Self‐compassion interventions were developed to explicitly target self‐criticism. The aim of this review was to estimate the overall effect of self‐compassion‐related interventions on self‐criticism outcomes and investigate potential moderating variables. A systematic search of the literature identified 20 randomized controlled trials (RCTs) that met the inclusion criteria. Nineteen papers, involving 1350 participants, had sufficient data to be included in the meta‐analysis. Pre‐ and post‐data points were extracted for the compassion and control groups. Study quality was assessed using an adapted version of the Cochrane Collaboration's risk of bias tool, which concluded that studies were of moderate quality. Meta‐analysis findings indicated that self‐compassion‐related interventions produce a significant, medium reduction in self‐criticism in comparison with control groups (Hedges' g = 0.51, 95% CI [0.33–0.69]). Moderator analysis found greater reductions in self‐criticism when self‐compassion‐related interventions were longer and compared with passive controls rather than active. The remaining moderators of forms of self‐criticism, sample type, intervention delivery, intervention setting and risk of bias ratings were insignificant. Overall, the review provides promising evidence of the effectiveness of self‐compassion‐related interventions for reducing self‐criticism. However, results are limited by moderate quality studies with high heterogeneity. Directions for future research indicate that more RCTs with active controls, follow‐ups, consistent use and reporting of measures and diverse samples are needed.

Background & objectivesGroups of clients and community volunteers with Generalized Anxiety Disorder (GAD) and clients with Panic Disorder were compared to a group with elevated worry but without GAD on a range of measures, to identify individual differences beyond a high propensity to worry.MethodParticipants completed standardised questionnaires and a behavioural worry task that assesses frequency and severity of negative thought intrusions.ResultsRelative to high worriers, clients with GAD had higher scores on trait anxiety, depression, more negative beliefs about worry, a greater range of worry topics, and more frequent and severe negative thought intrusions. Relative to community volunteers with GAD, clients in treatment reported poorer attentional control. Compared to clients with Panic Disorder, clients with GAD had higher trait anxiety, propensity to worry, negative beliefs and a wider range of worry content.ConclusionsResults confirmed expectations of group differences based on GAD diagnostic criteria, but also revealed other differences in mood, characteristics of worry, and perceived attentional control that may play a role in the decision to seek treatment.

Worry is characterized by streams of verbal thoughts about potential negative outcomes. Individuals with high levels of worry (and particularly those with generalized anxiety disorder) find it very difficult to control worry once it has started. What is not clear is the extent to which verbal negative thinking style maintains worry. Our study aimed to disentangle the effects of verbal versus imagery based thinking, and negative versus positive worry-related content on subsequent negative intrusive thoughts. High worriers were trained to engage in imagery or verbal processing, focusing on either negative or positive outcomes of their current main worry. Both thinking style and valence of worry content influenced later negative intrusive thoughts that play a role in initiating worry episodes. In contrast, only valence influenced subjective ratings of worry outcomes (i.e., cost, concern, and ability to cope, although not probability), with positive valence leading to lower ratings, irrespective of thinking style.

Clients in treatment for Generalized Anxiety Disorder (GAD) were compared to a control group to assess the extent and nature of imagery during worry or while thinking about a personally relevant positive future event. Two methods were used to assess mentation and were completed in counter balanced order within the worry and positive conditions. One method assessed the occurrence of imagery by requiring participants to categorize their mentation as verbal thoughts or images every 10 s. The other method involved participants estimating the duration of any imagery that occurred in the previous 10 s. Imagery during worry occurred less often than while thinking about a positive event for both groups, but GAD clients had a more pronounced deficit of imagery during worry than the control group. Images that occurred were briefer during worry than while thinking about a positive future event and were briefer in the GAD than the control group for both worry and positive conditions. The results thus confirmed that imagery is less common during worry in clients with GAD but also demonstrated that the imagery that does occur in GAD is briefer.