Could worry and rumination mediate relationships between self‐compassion and psychological distress in breast cancer survivors?

Abstract

Many breast cancer (BCa) patients experience clinically significant anxiety and depression in survivorship. Self-compassion offers a bulwark to anxiety and depression in nonclinical, mental health, and some chronic physical health populations. We examined whether self-compassion predicted lower anxiety and depression symptoms in survivors and whether this might be mediated by lower worry and rumination. The design was a cross-sectional survey using self-report measures. Female adult BCa survivors of mixed stages who had finished primary surgical, radiotherapy, or chemotherapy treatments completed self-compassion subscales and worry, rumination, and anxiety and depression scales. Higher self-compassion subscale scores were negatively associated with anxiety and depression. Depressive brooding and worry mediated any effects of self-kindness and mindfulness on depression and anxiety, whereas common humanity directly predicted lower depression scores.Findings are consistent with the view that self-compassion reduces threat-related rumination and worry in BCa survivors, consequently reducing anxiety and depression. This may form a basis for prevention and treatment.

The Effect of Self-Compassion on Psychosocial and Clinical Outcomes in Patients With Medical Conditions: A Systematic Review

“…Four of these studies looked specifically at self-compassion scores in relation to the Patient Health Questionnaire-9 (PHQ-9) scores, which found that increased SCS scores were associated with decreased levels of PHQ-9 scores [21,22,26,33]. Moreover, two studies looked at selfcompassion in relation to the Hospital Anxiety and Depression Scale (HADS) questionnaire and demonstrated similar results [16,18]. Five studies looked at the correlation between self-compassion and anxiety, two of which were previously discussed using the HADS questionnaire.…”

“…Eight articles were further excluded, for reasons shown in the Appendix section ( Figure 1). Finally, 19 articles (n=2,713 patients, of which 73.3% were females) met our eligibility criteria and were included in this systematic review [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. The baseline characteristics of the included studies are comprehensively described in Table 1.…”

“…The range for the self-compassion values was between 2.8-3.46. Three studies looked at specific subscales with the SCS [16,18,30]. A study by Ambridge, Fleming, and Henshall looked at the Self-Compassion Scale-Short-Form (SCS-SF), which was 5.69 ± 1.15 [16].…”

“…All included studies evaluated the correlation of self-compassion with other important psychosocial outcomes such as depression, anxiety, stress, resilience, shame, quality of life, and other outcomes as shown in Table 2. Nine studies evaluated the correlation between self-compassion and depression [16,18,[20][21][22][23]26,29,33]. All studies found that a higher self-compassion was correlated with lower levels of depression in individuals with a medical illness.…”

Self-Compassion and Anxiety and Depression in Chronic Physical Illness Populations: a Systematic Review

“…Studies focused on a range of physical health conditions (Table 1). Five studies used breast cancer samples (Brown et al 2020;Przezdziecki and Sherman 2016;Przezdziecki et al 2013;Sherman et al 2017;Todorov et al 2019), three non-breast cancers (Gillanders et al 2015;Schellekens et al 2017;Zhu et al 2019), three diabetes (Friis et al 2015;Morrison et al 2019;Ventura et al 2019) (Eller et al 2014;Kemppainen et al 2013a, b;Williams et al 2019;Zhu et al 2019). Eleven studies (Eller et al 2014;Kemppainen et al 2013a, b;Friis et al 2015;Gillanders et al 2015;Harrison et al 2017;Morrison et al 2019;Przezdziecki et al 2013;Schellekens et al 2017;Sherman et al 2017;Williams et al 2019;Ventura et al 2019;Zhu et al 2019) reported time since diagnosis, which ranged from less than 1 week to an average of 16.70 years.…”