Grief rumination mediates the association between self-compassion and psychopathology in relatives of missing persons

Abstract

Background: The disappearance of a loved one is a unique type of loss, also termed ‘ambiguous loss’, which may heighten the risk for developing prolonged grief (PG), depression, and posttraumatic stress (PTS) symptoms. Little is known about protective and risk factors for psychopathology among relatives of missing persons. A potential protective factor is self-compassion, referring to openness toward and acceptance of one’s own pain, failures, and inadequacies. One could reason that self-compassion is associated with lower levels of emotional distress following ambiguous loss, because it might serve as a buffer for getting entangled in ruminative thinking about the causes and consequences of the disappearance (‘grief rumination’). Objective: In a sample of relatives of missing persons we aimed to examine (1) the prediction that greater self-compassion is related to lower symptom-levels of PG, depression, and PTS and (2) to what extent these associations are mediated by grief rumination. Method: Dutch and Belgian relatives of long-term missing persons (N = 137) completed self-report measures tapping self-compassion, grief rumination, PG, depression, and PTS. Mediation analyses were conducted. Results: Self-compassion was significantly, negatively, and moderately associated with PG, depression, and PTS levels. Grief rumination significantly mediated the associations of higher levels of self-compassion with lower levels of PG (a*b = −0.11), depression (a*b = −0.07), and PTS (a*b = −0.11). Specifically, 50%, 32%, and 32% of the effect of self-compassion on PG, depression, and PTS levels, respectively, was accounted for by grief rumination. Conclusions: Findings suggest that people with more self-compassion experience less severe psychopathology, in part because these people are less strongly inclined to engage in ruminative thinking related to the disappearance. Strengthening a self-compassionate attitude using, for instance, mindfulness-based interventions may therefore be a useful intervention to reduce emotional distress associated with the disappearance of a loved one.

Self‐compassion, trauma, and posttraumatic stress disorder: A systematic review

“…The sample sizes ranged from 10 to 667 participants. Sample mean ages ranged from 18.71 years (Miron, Orcutt, Hannan, & Thompson, ) to 57.9 years (Lenferink, Eisma, de Keijser, & Boelen, ). The 35 studies represented 32 participant samples, with a combined sample of n = 6348.…”

“…Ten of the papers employed mediational analysis to explore the relationships between self‐compassion, trauma, and PTSD. One study found a significant direct relationship between self‐compassion and PTSD (Bistricky et al, ), and four studies found indirect relationships via interpersonal competence (Bistricky et al, ), emotional dysregulation (Barlow et al, ), self‐blame attributions, and disengagement coping (Hamrick & Owens, ) and grief ruminations (Lenferink et al, ). Scoglio et al () reversed the constructs and found that emotion regulation also mediated the relationship between PTSD and self‐compassion.…”

“…It is worth considering that much of the existing research used the DSM‐IV criteria, so tells us something about the relationship between that conceptualization of PTSD and self‐compassion. Ten of the reviewed studies used DSM‐5 criteria (Au et al, ; Boykin et al, ; Hamrick & Owens, ; Held et al, ; Lang et al, ; Lenferink et al, ; Maheux & Price, , ; McLean, Fiorillo, & Follette, ). With the reformulation of the PTSD symptom clusters, it is likely that the expanded clusters, which now include persistent and exaggerated negative beliefs about oneself, distorted cognitions that leads to self‐blame, and persistent negative emotional state such as guilt or shame, will be strongly negatively related to self‐compassion, as demonstrated by Maheux and Price ().…”

A framework of meaning attribution following loss

“…The situation with which family members of missing persons are confronted is also referred to as Ambiguous loss . Ambiguous loss is characterized by the absence of rituals and can be accompanied by grief symptoms, PTSD, depression and conflicts among those left behind (Boelen & Smid, 2017 ; Boss, 2006 ; Lenferink, Eisma, de Keijser, & Boelen, 2017 ).…”

Traumatic loss: Mental health consequences and implications for treatment and prevention

“…Lenferink, Eisma, de Keijser, and Boelen ( 2017 ) examined grief rumination as a mediator between self-compassion and emotional distress in 137 relatives of missing persons. They found that the buffering effect of self-compassion on emotional distress could be explained by reduction of ruminative thoughts related to the disappearance.…”