Mindfulness, cognitive fusion, and self-compassion in patients with schizophrenia spectrum disorders—A cross-sectional study

Abstract

In the last decades, third wave approaches in cognitive-behavioral therapies (CBT) have shown effectiveness in treating several mental disorders, including schizophrenia spectrum disorders (SSD). Three crucial processes associated with clinical changes in patients include mindfulness, psychological flexibility (PF) and self-compassion (SC). PF is generally assessed by cognitive fusion (CF), a negative formulated key process of PF. The current study encompasses a cross-sectional design to examine the interplay of mindfulness, CF, SC and symptom severity in SSD. It was hypothesized that mindfulness is negatively correlated with symptom severity, CF mediates the negative relation between mindfulness and symptom severity, and SC moderates the link between mindfulness and CF. In total, 79 persons with SSD were recruited at the Department of Psychiatry and Neurosciences at the Charité – Universitätsmedizin Berlin. Correlations, as well as moderated mediation analyses, were performed using the analysis modeling tool PROCESS with total symptom severity and negative symptom severity as outcome variables, measured by the Positive and Negative Syndrome Scale (PANSS) and the Self-Evaluation of Negative Symptoms Scale (SNS). Results show that the moderated mediation hypothesis was confirmed for negative symptom severity assessed by SNS, however, not for total symptom severity assessed by PANSS. In general, the association between mindfulness and CF was stronger for participants with higher SC scores in our data. Future studies should investigate the relationship between mindfulness, SC, and PF regarding symptom severity in SSD in longitudinal designs while considering the impact on different outcomes and differences regarding assessment tools.

The Relationship between Mindfulness, Psychological Flexibility, and Symptom Severity in Persons with Schizophrenia-Spectrum-Disorders – a Cross-Sectional Study

“…For example, CF was found to predict next-day mindful awareness in a study by Berghoff et al (2018) [33], and mindfulness was found to be the mediator between PF and symptoms of depression in a study by Curtiss & Klemanski (2914) [83]. Furthermore, although recruitment site was included as a covariate in the statistical design, similar to the studies by Bergmann et al (2021) [21] and Böge et al (2022) [24], the medication regime, the understanding of the concept of mindfulness, and already existing experiences should be examined in future trials within a longitudinal design.…”

“…Shapiro et al (2006) [23] claim that improving cognitive, emotional, and behavioural exibility might be one mechanism through which mindfulness exerts its positive effects. In recent years, psychological exibility (PF) was often associated with clinical change within the mindfulness framework [24]. PF can be de ned as the ability to consciously interact with the present moment in an accepting way, driven by chosen values and longterm goals rather than distressing internal experiences [25].…”

Mixed-Mode Mindfulness-based cognitive therapy for psychological resilience, Self Esteem and Stigma of patients with schizophrenia: a randomized controlled trial

“…Possible reasons for the stigma reduction observed in this study include: (a) Cognitive Functioning Enhancement: Mindfulness therapy may positively impact cognitive functioning by enhancing self and metacognition, challenging misconceptions about mental illness, and fostering acceptance of the reality of the condition. This, in turn, empowers patients to confront stigma more effectively, boosting confidence and treatment adherence [ 35 , 36 ]. (b) Attention Control: Mindfulness therapy might enhance patients’ attentional control, fostering a positive understanding of the surrounding environment and mitigating the negative impact of social opinions.…”

Self‐compassion as a mediator of the relationship between childhood sexual abuse and psychotic symptoms in clinical and non‐clinical groups

“…In their meta-analytic review, Bailey et al (2018) showed that CSA was linked to more severe hallucinations, delusions and other positive symptoms of psychosis, though not negative symptoms. Recent research on those with psychosis has shown that self-compassion moderates cognitive fusion as a mediator between mindfulness and negative symptom severity but not total symptom severity (Böge et al, 2022). CSA in psychosis is also linked to poor functioning (Aas et al, 2016), depression, suicidal thoughts and anxiety (Turner et al, 2020).…”