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Is Self-Compassion a Worthwhile Therapeutic Target for ICD-11 Complex PTSD (CPTSD)?

Published online by Cambridge University Press:  02 October 2018

Thanos Karatzias*
Affiliation:
Edinburgh Napier University, School of Health and Social Care, Edinburgh, UK NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
Philip Hyland
Affiliation:
National College of Ireland, School of Business, Dublin, Ireland Centre for Global Health, Trinity College Dublin, Dublin, Ireland
Aoife Bradley
Affiliation:
Edinburgh Napier University, School of Health and Social Care, Edinburgh, UK
Claire Fyvie
Affiliation:
NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
Katharine Logan
Affiliation:
NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
Paula Easton
Affiliation:
NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
Jackie Thomas
Affiliation:
NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
Sarah Philips
Affiliation:
NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
Jonathan I. Bisson
Affiliation:
Cardiff University, School of Medicine, Cardiff, UK
Neil P. Roberts
Affiliation:
Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, UK Cardiff University, School of Medicine, Cardiff, UK
Marylene Cloitre
Affiliation:
National Center for PTSD, Palo Alto Health Care System, Stanford University, Palo Alto, CA, USA
Mark Shevlin
Affiliation:
Ulster University, School of Psychology, Derry, Northern Ireland
*
Correspondence to Professor Thanos Karatzias, Edinburgh Napier University, Sighthill Campus, Sighthill Court, Edinburgh EH11 4BN, UK. E-mail: [email protected]

Abstract

Background: Two ‘sibling’ disorders have been proposed for the fourthcoming 11th version of the International Classification of Diseases (ICD-11): post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD). Examining psychological factors that may be associated with CPTSD, such as self-compassion, is an important first step in its treatment that can inform consideration of which problems are most salient and what interventions are most relevant. Aims: We set out to investigate the association between self-compassion and the two factors of CPTSD: the PTSD factor (re-experiencing, avoidance, sense of threat) and the Disturbances in Self-Organization (DSO) factor (affect dysregulation, negative self-concept and disturbances in relationships). We hypothesized that self-compassion subscales would be negatively associated with both PTSD and DSO symptom clusters. Method: A predominantly female, clinical sample (n = 106) completed self-report scales to measure traumatic life events, ICD-11 CPTSD and self-compassion. Results: Significant negative associations were found between the CPTSD DSO clusters of symptoms and self-compassion subscales, but not for the PTSD ones. Specifically it was also found that self-judgement and common humanity significantly predicted hypoactive affect dysregulation whereas self-judgement and isolation significantly predicted negative self-concept. Conclusions: Our results indicate that self-compassion may be a useful treatment target for ICD-11 CPTSD, particularly for symptoms of negative self-concept and affect dysregulation. Future research is required to investigate the efficacy and acceptability of interventions that have implicit foundations on compassion.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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References

Allen, A. B. and Leary, M. R. (2010). Self-compassion, stress, and coping. Social and Personality Psychology Compass, 4, 107118.Google Scholar
Arimitsu, K. (2014). Development and validation of the Japanese version of the Self-Compassion Scale. The Japanese Journal of Psychology, 85, 5059.Google Scholar
Azizi, A., Mohammadkhani, P., Lotfi, S. and Bahramkhani, M. (2013). The validity and reliability of the Iranian version of the Self-Compassion Scale. Iranian Journal of Clinical Psychology, 2, 1723.Google Scholar
Bernstein, D. P. and Fink, L. (1998). Childhood Trauma Questionnaire: A retrospective self-report manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Bowman, K. (2005). Commentary of ‘Loving-kindness meditation for chronic low back pain’. Journal of Holistic Nursing, 23, 305309.Google Scholar
Castilho, P., Pinto-Gouveia, J. and Duarte, J. (2015). Evaluating the multifactor structure of the long and short versions of the Self-Compassion Scale in a clinical sample. Journal of Clinical Psychology, 71, 856870.Google Scholar
Cloitre, M., Roberts, N. P., Bisson, J. I. and Brewin, C. R. (2017). The International Trauma Questionnaire (ITQ). Unpublished measure.Google Scholar
Dutton, M. A., Bermudez, D., Matas, A., Majid, H. and Myers, N. L. (2013). Mindfulness-based stress reduction for low-income, predominantly African American women with PTSD and a history of intimate partner violence. Cognitive and Behavioral Practice, 20, 2332.Google Scholar
Gilbert, P. (2010). Compassion focused therapy: Distinctive features. London: RoutledgeGoogle Scholar
Gilbert, P. and Irons, C. (2014). Compassion Focused Therapy (CFT). In Dryden, W. and Reeves, A. (eds), Handbook of Individual Therapy (sixth edition). Sage: LondonGoogle Scholar
Gray, M. J., Litz, B. T., Wang, J. and Lombardo, T. W. (2004). Psychometric properties of the Life Events Checklist. Assessment, 11, 330341.Google Scholar
Hayes, S. C., Strosahl, K. and Wilson, K. G. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York: Guilford Press.Google Scholar
Johnson, E. A. and O'Brien, K. A. (2013). Self-compassion soothes the savage ego-threat system: effects on negative affect, shame, rumination, and depressive symptoms. Journal of Social and Clinical Psychology, 32, 939963.Google Scholar
Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of your Body and Mind to Face Stress, Pain, and Illness. New York: Delacorte.Google Scholar
Karatzias, T., Shevlin, M., Fyvie, C., Hyland, P., Efthymiadou, E., Wilson, D. et al. (2016). An initial psychometric assessment of an ICD-11 based measure of PTSD and complex PTSD (ICD-TQ): evidence of construct validity. Journal of Anxiety Disorders, 44, 7379.Google Scholar
Karatzias, T., Shevlin, M., Fyvie, C., Hyland, P., Efthymiadou, E., Wilson, D. et al. (2017). Evidence of distinct profiles of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ). Journal of Affective Disorders, 207, 181187.Google Scholar
Kearney, D. J., McDermott, K., Malte, C., Martinez, M. and Simpson, T. L. (2012). Association of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample. Journal of Clinical Psychology, 68, 101116.Google Scholar
Krieger, T., Altenstein, D., Baettig, I., Doerig, N. and Holtforth, M. G. (2013). Self-compassion in depression: associations with depressive symptoms, rumination, and avoidance in depressed outpatients. Behavior Therapy, 44, 501513.Google Scholar
Lee, D. (2016). Compassion Focused Therapy: Is Compassion an Antidote to Shame and an Effective Treatment of Complex PTSD? Master Clinician Workshop at the International Society of Traumatic Stress Studies Annual Meeting, Dallas.Google Scholar
Lee, D. and James, S. (2012). The Compassionate Mind Approach to Recovering from Trauma using Compassion Focused Therapy. London: Constable and Robinson.Google Scholar
Linehan, M. M. (1993). Diagnosis and treatment of mental disorders. Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.Google Scholar
MacBeth, A. and Gumley, A. (2012). Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32, 545552.Google Scholar
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., Reed, G. M., van Ommeren, M. and Saxena, S. (2013). Proposals for mental disorders specifically associated with stress in the ICD-11. Lancet, 381, 16831685. doi: 10.1016/S0140-6736Google Scholar
Maheux, A. and Price, M. (2015) Investigation of the relation between PTSD symptoms and self-compassion: comparison across DSM IV and DSM 5 PTSD symptom clusters. Self and Identity, 14, 627637.Google Scholar
Neff, K. D. (2003a). Self-compassion: an alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85102.Google Scholar
Neff, K. D. (2003b). The development and validation of a scale to measure self-compassion. Self and Identity, 2, 223250.Google Scholar
Neff, K. D. (2011). Self-compassion, self-esteem, and well-being. Social and Personality Psychology Compass, 5, 112.Google Scholar
Scoglio, A. A, Rudat, D. A., Garvert, D., Jarmolowski, M., Jackson, C. and Herman, J. L. (2015). Self-compassion and responses to trauma: the role of emotion regulation. Journal of Interpersonal Violence. doi: 10.1177/0886260515622296Google Scholar
Segal, Z. V., Williams, J. M. G. and Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.Google Scholar
Tabachnick, B. G. and Fidell, L. S. (2001). Using Multivariate Statistics. New York: Harper and Collins.Google Scholar
Thompson, B. L. and Waltz, J. (2008). Self-compassion and PTSD symptom severity. Journal of Traumatic Stress, 21, 556558.Google Scholar
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