How do early affiliative memories explain body image shame? A 12-month longitudinal study in adolescent girls.

OBJECTIVE: This study aimed to explain adolescent girls' body image shame across a 12- month longitudinal design, and its relationship with early parental memories of warmth and safeness and fear of receiving compassion from others. DESIGN AND METHODS: Participants included 231 adolescent girls, who completed self-report measures at three different periods: baseline (W1), 6-month follow-up (W2), and 12-month follow-up (W3). Descriptive and correlational analyses were performed, and differences between participants at the different waves were explored through repeated measures ANOVA. A cross-lagged panel model tested the mediational effect of fears of receiving compassion on the association between early affiliative memories (W1) and body image shame (W3). RESULTS: ANOVA results found significant differences throughout time in memories of warmth and safeness (tending to diminish) and in body image shame (tending to rise). Correlation analysis revealed that all variables were significantly associated in the expected directions, across the three waves. Finally, path analysis revealed that early affiliative parental memories (in W1) had a direct effect on body image shame (in W3), through the fear of receiving compassion from others (in W2), accounting for 85% of body image shame's variance (W3). CONCLUSIONS: These findings indicate that the lack of early affiliative memories often leads to the development of defensive mechanisms such as fears of receiving compassion from others which in turn can foster isolation and distant relationships, enhancing feelings of inferiority and inadequacy, which in female adolescents can emerge centered on body image - body image shame. This study further highlights the importance of prevention and intervention strategies based on compassion to specifically target fears of receiving compassion from others, in adolescent girls dealing with feelings of inferiority and shame regarding their body.

Does fear of compassion effect nurses' caring behaviours? a cross-sectional study.

Aims: The aim of this study is to determine the levels of nurses' fear of compassion for others, fear of compassion from others, and fear of self-compassion and to examine the effect of fear of compassion on caring behaviors. Design: A cross-sectional, quantitative design was used. Participants and research context: The study was conducted between October 2022 and April 2023 with 304 nurses working in two public hospitals. Data collection tools were the "Fears of Compassion Scales" and the "Caring Behaviors Inventory." Data were analyzed using a t test, one-way ANOVA, Pearson correlation analysis, and stepwise multiple regression model. Ethical considerations: Ethics committee approval of the research was obtained from the non-invasive ethics committee of Kütahya Health Sciences University (Reference No: 25.05.2022/2022/06-19). The principles of the Declaration of Helsinki were followed in the study. The purpose of the research was explained to all participants, and their verbal/written informed consent was obtained. Results: The mean scores of nurses on fear of compassion for others and from others were at a moderate level, and their scores on fear of self-compassion were close to a moderate level. It was found that the level of nurses' fear of compassion was related to their sociodemographic and professional variables. Fear of self-compassion, fear of compassion for others, and fear of compassion from others explained 33.5% of the total variance in caring behaviors. Conclusions: Nurses' caring behaviors were shown to be more associated with fear of self-compassion than fear of compassion for others. Fear of compassion may be one of the barriers to compassionate care. Interventions that will reduce nurses' fear of compassion may be one way to provide compassionate care. It is recommended to conduct awareness studies on self-compassion and accepting compassion from others in nurses.

Never underestimate fears, blocks, and resistances: The interplay between experiential practices, self-conscious emotions, and the therapeutic relationship in compassion focused therapy.

Experiential practices are a core component of compassion focused therapy (CFT). Throughout the treatment process, the client's engagement with these practices may become blocked, resulting in a rupture in the therapeutic relationship. In these instances, the interplay between these experiential practices and the therapeutic relationship becomes an essential focus of therapy to repair the rupture, re-engage the client in the therapeutic process, and proceed with the CFT treatment plan. This paper presents the case of a man diagnosed with social anxiety disorder, with the presence of shame-based self-criticism, treated via 12 sessions of CFT. CFT was proceeding well until certain embodiment practices and chair work were introduced, at which point the client refused to continue and became disengaged in the session. The process of repair and re-engagement will be discussed from the perspective of this interplay between experiential exercises and therapeutic relationships. Implications for CFT practice and clinical recommendations will be provided.

Psychometric properties of the German version of the fears of compassion scales.

The cultivation of compassion is associated with beneficial effects on physical and psychological health, satisfaction with life and social relationships. However, some individuals, especially those high in psychopathological symptoms or those with particular disorders such as borderline personality disorder (BPD) may demonstrate pronounced fears of engagement in compassionate experiences or behaviours. Furthermore, fears of compassion have been found to impede progress in psychotherapy. The 38-item fears of compassion scales (FCS) is a self-report questionnaire for measuring trait levels of fears of compassion (a) one receives from others (FCFO), (b) one feels towards others (FCTO) and (c) one feels for oneself (self-compassion; FSC). The FCS is an internationally used instrument of proven validity and reliability in both clinical and nonclinical samples. In the present study, a German translation of the FCS including its three subscales was provided, and the psychometric properties were examined in 430 participants from four different samples: (a) a sample from the general population; (b) a mixed sample of psychiatric residential and outpatients; (c) a clinical sample of residential and outpatients with a primary diagnosis of BPD and (d) a sample of healthy control participants. Internal consistencies were excellent for the German version of the FSC and acceptable to excellent for its subscales. Correlations with established measures of mental health demonstrate its validity. Additionally, the German FCS discriminates significantly between individuals from the general population and patients, thus supporting its specificity. The German FCS is suitable to detect potential obstacles in cultivating compassion in psychotherapeutic treatments and beyond.

Fears of compassion magnify the harmful effects of threat of COVID-19 on mental health and social safeness across 21 countries.

BACKGROUND: The COVID-19 pandemic is a massive global health crisis with damaging consequences to mental health and social relationships. Exploring factors that may heighten or buffer the risk of mental health problems in this context is thus critical. Whilst compassion may be a protective factor, in contrast fears of compassion increase vulnerability to psychosocial distress and may amplify the impact of the pandemic on mental health. This study explores the magnifying effects of fears of compassion on the impact of perceived threat of COVID-19 on depression, anxiety and stress, and social safeness. METHODS: Adult participants from the general population (N = 4057) were recruited across 21 countries worldwide, and completed self-report measures of perceived threat of COVID-19, fears of compassion (for self, from others, for others), depression, anxiety, stress and social safeness. RESULTS: Perceived threat of COVID-19 predicted increased depression, anxiety and stress. The three flows of fears of compassion predicted higher levels of depression, anxiety and stress and lower social safeness. All fears of compassion moderated (heightened) the impact of perceived threat of COVID-19 on psychological distress. Only fears of compassion from others moderated the effects of likelihood of contracting COVID-19 on social safeness. These effects were consistent across all countries. CONCLUSIONS: Fears of compassion have a universal magnifying effect on the damaging impact of the COVID-19 pandemic on mental health and social safeness. Compassion focused interventions and communications could be implemented to reduce resistances to compassion and promote mental wellbeing during and following the pandemic.

Striving as a paradoxical strategy to deal with fears of compassion: impact on disordered eating.

PURPOSE: Recent literature has documented the relationship between fears of compassion and disordered eating attitudes and behaviours. However, research on the processes underlying this association is still in the early stages. As such, this study tested a mediator model where insecure striving and inflexible eating (i.e. psychological inflexibility focused on eating) were hypothesized to mediate the impact of fears of compassion on the severity of disordered eating, while controlling for the effects of body mass index and age. METHODS: The study's sample comprised 310 Portuguese women from the general population, aged between 18 and 65 years, who completed an online survey. RESULTS: Path analysis results revealed that the impact of fear of compassion for self and for others on disordered eating was fully mediated by insecure striving and inflexible eating, whereas the impact of fear of compassion from others was only partly mediated by these processes. The tested model accounted for 48% of disordered eating's variance and presented excellent fit indices. CONCLUSIONS: These results suggest that fears of experiencing compassion may preclude the experience of social safeness, hindering the activation of social mentalities other than rank-focused mentality. Maladaptive competitive strategies may ensue (insecure striving), such as inflexible eating, which is linked to the development of disordered eating. In terms of clinical implications, these findings stress the need to effectively assess and address fears of compassion, as they not only seem to be involved in the development of disordered eating, but also have been reported to be significant predictors of poor treatment outcomes. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Influence of fears of compassion on body image shame and disordered eating.

PURPOSE: The current study tested a path model examining the impact of fears of compassion in the adoption of disordered eating and whether social safeness and body shame would mediate this relationship. METHODS: Participants were 645 women (aged between 18 and 55) from the general community, who completed an online survey. RESULTS: Results indicated that fears of compassion were negatively associated with one's ability to feel secure and safe within close relationships, and positively linked with higher levels of body shame and disordered eating. The tested model accounted for 62% of the variance of disordered eating. Path analyses results revealed that the three dimensions of fears of compassion impacted on disordered eating. Particularly, fear of expressing compassion for others presented a direct impact on disordered eating. Moreover, fears of self-compassion and fears of receiving compassion from others partially impacted on disordered eating attitudes and behaviours, through the mechanisms of social safeness and body image-focused shame. These findings suggested that women who present higher levels of fear of self-compassion and of receiving signs of affection and compassion from others tend to feel more insecure in their social group, which seem explain body shame and the engagement in disordered eating behaviours. CONCLUSIONS: This study highlights the pathogenic impact of fears of compassion on body image and eating attitudes and behaviours. The current data seem to offer relevant insights for research and clinical practice, by supporting the relevance of developing compassionate abilities and attitudes to target body image and eating-related difficulties.

Shame and eating psychopathology in Portuguese women: Exploring the roles of self-judgment and fears of receiving compassion.

Shame has been for long associated with the development and maintenance of body image and eating-related difficulties. However, the mechanisms underlying this association remain unclear. Therefore, the current study sought to examine the mechanisms of self-judgment and fears of receiving compassion from others in the association between external shame and disordered eating, while controlling for body mass index (BMI). Participants in this study were 400 women from the general population, aged between 18 and 55 years old. Correlation analyses revealed significant and positive relationships between external shame, self-judgment, fears of receiving compassion from others and eating psychopathology. A path analysis confirmed that, when controlling for the effect of BMI, external shame has a direct effect on disordered eating severity, and also an indirect effect, mediated by higher levels of self-judgment and increased fears of receiving others' kindness and compassion. Results showed the plausibility of the tested model which explained 36% of the variance of disordered eating. These findings seem to support that women who perceive that others view them negatively tend to be defensive and engage in maladaptive emotion regulation strategies (such as harsh critical attitudes towards the self and being resistant to others' compassion), which may trigger maladaptive eating attitudes and behaviours. The current research appears to be an innovative study in the field of body image and eating-related psychopathology and seems to represent a new avenue for future research and for the development of intervention programs.

Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study.

During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.

Fear leads to suffering: Fears of compassion predict restriction of the moral boundary.

Empirical investigations into the psychological drivers of more or less expansive moral thinking are lacking from the psychological literature. One potential driver that warrants deeper investigation is compassion - a prosocial motivation to both identity and alleviate suffering. The current research examined the extent to which compassion, and fears of compassion, act as a driver and inhibitor, respectively, of a morally expansive mindset. We tested these associations across three studies (N = 749) and found robust support for our predictions. Specifically, stronger compassion to others, and greater fears of extending compassion to others, were linked to enhanced and reduced moral expansiveness, respectively. Moreover, over and above empathy and mindfulness, fears of compassion and compassion uniquely predicted moral expansiveness. Finally, compassion was found to consistently mediate the relationship between fears of compassion to others and moral expansiveness. Our findings further our understanding of the psychological factors that may drive and restrict morally expansive mindsets and hold implications for the broader domains of moral decision-making and prosocial motivation as well as the application of practices that are designed to facilitate a compassionate mindset (e.g., Compassionate Mind Training).

Beyond the Centrality of Shame: How Self-Concealment and Fear of Receiving Compassion From Others Impact Psychological Suffering in Transgender Adults.

Shame-based social interactions are a minority social stressor commonly experienced by transgender individuals. However, few studies have explored the centrality of shame experiences in transgender identity and mental health. Also, the ability to receive care and soothing support may be influenced by intrapersonal shame- and fear-related factors, which may hinder openness, and support and care seeking, thus contributing to psychological distress. This study aims to examine the relationship between central shame experiences, fear of receiving compassion from others, self-concealment, and psychological distress (depression, anxiety, and stress symptoms) in a sample of Portuguese transgender adults. Following a cross-sectional design, data from a convenience sample of 70 self-identified transgender individuals undergoing gender-affirming medical interventions (GAMIs) were analyzed, using SPSS PROCESS, to determine whether the relationship between central shame experiences and psychological suffering occurred indirectly through fear of receiving compassion from others, and self-concealment. Results suggest that fear of receiving compassion from others, but not self-concealment, was the underlying factor between central shame experiences, and depression and anxiety. Results suggest that the centrality of shame experiences and stress symptomatology associate sequentially through fear of compassion and, in turn, through self-concealment. Clinical implications for mental health interventions with transgender individuals undergoing GAMI are discussed.

The Relationship Between Fears of Compassion, Emotion Regulation Difficulties, and Emotional Eating in College Students: A Moderated Mediation Model.

Although previous research has found the impact of fears of compassion on eating disorders, the mechanism underlying the relationship between fears of compassion and emotional eating remains to be examined. This study aimed to examine the mediating role of emotion regulation difficulties in the relationships between fears of compassion and emotional eating in college students, as well as the gender difference in the mediation model. The Fears of Compassion Scale, Difficulties in Emotion Regulation Scale, and Dutch Eating Behavior Questionnaire were completed by 673 college students in Fujian Province, China. Structural Equation Modeling was primarily employed to analyze the data. The results showed that both fear of compassion for self and fear of compassion from others were positively associated with emotion regulation difficulties, which in turn were related to emotional eating for female college students. Emotion regulation difficulties played a significant mediating effect in the relationship between fears of compassion and emotional eating. Comparatively, for male college students, only fear of compassion for self was positively associated with emotion regulation difficulties, but emotion regulation difficulties were not related to emotion eating. Moreover, the mediating effect of emotion regulation difficulties was not significant in the relationship between fears of compassion and emotion eating for male college students. The findings suggest that it is important to improve individuals' fears of compassion to reduce emotional eating, particularly for female college students.

A social rank approach to disordered eating: Exploring relationships between shame, fears of compassion, striving, and body shame.

OBJECTIVES: The impact of a social rank mentality on eating-related difficulties has been previously recognized, although mediating processes involved remain to be clarified. The current study aimed to explore the roles of insecure striving and body image shame on the relationships between external shame and fears of receiving compassion from others with eating difficulties, while controlling for BMI effects. METHODS: A total of 335 women from the general population participated in this study, aged between 18 and 62 years, who completed an investigation protocol, with self-report measures. RESULTS: Path analysis results showed that, when controlling for BMI, external shame and fears of compassion from others presented an indirect effect on eating difficulties, mediated by insecure striving and body image shame. The model explained 63% of the variance of eating-related difficulties. CONCLUSIONS: Findings suggest that, in Western societies, women who highly feel that others negatively evaluate the self and present higher levels of fears of receiving compassion from others may endorse maladaptive strategies (as insecure striving) which in turn may lead to experiencing greater levels of body image shame and eating-related difficulties. PRACTITIONER POINTS: This study suggests that therapists may observe that individuals who are vulnerable to developing body image and eating-related difficulties present high levels of shame and fears of compassion from others, as well as a need to compete to avoid inferiority. Therapeutic targets for people with eating-related difficulties may focus on shame, insecure striving, and fears of receiving compassionate and affiliative emotions. Addressing fears of receiving compassion and reducing shame may decrease the need to compete to avoid undesired inferiority and facilitate adaptive eating attitudes and behaviours.

The 'Flow' of compassion: A meta-analysis of the fears of compassion scales and psychological functioning.

This meta-analysis examined the associations between the fears of compassion and mental health. We extracted 19 studies reporting 154 effect sizes (Pearson's r) from 22 independent samples published during the last seven years, with data from 4723 participants. All studies used the Fears of Compassion Scales (FCS), which includes three subscales; fears of compassion for self, for others, and receiving from others. Specific mental health outcomes included: depression; anxiety; distress; and well-being, as well as the psychological vulnerability factors of self-criticism and shame. The overall association between the three FCS subscales and mental health difficulties was .49, .30 and .48 for fears of self-compassion, fears of compassion for others, and fears of compassion from others, respectively. Across mental health domains and vulnerability factors, pooled effect sizes ranged between r = .13 and .55 (in absolute value), with the strongest associations found between the mental health variables of shame, self-criticism, and depression, and the FCS subscales of fears of self-compassion and fears of receiving compassion. Moderator analyses were also conducted, including, age, gender, publication status, and sample (clinical vs. non-clinical). Overall, clinical populations demonstrated significantly stronger associations between mental health difficulties and fears of self-compassion, relative to non-clinical populations.

Behind women's body image-focused shame: Exploring the role of fears of compassion and self-criticism.

PURPOSE: Recent studies seem to support that being open to compassion from self and others is key for psychological and social well-being. In particular, findings indicated that fears of affiliative emotions are associated with negative affect and difficulties in threat regulation. The current study examined a path model which tested the direct and indirect effect of fears of compassion on both externalized and internalized body image-related shame, and the potential mediator role of self-criticism on these relationships. METHODS: In this study participated 651 Portuguese women, aged between 18 and 55, from the general population who completed a set of self-report measures of fears of compassion, self-criticism, and body image-related shame. RESULTS: The tested model accounted for 53% of externalized and 45% of internalized body image shame's variance and revealed an excellent fit. Findings corroborated the plausibility of the hypothesized model suggesting that fears of self-compassion and receiving compassion from others are positively associated with body image shame, and that self-criticism is a significant mediator of these associations, even when controlling for the effects of age and BMI. CONCLUSIONS: These findings highlight the relevance of addressing fears of compassion and critical forms of self-relating in the understanding and management of body image-related difficulties. This study seems to have important clinical implications by suggesting the pertinence of the cultivation of compassionate abilities and attitudes, as adaptive self-regulatory strategies to target body image difficulties.

Factorial structure and construct validity of an Italian version of the Fears of Compassion Scales: A study on non-clinical subjects.

OBJECTIVES: This study was aimed at investigating the factorial structure and the construct validity of the Italian translation of the Fears of Compassion (FC) Scales in a non-clinical sample (i.e., Fear of Compassion From Others [FCFO], Fear of Compassion Towards Others [FCTO] and Fear of Self-Compassion [FSC]). An exploratory factor analysis was conducted on all the items to investigate the dimensionality of the FC scales. To assess construct validity, correlations between the FC scales and a series of construct-related measures were analysed. DESIGN/METHODS: After being translated into Italian using a back-translation procedure, the questionnaire was administered to a community sample of 298 participants (82 males) with a mean age of 24.31 (SD = 8.75), along with self-report measures of psychopathological symptoms, attachment style, self-esteem, satisfaction with life and altruistic behaviour. A behavioural test of altruism was also administered in a subsample of 40 subjects. RESULTS: Thirteen of 38 items did not show adequate psychometric characteristics and thus were removed. The remaining 25 items showed a clear 3-factor solution which explained 48% of the variance. FC Scales were significantly correlated with all the construct-related scales administered in the expected direction, with higher effect sizes for FCFO and FSC than FCTO. CONCLUSIONS: Although 13 items were removed, results confirmed the expected three factor solution for the Italian translation of FC scales, and provided new evidence for their construct validity. In this vein, an interesting pattern of correlations emerged with psychiatric symptoms and prosocial behaviour, indicating that FCFO and FSC are more powerful correlates of psychopathology and altruism with respect to FCTO. PRACTITIONER POINTS: Fears of Compassion Scales have been increasingly used in clinical and research settings. The reduced Italian version of the FCS developed in this study is a valid and parsimonious instrument. Fears of receiving compassion from others and from ourselves are more powerful predictors of psychopathological symptoms than fear of giving compassion to others. Fears of Compassion Scales were correlated with both a self-report and a behavioural measure of altruism.

Dificuldades no engajamento às medidas contra a COVID-19: o papel dos medos da compaixão / Difficulties to engage with measures against COVID-19: the role of fears of compassion / Dificultades para comprometerse con las medidas contra COVID-19: el papel de los miedos a la compasión

Como motivação pró-social, a compaixão tende a promover maior envolvimento em mentalidades de cuidado e ações de senso coletivo, capacidades prejudicadas pelos medos da compaixão. O estudo objetivou investigar o papel dos medos da compaixão em fatores envolvidos no engajamento às medidas de distanciamento social. Duzentos e oitenta e quatro adultos (idade média = 36,47) responderam as escalas de medos da compaixão, escala de dificuldades de regulação emocional e um questionário sobre engajamento aos protocolos contra a COVID-19. Um modelo de path analysis explicou 32% da variância na adesão aos protocolos por duas vias: o medo de ser compassivo por outros diminui o engajamento por motivações pró-sociais; enquanto os medos de expressar compaixão por si e outros predizem maiores dificuldades de regulação emocional, diminuindo a aderência por exaustão emocional. Oportunizar o desenvolvimento da compaixão pode contribuir para um enfrentamento mais saudável às dificuldades emocionais suscitadas pela pandemia e no envolvimento em ações coletivas

As a prosocial motivation, compassion enables to engage in care and collaborative behaviors, what can be impaired in people facing fears of compassion. This study proposed to investigate factors involved in the difficulties to engage in distancing measures, evaluating the role of the fears of compassion. 284 adults (mean age = 36,47) answered fears of compassion scales, difficulties in emotion regulation scale and a questionnaire about the engagement to social distancing measures. A path analysis model explained 32% of the variance on the recommended measures in two ways: fear of expressing compassion to others reduces the compliance with the recommendations decreasing prosocial motivations to follow the measures; fears of expressing compassion to self and others predicted stronger difficulties on emotional regulation, reducing the adherence to protocols because of emotional exhaustion. Providing the development of compassion can help to promote healthier emotional strategies to deal with the pandemic and to promote a more collaborative society to engage in social actions

Como una motivación prosocial, la compasión tiende a promover una mayor participación en las mentalidades de cuidado y sentido colectivo, capacidades que pueden estar afectadas por el miedo a la compasión. Este estudio tuvo como objetivo investigar el papel de los miedos a la compasión en el compromiso en seguir medidas de distanciamiento social en contra COVID-19. 284 adultos (edad media = 36,47) respondieron escalas de miedo a la compasión, escala de dificultades de regulación emocional y un cuestionario sobre compromiso con protocolos contra COVID-19. Un modelo de path analysis explicó 32% de la variación en la adhesión a los protocolos de dos maneras: el miedo a ser compasivo con los demás disminuye el compromiso debido a motivaciones prosociales; mientras que los miedos a expresar compasión por uno mismo y por los demás predicen mayores dificultades en la regulación emocional, disminuyendo la adherencia por agotamiento emocional. Ofrecer el desarrollo de la compasión puede contribuir a afrontar de manera más saludable las dificultades emocionales planteadas por la pandemia y en la participación en acciones colectivas