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.

Compassion Protects Mental Health and Social Safeness During the COVID-19 Pandemic Across 21 Countries.

Objectives: The COVID-19 pandemic is having an unprecedented detrimental impact on mental health in people around the world. It is important therefore to explore factors that may buffer or accentuate the risk of mental health problems in this context. Given that compassion has numerous benefits for mental health, emotion regulation, and social relationships, this study examines the buffering effects of different flows of compassion (for self, for others, from others) against the impact of perceived threat of COVID-19 on depression, anxiety, and stress, and social safeness. Methods: The study was conducted in a sample of 4057 adult participants from the general community population, collected across 21 countries from Europe, Middle East, North America, South America, Asia, and Oceania. Participants completed self-report measures of perceived threat of COVID-19, compassion (for self, for others, from others), depression, anxiety, stress, and social safeness. Results: Perceived threat of COVID-19 was associated with higher scores in depression, anxiety, and stress, and lower scores in social safeness. Self-compassion and compassion from others were associated with lower psychological distress and higher social safeness. Compassion for others was associated with lower depressive symptoms. Self-compassion moderated the relationship between perceived threat of COVID-19 on depression, anxiety, and stress, whereas compassion from others moderated the effects of fears of contracting COVID-19 on social safeness. These effects were consistent across all countries. Conclusions: Our findings highlight the universal protective role of compassion, in particular self-compassion and compassion from others, in promoting resilience by buffering against the harmful effects of the COVID-19 pandemic on mental health and social safeness. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-021-01822-2.

The role of social connection on the experience of COVID-19 related post-traumatic growth and stress.

BACKGROUND: Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense of social disconnection and loneliness. This study explores how people's experience of compassion and feeling socially safe and connected, in contrast to feeling socially disconnected, lonely and fearful of compassion, effects the impact of perceived threat of COVID-19 on post-traumatic growth and post-traumatic stress. METHODS: Adult participants from the general population (N = 4057) across 21 countries worldwide, completed self-report measures of social connection (compassion for self, from others, for others; social safeness), social disconnection (fears of compassion for self, from others, for others; loneliness), perceived threat of COVID-19, post-traumatic growth and traumatic stress. RESULTS: Perceived threat of COVID-19 predicted increased post-traumatic growth and traumatic stress. Social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. These effects were consistent across all countries. CONCLUSIONS: Social connection is key to how people adapt and cope with the worldwide COVID-19 crisis and may facilitate post-traumatic growth in the context of the threat experienced during the pandemic. In contrast, social disconnection increases vulnerability to develop post-traumatic stress in this threatening context. Public health and Government organizations could implement interventions to foster compassion and feelings of social safeness and reduce experiences of social disconnection, thus promoting growth, resilience and mental wellbeing during and following the pandemic.

Knowledge and competency standards for specialized cognitive behavior therapy for adult obsessive-compulsive disorder.

Obsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illness for as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and Simpson, 2013). However, these treatments are not accessible to many sufferers around the world. Currently available guidelines for care are deemed to be essential but insufficient because of highly variable clinician knowledge and competencies specific to OCD. The phase two mandate of the 14 nation International OCD Accreditation Task Force (ATF) created by the Canadian Institute for Obsessive Compulsive Disorders is development of knowledge and competency standards for specialized treatments for OCD through the lifespan deemed by experts to be foundational to transformative change in this field. This paper presents knowledge and competency standards for specialized CBT for adult OCD developed to inform, advance, and offer a model for clinical practice and training for OCD. During upcoming ATF phases three and four criteria and processes for training in specialized treatments for OCD through the lifespan for certification (individuals) and accreditation (sites) will be developed based on the ATF standards.

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.

Gagging prevalence and its association with dental fear in 4-12-year-old children in a dental setting.

AIM: The aims were to determine the prevalence of gagging in children in the dental setting, detect any association between gagging and dental fear in that setting, and determine if the association varied by type of setting. DESIGN: A total of 734 children (4-12 years old), seeking dental care either at a University paediatric dental clinic (UC) or at a private paediatric practice (PP), filled out the Greek version of the Gagging Assessment Scale (GAS, subjective assessment) and the Greek version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). The shorter form of the Gagging Problem Assessment-dentist part for children (GPA-de-c/SF, dentist's objective measurement) was used to assess their gag reflex. RESULTS: A total of 209 children (28.47%) gagged according to the GPA-de-c/SF. There was no significant difference in gagging between UC and PP children. Children rated as gaggers on the GPA-de-c/SF reported significantly higher GAS and CFSS-DS scores (U = 33 629.000; P < 0.001, U = 31 955.500, P < 0.001, respectively). Also, there was a significant association between GAS and CFSS-DS (rho = 0.307, P < 0.001). CONCLUSIONS: In the dental setting, there were significant relationships between dental fear, the dentist's objective measurement of gagging severity, and the child's subjective gagging assessment.

Epidemiology and comorbidity of obsessive-compulsive disorder in late adolescence: a cross-sectional study in senior high schools in Greece.

OBJECTIVE: The aim of this study was to examine the epidemiology, comorbidity and use of health services of obsessive-compulsive disorder (OCD) and subclinical obsessive-compulsive symptoms in late adolescence. METHODS: A total of 2427 adolescents attending senior high schools in Greece were selected for a detailed psychiatric interview using the revised clinical interview schedule (CIS-R). Use of alcohol, nicotine and cannabis, and several socio-demographic and socio-economic variables were also assessed. RESULTS: The prevalence of OCD was 1.39% (95% confidence interval [CI]: 1.05-1.84) while that of subclinical obsessive-compulsive symptoms was 2.77% (2.22-3.45). There was a female preponderance for subclinical symptoms. Financial difficulties of the family was the only socio-demographic variable that was significantly associated with OCD but not with subclinical symptoms. The pattern of comorbidity was similar for both conditions but milder in the subclinical form. About one in three reported use of general health services and one in ten use of psychiatric services. CONCLUSIONS: OCD and subclinical obsessive-compulsive symptoms were relatively common. Comorbidity with other psychiatric disorders and use of substances was considerable even in subclinical status, but use of specialised health services was small. Clinical and research implications are discussed.

Collaboration in psychopharmacotherapy.

Collaboration in pharmacotherapy implies a professional willing to prescribe an effective medication and a patient willing to adhere to the therapeutic regimen in order for both to achieve their common goal. This relationship requires trust in the relationship, collaboration in goal setting, and effective means for promoting and restoring mental health. Variables like illness insight and patients' attitudes towards medication should be dealt within a collaborative relationship. Several methods of shared decision making, culled from the research literature and clinical experience, promote such prescriber-patient collaboration and, even more specifically, medication adherence. Detailed physician-patient interactions in 2 cases, one of a depressed patient and one of a patient suffering from schizophrenia, serve to highlight common difficulties in the management of pharmacotherapy in the context of a collaborative relationship.