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

Kerem Böge, Franziska Pollex, Niklas Bergmann, Inge Hahne, Marco Matthäus Zierhut, Selin Mavituna, Neil Thomas, Eric Hahn, Kerem Böge, Franziska Pollex, Niklas Bergmann, Inge Hahne, Marco Matthäus Zierhut, Selin Mavituna, Neil Thomas, Eric Hahn

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.

Keywords: mindfulness; moderated mediation; negative symptoms; psychological flexibility; psychosis; schizophrenia spectrum disorders; self-compassion.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Böge, Pollex, Bergmann, Hahne, Zierhut, Mavituna, Thomas and Hahn.

Figures

Figure 1
Figure 1
Moderated mediation model for mindfulness, self-compassion, cognitive fusion, and symptom severity.
Figure 2
Figure 2
Model 1. Moderated mediation model for mindfulness, self-compassion, cognitive fusion, and symptom severity. SMQ, Southampton Mindfulness Questionnaire; CFQ, Cognitive Fusion Questionnaire; PANSS, Positive and Negative Syndrome Scale; SCS, Self-Compassion Scale.
Figure 3
Figure 3
Model 2. Moderated mediation model for mindfulness, self-compassion, cognitive fusion, and negative symptom severity. SMQ, Southampton Mindfulness Questionnaire; CFQ, Cognitive Fusion.

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