Effects of a Mindfulness-Based Intervention on Self-Compassion and Psychological Health Among Young Adults With a History of Childhood Maltreatment

Diane Joss, Alaptagin Khan, Sara W Lazar, Martin H Teicher, Diane Joss, Alaptagin Khan, Sara W Lazar, Martin H Teicher

Abstract

Background: Individuals who were maltreated during childhood are faced with increased risks for developing various psychological symptoms that are particularly resistant to traditional treatments. This pilot study investigated the effects of a mindfulness based behavioral intervention for young adults with a childhood maltreatment history.

Methods: This study looked at self-report psychological questionnaires from 20 subjects (5 males) before and after a mindfulness-based behavioral intervention, compared to 18 subjects (6 males) in the waiting list control group (age range 22-29); all subjects experienced mild-to-moderate childhood maltreatment. We analyzed changes in stress, anxiety, depression, mindfulness and self-compassion related to the intervention with linear mixed effects models; we also analyzed the relationships among questionnaire score changes with partial correlation analyses and mediation analysis.

Results: Linear mixed effects model analyses revealed significant group by time interaction on stress (p < 0.01), anxiety (p < 0.05), and self-compassion (p < 0.01), with the mindfulness group having significant reduction in stress and anxiety (p < 0.01), and significant increase in mindfulness (p < 0.05) and self-compassion (p < 0.001). Partial correlation analyses showed that among all subjects from both groups, changes in mindfulness positively correlated with changes in self-compassion (r = 0.578, p = 0.001), which negatively correlated with changes in depression (r = -0.374, p = 0.05) and anxiety (r = -0.395, p < 0.05). Changes in self-compassion mediated, in part, the relationship between changes in mindfulness and changes in anxiety (average causal mediation effect = -4.721, p < 0.05). We observed a dose-dependent effect of the treatment, i.e., the number of intervention sessions attended were negatively correlated with changes in stress (r = -0.674, p < 0.01), anxiety (r = -0.580, p < 0.01), and depression (r = -0.544, p < 0.05), after controlling for the individual differences in childhood maltreatment severity.

Conclusion: Our results suggest that, to some extent, the mindfulness-based intervention can be helpful for improving self-compassion and psychological health among young adults with a childhood maltreatment history.

Clinical trial registration: www.ClinicalTrials.gov, identifier NCT02447744.

Keywords: anxiety; childhood maltreatment; depression; mindfulness; self-compassion; stress.

Copyright © 2019 Joss, Khan, Lazar and Teicher.

Figures

FIGURE 1
FIGURE 1
Flow chart of subject enrolment and retention.
FIGURE 2
FIGURE 2
Significant group by time interaction with scores of STAI-t (A), PSS (B), and SCS (C). In all panels, red triangles with dashed red lines represent the control group while blue circles with solid blue lines represent the mindfulness group; error bars are standard errors.
FIGURE 3
FIGURE 3
Positive correlation between changes in mindfulness and self-compassion. Subjects with more increase in mindfulness (measured by the Mindful Attention Awareness Scale) tend to have more increase in self-compassion (measured by the Self-Compassion Scale).
FIGURE 4
FIGURE 4
The amount of changes in depression and anxiety severity is negatively correlated with the amount of changes in self-compassion (A) and positively correlated with the amount of changes in stress (B).
FIGURE 5
FIGURE 5
Mediation effects of self-compassion (ΔSCS: the amount of changes in scores of Self-Compassion Scale) between the changes in mindfulness (ΔMAAS: the amount of changes in scores of Mindful Attention Awareness Scale) and changes in anxiety (A) (ΔSTAI-t: the amount of changes in scores of State-Trait Anxiety Inventory-Trait subscale) and stress (B) (ΔPSS: the amount of changes in scores of Perceived Stress Scale).
FIGURE 6
FIGURE 6
Intervention compliance and treatment effects: subjects who attended more intervention sessions had more reduction in depression, anxiety and stress (A), while subjects who practiced more at home had more increase in self-compassion (B).
FIGURE 7
FIGURE 7
Childhood maltreatment negatively impacts treatment effects. Subjects with more severe maltreatment (A), or more severe physical maltreatment as measured by Childhood Trauma Questionnaire (CTQ) or MACE (B), or more severe parental verbal maltreatment (C), tend to have less reduction in anxiety symptoms.

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