Above and beyond emotional suffering: The unique contribution of compassionate and uncompassionate self-responding in chronic pain

Abstract

Objectives: Studieshave shownthat self-compassion plays a protective role against depression inwomenwith chronic pain (CP). However, the majority of studies inCPhaveused the total score of the self-compassion scale (SCS), which have raised concerns due to potential overlap, not only between the uncompassionate self-responding factors and psychopathology, but also between self-compassion as a whole and other wellknown psychological processes (e.g., mindfulness, acceptance, psychological flexibility). This calls for amore nuanced understanding of which components of (un)compassionate self-responding adds to better mental health in CP. Methods: This study explores the unique contribution of compassionate and uncompassionate self-responding to depressive symptoms in women with CP undergoing pain consultation (n = 49). Results: Correlation analyses suggest that compassionate self-responding only significantly correlates with progress in valued living, while the uncompassionate selfresponding significantly correlates with pain fusion, pain avoidance, obstructions to valued living and depression. Multiple regression analysis showed that self-compassion contributes to depressive symptoms (R2 = 8%) above and beyond pain intensity and disability (R2 = 12%) and psychological (in) flexibility processes (R2 = 31%), and uncompassionate (but not compassionate) self-responding uniquely contributes to depressive symptoms (sr2 = 18%). Conclusions: Findings suggest that uncompassionate selfresponding is a stronger contributor to depression in CP than compassionate self-responding. Clinical implications are further discussed.