Abstract
Background: There is a paucity of research on mediators of change, within compassion training programs. The aim was to investigate the mediators, of an 8-week compassion cultivation training (CCT) program, on the effect of psychological distress on caregivers of people with a mental illness.Method: Longitudinal path models in a randomized controlled trial (RCT). One hundred ninety-two participants were assessed for eligibility, and 161 participants were included into the trial and randomized. The main outcome was psychological distress measured by the Depression, Anxiety and Stress scale at 6 months. Mediators included self-compassion (SC), mindfulness (FM), emotion regulation (ER), emotion suppression (ES), and cognitive reappraisal (CR). Baseline, post, and 3- and 6-month follow-up measurements were collected.Results: The mediated effects for CCT are as follows: depression at 6 months: SC: −1.81 (95% CI: −3.31 to −0.31); FM: −1.98 (95% CI: −3.65 to −0.33); ER: −0.14 (95% CI: −1.31 to 1.02); anxiety at 6 months: SC: −0.71 (95% CI: −1.82 to 0.40); FM: −1.24 (95% CI: −2.39 to −0.09); ER: 0.18 (95% CI: −1.04 to 1.40); stress at 6 months: SC: −1.44 (95% CI: −2.84 to −0.05); FM: −2.17 (95% CI: −3.63 to −0.71); ER: −0.27 (95% CI: −1.51 to 0.98).Conclusion: Mindfulness and self-compassion are important components in reducing psychological distress experienced by informal caregivers of people with a mental illness. Results contribute to the knowledge about the underlying mechanisms of CCT.
Highlights
Poor mental health is on the rise (1), and there is a need for evidence-based interventions that decrease psychological distress and increase overall wellbeing
There is a paucity of research on the mediators of compassion training programs (6, 7)
We found no support for our hypothesis regarding emotion regulation (ER and expressive suppression (ES)) as mediators, and mediation of emotion regulation through mindfulness or self-compassion was not found
Summary
Poor mental health is on the rise (1), and there is a need for evidence-based interventions that decrease psychological distress and increase overall wellbeing. Compassion-based training programs may be one way to address this need (2). There is a paucity of research on the mediators (an intervening variable that may statistically account for the relationship between the independent and dependent variables) of compassion training programs (6, 7). Only one randomized controlled trial (RCT) has investigated the mediating variables of a selfhelp book intervention that was based on the principles of a compassion-based therapy (7, 8). There is a paucity of research on mediators of change, within compassion training programs. The aim was to investigate the mediators, of an 8-week compassion cultivation training (CCT) program, on the effect of psychological distress on caregivers of people with a mental illness
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