Pathways from paranoid conviction to distress: exploring the mediator role of Fears of Compassion in a sample of people with psychosis

Abstract

Fears of Compassion (FOC) relate to experiencing defensive emotions and avoidance reactions when receiving and giving compassion. Three different flows have been identified: giving compassion to others, receiving compassion, and self-compassion. This study sought to explore: FOC within a sample of patients with psychosis; the associations between FOC and paranoia; and the mediator role of FOC in the relationship between paranoid conviction and distress. Seventy-two patients with psychosis (74% diagnosed with schizophrenia), mostly male (85%), with a mean age of 33.46 (SD = 9.43), were recruited and assessed with measures of paranoia (conviction and distress) and FOC. Participants presented significantly higher levels of FOC than non-clinical samples and lower levels than depressed patients. Different flows of FOC were associated with each other and with paranoia-related measures. A mediation effect of FOC from others and fears of self-compassion was found. Results support the relevance of including FOC in formulation and treatment protocols for psychosis.