Understanding the Links Between Self-Compassion, Emotion Regulation, and Internalizing Symptoms in Adolescents Open Access

Abstract

Adolescent mood and anxiety disorders have been deemed an urgent public health crisis and, as prevalence estimates continue to rise, more adolescents are impacted by a variety of negative outcomes including functional impairment, psychiatric comorbidities, and suicidal thoughts and behaviors. Despite a range of evidence-based treatments for adolescent mood and anxiety disorders, response rates are modest, and relapse rates are high. Identifying new treatment targets is critical. Accumulating research supports a self-compassion (SC) model of emotion regulation (ER) in which SC is hypothesized to deactivate the psychobiological threat system and activate the self-soothing system. However, few studies have examined SC and ER together in adolescent samples. The present study reports on the relationships between these constructs and clinical outcomes (i.e., internalizing symptom severity, a history of non-suicidal self-injury (NSSI), and a history of suicidal thoughts and behaviors (STBs)) in a sample of adolescents aged 14 to 17 (n=113), including those with diagnosed anxiety and/or depression as well as healthy controls. Mediation analyses revealed that two aspects of SC (capacity for and barriers to) related to the clinical outcomes and that ER difficulties partially mediated those relationships. The findings suggest that positive and negative attitudes towards self-compassion contribute directly to clinical outcomes in addition to their effect through enhancing emotion regulation. The significant findings for barriers to (e.g., negative attitudes towards) SC, a relatively less well studied aspect of SC, highlight the possibility that targeting this aspect of SC more directly could improve treatment outcomes for internalizing disorders and STBs.

Table of Contents

Introduction......................................................................................................................................1

Method............................................................................................................................................23

Results ............................................................................................................................................30

Discussion........................................................................................................................................35

References........................................................................................................................................44

Table 1. Operational Definitions of Study Variables..............................................................................63

Table 2. Sample Characteristics...........................................................................................................64

Table 3. Descriptive Statistics of Study Variables..................................................................................65            

Table 4. Correlations between Study Variables.....................................................................................66

Table 5. Regression Table (Aims 1 and 2).............................................................................................67

Figure 1. Mediation Model (Aim 3)......................................................................................................68

Figure 2. Mediation Model (Aim 3)......................................................................................................69

About this Dissertation

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School	Laney Graduate School
Department	Psychology
Subfield / Discipline	Clinical Psychology
Degree	Ph.D.
Submission	Dissertation
Language	English
Research Field	Psychology, Clinical
Keyword	Adolescence Self-compassion Depression Anxiety Emotion regulation
Committee Chair / Thesis Advisor	Linda W. Craighead, PhD, Emory University
Committee Members	Lynne C. Nygaard, PhD, Emory University Allison LoPilato, PhD, Emory University Devon LoParo, PhD, Emory University Elaine Walker, PhD, Emory University

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