"Love Your Neighbor as Yourself": Prevalence and Roles of Self-Compassion and Other-Compassion in Relation to Depression with Empathy as a Mediator in a National Sample of Poles

doi:10.21203/rs.3.rs-4875811/v1

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"Love Your Neighbor as Yourself": Prevalence and Roles of Self-Compassion and Other-Compassion in Relation to Depression with Empathy as a Mediator in a National Sample of Poles

https://doi.org/10.21203/rs.3.rs-4875811/v1

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The Christian commandment to "love your neighbor as yourself" underscores the importance of extending love, compassion, and empathy to oneself and others. However, little is understood regarding the prevalence and disparities in the direction of compassion flow within the general population and its association with mental health. This study aims to assess the prevalence of self-compassion and compassion for others and to explore the model depicting the relationship between compassion flows and depression intensity, with dimensions of empathy hypothesized to mediate this relationship. A representative sample of 604 adult Poles was recruited for this study. Participants completed questionnaires assessing self-compassion, compassion for others, dimensions of empathy, and depression. Structural equation modeling (SEM) was employed to analyze the relationships between the variables. Most participants (60.6%) exhibited greater compassion for others than for themselves (27.6%), while 11.8% reported equal levels of self- and other-compassion. SEM revealed that self-compassion exhibited a stronger, negative relationship with depression, both directly and through the mediation of personal distress. Conversely, compassion for others showed a positive relationship with depression through the mediation of personal distress and a negative relationship through weaker mediation of empathic concern. Overall, individuals tend to demonstrate greater compassion toward others than toward themselves, potentially contributing to elevated levels of depression. These findings suggest that self-compassion serves as a protective factor against depression, whereas compassion for others may have mixed effects, contingent on levels of personal distress and empathic concern.

Psychology

self-compassion

compassion for others

empathy

personal distress

depression

SEM

In times of humanitarian crises, it is common to observe a surge of help extended by individuals who are more fortunate to those impacted by such situations. This has been well documented during events such as the Hurricane Katrina disaster, the 2015 European migrant crisis, and, more recently, during the Russian invasion of Ukraine, when an estimated three million Ukrainian refugees fled to Poland during the first three months of the attack¹ and were received by an estimated 70% of Poles with open arms². Interestingly, some people who engage in prosocial behavior – driven by various motives, such as empathy and compassion for the victims – may consequently experience adverse psychological effects like compassion fatigue, anxiety, depressive symptoms, and burnout³. However, the connection between other-directed attitudes and negative psychological consequences is not fully understood. Moreover, this knowledge is limited as previous research on the effects of compassion toward others has often focused on healthcare workers since their occupations typically require them to be compassionate toward their patients over extended periods. More studies are needed to understand better the interplay between compassion and mental health outcomes, such as depression, particularly in the general population.

Self- and Other-Compassion

Compassion is an awareness of another’s suffering and a motivation to help ease it due to an emotional and/or cognitive reaction to observing it⁴. According to Gilbert⁵, compassion can have different directions toward whom it “flows.” One of these directions of compassion is toward others (other-compassion), and studies showed some beneficial effects on the compassionate individual’s well-being, such as positive affectivity and self-reported happiness⁶. While other-compassion typically brings about positive outcomes for individuals, compassion fatigue can emerge when individuals repeatedly engage in helping or wanting to assist others in distressing situations. Compassion fatigue is characterized as exhaustion and dysfunction across biological, psychological, and social domains, stemming from prolonged exposure to compassion stress and its associated challenges⁷. This condition can manifest in various negative physical and psychological symptoms, including headaches, digestive issues, mood fluctuations, anxiety, and depression⁸. These findings suggest that while compassion is beneficial, solely relying on it without adequate self-care measures may lead to adverse mental health outcomes.

Another direction of compassion flow proposed by Gilbert⁵is self-compassion. Self-compassion shares similar characteristics with other-compassion; however, it is directed inwardly, involving feelings of kindness and concern towards oneself, especially during personal suffering or failure^9,10. The term "self-compassion" was coined by Kristin Neff, who introduced it in 2003¹⁰ building upon research in Buddhist psychology¹¹. Neff delineated three critical components of self-compassion: self-kindness, which involves being kind and gentle to oneself; common humanity, which emphasizes the recognition of shared human experiences; and mindfulness, which entails being present and aware of one's thoughts and feelings¹⁰. Importantly, self-compassion is not inherently self-centered but fosters a connection to the universal human experience¹². Therefore, aside from positively influencing self-focused outcomes like well-being and psychological distress (for meta-analyses, see¹³), self-compassion has also been proposed to enhance other-focused concerns such as compassion for others¹⁴.

However, the understanding of the interaction between other-compassion and self-compassion remains limited due to the scarcity of studies on their relationship. Research outcomes vary, with some indicating small, significant positive correlations between self-compassion and other-compassion (e.g.^15,16), while others find no notable connection (e.g., ^17,18). Recent study by García-Campayo¹⁹ noted a strong positive association between self-compassion and compassion for others, particularly in individuals with good mental health but not those with poor mental health. Both flows of compassion exhibited links to well-being, whereas only self-compassion correlates with reduced psychological distress¹⁹. Recently, Sahdra²⁰, employing an experience sampling approach among patients with diverse diagnoses, revealed a nuanced relationship between self- and other-compassion. While a positive correlation between self-compassion and other-compassion was predominant, notable variations existed across individuals.
These findings underscore the significance of understanding the interplay between self-compassion and other-compassion for mental health outcomes. Additionally, factors such as empathy, particularly its affective component of personal distress, may need to be taken into account as possible mediators when evaluating the relationship between the described flow of compassion and mental health indicators, and the current study was meant to fill this gap in respect to depression intensity.

Compassion, Empathy, and Depression

Compassion and empathy are two distinct constructs, yet they are often used interchangeably, at least within healthcare literatur²¹. Empathy is a complex phenomenon where individuals understand and resonate with others' feelings and thoughts, encompassing both understanding and emotional connection. Empathy is critical for healthy social relationships and essential in therapeutic relationships, accounting for about 10% of psychotherapy outcomes²². Despite its importance for prosocial behavior, empathy is not always beneficial. Recent research²³ suggests a link between empathy and depression. Empathy allows us to understand others' distress, prompting us to offer assistance. However, excessive exposure to others' distress without proper emotional regulation may impede our ability to help effectively. Therefore, empathy is regarded as a contributor to the development of secondary stress disorders²⁴, as it creates vulnerability to stress, emotional exhaustion, and burnout²⁵It is also regarded as a risk factor for depression²⁶, particularly in adolescents²⁷.

These discrepancies in empathic action can be understood in light of its different facets. Empathy is a multidimensional construct²⁸. It is comprised of two other-centered dimensions: perspective taking (PT) – reflection about the emotions and mental states of others, and empathic concern (EC) – involving feelings of compassion and sympathy for another person, and one self-oriented dimension – personal distress (PD)²⁹. The last dimension (PD) refers to a tendency to experience distress and discomfort when observing others’ suffering. Another conceptualization based on research in both behavioral and neuroimaging fields delineates two primary forms of empathic responses. Cognitive empathy entails comprehending and empathizing with the thoughts and motivations of others³⁰, while emotional empathy involves experiencing and resonating with their emotions⁶. Importantly, empathy components yield distinct motivational and behavioral outcomes. Other-focused dimensions often lead to prosocial concerns and actions³¹, aiming to alleviate others' suffering, whereas the self-focused affective response of personal distress tends to prompt withdrawal or avoidance rather than a propensity to assist the suffering individual^24,29. In this context, other-oriented empathy dimensions, particularly empathic concern, closely resemble the construct of compassion toward others. Numerous studies have shown positive associations between other-oriented empathy, particularly its perspective-taking facet, and well-being^32,33.

Conversely, self-oriented personal distress is often negatively correlated with well-being but positively linked to depressive and anxious symptoms^34,35 and burnout syndrome³³. Highly empathetic people may absorb and internalize the negative emotions of others, which may contribute to emotional exhaustion and an increased risk of depression. Indeed, a recent meta-analysis investigating the relationship between empathy and depression shows that affective empathy is significantly associated with depression, in contrast to cognitive empathy, which was uncorrelated²⁷. Neff and Pommier⁹ studied the relationships of self-compassion with dimensions of empathy and found that self-compassion was positively associated with perspective-taking and empathic concern but negatively related to personal distress.

The Present Study

The aim of the current study was two-fold:

Our first aim was to establish the percentage of individuals with relative differences in self- or other-compassion in a representative sample of the Polish adult population. To our knowledge, little research has examined the prevalence of other-compassion and self-compassion in representative samples and evaluated their differences. López¹⁸ reported in a non-representative group of 328 individuals from the general population that most people tended to feel more compassion for others than themselves. Similarly, Knox, Neff, and Davidson³⁶ reported in an unpublished conference paper that 78% of the general US population was more compassionate toward others, whereas only 6% was more compassionate toward themselves. Therefore, it was hypothesized that the level of compassion for others would be higher than the level of self-compassion for most participants.

Our second aim was to evaluate the model of the relationship between self-compassion, other-compassion, and depressive symptoms, with empathy dimensions as mediators of the link between the flow of compassion and depression. Based on previous work discussed above, it was hypothesized that self- and other-compassion would be positively correlated with one another and positively associated with other-focused dimensions of empathy, that is, empathic concern and perspective-taking. Compassion for others would be positively related to personal distress and, through personal distress, would be positively associated with depression. As a growing body of evidence indicates that greater self-compassion is associated with lower depression³⁷, and cultivating self-compassion is beneficial in preventing and reducing depression³⁸, it was hypothesized that higher self-compassion would be related to lower depression. Moreover, this association was expected to be partially mediated through its negative association with personal distress and positive associations with other-oriented components of empathy. It was also expected that personal distress would be the strongest mediator of the link between flows of compassion and depression.

Participants

A representative sample of 604 Poles aged 18–85 (M = 47.93; SD = 14.55), 278 women (46.0%) aged 18–85 (M = 50.30; SD = 13.74) and 326 men (54.0%) aged 18–80 (M = 45.92; SD = 14.93) were recruited by a professional company specializing in nationwide Polish research panels. Table 1 depicts the sociodemographic characteristics of the sample in the current study. The sample was balanced regarding participants’ gender. Most participants lived in villages, had higher education, and were married.

Table 1

*Sociodemographic characteristics of the sample in the current study*
Sociodemographic variables	n	%
Gender
women	278	46.0
men	326	54.0
Place of residence
village	234	38.7
small town (up 20 th. inhabitants)	62	10.3
medium town (20–99 th. inhabitants)	134	22.2
big town (100–500 th. inhabitants)	96	15.9
very big town (more than 500 th. inhabitants)	78	12.9
Education
primary	18	3.0
vocational	60	9.9
secondary	183	30.3
post secondary	57	9.4
higher – bachelor	49	8.1
higher- M.A./engineer	237	39.2
Relationship status
single	97	16.1
informal relationship	103	17.1
married	343	56.8
widow/widower	22	3.6
divorced	41	6.8

Procedure

All data were collected online in April 2021 by a professional company using a nationwide survey panel, which also conducted the recruitment. The company possesses a valid certificate from the Pollsters' Quality Control Program (PKJPA) confirming the high quality of survey services. The Institutional Review Board (IRB) of the authors' institution approved the research protocol. All participants gave informed consent and received points as a reward, which they could exchange for small gifts. The study was not preregistered.

The size of the population, i.e. the number of adults in Poland was equal to 31,142,016 (Statistics Poland, https://stat.gov.pl/en/). The sample consisted of 604 participants. Therefore, the maximum statistical error for prevalence rates is equal to 4.0%.

Measures

Brief version of the Empathic Sensitivity Questionnaire (Brief-ESQ; Woźniak-Prus³⁹). The Brief-ESQ is a 12-item short version of the multidimensional tool, the Empathic Sensitivity Questionnaire, based on Davis' theory and modeled on his Index of Interpersonal Reactivity. It uses a 5-point Likert response format. The cognitive aspect of empathy is represented by the Perspective Taking subscale (4 items), while its emotional aspects are represented by the two subscales: Personal Distress (4 items) and Empathic Concern (4 items). In the current study, Cronbach’s alpha was α = .76 for Empathic Concern, α = .77 for Perspective Taking, and α = .81 for Personal Distress.

Self-compassion Scale – Short Form (SCS-SF⁴⁰, Polish validation by Holas⁴¹) is a 12-item questionnaire evaluating an individual’s self-compassion across its six different subscales (two items each): self-kindness, self-judgment, common humanity, isolation, mindfulness, and overidentification. The measure uses a five-point Likert-type response format, ranging from 1 (almost never) to 5 (almost always). An example item is, “I try to be understanding and patient towards those aspects of my personality I don’t like.” The SCS-SF is a short version of the 26-item Self-Compassion Scale¹⁰. Cronbach's alpha for the present study was .89.

The Santa Clara Brief Compassion Scale (SCBCS⁴²) is a short 5-item version of the Compassionate Love Scale (strangers version;⁴³ that instructs participants to “think about all of humanity or humankind” when answering the questions. A sample item is “I tend to feel compassion for people, even though I do not know them." A 5-point Likert scale was used. The participants gave answers on a scale from 1 – not at all true of me to 5 – very true of me. Cronbach's alpha in the current research was .88.

The Patient Health Questionnaire-9 (PHQ-9 ^18.19; Polish version: www.phqscreeners.com) is a screening tool for assessing the risk of depressive disorders. It consists of nine basic items that refer to the frequency of depressive symptoms (described in the DSM-IV and DSM-V diagnostic criteria) in the last two weeks. The participants give answers on a scale from 0 – not at all to 3 – nearly every day. Cronbach's alpha was .91.

Data analysis

The analysis was based on structural equation modeling. In the first stage, measurement models were acquired. In the next step, the model of mediation was verified. The mediation effects verification was based on user-defined estimands and the bootstrap method. The analysis was performed using AMOS Graphics 26.0 software.

The mean values of the appropriate items were calculated to compare levels of self-compassion and compassion for others. Based on these values, the group of participants with a level of compassion for others higher than self-compassion, the group of participants with a level of self-compassion higher than compassion for others, and the group of participants with an equal level of both were acquired and further compared in terms of percentages.

First, the percentage of individuals with relative differences in self- or other-compassion was established. In most participants, the level of other-compassion was higher than the level of self-compassion (60.6 ± 4%). The opposite was true for 27.6 ± 4% of participants in the current sample. Both were equal in 11.8 ± 4% of cases.

Confirmatory factor analysis was applied to verify the factorial structure of each questionnaire on the studied sample and to identify which items to use in formulating each indicator ⁴⁴. Tables (S1-S6), which include factor loadings for the questionnaires used in the study, are included in the supplement. The unidimensional model of PHQ-9 revealed a good enough fit to the data after including correlations between items no. 43, 44, and 42, between items no. 38 and 39, between items no. 39 and 44 and between items no. 37 and 40. The values of fit indices were equal to CFI = .98, RMSEA = .07. The unidimensional model of personal distress revealed a good enough fit to the data after deleting item no. 12. The values of fit indices were equal to CFI = .99, RMSEA = .08. The unidimensional model of compassion for others revealed a good enough fit to the data after including correlations between items no. 5, 1, and 3 and between items no. 3 and 4. The values of fit indices were equal to CFI = .99, RMSEA = .05. The unidimensional model of self-compassion scale revealed a good enough fit to the data after including correlations between items no. 3 and 7, 2 and 10, 8 and 9, 11 and 12, 2 and 6. The values of fit indices were equal to CFI = .90, RMSEA = .08. The unidimensional model of perspective-taking revealed a good enough fit. The values of fit indices were equal to CFI = .99, RMSEA = .08. Finally, the unidimensional model of empathic concern revealed also a good enough fit. The values of fit indices were equal to CFI = .99, RMSEA = .08.

In the next stage, the structural model of mediation was verified. No statistically significant correlation between self-compassion and other-compassion was detected (r = − .091, p > .05), so it was not included in the model. The preliminary model is depicted in Fig. 1.

Figure 1. The verified model of mediation.

--------------------------Insert Fig. 1--------------------------

Personal distress, perspective-taking, and empathic concern were analyzed as mediators of the relationship between other-compassion and depression and between self-compassion and depression. However, there were no statistically significant relationships between self-compassion and empathic concern, B = − .06, p > .05, and between perspective-taking and depression, B = .11, p > .05. Since perspective-taking was not significantly related to depression symptoms, it could not be a mediator, and was thus removed from the model. The insignificant relationship between self-compassion and empathic concern was also removed. The final model is depicted in Fig. 2.

Figure 2. The final model of relationships between analyzed variables.

--------------------------Insert Fig. 2--------------------------

The fit of the model to the data was adequate. The values of fit indices were equal to CFI = .90, RMSEA = .06.

The tests for indirect effects based on the bootstrap method revealed that the relationship between compassion for others and depression symptoms was mediated by personal distress, B = [.01; .08], p < .01, and by empathic concern, B = [-.15; − .02], p < .05. The relationship between self-compassion and depression was mediated by personal distress, B = [-4.39; − .47], p < .05. Table 2 presents standardized regression coefficients acquired in the analysis.

Table 2

Results of structural equation modelling regarding structural model
Relationships				B		p
Personal distress	<---		Compassion to others	.11		.002
Personal distress	<---		Self-compassion	− .78		.001
Empathic concern <--		Compassion for others			.83		.001
Depression	<---		Personal distress	.32		.001
Depression	<--		Empathic concern	− .13		.002
Depression	<---		Self-compassion	− .31		.008
B – standardized regression coefficient; p – statistical significance

Other-compassion was positively related to personal distress, while self-compassion was negatively related. Personal distress, in turn, was positively related to the intensity of depression. The higher compassion for others and the lower self-compassion, the higher personal distress and, consequently, the higher the intensity of depression. Also, compassion for others was positively related to empathic concern, which in turn was negatively related to depression. The correlation between self-compassion and compassion for others was also verified, and it was statistically insignificant, r = -0.09, p > 0.05. Therefore, it was not included in the model. The verified model of mediation explained 38.5% of depression variance.

Moreover, 95% confidence intervals for the relationships between explaining variables and personal distress were equal to [.03; .21] for compassion for others and equal to [-.84; − .70] for self-compassion. The absolute values for self-compassion were significantly higher than those for compassion for others (the confidence intervals do not overlap), meaning that the relationship between self-compassion and personal distress is significantly stronger than the relationship between compassion for others and personal distress. All examined variables were included in a single statistical model, meaning that the regression coefficient values were adjusted depending on correlations between analyzed variables. Therefore, the results show that when the level of other-compassion remains constant, the higher self-compassion leads to a decrease in personal distress and, as a consequence, a lower level of depression. On the other hand, when self-compassion remains constant, the higher level of other-compassion leads to greater personal distress and consequently higher levels of depression, but this process is significantly weaker.

The first purpose of the present study was to establish the percentage of individuals who tend to be more compassionate for others than for themselves, the percentage of people with the opposite pattern, and those with equal levels of compassion flow toward themselves and others in a representative sample of the Polish population. The second aim was to verify the model of the relationship between flows of compassion and depression with dimensions of empathy hypothesized to act as mediators of this relationship.

Regarding the first aim, following expectations, it was found that most of the sample (60.6%) exhibited more other-compassion than self-compassion. The percentage of those who tend to be more compassionate toward other people than toward themselves was more than twice as high as the percentage of those with a relative predominance of self-compassion over other-compassion (27.6%) and nearly six times higher over those with equal levels of self- and other-compassion (11.8%). These findings align with those of Lópe¹⁸ and the unpublished work of Knox³⁶ on a convenience sample of US citizens. To the best of the authors’ knowledge, the present research is the first to evaluate the relative differences between the flows of compassion in a representative sample of the population.

The critical question arises as to why more people are compassionate toward others than themselves. This finding seems striking when looking at the roots of Christianity and, hence, European culture. The saying "Love thy neighbor as thyself" is well-known and is considered one of the greatest biblical commandments in the New Testament of the Christian Bible (New International Version, 2011, Mt 22:36–40). Note that Polish society is overwhelmingly Christian, and despite the increasing secularization in Poland and other Western countries in recent years, Christianity is still considered the cultural foundation for societies in the West. The command to "love your neighbor as yourself" emphasizes the importance of showing love, compassion, and empathy not only to oneself but also to others, in the same proportion as to oneself. It is often interpreted as a guiding principle for ethical behavior and interpersonal relationships, promoting kindness, empathy, and altruism toward others. However, as was found in the current study, most people tend to be more compassionate to others than themselves.

Moreover, the results indicate that this unbalanced proportion of the flow of compassion might be related to depression. These results seem to suggest the importance of the inversion of the biblical commandment – that it would be beneficial to love oneself as one loves one's neighbors. However, upon closer inspection of this fundamental Christian commandment through the lens of the current findings, it can be viewed as a reminder to have a balanced flow of compassion. Importantly, recent research by Sahdra²⁰– using experience sampling methodology – supported this point. They found that the degree of self-other harmony moderated the link between compassion directed toward the self or others and well-being. That is, elevated levels of compassion were associated with higher levels of well-being, but only for those who experienced self-other harmony (alignment of two distinct forms of compassion). When other- and self-compassion were not in harmony, levels of self-/other-compassion were largely unrelated to well-being²⁰.

Still, why do most people tend to be more compassionate to others than themselves? Perhaps Paul Gilbert⁵ are right when they suggested that this phenomenon may be due to an inherent fear of compassion, making it easier to be compassionate for others than oneself. More research is needed to answer this question.

Relationships between Self-compassion, Other-compassion, and Depressive Symptoms

Next, using structural equation analysis, models that linked compassion flows with depression via mediation of empathy components were tested. First, in the model with the best fit, there was a lack of a significant relationship between other-compassion and self-compassion, which is in line with several prior studies that also found no correlation between these flows of compassion (e.g.⁴⁵). However, this finding contrasts the findings of studies that reported a significant positive association between these constructs^9,46. Several factors, including different psychometric measures, might cause these discrepancies. It should also be noted that the present results are based on between-person analyses and may not accurately reflect the nuanced relationship between self- and other-compassion on within-person level, as Sahdra²⁰ described recently. It is plausible to state that this relationship self- and other compassion is significantly positive for some individuals but not for others.

As predicted, self-compassion had a significant negative relationship with depression, which aligns with the findings of Krieger⁴⁷. Whereas, in the case of the relationship between other-compassion and depression, there was no significant correlation between these constructs. While this finding is contrary to those of prior studies⁴⁸ in which compassion for others was negatively related to depression, it is consistent with the findings of Saarinen⁴⁹, who observed a negative relationship between dispositional compassion for others and depressive symptoms among young adults but also found no correlation among middle-aged participants. Note that the mean age of participants in the current study was 48.

Next, it was evaluated whether dimensions of empathy serve as mediators between self- and other-compassion and depression. Previous research demonstrated that perspective-taking was positively related to self-compassion^9,50 and other-compassion⁵¹ and negatively related to symptoms of depression⁵². Contrary to expectations, the structural equation modeling analysis did not show significant results for perspective-taking as a mediator between self- or other-compassion and depression. However, both empathic concern and personal distress acted as mediators of the relationship between compassion flows and depression. As was expected and in line with previous work⁵² empathic concern was positively related to other-compassion and negatively to depression. However, contrary to previous research⁵⁰ and the authors’ hypothesis, empathic concern was unrelated to self-compassion. Empathic concern resembles the concept of compassion for others, as it involves the emotional response to others' suffering, such as compassion, sympathy, or tenderness toward a person in pain. However, compassion is a broader orientation toward suffering, encompassing the emotional response to others' distress and the recognition of their inherent dignity and worth. According to Gilbert⁵, compassion involves a deep understanding of the universality of suffering and a commitment to relieving it with kindness, empathy, and nonjudgmental acceptance. It seems that empathic concern mediates the link between other-compassion and depression and may, through associated positive feelings, alleviate depressive symptoms. This assumption requires further research, preferably using experimental methods.

Results of the current study, showed that personal distress has the strongest contribution to depression intensity and acts as a mediator between both flows of compassion and depression. However, other- and self-compassion differed concerning the strength and direction of this relationship. Other-compassion was positively related to personal distress, which was, in turn, positively related to depression. This result supports the findings of Li⁵², who demonstrated that personal distress had the highest positive bridge expected influence on depression (empathic concern had the highest negative bridge expected influence) in a network analysis of the relationship between empathy and depression. Self-compassion, on the other hand, was strongly negatively related to personal distress and, through this relationship, lowered depressive intensity. This is consistent with the findings of Neff and Pommier⁵⁰, who also reported a negative relationship between self-compassion and personal distress.

Previous research reported a negative relationship between self-compassion and depression. However, the mechanisms of this effect are unclear. One possibility is that self-compassion might relate to lower depressive symptoms by protecting against the increase in self-judging responses⁵³. Individuals high in self-compassion are less likely to engage in negative self-talk and self-blame, which are common cognitive patterns associated with depression⁴⁷. By reducing self-criticism, self-compassion helps individuals break the cycle of rumination and negative thinking that can exacerbate depressive symptoms. By fostering a compassionate and accepting attitude toward oneself, individuals can interrupt the cycle of rumination and reduce the maintenance of depressive symptoms. Furthermore, by cultivating a positive and supportive relationship with oneself, self-compassion is a source of strength and resilience in the face of adversity, which otherwise may trigger or exaggerate depressive symptoms.

Summary and Clinical Implications

The current findings suggest that self-compassion and other-compassion vary in their relationships with depressive symptom severity. Generally, it was found that self-compassion had a stronger and negative relationship with depression, both directly and through mediation of personal distress. Other compassion has both a positive (through the mediation of personal distress) and a negative (through the weaker mediation of emphatic concern) relationship with depression. Therefore, current findings suggest that self-compassion may have a protective role against the possible negative consequences of compassion for others in the form of depression. Similarly, Wiklund¹⁴ suggested that self-compassion may protect from compassion fatigue – the negative consequence of exaggerated compassion for others. Present findings suggest, as well, the importance of integrating self-compassion practices in tandem with other-compassion as a means of abating the effect of personal distress on depressive symptoms.

The findings from this study have several important clinical implications for therapy and understanding the relationships between self-compassion, other-compassion, empathy, and depressive symptom severity. Providing psychoeducation about the protective role of self-compassion against depression can empower individuals to cultivate self-compassion as part of their self-care practices. Clinicians working with individuals experiencing depressive symptoms may consider implementing interventions that specifically target self-compassion skills. Enhancing self-compassion can serve as a protective factor against depression by directly reducing symptom severity and mitigating personal distress. Interventions such as mindfulness-based therapies and compassion-focused therapy may be particularly beneficial in cultivating self-compassion¹³. Clinicians should also assess both self-compassion and other-compassion when working with individuals experiencing depressive symptoms. Understanding the differential effects of these two forms of compassion on depression can inform treatment planning and intervention strategies. Assessing levels of personal distress and empathic concern can provide insights into how individuals respond to the suffering of others and their own emotional experiences. Clinicians should help individuals balance compassion for others and self-compassion to prevent the potential negative consequences of empathic distress. While compassion for others is important to empathy and prosocial behavior, excessive empathy and caretaking can lead to emotional exhaustion and burnout. Encouraging individuals to practice self-compassion can help offset the emotional toll of caring for others and reduce the risk of depression⁵⁴.

Limitations and FutureDirections

This study has several limitations. The cross-sectional design limits definitive causal inferences. However, drawing from established evidence, it can be inferred that self-compassion likely influences depression. Previous randomized controlled trials have demonstrated the efficacy of compassion-focused interventions in alleviating psychological distress across diverse populations¹³. Nevertheless, the precise causal link between low self-compassion, compassion for others, dimensions of empathy, and depression remains unresolved. Moreover, this study's reliance on self-reported measures introduces potential biases, as participants were not subject to clinical evaluations or objective assessments with experimental tasks. Therefore, caution is warranted when interpreting these findings, as they may not fully capture the complexities of individuals' experiences with both kinds of compassion and empathy and their implications for mental health. Furthermore, these results are based on between-person analyses and may not accurately reflect the nuanced relationship between self- and other-compassion as described in Sahdra²⁰. Future studies may benefit from using the ecological momentary assessment (EMA) method to establish within-person dynamics of the relationships between these variables. Still, the current research brings about crucial new knowledge regarding understanding the relationships between self-compassion, other-compassion, empathy, and depression, which has practical implications individually and societally.

Author contributions

P.H.—conceptualization, methodology, funding acquisition, statistical analyses, writing original draft; P.R. – data collection, statistical analyses, writing—original draft; All authors reviewed the final draft of the manuscript.

Funding

The research was financed by the funds from the Faculty of Psychology at the University of Warsaw awarded by the Polish Ministry of Science and Higher Education in the form of a subvention for maintaining and developing research potential in 2020.

Data Availability

The raw data are available at https://osf.io/fr2g7/.

Competing interests

The authors declare no competing interests.

All methods were carried out in accordance with relevant guidelines and regulations.

Duszczyk M, Kaczmarczyk P (2022) The War in Ukraine and Migration to Poland: Outlook and Challenges. Intereconomics 57:164–170
Polish Economic Institute (2022) Poland has spent 1% of its GDP helping refugees from Ukraine in the first months of the war. Polish Economic Institute. https://pie.net.pl/en/poland-has-spent-1-of-its-gdp-helping-refugees-from-ukraine-in-the-first-months-of-the-war/
Abendroth M, Flannery J (2006) Predicting the Risk of Compassion Fatigue. J Hospice Palliat Nurs 8:346–356
Strauss C et al (2016) What is compassion and how can we measure it? A review of definitions and measures. Clin Psychol Rev 47:15–27
Gilbert P (2015) The Evolution and Social Dynamics of Compassion. Soc Personal Psychol Compass 9:239–254
Singer T, Klimecki OM (2014) Empathy and compassion. Curr Biol 24:R875–R878
Figley CR (1995) Compassion Fatigue: Toward a New Understanding of the Costs of Caring. In B. H. Stamm (Ed.) Compassion Fatigue: Toward a New Understanding of the Costs of Caring. In B. H. Stamm (Ed.), Secondary Traumatic Stress: Self-Care Issues for Clinicians, Researchers, and EducatorsThe Sidran Press
Lombardo B, Eyre C, Compassion Fatigue (2011) A Nurse’s Primer. OJIN: Online J Issues Nurs. 10.3912/OJIN.Vol16No01Man03
NEFF K (2003) Self-Compassion: An Alternative Conceptualization of a Healthy Attitude Toward Oneself. Self Identity 2:85–101
NEFF KD (2003) The Development and Validation of a Scale to Measure Self-Compassion. Self Identity 2:223–250
Bennett-Goleman T (2001) How Your Mind Can Heal Your Heart
Neff K, Seppälä E (2016) Compassion, Well-Being, and the Hypo-Egoic Self, vol 1. Oxford University Press
Kirby JN, Tellegen CL, Steindl SR (2017) A Meta-Analysis of Compassion-Based Interventions: Current State of Knowledge and Future Directions. Behav Ther 48:778–792
Wiklund Gustin L, Wagner L (2013) The butterfly effect of caring – clinical nursing teachers’ understanding of self-compassion as a source to compassionate care. Scand J Caring Sci 27:175–183
Ari E, Cesur-Soysal G, Basran J, Gilbert P (2022) The Compassionate Engagement and Action Scales for Self and Others: Turkish Adaptation, Validity, and Reliability Study. Front Psychol 13
Gu J, Baer R, Cavanagh K, Kuyken W, Strauss C (2020) Development and Psychometric Properties of the Sussex-Oxford Compassion Scales (SOCS). Assessment 27:3–20
Durkin M, Beaumont E, Hollins Martin CJ, Carson J (2016) A pilot study exploring the relationship between self-compassion, self-judgement, self-kindness, compassion, professional quality of life and wellbeing among UK community nurses. Nurse Educ Today 46:109–114
López A, Sanderman R, Ranchor AV, Schroevers MJ (2018) Compassion for Others and Self-Compassion: Levels, Correlates, and Relationship with Psychological Well-being. Mindfulness (N Y) 9:325–331
García-Campayo J et al (2023) Exploring the Relationship Between Self-Compassion and Compassion for Others: The Role of Psychological Distress and Wellbeing. Assessment. 10.1177/10731911231203966
Baljinder K, Sahdra1* JCM, I. F. K. (2023) Y. E. H. S. C. H. S. G. H. & A. T. G. The Compassion Balance: Understanding the Interrelation of Self- and Other-Compassion for Optimal Well-being. In press at Mindfulness
Sinclair S et al (2017) Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences. Palliat Med 31:437–447
Lambert MJ, Barley DE (2001) Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy 38:357–361
Tully EC, Ames AM, Garcia SE, Donohue MR (2016) Quadratic Associations Between Empathy and Depression as Moderated by Emotion Dysregulation. J Psychol 150:15–35
Decety J, Lamm C (2009) Empathy versus Personal Distress: Recent Evidence from Social Neuroscience. in The Social Neuroscience of Empathy 199–214The MIT Press, 10.7551/mitpress/9780262012973.003.0016
Figley CR (2002) Compassion fatigue: Psychotherapists’ chronic lack of self care. J Clin Psychol 58:1433–1441
Melillo S et al (2014) EPA-0168 – Can depression affect empathy? Eur Psychiatry 29:1
Yan Z, Zeng X, Su J, Zhang X (2021) The dark side of empathy: Meta-analysis evidence of the relationship between empathy and depression. Psych J 10:794–804
Singer T, Lamm C (2009) The Social Neuroscience of Empathy. Ann N Y Acad Sci 1156:81–96
Davis MH (1983) Measuring individual differences in empathy: Evidence for a multidimensional approach. J Pers Soc Psychol 44:113–126
Dvash J, Shamay-Tsoory SG (2014) Theory of Mind and Empathy as Multidimensional Constructs. Top Lang Disord 34:282–295
(PDF) The empathy-altruism hypothesis. https://www.researchgate.net/publication/313391047_The_empathy-altruism_hypothesis
Choi D, Minote N, Sekiya T, Watanuki S (2016) Relationships between Trait Empathy and Psychological Well-Being in Japanese University Students. Psychology 07:1240–1247
Holas P G. M., W. N., K. G., & Ł. E. Relationship of burnout with empathy dimensions in healthcare workers in Poland during the COVID-19 pandemic (accepted). Health Psychol Rep
Gambin M et al (2021) Investigation of prospective effects of emotion-regulation difficulties and empathic dimensions on depressive symptoms during the COVID-19 outbreak in poland. Eur Psychiatry 64:S255–S255
Gupta M, Das, Basu A, Thakurta R (2022) Re-examining the relationship between interpersonal reactivity index sub-scales and mental well-being: Implications of the pandemic. Acta Psychol (Amst) 228:103621
Knox M N. K. & D. O. Comparing compassion for self and others: Impacts on personal and interpersonal well-being. Paper presented at the 14th Annual Association for Contextual Behavioral Science World Conference,. in Seattle, WA.
Leary MR, Tate EB, Adams CE, Batts Allen A, Hancock J (2007) Self-compassion and reactions to unpleasant self-relevant events: The implications of treating oneself kindly. J Pers Soc Psychol 92:887–904
Shapira LB, Mongrain M (2010) The benefits of self-compassion and optimism exercises for individuals vulnerable to depression. J Posit Psychol 5:377–389
Woźniak-Prus M (2024) G. M., S. M., C. A., P. E., K. E.,. .. & K. G. Positive experiences in the parent–child relationship during the COVID‐19 lockdown in Poland: The role of emotion regulation, empathy, parenting self‐efficacy, and social support. Fam Process,. 443–468
Bratt A, Fagerström C (2020) Self-compassion in old age: confirmatory factor analysis of the 6-factor model and the internal consistency of the Self-compassion scale-short form. Aging Ment Health 24:642–648
Holas P S. J., R. M., K. I., N. J., J. T. (in press). The Polish adaptation of the Self-Compassion Scale Short Form. Psychiatria Polska. PP-00115-2022-01
Hwang JY, Plante T, Lackey K (2008) The Development of the Santa Clara Brief Compassion Scale: An Abbreviation of Sprecher and Fehr’s Compassionate Love Scale. Pastoral Psychol 56:421–428
Sprecher S, Fehr B (2005) Compassionate love for close others and humanity. J Soc Pers Relat 22:629–651
Byrne BM (2016) Structural Equation Modeling With AMOS (Multivariate Applications Series). in (ed. Taylor and Francis.)
Grynberg D, López-Pérez B (2018) Facing others’ misfortune: Personal distress mediates the association between maladaptive emotion regulation and social avoidance. PLoS ONE 13:e0194248
Cha JE, Serlachius AS, Kirby JN, Consedine NS (2023) What Do (and Don’t) We Know About Self-Compassion? Trends and Issues in Theory, Mechanisms, and Outcomes. Mindfulness (N Y) 14:2657–2669
Krieger T, Altenstein D, Baettig I, Doerig N, Holtforth MG (2013) Self-Compassion in Depression: Associations With Depressive Symptoms, Rumination, and Avoidance in Depressed Outpatients. Behav Ther 44:501–513
Frick A, Thinnes I, Hofmann SG, Windmann S, Stangier U (2021) Reduced Social Connectedness and Compassion Toward Close Others in Patients With Chronic Depression Compared to a Non-clinical Sample. Front Psychiatry 12
Saarinen A et al (2019) The relationship of dispositional compassion for others with depressive symptoms over a 15-year prospective follow-up. J Affect Disord 250:354–362
Neff KD, Pommier E (2013) The Relationship between Self-compassion and Other-focused Concern among College Undergraduates, Community Adults, and Practicing Meditators. Self Identity 12:160–176
Oveis C, Horberg EJ, Keltner D (2010) Compassion, pride, and social intuitions of self-other similarity. J Pers Soc Psychol 98:618–630
Li J et al (2022) The relationship between dimensions of empathy and symptoms of depression among university students during the COVID-19 pandemic: A network analysis. Front Public Health 10
Dundas I, Svendsen JL, Wiker AS, Granli KV, Schanche E (2016) Self-compassion and depressive symptoms in a Norwegian student sample. Nord Psychol 68:58–72
Neff KD, McGehee P (2010) Self-compassion and Psychological Resilience Among Adolescents and Young Adults. Self Identity 9:225–240

The authors declare no competing interests.

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"Love Your Neighbor as Yourself": Prevalence and Roles of Self-Compassion and Other-Compassion in Relation to Depression with Empathy as a Mediator in a National Sample of Poles

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