The Relationships Between Self-Compassion, Attachment and Interpersonal Problems in Clinical Patients with Mixed Anxiety and Depression and Emotional Distress

Abstract

Self-compassion has been consistently linked to psychological well-being. The ability to be self-compassionate may be shaped by early attachment experiences and associated with interpersonal difficulties. However, evidence has yet to be extended to clinical populations. This study examined the role of self-compassion and its relationship with attachment and interpersonal problems in clinical patients with anxiety and depression. Participants (N = 74; 60% female, mean age 40 years) were recruited from a primary care psychological therapies service in Scotland, UK. Participants completed four self-report questionnaires assessing self-compassion, attachment, interpersonal problems and emotional distress (including depression and anxiety). Low self-compassion, attachment-related avoidance (but not attachment-related anxiety) and high interpersonal problems were all associated with higher levels of emotional distress and anxiety. Low self-compassion and high interpersonal problems were predicted by attachment-related avoidance. Self-compassion mediated the relationship between attachment-related avoidance and emotional distress and anxiety. This was a cross-sectional design and therefore a definitive conclusion cannot be drawn regarding causal relationships between these variables. Self-reported questionnaires were subject to response bias. This study has extended the evidence base regarding the role of self-compassion in patients with clinical levels of depression and anxiety. Notably, our findings indicated that self-compassion may be a particularly important construct, both theoretically and clinically, in understanding psychological distress amongst those with higher levels of attachment avoidance. This study supports the development and practice of psychotherapeutic approaches, such as compassion-focused therapy for which there is a growing evidence base.