Abstract
Objectives
This study examined the efficacy of a brief online self-compassion training in reducing explicit and implicit self-criticism, pain endurance, and inclination to engage in self-harm among non-suicidal self-injury (NSSI) engagers and ideators.
Methods
Sixty-three adults reporting presence of self-injurious thoughts or behaviors in the past year were randomly assigned to either a one-week self-compassion training group or a waitlisted control group.
Results
As compared to the control group (n = 33), the training group (n = 30) yielded significantly greater reduction in explicit self-criticism after a single session (p = .013, partial η2 = .101) and significantly greater reduction in self-criticism (p = .001, partial η2 = .170), and pain endurance (p = .004, partial η2 = .130), as well as the explicit inclination to self-injure (p = .051, partial η2 = .063) after the one-week training. The reduction in explicit self-criticism (p = .006, partial η2 = .155) and inclination to self-injure (p = .04, partial η2 = .105) was maintained at the two-week follow-up.
Conclusions
The findings provide suggestive evidence supporting the use of an online self-compassion training in reducing self-criticism and pain endurance in NSSI ideators. This study supports the potential use of brief online trainings in order to improve accessibility and adherence of treatment especially for individuals suffering from highly stigmatized conditions such as self-harm.



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Data Availability
All data have been made publicly available at Mendeley Data, V1, and can be accessed at [http://dx.doi.org/10.17632/j6k24wcj7k.1].
References
Albertson, E. R., Neff, K. D., & Dill-Shackleford, K. E. (2015). Self-compassion and body dissatisfaction in women: A randomized controlled trial of a brief meditation intervention. Mindfulness, 6(3), 444–454. https://doi.org/10.1007/s1267one-014-0277-3
Armey, M. F., Crowther, J. H., & Miller, I. W. (2011). Changes in ecological momentary assessment reported affect associated with episodes of nonsuicidal self-injury. Behavior Therapy, 42(4), 579–588. https://doi.org/10.1016/J.BETH.2011.01.002
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The hopelessness scale. Journal of Consulting and Clinical Psychology, 42(6), 861–865. https://doi.org/10.1037/H0037562
Bernstein, M. J., & Claypool, H. M. (2012). Social exclusion and pain sensitivity: Why exclusion sometimes hurts and sometimes numbs. Personality and Social Psychology Bulletin, 38(2), 185–196. https://doi.org/10.1177/0146167211422449
Britton, W. B., Bootzin, R. R., Cousins, J. C., Hasler, B. P., Peck, T., & Shapiro, S. L. (2010). The contribution of mindfulness practice to a multicomponent behavioral sleep intervention following substance abuse treatment in adolescents: A treatment-development study. Substance Abuse, 31(2), 86–97. https://doi.org/10.1080/08897071003641297
Cȃndea, D. M., & Szentágotai-Tătar, A. (2018). The impact of self-compassion on shame-proneness in social anxiety. Mindfulness, 9(6), 1816–1824. https://doi.org/10.1007/s12671-018-0924-1
Ehret, A. M., Joormann, J., & Berking, M. (2018). Self-compassion is more effective than acceptance and reappraisal in decreasing depressed mood in currently and formerly depressed individuals. Journal of Affective Disorders, 226, 220–226. https://doi.org/10.1016/j.jad.2017.10.006
Forgione, A. G., & Barber, T. X. (1971). A strain gauge pain stimulator. Psychophysiol, 8(1), 102–106. https://doi.org/10.1111/J.1469-8986.1971.TB00441.X
Fox, K. R., Ribeiro, J. D., Kleiman, E. M., Hooley, J. M., Nock, M. K., & Franklin, J. C. (2018). Affect toward the self and self-injury stimuli as potential risk factors for nonsuicidal self-injury. Psychiatry Research, 260, 279–285. https://doi.org/10.1016/J.PSYCHRES.2017.11.083
Fox, K. R., Toole, K. E., Franklin, J. C., & Hooley, J. M. (2017). Why does nonsuicidal self-injury improve mood? A preliminary test of three hypotheses. Clinical Psychological Science, 5(1), 111–121. https://doi.org/10.1177/2167702616662270
Franklin, J. C., Fox, K. R., Franklin, C. R., Kleiman, E. M., Ribeiro, J. D., Jaroszewski, A. C., Hooley, J. M., & Nock, M. K. (2016). A brief mobile app reduces nonsuicidal and suicidal self-injury: Evidence from three randomized controlled trials. Journal of Consulting and Clinical Psychology, 84(6), 544–557. https://doi.org/10.1037/CCP0000093
Gilbert, P. (2010). Compassion Focused Therapy: The CBT Distinctive Features Series. Routledge London UK. https://doi.org/10.4324/9780203851197
Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13(6), 353–379. https://doi.org/10.1002/cpp.507
Glassman, L. H., Weierich, M. R., Hooley, J. M., Deliberto, T. L., & Nock, M. K. (2007). Child maltreatment, non-suicidal self-injury, and the mediating role of self-criticism. Behaviour Research and Therapy, 45(10), 2483–2490. https://doi.org/10.1016/J.BRAT.2007.04.002
Glenn, J. J., Michel, B. D., Franklin, J. C., Hooley, J. M., & Nock, M. K. (2014). Pain analgesia among adolescent self-injurers. Psychiatry Research, 220(3), 921–926. https://doi.org/10.1016/J.PSYCHRES.2014.08.016
TM Glück A Maercker 2011 A randomized controlled pilot study of a brief web-based mindfulness training BMC Psychiatry 11 https://doi.org/10.1186/1471-244X-11-175
Gregory, W. E., Glazer, J. V., & Berenson, K. R. (2017). Self-compassion, self-injury, and pain. Cognitive Therapy and Research, 41(5), 777–786. https://doi.org/10.1007/s10608-017-9846-9
Hamza, C. A., Willoughby, T., & Armiento, J. (2014). A laboratory examination of pain threshold and tolerance among nonsuicidal self-injurers with and without self-punishing motivations. Archives of Scientific Psychology, 2(1), 33–42. https://doi.org/10.1037/ARC0000008
Harrison, D. P., Stritzke, W. G. K., Fay, N., Mark Ellison, T., & Hudaib, A. R. (2014). Probing the implicit suicidal mind: Does the death/suicide implicit association test reveal a desire to die, or a diminished desire to live? Psychological Assessment, 26(3), 831–840. https://doi.org/10.1037/PAS0000001
Heath, N. L., Carsley, D., De Riggi, M. E., Mills, D., & Mettler, J. (2016). The relationship between mindfulness, depressive symptoms, and non-suicidal self-injury amongst adolescents. Archives of Suicide Research, 20(4), 635–649. https://doi.org/10.1080/13811118.2016.1162243
Hooley, J. M., & Delgado, M. L. (2001). Pain insensitivity in the relatives of schizophrenia patients. Schizophrenia Research, 47(2–3), 265–273. https://doi.org/10.1016/S0920-9964(00)00064-5
Hooley, J. M., Fox, K. R., Wang, S. B., & Kwashie, A. N. D. (2018). Novel online daily diary interventions for nonsuicidal self-injury: A randomized controlled trial. BMC Psychiatry, 18, 264. https://doi.org/10.1186/s12888-018-1840-6
Hooley, J. M., & Franklin, J. C. (2018). Why do people hurt themselves? A new conceptual model of nonsuicidal self-injury. Clinical Psychological Science, 6(3), 428–451. https://doi.org/10.1177/2167702617745641
Hooley, J. M., Ho, D. T., Slater, J., & Lockshin, A. (2010). Pain perception and nonsuicidal self-injury: A laboratory investigation. Personality Disorders: Theory, Research, and Treatment, 1(3), 170–179. https://doi.org/10.1037/a0020106
Hooley, J. M., & St Germain, S. A. (2014). Nonsuicidal self-injury, pain, and self-criticism: Does changing self-worth change pain endurance in people who engage in self-injury? Clinical Psychological Science, 2(3), 297–305. https://doi.org/10.1177/2167702613509372
Johnson, E. A., & O’Brien, K. A. (2013). Self-compassion soothes the savage ego-threat system: Effects on negative affect, shame, rumination, and depressive symptoms. Journal of Social and Clinical Psychology, 32(9), 939–963. https://doi.org/10.1521/JSCP.2013.32.9.939
Kelly, A. C., & Carter, J. C. (2015). Self-compassion training for binge eating disorder: A pilot randomized controlled trial. Psychology and Psychotherapy: Theory, Research, and Practice, 88(3), 285–303. https://doi.org/10.1111/papt.12044
Kharsati, N., & Bhola, P. (2015). Patterns of non-suicidal self-injurious behaviours among college students in India. International Journal of Social Psychiatry, 61(1), 39–49. https://doi.org/10.1177/0020764014535755
Latimer, S., Meade, T., & Tennant, A. (2013). Measuring engagement in deliberate self-harm behaviours: Psychometric evaluation of six scales. BMC Psychiatry, 13(4), 1–11. https://doi.org/10.1186/1471-244X-13-4
Leary, M. R., Tate, E. B., Adams, C. E., Allen, A. B., & Hancock, J. (2007). Self-compassion and reactions to unpleasant self-relevant events: The implications of treating oneself kindly. Journal of Personality and Social Psychology, 92(5), 887–904. https://doi.org/10.1037/0022-3514.92.5.887
Lebel, E. P., & Paunonen, S. V. (2011). Sexy but often unreliable: The impact of unreliability on the replicability of experimental findings with implicit measures. Personality and Social Psychology Bulletin, 37(4), 570–583. https://doi.org/10.1177/0146167211400619
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U
MacDonald, G. (2008). Use of pain threshold reports to satisfy social needs. Pain Research & Management, 13(4), 309–319. https://doi.org/10.1155/2008/289575
Mori, K., & Uchida, A. (2015). Paper-based affect misattribution procedure for implicit measurement. Psychology, 06(12), 1531–1538. https://doi.org/10.4236/PSYCH.2015.612149
Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101. https://doi.org/10.1080/15298860309032
Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860309027
Neff, K. D. (2016). Does self-compassion entail reduced self-judgment, isolation, and over-identification? A response to muris, otgaar, and petrocchi (2016). Mindfulness. https://doi.org/10.1007/s12671-016-0531-y
Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28–44. https://doi.org/10.1002/jclp.21923
Nock, M. K. (2009). Why do people hurt themselves?: New insights into the nature and functions of self-injury. Current Directions in Psychological Science, 18(2), 78–83. https://doi.org/10.1111/J.1467-8721.2009.01613.X
Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885. https://doi.org/10.1037/0022-006X.72.5.885
Nock, M. K., Holmberg, E. B., Photos, V. I., & Michel, B. D. (2007). Self-injurious thoughts and behaviors interview: Development, reliability, and validity in an adolescent sample. Psychological Assessment, 19(3), 309–317. https://doi.org/10.1037/1040-3590.19.3.309
Payne, B. K., Cheng, C. M., Govorun, O., & Stewart, B. D. (2005). An inkblot for attitudes: Affect misattribution as implicit measurement. Journal of Personality and Social Psychology, 89(3), 277–293. https://doi.org/10.1037/0022-3514.89.3.277
Podsakoff, P. M., MacKenzie, S. B., & Podsakoff, N. P. (2012). Sources of method bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63, 539–569. https://doi.org/10.1146/annurev-psych-120710-100452
Shapira, L. B., & Mongrain, M. (2010). The benefits of self-compassion and optimism exercises for individuals vulnerable to depression. Journal of Positive Psychology, 5(5), 377–389. https://doi.org/10.1080/17439760.2010.516763
Sirois, F. M., Kitner, R., & Hirsch, J. K. (2015). Self-compassion, affect, and health-promoting behaviors. Health Psychology, 34(6), 661–669. https://doi.org/10.1037/HEA0000158
Sornberger, M. J., Heath, N. L., Toste, J. R., & McLouth, R. (2012). Nonsuicidal self-injury and gender: Patterns of prevalence, methods, and locations among adolescents. Suicide and Life-Threatening Behavior, 42(3), 266–278. https://doi.org/10.1111/j.1943-278X.2012.0088.x
St. Germain, S. A. & Hooley, J. M. (2013). Aberrant pain perception in direct and indirect non-suicidal self-injury: An empirical test of Joiner’s interpersonal theory. Comprehensive Psychiatry, 54(6), 694-701. https://doi.org/10.1016/J.COMPPSYCH.2012.12.029
Tang, J., Yu, Y., Wu, Y., Du, Y., Ma, Y., Zhu, H., Zhang, P., & Liu, Z. (2011). Association between non-suicidal self-injuries and suicide attempts in Chinese adolescents and college students: A cross-section study. PLoS ONE, 6(4), e17977. https://doi.org/10.1371/journal.pone.0017977
Taylor, P. J., Jomar, K., Dhingra, K., Forrester, R., Shahmalak, U., & Dickson, J. M. (2018). A meta-analysis of the prevalence of different functions of non-suicidal self-injury. Journal of Affective Disorders, 227, 759–769. https://doi.org/10.1016/j.jad.2017.11.073
Toole, A. M., & Craighead, L. W. (2016). Brief self-compassion meditation training for body image distress in young adult women. Body Image, 19, 104–112. https://doi.org/10.1016/j.bodyim.2016.09.001
Trompetter, H. R., de Kleine, E., & Bohlmeijer, E. T. (2017). Why does positive mental health buffer against psychopathology? An exploratory study on self-compassion as a resilience mechanism and adaptive emotion regulation strategy. Cognitive Therapy and Research, 41(3), 459–468.
Wakelin, K. E., Perman, G., & Simonds, L. M. (2022). Effectiveness of self-compassion-related interventions for reducing self-criticism: A systematic review and meta-analysis. Clinical Psychology and Psychotherapy, 29(1), 1–25. https://doi.org/10.1002/cpp.2586
Warren, R. (2015). Emotion regulation in borderline personality disorder: The role of self-criticism, shame, and self-compassion. Personality and Mental Health, 9(1), 84–86. https://doi.org/10.1002/PMH.1290
Washburn, J. J. (2019). Nonsuicidal self-Injury: Advances in research and practice. Routledge.. https://doi.org/10.4324/9781315164182
Welford, M.(2016). Compassion focused therapy for dummies. John Wiley & Sons, Ltd, Chichester, West Sussex.
Whitlock, J., Muehlenkamp, J., Purington, A., Eckenrode, J., Barreira, P., Baral Abrams, G., Marchell, T., Kress, V., Girard, K., Chin, C., & Knox, K. (2011). Nonsuicidal self-injury in a college population: General trends and sex differences. Journal of the American College of Health, 59(8), 691–698. https://doi.org/10.1080/07448481.2010.529626
Xavier, A., Pinto Gouveia, J., & Cunha, M. (2016). Non-suicidal self-injury in adolescence: The role of shame, self-criticism and fear of self-compassion. Child Youth Care Forum, 45(4), 571–586. https://doi.org/10.1007/s10566-016-9346-1
Yang, X., & Feldman, M. W. (2018). A reversed gender pattern? A meta-analysis of gender differences in the prevalence of non-suicidal self-injurious behaviour among Chinese adolescents. BMC Public Health, 18(1), 1–7. https://doi.org/10.1186/s12889-017-4614-z
Yip, V. T., & Tong, M. W. E. (2020). Self-compassion and attention: Self-compassion facilitates disengagement from negative stimuli. Journal of Positive Psychology, 1–17. Advance of Print. https://doi.org/10.1080/17439760.2020.1778060
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S. D.: designed and executed the study, assisted with the data analyses, and wrote the paper. O. S.: collaborated with the design of the study, writing and editing of the final manuscript. R. Y. H.: collaborated with the design of the study, writing and editing the final manuscript. All authors approved the final version of the manuscript for submission.
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Drabu, S., Sündermann, O. & Hong, R.Y. A one-week online self-compassion training reduces self-criticism and pain endurance in adults with non-suicidal self-injury ideation: A randomized-waitlist controlled study. Mindfulness 13, 1232–1245 (2022). https://doi.org/10.1007/s12671-022-01870-2
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DOI: https://doi.org/10.1007/s12671-022-01870-2