Compassion induction in personality disorder

SUMMARY

Background

Emotion dysregulation, that is, the inability to effectively respond to and manage emotions, has been established as a core symptom in patients with personality disorders (PDs). Effective treatment of emotion dysregulation may significantly reduce the burden and improve the quality of life of patients with personality disorders. Unfortunately, conventional treatments are only moderately successful in attenuating emotion regulation difficulties. An alternative form of treatment which may offer a helpful strategy for improving emotion regulation in this specific group of patients is compassion-focused therapy (CFT). CFT may contribute to more effective emotion regulation through (1) strengthening the capacity for experiencing and tolerating affiliative/soothing emotions in the face of setbacks; and (2) strengthening the capacity for regulating and engaging with unpleasant or feared emotions. Despite some preliminary, promising evidence that PD patients may benefit from practising compassion in terms of mental health and well-being, it remains as yet unclear whether the use of compassion may help PD patients improve their abilities for adaptive emotion regulation.



Objective

The primary aim of the current study is to examine the immediate effects of a brief compassion induction exercise on PD patients’ affect regulation choice in response to the recall of a recent emotional salient experience. A secondary aim is to assess to what extent a brief compassion induction impacts patients’ affective states. The effects of the compassion induction exercise will be compared to the effects of a neutral exercise. We hypothesize that a brief compassion induction in a sample of PD patients will facilitate the choice of more adaptive emotion regulation strategies in response to the recall of a recent emotional salient experience, lower levels of negative affect and higher levels of positive affect.



Study design

Experimental study with a two-group cross-over design. Participants with personality disorders will be randomly allocated over two groups. Both groups take part in two consecutive experimental sessions on the same day. One group receives a compassion induction exercise during the first session and a neutral exercise during the second session, and vice versa for the other group. Measurements, in the form of self-report questionnaires, take place at baseline and at the end of each session (i.e. following the exercise).



Study population

Adult patients (18-65 years) with personality disorders.



Intervention

The brief compassion induction consists of a 10-minute exercise called “building a compassionate image”. During the neutral exercise, participants are instructed to describe the room with all their senses, during 10 minutes.



Primary study parameters/outcome of the study:

The Emotion Regulation Profile – Revised (ERPR) is administered to examine the choice of emotion regulation strategies in response to recent positive or negative emotion eliciting experiences (primary outcome).



Secondary outcomes include:

Selfcompassion and selfcriticism, as measured with the Forms of SelfCriticising/
Attacking and SelfReassuring Scale (FSCRS).

Positive and negative affect, as measured with the Positive and Negative Affect Schedule (PANAS).

Trait emotion regulation strategies, as measured with the Difficulties in Emotion Regulation Scale (DERS).

The effects of a brief compassion induction exercise will be compared to the effects of a neutral exercise. We hypothesize that a brief compassion induction in a sample of patients with PD will facilitate the choice of more adaptive emotion regulation strategies in response to the recall of a recent emotional salient experience, lower levels of negative affect and higher levels of positive affect.

Crossover design, four timepoints:

1. Before compassion or neutral exercise (pre-test)

2. After compassion or neutral exercise (post-test)

Short break

3. Before compassion or neutral exercise (pre-test)

4. After compassion or neutral exercise (post-test)

The intervention, a brief compassion induction, consists of a 10 minute exercise called “building a compassionate image”.



In the control condition, a neutral exercise of 10 minutes, participants are instructed to describe the room with all their senses.