Cognitive Therapy and Research

, Volume 42, Issue 3, pp 236–249 | Cite as

Examining the Role of Repetitive Negative Thinking in Relations Between Positive and Negative Aspects of Self-compassion and Symptom Improvement During Intensive Treatment

  • Lauren P. Wadsworth
  • Marie Forgeard
  • Kean J. Hsu
  • Sarah Kertz
  • Michael Treadway
  • Thröstur Björgvinsson
Original Article


Positive aspects of self-compassion (i.e., self-kindness and nonjudgmental acceptance of personal experiences) as well as negative aspects (i.e., high self-criticism and self-coldness) are strong predictors of anxiety, depression, worry, and quality of life. To date, however, relatively little is known about (a) how both aspects of self-compassion change during naturalistic treatment, (b) whether and how such changes relate to symptom improvement, and (c) which processes might explain the potential benefits of self-compassion. To address these gaps, the present study examined whether relations between changes in both aspects of self-compassion and treatment outcomes in a brief partial hospital setting for acute psychology could be explained by associated changes in repetitive negative thinking (RNT), an established maladaptive cognitive process involved in anxiety and depressive disorders. In a sample of 582 people receiving cognitive-behavioral (CBT) and dialectical behavior therapy over the course of 1–2 weeks, increases in positive aspects of self-compassion and decreases in negative aspects related to improvements in depression and anxiety. RNT mediated the relationship between decreases in negative aspects of self-compassion and improvements in anxiety and depression. However, a reverse model also showed that decreases in negative aspects of self-compassion could also explain relations between RNT and depressive symptom improvement only. These findings suggest that negative aspects of self-compassion and RNT may constitute important targets for treatment in acute settings. Future studies should investigate the impact of greater focus on self-compassion on RNT and symptom improvement using longitudinal experimental designs with multiple assessment points, examining causality and directionality.


Self-compassion Depression Anxiety Rumination Repetitive negative thinking Treatment outcomes 


Compliance with Ethical Standards

Conflict of Interest

Lauren P. Wadsworth, Marie Forgeard, Kean Hsu, Sarah Kertz, Michael Treadway and Thröstur Björgvinsson declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Animal Rights

No animal studies were carried out by the authors for this article.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Lauren P. Wadsworth
    • 1
  • Marie Forgeard
    • 2
  • Kean J. Hsu
    • 3
  • Sarah Kertz
    • 4
  • Michael Treadway
    • 5
  • Thröstur Björgvinsson
    • 2
  1. 1.Clinical PsychologyUniversity of Massachusetts BostonBostonUSA
  2. 2.Behavioral Health Partial Hospital Program, McLean Hospital/Department of PsychiatryHarvard Medical SchoolBelmontUSA
  3. 3.Department of PsychologyUniversity of California, Los AngelesLos AngelesUSA
  4. 4.Department of PsychologySouthern Illinois UniversityCarbondaleUSA
  5. 5.Department of PsychologyEmory UniversityAtlantaUSA

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