关键词: 焦虑, 暴露疗法, 负性情绪, 自悯, 恐惧消退

Abstract:

Self-compassion is the tendency to care for and understand oneself, and cultivating this behavior is considered a promising cognitive treatment for anxiety disorders. However, the underlying mechanism of how self-compassion reduces anxiety remains unknown. Given the central role of fear extinction-based exposure therapy for the treatment of anxiety, studying how self-compassion affects fear extinction may help elucidate the underlying mechanisms. Previous studies have found that writing can be an effective way to promote self-compassion and emotional regulation. Thus, this study aimed to test the impact of self-compassion writing on fear extinction.

This study contained 56 healthy effective participants, who were randomly assigned into self-compassion and control writing groups. The experimental process included five phases: pre-conditioning, negative event writing, fear conditioning, self-compassion writing, and fear extinction. All the participants completed the Self-Compassion Scale (SCS), the Positive and Negative Affect Scale (PANAS), and the State-Trait Anxiety Inventory (STAI) before and after the experiment. The PANAS was also assessed immediately after the negative event writing phase to assess the effectiveness of manipulation. Participants were asked to write about an adverse event that made them feel bad about themselves during the negative writing phase. The self-compassion group was guided to respond to three prompts that focus on self-kindness, common humanity, and mindfulness. The control group was asked to write about their daily routines in a factual and unemotional manner. The shock expectancy ratings and skin conductance response (SCR) were recorded as the index of extinction learning. Three-way repeated measure ANOVA was conducted to examine the between-group differences in ratings and SCR across time extinction learning, with writing condition as the between-subject variable (self-compassion, control), and stimuli type (conditioned danger stimuli [CS+], conditioned safe stimuli [CS−]) and extinction phase (early, late) as within-subject variables.

The results showed that the writing of negative events successfully reduced the positive affect (PA) of participants. There was no group difference during the fear conditioning phase and all participants successfully acquired fear. After writing intervention, the negative affect (NA) was significantly reduced in both groups. However, compared to the control group, the self-compassion group showed lower shock expectancy ratings in response to danger (CS+) and safety (CS−) cues during both early and late extinction. The SCR results showed that early extinction induced lower response than late extinction in the self-compassion group. Overall, the results demonstrate that self-compassion may promote fear extinction by regulating the response to both danger and safety cues. To our knowledge, this is the first study that uses the fear extinction model to test how self-compassion intervention can influence fear processing. Our results expand our understanding into the psychological and physiological mechanism of how self-compassion can reduce anxiety-related symptoms.

These findings have several implications. First, self-compassion writing intervention is independent of control writing as a method to cope with threats. Second, compared to PANAS, shock expectancy ratings might be a sensitive indicator to characterize the effect of self-compassion intervention on anxiety-related symptoms. Finally, self-compassion might could be a reasonable strategy to counter enhanced response to danger cues and inhibited fear response to safety cues.

Key words: anxiety, exposure therapy, negative affect, self-compassion, fear extinction