Spirituality in Clinical Practice

Manuscript version of

Compassionate Hearts Protect Against Wandering Minds: Self-Compassion

Moderates the Effect of Mind-Wandering on Depression
Jonathan Greenberg, Tanya Datta, Benjamin G. Shapero, Gunes Sevinc, David Mischoulon, Sara W. Lazar

Funded by:
• AlterMed Research Foundation
• National Institutes of Health

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Running head: COMPASSIONATE HEART PROTECT AGAINST WANDERING MINDS

Compassionate Hearts Protect Against Wandering Minds: Self-compassion Moderates the Effect

of Mind-Wandering on Depression

Jonathan Greenberg1*, Tanya Datta1, Benjamin G. Shapero1, Günes Sevinc1, David Mischoulon1

& Sara W. Lazar1

1
Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School

Authors’ note

Correspondence concerning this article should be addressed to Jonathan Greenberg;

jgreenberg5@mgh.harvard.edu; jongreen80@gmail.com; 120 2nd Ave, Charlestown MA, 02129;

Tel. 1-617-643-9602

Acknowledgements: Authors wish to thankfully acknowledge Dr. Gaelle Desbordes and Ms.

Ana Acevedo-Barga for their contributions to this work. This work was funded by a research

grant to the first author from the AlterMed Research Foundation and by the National Institutes of

Health R01-AG-048351.

1
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

Abstract

Depression is associated with high levels of mind-wandering and low levels of self-compassion.

However, little is known about whether and how these two factors interact with one another to

influence depressive symptoms. The current study examined the interaction between mind-

wandering, self-compassion and depressive symptoms in a depressed sample and tested the

effects of an eight-week Mindfulness Based Cognitive Therapy (MBCT) program on these

constructs. At baseline, mind-wandering was associated with higher depressive symptoms only

among individuals with low self-compassion. Self-compassion additionally predicted depressive

improvement. As expected, MBCT increased self-compassion and reduced mind-wandering

compared to a treatment-as-usual control group. Overall, longitudinal changes in self-

compassion produced a moderation effect similar to the one at baseline so that increases in mind-

wandering were associated with increases in depressive symptoms only among those who

decreased in self-compassion. Results provide the first evidence that self-compassion can protect

against the deleterious effects of mind-wandering among depressed participants, both at baseline

and longitudinally. Findings also suggest that self-compassion is an effective predictor of

depressive improvement. Finally, MBCT is effective not only at reducing depressive symptoms,

but also at targeting protective and risk factors associated with depression.

Keywords: Depression, mind-wandering, self-compassion, Mindfulness Based Cognitive

Therapy
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

Introduction

People spend almost half of their waking hours mind-wandering rather than focused on their

current activity or surroundings (Killingsworth & Gilbert, 2010). Mind-wandering has been

described as the interruption of task-focus by task-unrelated-thought (Mrazek, Phillips, Franklin,

Broadway, & Schooler, 2013; Smallwood & Schooler, 2013), and associated with increased

depressive symptoms (Deng, Li, & Tang, 2014; Killingsworth & Gilbert, 2010; Ottaviani et al.,

2015; Stawarczyk, Majerus, & D’Argembeau, 2013; Watts, MacLeod, & Morris, 1988). In

contrast, self-compassion is linked to decreased depressive symptoms and higher levels of

resilience and well-being (Barnard & Curry, 2011; Ehret, Joormann, & Berking, 2015; Krieger,

Altenstein, Baettig, Doerig, & Holtforth, 2013; MacBeth & Gumley, 2012; Van Dam, Sheppard,

Forsyth, & Earleywine, 2011; Wang, Lin, & Pan, 2015). Self-compassion is described as “being

open to and moved by one’s own suffering, experiencing feelings of caring and kindness toward

oneself, taking an understanding, nonjudgmental attitude toward one’s inadequacies and failures,

and recognizing that one’s own experience is part of the common human experience” (Neff,

2003a, pp.224). Very little is currently known about whether and how self-compassion and

mind-wandering interact with one another over the course of treatment for depression and the

potential impact of this interaction on longitudinal change in depressive symptoms. Such an

interaction may better inform clinicians about potential mechanisms of depressive improvement

and help optimize treatment programs for depression. The current study aims to examine whether

self-compassion influenced the relationship between mind-wandering and depressive symptoms

in a depressed sample as well as to test the effects of Mindfulness Based Cognitive Therapy

(MBCT; Segal, Williams, & Teasdale, 2012) for depression on these constructs.
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

A 2010 report concluded that “a wandering mind is an unhappy mind” (Killingsworth & Gilbert,

2010). The study followed 2250 adults through 22 different activities, and found that people

were less happy when their minds wandered. Mind-wandering to happy topics did not increase

happiness compared to focusing on the current activity. These findings complement other

findings that indicate a bi-directional relationship between mind-wandering and negative moods

in which mind-wandering leads to a negative mood, which can in turn increase the mind’s

tendency to wander, creating a reinforcing cycle (Deng et al., 2014; Mrazek, Phillips, et al.,

2013; Ottaviani et al., 2015; Stawarczyk et al., 2013; Watts et al., 1988). Although mind-

wandering is associated with certain benefits such as improved future planning and creative

problem solving (Mooneyham & Schooler, 2013), it has been found to be overall detrimental to

physical health (Epel et al., 2013; Ottaviani, Shapiro, & Couyoumdjian, 2013) and to desensitize

one’s perception of the discomfort of others (Kam, Xu, & Handy, 2014; see also Jazaieri et al.,

2016). Importantly, depressed individuals spend more of their time mind-wandering, and tend to

wander more to negative, maladaptive and self-critical topics which may perpetuate depression

(Carver & Ganellen, 1983; Hoffmann, Banzhaf, Kanske, Bermpohl, & Singer, 2016; Marchetti,

Koster, Klinger, & Alloy, 2017). While this increased mind-wandering may include depressive

rumination, during which individuals focus on their distress and its possible causes and

consequences in a rigid and repetitive way (Nolen-Hoeksema, 1991), it is not limited to such

rumination, and may include other forms of thought, including non-ruminative depression-

related thinking (Killingsworth & Gilbert, 2010). Given the frequency and negative valence of

mind-wandering among depressed individuals, there is a clear need to help reduce mind-

wandering among this population.

COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

Conversely, self-compassion has a positive effect on mood and depression. Self-compassion

consists of three components: self-kindness, common humanity, and mindfulness. Self-

compassion has been shown to effectively increase depression resilience (Ehret et al., 2015;

Ford, Klibert, Tarantino, & Lamis, 2017; Krieger et al., 2013; Neff & Vonk, 2009; Raes, 2010;

Svendsen, Kvernenes, Wiker, & Dundas, 2017; Wang et al., 2015). A meta-analysis of 14 studies

found a large effect size for the relationship between compassion and psychopathology and

concluded that compassion is an important explanatory variable in understanding mental health

and resilience to conditions such as depression and anxiety (MacBeth & Gumley, 2012).

While current evidence suggests that mind-wandering and depressive symptoms positively co-

vary and self-compassion and depressive symptoms inversely co-vary, very little is known about

the interaction between these factors. An intervention that could impact these constructs and help

elucidate their interrelation could be of great value in the management of depression. We seek to

determine whether MBCT, a treatment program for depression, could benefit depressed

individuals by impacting on mind-wandering, self-compassion, and depressive symptoms.

MBCT is a structured eight-week intervention combining mindfulness and meditative practices

with elements of cognitive therapy for depression (Segal et al., 2012; Shapero et al., in press(a)).

There is considerable evidence demonstrating MBCT’s efficacy in preventing depressive relapse

(Kuyken et al., 2016; Piet & Hougaard, 2011) and reducing depressive symptoms (Geschwind,

Peeters, Huibers, Van Os, & Wichers, 2012; Greenberg, Shapero, Mischoulon, & Lazar, 2016;

Hofmann, Sawyer, Witt, & Oh, 2010; Kingston, Dooley, Bates, Lawlor, & Malone, 2007). Two

of the most basic principles emphasized in MBCT are keeping attention focused on the

experience of the present moment, and adopting an accepting and non-judgmental attitude (Segal

et al., 2012). These principles of present-moment attention and non-judgmental acceptance

COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

directly relate to the concepts of mind-wandering and self-compassion. Accumulating evidence

supports the effects of MBCT on self-compassion (Kuyken et al., 2010a; Melyani, Allahyari,

Falah, Ashtiani, & Tavoli, 2015; Rimes & Wingrove, 2011; van der Velden et al., 2015). There

is some evidence regarding the effect of mindfulness based interventions on mind-wandering

(Mrazek, Franklin, Phillips, Baird, & Schooler, 2013), although the specific effects of MBCT on

mind-wandering are yet to be conclusively established.

In the current study, our overarching hypothesis is that self-compassion would protect against the

deleterious effects of mind-wandering on depressive symptoms. To test this, we examined the

relationship between mind-wandering, self-compassion and depressive symptoms both at

baseline and longitudinally, and tested the effect of MBCT on changes in these constructs.

Consistent with previous research, we hypothesized that higher levels of mind-wandering and

lower levels of self-compassion will be associated with depressive symptoms. However, we

further hypothesized a protective influence of self-compassion on the relationship between mind-

wandering and depressive symptoms so that baseline levels of mind-wandering would be

associated with increased depressive symptoms at baseline only among those low in self-

compassion, and that baseline levels would predict longitudinal depressive improvement.

Finally, we hypothesized that MBCT would effectively reduce mind-wandering and improve

self-compassion compared to a control group receiving treatment as usual, and that overall

longitudinal improvements in self-compassion would moderate the relationship between changes

in mind-wandering and changes in depressive symptoms.

Methods

Participants
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

A total of 52 participants were recruited from the Massachusetts General Hospital in addition to

physician referrals, mailing lists, flyers and clinicaltrials.gov postings. Participants were screened

for mild to severe depressive symptoms, designated by a score of ≥11, indicating at least mild

depression, on the 28-item Hamilton Depression Scale (HAM-D-28). This cutoff was chosen to

obtain a full extent of depressive symptom severity in accordance with a recent focus on a

spectrum of diagnoses found in the DSM (APA, 2013). Additional inclusion criteria included age

between 18 and 65 years, dysphoria or low mood for a minimum of two months prior, no prior

experience with systematic mindfulness programs including MBCT, no psychotic features, and

no suicidal attempts in the past six months (see Greenberg et al., 2016; Shapero et al., in press (b)

for further details about this sample). Participants with a history of substance dependence or

abuse were excluded because of the complicated nature of dual diagnosis treatment (Quello,

Brady, & Sonne, 2005) and the need for modified mindfulness-based training programs with

such populations (Grant et al., 2017). Antidepressant doses were required to be stable for a

minimum of 6 weeks prior to the start of the study.

A final sample of 40 participants were assigned to MBCT + treatment-as-usual (TAU) or waitlist

+ TAU (Figure 1). Treatment-as-usual was defined as ongoing, unchanged medication or

individual therapy and was received by both groups in addition to the study intervention.

Waitlisted participants were offered the MBCT program after the conclusion of their

participation in the study. The first 13 participants were quasi-randomized in the order of their

enrollment, with the first group of 8 assigned to MBCT and the second group of 5 assigned to the

waitlist. This quasi-randomization was not based on any demographic or clinical measures and

has been used in previous mindfulness studies (Dimidjian et al., 2014; Grossman, Tiefenthaler-

Gilmer, Raysz, & Kesper, 2007; Hölzel et al., 2011). Due to an increase in recruitment, the next
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

27 participants were fully randomized after completion of their baseline testing. Fourteen were

randomized to MBCT and 13 were randomized to the waitlist. The 40 enrolled participants

showed a range of depressive symptoms from mild to severe, with the BDI-II showing a normal

distribution at baseline. The scores ranged from 11-42 and were distributed among four severity

levels of Minimal (0-13) = 5, Mild (14-19) = 12, Moderate (20-28) = 13, and Severe (29-63) =

10 depressive symptoms.

Overall, 22 participants were assigned to the MBCT group and 18 were waitlisted. Groups did

not statistically differ in age (t(38)=0.69, p=.55), gender, Major Depressive Disorder (MDD)

diagnosis, or co-morbidity with anxiety disorders (minimal p =.26; Fischer’s exact test; Table 1).

Furthermore, groups did not differ in ongoing treatment-as-usual in terms of antidepressant use

or psychotherapy treatment (See Table 1; Shapero et al., in press (b) for more details). A Mann-

Whitney test further indicated the MBCT group and the Wait-List group did not differ in

education level (U = 68, p=.82; Table 1). Although a current diagnosis of MDD was not a

specific inclusion criteria in order to examine a range of severity of depression, 82% of

participants met the full criteria based on the Mini International Neuropsychiatric Interview

(MINI; Sheehan et al., 1997)

Procedure

At the baseline visit, participants signed the consent form and underwent the clinician-rated Mini

International Neuropsychiatric Interview (MINI) and HAM-D-28 to determine eligibility.

Eligible participants then completed measures of self-compassion and mind-wandering, as well

as other measures outside the scope of this paper (see Greenberg et al., 2016; Shapero et al., in

press (b)). Beck’s Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996), a self-reported

measure of depressive symptoms, was completed 0-2 weeks before the start of the program and
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

every 2-3 weeks during the program. Testing procedures, with the exception of the MINI, were

repeated for all participants 0-3 weeks after the MBCT program for all participants. Assessors

were blind to group assignment for all randomized participants. The study was approved by the

Massachusetts General Hospital’s Institutional Review Board and registered at clinicaltrials.gov

(NCT02457936).

Mindfulness Based Cognitive Therapy Program

The MBCT program consisted of eight weekly 2-hour sessions and followed the guidelines of

Segal, Williams and Teasdale (2012), combining elements of cognitive therapy and experiential

meditation exercises. These sessions were led by two MBCT teachers having 8-13 years of

experience teaching mindfulness-based group programs. Each session consisted of didactic

content, which followed the session outline closely, in combination with discussing participants’

experiences encountered in the moment. The curriculum included psychoeducation about

depression, mindful breathing exercises, mindfully exploring bodily sensations (“body scan”),

walking meditation, mindful eating, attending thoughts mindfully, and gentle yoga exercises. In

between sessions, participants were asked to practice these skills and complete practice logs. The

teachers were blinded to the study hypotheses and the group assignment (i.e. whether

participants were on the waitlist before the MBCT program).

Measures

Depressive Symptoms. For the eligibility screen, psychiatrists and psychologists administered

the Mini International Neuropsychiatric Interview (MINI) version 5.0.0 and the 28-item

Hamilton Rating Scale for Depression (HAM-D-28; Hamilton, 1960). Massachusetts General

Hospital clinicians hold regular re-training sessions to ensure inter-rater reliability, which
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

produce internal produced internal consistencies of 0.7-0.8. The MINI is a widely used,

standardized psychiatric interview instrument and was utilized to ensure no participants met the

clinical exclusionary criteria (see Participants section). The HAM-D-28 is a well-validated

clinician-rated diagnostic interview which assesses the severity of depressive symptoms from

“normal” to “very severe depression”. Consistent with previous studies that defined “remission”

as a score of 0-10 on the HAM-D-28 (e.g., Kayser et al., 2015; Schlaepfer et al., 2008), the

minimum cutoff for this study was 11 which indicated mild depression. Since up to eight weeks

could have passed between the screening visit and the beginning of the program, the HAM-D-28

that was administered at the visit was primarily used as a screening tool. The BDI-II, which was

administered 0-2 weeks before the beginning of the MBCT program, was the primary depressive

symptom measure for this study (see Greenberg et al., 2016; Shapero et al., in press (b)). By

administering the BDI-II closer to the beginning of the program than the HAM-D-28, it more

accurately reflected potential changes in depressive symptoms during the course of the

intervention. No enrollment decisions utilized the BDI-II. The BDI-II is a well validated, self-

reported 21-item measure of depression with high internal consistency (α=0.92 for outpatients;

Beck et al., 1996).

Self-Compassion. The Self-Compassion Scale (SCS; Neff, 2003b) is a 26-item self-reported

scale that asks participants to rate statements on a scale of 1 (Almost Never) to 5 (Almost

Always) based on how participants typically act towards themselves in difficult times. It is the

most widely used measure to assess self-compassion (Neff, 2016). The SCS includes items such

as “I’m disapproving and judgmental about my own flaws and inadequacies” and “When I’m

feeling down I tend to obsess and fixate on everything that’s wrong”. The SCS has 6 subscales

describing self-kindness, self-judgment, common humanity, isolation, mindfulness and over-

COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

identification. A total self-compassion score is calculated by adding the scores of the sub-scales

together after reverse-scoring the negative aspects. The SCS has a demonstrated a test-retest

validity of α = 0.93.

Mind-wandering. The Mind-Wandering Questionnaire (MWQ; Mrazek, Phillips, et al., 2013)

is a 5-item self-reported scale that asks participants to rate statements on a 6-point Likert scale

from 1 (Almost Never) to 6 (Almost Always). This measure captures trait levels of mind-

wandering, defined as the interruption of focus on a specific task by task-unrelated thought,

distinct from day-dreaming (Mrazek, Phillips, et al., 2013). It focuses on the frequency of lapses

in attention rather than the specific content to which the mind has wandered to. Items include

statements such as “While reading, I find I haven’t been thinking about the text and must

therefore read it again” and “I do things without paying full attention”. The MWQ has a

demonstrated internal validity of α = 0.85.

Analytic Plan

We first assessed whether groups significantly differed in baseline characteristics. The

correlation between baseline outcome measures was then examined. To test the hypothesized

role of self-compassion as a moderator of the relationship between mind-wandering and

depressive symptoms at baseline, we conducted a moderation analysis with a follow-up simple

slope analysis. Gender was controlled for in analyses including self-compassion due to common

gender differences in the self-compassion scale and related constructs such as self-criticism and

interdependent vs. dependent sense of self (Cross & Madson, 1997; Leadbeater, Kuperminc,

Blatt, & Hertzog, 1999; Neff, 2003a). Change scores in the outcome measures were then

calculating by subtracting post-program values from baseline values, and their correlations with

each other reported. The degree to which baseline levels of self-compassion predicted
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

improvement in depressive symptoms was assessed using linear regression. Differences in the

effects of MBCT vs. the control group on mind-wandering and self-compassion were assessed

via Analysis of Covariance (ANCOVA) with group as the independent variable and post-

program values as the dependent variables, while covarying baseline outcome measure values.

To examine whether changes in self-compassion impacted the relationship between changes in

mind-wandering and depressive symptoms over time, we ran a moderation analysis similar to

that conducted at baseline level, but with change scores from baseline to prospective assessment.

Results

Preliminary Analysis

Participant flow is detailed in Figure 1. Twelve participants (6 of each group) withdrew from the

study prior to conclusion of post-program testing. Of the 28 remaining participants, eight did not

complete the post-program SCS and two did not complete the post-program MWQ. Comparisons

between completers in the final pre-post analyses versus those who withdrew or had missing

data, revealed no significant differences in baseline SCS, MWQ or BDI-II scores (maximal

t(36)=1.09, p=.28). Participants in the MBCT group who were included in the longitudinal

analysis attended an average of 7 classes (Range: 6-8; All greater than what has been considered

the minimally adequate dose (4 sessions) in previous research; Ma & Teasdale, 2004).

Participants reported practicing MBCT skills and exercises an average of 80 times (SD=55.09).

Overall, baseline mind wandering data were analyzed from 38 participants (22 MBCT) and self-

compassion data from 37 participants (20 MBCT). Pre-post mind wandering data were analyzed
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

from 25 participants (15 MBCT) and self-compassion from 18 (11 MBCT) participants (see

Figure 1).

Relationship between Measures at Baseline

Higher baseline BDI-II depression scores were significantly correlated with the HAMD (r=0.54,

p=.001), the MWQ (r=.45, p=.005), and the SCS (r=-.47, p=.004) so that individuals with more

severe depressive symptoms also had higher mind-wandering scores and lower self-compassion

scores. Moreover, higher levels of baseline self-compassion were significantly correlated with

lower mind-wandering (r=-.45, p=.005).

To investigate whether self-compassion moderated the relationship between mind-wandering and

depressive symptoms, we conducted a moderation analysis utilizing an SPSS macro (Process)

(Hayes, 2013). The main predictors of self-compassion and mind-wandering were mean centered

as outlined by Aiken and West (1991). The regression analysis supported the hypotheses that

self-compassion moderated the relationship between mind-wandering and depressive symptoms

(Beta = -.03, t = 2.07, p=.047, ∆ R2 = .09). To examine the form of the interaction, follow-up

analyses examined the simple slopes at one standard deviation above and below the centered

mean (Aiken & West, 1991). Analysis revealed that the slope was significant only for low self-

compassion (t = 2.85, p=.007) and not for high self-compassion (t = 0.223, p=.824). As seen in

Figure 3a, when individuals had high levels of self-compassion, the levels of mind-wandering

did not differ in their relation to depressive symptoms. However, when individuals had low

levels of self-compassion, mind-wandering differentially related to depression so that lower

levels of mind-wandering were associated with lower depressive symptoms and higher levels of

mind-wandering were associated with higher depressive symptoms.

COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

Prediction of Depressive Improvement

To test the hypothesis that baseline levels of self-compassion would predict longitudinal

depressive improvement, a linear regression model was constructed with changes in BDI-II

scores as the dependent variable, predicted by baseline SCS levels and gender (see Analytic

Plan). The model was found to be significant (F(2,23)=4.71, p=.019) with higher levels baseline

self-compassion significantly predicting longitudinal reduction in depressive symptoms (β=0.54,

p=.008; Figure 2). The multiple correlation coefficient was 0.54 indicating that the model

explained 29.1% of the variance in change in depressive symptoms (R=.539, R2=.291).

Effects of MBCT

The two groups, MBCT versus Waitlist, did not differ in baseline SCS, MWQ or BDI-II scores,

or in any other of the clinical or demographic variables (Table 1).

Mind-wandering. A one way ANCOVA applied to post-program MWQ scores with Group as

the independent variable while controlling for baseline MWQ scores revealed that following

MBCT training, the MBCT group exhibited lower mind-wandering than the control group

F(1,21)=7.00, p=.015; ηp²=0.25; Table 2; Figure 4).

Self-compassion. An ANCOVA applied to post-program SCS total scores with Group as the

independent variable while controlling for baseline SCS total scores and gender revealed that the

MBCT group exhibited higher self-compassion than the control group (F(1,14)=13.75, p=.002;

ηp²=0.495; Table 2; Figure 5) following MBCT training. Similar ANCOVAs on each of the SCS

subscales revealed that MBCT exhibited significantly higher levels of Common Humanity

(F(1,14)=12.12 , p=.004; ηp²=0.464), Mindfulness (F(1,14)=12.87 , p=.003; ηp²=0.479) and

COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

Over-Identification (F(1,14)=21.16 , p<.001; ηp²=0.60). No significant group differences were

found in Self-Kindness, Self-Judgement, or Isolation (Maximal F=3.13, p=.099).

Relationship between Changes in Outcome Measures

Changes in BDI-II scores correlated with changes in the HAMD (r=.53, p=.017), changes in SCS

(r=-.65, p=.005) as well as with changes in the MWQ (r=.51, p=.14) so that reductions in

depressive symptoms were associated with increases in self-compassion and reductions in mind-

wandering.

To investigate whether changes in self-compassion impacted the relationship between changes in

mind-wandering and in depressive symptoms, we again conducted a moderation analysis

utilizing an SPSS macro (Process) and covaried gender. The regression analysis supported the

hypotheses that changes in self-compassion impacted the relationship between changes in mind-

wandering and in depressive symptoms (Beta = .098, t = 2.34, p=.037, ∆ R2 = .163). To examine

the form of the interaction, follow-up analyses examined the simple slopes at one standard

deviation above and below the centered mean (Aiken & West, 1991). Analysis revealed that the

slope was just-significant only for individuals whose self-compassion increased (t = 2.11, p=.05)

and not for those whose self-compassion decreased (t = 0.86, p=.403). As seen in Figure 3b,

when individuals had increases in self-compassion, changes in mind-wandering were not

differentially associated with changes in depressive symptoms. However, when individuals

decreased in self-compassion, those who also decreased in mind-wandering improved in

depressive symptoms, whereas those who increased in mind-wandering showed a trend of a

worsening in in depressive symptoms. We further tested whether group influenced the

moderating influence of self-compassion on the relationship between mind-wandering and

depressive symptoms. The three-way interaction was not significant (Beta = -.18, t = 0.84,
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

p=.42, ∆ R2 = .017).This suggests that the moderation was found as a whole for the entire

sample, beyond the specific effects of MBCT.

Discussion

This study set out to examine whether self-compassion is protective against the deleterious effect

of mind-wandering on depressive symptoms in a sample of depressed participants, and test the

effect of MBCT on these constructs. Greater depressive severity was associated with higher

levels of mind-wandering and lower levels of self-compassion. Moreover, self-compassion

moderated the effects of mind-wandering on depressive symptoms at baseline such that mind-

wandering was associated with higher depressive severity only among individuals with low self-

compassion. Self-compassion additionally predicted depressive improvement. As expected,

MBCT increased self-compassion and reduced mind-wandering compared to a treatment-as-

usual control group. Overall, longitudinal changes in self-compassion produced a moderation

effect similar to the one at baseline so that increases in mind-wandering were associated with

increases in depressive severity only among those who decreased in self-compassion. Previous

findings demonstrated a well-established link between mind-wandering and depressive

symptoms (Deng et al., 2014; Killingsworth & Gilbert, 2010; Ottaviani et al., 2015; Stawarczyk

et al., 2013; Watts et al., 1988). The current findings suggest that self-compassion helps protect

depressed individuals against these deleterious effects of mind-wandering on depressive

symptoms.

Depression has long been associated with a negative view of the self, harsh self-criticism, and

self-blame (Beck, Rush, Shaw, & Emery, 1979; Blatt, Quinlan, Chevron, McDonald, & Zuroff,

1982; Carver & Ganellen, 1983). Self-compassion plays a significant role in these processes,

leading some to conceptualize depression as a compassionate deficit (Allen & Knight, 2005).
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

One important way in which self-compassion may help protect against depression is by

strengthening self-kindness, which has been regarded as the opposite end of the spectrum with

regards to the way individuals treat and approach themselves (Neff, 2003a). Self-compassion

may thereby pacify self-criticism and blame while facilitating a more caring, understanding, and

supportive stance towards oneself (Ehret et al., 2015; Ford et al., 2017).

The protective effect of self-compassion coupled with the finding that self-compassion predicted

depressive improvement over time emphasizes the importance of self-compassion in resilience

and alleviation of depression, and supports findings of previous studies (Barnard & Curry, 2011;

Ehret et al., 2015; Krieger et al., 2013; MacBeth & Gumley, 2012; Van Dam et al., 2011; Wang

et al., 2015). Several important clinical implications stem from this finding. First, measures of

self-compassion may be used to predict clinical prognosis and chances of recovery in depression.

Additionally, the moderating role of self-compassion suggests a novel potential mechanism of

depressive improvement. This supports the potential benefit of MBCT and other treatment

programs that show promise with regards to their effect on self-compassion, including short-term

dynamic therapy (Schanche, Stiles, Mccullough, Svartberg, & Nielsen, 2011) as well as

treatments in which compassion is the main program focus such as Compassion Focused

Therapy (Gilbert, 2012), Attachment-Based Compassion Therapy (Navarro-Gil et al., 2018), and

Compassionate Mind Training (Gilbert & Procter, 2006). Moreover, adopting a self-

compassionate attitude may also be better emphasized in other therapeutic programs as a means

to alleviate depressive symptoms and guard patients against the deleterious effects of their

mind’s increased predisposition to wander (Hoffmann et al., 2016).

Our findings that MBCT significantly improved self-compassion and reduced mind-wandering

compared to the control group, coupled with our findings that MBCT reduces depressive
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

symptoms (Greenberg et al., 2016) converge with previous findings (Kuyken et al., 2010b, 2016;

Melyani et al., 2015; Piet & Hougaard, 2011; Rimes & Wingrove, 2011; van der Velden et al.,

2015; Wells et al., 2013) and suggest that MBCT does not only target depression. It specifically

reduces mind-wandering while also potentially reducing its harmful effects via increases in self-

compassion, a resilience factor predictive of depressive improvement. This may provide tentative

support for the use of MBCT for conditions such as attention deficit disorders (Schoenberg et al.,

2014; Semple, Lee, Rosa, & Miller, 2010), which are characterized by high degrees of mind-

wandering, and have an elevated co-morbidity rate with depression (Biederman, Newcorn, &

Sprich, 1991; Knouse, Zvorsky, & Safren, 2013). It is possible that the improvements in mind-

wandering and self-compassion observed in the current study are a direct result of the emphasis

MBCT places on present moment awareness, acceptance, and non-judgement, although further

investigation is needed in order to pinpoint the precise related mechanisms specific to MBCT.

Many religions and theological traditions emphasize compassion as a core value and milestone

on one’s spiritual path (Gilbert & Gilbert, 2015). Self-compassion is a particular case of such

compassion, in which being touched by suffering, being open to it, and having a desire to

alleviate it are directed towards one’s own suffering rather than that of others’. Self-compassion

not only shares similar beneficial outcomes as spiritual experiences do, such as social support,

life satisfaction, happiness, and optimism, but also has also been found to predict spiritual

experiences (Akin & Akin, 2017). Given the link between self-compassion and spirituality,

understanding how self-compassion can be increased, as done in the current study, may

potentially shed light on the broader workings of spiritual processes.

A few limitations of the study should be taken into account when considering our results. First,

the sample size was small, due in part to attrition levels, primarily in the longitudinal analyses. A
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

small sample, however, primarily limits statistical power and is therefore more problematic with

regards to “missed” effects (type II error) than with regards to the significant effects found. To

help minimize attrition, future studies may implement study-attrition prevention strategies such

as providing material incentives for study completers, communicating the importance of follow-

up testing to participants, as well as strategies additionally relevant to keeping patients in

treatment such as using reminder emails and phone calls, rapid follow-up of missed

appointments, and early detection of factors which may interfere with treatment retainment and

follow-up participation (Zweben, Fucito, & O’Malley, 2009). A second limitation of this study

is reliance mostly on self-reported measures, which are subjective. Third, the MBCT group

received an active intervention compared to the control group, which received treatment as usual.

This enables the attribution of the results to the MBCT program as a whole rather than to specific

components of it such as group and teacher support. Finally, although group assignment for most

participants was random, the first few participants were quasi-randomized by enrollment order.

The latter two limitations concerning the control group and randomization, however, primarily

relate to the specific effects of MBCT rather than our findings regarding the baseline and

longitudinal relationship between mind-wandering, self-compassion, and depressive symptoms.

Due to these limitations, the current results should be taken as preliminary evidence, in need of

future validation by studies with larger samples and active control groups.

Conclusion

This study was the first to demonstrate that self-compassion can provide protection against the

deleterious effects of mind-wandering on depressive symptoms among depressed participants,

both at baseline and longitudinally. Findings additionally suggest that self-compassion is an

effective predictor of depressive improvement, and that MBCT is effective not only at reducing
COMPASSIONATE HEARTS PROTECT AGAINST WANDERING MINDS

depressive symptoms, but also at targeting protective and risk factors associated with depression.

This adds to the growing body of literature supporting self-compassion as a crucial factor for

flourishing and well-being, and emphasizes the importance of directly addressing and facilitating

self-compassion in treatments for depression.

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