Self-Compassion, Perceived Stigma, and Anger in Prolonged Grief and PTSD

A recent cross-sectional mediation analysis examined how self-compassion relates to prolonged grief disorder (PGD) and posttraumatic stress disorder (PTSD) symptom severity in bereaved adults.

Data were collected via an online survey conducted from July to November 2023, with recruitment through social networking websites and mobile applications. The authors report that 308 people completed the survey. Participants were bereaved adults in China; the sample was 70.2% women, with a mean age of 42.27 years.

Self-compassion was measured with the SCS-SF (Cronbach’s α = 0.70). Perceived stigma was assessed using the 10-item stigma subscale of the Grief Experience Questionnaire (GEQ). Anger was assessed with an adapted 8-item Post-Bereavement Anger Questionnaire, using self-directed and other-directed subscales (α = 0.90 and 0.88, respectively). PGD symptoms were measured with the International ICD-11 Prolonged Grief Disorder Scale (IPGDS; α = 0.94) and PTSD symptoms with the PCL-5 (α = 0.97).

Higher self-compassion corresponded to lower PGD and PTSD symptom severity, and perceived stigma was described as showing a significant indirect association in both outcome models. For PGD, the authors report an indirect effect via self-directed anger (−0.1360, 95% CI [−0.2518, −0.0439]) and a serial pathway through perceived stigma then self-directed anger (−0.0573, 95% CI [−0.0992, −0.0214]). For PTSD, they report an indirect effect via other-directed anger (−0.0779, 95% CI [−0.1692, −0.0106]) and a serial pathway through perceived stigma then other-directed anger (−0.0872, 95% CI [−0.1565, −0.0280]). As framed in the article, the anger subtype pattern differed by outcome, with self-directed anger appearing in the PGD pathway and other-directed anger appearing in the PTSD pathway.

The authors also report that direct effects of self-compassion on both outcomes remained statistically significant after including perceived stigma and both anger subtypes in the models (PGD direct effect = −0.6409, 95% CI [−0.8591, −0.4227]; PTSD direct effect = −0.8719, 95% CI [−1.1798, −0.5641]). I

The authors note the cross-sectional design as a constraint, describing the mediation results as statistical associations that do not establish temporal or causal direction. Overall, the report presents differentiated mediation pathways describing how self-compassion, perceived stigma, anger subtypes, and symptom measures co-occur in this bereaved sample.

Key Takeaways:

• In this online, cross-sectional sample of Chinese bereaved adults, self-compassion was associated with lower PGD and PTSD symptom severity.
• Perceived stigma appeared in indirect pathways linking self-compassion with both PGD and PTSD symptoms in the authors’ mediation models.
• In these models, indirect effects involving self-directed anger were statistically significant for PGD but not PTSD, while indirect effects involving other-directed anger were statistically significant for PTSD but not PGD.