Does Cultivating Self-compassion Improve Resilience to Criticism and Improve Mental Health in Adults With ADHD?

NCT04978792 | Unknown

• 1 other identifier: 172839
• Study Type: interventional
• Target: 114
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to investigate the effect that increasing levels of self-compassion may have on levels of perceived criticism, self-criticism, and mental health of adults with ADHD. A secondary aim of the study is to capture how feasible using an online self-guided self-compassion practice maybe with people with ADHD. Research Questions

1. 1.Does a short self-guided self-compassion intervention increase levels of state and/or trait self-compassion in adults with ADHD over time?
2. 2.Are changes in state and/or trait self-compassion associated with changes in levels of self-criticism or perceived criticism?
3. 3.Are changes in state and/or trait self-compassion associated with improvements in mental health?
4. 4.Are changes in mental health mediated by changes in self-criticism or perceived criticism?

Conditions

ADHD; Depression; Stress; Self-Criticism; Anxiety; Wellbeing; Self-compassion

Keywords

self-compassion; criticism; ADHD; mental health

Outcome Measures

Primary Outcomes (9)

• Change in trait Self-compassion

  The self-compassion scale (SCS, Neff, 2003) consists of 26 items measured on a scale between 1-5 (never - always). The items include 3 sub-scales that represent compassionate self-responding (self-kindness, mindfulness and common humanity) and 3 sub-scales of uncompassionate self-responding (self-judgement, isolation and over-identification). To obtain a total self-compassion score, the uncompassionate items are reverse coded, the mean score for each subscale is calculated, then the mean of the six subscale scores added together is calculated. The mean scores can range between 1 - 5, whereby higher scores indicate higher self-compassion

  Baseline. Immediately following intervention end point. One month (4 weeks) following intervention end point.

• Change in state self-compassion

  The State Self-Compassion Scale Short Form (SSCS-S; (Neff et al., 2021) is a six-item measure of state self-compassion. The six items are rated on a 5-point scale from 1 (not at all true for me) to 5 (very true for me), and responses are summed (after negatively worded questions are reverse coded) to provide a global state self-compassion measure. Higher scores equate to higher levels of state self-compassion.

  4x a week after intervention exercise complete.

• Change in Perceived Criticism

  An adapted version of The Perceived Criticism Scale (PCS) (Hooley \& Teasdale, 1989) will be used to measure how much criticism is "getting through" to individuals. The measure is a single question, "How critical do you think people in your nearest environment - such as family, friends, colleagues - are of you?", that is rated between 0 (not at all critical of me) to 10 (very critical of me). The measure can also include a second item also rated on a 1-10 scale that asks how upset the respondent may become when criticised.

  Baseline. Immediately following intervention end point. One month (4 weeks) following intervention end point.

• Change in wellbeing

  The Mental Health Continuum Short Form (MHC-SF) (Keyes, 2009) will be used to measure the frequency of well-being symptoms (never \[0\] - every day \[5\]). The self-report questionnaire includes 14-items that measure emotional well-being (3-items), psychological well-being (6-items) and social well-being (5-items). A global well-being score between 0 - 70 is achieved by summing the scores for each item, whereby higher scores equal greater well-being. Subscale scores are calculated by summing the responses for each item of the corresponding sub-scale; emotional well-being scores can range between 0 - 15, social well-being scores can range between 0 - 25, and psychological well-being scores can range between 0 - 30.

  Baseline. Immediately following intervention end point. One month (4 weeks) following intervention end point.

• Change in Depression

  The Patient Health Questionnaire - 9 (PHQ-9) (Kroenke et al., 2001) will be used to assess the severity of depressive symptoms and assess responses to treatment. The PHQ-9 has nine items that represent each of the DSM-IV (APA) criteria of depression. The items, such as "feeling down, depressed, or hopeless?", are rated on a scale of 0 (not at all) to 3 (nearly every day) to represent how frequently the symptoms are experienced over the previous two weeks. A total score is calculated by summing the scores for each item, providing a severity score between 0 and 27. Higher scores represent more severe depression, and scores of 5, 10, 15, and 20 represent cut-off points for mild, moderate, moderately severe and severe depression, respectively.

  Baseline. Immediately following intervention end point. One month (4 weeks) following intervention end point.

• Change in Anxiety

  General Anxiety Disorder- 7 (GAD-7) (Spitzer et al., 2006) will be used to assess the severity of anxiety. The GAD-7 includes 7 items that represent the DSM-IV (APA) clinical criteria. The items, such as "becoming easily annoyed or irritable", are scored on a scale between 0 (not at all) to 3 (nearly every day) to represent how frequently the symptoms are experienced over the previous two weeks. A total score between 0 - 21 is calculated by summing each individual item's rating. Higher scores represent more severe anxiety, and scores of 5, 10 and 15 are the cut-off points for mild, moderate and severe anxiety, respectively.

  Baseline. Immediately following intervention end point. One month (4 weeks) following intervention end point.

• Change in Stress

  The Perceived Stress Scale (PSS, Cohen et al., 1983) will be used to measure participant's perception of stress. The 10-item self-report questionnaire includes four positively worded items and six negatively worded items that are rated on how frequently (never \[0\] - very often \[4\]) respondents perceive their lives as unpredictable, uncontrollable or overwhelming. Positively worded items are reverse scored, and each item response is summed to provide a total score of between 0 - 40 whereby higher scores equal higher perceived stress.

  Baseline. Immediately following intervention end point. One month (4 weeks) following intervention end point.

• ADHD severity

  The Adult ADHD Self-report Scale (ASRS; Kessler, 2010) will be used as a screening tool to assess the frequency of ADHD symptoms and as a measuring tool to assess any changes in ADHD symptomatology over time. The measure was created in association with the World Health Organisation (WHO) and is based on the clinical criteria presented in the DSM-IV (APA, 2013). Part A is a 6-item questionnaire that assesses the frequency to which ADHD symptoms are present on a 5-point Likert Scale (Never - Always). It is recommended that individuals who report "sometimes", "often" or "very often" to the first three questions, or "often", "very often" to the final three questions four or more items, have symptoms highly consistent with ADHD.

  Baseline.

• Changes in self-criticism

  The Self-Critical Rumination Scale (SCRS, Smart et al., 2016) is a 10-item self-report questionnaire which measures the frequency of self-criticism on a 4-point scale from not at all (0) to very well (3). Self-criticism in this measure is conceptualised as a form of negative thinking that focuses on devaluing oneself. A total score is obtained by summing item responses, whereby higher scores equal greater self-criticism. Scores can range between 0 - 30.

  Baseline. Immediately following intervention end point. One month (4 weeks) following intervention end point.

Secondary Outcomes (5)

• Fear of compassion

  Baseline

• Acceptability of the Intervention

  Immediately following intervention end

• Change in daily Mood

  Prior to each intervention session

• Change in ADHD trait severity

  Baseline. Immediately following intervention end point. One month (4 weeks) following intervention end point.

• Perfectionism

  Baseline.

Study Arms (2)

Self-compassion Intervention

EXPERIMENTAL

The intervention will include 14 self-compassion exercises completed over a 3-week period. The intervention will include methods of psychoeducation, meditation, and self-compassion exercises similar to Beshai et al.'s (2020) self-compassion-based intervention. The psychoeducation will focus on self-compassion, the meditations will be kindness and loving meditations and self-compassion breaks. The self-compassion exercises will be based on the writing exercises available on Neff's self-compassion website.

Behavioral: Online self-compassion intervention

Control Group

ACTIVE COMPARATOR

The active control will also include 14 exercises completed over a 3-week period. The 14 exercises will comprise of a psychoeducation video, writing exercises, video/audio-guided relaxation, and journal entries. The same psychoeducation video used in the intervention will be shown to participants, however, the other exercises will be altered to focus on factual information and not focused on self-compassion. The exercises will be matched to the self-compassion exercise so that similar exercises are completed in parallel time with the intervention.

Behavioral: Active Control

Interventions

Online self-compassion intervention BEHAVIORAL

An online self-guided intervention that uses widely available exercises and information.

Self-compassion Intervention

Active Control BEHAVIORAL

Participants will complete written exercises and breathing exercises that are not associated with self-compassion

Control Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Self-report a formal diagnosis of ADHD
• Scores on the Adult ADHD Self Report Questionnaire (ASRS) meet the clinical cut-off.
• No previous engagement with self-compassion interventions/practice

You may not qualify if:

• No previous experiences of trauma.
• No PTSD
• No personality disorder

Sponsors & Collaborators

• University of Sheffield: lead

Study Sites (1)

The University of Sheffield

Sheffield, South Yorkshire, S10 2TN, United Kingdom

Location

Related Links

• self-compassion website where intervention exercises are found.

MeSH Terms

Conditions

Attention Deficit Disorder with Hyperactivity; Depression; Anxiety Disorders; Psychological Well-Being

Condition Hierarchy (Ancestors)

Attention Deficit and Disruptive Behavior Disorders; Neurodevelopmental Disorders; Mental Disorders; Behavioral Symptoms; Behavior; Personal Satisfaction

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principle Investigator

Study Record Dates

• First Submitted: July 9, 2021
• First Posted: July 27, 2021
• Study Start: September 23, 2021
• Primary Completion: April 25, 2022
• Study Completion: September 1, 2022
• Last Updated: July 29, 2022

Record last verified: 2022-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: ANALYTIC CODE
• Time Frame: When study results are accepted for publication.

Locations

GB (1)