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  • Running head: SELF-COMPASSION, MINDFULNESS, AND SAD

    Does Increased Self-Compassion Improve Social Anxiety Symptomology? Results from a

    Mindfulness-Based Intervention for Social Anxiety Disorder

    Jennifer Thake

    A thesis submitted to the Faculty of Graduate and Postdoctoral Studies in partial fulfillment

    of the requirements for the degree of Master of Arts in Educational Counselling

    Faculty of Education

    University of Ottawa

    Jennifer Thake, Ottawa, Canada 2015

  • SELF-COMPASSION, MINDFULNESS, AND SAD ii

    Acknowledgements

    I would like to express my deepest appreciation for my thesis supervisor, Dr.

    Kosyzcki, who expertly guided me through my graduate education at University of Ottawa.

    She not only provided me with the opportunity to be involved in a thesis project that was

    academically stimulating, but more importantly, a project that stimulated great momentum

    in my own spiritual journey. Dr. Koszycki was an incredible mentor who gave constructive

    feedback and cherished encouragement throughout this learning process. In addition, she

    modelled an unrelenting work ethic and resulting successes that have inspired me greatly.

    I would like to thank my committee members, Dr. Kelly Raab and Dr. David Smith,

    whose interest and confidence in the project drove me harder to tell the story. I enjoyed our

    exchange of ideas. Your feedback served to increase the quality and breadth of this thesis.

    In addition, I would like to thank those others who helped to facilitate this research.

    Much appreciation to Dr. Bradwejn and Dr. Daoust for their time, their great flexibility and

    their kind correspondence. You helped to make this project move along smoothly. Great

    thanks to Celine Mavounza and Eva Gurin for very warmly and very patiently helping me

    find my bearings when I was new to the project. Thanks also to Julie Wallis, who was there

    with a smile when I needed help in a pinch.

    I would also like to thank my family for their unwavering support of my desire to

    pursue this newest venture. I truly believe it was the right path and I am thankful for your

    love and care during the rocky parts of the road. I would also like to thank my good friend

    Lorena who opted to wonder this path with me. I could not have asked for a more perfect

    companion.

  • SELF-COMPASSION, MINDFULNESS, AND SAD iii

    The study was funded in part by a grant from the Institut de recherch de lHopital

    Montfort awarded to Dr. Koszycki.

  • SELF-COMPASSION, MINDFULNESS, AND SAD iv

    Abstract

    Purpose: This study assessed whether a mindfulness-based intervention (MBI)

    adapted for social anxiety disorder (SAD) led to increases in self-compassion and trait

    mindfulness, and whether these increases mediated change in SAD symptom severity.

    Methods: Participants were randomly assigned to a 12-week MBI adapted for SAD (MBI-

    SAD, n = 21) or a wait-list control (WLC, n = 18). The MBI-SAD included aspects of the

    mindfulness-based stress reduction program, as well as explicit training in self-compassion

    and mindful exposure. Participants were assessed at baseline and weeks 6 and 12.

    Results: The MBI-SAD resulted in higher self-compassion and trait mindfulness and lower

    levels of social anxiety, compared to the WLC. Mediation analyses revealed that self-

    compassion and aspects of trait mindfulness mediated clinical response. Implications:

    Results suggest that self-compassion and aspects of trait mindfulness are possible

    mechanisms of change for the MBI-SAD. Results and their implications are discussed.

  • SELF-COMPASSION, MINDFULNESS, AND SAD v

    Table of Contents

    Introduction ............................................................................................................................ 1

    What is Social Anxiety Disorder? ...................................................................................... 1

    Treatment of Social Anxiety Disorder ................................................................................ 7

    Mindfulness ........................................................................................................................ 9

    Mindfulness versus CBT ............................................................................................... 11

    Mindfulness-based interventions .................................................................................. 11

    Mindfulness interventions and SAD ............................................................................. 13

    Self-compassion ............................................................................................................... 13

    What is self-compassion? ............................................................................................. 14

    Why self-compassion for SAD? .................................................................................... 15

    Self-compassion and mindfulness ................................................................................. 17

    Self-compassion as a mediator of the mindfulness-well-being association ................. 19

    MBI interventions that include self-compassion .......................................................... 22

    The current study ............................................................................................................. 23

    Methods ............................................................................................................................... 23

    Design .............................................................................................................................. 23

    Participants and recruitment ........................................................................................... 24

    MBI-SAD Treatment......................................................................................................... 25

    Outcome measures ........................................................................................................... 27

    Mechanism measures ....................................................................................................... 28

    Statistical analyses ........................................................................................................... 30

    Results .................................................................................................................................. 32

    Flow of Participants ......................................................................................................... 32

    Missing data ..................................................................................................................... 32

    Participant information .................................................................................................... 33

    Baseline correlations between mediation and outcome variables ................................... 34

    Post intervention differences in mediating and outcome variables ................................. 35

    Self-compassion mediation analyses ................................................................................ 37

    Mindfulness mediation analyses ...................................................................................... 40

    Discussion ............................................................................................................................ 44

    Limitations and future research ....................................................................................... 68

    Conclusions ...................................................................................................................... 72

    References ............................................................................................................................ 74

  • SELF-COMPASSION, MINDFULNESS, AND SAD vi

    Appendix A: Eligibility measures...................................................................................... 105

    Appendix B: Description of MBI-SAD ............................................................................. 109

    Appendix C: Session overview .......................................................................................... 111

  • SELF-COMPASSION, MINDFULNESS, AND SAD vii

    Table of Tables

    Table 1: Bivariate correlations among baseline measures of self-compassion (SCS-SF) and

    self-reported (SPIN) and clinician-rated (LSAS) social anxiety symptoms ........................ 34

    Table 2: Bivariate correlations among baseline measures of trait mindfulness (FFMQ) and

    self-reported (SPIN) and clinician-rated (LSAS) social anxiety symptoms ........................ 35

    Table 3: Bivariate correlations among baseline measures of trait mindfulness (FFMQ) and

    self-compassion (SCS-SF) ................................................................................................... 35

    Table 4: Means and statistics at baseline and week 12 for MBI-SAD and WLC................ 36

    Table 5: Model of group assignment as a predictor of social anxiety symptoms (LSAS total

    and SPIN), mediated by fa