Depression in people with skin conditions: The role of self-compassion as an adaptive response

The research presented in this thesis investigated the role of self-compassion in relation to depression in people with chronic skin conditions. A systematic review of the literature indicated that compassion-based interventions can reduce depression, although at the time of the review more rigorously-designed studies were required. Study 1 used surveys to investigate the relationships between self-compassion, depression and disgust traits in sample of patients attending a dermatology clinic (N = 147) and at three-month follow-up (N = 80). Self-compassion was associated with depression cross-sectionally and prospectively. Findings further indicated that self-compassion moderated the effect of disgust propensity on depression, as disgust propensity had a significant positive relationship with depression in people with low and average levels of self-compassion, but not in people with high self-compassion. In Study 2, a purposive sample of people with skin conditions and high self-compassion (N = 10) took part in qualitative interviews. Template analysis of the interview data was used to explore how high self-compassion operates in managing the difficulties of living with a skin condition. Sensitivity to distress and care for wellbeing emerged as fundamental attributes unpinning a wide variety of compassionate responses to skin-related distress. An online, compassion-based, guided self-help intervention for depression in people with skin conditions was then developed. Study 3 assessed the acceptability and feasibility of the intervention among people with heterogenous skin conditions (N = 34) recruited online. Recommendations were made for future intervention development, based on participants’ feedback, and for future research, based on methodological difficulties. In conclusion, the current findings suggest that self-compassion is a valid therapeutic target for people with skin conditions and depression, and that self-compassion can be used flexibly to manage the difficulties of living with a skin condition. Further research on online compassion-based self-help for depression in people with skin conditions is warranted.