Edited by: Jochen Mutschler, Private Clinic Meiringen, Switzerland
Reviewed by: Lais Boralli Razza, University of São Paulo, Brazil; Siddharth Sarkar, All India Institute of Medical Sciences, India
This article was submitted to Public Mental Health, a section of the journal Frontiers in Psychiatry
†ORCID: Bobo Hi-Po Lau
Cecilia Lai-Wan Chan
Siu-Man Ng
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
COVID-19 has brought tremendous and abrupt threats to various aspects of our daily lives, from school and work to interpersonal relationships. Self-compassion is put forth as a salutogenic perspective on oneself that buffers the adverse mental health impacts of these threats. During the peak of a local outbreak in Hong Kong in Spring 2020, 761 participants completed questionnaires on self-compassion, perceived threats, as well as perceived benefits and psychological distress. Controlling for demographic variables, negative indicators of self-compassion (aka self-coldness) was found to intensify the impacts of threats on psychological distress. The positive indicators of self-compassion also moderated the link between threats and perceived benefits, such that perceived benefits tend to be less related to threats in participants with higher self-compassion. Our findings highlight the impacts of both positive and negative indicators of self-compassion on the adjustment to such unprecedented challenges, and point to the possibility of enhancing people's resilience through fostering self-compassion and alleviating self-coldness.
The Coronavirus Disease-2019 (COVID-19) has imposed unprecedented changes to our everyday lives. In countries where cities were locked down, citizens were forced into furlough or work-/school-at-home arrangements with wide-spread suspension of services and businesses, entailing pervasive loneliness, and sense of insecurity (
This study was conducted during the peak of the Spring 2020 outbreak in Hong Kong, when public health orders banning public gatherings, restricting catering capacity of restaurants to half and mandating closure of high-risk businesses were enforced for the first time after reports of infection clusters in March. Conceivably, these measures have drastically changed the citizens' daily routines and resulted in enormous challenges to the local businesses and the civil society, especially after months of conflicts during the Anti-extradition law amendment bill (Anti-ELAB) movement (
Neff proposed that self-compassion entails (i) extending kindness and understanding to oneself rather than treating oneself with harshness and criticism (self-kindness vs. self-judgment), (ii) seeing one's suffering as a part of the shared human experience rather than an isolated experience (common humanity vs. isolation), and (iii) a balanced perspective of one's suffering rather than overly attached to it (mindfulness vs. over-identification) (
Self-compassion may modulate how people confront threats by encouraging adaptive coping responses. Allen and Leary summarized the associations between self-compassion and coping styles (
Self-compassion is often assessed with the full- or short-version of Self-Compassion Scale [SCS; (
Moreover, the positive and the negative factors appear to be asymmetrically related to psychopathology and well-being. Muris and Petrocchi found that while the positive and the negative indicators are related to psychopathology in expected directions, comparisons over the strengths of the relationships revealed the negative indicators as significantly stronger predictors than the positive ones (
A bifactor model that distinguishes self-compassion from self-coldness may better fit how Asians affectively evaluate things in general. For instance, a dialectical thinking style, which has roots in Asian philosophies and religions (e.g., Confucianism and Buddhism), facilitates tolerance and flexible integration of affectively opposite judgments and coping strategies (
In this study, we tested the moderation effects of self-compassion and self-coldness simultaneously on the impacts of pandemic-related perceived threats on well-being. Also, as self-compassion and self-coldness may be differentially associated with well-being and psychopathology, we tested on outcomes indicating both negative and positive adaptations (
This is a part of a longitudinal study on how people of Hong Kong adjust to the COVID-19 pandemic. The current analysis utilized only the cross-sectional data collected between mid-March to early-April 2020, right after the World Health Organization declaring COVID-19 a pandemic (
Adults aged 18 or above residing in Hong Kong were eligible for the study. Participants who could not read traditional Chinese or had no access to the internet were excluded. Conducted as a swift response to the situation, participants were recruited through snowballing by social media and email lists. Participants were reimbursed HKD$50 in cash or supermarket coupons for participating in the current survey.
Participants were asked to rate the extent to which the pandemic has rendered threats to their (i) work/academic life, (ii) personal finance, (iii) family relationships, and (iv) social life on a 10-point scale running from 1 (not at all) to 10 (extremely). The four self-constructed items were averaged to form an overall perceived threats scale, with good reliability (Cronbach α = 0.79).
The 12-item Self-Compassion Scale Short Form [SCS-SF; (
Psychological distress over the past 2 weeks was measured by the Patient Health Questionnaire-4 [PHQ-4; (
Eleven self-constructed items were employed to indicate perceived benefits experienced by our participants during the pandemic (
Demographic information, such as gender, age, education background, marital status, income, religion as well as health and pandemic exposure related data, such as presence of a chronic health condition, co-residence with an individual vulnerable to a severe course of illness in case of infection (e.g., children, elderly, individuals with chronic illness, pregnant women, etc.), level of risk at occupational setting, SAR-CoV-2 test results (if any) and medical quarantine experience were also collected from the online survey. The online survey was conducted in traditional Chinese.
Descriptive statistics were used to explore the levels of perceived threats, self-compassion, self-coldness, perceived benefits and psychological distress of the participants, while the intercorrelations among the key variables were scrutinized by Pearson's correlations. The moderating role of self-compassion and self-coldness were tested with SPSS PROCESS macro (version 3). Assuming a moderate effect size (
Among the 761 participants (
Sample characteristics (
Female | 515 | 67.7 |
Male | 246 | 32.3 |
Primary or less | 6 | 0.8 |
Secondary | 157 | 20.6 |
Higher diploma/Associate degree | 123 | 16.2 |
Undergraduate | 262 | 34.4 |
Post-graduate or above | 213 | 28.0 |
Single, divorced, separated, bereaved | 381 | 50.1 |
Married | 380 | 49.9 |
<10,000 | 57 | 7.5 |
10,000–19,999 | 91 | 12 |
20,000–29,999 | 107 | 14.1 |
30,000–39,999 | 89 | 11.7 |
40,000–49,999 | 86 | 11.3 |
50,000–69,999 | 132 | 17.4 |
70,000–89,999 | 85 | 11.2 |
90,000 or more | 114 | 15 |
Yes | 358 | 47 |
No | 403 | 53 |
Yes | 187 | 24.6 |
No | 574 | 75.4 |
Yes | 385 | 50.6 |
No | 376 | 49.4 |
Yes | 272 | 35.7 |
No | 489 | 64.3 |
Both perceived threats and benefits from COVID-19 were moderate [Means (SDs) = 4.89 (2.10), 4.65 (0.99), respectively]. The mean of PHQ-4 was 3.29 (
Intercorrelations among the key variables (
1. Self-compassion | 4.89 (2.10) | 1.00 | – | – | – | – |
2. Self-coldness | 3.59 (0.68) | −0.28 |
1.00 | – | – | – |
3. Perceived threats | 3.19 (0.73) | −0.16 |
0.28 |
1.00 | – | – |
4. Psychological distress | 3.29 (2.91) | −0.29 |
0.40 |
0.41 |
1.00 | – |
5. Perceived benefits | 4.65 (0.99) | 0.32 |
−0.11 |
0.06 | −0.06 | 1.00 |
Results of moderation models (
Female (vs. male) | 0.36 (0.19) | 0.20 (0.07) |
Age | −0.00 (0.01) | 0.00 (0.00) |
University educated (vs. no) | 0.08 (0.21) | −0.01 (0.08) |
Income | −0.00 (0.03) | −0.01 (0.01) |
Presence of own chronic health problems (vs. no) | 0.25 (0.22) | 0.02 (0.08) |
Co-living with a vulnerable individual (vs. no) | 0.25 (0.18) | 0.02 (0.07) |
Religious affiliation (vs. no) | −0.24 (0.18) | 0.04 (0.07) |
In a high-risk occupation (vs. no) | 0.05 (0.19) | −0.05 (0.07) |
Perceived threats | 0.24 (0.29) | 0.34 (0.11) |
Self-coldness | 0.13 (0.30) | 0.09 (0.11) |
Self-compassion | −0.15 (0.32) | 0.73 (0.12) |
Self-coldness × perceived threats | 0.19 (0.06) |
−0.03 (0.02) |
Self-compassion × perceived threats | −0.12 (0.06) |
−0.05 (0.02) |
Model summary: Δ |
0.2968 |
0.1412 |
Moderation roles of self-compassion and self-coldness on the effects between perceived threats and psychological distress (
For perceived benefits, the main effect of self-compassion was significant, meaning that higher self-compassion was related to more perceived benefits, whereas that from self-coldness was non-significant. The main effect of perceived threat remained significant but positive, indicating more perceived benefits from higher levels of perceived threat. Only the moderation effect from self-compassion was significant (
Moderation roles of self-compassion and self-coldness on the effects between perceived threats and perceived benefits (
Based on a bifactor model that distinguishes self-compassion from its negative counterpart—self coldness, our findings underscore the moderating roles of both constructs on how pandemic-related threats may impact well-being (
The findings on the buffering role of self-compassion and the amplifying role of self-coldness on the threat-psychopathology link echo with the conceptualization of the former as a protective factor in Neff and colleagues as well as the model of self-relating of Brenner et al. that views the latter as a risk factor (
In contrary to our expectation, more benefits were actually perceived in people facing more pandemic-related threats. The levels of perceived threats experienced by our participants were in general moderate. Such a level of threats would be threatening enough to trigger a response, but not too severe to have “frozen” the participants from responding or incurred resource loss so severe that adaptive coping strategies became impossible. Hence, greater threat perceptions could have triggered vigilance as well as cognitive and behavioral adaptations, which in turn enabled the discovery of benefits (
The relationship of self-coldness with perceived benefits might be less straight forward then the one with psychological distress. In the Asian culture that rewards modesty and emphasizes group harmony, being critical to oneself is not necessarily bad (
Due to the unprecedented nature of COVID-19 pandemic, we relied on self-constructed measures to assess the degree of perceived threats imposed onto the participants' daily lives and the extent to which benefits and gains are experienced from the disrupted livelihood. As noted by Horesh and Brown, COVID-19 may represent a new type of mass trauma characterized by its global nature, lethality, novelty, and unpredictability, as well as the enormous anticipatory anxiety it ensues (
Mental health scientists are calling for studies on the causal and modifiable psychological factors that foster people's coping in the pandemic (
The COVID-19 pandemic is a humbling experience for many of us. Instead of a relentless chase after self-enhancement and self-esteem, acknowledging one's limitations as a part of the shared human experience with compassion could be particularly salutogenic, especially in such an unprecedented, challenging time. Our findings highlight the role of self-compassion to buffer the adverse consequences of perceived threats on well-being and to facilitate a general tendency to find benefits regardless of threats. Our findings also caution mental health professionals against the detrimental effects of self-coldness, as it may amplify psychological distress from perceived threats.
The raw data supporting the conclusion of this article will be available upon request to the corresponding author.
The studies involving human participants were reviewed and approved by Human Research Ethics Committee of University of Hong Kong. The patients/participants provided their written informed consent to participate in this study.
BL conducted the data analysis. All authors contributed significantly to the conception, data collection, and writing up of the study.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The authors thank Lian Pat for her support in this manuscript and the administration of the project.