Effectiveness of Self-compassion Group Training on the Reduction of Anxiety, Stress, and Depression in Type 2 Diabetic Patients

Document Type : Original Article


1 Master of Psychology, Razi University, Kermanshah, Iran

2 Associate of Psychology, Razi University, Kermanshah, Iran


Introduction: Type 2 diabetes is one of the common acute diseases that should be controlled; otherwise, it leads to inevitable consequences for the patient. The aim of the present study was to evaluate the effect of self-compassion training on the reduction of anxiety, stress, and depression of patients with type 2 diabetes referring to the Taleghani Diabetes Clinic in Kermanshah City.
Methods: In the present semi-experimental study, 20 types 2 diabetes patients referring to the Taleghani Diabetes Clinic in Kermanshah City were enrolled through a simple randomized sampling method in 2017. The selected subject was divided into two treatment and control groups (10 subjects in each group). The treatment group participated in a self-compassion training class for 8 sessions (90 min), but the control group did not receive any training. In order to collect data, Depression Anxiety Stress Scales (DASS) was used. In addition, to analyze data, ANOVA and t-test methods were done using SPSS V.22 software.
Results: The results showed that in the treatment group, the mean score of anxiety, stress, and depression was significantly reduced compared to the control group (P<0.001).
Conclusion: In diabetic patients, self-compassion group training is one of the effective method on the reduction of anxiety, stress, and depression. Therefore, it is suggested employing self-compassion group training method to the reduction of anxiety, stress, and depression in patients suffering from type 2 diabetes by therapists, counselors, and psychologists.


1. Kastorini C-M, Panagiotakos DB. Mediterranean diet and diabetes
prevention: Myth or fact? World journal of diabetes. 2010;1(3):65.
2. Peters KE, Chubb SP, Davis WA, Davis TM. The relationship
between hypomagnesemia, metformin therapy and cardiovascular
disease complicating type 2 diabetes: the Fremantle Diabetes Study.
PloS one. 2013;8(9):e74355.
3. Papelbaum M, Lemos H, Duchesne M, Kupfer R, Moreira R,
Coutinho W. The association between quality of life, depressive
symptoms and glycemic control in a group of type 2 diabetes patients.
Diabetes research and clinical practice. 2010;89(3):227-30.
4. Nieuwesteeg A, Pouwer F, van der Kamp R, van Bakel H, Aanstoot
H-J, Hartman E. Quality of life of children with type 1 diabetes: a
systematic review. Current diabetes reviews. 2012;8(6):434-43.
5. American Psychiatric Association. (2015). Diagnostic and statistical
manual of mental disorders (5th ed.).
Arlington, VA: American Psychiatric Publishing.
6. Sadock B, Kaplan SV, Sadock VK. Sadocks Synopsis of Psychiatry.
Philadelphia: Williams and Wilkins; 2003.
7. Egede LE, Ellis C. Diabetes and depression: global perspectives.
Diabetes research and clinical practice. 2010;87(3):302-12.
8. Petrak F, Baumeister H, Skinner TC, Brown A, Holt RI. Depression
and diabetes: treatment and health-care delivery. The Lancet Diabetes
& Endocrinology. 2015;3(6):472-85.
9. Kirk KD, Fedele DA, Wolfe-Christensen C, Phillips TM, Mazur T,
Mullins LL, et al. Parenting characteristics of female caregivers of
children affected by chronic endocrine conditions: a comparison
between disorders of sex development and type 1 diabetes mellitus.
Journal of Pediatric Nursing. 2011;26(6):e29-e36.
10. Sadock BJ, Sadock, V. A., & Ruiz, P. (2015). Kaplan, Behavioral
Sssop, edition.). scpE, Kluwer. PW.
11. Ebrahim poor FAS, N%A Ghaljaei, F%A Naderi nfar, M. Insulininduced
Anxiety in Children with Diabetes. Journal of Diabetes
Nursing. 2015;3(3):63-74. (In Persian)
12. Everly Jr GS, Lating JM. A clinical guide to the treatment of the
human stress response: Springer Science & Business Media; 2012.
13. Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link
between stress, depression, and type 2 diabetes mellitus. Annals of the
New York Academy of Sciences. 2017;1391(1):20-34.
14. Sheehan A, While A, Coyne I. The experiences and impact of
transition from child to adult healthcare services for young people with
Type 1 diabetes: a systematic review. Diabetic Medicine.
15. Raes F. Rumination and worry as mediators of the relationship
between self-compassion and depression and anxiety. Personality and
Individual Differences. 2010;48(6):757-61.
16. Riegel B, Jaarsma T, Strömberg A. A middle-range theory of selfcare
of chronic illness. Advances in Nursing Science. 2012;35(3):194-
17. Habibzade H, Khalkhali H, Davarpanah M. The study of the effect
of Orem self care model on self efficacy in hemodialysis patients in
Urmia Medical Science Hospitals during 2011. The Journal of Urmia
Nursing and Midwifery Faculty. 2012; 10(2):190-9. (In Persian)
18. Ashworth F, Gracey F, Gilbert P. Compassion focused therapy after
traumatic brain injury: Theoretical foundations and a case illustration.
Brain Impairment. 2011;12(2):128-39.
19. Neff KD, Vonk R. Self-compassion versus global self-esteem: Two
different ways of relating to oneself. Journal of personality.
20. Neely ME, Schallert DL, Mohammed SS, Roberts RM, Chen Y-J.
Self-kindness when facing stress: The role of self-compassion, goal
regulation, and support in college students’ well-being. Motivation and
Emotion. 2009;33(1):88-97.
21. MacBeth A, Gumley A. Exploring compassion: A meta-analysis of
the association between self-compassion and psychopathology. Clinical
psychology review. 2012;32(6):545-52.
22. Krieger T, Altenstein D, Baettig I, Doerig N, Holtforth MG. Selfcompassion
in depression: Associations with depressive symptoms,
rumination, and avoidance in depressed outpatients. Behavior therapy.
23. Diedrich A, Grant M, Hofmann SG, Hiller W, Berking M. Selfcompassion
as an emotion regulation strategy in major depressive
disorder. Behaviour research and therapy. 2014;58:43-51.
24. Özyeşđl Z, Akbağ M. Self-compassion as a protective factor for
depression, anxiety and stress: A research on Turkish sample. The
Online Journal of Counseling and Education. 2013;2(2):36-43.
25. Yamaguchi A, Kim M-S, Akutsu S. The effects of self-construals,
self-criticism, and self-compassion on depressive symptoms.
Personality and Individual Differences. 2014;68:65-70.
26. Zareh F. Effectiveness of compassion-focused therapy in the
treatment of depression and blood glucose control in patients with type
2 diabetes 2014.
27. Golpour R, Abolghasemi A, Ahadi B, Narimani M. The
Effectiveness of Cognitive Self-Compassion Training and Emotion-
Focused Therapy on Quality of Life with Depression Disorder. Journal
of Clinical Psychology. 2014;6(1):53-64. (In Persian)
28. Sahebi A, Asghari MJ, Salari RS. Validation of Depression, Anxiety
and Stress Scale (DASS-21) for an Iranian population. Developmental
Psychology: Iranian Psychologists 2005; 1: 299-310. [In Persian]
29. Antoni MH, Wimberly SR, Lechner SC, Kazi A, Sifre T, Urcuyo
KR, et al. Reduction of cancer-specific thought intrusions and anxiety
symptoms with a stress management intervention among women
undergoing treatment for breast cancer. Am J Psychiatry 2006; 163 :
30. Pace TW, Negi LT, Adame DD, Cole SP, Sivilli TI, Brown TD, et
al. Effect of compassion meditation on neuroendocrine, innate immune
and behavioral responses to psychosocial stress.
Psychoneuroendocrinology. 2009;34(1):87-98.
31. Wren AA, Somers TJ, Wright MA, Goetz MC, Leary MR, Fras AM,
et al. Self-compassion in patients with persistent musculoskeletal pain:
relationship of self-compassion to adjustment to persistent pain. Journal
of Pain and Symptom Management. 2012;43(4):759-70.
32. Neff KD, Germer CK. A pilot study and randomized controlled trial
of the mindful self-compassion program. Journal of clinical
psychology. 2013;69(1):28-44.
Rafie Delfan and Karami
107 Int J Behav Sci Vol.12, No.3, Autumn 2018
33. Hilliard ME, Yi-Frazier JP, Hessler D, Butler AM, Anderson BJ,
Jaser S. Stress and A1c Among People with Diabetes Across the
Lifespan. Current diabetes reports. 2016;16(8):67.
34. Streisand R, Mackey ER, Herge W. Associations of parent coping,
stress, and well-being in mothers of children with diabetes:
Examination of data from a national sample. Maternal and Child Health
Journal. 2010;14(4):612-7.
35. Surwit RS, Van Tilburg MA, Zucker N, McCaskill CC, Parekh P,
Feinglos MN, et al. Stress management improves long-term glycemic
control in type 2 diabetes. Diabetes care. 2002;25(1):30-4.
36. van Dulmen S, Sluijs E, van Dijk L, de Ridder D, Heerdink R,
Bensing J. Patient adherence to medical treatment: a review of reviews.
BMC health services research. 2007;7(1):55.
37. Neff KD, Kirkpatrick KL, Rude SS. Self-compassion and adaptive
psychological functioning. Journal of research in personality.
38. Veickarami H, Rezai F, Mansouri L. evaluating the effect of
cognitive self-compassion training on reduction of rumination and selfblame
in female student with pervasive anxiety. World Conference on
Psychology and Educational Sciences, Law and Social Sciences at the
Beginning of the Third Millennium: Research Company of Ideh-
Bazareh-Sanateh-Sabz; 2016.
39. Breines JG, Thoma MV, Gianferante D, Hanlin L, Chen X,
Rohleder N. Self-compassion as a predictor of interleukin-6 response to
acute psychosocial stress. Brain, behavior, and immunity. 2014;37:109-
40. Mirzaei M, Daryafti H, Fallahzadeh H, Azizi B. Evaluation of
Depression, Anxiety and Stress in Diabetic and Non-Diabetic Patients.
The Journal of Shahid Sadoughi University of Medical Sciences.
41. Ahrari S, Toghian Cn, Basiri Mm, Khodadoost S, Mohtasham F. the
relationship between depression and adherence to treatment regimens
in patients with type 2 diabetes admitted to 22 bahman hospital in
gonabad. 2015.
42. Noroozinejad G, Boustani H, Neamat Ps, Behrouzian F.
Comparison of depression among diabetic and non-diabetic patients.
43. Behnam B, Ghorbani R. Epidemiologic features of depression in
non–insulin dependent diabetic patients in Semnan. Research in
Medicine. 2005;29(1):45-9.
44. Leary MR, Tate EB, Adams CE, Batts Allen A, Hancock J. Selfcompassion
and reactions to unpleasant self-relevant events: the
implications of treating oneself kindly. Journal of personality and social
psychology. 2007;92(5):887.
45. Lester L, Mistler B. Compassion: Conceptualisations, research, and
use in psychotherapy. Routledge Journals, Taylor & Francis Ltd 4 park
square, milton park, abingdon ox14 4rn, oxfordshire, england; 2006.