Skinner Chelsea M, Kuijer Roeline G
University of Canterbury, New Zealand.
J Psychosom Res. 2025 Sep;196:112322. doi: 10.1016/j.jpsychores.2025.112322. Epub 2025 Jul 9.
Endometriosis negatively impacts psychological wellbeing and health-related quality of life (HRQoL). Emerging research suggests that self-compassion may be a protective resource, although the mechanisms through which it influences functioning in endometriosis are not well understood. This study examined the relationship between self-compassion, psychological distress, and HRQoL over a six-month period. Pain catastrophising, pain acceptance, and resilience were examined as potential mediators.
264 individuals with endometriosis completed questionnaires twice over a 6-month period assessing self-compassion (T1 only), psychological distress (depression, anxiety, and stress), HRQoL, pain catastrophising, pain acceptance (activity engagement, pain willingness), resilience, and endometriosis-related information (T1 and T2). Bootstrapped mediation analyses were conducted to examine the relationship between the key variables cross-sectionally and over time (two-wave mediation).
Psychological wellbeing and HRQoL was significantly impaired in this sample. Higher self-compassion was associated with less impairment on all outcome variables at T1 (r > -0.25, p < .001) and improvements in depression (b = -0.28, p < .01) and stress (b = -0.21, p < .05) over the study period. Cross-sectionally, pain catastrophising mediated the relationship between self-compassion and all outcome variables. Prospectively, higher self-compassion at baseline was related to a decrease in pain catastrophising over the study period, which in turn was related to a decrease in depression, anxiety, stress, and HRQoL impairment over the study period. Pain willingness, activity engagement, and resilience were less consistent mediators at baseline and did not mediate the relationship between self-compassion and the outcome variables prospectively.
Future research should consider interventions that address self-compassion and pain catastrophising to reduce impairment in psychological wellbeing and HRQoL in individuals with endometriosis.
子宫内膜异位症对心理健康和健康相关生活质量（HRQoL）产生负面影响。新出现的研究表明，自我同情可能是一种保护性资源，尽管其影响子宫内膜异位症患者功能的机制尚不完全清楚。本研究考察了六个月期间自我同情、心理困扰和健康相关生活质量之间的关系。研究还考察了疼痛灾难化、疼痛接纳和心理韧性作为潜在中介变量的情况。
264名子宫内膜异位症患者在6个月内完成了两次问卷调查，评估自我同情（仅在T1时）、心理困扰（抑郁、焦虑和压力）、健康相关生活质量、疼痛灾难化、疼痛接纳（活动参与度、疼痛意愿）、心理韧性以及子宫内膜异位症相关信息（T1和T2）。采用自抽样中介分析来考察关键变量之间的横断面关系和随时间的关系（两波中介分析）。
该样本的心理健康和健康相关生活质量显著受损。在T1时，较高的自我同情与所有结果变量的较少损害相关（r > -0.25，p <.001），并且在研究期间抑郁（b = -0.28，p <.01）和压力（b = -0.21，p <.05）有所改善。横断面分析中，疼痛灾难化介导了自我同情与所有结果变量之间的关系。前瞻性分析中，基线时较高的自我同情与研究期间疼痛灾难化的减少相关，而这又与研究期间抑郁、焦虑、压力和健康相关生活质量损害的减少相关。在基线时，疼痛意愿、活动参与度和心理韧性作为中介变量的一致性较差，并且在前瞻性分析中未介导自我同情与结果变量之间的关系。
未来的研究应考虑采取干预措施来提高自我同情并减少疼痛灾难化，以减轻子宫内膜异位症患者的心理健康和健康相关生活质量损害。
