Could worry and rumination mediate relationships between self‐compassion and psychological distress in breast cancer survivors?
Open accessAbstract
Many breast cancer (BCa) patients experience clinically significant anxiety and depression in survivorship. Self‐compassion offers a bulwark to anxiety and depression in nonclinical, mental health, and some chronic physical health populations. We examined whether self‐compassion predicted lower anxiety and depression symptoms in survivors and whether this might be mediated by lower worry and rumination. The design was a cross‐sectional survey using self‐report measures. Female adult BCa survivors of mixed stages who had finished primary surgical, radiotherapy, or chemotherapy treatments completed self‐compassion subscales and worry, rumination, and anxiety and depression scales. Higher self‐compassion subscale scores were negatively associated with anxiety and depression. Depressive brooding and worry mediated any effects of self‐kindness and mindfulness on depression and anxiety, whereas common humanity directly predicted lower depression scores. Findings are consistent with the view that self‐compassion reduces threat‐related rumination and worry in BCa survivors, consequently reducing anxiety and depression. This may form a basis for prevention and treatment.
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Research in those with breast cancer suggests that self-compassion activates the resting parasympathetic nervous system and suppresses the threat system, to lower rumination and anxiety.
“research in those with breast cancer suggests that it activates the resting parasympathetic nervous system and suppresses the threat system, to lower rumination and anxiety.”
From Mindfulness for the self-management of negative coping, rumination and fears of compassion in people with cancer: An exploratory study (2023) · cites this paper as [30]
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“Self-compassion predicts emotional coping that is adapted to the hassles of daily life and even to life events and that serves as a defense against negative emotions and stressful incidents.(31,49) The multivariate analysis provided some useful insights.”
BackgroundAnthes, L. S., & Dreisoerner, A. (2026) · Mindfulness · doi:10.1007/s12671-025-02753-y · Cited by 6 · see citing works
Bühlmann, V., Schlüter-Müller, S., Fürer, L., Steppan, M., Birkhölzer, M., Schmeck, K., Koenig, J., Kaess, M., & Zimmermann, R. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03549-9 · Cited by 7 · see citing works
Zarei, K., Musarezaie, A., & Ashouri, E. (2021) · Iranian Journal of Nursing and Midwifery Research · doi:10.4103/ijnmr.ijnmr_284_20 · Cited by 3 · see citing works
“Iranian Journal of Nursing and Midwifery Research ¦ Volume 26 ¦ Issue 4 ¦ July-August 2021 293 incidence of depression and anxiety in patients with breast cancer, so that an increased self‐compassion reduced mental rumination and worrying and thus also decreased anxiety and depression.[43] Arambasic et al.”
BackgroundLi, F., Liao, J., Liu, L., Yang, T., Dai, X., & Li, J. (2022) · Sexuality Research and Social Policy · doi:10.1007/s13178-022-00730-x · Cited by 3 · see citing works
Krok, D., Telka, E., & Skalski‐Bednarz, S. B. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14134696 · Cited by 3 · see citing works
“Among women with breast cancer who had completed treatment, higher levels of self-compassion were found to be negatively associated with worry and ruminative thinking—core cognitive features underlying the fear of cancer recurrence [12].”
Mehrabi, N., Amiri, H. R., Omidi, A., & Sarvizadeh, M. (2025) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2025.2543063 · Cited by 3 · see citing works
“54 The less self-compas-sionate breast cancer survivors are, the more distress they experience.”
Widdrington, H., Cherry, M. G., Herron, K., & Krahé, C. (2025) · Behaviour Research and Therapy · doi:10.1016/j.brat.2025.104922 · Cited by 2 · see citing works
Self-citationEldin, F. A. S., Ibrahim, S., & Elsayed, S. S. (2021) · Egyptian Journal of Health Care · doi:10.21608/ejhc.2021.307158 · Cited by 2 · see citing works
“For several reasons, self-compassion is a potential factor that lowers body dissatisfaction and fosters a healthier body image (Brown et al., 2020).”
BackgroundHodzic, A., Flynn, A. R., Lamont, J. M., Khin, M., & Grubbs, A. (2024) · Cognitive Processing · doi:10.1007/s10339-024-01249-2 · Cited by 2 · see citing works
“This finding supports the self-regulation resources model, which suggests self-compassion can help regulate negative emotions (Sirois 2015; Terry and Leary 2011), including those associated with body image threats (Brown et al. 2020).”
Meme Kanseri Olan Kadınlarda Psikolojik Belirtiler ve Travma Sonrası Gelişim ile İlişkili Faktörler
AYDOĞDU, B. E., & Di̇ri̇k, G. (2021) · Nesne Psikoloji Dergisi · doi:10.7816/nesne-09-22-07 · Cited by 2 · see citing works
Shahbeik, S., Moazedian, A., Sabahi, P., & Otaghsara, A. K. (2022) · doi:10.61838/kman.aftj.3.4.16 · Cited by 1 · see citing works
Uğuz, Ö., & Doğan, S. (2024) · Cancer Nursing · doi:10.1097/ncc.0000000000001434 · Cited by 2 · see citing works
Yuan, J., Chen, L., & Hongye, G. (2025) · Scientific Reports · doi:10.1038/s41598-025-11973-0 · Cited by 1 · see citing works
“…model could involve: Higher levels of chronic rumination are correlated with reduced executive resource availability and attenuated metacognitive monitoring capacities, which in turn are associated with the emotional disorientation and expressive limitations characteristic of alexithymia 74,87 .”
Tang, A., Li, F., He, B., Zheng, Y., Li, Q., Zhou, L., Wu, J., Zeng, H., Tang, N., Qiu, X., et al. (2025) · Asia-Pacific Journal of Oncology Nursing · doi:10.1016/j.apjon.2025.100814 · Cited by 1 · see citing works
“Women typically exhibit heightened emotional sensitivity and are more vulnerable to negative emotions such as anxiety, depression, and fear, 41 which can adversely affect eating behaviors and intensify ERD.”
Self-Compassion and Chronic Medical Conditions
Finlay‐jones, A. L., Boggiss, A. L., & Serlachius, A. S. (2023) · Mindfulness in behavioral health · doi:10.1007/978-3-031-22348-8_19 · Cited by 1 · see citing works
Gayman, M. D., Stover, S., Tsukerman, K., Nielsen, K., & Wilkin, H. A. (2023) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-023-01721-3 · Cited by 1 · see citing works
“Health rumination and health worry both refer to excessive attention and concern regarding one’s health [6, 7], with rumination focusing on past or current health and worry focusing on future health [30].”
Individual Rumination in Adult Cancer Care: A Concept Analysis
Cao, J., & Üzar‐Özçetin, Y. S. (2025) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2024.151802 · Cited by 1 · see citing works
Sexual quality of life, self-compassion and desire to use onco-sexology support by cancer patients
Lantheaume, S., Moták, L., Guy, J., Paucsik, M., Doublet, L., Préau, M., Kotsou, I., & Huyghe, É. (2025) · Bulletin du Cancer · doi:10.1016/j.bulcan.2025.07.006 · Cited by 1 · see citing works
Florio, G., Abbatantuono, C., Antonucci, L. A., Verri, V., Taurino, A., Taurisano, P., & Caro, M. F. D. (2023) · PSICOLOGIA DELLA SALUTE · doi:10.3280/pds2023-001010
Development and preliminary validation of the Brief Self-Compassion Inventory
Chinh, K., Wu, W., Johns, S. A., Stutz, P. V., McGrew, J. H., & Mosher, C. E. (2023) · PLoS ONE · doi:10.1371/journal.pone.0285658 · Cited by 1 · see citing works
“The inverse link between self-compassion and rumination is consistent with prior research with cancer populations [17].”
ResultGambaran Self-Compassion pada Pasien Kanker Dewasa Muda dan Dewasa Madya
Gandapriatna, W., & Warmiyati, M. T. (2024) · MANASA · doi:10.25170/manasa.v12i2.4802
PREDIKSI SELF-COMPASSION TERHADAP PSYCHOLOGICAL DISTRESS PADA MAHASISWA YANG SEDANG MENYUSUN SKRIPSI
Vanessa, S. R., & Ferdian, F. R. (2024) · MANASA · doi:10.25170/manasa.v12i2.4800
“…Kota Bandung (Zulian & Wahyudi, 2020), para psikolog keturunan Prancis dan Kanada (Bourgault & Dionne, 2019), wanita yang mengidap kanker payudara (Brown et al., 2020), orang dewasa di Turki (Hatun & Kurtça, 2023), remaja perempuan dengan gangguan makan (Pullmer et al., 2019), dan para atlet…”
BackgroundNasab, S. K., Amiri, H. R., Omidi, A., & Sarvizadeh, M. (2025) · Journal of Health Psychology · doi:10.1177/13591053251380032
“…and chemotherapy—often administered to younger patients—may result in profound disruptions to self-image and identity, thereby diminishing self-compassion and exacerbating feelings of self-blame, shame, and emotional isolation (Brown et al., 2020; Kaplan et al., 2023; Mosher et al., 2013).”
Gustafsson, M. V., Ismail, A., Støre, S. J., Blomqvist‐Storm, M., & Trindade, I. A. (2025) · Journal of Psychosocial Oncology Research and Practice · doi:10.1097/or9.0000000000000185
“Recent studies on women with breast cancer have found self-compassion to be negatively associated with anxiety and depressive symptoms, 8,9 stress, 9 avoidance, 10 worry, rumination, 8 and fear of cancer recurrence 11 and positively associated with hope 9 and psychological adjustment.”
Trindade, I. A., Caçador, M. I., & Moreira, H. (2025) · Springer eBooks · doi:10.1007/978-3-031-89095-6_22
Li, S., Yang, T., Zhou, Z., Huang, S., & Yan, M. (2026) · Journal of Biosciences and Medicines · doi:10.4236/jbm.2026.148013
Zouerami, A., Kianimoghadam, A., & Shojaei, A. (2026) · Health Psychology Open · doi:10.1177/20551029261480931
- Authors
- Brown, S. L., Hughes, M., Campbell, S., & Cherry, M. G.
- Affiliations
- University of Liverpool (GB)
- Corresponding author
- Brown, Stephen L.
- Venue
- Clinical Psychology & Psychotherapy
- Publisher
- Wiley
- Published
- 2019-12-04
- Volume
- 27
- Issue
- 1
- Pages
- 1-10
- ISSN
- 1063-3995 (ISSN-L)
- 1099-0879
- OpenAlex
- W2990357766
- Cited by
- 55
- References
- 72
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 8 · 2023: 7 · 2022: 8 · 2021: 11 · 2020: 7
- FWCI
- 2.72
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Clinical Psychology & Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- RUNE (Research UNE) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- self-compassion, breast cancer survivors, worry, rumination, anxiety, depression, psychological distress, mediation, self-kindness, mindfulness, common humanity
- MeSH terms
- Rumination, Cognitive, Psychological Distress, Anxiety Disorders, Breast Neoplasms, Empathy, Female, Humans, Middle Aged, Surveys and Questionnaires, Self Concept, Stress, Psychological, Survivors, Mindfulness
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