نقش تعدیل‌کنندگی خودشفقت‌ورزی در رابطه بین نشانگان افسردگی با بهزیستی روان‌شناختی زنان بیوه

The association between depression symptoms and psychological well-being has received both theoretical and empirical support, however, less is known about the moderating mechanisms in this relationship. The current study aimed to explore the moderating role of self-compassion in the relationship between depressive symptoms and psychological well-being. The research method was descriptive – correlational. The statistical population was widowed women who referred to the East Tehran Welfare Organization in 2019, and a total of 130 women were selected via a simple accidental sampling method. Psychological Well-being Scale (PWS), Self-Compassion Scale (SCS), and Beck Depression Inventory-II (BDI-II) were used to collect the data. Collected data were analyzed using hierarchical linear regression. Results showed that the relationship between depressive symptoms and psychological well-being (r= -0.54, p<0.001) was significantly negative. Also, results of hierarchical regression confirmed the moderating role of self-compassion in the relationship between depressive symptoms and psychological well-being (β= -0.23, p<0.01). The present study highlights the moderating role of self-compassion as an underlying mechanism between depression symptoms and psychological well-being. Therefore, increasing self-compassion in widowed women could be a good way to protect them in the face of adversity and suffering in life.
 
Keyword
Self-compassion, Depression, Psychological Well-being, Widowed Women.
 
Introduction
The death of a spouse is a traumatic and painful situation in life that is associated with a high prevalence of psychological distress such as depression and anxiety (Kristiansen et al., 2019). Men and women both will suffer from reduced psychological well-being following widowhood, however, researchers report that this rate is much higher in women than in men (Xu et al., 2017). The absence of a husband affects almost the entire sphere of a woman's life and affects her well-being in various psychological, social, physical, behavioral and economic dimensions (Moon et al., 2014). Widowed women, despite these sufferings, are obliged to take responsibility and are forced to raise their children (Zhou & Hearst, 2016).
Therefore, it is necessary to pay attention to the psychological well-being of widows and help them cope with their stressful lives because psychological well-being influences their ability to cope with problems and will protect their children and families (Agrawal & Keshri, 2014). Therefore, it is important to note how and under what conditions and in fact through what variables the effect of widow depressive symptoms on psychological well-being is reduced. In this area, studies show that self-compassion is a positive orientation toward pain, suffering, and distress that influence psychological functioning (Neff & Germer, 2018). Therefore, the present study aimed to investigate the moderating role of self-compassion as a psychological competence in the relationship between depressive symptoms and the psychological well-being of widows.
 
Methods
This cross-sectional and correlational study was conducted on widowed women referring to the east Tehran Welfare Organization who in 2019 had an active record of receiving social services. Using a simple sampling method, 150 people were selected as samples. Psychological Well-being Scale (Ryyf, 1989), Self- Compassion Scale (Neff, 2003), and Beck Depression Inventory-II (Beck, Steer & Brown, 2000) were used to collect the data. It is noted that 20 participants were excluded from subsequent analyses. Collected data were analyzed using Pearson correlation and hierarchical linear regression using SPSS 23.0.
Results
About the demographic characteristics of 130 widowed women participants, it is noted that age averaged 41.58 years (SD = 8.03). The results of hierarchical regression analysis showed that in the first step, depression symptoms alone explains 38% of the variance of psychological well-being. In the second step, self-compassionate as a moderator variable by adding to the regression equation along with depression symptoms explain 45% or the variance of psychological well-being.  Finally, in the third step, the interaction between depression symptoms and self-compassion was added to the regression equation, and the results of this interaction have 59% of the power to explain psychological well-being. Therefore, due to the increase in the explained variance of the psychological well-being variable as a result of the interactive variable of depression and self-compassion, it can be concluded that self-compassion can moderate the relationship between depressive symptoms and psychological well-being.
 
Discussion and Conclusion
The results showed that self-compassion has a moderating role in the relationship between depressive symptoms and psychological well-being, which indicates that self-compassion, has a deterrent function to the negative effects of depressive symptoms on psychological well-being. Explaining this finding, it can be said that self-compassion increases well-being because it helps people to have a stronger sense of dependence, communication and security (Neff & Germer, 2018). Also, self-compassion can increase positive emotions and resources that weaken negative emotions such as depressive symptoms, and this factor leads to increased psychological well-being (Kirby et al., 2017). In another explanation, it can be stated that self-compassion can be used as a barrier against widowed’ negative experiences and increase their positive emotions when negative events occur in their lives and act as an important potential protective factor against emotional issues such as depressive symptoms (Holm et al., 2019).
Because the relationship between depression symptoms and psychological well-being varies depending on the individual's level of self-compassion, counselling or psychological intervention programs focusing on increasing self-compassion can help widows reduce depression and mental well-being. Therefore, mental health professionals must develop programs to increase self-compassion among widowed women to cope with difficult emotions, adversity and life breakdowns.
 
References
Agrawal, G., & Keshri, K. (2014). Morbidity patterns and health care seeking behavior among older widows in India. PLoS ONE, 9(4), e94295. https://dx.doi.org/10.1371%2Fjournal.pone.0094295
Akbari Torkamani, N., Ghasemi, V., & Aqababaee, E. (2018). Empowering Female- headed Households in District 5 of Isfahan with Emphasis on Occupation Factor. Women's Studies Sociological and Psychological, 16(3), 7-36. [Text in Persian]
Akin, A., & Akin, U. (2015). Self-compassion as a predictor of social safeness in Turkish university students. Revista Latinoamericana de Psicología, 47(1), 43-49.
Arimitsu, K., & Hofmann, S. G. (2015). Cognitions as mediators in the relationship between self-compassion and effect. Personality and Individual Differences, 74, 41–48. https://psycnet.apa.org/doi/10.1016/j.paid.2014.10.008
Baron, R. M., & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.
Beck, A. T., Steer, R. A., & Brown, G. K. (2000). Manual for the Beck depression inventory II. San Antonio. TX: The Psychological Corporation.
Ben-Zur, H. (2012). Loneliness, optimism, and well-being among married, divorced, and widowed individuals. The Journal of Psychology: Interdisciplinary and Applied, 146(1-2), 23-36
Blutha, K., & Blanton, P. W. (2015). The influence of self-compassion on emotional well-being among early and older adolescent males and females. Journal of Pos Psychology, 10(3), 219–230.
Burns, R. A., Browning, C. J., & Kendig, H. L. (2015). Examining the 160‐ year trajectories of mental health and wellbeing through the transition into widowhood. International Psychogeriatrics, 27(12), 1979–1986.
Busari, A. O., & Folaranmi, O. O. (2014). An Empirical inquiry to psychological variables constituting stress: Middle-aged widows in rural communities in Nigeria. Journal of Pan African Studies, 7(3), 210-222.
Cheng, S. T., Chan, T. W. S., Li, G. H. K., & Leung, E. M. F. (2014). Childlessness and subjective well‐being in Chinese widowed persons. The Journals of Gerontology Series B, 69 (1), 48–52.
Chitrali, J.A., Anwar,  A.(2013).  Socio-psychological consequences of spouse's death on widows of Khyber Pakhtunkhwa. Putaj Humanities & Social Sciences, 20(1), 147-156.
El Mozini, O.( 2011). Psychological suffering to the wives of the martyrs of the war in Gaza 2008, in the light of some variables, Journal of humanistic of Islamic University,19(2), 273-304.
Erlangsen, A., Runeson, B., & Bolton, J. M. (2017) Association between spousal suicide and mental, physical, and social health outcomes: a longitudinal and nationwide register-based study. JAMA Psychiatry, 74(5), 456–464.
Evans, S., Wyka, K., Blaha, K. T., & Allen, E. S. (2018). Self-compassion mediates improvement in well-being in a mindfulness-based stress reduction program in a community-based sample. Mindfulness, 9(4), 1280–1287.
Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness, 10(8), 1455–1473.
Holm, A. L., Berland, A. K., & Severinsson, E. (2019). Factors that influence the health of older widows and widowers—A systematic review of quantitative research. Nursing Open, 6(2), 591–611.
Inwood, E., & Ferrari, M. (2018). Mechanisms of change in the relationship between self-compassion, emotion regulation, and mental health: A systematic review. Applied Psychology and Health Well Being, 10(2), 215–235.
Jadhav, A., & Weir, D. (2017). Widowhood and Depression in a Cross-National Perspective: Evidence from the United States, Europe, Korea, and China. Journal Gerontol B Psychology Science and Social Science, 73(8), 143-153.
Kaneez, S.(2015).Grief,  traumatic loss and coping following bereavement:  case study of women.  The International Journal of Indian Psychology, 2(3), 17-23.
Khazaei, A., Shamsipour, H., & Davazdah Emamy M H. (2018). The effectiveness of Group well-being Therapy on marital satisfaction and psychological well-being among housewives. Shenakht Journal of Psychology and Psychiatry, (5), 43-52. [Text in Persian]
Kirby, J. N., Tellegen, C. L., & Steindl, S. R. (2017). A meta-analysis of compassion-based interventions: Current state of knowledge and future directions. Behavior Therapy, 48(6), 778–792.
Kristiansen, C. B., Kjær, J. N., Hjorth, P., Andersen, K., & Prina, A. M. (2019). Prevalence of common mental disorders in widowhood: a systematic review and meta-analysis. Journal of Affective Disorder, 245, 1016–1023. https://doi.org/10.1016/j.jad.2018.11.088
Lim, G. Y., Tam, W. W., Lu, Y., Ho, C. S., Zhang, M. W., & Ho, R. C. (2018). Prevalence of depression in the community from 30 countries between 1994 and 2014. Science Report, 8(1), 2861
Lloyd‐Sherlock, P., Corso, B., & Minicuci, N. (2015). Widowhood, socio-economic status, health and wellbeing in low and middle‐income countries. The Journal of Development Studies, 51(10), 1374–1388.
Lopez, A., Sanderman, R., & Schroevers, M. J. (2018). A close examination of the relationship between self-compassion and depressive symptoms. Mindfulness, 9(5), 1470–1478.
Merz, E. M., & De Jong Gierveld, J. (2016). Childhood memories, family ties, sibling support and loneliness in ever‐widowed older adults: Quantitative and qualitative results. Ageing & Society, 36(03), 534–561.
Michael, S. T., Crowther, M. R., Schmid, B., & Allen, R. S. (2003). Widowhood and spirituality: Coping responses to bereavement. Journal of Women and Aging, 15, (2-3), 145-165.
Minton, M, E., Hertzog, M., Barron, C, R., French, J., &  Reiter-Palmon, R. (2009).The first anniversary: stress, well- Being, and optimism in older widows. Western Journal of Nursing Research, 31(8), 1035-1056.
Momtaz, Y., Ibrahim, R., Hamid, T.,  &Yahaya, N. (2010). Mediating effects of social and personal religiosity on the psychological well-being of widowed elderly people. Omega: Journal of Death & Dying, 61(2), 145-162.
Monserud, M. A., & Wong, R. (2015). Depressive symptoms among older Mexicans: The role of widowhood, gender and social integration. Research on Aging, 37(8), 856–886.
Moon, J. R., Glymour, M. M., Vable, A. M., Liu, S. Y., & Subramanian, S. V. (2014). Short‐ and long‐term associations between widowhood and mortality in the United States: Longitudinal analyses. Journal of Public Health, 36(3), 382–389.
Muris, P., Otgaar, H., & Petrocchi, N. (2016). Protection as the mirror image of psychopathology. Further critical notes on the self-compassion scale. Mindfulness, 7(3), 787–790.
Naef, R., Ward, R., Mahrer‐Imhof, R., & Grande, G. (2013). Characteristics of the bereavement experience of older persons after spousal loss: An integrative review. International Journal of Nursing Studies, 50(8),1108–1121.
Neff, K. D. (2018). Setting the record straight about the self-compassion scale. Mindfulness, 10, 200–202. https://doi.org/10.1007/s12671-018-1061-6
Neff, K. D., & Germer, C. K. (2018). The mindful self-compassion workbook: A proven way to accept your- self, find inner strength and thrive. New York: Guilford Press.
Neff, K. D., Toth-Kiraly, I., Yarnell, L. M., Arimitsu, K., Castilho, P., & Ghorbani, N. (2019). Examining the factor structure of the Self-Compassion Scale in 20 diverse samples: Support for use of a total score and six subscale scores. Psychological Assessment, 31(1), 27–45.
Neff, K. D., Whittaker, T. A., & Karl, A. (2017). Examining the factor structure of the Self-Compassion Scale in four distinct populations: Is the use of a total scale score justified? Journal of Personality Assessment, 99(6), 596–607.
Onrust, S. A., & Cuijpers. P. (2006).Mood and anxiety disorders in widowhood: a systematic review. Aging Men Health, 10(4), 327-334.
O'Rourke, N. (2004). Psychological resilience and the well-being of widowed women. Ageing International, 29(3), 267-280.
Powers, S. M., Bisconti, T. L., & Bergeman, C. S. (2014). Trajectories of social support and well‐being across the first two years of widowhood. Death Studies, 38(8), 499–509.
Reizer, A. (2019). Bringing self-kindness into the workplace: Exploring the mediating role of self-compassion in the associations between attachment and organizational outcomes. Frontiers in Psychology, 10, 1148-1161. https://doi.org/10.3389/fpsyg.2019.01148
Roff, L. L., Durkin, D., FeiSun, R., & Klemmack, L. (2007). Widowhood, religiousness, and self-assessed well-being among older adults. Journal of Religion, Spirituality & Aging, 19 (4), 43-59.
Safiri, K., Ehyaei, P., Markazi, A. (2020). Sociological Study of the Sense of Exclusion in Female-Headed Households Supported by Welfare Office in Mashhad. Women's Studies Sociological and Psychological, 18(1), 65-104. [Text in Persian]
Sasson, I., & Umberson, D. J. (2014). Widowhood and depression: new light on gender differences, selection, and psychological adjustment. Journal Gerontology Psychology Sciences and Social Science, 69(1), 135–145.
Sharifi Saki, S., Alipore, A., Aghayuosefi, A., Mohamadi, M., & Ghobari Bonab, B. (2019). The Relationship between Self-Compassion with Depression in Women with Breast Cancer with Mediation Death Anxiety. Quarterly Journal of Health Psychology, 8(29), 52-67. [Text in Persian]
 Siflinger, B. (2017). The effect of widowhood on mental health—an analysis of anticipation patterns surrounding the death of a spouse. Health Economy, 26(12), 1505–1523.
Spahni, S., Morselli, D., Perrig‐Chiello, P., & Bennett, K. M. (2015). Patterns of psychological adaptation to spousal bereavement in old age. Gerontology, 61(5), 456–468.
Stangor, C. (2015). Research methods for the behavioral sciences. (5^th Ed). Belmont: Wadsworth Cengage Learning.
Tiedt, A. D., Saito, Y., & Crimmins, E. M. (2016). Depressive Symptoms, transitions to widowhood and informal support from adult children among older women and men in Japan. Research on Aging, 38(6), 619–642.
Winefield, H. R., Gill, T. K., Taylor, A. W., & Pilkington, R. M. (2012). Psychological well-being and psychological distress: Is it necessary to measure both? Psychology of Well-Being: Theory Research and Practice, 2(3), 1-16.
Xu, L., Li, Y., Min, J., & Chi, I. (2017). Worry about not having a caregiver and depressive symptoms among widowed older adults in China: The role of family support. Aging & Mental Health, 21(8), 879–888.
Yaaghoubi Hashjin, S., & Elahi, T. (2013). Study of Perceived Gender Discrimination on Women's Mental Health. Women's Studies Sociological and Psychological, 11(3), 7-26. [Text in Persian]
Yopp, J. M., Park, E. M., Edwards, T., Deal, A., & Rosenstein, D. L. (2015). Overlooked and underserved: Widowed fathers with dependent-age children. Palliat Support Care, 13(5), 1325–1334.
Zare M., Taghiloo, S. & Kakavand, A. (2016). The relationship between anxiety and depression with the mediation of referential thinking and perfectionism: Structural equation method. Journal of Fundamentals of Mental Health, 18(Special Issue), 455-464. [Text in Persian]
Zhou, J., & Hearst, N. (2016). Health‐related quality of life among elders in rural China: The effect of widowhood. Quality of Life Research, 25(12), 3087–3095.