The role of self-criticism and self-compassion in psychotic experiences and associated distress – Risk or resilience? A systematic literature review

Introduction: Research suggests that both self-criticism and self-compassion may be associated with psychotic experiences, but the nature of these relationships is unclear. Understanding this further could provide insight into the aetiology of psychotic experiences and support the development of effective interventions. The aim of the current study is therefore to conduct a systematic review of the relationship between self-criticism, self-compassion and psychotic experiences (frequency, severity, endorsement and distress) in clinical and non-clinical populations.

Method: A systematic search of MEDLINE (Ovid), Embase (Ovid) and APA Psycinfo (Ovid) was conducted. Studies were selected according to the inclusion criteria. A
quality assessment of eligible studies was conducted.

Results: A narrative synthesis of 17 empirical, quantitative studies revealed high-quality evidence supporting links between self-compassion, self-criticism and a range of psychotic experiences including general, broad measures of overall psychotic experiences; measures of voice-hearing; measures of unusual beliefs; and measures of paranoia.

Self-criticism appeared most strongly linked to distress associated with psychotic experiences. Longitudinal studies could provide further insight into the role of self-criticism and self-compassion in the development of psychosis.

Conclusions: Findings indicate self-criticism is associated with distressing psychotic experiences, and self-compassion may be a protective factor, indicating the potential benefits of therapies such as Compassion Focused Therapy.