Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 14, 2022
Date Accepted: May 8, 2023
Boosting Empathy and Compassion through Mindfulness-Based and Socio-Emotional Dyadic Practice: A Randomized Control Trial with App-Delivered Trainings
ABSTRACT
Background:
Contemplative mental trainings have been found to effectively improve adaptive social skills such as empathy and compassion. However, there is a lack of research on the efficacy of purely app-delivered online mental programs and of dyadic practices in boosting socio-affective capacities.
Objective:
The first aim of this study was to probe a novel app-delivered partner-based socio-emotional (Affect Dyad) in comparison with classic mindfulness-based mental training in its effects in fostering empathy and (self)compassion. The second aim of the study was to investigate underlying mechanisms of these effects.
Methods:
In a randomized controlled trial with socio-emotional (SE) and mindfulness-based (MB) interventions and a waitlist control group (WC), which received socio-emotional training only after posttest (WSE), we investigated intervention effects on self-report measures and an ecologically valid computer task of empathy, (self)compassion and theory of mind. We employed linear mixed-effects models for pretest to posttest changes on all outcome measures, and moderated mediation models to investigate whether changes in acceptance, empathic distress, empathic listening, interoceptive awareness and mindfulness serve as underlying mechanisms of intervention effects on empathy and (self)compassion.
Results:
In n = 218 participants (44.12 ± 11.71 years; 73% female), we found all interventions to have positive effects on composite scores for compassion towards self (betaSE = .44, p < .001; betaWSE = .30, p = .002; betaMB = .35, p < .001) and others (betaSE = .24, p = .003; betaWSE = .35, p < .001; betaMB = .29, p < .001). Compassion measured with the computer task did not change significantly, but showed a trend towards increase only in the socio-emotional dyadic practice (betaSE = .08, p = .078; betaWSE = .11, p = .061). Similarly, on the empathic concern subscale of the Interpersonal Reactivity Index, a trend towards increase was found in SE (betaSE = .17, p = .083). Empathy was significantly increased in both socio-emotional groups (betaSE = .16, p = .034; betaWSE = .35, p < .001) and MB (betaMB = .15, p = .040). Measures of theory of mind remained stable over time. In MB, the increase in self-compassion was mediated by a decrease in empathic distress (abMB = .07 [.02, .14]). In SE, an increase in self-compassion could be predicted by an increase in acceptance (betaSE = 6.63 [.52, 12.38]).
Conclusions:
Using a multimethod approach, this study shows that app-delivered socio-emotional dyadic and mindfulness-based trainings are effective in fostering empathy and (self)compassion. Dose-response relationship for impacts on behavioral and dispositional markers was lower, with a slight advantage for the dyadic training. The training-related increase in self-compassion relies on differential mechanisms with changes in empathic distress regulation in the mindfulness group, and activation of a human care- and acceptance-based system through socio-emotional dyadic training. Clinical Trial: The trial has been registered on May 17th, 2020 with ClinicalTrials.gov NCT04889508
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