The role of self-compassion in the relationship between attachment, depression, and quality of life.

Background: Self-compassion may be shaped by early attachment experiences, and has been linked to mental health and well-being. This study examined the role of two distinct features of self-compassion, self-warmth and self-coldness, in the relationship between attachment insecurity and depression as well as quality of life in a general population sample in Germany.

Methods: Participants (N = 2,253; 53.4% female, Mage 50 years) completed the Self-Compassion Scale (SCS), Adult Attachment Scale (AAS), Beck Depression Inventory-Fast Screen (BDI-FS), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Mediation analysis was used to examine whether insecure attachment predicted increased symptoms of depression and decreased quality of life through decreased self-warmth and increased self-coldness.

Results: Attachment-related anxiety and avoidance had a significant direct effect on depressive symptoms and significant indirect effect via self-warmth and self-coldness. The indirect effect via self-warmth appears to be of negligible magnitude. Attachment-related anxiety and avoidance had a significant direct effect on quality of life, and significant indirect effect via self-coldness. The indirect effect via self-warmth was not statistically significant, speaking against self-warmth as a relevant mediator. Limitations: Causal conclusions cannot be drawn based on cross-sectional research design. All measures were based on participant self-report.

Conclusions: This study contributes to a more differentiated understanding of how attachment insecurity and self-compassion may contribute to affective disorders. Findings suggest that self-coldness may be particularly relevant in affective disorders and when addressing relational struggles, with both theoretical and clinical implications for psychotherapy and future research.