ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Mahmoodi   H. (*)






(*) Psychology Department, Humanities Faculty, Golestan University, Gorgan, Iran

Correspondence

Address: Faculty of Humanities & Social Sciences, Golestan University, Shahid Beheshti Street, Gorgan, Iran. Postal Code: 1575941138
Phone: +98 (19) 81840726
Fax: -
mahmoudi.hiva@gmail.com

Article History

Received:  February  24, 2018
Accepted:  July 7, 2018
ePublished:  October 11, 2018

BRIEF TEXT


War is one of the most important and effective factors in the public health of the society, and the war-induced mortalities and destructions can result in permanent and long-term effects on people's physical and mental states. .... [1].

Given the psychological and physical problems of the veterans, resilience is a new concept that has been considered in recent years. Resilience is a psychological concept explaining how to approach with unexpected situations [2]. ... [3-5]. Gilbert considers self-compassion as a factor in increasing the mental health of veterans, which as a source of internal resistance can reduce the negative effects of war and war-induced injuries and increase the resilience and tolerance of uncertainty. ... [7-10]. Ferreira et al. [11] showed that training self-compassion skills can reduce depression, anxiety, and stress and increase resilience in people with post-traumatic stress disorder (PTSD). According to the Neff et al. [12] study, entitled “prediction of self-compassion in the resilience of people with PTSD” which was done on 212 soldiers involved in the Afghan war, there was a positive and significant correlation between their self-compassion and resilience. ... [13]. Given that veterans have psychological problems, they certainly need empathy in order to increase the resilience and tolerance of difficult conditions [14]. ... [15]. Greason and Cashwell [16] study, on the emotional sympathy and psychological resilience of women and men, showed that people with high emotional empathy had also higher resilience. Konrath et al. [17] showed that altruism and empathy lead to companionship. People with high empathy, have more sympathy, tolerance of uncertainty, and psychological hardiness than others. ... [18-25].

The aim of this study was to predict the resilience based on self-compassion and empathy in veterans of the eight-year Iran-Iraq war.

This study is a descriptive-correlational study.

This study was conducted on all veterans with the war-induced physical and mental disorders in Saqqez city in 2017. The statistical population included 1300 people (1150 men and 150 women).

According to the Morgan's table, 297 people (262 men and 35 women) were selected using proportionate stratified random sampling method (male and female). Inclusion criteria included the veterans with over 10% level of injury. The acute psychiatric disorders such as psychosis were considered as the exclusion criteria.

The following questionnaires were used as research tools: 1) Connor-Davidson Resilience Scale: This scale was used to measure resilience [2]. It has 25 items that are scored on a Likert scale between zero (not true at all) and 5 (true all of the time). The scores are ranged between 0 and 100 and the scores over 50 indicate an appropriate resilience. This scale has been standardized by Mohammadi in Iran. To determine the validity, the correlation of each item with the total score, except for the item 3 was calculated, by which the coefficients between 0.41 and 0.44 were obtained. The reliability coefficient was obtained 0.89 using Cronbach's alpha and its validity was obtained 0.80 through re-test method. 2) Davis’s Empathy Questionnaire: It was developed by Davis in 1983, evaluating empathy in individuals. It consists of 21 items and three subscales, including empathetic concern, perspective taking, and personal disturbance. This scale is scored on the five-point Likert scale (totally agree to totally disagree). The scores are ranged from 21 to 105. The sum of scores is used to obtain the total score. Higher scores represent more empathy. The level of empathy is ranged as follows: 12-42: weak, 42-63: average; and over 63: high. According to the Davis study, its reliability was obtained more than 0.75 using Cronbach's alpha method, and its validity obtained 0.74 through the re-test method [27]. The validity and reliability of the empathy scale for Iranian people has reported desirable by Arefi [28]. Its reliability coefficient was obtained 0.79 through the re-test method in a two-week interval from the first run. The reliability for the empathic concern, perspective taking, and personal disturbance were obtained 0.71, 0.75, and 0.77, respectively. The negative correlation between empathy and aggression scores (r=-0.42) and the positive correlation with pro-social behavior (r=0.63) indicated its appropriate validity. 3) Self-Compassion Questionnaire: The 26-item self-compassion questionnaire was developed by Neff. The questionnaire consists of six subscales including, self-kindness vs. self-judgment, common humanity vs. isolation, and mindfulness vs. over-identification. The items can be rated on a five-point Likert scale with 1 indicating almost never and 5 indicating almost always. Scores are ranged from 26 to 130. In this scale, higher scores indicate higher self-compassion. Cronbach's alpha coefficient was obtained 0.91 for the whole scale, and it was calculated for the six subscales as follows: extreme identification: 0.77, self-kindness: 0.83, mindfulness: 0.92, isolation: 0.88, common humanity: 0.91, and self-judgment: 0.87 [7]. Based on Abolghasemi et al. [29], its validity coefficient was reported 0.81 using re-test method and its reliability was obtained 0.79 through the Cronbach's alpha. The samples were selected after obtaining permission from the Saqqez Foundation of Martyrs and Veterans Affairs and the empathy, resilience, and self-compassion questionnaires were completed in accordance with ethical principles of the research, such as no use of the names and confidentiality of the results. They were distributed individually in the Foundation of Martyrs and Veterans Affairs and were completed through three weeks. Data analysis was performed using SPSS 24. The Kolmogorov-Smirnov test was used to check the normal distribution of data. Pearson correlation coefficient was used to analyze correlation between variables and multivariate regression analysis was used to predict the criterion variable based on predictive variables.

Of the total number of veterans, 262 subjects (88.2%) were males and 35 subjects (11.8%) were females. Their mean ages were 49.99±6.60 and 43.26±7.45 years, respectively. 64 subjects (21.5%) were single and 233 subjects (78.5%) were married. 27 subjects had 10% level of injury, 19 subjects had 15%, 48 subjects had 20%, 69 subjects had 25%, 54 subjects had 30%, 29 subjects had 35%, 32 subjects had 40%, and 19 subjects had 45% level of injury. Self-kindness had the highest mean score from the self-compassion scale, and perspective taking had the highest mean score from the empathy scale (Table 1). There was a positive and significant correlation between resilience and empathy (r=0.69), self-compassion (r=0.78), self-kindness (r=0.81), self-judgment (r=0.73), common humanity (r=0.69), isolation (r=0.50), mindfulness (r=0.61), and over-identification (r=0.87). Moreover, there was a positive and significant correlation between resilience and empathic concern (r=0.61) and perspective taking (r=0.51) and there was a reverse and significant correlation between resilience and personal disturbance (r=-0.78) (p<0.01). Self-compassion (β=0.715) and empathy (β=0.601) explained 71% and 60% of variance of resilience in veterans, respectively and self-compassion was more effective to explain resilience. In addition, self-kindness (β=0.555) and self-judgment (β=0.232) from the self-compassion scale were more effective to explain resilience, whereas personal disturbance (β=-0.633) had a more negative effect on resilience.

Self-compassion and empathy were effective on the resilience of veterans and there was a positive and significant correlation between them, which was consistent with the studies by Ferreira et al. [11], Neff [12], Hiraoka et al. [13], Greason & Cashwell [16], Konrath et al. [17] and Siyez et al. [18]. ... [30, 31]. Neff [12] showed that self-compassion has a positive and significant relationship with the resilience of the veterans. Furthermore, people with high resilience have fewer psychological problems. ... [32-34]. Siyez et al. [18] showed a positive and significant correlation between empathy and resilience. In addition, high self-efficacy was positively associated with resilience. ... [35, 36].

It is suggested that more extensive research be conducted to increase empathy in veterans' families.

There were several limitations including, the lack of high generalizability due to the geographic and age limitations of the veterans, the lack of control of some variables affecting the results, such as previous trainings, confidence level, and family conditions.

The veterans with high self-compassion and empathy are more resilient.

Thanks to the veterans for their cooperation as well as the Saqqez Foundation of Martyrs and Veterans Affairs for their support.

None declared.

The essential agreements were made with the Foundation of Martyrs and Veterans Affairs and the participants consent were obtained prior study.

This study is based on a research and no support has been given by a particular institution or organization.

TABLES and CHARTS

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CITIATION LINKS

[1]Bahreinian SA, Borhani H. Mental health in a population of veterans and their wives in Qom province. Res Med. 2001;27(4):305-12. [Persian]
[2] Conner KM, Davidson JR. Development of a new resilience scale: The Conner-Davidson Resilience scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82.
[3]Walsh F. Strengthening family resilience. 3rd Edition. New York and London: Guilford Press; 2016. pp. 23-6.
[4]Anasuri S. Building resilience during life stages: Status and strategies. Int J Humanit Soc Sci. 2016;6(3):1-9.
[5]Watson CC, Rich BA, Sanchez L, O’Brien K, Alvord MK. Preliminary study of resilience based group therapy for improving the functioning of anxious children. J Child Youth Care Forum. 2014;43(3):269-86.
[6]Gilbert P. Defense and safety: Their function in social behavior and psychopathology. Br J Clin Psychol. 1993;32(Pt2):131-53.
[7]Neff KD, Germer CK. A pilot study and randomized controlled trial of the Mindful Self-Compassion Program. J Clin Psychol. 2013;69(1):28-44.
[8]Alvord MK, Grados JJ. Enhancing resilience in children: A proactive approach. Prof Psychol: Res Pract. 2005;36(3):238-45.
[9] Neff KD, Kirkpatrick KL, Rude SS. Self-compassion and adaptive psychological functioning. J Res Personal. 2007;41(1):139-54.
[10] Mashayekh M, Borjali A, Delavar A, Shafi Abadi A. Modeling of victim resilience and their family based on cognitive and emotional variables. J Mil Psychol. 2012;2(8):1-23. [Persian]
[11]Ferreira C, Pinto-Gouveia J, Duarte C. Self-compassion in the face of shame and body image dissatisfaction: Implications for eating disorders. Eat Behav. 2013;14(2):207-10.
[12]Neff KD, Kirkpatrick KL, Rude SS. Self-compassion and adaptive psychological functioning. J Res Personal. 2007;41(1):139-54.
[13]Hiraoka R, Meyer EC, Kimbrel NA, DeBeer BB, Gulliver SB, Morissette SB. Self‐compassion as a prospective predictor of PTSD symptom severity among trauma‐exposed US Iraq and Afghanistan war veterans. J Trauma Stress. 2015;28(2):127-33.
[14]Charney DS. Psychobiological mechanisms of resilience and vulnerability: Implications for successful adaption to extreme stress. AM J Psychiatry. 2004;161(2):195-216.
[15]Preston SD, De Waal FB. Empathy: Its ultimate and proximate bases. Behav Brain Sci. 2002;25(1):1-71.
[16]Greason PB, Cashwell CS. Mindfulness and counseling self-efficacy: The mediating role of attention and empathy. Couns Educ Superv. 2009;49(1):2-19.
[17]Konrath SH, O’Brien EH, Hsing C. Changes in dispositional empathy in American college students over time: A meta-analysis. Pers Soc Psychol Rev. 2011;15(2):180-98.
[18]Siyez DM, Savi F. Empathy and self-efficacy, and resiliency: An exploratory study of counseling students in Turkey. Proced Soc Behav Sci. 2010;5(2):459-63.
[19] Wren AA, Somers TJ, Wright MA, Goetz MC, Leary MR, Fras AM, et al. Self-compassion in patients with persistent musculoskeletal pain: Relationship of self-compassion to adjustment to persistent pain. J Pain Symptom Manage. 2012;43(4):759-70.
[20]Greene KT, Calhoun PS, Dennis MF, Beckham JC. Exploration of resilience construct in PTSD severity and functional correlates in military combat veteran who have served since September 11, 2001. J Clin psychiatry. 2010;71(7):823-30.
[21]Pietrzak RH, Southwick SM. Psychological resilience in OEF-OIF Veterans: Application of a novel classification approach and examination of demographic and psychosocial correlates. J Affect Disord. 2011;133(3):560-8.
[22]Akbari Z, Vafaei T, Khosravi S. Relationship between attachment styles and the resiliency amount of veterans wives. Iran J War Public Health. 2011;3(2):12-7. [Persian]
[23] Tylka TL, Russell HL, Neal AA. Self-compassion as a moderator of thinness-related pressures' associations with thin ideal internalization and disordered eating. Eat Behav. 2015;17:23-6.
[24] Garmezy N. Resilience and vulnerability to adverse developmental outcomes associate with poverty. Am Behav Sci. 1991;34(4):416-30.
[25] Manteghi A, Hebrani P, Samari AA, Heydari AS. Expression level of depression and psychological stress in caring for spouses of veterans hospitalized in psychiatry and its relation with the rate of hospitalization. J Fundam Ment Health. 2010;12(45):410-9.
[26] Mohammadi M. Factors affecting resilience in subjects at risk of substance abuse [Dissertation]. Tehran: University of Social Welfare and Rehabilitation Sciences; 2006. [Persian]
[27]Davis MH. Empathic concern and the muscular dystrophy telethon: Empathy as a multidimensional construct. Personal Soc Psychol Bull. 1983;9(2):223-9.
[28] Arefi M, Latifian M. Investigating the role of empathy and maxiolistic beliefs in the adequacy and social inability of 9-12-year-old students. J Educ Learn Stud. 2011;3(1):61-82. [Persian]
[29] Abolghasemi A, Taghipour M, Narimani M. Relationship between personality type D, self-compassion and social support with health behaviors in coronary heart disease patients. Health Psychol. 2011;1(1):5-19. [Persian]
[30]Tedschi RG, Kilmer RP. Assessing strengths, resilience, and growth to guide clinical interventions. Prof Psychol: Res Pract. 2005;36(3):230-7.
[31]Wispé L. The psychology of sympathy. 1st Edition. New York: Springer US; 1991.
[32]Brown KW, Ryan RM, Creswell JD. Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychol inq. 2007;18(4):211-37.
[33] Refahi ZH, Moghtaderi N. Effectiveness of group empathy training on the increase of couples' intimacy. Fam Couns Psychother. 2012;3(1):44-55. [Persian]
[34]Papadatou D. Training health professionals in caring for dying children and grieving families. Death Stud. 1997;21(6):575-600.
[35]Madi Neshat M, Lashkardost H, Tabatabaeichehr M. Investigating the effect of role play scenarios on changing mood and empathy of nursing students in psychiatry. Strides Dev Med Educ. 2012;10(4):431-8. [Persian]
[36]Masten AS, Wright MOD. Resilience over the lifespan: Developmental perspectives on resistance, recovery and transformation. In: Reich JW, Zautra AJ, Hall JS, editors. Handbook of adult resilience. New York: Guilford Press; 2010. pp. 213-37.