SELF-COMFORTING BEHAVIOURS ACROSS THEORETICAL FRAMEWORKS: A 50-YEAR SYSTEMATIC REVIEW OF PATTERNS, MECHANISMS, AND SOCIO-CULTURAL INFLUENCES

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PUBLISHED DATE: - 08-12-2024

DOI: -

https://doi.org/10.37547/tajssei/Volume06Issue12-07

PAGE NO.: - 51-177

SELF-COMFORTING BEHAVIOURS ACROSS
THEORETICAL FRAMEWORKS: A 50-YEAR
SYSTEMATIC REVIEW OF PATTERNS,
MECHANISMS, AND SOCIO-CULTURAL
INFLUENCES

Obohwemu Oberhiri Kennedy, PhD

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes
University, Birmingham, United Kingdom; PENKUP Research Institute, Birmingham, United

Kingdom

Yakpir Mabengban Gordon, PhD

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham,

United Kingdom

Koretaine Simran, LLM

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham,

United Kingdom

Ndioho Ibiangake Friday, PhD

Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom

Owusuaa-Asante Maame Ama, PhD

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham,

United Kingdom

Abdelkader Nourhan, MSC

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham,

United Kingdom

Ally Jamila, MSC

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Birmingham,

United Kingdom

Henry Karen, MSC

IBIC Change, London, United Kingdom

REVIEW ARTICLE

Open Access

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Omoregie Jesse, PhD

Department of Psychology, University of Bolton, Bolton, United Kingdom

Abayomi Gabriel, PhD

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Manchester,
United Kingdom

Bewaji Aderinsola Oluwatoyin, PhD

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Manchester,
United Kingdom

Sai Bo Bo Htet Aung, MPH

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Manchester,
United Kingdom

Augustine Angela, MSC

Department of Health, Wellbeing & Social Care, Global Banking School/Oxford Brookes University, Manchester,
United Kingdom

Onuorah R. Adaorah, PhD

Department of Health, Wellbeing & Social Care, Oxford Brookes University, Leeds, United Kingdom

Amanze Ugochukwu Reginald, PhD

Department of Psychology, University of Bolton, Bolton, United Kingdom

Corresponding Author: Obohwemu Kennedy Oberhiri, PhD

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INTRODUCTION

Self-comforting behaviours encompass a range of
conscious or unconscious actions individuals
employ to regulate emotions, manage stress, and
maintain a sense of security. These behaviours
manifest in various forms, encompassing physical,
cognitive, and social dimensions. Physical
manifestations include actions such as thumb-
sucking, blanket clutching, or repetitive
movements like rocking. Cognitive strategies
involve internal processes like positive self-talk,
visualization,

or

problem-solving.

Social

behaviours, such as seeking support from loved
ones, also fall under the umbrella of self-
comforting mechanisms.

The prevalence of self-comforting behaviours
extends from infancy to adulthood, highlighting

their enduring role in human adaptation (Suomi,
2002; Schore, 2003). In infancy, these actions are
often innate responses to distress, such as sucking
or clinging to a caregiver. As individuals mature,
self-comforting strategies become more complex
and nuanced, reflecting cognitive and emotional
development. For instance, adolescents may
engage in self-soothing behaviours like listening to
music or spending time in nature, while adults
might rely on hobbies, exercise, or meditation to
manage stress and maintain wellbeing.

Researchers from various disciplines, including
psychology,

developmental

science,

and

psychiatry, have taken an interest in these
behaviours. Although often overlooked or
considered transitory, self-comforting behaviours

Abstract

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serve crucial functions in emotional regulation,
stress management, and maintaining a sense of
wellbeing (Feldman, 2007). While self-comforting
behaviours typically serve as adaptive coping
mechanisms, their excessive or maladaptive use
can contribute to psychological distress
(Kalinowski & Leibenluft, 2016). For example,
excessive thumb-sucking in childhood or
compulsive nail-biting in adulthood may indicate
underlying emotional difficulties. Moreover, the
reliance on certain self-comforting behaviours,
such as substance use or avoidance coping, can
have detrimental consequences for overall health
and wellbeing.

Self-comforting behaviours become particularly
salient in the face of adverse life events, such as the
loss of a loved one, near-death experiences, loss of
investment, or academic failure (Mine, 2014).
These challenging experiences often trigger
increased reliance on self-comforting behaviours
as a means of coping with intense emotional
distress and uncertainty (Skinner et al., 2016).
Understanding how self-comforting behaviours
function during such times can provide deeper
insights into their adaptive and maladaptive roles.

Understanding the complex interplay between
self-comforting behaviours, individual differences,
and environmental factors is crucial for developing
effective interventions and promoting mental
health. By exploring the various forms, functions,
and outcomes of self-comforting behaviours,
researchers can gain valuable insights into human
behaviour and develop strategies to support
individuals in developing healthy coping
mechanisms.

To fully comprehend the complexities of self-
comforting behaviours, it is imperative to examine
them through the lens of multiple theoretical
frameworks. This review considers the interplay
between attachment theory, stress and coping,
developmental

psychology,

and

clinical

psychology to elucidate the multifaceted nature of
these behaviours. Synthesizing findings from these
diverse perspectives will allow us to illuminate the
complex interplay of biological, psychological, and
environmental factors influencing the emergence,
development, and function of self-comforting
behaviours. By examining studies that explore self-
comforting behaviours within different theoretical
frameworks

—

such as attachment theory, stress

and coping, infant development, psychopathology,
cognitive-behavioural theory, and psychodynamic
theory

—

common themes and patterns can be

identified to construct a more comprehensive
understanding of the phenomenon.

Attachment Theory and Self-Comforting
Behaviours

Attachment theory, pioneered by John Bowlby,
provides

a

foundational

framework

for

understanding the development of self-comforting
behaviours (Bowlby, 1969). Secure attachment
fosters a sense of safety and security, reducing the
need for excessive self-comforting. Conversely,
insecure attachment styles, characterized by
anxiety or avoidance, may lead to increased
reliance on self-soothing mechanisms (Ainsworth,
Blehar, Waters, & Wall, 1978).

Self-comforting behaviours can serve as
proximity-seeking mechanisms, attempting to
recreate the soothing presence of a caregiver
(Beebe et al., 2010). For instance, a child might
clutch a blanket associated with bedtime routines,
evoking feelings of security and comfort. In adults,
self-comforting behaviours might manifest as
repetitive actions, such as nail-biting or hair-
twirling, especially when faced with stress or
uncertainty, such as the loss of a loved one or
significant life changes.

Stress, Coping, and Self-Comforting Behaviours

Lazarus and Folkman’s stress and coping theory

offers a complementary perspective on self-

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comforting behaviours (Lazarus & Folkman,
1984). Within this framework, self-comforting can
be viewed as a coping mechanism employed to
manage stress and restore emotional equilibrium.
Engaging in self-soothing behaviours can help
individuals regulate physiological arousal and
reduce the perceived intensity of stressors.

For example, individuals experiencing high levels
of stress might exhibit increased self-comforting
behaviours such as excessive grooming or
substance use. These behaviours can provide
temporary relief but may also have detrimental
long-term consequences. Adverse life events, such
as academic failure or financial loss, may
particularly trigger these

behaviours as

immediate, albeit short-term, coping mechanisms.
Understanding the relationship between stress
and self-comforting is crucial for developing
effective interventions to address both issues.

Self-Comforting Behaviours in Infant and Child
Development

During infancy and childhood, self-comforting
behaviours play a vital role in emotional regulation
and self-soothing (Beebe & Lachmann, 1998).
Thumb-sucking, pacifier use, and blanket clutching
are common examples of self-comforting
behaviours in this developmental stage. These
behaviours help infants and young children cope
with the challenges of a rapidly changing
environment and develop the capacity for self-
regulation.

As children grow older, the nature of self-
comforting

behaviours

evolves.

Repetitive

movements, such as rocking or swaying, may
replace earlier forms of self-soothing. These
behaviours can serve as transitional objects,
providing a sense of security and continuity during
periods of change or stress.

Self-Comforting

Behaviours

and

Psychopathology

While self-comforting behaviours are typically
considered adaptive, they can become problematic
when excessive or maladaptive. In some cases,
they may be associated with the development of
psychopathology, such as anxiety disorders,
obsessive-compulsive disorder (OCD), and eating
disorders (Kalinowski & Leibenluft, 2016).

For instance, individuals with OCD may engage in
excessive washing or checking rituals as a form of
self-comforting, aimed at reducing anxiety and
uncertainty. Similarly, individuals with eating
disorders might use restrictive eating or binge
eating as a way to cope with emotional distress.
Understanding the relationship between self-
comforting behaviours and psychopathology is
crucial for developing effective prevention and
treatment strategies.

Cognitive-Behavioural Perspective on Self-
Comforting Behaviours

Cognitive-behavioural theory (CBT) emphasizes
the role of thoughts, beliefs, and behaviours in
shaping emotional experiences. Self-comforting
behaviours can be viewed as conditioned
responses or cognitive distortions aimed at
reducing anxiety or distress (Beck, 1976). For
example, individuals with obsessive-compulsive
disorder might engage in repetitive handwashing
to neutralize intrusive thoughts, even though they
recognize the irrationality of this behaviour.

Psychodynamic Perspective on Self-Comforting
Behaviours

Psychodynamic

theory

emphasizes

the

unconscious

mind

and

early

childhood

experiences in shaping personality and behaviour
(Bornstein, Maracic, & Natoli, 2018). Self-
comforting behaviours can be seen as defence
mechanisms or attempts to re-experience a sense
of security and comfort associated with earlier life
experiences (Freud, 1923). For instance, thumb-
sucking might represent a regression to an oral

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stage of development, providing a sense of comfort
and gratification.

By examining self-comforting behaviours through
various theoretical lenses and understanding their
role in coping with adverse life events, this review
provides the foundation for constructing a more
comprehensive theory about self-comforting
behaviours. Synthesizing findings from diverse
perspectives, we aim to illuminate the complex
interplay of factors influencing these behaviours
and their implications for mental health and
development.

METHODOLOGY

Review Questions

The following review questions guided the
systematic review:

1.

How do different types of adverse life events

(e.g., trauma, loss, chronic stress) influence the
emergence or frequency of self-comforting
behaviours?

2.

How do theoretical frameworks (e.g.,

attachment

theory,

stress

and

coping,

psychodynamic theory) explain the development,
maintenance, and function of self-comforting
behaviours?

3.

What are the most commonly used methods

and instruments for assessing the frequency,
intensity,

and

impact

of

self-comforting

behaviours on wellbeing?

Objectives

The primary objective of this review is to
systematically evaluate and synthesize existing
research on the relationship between self-
comforting behaviours and adverse life events,
examining

the

theoretical

frameworks,

developmental stages, and mental health outcomes
associated with these behaviours. By exploring the
concept through various theoretical lenses,
including attachment theory, stress and coping,
developmental

psychology,

and

clinical

psychology, the review aims to identify and
analyze how self-comforting behaviours are
measured and reported in terms of frequency,
intensity, and impact on wellbeing, identifying
commonalities, discrepancies, and gaps in the
literature.

Search Strategy

To ensure comprehensive coverage of the
literature, a combination of subject-specific and
multidisciplinary databases was searched (Table
1).

Table 1: Relevant Databases

Database

Reason for Selection

PubMed

Covers biomedical and life sciences

PsycINFO

Covers psychology and behavioural sciences

CINAHL

Covers a wide range of topics, including mental health,
developmental psychology, and stress management

Embase

Covers biomedical and pharmacological research

Web of Science

Covers multiple disciplines, including science, social sciences,
arts, and humanities

Scopus

Covers science, social sciences, and humanities, with a strong
emphasis on citation analysis and research impact

ERIC

Focuses on education research

Sociological Abstracts

Covers sociology and related disciplines

The search was also extended to Google Scholar (for grey literature) and ProQuest (for dissertations and
thesis). The database search was supplemented by a manual exploration of the reference lists of included

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studies. This approach helped to identify additional relevant articles that might have been missed in the
initial database search.

Search terms were developed to capture the concept of self-comforting behaviours across different
theoretical frameworks (Table 2). The search terms were combined using Boolean operators (AND, OR,
NOT). The search terms were adjusted slightly based on the specific database's search algorithm.

Table 2: Search string for selected databases

Self-comforting behaviours and adverse life events

(Self-comforting behaviours OR self-soothing OR self-consolation OR self-compassion OR self-
regulation OR self-kindness OR self-warmth OR coping mechanisms OR comfort behaviours OR
repetitive behaviours OR compassionate mind OR loving-kindness) AND (Adverse life events
OR loss of a loved one OR near-death experience OR loss of investment OR academic failure OR
trauma OR stress)

Self-comforting behaviours across theories

(Self-comforting behaviours OR self-soothing OR self-consolation OR self-compassion OR self-

regulation OR self-kindness OR self-warmth OR coping mechanisms OR comfort behaviours OR
repetitive behaviours OR compassionate mind OR loving-kindness) AND (Attachment theory
OR stress and coping OR developmental psychology OR clinical psychology OR cognitive-
behavioural theory OR psychodynamic theory OR psychopathology)

Self-comforting behaviours and lifespan

(Self-comforting behaviours OR self-soothing OR self-consolation OR self-compassion OR self-
regulation OR self-kindness OR self-warmth OR coping mechanisms OR comfort behaviours OR
repetitive behaviours OR compassionate mind OR loving-kindness) AND (Infant OR child OR
adolescent OR adult OR lifespan development OR developmental stages OR lifespan)

Self-comforting behaviours and mental health outcomes

(Self-comforting behaviours OR self-soothing OR self-consolation OR self-compassion OR self-
regulation OR self-kindness OR self-warmth OR coping mechanisms OR comfort behaviours OR
repetitive behaviours OR compassionate mind OR loving-kindness) AND (Mental health OR
psychopathology OR stress OR anxiety OR anxiety disorders OR generalised anxiety disorder
OR depression OR panic disorder OR emotion regulation OR specific phobia OR psychological
distress OR panic OR obsessive

–

compulsive disorder OR risk factors OR protective factors)

To capture the evolution of theoretical
frameworks, methodological advancements, socio-
cultural changes, comprehensive data collection,
and the identification of research gaps and
continuities, the review focused on publications
from the past 50 years (1974-2024). This
comprehensive approach ensured a rich, balanced,
and thorough understanding of self-comforting
behaviours across different contexts and
theoretical perspectives.

Eligibility Criteria

To ensure that the literature is relevant to the
study, reduce the risk of bias and errors, and
produce more accurate, objective, and meaningful
results, a set of inclusion and exclusion criteria
were considered.

Inclusion Criteria

1.

Study design: Quantitative studies (e.g.,
randomized controlled trials, cohort studies,
case-control studies) that examine self-

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comforting behaviours.

2.

Population:

Studies

involving

human

participants across the lifespan (infants,
children, adolescents, adults).

3.

Theoretical

frameworks:

Studies

that

investigate the relationship between self-
comforting behaviours and adverse life events,
theoretical frameworks (e.g., attachment
theory, stress and coping, psychodynamic
theory), developmental stages, or mental
health outcomes.

4.

Outcomes: Studies that measure or report
outcomes

related

to

self-comforting

behaviours, such as frequency, intensity, or
impact on wellbeing.

5.

Publication status: Both published and
unpublished studies (e.g., grey literature) to
ensure comprehensive coverage.

6.

Language: Studies published in English to
manage the volume of literature.

Exclusion Criteria

1.

Study design: Qualitative studies, wait-list
control trials, research protocols, pilot studies,
case reports, and opinion pieces due to their
limited generalizability.

2.

Population: Studies focusing exclusively on
animal models or specific populations (e.g.,
individuals with rare disorders) that are not
relevant to the broader scope of the review.

3.

Theoretical frameworks without a focus on
self-comforting: Studies that do not explicitly
discuss or apply theories relevant to self-
comforting behaviours.

4.

Interventions or exposures: Studies that do not
directly address self-comforting behaviours.

5.

Outcomes: Studies that do not report relevant
outcomes

related

to

self-comforting

behaviours.

6.

Publication type: Non-peer-reviewed articles,
dissertations, and theses.

To ensure the focus of the review remains relevant,
specific population parameters would be defined.

Inclusion Criteria for Population

1. Age: Given the developmental nature of self-
comforting behaviours, there was no strict age
restrictions. However, studies focusing on specific
age groups (e.g., infants, children, adolescents,
adults) would be prioritized for in-depth analysis.

2. Gender: Both male and female participants were
included to examine potential gender differences
in self-comforting behaviours.

3. Ethnicity: To explore the influence of cultural
factors, studies including diverse ethnic
populations were included.

4. Health status: Participants with a range of health
conditions (both physical and mental) would be
included to assess the relationship between self-
comforting behaviours and overall wellbeing.

Exclusion Criteria for Population

1. Specific populations: Studies focusing
exclusively on rare or highly specialized
populations (e.g., individuals with specific genetic
disorders) were excluded unless they contribute
significantly to understanding self-comforting
behaviours.

2. Non-human populations: Studies involving
animals were excluded.

Search Process

The PRISMA guidelines (Page et al., 2021) were
adhered to, and the review protocol was registered
on

PROSPERO

in

August

2020

(CRD42024576445). The search was conducted
from 14th July 2024 to 16th September 2024.
Initial searches in each database were conducted
using the search strings outlined in Table 2.

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Publication year filters were applied to restrict
results to articles published between 1974 and
2024. Using Mendeley, search results were
imported,

and

duplicate

records

were

automatically identified and removed. The titles
and abstracts of all retrieved articles were
independently screened by two reviewers to
determine their relevance based on the inclusion
criteria. The full texts of articles that met the
inclusion criteria were retrieved and reviewed by
both reviewers to confirm their suitability for the
study.

Data Extraction

Key data were extracted from the included studies,
including definitions, measurement methods,
developmental stages, theoretical perspectives,
and mental health outcomes. This process involved
several crucial steps. First, the definitions of self-
comforting behaviours as provided by each study
were noted and compared. These definitions were
examined to identify how self-comforting is
conceptualized across different research contexts,
noting any variations in interpretation.

In addition to examining definitions, the methods
used to measure self-comforting behaviours were
also a focal point. This included identifying specific
instruments, scales, or observational techniques
employed in the studies to quantify self-comforting
behaviours. Furthermore, data were extracted
regarding the developmental stages at which self-
comforting behaviours were studied, such as
childhood, adolescence, or adulthood. This
information was used to examine how self-
comforting behaviours evolve over time and how
different stages of development may impact the
efficacy or expression of these behaviours. The
review considered whether certain interventions
or behaviours were more effective or prevalent at
specific developmental stages, thus providing a
developmental perspective on self-comforting
practices.

The theoretical frameworks underpinning the
studies were also identified and analyzed. This
involved categorizing the studies based on their
theoretical orientation, such as cognitive-
behavioural theories, resilience theory, or growth
mindset theory. By examining these frameworks,
the review sought to understand how different
theories conceptualize self-comforting behaviours
and to identify any commonalities or
contradictions

between

them.

Theoretical

perspectives were also assessed in terms of how
they informed the study design, intervention
strategies, and interpretation of results.

Finally, the review focused on the mental health
outcomes

associated

with

self-comforting

behaviours. Data were extracted on how these
behaviours impacted various aspects of mental
health, such as stress reduction, emotional
regulation, resilience, and overall wellbeing. The
review compared the effectiveness of different
self-comforting interventions across studies,
examining both short-term and long-term mental
health outcomes. This analysis aimed to determine
the extent to which self-comforting behaviours
contribute to mental health and wellbeing, and to
identify which interventions appear most effective
based on the evidence.

Quality Assessment

The quality of the included studies was assessed
using the Joanna Briggs Institute Critical Appraisal
Tool (JBI-CAT). JBI-CAT is a widely used
instrument for evaluating the methodological
quality of research studies across various domains
(Shea et al., 2017; Aromataris & Munn, 2020;
Barker et al., 2023). It systematically assesses key
aspects such as the clarity and specificity of the
research question, the appropriateness of the
study design, and the inclusion and exclusion
criteria for participants (Moola et al., 2020). The
tool also examines the sampling methods
employed, including how participants are

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allocated to different study groups, as well as the
use of blinding in reducing bias (Munn, Tufanaru &
Aromataris, 2014). Furthermore, the JBI-CAT
evaluates the adequacy of intervention and control
groups, the rigor of data collection and analysis
processes, and the thoroughness of results
reporting (Tufanaru et al., 2020). By addressing
these critical areas, the JBI-CAT provides a robust
framework for assessing the overall risk of bias in
a study. Its comprehensive approach makes it a
versatile tool, suitable for evaluating the quality of
both

randomized

controlled

trials

and

observational studies, thereby ensuring that
research findings are based on sound and reliable
evidence (Shea et al., 2017; Aromataris & Munn,
2020).

Data Synthesis

The findings were synthesized to identify
commonalities, discrepancies, and gaps in the
literature, as well as patterns and themes. This
synthesis involved a comprehensive analysis of the
existing studies to determine consistent trends
and divergences in the data. By systematically
comparing the results across various studies, we
were able to pinpoint recurring themes that were
common in the literature, as well as areas where
findings were inconsistent or contradictory.
Additionally, this process highlighted significant
gaps in the current research, indicating areas
where further investigation is needed to build a
more complete understanding of the topic. Recent
studies, such as those by Smith, Brown &
Thompson (2023) and Johnson and Lee (2022),
have emphasized the importance of this approach
in identifying both the strengths and weaknesses
of the current div of knowledge, thereby guiding
future research directions.

RESULTS

Study Inclusion

Figure 1 illustrates the process of study selection

according to PRISMA guidelines (Page et al. 2020).
The diagram provides a clear and transparent
representation of the systematic review process,
making it easy to understand the flow of studies
from the initial search to the final inclusion in the
review. It also highlights the reasons for exclusion,
which is important for ensuring the quality and
validity of the review.

The search process began with a large number of
articles, totalling 7360, of which 635 were
duplicates. After eliminating duplicates, 6784
unique titles and abstracts were screened. This
initial screening led to a further review of 1343
articles based on their full text. Ultimately, a final
selection of 95 studies, published between 1986
and 2024, were included in the review. The
majority of the studies (n = 42) were conducted in
the USA, indicating that self-comforting behaviour
is of significant interest and relevance to the
American healthcare system or research
community. The next most common locations were
the UK (n = 12), Germany (n = 7), and The
Netherlands (n = 5), which suggests that self-
comforting behaviour is also of interest in Europe,
particularly in countries with well-established
healthcare systems. The inclusion of studies from
Asia [China (n = 5), Japan (n = 2), Thailand (n = 1),
and Iran (n = 1)] and Australia (n = 4) indicates that
the self-comforting behaviour is being explored
globally, with researchers from diverse regions
contributing to the understanding of the topic. The
smaller number of studies from Canada (n = 2),
Belgium (n = 2), and Norway (n = 3) may suggest
that the self-comforting behaviour is less well-
studied in these countries or that the research
focus is more concentrated in other regions. The
inclusion of studies from Portugal (n = 4), Spain (n
= 1), Denmark (n = 1), Ireland (n = 1), Finland (n =
1), and Romania (n = 1) suggests that the self-
comforting behaviour is being explored in various
European countries, although the number of
studies from each country is relatively small. There

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was a notable lack of studies from South America
and Africa, which may indicate that the research
priorities in these regions may be different from
those in other regions. This geographical bias may

also limit the generalizability of findings to diverse
cultural and socio-economic contexts. A summary
of study characteristics can be found in Appendices
1A-1D.

Fig. 1: PRISMA Flowchart for selection process of studies in systematic review

Records identified through

database search (n = 7360)

Records identified through manual

search of reference lists (n = 59)

Records after duplicates removed (n = 6784)

Reports screened by title

and abstract (n = 6784)

Reports excluded (n = 5441)

Reports assessed for

eligibility

(n = 1343)

Reports excluded (n= 1249):

•

Not related to self-comforting (n = 564)

•

Not mental health

problem/psychological distress (e.g.,
anxiety, depression, stress) (n = 356)

•

Only protocol available (n = 36)

•

Full-texts not available (n = 66)

•

Not a journal article (n = 99)

•

Duplicate (n = 22)

•

Poor methodological quality (n = 10)

•

Qualitative only (n = 12)

•

Did not report appropriate data (n = 68)

•

Not in English (n = 16)

•

Studies included in review

(n = 94)

Identification of studies via databases and manual search

Identification

Screen

ing

Included

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Sample Characteristics

Sampling Strategy

Most of the included studies employed
convenience sampling, a methodological approach
that was particularly prevalent in the works of
Arch et al. (2014), Arimitsu (2016), Armstrong &
Rimes (2016), Beaumont et al. (2016), Collett et al.
(2016), and Dundas et al. (2017). This sampling
strategy was also frequently utilized in Fuertes et
al. (2020), Hall et al. (2013), Greeson et al. (2014),
Huberty et al. (2019), and Ko et al. (2018).
Furthermore,

convenience

sampling

was

commonly employed in studies such as Lahtinen et
al. (2019), Lathren, Bluth & Park (2019), Miron et
al. (2016), Neff (2003), and Polizzi, Baltman, &
Lynn (2022). This sampling approach was often
used due to its accessibility, particularly in studies
that recruited participants from local clinics,
university students, or community organizations.
The widespread adoption of convenience sampling
in these studies can be attributed to the fact that
many of the participants were recruited from
university campuses, online platforms, or clinical
settings where researchers had easy access. This
sampling strategy allowed researchers to quickly
and efficiently gather data, which may have been
particularly important in studies with limited
resources or time constraints. It is essential to
acknowledge the potential limitations and biases
associated

with

convenience

sampling,

particularly when generalizing findings to broader
populations. Future research should consider the
use of more representative sampling strategies to
ensure the validity and generalizability of their
findings.

Purposive sampling was employed in a subset of
studies that required specific criteria for
participation, enabling researchers to target
specific clinical populations or demographic
characteristics. This approach was evident in the
works of Braehler et al. (2013), Diedrich et al.

(2016), and Døssing et al. (2015), where
participants were selected based on their clinical
diagnoses or characteristics. Similarly, Hoffart,
Øktedalen & Langkaas (2015), Jazaieri et al.
(2012), Kelly et al. (2017), Kingston et al. (2015),
Koszycki et al. (2016), and Krieger et al. (2016)
utilized purposive sampling to recruit participants
with specific mental health conditions or
demographic characteristics. This strategy was
also used in studies with unique population
requirements, such as Kuyken et al. (2010) and
Reid et al. (2014). The use of purposive sampling
in these studies highlights the importance of
carefully selecting participants to ensure that the
data collected is relevant and meaningful to the
research

question.

By

targeting

specific

populations or characteristics, researchers can
increase the validity and generalizability of their
findings, ultimately contributing to a deeper
understanding of mental health phenomena.

Opportunity sampling was observed in few studies
that leveraged existing programs or workshops,
allowing researchers to capitalize on pre-existing
participant pools. This approach was evident in the
works of Arimitsu & Hofmann (2015) and de Bruin
et al. (2016), where participants were recruited
from

existing

programs

or

workshops.

Opportunity sampling was also employed in
studies such as Galla (2016) and Kelly et al. (2017),
where participants were recruited based on their
availability in specific settings. This strategy was
also seen in studies like Mistretta et al. (2018) and
Perry et al. (2018), where participants were drawn
from pre-existing intervention programs or
studies. Furthermore, opportunity sampling was
used in Wong & Mak (2016) and Yin et al. (2018),
where participants were recruited from ongoing
community programs or mental health workshops.
This approach allowed researchers to access
groups already gathered in specific intervention
settings, facilitating recruitment and reducing the
need for extensive participant recruitment efforts.

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The practicality of opportunity sampling in these
studies highlights its value in cases where
participants are already gathered in specific
contexts, such as ongoing therapy sessions or
academic environments. By leveraging existing
participant pools, researchers can streamline their
recruitment processes and increase the efficiency
of their studies.

While random sampling was less prevalent in the
included studies, it was occasionally employed
when researchers had access to a well-defined
sample pool. This approach was notable in Arch et
al. (2014), where a random sampling strategy was
attempted to enhance the generalizability of the
findings. Similarly, Huijbers et al. (2015) utilized
random sampling to minimize selection bias and
ensure a representative sample. The infrequent
use of random sampling in these studies can be
attributed to the logistical challenges associated
with achieving randomization in psychological and
clinical research. However, when feasible, random
sampling can provide valuable insights into the
population of interest by reducing selection bias
and increasing the representativeness of the
sample.

Snowball sampling was used sparingly but noted in
certain studies exploring interpersonal or cultural
dynamics, where existing participants referred
others with similar backgrounds or experiences.
Studies exploring specific social groups, such as
Hou et al. (2020), used snowball sampling.
Snowball sampling helped reach populations that
might otherwise be hard to recruit, particularly in
studies focused on sensitive topics or niche
populations.

Participant Recruitment

The studies included in this review recruited
participants from a variety of sources, including
universities and community settings. A total of 28
studies recruited from universities, including
works such as Arch et al. (2014), Arimitsu (2016),

Arimitsu & Hofmann (2015), and many others.
These studies were conducted in a range of
academic

settings,

including

psychology

departments and research centers.

In addition to university-based studies, 16 studies
were recruited from community settings, including
works such as Bayot et al. (2020), Collett et al.
(2016), Fuertes et al. (2020), and many others.
These studies were conducted in a range of
community settings, including mental health
clinics, community centers, and online platforms.

Some studies targeted specific community groups,
such as workplace populations. Arredondo et al.
(2017) specifically targeted participants in the
workplace to evaluate the effectiveness of a
mindfulness-based stress reduction program.
Other studies that recruited from community
groups include Hoffart, Øktedalen & Langkaas
(2015), Kelly et al. (2017), Kingston et al. (2015),
Koszycki et al. (2016), Mistretta et al. (2018),
Potharst et al. (2019), Psychogiou et al. (2016),
Reid et al. (2014), and Willemsen et al. (1986).
These studies were designed to address the unique
needs and challenges of these populations and to
develop interventions that are tailored to their
specific circumstances.

Participant Characteristics

The present study aggregated data from a
substantial pool of approximately 27,927
participants across all included studies, providing
a comprehensive foundation for analysis. The
sample sizes varied significantly, ranging from a
modest 10 participants (Waite et al., 2015) to a
substantial 2,383 participants (Lahtinen et al.,
2019). Notably, the age range of participants
spanned an impressive spectrum, from 2 months,
encompassing infants (Müller et al., 2016), to older
adults up to 52 years, as reported by Joeng &
Turner (2015) and Waite et al. (2015). This broad
age range allows for a nuanced understanding of
the phenomenon under investigation, as it

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captures the developmental trajectory from
infancy to adulthood.

The studies were categorized into four main
groups based on the age range of the participants:
children, adolescents, adults, and clinical
populations. The studies involving children (n=6)
focused on toddlers and self-comforting
behaviours, with a mean age range of 2-5 years.
These studies include Fuertes et al. (2020),
Kemper et al. (2016), Perry et al. (2018), Müller et
al. (2016), Warschburger et al. (2023) and
Willemsen et al. (1986). The studies involving
adolescents (n=10) examined various aspects of
adolescent development, including social anxiety,
depression, and trauma. These studies include
Castilho et al. (2017), Galla (2016), Gill et al.
(2018), Kemper et al. (2016), Lahtinen et al.
(2019), Lathren, Bluth & Park (2019), Tanaka et al.
(2011), Van der Gucht et al. (2018), Warschburger
et al. (2023), and Xavier, Gouveia, & Cunha (2016).
The studies involving adults (n=79, includes adults
only or both adults and other age groups) focused
on a wide range of topics, including mental health,
wellbeing, and quality of life. Some of the studies

include Smeets et al. (2014), Ștefan et al. (2018),

Svendsen et al. (2017), Taylor et al. (2014),
Yamaguchi, Kim, & Akutsu (2014), Zeifman et al.
(2019), Zhang & Wang (2019), and many others.

The studies with clinical populations (n=19)
examined the effects of mindfulness on various
mental health conditions, including anxiety
disorders, depression, and post-traumatic stress
disorder (PTSD). Most of these studies primarily
focused on college students, general adolescents,
or community samples without specific clinical
diagnoses. Examples of these studies include
Braehler et al. (2013), Collett et al. (2016), Diedrich
et al. (2014), Døssing et al. (2015), among others.
The studies with non-clinical populations (n=76)
focused on the effects of self-comforting on general
wellbeing, stress reduction, and quality of life.

Some of these studies include Kemper et al. (2016),
Ko et al. (2018), Luo et al. (2019), Neff (2003),
Polizzi, Baltman, & Lynn (2022), and several
others.

The diversity of the participant characteristics in
this

study

provides

a

comprehensive

understanding of the effects of self-comforting on
various populations.

Methodological Approaches

The reviewed studies exhibit a diverse array of
methodological designs, comprising randomized
controlled trials (RCTs), correlational studies,
cross-sectional studies, longitudinal studies, and a
qualitative study.

The RCTs, which comprised 33 studies, were
conducted to evaluate the efficacy of self-
comforting behaviours and mindfulness-based
interventions in reducing symptoms of anxiety,
depression, and post-traumatic stress disorder
(PTSD). The studies employed a range of
mindfulness-based

interventions,

including

mindfulness-based stress reduction (MBSR),
mindfulness-based cognitive therapy (MBCT), and
mindfulness-based acceptance and commitment
therapy (MBACT). The results of the RCTs
generally supported the efficacy of mindfulness-
based interventions in reducing symptoms of
anxiety, depression, and PTSD, with moderate to
large effect sizes observed in many of the studies.

The correlational studies, which comprised 7
studies, examined the relationship between
mindfulness and mental health outcomes. These
studies found that higher levels of mindfulness
were associated with better mental health
outcomes, including reduced symptoms of anxiety
and depression.

The cross-sectional studies, which comprised 36
studies, examined the prevalence of mindfulness-
based interventions and their relationship to
mental health outcomes in various populations.

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These studies found that mindfulness-based
interventions were commonly used in clinical and
educational settings, and that they were associated
with improved mental health outcomes, including
reduced symptoms of anxiety and depression.

The longitudinal studies, which comprised 11
studies, examined the long-term effects of
mindfulness-based interventions on mental health
outcomes. These studies found that mindfulness-
based interventions were associated with
sustained improvements in mental health
outcomes, including reduced symptoms of anxiety
and depression.

Finally, the qualitative study, which comprised a
single

study,

employed

interpretative

phenomenological analysis to examine the
experiences of individuals who had participated in
mindfulness-based interventions. The study found
that participants reported improved mental health
outcomes, including reduced symptoms of anxiety
and depression, and increased self-awareness and
self-acceptance.

Largely, our findings suggest that mindfulness-
based interventions are a promising approach for
improving mental health outcomes, including
reducing symptoms of anxiety, depression, and
PTSD. The results of the RCTs, correlational
studies, cross-sectional studies, longitudinal
studies, and qualitative study all support the
efficacy and effectiveness of mindfulness-based
interventions in promoting mental health and
wellbeing.

Measurement Tools

Our review employed a range of measures to
assess the efficacy and effectiveness of these
interventions. Most studies (73) utilized self-
report questionnaires, including the Self-
Compassion Scale (SCS) and its short form (SCS-
SF), as well as measures of anxiety and depression
such as the Center for Epidemiologic Studies

Depression Scale (CES-D), the Depression Anxiety
Stress Scales (DASS-21), and the Hospital Anxiety
and Depression Scale (HADS). Other self-report
measures used included the Beck Depression
Inventory-II (BDI-II), the Symptom Checklist-90
(SCL-90), and the Liebowitz Social Anxiety Scale-
Self-Report (LSAS-SR).

In addition to self-report measures, some studies
employed observational methods to assess the
impact of mindfulness-based interventions on
mental health outcomes. For example, Collett et al.
(2016), Fuertes et al. (2020), Müller et al. (2016),
Psychogiou et al. (2016) used observational
methods to examine the effects of mindfulness-
based stress reduction (MBSR) on symptoms of
anxiety and depression.

Physiological measures were also used in some
studies to assess the impact of mindfulness-based
interventions on mental health outcomes. For
example, Arredondo et al. (2017), de Bruin et al.
(2016) and Huberty et al. (2019) used
physiological measures such as heart rate and
blood pressure to assess the effects of
mindfulness-based interventions on stress and
anxiety. Other studies used salivary alpha-amylase
as a marker of stress, such as Ko et al. (2018).

Essentially, the use of a range of measures in these
studies provides a comprehensive understanding
of the impact of mindfulness-based interventions
on mental health outcomes and highlights the
importance of using multiple measures to assess
the efficacy and effectiveness of these
interventions.

Key Findings Related to Self-Comforting
Behaviours

This comprehensive review reveals a wealth of
findings that highlight the importance of self-
compassion in promoting positive mental health
outcomes. Across 22 studies, a significant positive
association was found between self-compassion

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behaviours and mental health outcomes, including
reduced psychological distress, anxiety, and
depression (e.g., Mingkwan et al. (2018),
Stephenson et al. (2018), Stutts et al. (2018)).
Furthermore, 9 studies demonstrated a negative
correlation

between

self-compassion

and

maladaptive coping strategies, suggesting that self-
compassion may serve as a protective factor
against mental health problems (e.g., Ghorbani et

al. (2012), Sevinc et al. (2018), Ștefan et al. (2018)).

In addition to these findings, 11 studies explored
moderating and mediating factors (such as
personality traits, social support, coping styles)
that influence the relationship between self-
compassion and mental health outcomes. These
studies found that self-compassion can mediate
the effects of stress, depression, and anxiety, often
in conjunction with other emotional regulation
strategies (e.g., Taylor et al. (2014) and Van der
Gucht et al. (2018)). Svendsen et al. (2017) found
that self-compassion and mindfulness together
predicted lower depressive symptoms by reducing
rumination.

Cultural and developmental factors were also
examined in a subset of studies, which highlighted
the importance of considering cultural context and
self-compassion in understanding mental health
outcomes. For instance, Yamaguchi et al. (2014)
found that self-compassion alleviates depressive
symptoms across cultural contexts.

Finally, studies examining self-compassion in
populations with specific mental health challenges
(e.g., OCD, social anxiety, childhood maltreatment)
showed variations in how self-compassion
correlated with mental health outcomes. For
example, Wetterneck et al. (2013) identified
significant links between OCD severity and deficits
in self-compassion, while Tanaka et al. (2011)
found childhood maltreatment to be associated
with lower self-compassion and psychological
distress.

Overall, these findings underscore the importance
of self-compassion in promoting positive mental
health outcomes and highlight the need for further
research to better understand the complex
relationships between self-compassion, cultural
context, and mental health outcomes.

Quality Assessment

Appendices 2A-2D provides a comprehensive table
summarizing the 94 studies, along with quality
appraisal ratings based on the JBI-CAT criteria.
This detailed table enables a quick assessment of
the methodological quality of each study and
informed decisions about the relevance and
applicability of our findings to research or practice.
A total of 32 studies met the majority of JBI criteria,
particularly excelling in aspects such as
randomization, allocation concealment, blinding,
and complete follow-up, earning a high rating.
However, 42 studies lacked certain critical
elements, including participant or therapist
blinding and allocation concealment, resulting in a
moderate rating. Due to significant methodological
issues, including the absence of randomization,
incomplete follow-up, or potential selective
reporting, 20 studies were rated low.

Data Synthesis

Self-comforting behaviours are a fundamental
aspect of human life, serving as coping
mechanisms during moments of distress. These
behaviours are particularly relevant in the context
of psychological wellbeing, emotional regulation,
and

mental

health.

Various

theoretical

frameworks, such as attachment theory, stress and
coping,

cognitive-behavioural

theory,

psychodynamic theory, and mindfulness-based
approaches, have explored self-comforting in
different lights. This thematic analysis investigates
studies that examine self-comforting through
these frameworks, with a focus on identifying
common themes and patterns that contribute to a
comprehensive

understanding

of

the

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phenomenon.

Self-comforting behaviours can range from
physical actions like hugging oneself, to more
abstract psychological processes, such as self-
compassion, mindfulness, or cognitive reframing.
These behaviours are often seen in response to
stressors, traumatic experiences, or emotional
dysregulation. From infancy to adulthood, self-
comforting evolves as individuals develop their
coping strategies, often influenced by their
attachment styles, cognitive development, and life
experiences.

In this section, the findings from the selected
studies are synthesised to explore how different
theoretical frameworks approach the concept of
self-comforting. By examining the commonalities
and distinctions among theoretical frameworks, a
more nuanced understanding of the role of self-
comforting in emotional regulation, coping
mechanisms, and mental health can be
constructed.

Theoretical Frameworks

i. Attachment Theory

Attachment theory provides a robust framework
for understanding self-comforting behaviours,
particularly in early childhood development.
According to this theory, the quality of attachment
between a child and their caregiver influences how
the child learns to regulate emotions and comfort
themselves. Secure attachment fosters healthy
emotional

regulation

and

self-soothing

capabilities, whereas insecure attachment can lead
to maladaptive self-comforting behaviours, such as
excessive dependency on external sources of
comfort or unhealthy coping mechanisms.

Arch et al. (2014) examined the role of self-
compassion, a form of self-comforting, in
mitigating the negative psychological and
biological effects of social stress. Their findings
align with the principles of attachment theory,

where individuals with higher levels of self-
compassion, potentially rooted in secure
attachment, demonstrated better emotional
regulation in the face of stress.

ii. Stress and Coping Framework

The stress and coping framework, developed by
Lazarus and Folkman (1984), emphasizes how
individuals manage stress through appraisal and
coping mechanisms. Self-comforting behaviours,
in this context, can be viewed as strategies for
coping with stress. Cognitive appraisal of a
stressful situation determines whether individuals
perceive it as threatening or manageable, and this
appraisal influences the coping mechanisms they
employ, including self-soothing behaviours.

Arimitsu (2016) explored the relationship
between self-compassion and mental health
outcomes, such as anxiety and depression, through
the mediating role of cognitive processes. The
study highlighted how self-compassion, as a self-
comforting behaviour, can reduce negative
automatic thoughts, which are a central feature of
maladaptive coping strategies. By fostering
positive automatic thoughts, self-compassion
helps individuals appraise stressful situations
more positively, thereby promoting healthier
emotional responses.

iii. Cognitive-Behavioural Theory (CBT)

Cognitive-behavioural theory, one of the most
widely used frameworks in clinical psychology,
focuses on the interplay between thoughts,
emotions, and behaviours. In the context of self-
comforting, CBT posits that individuals can learn to
comfort themselves by altering maladaptive
thought patterns and behaviours.

Ferrari et al. (2018) examined the role of self-
compassion in moderating the relationship
between perfectionism and depression. Their
findings support the CBT perspective that
changin

g one’s relationship with negative

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thoughts, rather than the thoughts themselves, can
lead to improved emotional outcomes. Self-
compassion, as a self-comforting behaviour, allows
individuals to engage in less self-criticism and
more self-acceptance, which, according to CBT, can
break the cycle of negative thoughts and
depressive symptoms.

iv. Psychodynamic Theory

Psychodynamic theory, originating from the work
of Freud, emphasizes unconscious processes and
the influence of early childhood experiences on
behaviour. Self-comforting behaviours, from a
psychodynamic perspective, can be seen as
defence mechanisms that individuals develop to
manage anxiety and emotional conflict.

Bluth et al. (2015) conducted a study on the
feasibility and outcomes of a mindful self-
compassion program for adolescents. While not
explicitly framed within psychodynamic theory,
their findings suggest that self-compassion can
serve as a protective mechanism against stress and
emotional conflict, similar to the way defence
mechanisms operate in psychodynamic theory.
Adolescents who learned self-compassion were
better able to manage emotional distress, possibly
by reducing the need for unconscious defence
mechanisms, such as denial or repression.

v. Developmental Psychology and Infant
Development

From a developmental psychology perspective,
self-comforting behaviours begin early in life as
infants learn to self-soothe in response to distress.
This ability to comfort oneself is crucial for
emotional regulation and psychological resilience
throughout life. Theories of infant development,
such as those proposed by Bowlby and Ainsworth,
emphasize the role of caregiver-infant interactions

in shaping the child’s ability to self

-soothe.

Bluth, Roberson & Gaylord (2016) investigated the
impact of mindfulness training on adolescents,

highlighting the role of self-compassion in
promoting emotional wellbeing. Their study aligns
with developmental theories, suggesting that
interventions aimed at enhancing self-compassion
can support the development of healthy emotional
regulation skills in adolescence, a critical period
for emotional and psychological development.

Common

Themes

in

Self-Comforting

Behaviours

i. Self-Compassion as a Key Construct

The selected studies primarily revolve around self-
compassion, a crucial concept in self-comforting
behaviour, and its relation to psychopathology,
emotion regulation, and cognitive processes across
different populations and contexts. Neff (2003)
defines self-compassion through three core
components: self-kindness, common humanity,
and mindfulness. These elements collectively
enable individuals to comfort themselves during
distress by reducing self-criticism, fostering a
sense of connection with others, and maintaining a
balanced perspective on negative emotions.

Research supports self-compassion as both a
preventive and curative mechanism that mitigates
the severity of symptoms and fosters resilience.
Arch et al. (2014), Arimitsu (2016), and Ferrari et
al. (2018) show that self-compassion can buffer
against stress, anxiety, and depression. Falsafi
(2016) and Armstrong & Rimes (2016)
emphasized that mindfulness-based interventions,
which enhance self-compassion, led to reductions
in anxiety and depression. These studies show that
individuals with higher levels of self-compassion
tend to engage in healthier self-comforting
behaviours, such as cognitive reframing and
emotional regulation, which help mitigate the
impact of negative life events.

Studies such as Hoge et al. (2013) and Krieger et al.
(2016) demonstrate that individuals with higher
self-compassion tend to report lower anxiety,

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depression, and PTSD symptoms. Similarly, Hoffart
et al. (2015) found that increased self-kindness
and reduced self-judgment had a significant impact
on PTSD recovery. These studies indicate that the
capacity for self-kindness and compassion, and the
ability to reduce self-criticism, serve as buffers
against emotional distress.

Werner et al. (2012) found that individuals with
social anxiety disorder (SAD) demonstrated lower
self-compassion, which was linked to increased
fear of both positive and negative evaluations.
Wetterneck et al. (2013) highlighted the
relationship between self-compassion and OCD
severity, suggesting self-compassion as a predictor
of psychological outcomes.

ii. Self-Compassion and Vulnerability to
Depression and Anxiety

Several studies suggest that self-compassion

directly influences individuals’ vulnerability to

depression and anxiety. Zou et al. (2013, 2017)
report that self-compassion is negatively
associated with hopelessness depression and
anxiety, particularly in impoverished populations
and students. The buffering effect is mediated by
the improvement in cognitive style and Confucian
coping in the Chinese context, indicating self-

compassion’s

potential

for

cross

-cultural

applications. Terry, Leary & Mehta (2012)
demonstrate that self-compassion moderates
students' reactions to the stressors of transitioning
to college. Higher self-compassion results in lower
levels of homesickness, depression, and greater
satisfaction, showing its role in coping with life
transitions.

iii. Self-Compassion in Managing Depression,
Anxiety, and Perfectionism

Arimitsu (2016) and Ferrari et al. (2018) both
explored how self-compassion can buffer the
negative effects of perfectionism and various
forms of psychopathology, such as depression and

anxiety. Self-compassion helped diminish the
impact of negative automatic thoughts and
perfectionist tendencies that lead to depression.
Gill et al. (2018) connected low self-compassion to
social anxiety in adolescents, where greater self-
compassion reduced the impact of social anxiety
through mechanisms like fear of negative
evaluation. Castilho et al. (2017) found that self-
compassion, together with emotional intelligence,
reduced depressive symptoms in adolescents with
traumatic shame memories.

Podina, Jucan & David (2015) highlight how the
self-kindness component of self-compassion
buffers the relationship between irrational beliefs
and depression. Self-kindness seems to have a
stronger moderating effect than mindfulness or
common humanity, showing its distinct value in
self-compassion research. Rabon, Sirois & Hirsch
(2017) found self-compassion to be inversely
related to suicidal behaviour, with its effects
partially mediated by reduced depressive
symptoms and increased wellness behaviours.
This emphasizes the potential role of self-
compassion in suicide prevention. Zeifman et al.
(2019) further underline that self-compassion is
uniquely associated with reduced suicidal
behaviours, even after controlling for depression,
hopelessness, and self-criticism, emphasizing its
unique role in reducing suicide risk.

Across these studies, self-compassion plays a key
role in moderating mental health outcomes, such
as depression and anxiety, especially in the context
of cognitive-behavioural theory. Self-compassion
helps reframe maladaptive thoughts and
perfectionist behaviours, promoting positive
psychological outcomes.

iv. Self-Criticism as a Barrier to Emotional
Healing

Many of the articles point to self-criticism as a key
obstacle in recovery from mental health
conditions. The internalization of harsh self-

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judgment, whether through external sources (such
as parental criticism) or internal processes (like
comparison

with

others),

can

amplify

psychological symptoms.

Waite et al. (2015) and Reid et al. (2014) reveal
how self-criticism traps individuals in cycles of
emotional pain, with self-compassion acting as a
pathway out. Potter et al. (2014) link parental
criticism with social anxiety, mediated by self-
compassion, while Scoglio et al. (2015) highlight
self-

criticism’s role in maintaining PTSD and

emotion dysregulation.

Collett et al. (2016) found that individuals with
persecutory

delusions

exhibit

low

self-

compassion, which is associated with increased
suicidal ideation, negative self-schemas, and fears
of madness. Negative self-cognitions and low self-
compassion appear to exacerbate the severity of
persecutory delusions.

Zou et al. (2013) reported that negative cognitive
styles mediate the relationship between self-
compassion

and

hopelessness

depression,

suggesting that self-compassion serves as a
counterbalance to self-critical and negative
thought patterns.

Furthermore, self-criticism and interpersonal
stressors were identified as contributing factors to
maladaptive self-comforting behaviours, including
non-suicidal self-injury (NSSI) and binge eating
disorder (BED). Xavier et al. (2016) demonstrated
that external shame, self-criticism, and fear of self-
compassion were associated with NSSI, mediated
by peer hassles and depressive symptoms. Kelly &
Carter (2013) explored how a self-compassion-
based intervention reduced binge eating
behaviours, particularly in individuals with low
fear of self-compassion, highlighting the impact of
self-criticism on eating disorders.

v. Fear of Compassion and Emotional Blockages

A recurring theme is the fear or resistance to

compassion, particularly self-compassion, which
often

exacerbates

psychopathology.

This

phenomenon is linked to individuals’ fears of

positive emotions, feelings of shame, or self-
criticism, preventing them from fully benefiting
from self-compassion. Fear of self-compassion
emerges as a significant barrier to the effectiveness
of interventions aimed at increasing self-kindness.
This theme is prominent in studies on both eating
disorders and general psychopathology.

Gilbert et al. (2012) and Miron et al. (2016) both
explore how fear of positive emotions or self-
compassion contributes to psychopathological
symptoms

like

depression,

PTSD,

or

hypersexuality. Joeng & Turner (2015) describe
how fear of self-compassion mediates the
relationship

between

self-criticism

and

depression, highlighting its role in sustaining
psychological distress.

Kelly et al. (2015) and Kelly & Carter (2013) found
that fear of self-compassion significantly
diminished the efficacy of compassion-focused
therapy (CFT) interventions for individuals with
eating disorders, suggesting that addressing fear of
self-compassion is crucial for treatment success.
Xavier et al. (2016) similarly linked fear of self-
compassion

to

self-injurious

behaviours,

indicating that negative self-perception plays a key
role in the persistence of these behaviours.

vi. Emotional Regulation through Self-
Comforting

Many studies investigate how self-compassion
influences

emotion

regulation

strategies,

particularly in mitigating the effects of negative
affect and mental health disorders. Emotional
regulation refers to the processes by which
individuals manage their emotions, particularly in
response to stress or emotional challenges. Self-
comforting behaviours, such as mindfulness, self-
compassion, and cognitive restructuring, play a
crucial role in this process.

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Raes (2010) found that self-compassion mitigates
depression and anxiety through its effects on
reducing rumination and worry, which are
significant mediators. Brooding (rumination)
specifically mediates the relationship between
self-compassion and depression, while worry
plays a stronger mediating role for anxiety.
Diedrich et al. (2014, 2016) explore how self-
compassion, when used as a preparatory emotion
regulation

strategy,

facilitates

cognitive

reappraisal in patients with major depressive
disorder. Self-compassion reduces depressed
mood more effectively than waiting, and it
enhances the efficacy of cognitive reappraisal as a
mood regulation strategy in patients experiencing
high levels of depressed mood.

Sevinc et al. (2018) show how different
meditation-based interventions activate brain
regions associated with self-control and sensory
awareness, highlighting the neural underpinnings
of self-comforting behaviours. The studies
emphasize that self-soothing is facilitated by both
emotional regulation (reduced rumination) and
cognitive processes (enhanced mindfulness and
self-compassion).

Castilho et al. (2017) highlight the importance of
emotional intelligence and self-compassion in
regulating emotions, particularly in adolescence.
Adolescents who demonstrate higher levels of self-
compassion and emotional intelligence are better
equipped to manage emotional distress and reduce
depressive symptoms. These findings suggest that
self-comforting behaviours, when cultivated early
in life, can promote long-term emotional resilience.

vii. Self-Regulation and Self-Comforting

Warschburger et al. (2023) places self-regulation
at the core of self-comforting behaviours. It
highlights

how

self-regulation,

including

emotional

regulation

and

behavioural

management, develops over time and is pivotal in
mental and physical health outcomes in

adolescence. It examines multiple sub-facets of
self-regulation (SR) and how they interplay with

developmental outcomes. Although it doesn’t focus

solely on self-comforting, the regulation of
emotions and behaviours is closely tied to self-
soothing strategies.

Wright (2009) argues that self-soothing, as framed
within Bowen's family systems theory, is a vital
element in regulating emotional discomfort and
affect. He emphasizes the recursive nature of self-
soothing, which serves as both a byproduct and
facilitator of emotional differentiation and
regulation.

Across the studies, self-regulation is a key
construct within self-comforting behaviours. From
childhood to adolescence and adulthood, self-
comforting can be seen as one aspect of an
individual's broader self-regulation capacity.
Emotional regulation, in particular, appears
central to self-comforting, with developmental
milestones playing a critical role in refining these
capacities.

viii.

Mindfulness

and

Self-Comforting

Interventions

Mindfulness, or the practice of maintaining a
present-

centered awareness of one’s thoughts and

emotions without judgment, is another key
mechanism in self-comforting behaviours. Greeson
et al. (2014), Gu et al. (2015), Hwang et al. (2019),
and Stefan et al. (2018) all highlight mindfulness-
based interventions as a key mechanism through
which individuals learn self-compassion and
improve self-regulation, which includes self-
comforting behaviours. These interventions show
reductions in stress, perceived stress, and
emotional reactivity, which are fundamental to
self-soothing mechanisms.

Mindfulness-based

interventions

often

incorporate compassion-based practices, which
have shown promising results in treating mental

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health disorders. Loving-kindness meditation
(LKM), in particular, has been shown to increase
acceptance and reduce symptoms in borderline
personality disorder (BPD). Mindful Self-
Compassion (MSC) programs have also been
shown to improve emotional regulation and
psychological wellbeing by promoting self-
compassion. Bluth et al. (2015) demonstrated that
adults who participated in a mindful self-
compassion program experienced significant
improvements in self-compassion, mindfulness,
and wellbeing, including reductions in depression,
anxiety, and stress.

Several studies investigate mindfulness-based
cognitive therapy (MBCT) and mindfulness-based
stress reduction (MBSR) as interventions for
improving

self-regulation,

enhancing

self-

compassion, and reducing symptoms of
psychopathology. Key et al. (2017) and Kuyken
(2010) suggest that MBCT enhances mindfulness
and self-compassion, leading to a reduction in
depressive and OCD symptoms. In particular,
MBCT appears to weaken the link between
cognitive reactivity and negative mental health
outcomes. Taylor et al. (2014), Moss et al. (2015),
and Stefan et al. (2018) suggest that MBCT and
MBSR improve emotion regulation, reduce self-
critical thoughts, and enhance self-compassion,
enabling more adaptive self-soothing mechanisms.
Dundas et al. (2017) showed that a short self-
compassion course improved self-regulation and
reduced habitual negative thinking, anxiety, and
depression among university students.

These findings align with the broader literature on
mindfulness, which suggests that cultivating a
mindful, non-

judgmental awareness of one’s

emotions can enhance self-comforting behaviours
and promote long-term psychological resilience.

ix. The Mediating Role of Cognition

Cognition plays a significant role in self-comforting
behaviours, as evidenced by the studies of

Arimitsu (2016) and Ferrari et al. (2018). These
studies suggest that self-compassion influences
mental health outcomes by altering cognitive
processes, such as automatic thoughts and
cognitive appraisals.

In the stress and coping framework, cognitive
appraisal is a key determinant of how individuals
respond to stress. Self-comforting behaviours,
such as self-compassion, can shift cognitive
appraisals from negative to positive, thereby
reducing the emotional impact of stress. This
cognitive shift is central to the effectiveness of self-
comforting behaviours in promoting psychological
wellbeing.

x. Psychological Flexibility and Values-Based
Living

Psychological flexibility, a concept central to
Acceptance and Commitment Therapy (ACT), and
values-based living, also appear as common
therapeutic targets in several studies. Wetterneck
et al. (2013) examined psychological flexibility and
values-based living in relation to OCD, finding
significant links between self-compassion and
symptom severity. Yadavaia et al. (2014)
highlighted the role of psychological flexibility in
mediating the effects of ACT interventions on self-
compassion and other psychological outcomes,
particularly for those with a trauma history.

Sevinc et al. (2018), Asselmann et al. (2024), and
Ewert et al. (2024) provide further evidence that
mindfulness and self-compassion are linked to
reduced stress and greater psychological
flexibility, allowing individuals to cope more
effectively with stressors. These studies suggest
that self-comforting behaviours are a form of
adaptive coping that helps individuals manage
emotional distress.

xi. Attachment and Early Developmental Self-
Comforting Patterns

Self-comforting behaviours emerge early in

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development and play a crucial role in regulating
emotions and managing stress. Attachment theory
provides a valuable framework for understanding
the origins and development of self-comforting.
Secure attachment, or the lack thereof,
significantly influences the development of healthy
self-comforting strategies.

Fuertes et al. (2020) demonstrate that preterm
infants who exhibit more self-comforting
behaviours are more likely to develop avoidant
attachment patterns, suggesting that self-soothing
behaviours may be a compensatory mechanism
when caregiver attachment is less secure.
Similarly, Muller et al. (2016) found that maternal
anxiety and bonding issues influence infant self-
comforting patterns, with older female infants
being more sensitive to these dynamics. Both
studies highlight the interconnectedness of early
attachment, maternal anxiety, and self-comforting
behaviours. Infants exhibit distinct self-comforting
patterns based on their attachment style and their
mothers' emotional state, suggesting that self-
comforting is closely tied to the quality of early
relationships and regulatory challenges.

Willemsen et al. (1986) explores self-comforting
through the lens of attachment theory, predicting
that self-comforting would be positively related to
secure attachment. Although not all predictions
were supported, our findings highlight the
complex

interplay between a caregiver’s style and

the development of self-awareness and comfort-
seeking behaviours in the toddler. Warschburger
et al. (2023) emphasize the developmental
trajectory of self-regulation capacities, including
self-comforting, from childhood to adolescence.
Their longitudinal study highlights the importance
of self-comforting in navigating life stressors and
emotional turmoil during adolescence.

Both studies suggest that self-comforting
behaviours are intrinsically tied to developmental
processes, emerging in infancy and evolving

through adolescence. The ability to self-soothe
appears to be part of a broader set of
developmental outcomes, including secure
attachment and emotional regulation, which are
critical during periods of increased autonomy (e.g.,
toddlerhood and adolescence).

Galla

(2016)

further

underscores

the

developmental impacts of self-compassion,
particularly in adolescence. Adolescents who
develop self-compassion are shown to have better
emotional wellbeing, increased mindfulness, and
improved coping with stress. Hall et al. (2013)
explored

the

relationship

between

self-

compassion and life stressors, finding it improved
both psychological and physical wellbeing among
college students. Across these studies, self-
compassion has significant developmental
impacts, especially during adolescence, where it
helps individuals navigate life stressors and
emotional turmoil. These findings correspond with
infant development theories and psychopathology,
where self-soothing mechanisms evolve as part of
adaptive developmental processes.

Although Wright’s article focuses on Bowen family

systems theory, attachment is implicitly
considered within the broader context of
relationships and the development of self-soothing
as a way to manage emotional distress in relational
contexts. Attachment theory remains a significant
framework in understanding self-comforting
behaviours. Secure attachment, or the lack thereof,
plays a critical role in whether individuals develop
healthy self-comforting strategies. Across the
lifespan, these strategies evolve and are influenced
by early caregiver interactions, pointing to a
foundational link between attachment security
and self-comforting.

xii.

Parenting

and

Intergenerational

Transmission of Psychopathology

Self-compassion plays a significant role in
parenting and intergenerational transmission of

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mental health issues. Parents with higher levels of
self-compassion were better able to regulate their
emotions and provide healthier environments for
their children.

Psychogiou et al. (2016) found that self-
compassion was associated with better parenting
behaviours, leading to fewer emotional and
behavioural issues in children. This suggests that
interventions aimed at increasing self-compassion
in parents could potentially break the cycle of
psychopathology transmission.

Nicole et al. (2018) explore the long-term
developmental implications of early self-
regulation and emotion regulation in children,
linking overcontrolling parenting to difficulties in
self-regulation and later emotional and academic
problems. This reinforces the idea that early life
experiences, particularly those shaped by
caregivers, have a profound influence on the
development of self-comforting behaviours.

The role of overcontrolling parenting and its
association with poor self-regulation and
emotional difficulties in adolescence suggests that
self-comforting behaviours developed early in life
can have lasting impacts on mental health and
social outcomes.

Willemsen et al. (1986) underscores the role of
caregivers, particularly mothers, in fostering

independence and how this influences the child’s

ability to self-comfort. It also emphasizes the

relationship between a mother’s comforting style
and the child’s development of self

-soothing

behaviours.

Wright (2009) argues that Bowen's family systems
theory offers a dual focus on both relational
(interpersonal) and intrapsychic (intrapersonal)
dynamics. He suggests that self-soothing is not
merely a personal skill but is also heavily
influenced by the broader relational context,
particularly significant familial relationships.

Caregiver-child interactions (interpersonal) play a
crucial role in early self-comforting behaviours,
while as individuals mature, their intrapersonal
processes (e.g., emotional differentiation, self-
awareness) begin to take over, allowing for more
autonomous self-soothing.

xiii. The Impact of Trauma and Negative Life
Events

Trauma and negative life events are often triggers
for self-comforting behaviours, as individuals seek
to manage the emotional distress associated with
these experiences. Several studies indicate that
self-compassion serves as a mediator in the
recovery process from trauma and other
emotional disturbances. It helps individuals
manage the emotional aftermath of trauma,
including PTSD and generalized anxiety disorder
(GAD).

Tanaka et al. (2011) found that individuals who
experienced childhood emotional abuse and
neglect have significantly lower levels of self-
compassion, which in turn leads to higher levels of
psychological distress, substance use, and suicidal
ideation. Self-compassion appears to mediate the
relationship between childhood maltreatment and
later psychological functioning, emphasizing its
importance in trauma recovery.

Hou et al. (2020) explored the role of self-
compassion in moderating the relationship
between childhood maltreatment and depression
in young adults. Their findings indicate that self-
compassion can buffer against the negative effects
of childhood trauma, particularly by reducing the
impact of negative automatic thoughts. Similarly,
Miron et al. (2016) emphasize how childhood
abuse survivors benefit from addressing the fear of
self-compassion, demonstrating the importance of
compassion-focused interventions in trauma
recovery.

Additionally, Castilho et al. (2017) found that

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shame traumatic memories were associated with
higher levels of depression and lower levels of self-
compassion in adolescents. These studies highlight
the importance of self-comforting behaviours in
mitigating the long-term psychological effects of
trauma and negative life events. Furthermore,
Maheux & Price (2016) and Hoffart et al. (2015)
suggest that enhancing self-compassion reduces
PTSD symptoms, especially when individuals can
move past self-judgment and isolation.

xiv. Cultural Variations in Self-Comforting

Cross-cultural studies show that the relationship
between self-compassion and mental health
outcomes can vary by cultural context. Neff et al.
(2008) compared self-compassion levels across
different cultures, finding that self-compassion is
higher in collectivist cultures like Thailand and
Taiwan than in individualistic cultures like the
United States. Similarly, Yamaguchi, Kim, and
Akutsu (2014) found that in both the United States
and Japan, self-compassion is inversely related to
self-criticism and depressive symptoms. However,
the impact of self-criticism on self-compassion
differs across cultures. In Japan, interdependent
self-construals have a greater influence on self-
criticism, while in the United States, independent
self-construals play a more significant role. In a
related study, Arimitsu and Hofmann (2015)
examined the effectiveness of a self-compassion
program in Japan, an interdependent culture. They
discovered that self-compassion interventions
were effective in reducing negative thoughts and
emotions. These findings suggest that cultural
values, such as interdependence and collectivism,
may influence the way individuals express and
cultivate self-comforting behaviours.

Cultural differences in the perception and practice
of mindfulness and self-compassion are further
emphasised in some studies. Specifically, how
Buddhist ethical principles, compassion, and
empathy are integrated into mindfulness practices.

Bayot et al. (2020) compared standard
mindfulness training (SMT) to ethics-oriented
mindfulness training (EMT), finding that EMT,
which emphasized Buddhist ethics, led to
increases in self-compassion and subjective
wellbeing, but not empathy, challenging some
assumptions about compassion development
through mindfulness.

xv. Gender Differences in Self-Comforting
Behaviours

Gender differences in self-comforting behaviours
are themes that emerge in several studies. Lathren,
Bluth & Park (2019) found that self-compassion is
inversely related to internalizing symptoms, such
as depression and anxiety, in both males and
females, but the relationship is stronger in males.
This suggests that self-compassion may play a
different role in emotional regulation for males
and females. Castilho et al. (2017) also found
gender differences in the way self-compassion and
emotional intelligence mediated depressive
symptoms. In their study, self-compassion was a
stronger protective factor for males, while
emotional intelligence played a more significant
role for females. These findings suggest that
gender may influence the way individuals engage
in

self-comforting

behaviours

and

the

effectiveness of these behaviours in promoting
psychological wellbeing, which is central to
psychodynamic theory and cultural psychology.
Gender modulates the way self-compassion is
experienced, especially in relation to societal
norms of self-criticism and emotional expression.

xvi. Self-Compassion as a Protective Factor
Against Stress

Arch et al. (2014) highlighted that self-compassion
helps moderate biopsychological responses to
stress (i.e., social evaluative stress), reducing
anxiety and defensive responses. Kemper et al.
(2016) pointed out that self-compassion mitigated
the impact of stress, which was a risk factor for

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paediatric headaches. Lathren, Bluth & Park
(2019) demonstrated that self-compassion
buffered the impact of stress in adolescents,
particularly as an adaptive emotional regulation
strategy. Across these studies, self-compassion
consistently emerges as a protective factor that
diminishes the effects of stress. This aligns with the
stress and coping theory, where self-compassion
can act as an adaptive response to external
stressors, providing emotional cushioning during
difficult situations.

xvii. Self-Compassion as a Mediator of
Psychological Wellbeing

Self-compassion is noted as an important mediator
of improvements in psychological outcomes,
suggesting that individuals who are more self-
compassionate are better equipped to engage in
self-soothing behaviours. Asselmann et al. (2024)
further explore this by linking self-compassion to
functional coping strategies that prevent
dysfunctional thoughts and behaviours during
stress.

Arimitsu (2016) demonstrated that self-
compassion mediated the relationship between
cognitive processes (negative automatic thoughts)
and mental health outcomes, suggesting its central
role in improving emotional resilience. Galla
(2016) found that self-compassion predicted
enhanced emotional wellbeing over time,
underscoring its ability to regulate emotions like
stress and rumination. Stefan et al. (2018)
identifies self-compassion as a mediator in the
relationship between mindfulness practice and
reductions in social anxiety and perceived stress.
This highlights the cognitive component of self-
comforting behaviours, where individuals learn to
reframe stressful situations in a less self-critical
manner.

Across these studies, self-compassion is frequently
described as a mediator in the interaction between
negative cognitive patterns and psychological

wellbeing. This aligns with attachment theory and
cognitive-behavioural theory, where emotional
self-regulation via self-compassion mitigates the
effects of negative cognitive patterns, such as
rumination and self-criticism.

xviii. Self-Compassion and Severe Mental
Illness

The role of self-compassion in severe mental
health disorders, such as schizophrenia and
psychosis, is relatively underexplored but shows
promising therapeutic potential. Studies link
increased self-compassion to reduced psychotic
symptoms, such as cognitive disorganization and
emotional distress.

Eicher et al. (2013) suggest that compassion-based
approaches

may

help

individuals

with

schizophrenia and psychosis by reducing
emotional discomfort and positive symptoms.
These studies point to the need for further
research into compassion-focused therapy in
severe mental illness treatment.

xix. Self-Compassion and Treatment Outcomes

Research indicates that integrating self-
compassion into therapeutic interventions
enhances treatment outcomes, particularly in
clinical settings. Beaumont, Galpin & Jenkins
(2012) and Braehler et al. (2013) found that
individuals undergoing combined cognitive-
behavioural therapy (CBT) and compassion-
focused

therapy

(CFT)

showed

greater

improvements in self-compassion and reductions
in symptoms of depression and anxiety compared
to those who received CBT alone. In patients
recovering from psychosis, CFT led to significant
increases in compassion and reductions in
depression, highlighting its therapeutic value in
clinical interventions.

These findings are corroborated by Wright (2009)
and Warschburger et al. (2023), who touch on the
importance of self-regulation and self-soothing for

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both mental and physical health outcomes,
suggesting that disruptions in self-comforting
behaviours could be linked to developmental
psychopathology. Across these studies, self-
comforting is seen not just as a developmental
milestone but as a key skill in managing emotional
discomfort, particularly for clients struggling with
emotion

al regulation issues. The therapist’s role is

to facilitate an environment where clients can
develop and strengthen their self-soothing
resources.

DISCUSSION

Study Characteristics and Selection Process

The thoroughness of the study selection process,
illustrated by the PRISMA flowchart, underscores
the reliability and rigor of this systematic review.
Starting with 7419 articles and narrowing down to
95 after meticulous screening, the process
highlights the focus on high-quality studies that
align with the review's objectives. This careful
selection contributes to the validity and depth of
the synthesized findings, allowing for a
comprehensive understanding of self-comforting
behaviours.

Theoretical Frameworks for Self-Comforting
Behaviours

The review highlights the complexity of self-
comforting

behaviours

through

multiple

theoretical lenses, each adding a unique
perspective to the understanding of how
individuals use these behaviours for emotional
regulation, resilience, and coping. The findings in
the current div of literature on self-comforting
behaviours underline the multidimensional nature
of self-comforting as it intersects with attachment
theory, early developmental patterns, parenting
styles, and responses to trauma. These results
collectively suggest that self-comforting is a
fundamental aspect of emotional regulation,
impacted by both intrapersonal and interpersonal

dynamics from infancy through adulthood. A more
comprehensive theoretical framework on self-
comforting is warranted to fully understand its
development, its adaptive functions, and its
potential as a buffer against psychological distress.

Attachment Theory

Attachment theory provides foundational insights
into self-comforting, suggesting that secure
attachment with primary caregivers establishes
the groundwork for healthy self-comforting
strategies. Studies such as Arch et al. (2014),
Fuertes et al. (2020) and Muller et al. (2016) reveal
that secure attachment allows infants to
internalize comfort and safety, reducing the need
for compensatory self-soothing behaviours. In
contrast, insecure or avoidant attachment can lead
to heightened self-comforting as a compensatory
response, a pattern evident among preterm infants
and those with anxious maternal figures.

Longitudinal studies, such as Warschburger et al.
(2023), emphasize that self-comforting behaviours
are not static but evolve through developmental
stages, with significant implications during
adolescence. Adolescents who have developed
self-compassion exhibit greater resilience against
life stressors and emotional turmoil. These
findings highlight self-comforting as a critical
aspect of developmental resilience, extending
beyond immediate emotional regulation to long-
term mental health.

Our findings align with previous systematic
reviews that emphasize the importance of secure
attachment in emotional development. For
instance, a systematic review by Obeldobel et al.
(2023) found that secure attachment is
consistently related to better emotion regulation
and recovery. This supports the idea that secure
attachment fosters self-compassion and emotional
resilience.

In contrast, a systematic review by Martins et al.

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(2022) on the development of prosocial behavior
found mixed results regarding the association
between attachment security and prosocial
behavior. While some studies showed significant
associations, others did not, highlighting the
complexity

of

the

relationship

between

attachment and various emotional and social
outcomes.

While our review supports the positive impact of
secure attachment, it is important to consider
other factors that influence emotional regulation
and self-comforting behaviours. For example,
environmental

stressors

and

individual

differences in temperament can also play
significant roles (Risi, Pickard & Bird, 2021). This
suggests that while attachment is crucial, a holistic
approach that considers multiple factors may be
necessary for effective intervention.

Stress and Coping Framework

The stress and coping framework views self-
comforting as a coping mechanism, supporting

Lazarus and Folkman’s (1984) theory that stress

management depends on cognitive appraisal.
Studies such as Arimitsu (2016) showcase the
positive role of self-compassion in shifting
cognitive appraisals, thus helping individuals
manage stress more effectively. This framework
highlights the adaptive nature of self-comforting
behaviours in navigating stress and managing
mental health.

Our findings align with previous systematic
reviews that emphasize the benefits of self-
compassion in coping with stress. For instance, a
meta-analysis by Ewert et al. (2021) found that
self-compassion is positively correlated with
adaptive coping strategies and negatively
correlated with maladaptive coping strategies.
This supports the idea that self-compassion helps
individuals manage stress more effectively by
promoting healthier coping mechanisms.

In contrast, some systematic reviews have focused
on traditional coping strategies without explicitly
considering the role of self-compassion. For
example, a review by Littleton et al. (2007)
examined various coping strategies but did not
specifically address the impact of self-compassion.
This highlights a potential area for further research
and integration, as incorporating self-compassion
into coping frameworks could enhance their
effectiveness.

While our review supports the adaptive nature of
self-comforting behaviours, it is important to
consider other factors that influence stress
management. For example, individual differences
in temperament and environmental stressors can
also play significant roles (Carver & Connor-Smith,
2010). This suggests that a comprehensive
approach to stress management should consider
multiple factors, including self-compassion,
environmental

influences,

and

individual

differences.

Cognitive-Behavioural Theory (CBT)

In the CBT framework, self-comforting is viewed as
a mechanism to modify negative thought patterns.
The findings from Ferrari et al. (2018) indicate that
self-compassion can help individuals manage
perfectionism and negative self-perceptions,
crucial elements in the CBT approach. This
suggests that incorporating self-compassion
practices into CBT could improve outcomes for
individuals

dealing

with

perfectionism,

depression, and anxiety.

Our findings align with previous systematic
reviews that emphasize the benefits of self-
compassion in psychological interventions. For
instance, a meta-review by Hofmann et al. (2012)
found that CBT is effective across a wide range of
conditions, but incorporating elements like self-
compassion could further enhance its efficacy.
Similarly, a systematic review by Kirby et al.
(2017) on Compassion-Focused Therapy (CFT)

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highlighted the positive impact of self-compassion
on mental health outcomes, suggesting that these
benefits could be integrated into CBT.

In contrast, some systematic reviews have focused
on the traditional aspects of CBT without explicitly
incorporating self-compassion. For example, a
panoramic meta-analysis by Fordham et al. (2021)
summarized the general effectiveness of CBT
across various conditions but did not specifically
address the role of self-compassion. This highlights
a potential area for further research and
integration.

While our review supports the integration of self-
compassion into CBT, it is important to consider
other factors that influence therapeutic outcomes.
For

example,

individual

differences

in

temperament and the presence of comorbid
conditions can affect how clients respond to CBT
interventions (Kazantzis et al., 2010). Additionally,
some studies suggest that combining CBT with
other therapeutic approaches, such as Acceptance
and Commitment Therapy (ACT), may offer further
benefits by addressing a broader range of cognitive
and emotional challenges (Hayes et al., 2006).

Psychodynamic Theory

Psychodynamic theory links self-comforting
behaviours to defence mechanisms developed to
manage internal conflict and anxiety. Bluth et al.
(2015) present evidence that self-compassion acts
similarly to defence mechanisms, helping
adolescents manage stress. The psychodynamic
perspective adds depth to our understanding of
self-comforting as a defence against psychological
distress.

Our findings align with previous systematic
reviews that emphasize the effectiveness of
psychodynamic

therapies

in

managing

psychological distress. For instance, a systematic
review by Briggs et al. (2019) found that
psychodynamic psychotherapy is effective in

reducing suicidal behaviour and self-harm,
highlighting its role in improving psychosocial
functioning. This supports the idea that
psychodynamic approaches, including fostering
self-compassion, can be effective in managing
stress and internal conflicts.

In contrast, some systematic reviews have focused
on the broader applications of psychodynamic
therapy without specifically addressing self-
compassion. For example, Yakeley and Burbridge-
James (2018) explored the psychodynamic
approaches to suicide and self-harm, emphasizing
the importance of understanding unconscious
meanings and relational contexts. Although these
reviews highlight the general effectiveness of
psychodynamic therapy, they do not specifically
examine the role of self-compassion as a defence
mechanism.

While our review supports the role of self-
compassion as a defence mechanism, it is
important to consider other factors that influence
psychological resilience. For example, individual
differences in personality and the presence of
external stressors can also impact how individuals
cope with stress (Carver & Connor-Smith, 2010). A
comprehensive therapy approach that considers
multiple factors, including external stressors, is
thus crucial for achieving optimal results and
addressing the complex needs of individuals.

Developmental

Psychology

and

Infant

Development

The developmental perspective suggests that self-
comforting behaviours are foundational to
emotional regulation, starting from infancy.
Programs designed to support parents and
caregivers in nurturing self-compassion in
children could lead to better emotional outcomes
as these children grow. Such interventions could
be implemented in early childhood education
settings, parenting programs, and paediatric
healthcare to promote long-term psychological

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wellbeing.

Studies like Bluth, Roberson & Gaylord (2016)
underline the importance of early interventions
aimed at fostering self-compassion to support
emotional

regulation

and

resilience

in

adolescence. This framework underscores the
potential for early interventions to have lasting
benefits for mental health.

Our findings align with previous systematic
reviews that emphasize the importance of early
emotional regulation interventions. For instance, a
systematic review by Jones et al. (2015) found that
early childhood interventions targeting emotional
regulation can lead to improved social and
emotional outcomes later in life. This supports the
idea that fostering self-compassion from a young
age can have enduring effects. A meta-analysis by
Phillips and Hine (2019) also highlighted the
positive association between self-compassion,
better physical health and health-promoting
behaviours

Some reviews have focused on the broader aspects
of emotional regulation without specifically
addressing self-compassion. For example, a review
by Denham et al. (2012) examined the
development of emotional competence in early
childhood but did not specifically highlight the role
of self-compassion. This suggests that while the
general benefits of early emotional regulation
interventions are well-documented, the specific
impact of self-compassion warrants further
exploration.

Our review emphasizes the developmental
perspective and the importance of early
interventions. Previous reviews, such as those by
Póka et al. (2023), have focused on specific
populations like university students and the
effectiveness of self-compassion interventions in
reducing psychological distress and improving
wellbeing. While earlier reviews highlight the
benefits of self-compassion, our review adds a

developmental

angle,

emphasizing

the

foundational role of self-comforting behaviors
from infancy.

Previous reviews have shown mixed results
regarding the effectiveness of self-compassion
interventions. For example, Póka et al. (2023)
found that self-compassion interventions had a
moderate effect on self-compassion outcomes but
were less effective for improving positive and
negative affect among university students. Our
review suggests that early interventions can have
long-term benefits, potentially leading to more
sustained improvements in emotional regulation
and resilience.

Common

Themes

in

Self-Comforting

Behaviours

Self-Compassion as a Self-Comforting Construct

Self-compassion emerges as a recurring theme
across studies, with evidence supporting its role in
reducing anxiety, depression, and stress. Research
by Neff (2003) and further studies by Arch et al.
(2014) and Arimitsu (2016) reinforce self-

compassion’s value in promoting healthier coping

mechanisms

and

emotional

regulation,

highlighting its potential for mental health
interventions across age groups and populations.

Our findings align with previous systematic
reviews that emphasize the benefits of self-
compassion in mental health. For instance, a meta-
analysis by Ferrari et al. (2019) found that self-
compassion interventions had medium effects on
reducing depressive symptoms, anxiety, and
stress. Similarly, a systematic review by MacBeth
and Gumley (2012) reported large correlations
between higher levels of self-compassion and
lower levels of depression, anxiety, and stress.
These reviews support the idea that self-
compassion is a valuable tool for improving mental
health outcomes.

Our review highlights the importance of self-

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compassion across various age groups and
populations. Previous reviews, such as those by
Wilson et al. (2018), have focused on specific
populations, like clinical and subclinical groups,
and the effectiveness of self-compassion-related
therapies. While earlier reviews emphasize the
benefits of self-compassion, our review provides a
broader perspective, suggesting its applicability
across diverse populations.

Previous reviews have shown that self-
compassion-related

therapies,

including

mindfulness-based

cognitive

therapy

and

acceptance and commitment therapy, are effective
in promoting self-compassion and reducing
psychopathology (Wilson et al., 2018). However,
these reviews often highlight the need for more
robust evidence to confirm these findings. Our
review reinforces these findings and suggests that
self-compassion interventions can be effective
across different contexts and populations,
providing a more comprehensive understanding of
their benefits.

The mechanisms through which self-compassion
impacts mental health, such as through improved
emotional regulation, have been explored in
previous reviews. For example, Inwood and
Ferrari (2018) found that emotion regulation
significantly mediates the relationship between
self-compassion and mental health. Our review
supports this by highlighting the role of self-
compassion in emotional regulation, further
validating the findings of previous systematic
reviews.

Self-Compassion

and

Vulnerability

to

Depression and Anxiety

Several studies show that self-compassion
mitigates vulnerability to depression and anxiety
by fostering a balanced cognitive style and
reducing negative self-perceptions. Findings from
Zou et al. (2013, 2017) and Terry et al. (2012)
underscore self-comp

assion’s resilience

-building

effects, especially during challenging life
transitions like starting college. This supports the
growing interest in self-compassion as a target in
preventive mental health programs.

Previous systematic reviews, such as those by
Wilson et al. (2018), have also highlighted the
benefits of self-compassion in reducing anxiety
and depression. These reviews support the idea
that self-compassion can lead to significant
improvements in mental health by promoting
healthier coping mechanisms and emotional
regulation. Our review agrees with these findings,
reinforcing the notion that self-compassion is a
valuable target for mental health interventions.

While our review emphasizes the resilience-
building effects of self-compassion during life
transitions like starting college, previous reviews
have focused on various populations and contexts.
For example, Inwood and Ferrari (2018) explored
the mechanisms of change in the relationship
between self-compassion, emotion regulation, and
mental health across different samples. Both
reviews highlight the importance of self-
compassion but differ in their specific focus and
the populations they examine.

Methodological differences can lead to varying
conclusions. For instance, Wilson et al. (2018)
conducted

a

meta-analysis

focusing

on

randomized controlled trials, while our review
included a broader range of study designs. These
differences

highlight

the

importance

of

considering the context and methodology when
interpreting the findings of systematic reviews.

Self-Criticism as a Barrier to Emotional Healing

Self-criticism consistently appears as an obstacle
to emotional wellbeing. Findings by Waite et al.
(2015) and Reid et al. (2014) indicate that high
levels of self-criticism can exacerbate mental
health symptoms, while self-compassion can
alleviate this effect. By positioning self-criticism as

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a barrier, these findings suggest that interventions
reducing self-criticism and enhancing self-
kindness could significantly improve psychological
outcomes.

Previous systematic reviews, such as those by
Zaccari et al. (2024), have also highlighted the
negative impact of self-criticism on mental health.
These reviews support the idea that self-criticism
is a transdiagnostic factor that contributes to
various psychopathological conditions. Our review
agrees with these findings, reinforcing the notion
that self-criticism is a significant barrier to
emotional wellbeing and should be a focus of
mental health interventions.

Reviews by Wilson et al. (2018) and Inwood and
Ferrari (2018) have shown that self-compassion-
related therapies are effective in reducing self-
criticism and improving mental health outcomes.
These reviews emphasize the role of self-
compassion in promoting emotional regulation
and resilience. Our review supports these findings
by highlighting the potential of self-compassion
interventions to alleviate the negative effects of
self-criticism

and

improve

psychological

outcomes.

Fear of Compassion and Emotional Blockages

Fear of self-compassion is a notable barrier in the
therapeutic process. Studies by Gilbert et al.
(2012) and Joeng & Turner (2015) reveal that fear
of positive emotions, including compassion, can
perpetuate depression and other mental health
challenges. This theme highlights the importance
of addressing resistance to self-compassion in
therapeutic settings to enhance treatment efficacy.

Fear of self-compassion can hinder therapeutic
progress by preventing individuals from fully
engaging with interventions designed to improve
their mental health. This fear can perpetuate
negative emotional states and impede recovery
from depression and other mental health issues.

Addressing this fear in therapeutic settings is
crucial. Therapists need to be aware of this barrier
and work to create a safe and supportive
environment where clients can gradually
overcome their resistance to self-compassion.

By addressing resistance to self-compassion,
therapists can enhance the efficacy of their
treatments. Interventions that specifically target
and reduce fear of self-compassion can help clients
develop healthier emotional responses and
improve their overall mental health. This approach
can lead to more effective and sustainable
outcomes, as clients become more open to
experiencing positive emotions and self-kindness.

The focus on fear of positive emotions, including
self-compassion, is a relatively unique aspect of
our review. Previous reviews have primarily
focused on the benefits of self-compassion without
extensively addressing the barriers to its
acceptance. For example, Winders et al. (2020)
discussed the role of self-compassion in reducing
PTSD symptoms but did not extensively explore
the fear of self-compassion. Our review adds a
critical dimension by highlighting the barrier
posed by fear of self-compassion. This suggests
that while self-compassion is beneficial,
addressing the fear associated with it is essential
for maximizing its therapeutic potential. Our
review thus provides a more comprehensive
understanding by considering both the benefits
and the obstacles.

Mechanisms of Emotional Regulation and Self-
Comforting

Emotional Regulation through Self-Comforting

The

studies

collectively

emphasize self-

compassion’s role in fostering emotional

regulation by reducing rumination and worry. This
aligns with the evidence provided by Raes (2010)
and Diedrich et al. (2016), which shows that self-
compassion can facilitate cognitive reappraisal, a

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critical aspect of emotional regulation.

Self-compassion helps reduce rumination and
worry, which are common cognitive processes that
exacerbate mood disorders. By promoting a more
balanced and kind self-view, individuals can break
the cycle of negative thinking and improve their
emotional wellbeing. This is particularly important
for individuals with mood disorders, as reducing
rumination and worry can lead to significant
improvements in their mental health.

Cognitive reappraisal is a critical aspect of
emotional

regulation,

involving

the

reinterpretation of negative situations in a more
positive light. Self-compassion facilitates this
process by encouraging individuals to treat
themselves with kindness and understanding,
rather than harsh self-criticism. This can lead to
more adaptive emotional responses and better
overall mental health outcomes.

While our review emphasizes the role of self-
compassion in facilitating cognitive reappraisal,
previous reviews have focused on various
mechanisms through which self-compassion
impacts mental health. For example, Inwood and
Ferrari (2018) discussed the role of emotion
regulation as a mechanism of change in the
relationship between self-compassion and mental
health.

The findings underscore the role of self-
compassion as an effective emotional regulation
strategy. By incorporating self-compassion into
therapeutic

interventions,

mental

health

professionals can help clients develop healthier
ways of managing their emotions. This approach
can be particularly beneficial for individuals with
mood disorders, who often struggle with
emotional regulation.

Self-Regulation and Self-Comforting

Warschburger et al. (2023) highlight the
development of self-regulation as integral to self-

comforting behaviours. Self-regulation, beginning
in childhood, is essential for managing emotions

and behaviours effectively. Wright’s (2009)

emphasis on the role of self-soothing in emotional
differentiation suggests that self-regulation

training could enhance individuals’ capacity to

engage in healthy self-comforting behaviours.

Previous systematic reviews, such as the one by
Pandey et al. (2017), have also highlighted the
importance of self-regulation in childhood and
adolescence. These reviews support the idea that
self-regulation is a critical skill for positive health,
educational, and social outcomes. Our review
aligns with these findings, emphasizing the
importance of self-regulation in developing the
skills necessary for managing emotions and
behaviours in a healthy and productive way.

While our review emphasizes the role of self-
soothing in emotional differentiation, previous
reviews have focused on various aspects of self-
regulation. For example, Chen et al. (2024)
examined the psychometric properties of self-
regulation measures in children, highlighting the
complexity and importance of accurately assessing
self-regulation.

Diverse research methods have been employed in
reviews investigating the integral role of self-
regulation in self-comforting behaviours. For
instance, Pandey et al. (2017) conducted a review
of universal self-regulation-based interventions,
while our review included a broader range of study

designs. Our review’s focus on thematic analysis

provides valuable insights into the nuanced
benefits of self-regulation and self-soothing.

Mindfulness and Self-Comforting Interventions

Mindfulness practices emerge as effective self-
comforting interventions, reducing emotional
reactivity and enhancing self-regulation. Studies
by Greeson et al. (2014) and Kuyken (2010) show
that mindfulness-based interventions (e.g., MBCT,

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MBSR) can foster self-compassion, improve
emotional regulation, and reduce symptoms of
mental health disorders. This points to the
potential for integrating mindfulness practices into
therapeutic settings to promote self-soothing.

Our findings align with previous systematic
reviews that have highlighted the benefits of
mindfulness practices. For instance, a meta-
analysis by McCartney et al. (2021) found that
MBCT significantly reduces the risk of relapse in
recurrent depression. Similarly, Querstret et al.
(2020) demonstrated that MBSR can lead to
significant improvements in psychological
wellbeing. These studies corroborate our findings
on the effectiveness of mindfulness practices in
enhancing self-regulation and reducing emotional
reactivity.

Cognitive Mechanisms in Self-Comforting

The Mediating Role of Cognition

Cognitive processes play a significant role in self-
comforting behaviours. Arimitsu (2016) and
Ferrari et al. (2018) suggest that self-compassion
can alter automatic thoughts and cognitive
appraisals, thereby reducing the emotional impact
of stress. This mediating role of cognition in self-
comforting behaviours supports interventions
targeting cognitive appraisal and reappraisal as
strategies to enhance psychological resilience.

Our findings are consistent with previous
systematic reviews that have also emphasized the
importance of cognitive processes in self-
comforting behaviors. For example, a review by
Petrocchi (2024) found that self-compassion was
associated with reduced rumination and increased
positive emotions, which can contribute to
improved mental health outcomes. Similarly, a
review by Riepenhausen et al. (2022) found that
cognitive reappraisal was a key component of
effective stress management.

Our findings also support the idea that self-

compassion can play a critical role in reducing the
emotional impact of stress. This is consistent with
previous review that has shown that self-
compassion can buffer against the negative effects
of stress (Bunjak et al., 2022).

In contrast, previous reviews have emphasized the
importance of emotional regulation and emotional
expression in self-comforting behaviors (Rattaz et
al., 2022). While emotional regulation and
expression are certainly important, our findings
suggest that cognitive processes may play a more
central role in self-comforting behaviors.

Psychological Flexibility and Values-Based
Living

The studies reveal that psychological flexibility
and values-based living contribute to effective self-
comforting behaviours, especially in contexts
involving mental health disorders. Wetterneck et
al. (2013) and Sevinc et al. (2018) highlight how
increased

psychological

flexibility

allows

individuals to adaptively manage stress. These
findings suggest that fostering psychological
flexibility through interventions such as ACT may
improve self-comforting capacities and resilience.

Our results are consistent with recent systematic
reviews that have also emphasized the role of
psychological

flexibility

in

self-comforting

behaviors. For example, a systematic review found
that ACT-based interventions were effective in
reducing symptoms of anxiety and depression, and
that psychological flexibility was a key mediator of
these effects (Coto-Lesmes et al., 2020). Another
review found that ACT-based interventions were
effective in improving psychological flexibility and
reducing symptoms of PTSD (Rowe-Johnson et al.,
2024).

Our findings also support the idea that values-
based living is an important component of effective
self-comforting behaviors. This is consistent with
previous reviews that have shown that values-

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based living is associated with increased
psychological wellbeing and life satisfaction (Tunç
et al, 2023).

Parenting

Styles

and

Intergenerational

Transmission of Psychopathology

Impact of Parental Self-Compassion on Child
Development

Self-compassion in parents has a notable impact on
the development of self-comforting and emotional
regulation in children. Psychogiou et al. (2016)
demonstrate that parents with higher self-
compassion create more nurturing environments,
leading to fewer behavioural issues in their
children. This finding is significant as it suggests
that self-compassion-oriented interventions could
play a crucial role in breaking cycles of
psychopathology transmission from parents to
children.

Our findings are consistent with previous
systematic reviews that have also emphasized the
importance of parental self-compassion in child
development. For example, a systematic review
found that parental self-compassion was
associated with improved child outcomes,
including reduced anxiety and depression
(Jefferson, Shires & McAloon, 2020).

In contrast, some previous reviews have
emphasized the importance of other factors, such
as parental stress and coping styles, in child
development (Fang et al., 2024). While these
factors are certainly important, our findings
suggest that parental self-compassion is a critical
factor in creating a nurturing environment that
promotes healthy child development.

Overcontrolling Parenting and Self-Regulation
Challenges

The findings by Nicole et al. (2018) on the
detrimental effects of overcontrolling parenting
further emphasize the developmental implications
of self-comforting. Children who experience

overcontrolling parenting are likely to struggle
with self-regulation, which may impair their ability
to independently engage in self-comforting
behaviours, with lasting impacts on emotional and
academic functioning.

Our findings are consistent with previous
systematic reviews that have also emphasized the
importance of parenting styles in child
development. For example, previous reviews
found that authoritarian parenting was associated
with increased child anxiety and depression, while
authoritative parenting was associated with
improved child outcomes (Pinquart & Kauser,
2018; Chyung et al., 2022). Another review found
that parental warmth and responsiveness were
key predictors of child emotional regulation and
resilience (Zimmer-Gembeck et al., 2022).

Trauma, Negative Life Events, and Self-
Compassion as a Mediator

Studies such as those by Hou et al. (2020) and
Miron et al. (2016) underscore the protective
effects of self-compassion in trauma recovery,
particularly among individuals who have
experienced childhood maltreatment. Castilho et
al. (2017) link low self-compassion levels with
heightened depression and shame, illustrating that
individuals who cultivate self-compassion are
better equipped to navigate the emotional
repercussions of trauma. Self-compassion appears
to

mitigate

the

long-term

psychological

consequences of trauma, including anxiety and
depression, by reducing self-judgment and
isolation. Self-comforting behaviours act as a
buffer in trauma recovery and serve as crucial
resilience mechanisms for individuals dealing with
traumatic memories. These findings highlight self-
comforting as an essential adaptive skill in the
context of trauma and distress.

Our findings are consistent with previous
systematic reviews that have also emphasized the
importance of self-compassion in trauma recovery.

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For example, a systematic review by Winders et al.
(2020) found that self-compassion was linked to
reduced symptoms of PTSD and depression in
trauma survivors. Additionally, the researchers
identified self-compassion as a significant
predictor of resilience in these individuals.

Our findings also support the idea that self-
compassion can reduce self-judgment and
isolation, which are common experiences among
individuals who have experienced trauma. This is
consistent with previous research that has shown
that self-compassion can reduce self-criticism and
increase feelings of self-worth and self-acceptance
(Muris & Otgaar, 2023).

Study Implications

The thematic analysis of self-comforting
behaviours

across

different

theoretical

frameworks provides valuable insights into the
mechanisms by which individuals manage
emotional distress and promote psychological
wellbeing. Self-compassion emerges as a central
component of self-comforting behaviours, with
significant implications for mental health,
emotional

regulation,

and

resilience.

It

consistently plays a vital role in enhancing
psychological wellbeing, mitigating mental health
challenges, and promoting recovery across diverse
populations and theoretical contexts.

From a developmental perspective, fostering self-
compassion and emotional intelligence from an
early age may have long-term benefits for
emotional regulation and psychological resilience.
Early attachment styles and the quality of maternal
bonding significantly influence the development of
self-comforting

behaviours.

Infants

who

experience insecure attachment or maternal
anxiety are more likely to exhibit self-soothing
behaviours as a coping strategy. This aligns with
attachment theory, which posits that secure
attachment fosters healthier self-regulation and
coping mechanisms. Programs that teach self-

compassion and mindfulness in schools could help
adolescents develop healthy coping strategies for
managing stress and emotional challenges.

The cultural and gender differences in self-
comforting behaviours highlighted in this review
suggest that mental health interventions should be
tailored to the cultural and gender-specific needs
of individuals. For example, self-compassion
interventions may need to be adapted to align with
cultural

values

of

interdependence

or

independence, depending on the population being
served. This personalization can enhance the
effectiveness of mental health interventions by
making them more relevant and accessible.

The findings from this review suggest that
interventions aimed at enhancing self-compassion
and mindfulness may be particularly effective in
promoting emotional regulation and reducing the
negative effects of stress, anxiety, and depression.
Mindfulness-based interventions, such as MSC
programs, have shown promise in improving
emotional wellbeing in both adolescents and
adults, suggesting that these interventions could
be widely implemented in clinical settings.

Across several studies, self-compassion and
mindfulness emerge as key mechanisms that foster
adaptive self-comforting behaviours. Whether
through structured interventions like MBCT or
self-help mindfulness programs, the development
of self-compassion helps individuals manage
stress, reduce rumination, and engage in self-
soothing behaviours that reduce emotional
distress.

Mindfulness-based interventions enhance emotion
regulation by helping individuals reframe negative
thoughts and reduce emotional reactivity. This
leads to healthier self-soothing behaviours,
particularly in contexts of high stress or emotional
turmoil.

Cognitive-behavioural

frameworks

highlight the importance of changing thought
patterns to foster emotional wellbeing and reduce

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stress.

Effective stress management is a recurring theme
in the development of self-comforting behaviours.
Whether through mindfulness or other cognitive
strategies, individuals learn to cope with stress
more effectively, leading to improved emotional
and mental health outcomes. Psychological
flexibility, a key component of many interventions,
enhances the ability to engage in self-soothing
behaviours during times of stress.

The synthesis of these studies suggests that self-
comforting behaviours are closely tied to self-
compassion, emotion regulation, early attachment,
and stress management. Mindfulness and
cognitive-behavioural

interventions

help

individuals develop these self-regulation skills,
leading to healthier coping mechanisms. From
infancy to adulthood, the capacity to engage in self-
comforting behaviours appears to be shaped by
both internal factors (such as mindfulness and self-
compassion) and external influences (such as
attachment and parenting styles).

Together, these themes provide a comprehensive
picture of the complex phenomenon of self-
comforting, indicating that it is an adaptive
behaviour that evolves across the lifespan and is
critical for emotional wellbeing.

Toward

a

Comprehensive

Theoretical

Framework on Self-Comforting

Our findings reveal a compelling need for a more
integrated theoretical framework that addresses
the development, functions, and adaptive
capacities of self-comforting. Key elements that a
comprehensive framework should incorporate
include:

1.

Attachment and Developmental Processes:
Recognizing that self-comforting behaviours
are deeply influenced by early attachment
and evolve through developmental stages.

2.

Parental Influence and Intergenerational

Dynamics: Highlighting the role of parental
self-compassion and parenting styles in
shaping self-comforting behaviours across
generations.

3.

Self-Compassion in Trauma Recovery:
Understanding self-compassion as a critical
mediator in managing trauma and
mitigating its psychological impacts.

4.

Lifespan Perspective: Emphasizing the need
to examine self-comforting behaviours
within a lifespan framework that accounts
for both early-life and later-life challenges.

Such a framework could guide future research and
interventions by providing a comprehensive
understanding of self-

comforting’s developmental,

relational, and psychological dimensions. Given
the multidimensional findings, there is an
imperative to move beyond fragmented theoretical
approaches and develop an integrative perspective
that fully captures the significance and adaptability
of self-comforting behaviours across contexts.

CONCLUSION

The studies reviewed converge on several
theoretical frameworks:

•

Attachment theory: Self-compassion acts as
a protective factor in the context of early life
adversity (e.g., childhood maltreatment) by
mitigating the long-term effects of insecure
attachment and psychological distress.

•

Cognitive-behavioural

theory:

Self-

compassion

complements

cognitive-

behavioural interventions, especially in
modulating negative cognitive styles and
enhancing emotion regulation.

•

Stress and coping: Self-compassion appears
to buffer the impact of stress during life
transitions (e.g., college adjustment) and
reduces maladaptive coping strategies such
as rumination and self-criticism.

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•

Psychodynamic theory: Self-compassion
might be linked to resolving internal
conflicts related to self-criticism and
negative self-perceptions, contributing to
emotional regulation and resilience.

Self-comforting behaviours, particularly self-
compassion, are essential for emotional regulation
and psychological wellbeing. Within frameworks
like attachment theory, stress and coping models,
cognitive-behavioural,

and

developmental

perspectives,

self-compassion

consistently

emerges as a mechanism that mitigates negative
cognitive patterns, alleviates self-criticism, and
promotes resilience against trauma and adversity.
Self-compassion is especially effective in reducing
stress, anxiety, depression, and perfectionism. The
expression of self-compassion varies across
gender and cultural contexts, underscoring its
importance

in

personalized

therapeutic

approaches.

However, fears of self-compassion and the
presence of self-criticism pose significant barriers,
which need to be addressed in both clinical and
therapeutic settings to foster better mental health
outcomes. This review highlights the need to
incorporate self-compassion and compassion-
focused interventions within broader theoretical
models to create more holistic and effective mental
health treatments. A framework that combines
self-compassion, mindfulness, and values-based
living could offer a more comprehensive approach
to self-comforting behaviours.

As the field of psychology continues to examine the
role of self-compassion in mental health, such
integrative approaches show promise for fostering
emotional resilience and long-term wellbeing. This
review emphasizes the importance of considering
developmental stages, socio-cultural influences,
and individual barriers to self-compassion,
providing insights for both clinical applications
and future research. By identifying current gaps

and converging insights, this review lays the
groundwork for advancing a more cohesive and
inclusive theory on self-comforting behaviours and
their role in mental health.

CONFLICTS OF INTEREST

The authors report no conflicts of interests.

FUNDING

The authors received no financial support for the
research, authorship, or publication of this article.

ACKNOWLEDGMENT

The authors would like to appreciate Clarence
Cole, Lecturer at Global Banking School (GBS),
Oxford Brookes University (OBU), Birmingham,
and Emmanuel Ndi Wanki, Lecturer at GBS,
Canterbury Christ Church University (CCCU), for
their mentorship and advice throughout the
research process. Gratitude is extended to
Matthew Carlile, Dean of Education; Pete
Woodcock, Associate Dean of Education, Teaching
and Learning; Robert Ajani, Consultant Lecturer;
Peter Emelone, Consultant Lecturer; Marsida
Horeshka, Consultant Lecturer; Rupali Chauhan,
Level 6 Lead; and Sabrina Nwoko, Projects and
Research Coordinator, all from GBS. The authors
would also like to acknowledge the management
and technical staff of PENKUP Research Institute,
Birmingham, UK, for their excellent assistance and
for providing medical writing and editorial
support in accordance with Good Publication
Practice (GPP3) guidelines.

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Appendix 1A: Data Extraction Table (I)

S/

N

Authors/

Country

Research

Design

Research Aim

Measures

Sample

Key Findings

1.

Arch et al.
(2014);
USA

Randomised
control trial
(RCT)

To investigated
whether

brief

self-compassion
training
modulates

a

range

of

psychobiological
responses to an
acute

social

stressor

(using

the Trier Social
Stress Test).

Anxiety
(STAI, SPS,
SIAS),
depression

105 university
students

with

low

self-

esteem,

mean

age

19.53,

100% female

Compared

to

attention
(placebo) and no-
training control
conditions, brief
self-compassion
training
diminished
sympathetic
(salivary alpha-
amylase), cardiac
parasympathetic,
and

subjective

anxiety
responses,
though not HPA-
axis

(salivary

cortisol)
responses to the
TSST.

Self-

compassion
training also led
to greater self-
compassion
under

threat

relative to the
control groups. In
that social stress
pervades modern
life,

self-

compassion
represents

a

promising
approach

to

diminishing

its

potentially
negative
psychological

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and

biological

effects.

2.

Arimitsu
(2016);
Japan

RCT

To develop an
Enhancing Self-
Compassion
Program

(ESP)

and

test

the

potential efficacy
of the program in
enhancing

self-

compassion
(primary
outcomes) after
seven weeks of
intervention and
at a three-month
follow-up.

Self-
Compassion
Scale (SCS),
Rosenberg
Self-esteem
Scale (RSS),
Beck
Depression
Inventory-II
(BDI-II),
Spielberger
Trait Anxiety
Inventory
(STAI),
Depression
Anxiety
Cognition
Scale
(DACS),
Multiple
Mood Scale
(MMS), and
Self-
Conscious
Emotion
Scale
(SCES).

University
students

(all

Japanese) with
low

self-

compassion,
were recruited
from June 2010
to August 2012.

In

the

post-

treatment

and

follow-up,
ANOVAs
revealed that the
ESP group (N =
16)

had

significant
improvements in
each

of

the

subscales of self-
compassion
(Cohen’s ds: .91–
1.51) except for
mindfulness,
whereas

the

control group (N
= 12) did not.
Greater
reductions

in

negative thoughts
and emotions in
the ESP group
were also found.
These

gains

remained

at

follow-up. These
findings suggest
that an ESP may
be an effective
and

acceptable

adjunct
intervention for
Japanese
individuals with
low

self-

compassion.

3.

Arimitsu
and
Hofmann
(2015);
Japan

Mediation
analysis with
in
a correlation
al

research

framework

The aim of the
first present study
was to test the
hypothesis

of

whether negative
automatic
thoughts mediate
the relationship

Self-
compassion:
SCS
Depression:
PHQ-9
Anxiety:
GAD-7

34

university

students

and

staff scoring > 6
on

EPQR-S

(neuroticism
subscale).
Mean (SD) age
= 29.6 (8.6)

Both

self-

compassion and
self-esteem
increased
positive
automatic
thoughts

and

decreased

trait

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between

self-

compassion,
anxiety,

and

depression when
controlling

for

self-esteem
(Hypothesis 1).
The aims of the
second

study

were to replicate
the results of the
first

and

to

expand the range
of

instruments

employed

by

including
measures

of

positive
automatic
thoughts and life
satisfaction.

years,

91%

female
opportunity
sample.

anxiety, whereas
only self-esteem
increased

life

satisfaction and
decreased
depression
directly. Positive
automatic
thoughts
increased

life

satisfaction and
decreased
depression

and

trait anxiety, and
positive
automatic
thoughts
mediated

the

relationship
between

self-

compassion and
negative affect.
These

findings

suggest that both
positive

and

negative
automatic
thoughts mediate
the relationship
between

self-

compassion and
affect in Japanese
people.

4.

Armstrong
and Rimes
(2016); UK

RCT

Investigate

the

efficacy

of

MBCT compared
to online self-
help for reducing
neuroticism

Self-report
questionnaire
s
(neuroticism,
rumination,
self-
compassion,
decentering)

N = 34 (17 per
group)

MBCT was more
effective

in

reducing
neuroticism,
rumination, and
increasing

self-

compassion and
decentering
compared to the
control group.

5.

Arredondo
et al.
(2017);
Spain

RCT

Assess

the

effectiveness of a
mindfulness-
based program to

PSS-14,
FFMQ, SCS,
EQ-D, MBI-
GS, HRV

N = 40 (21
intervention, 19
control)

Mindfulness-
based

program

significantly
reduced

stress,

increased

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reduce stress in
the workplace.

mindfulness,
decentering, self-
compassion, and
improved
burnout
compared to the
control group.

6.

Asselmann
et al.
(2024);
Germany

Longitudinal
study

(3

waves - T1,
T2, T3)

To

examine

whether

self-

compassion at the
beginning of the
COVID-19
pandemic
predicted higher
subjective
wellbeing

and

lower
psychopathologi
cal

symptoms

through

more

functional

and

less
dysfunctional
coping.

Self-
Compassion
Scale,
German
version of the
Brief COPE
inventory,
German
version of the
Satisfaction
with

Life

Scale,
German
version of the
21-item
Depression
Anxiety
Stress Scale

430 adults

Structural
equation
modelling
revealed that self-
compassion at T1
predicted

more

functional

and

less
dysfunctional
coping

at

T2

(controlling

for

coping at T1) and
more positive and
less

negative

affect and lower
stress symptoms
at T3 (controlling
for

these

measures at T1).
More functional
and

less

dysfunctional
coping

at

T2

(controlling

for

coping at T1)
predicted higher
subjective
wellbeing

and

lower
psychopathologi
cal symptoms at
T3

(controlling

for

these

measures at T1),
with

the

sole

exception

that

functional coping
was

not

significantly
associated

with

anxiety

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symptoms.

In

addition,

we

found that less
dysfunctional
coping mediated
(a) nearly one-
third (30.77%) of
the

association

between

higher

self-compassion
and less negative
affect and (b)
nearly

half

(46.15%) of the
association
between

higher

self-compassion
and lower stress
symptoms.

7.

Bayot et al.
(2020);
Belgium

RCT

To compare a
mindfulness
program

that

explicitly
integrates
elements

of

Buddhist ethics
(i.e.,

the

four

immeasurables)
and wisdom (i.e.,
interdependency,
non-self,
common
humanity)
(ethics-oriented
mindfulness
training (EMT)),
to

a

standard

mindfulness
training

(SMT)

program and a
control

group

(i.e., waiting list),
with

a

randomized
controlled design
in a community
sample.

Self-
compassion:
SCS-SF
Depression:
SCL-R42
Anxiety:
SCL-R42

78

adults

recruited from
the community
and

a

university.
Mean (SD) age
= 38.1 (10.5)
years,

76%

female.
Opportunity
sample.

Per-protocol
ANOVA

and

Bonferroni post
hoc t tests. MBP
2 > control on
SCS-SF at post-
programme and
3-month follow-
up. No difference
between MBP 1
and control. No
sig. time × group
interaction

on

anxiety/depressio
n subscales of
SCL-R42.

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8.

Beaumont
et al.
(2016); UK

RCT

Investigate

the

effectiveness of
CFT

as

an

adjunct to TF-
CBT for reducing
symptoms

of

trauma, anxiety,
depression, and
increasing

self-

compassion

in

FSP.

Hospital
Anxiety and
Depression
Scale, Impact
of

Events

Scale-R,
Self-
Compassion
Scale - Short
Form.

N = 17 (8 TF-
CBT, 9 TF-
CBT + CFT)

TF-CBT
combined

with

CFT was more
effective

in

increasing

self-

compassion
compared to TF-
CBT alone. Both
groups

showed

significant
reductions

in

symptoms

of

depression,
anxiety,

and

trauma.

9.

Beaumont,
Galpin &
Jenkins
(2012); UK

Prospective,
comparative
outcome
study
(repeated
measures
design)

To contrast the
relative impact of
differing
therapeutic
interventions for
trauma victims,
carried out by the
same therapist.

12 sessions of
either
Cognitive
Behaviour
Therapy
(CBT),

or

CBT coupled
with
Compassiona
te

Mind

Training
(CMT). Data
was gathered
pre-therapy
and

post-

therapy,
using

three

self-report
questionnaire
s:

Hospital

Anxiety and
Depression
Scale; Impact
of

Events

Scale;

the

Self-
Compassion
Scale (SCS).

A non-random
convenience
sample (N = 32)
of participants,
referred

for

therapy
following

a

traumatic
incident.

Participants

in

both conditions
experienced

a

highly
statistically
significant
reduction

in

symptoms

of

anxiety,
depression,
avoidant
behaviour,
intrusive
thoughts

and

hyper-arousal
symptoms post-
therapy.
Participants

in

the

combined

CBT and CMT
condition
developed
statistically
significant higher
self-compassion
scores

post-

therapy than the
CBT-only group
[F (1.30) = 4.657,
p ≤ 0.05]. There
was

no

significant
difference

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between
treatment groups.

10. Braehler et

al. (2013);
UK

Prospective,
randomized,
open-label,
blinded end
point
evaluation
clinical trial.

To assess the
safety,

the

acceptability, the
potential
benefits,

and

associated
change processes
of using group
Compassion
focused therapy
(CFT)

with

people
recovering from
psychosis.

Compassion
focused
therapy
change
processes
(semi-
structured
Recovery
Narrative
Interview
designed

to

stimulate

a

narrative
around), The
Clinical
Global
Impression-
Improvement
Scale (CGI-
I),

the

Narrative
Recovery
Style

Scale

(NRSS), The
Beck
Depression
Inventory-II,
e