1. To investigate the correlations between self-compassion-related variables in parents of adolescents with emotional disorders and parenting stress as well as self-stigmatization; and the correlations between self-compassion-related variables and the severity of depressive and anxiety symptoms in adolescents. 2. To evaluate the effectiveness of a Compassion-Focused Family Intervention in increasing self-compassion among adolescents and their parents, and in reducing parenting stress, self-stigmatization, and the severity of adolescent depression and anxiety. 3. To explore the neural and physiological mechanisms underlying the therapeutic effects of the compassion intervention on parent-child interactions, using functional near-infrared spectroscopy (fNIRS) hyperscanning and wearable wristband devices.
This study plans to recruit 120 families (each consisting of a 12-18-year-old adolescent with emotional disorders and their parents), and randomly divide them into an intervention group and a control group, with 60 pairs in each group. The intervention group received a 6-week compassion-based family intervention, once a week for 120 minutes each time, accompanied by family exercises including meditation training and emotional journal. The waiting list control group waited for 6 weeks after the baseline measurement for the post-test, and then conducted the same intervention. The study adopted multi-dimensional assessment: at five time points including baseline, immediately after the intervention, and 3, 6 month follow-up, the psychological state of parents and children was measured through psychological scales (such as the Children's Depression Inventory Scale and the Child-Parent Relationship Scale). At the same time, near-infrared hyperscanning technology was used to record the synchronization of brain signals when parents and children watched emotional videos (2 positive/neutral/negative segments each) (analyzing neural synchronization in the 0.02-0.10Hz frequency band), and a wearable bracelet was used to monitor physiological indicators such as heart rate variability. Data analysis will examine the effect of intervention on enhancing parents' self-compassion level, reducing parenting pressure and symptoms of depression and anxiety in adolescents, and explore the association mechanism between parent-child neural synchrony changes and intervention effects. Ultimately, it will verify the effectiveness of compassion therapy in improving the mental health of families of adolescents with emotional disorders.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
120
Draw ideas from traditional Chinese culture, the investigators have developed the compassion-based family intervention therapy to improve the mental health of both parents and children by enhancing their synchronization. The 6-week program followed a progressive thematic structure. Week 1 focuses on introduction and connection, themed "Setting Sail: The Additions and Subtractions for a Happy Family." Weeks 2 and 3 address self-compassion: Week 2 is themed "Self-compassion: Embrace yourself with compassion here and now."; Week 3 is themed "Self-compassion: Accepting "growing pains."." Weeks 4 and 5 explored developing compassion for others: Week 4 is themed "Listening to the heart: Enhancing communication, bringing us closer."; Week 5 is themed "Building a harbor together: Managing conflict, creating happiness" Week 6 involves integration and review, themed "Integrating knowledge and action: Practicing compassion, lighting the path forward."
Anhui Mental Health Center
Hefei, Anhui, China
RECRUITINGInstitute of Psychology, Chinese Academy of Sciences, Beijing
Beijing, China
NOT_YET_RECRUITINGPerceived emotional synchrony
Using the score of Perceived Emotional Synchrony Scale to assess perceived emotional synchrony of parents and children respectively. Perceived emotional synchrony scale (16-item version): items rated 1-7; the investigators report mean subscale scores (range 1-7) for Emotional Communion (items 1, 4, 5, 7, 8, 11, 14, 15) and Felt Unity (items 2, 3, 6, 9, 10, 12, 13, 16). Higher scores indicate greater perceived emotional synchrony (better outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Self-Compassion
Using the Self-Compassion Scale to assess self-compassion levels of parents and children respectively. Self-Compassion Scale (SCS): 26 items rated 1-5; the investigators report the mean score (range 1-5). Higher scores indicate greater self-compassion (better outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Fears of Compassion
Using the Fears of Compassion Scales to assess fears of compassion levels of parents and children respectively. Fears of Compassion Scales (FCS): three subscales rated 0-4 - Fear of Compassion for Self (15 items; total 0-60), Fear of Compassion for Others (10 items; total 0-40), and Fear of Receiving Compassion from Others (13 items; total 0-52). Higher scores indicate greater fear of compassion (worse outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Parenting Stress
Using the Parenting Stress Index-Short Form to assess parenting stress. Parenting Stress Index-Short Form (PSI-SF): 36 items rated 1-5; the investigators report the total score (range 36-180). Higher scores indicate greater parenting stress (worse outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Children's depression levels
Using the Children's Depression Inventory scale to assess children's depression levels. Children's Depression Inventory (CDI): 27 items rated 0-2; the investigators report the total score (range 0-54). Higher scores indicate more severe depressive symptoms (worse outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Children's anxiety levels
Using the Beck Anxiety Inventory to assess children's anxiety levels. Beck Anxiety Inventory (BAI): 21 items rated 0-3; the investigators report the total score (range 0-63). Higher scores indicate more severe anxiety (worse outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Oxy-hemoglobin concentration change (ΔHbO)
Functional near-infrared spectroscopy (fNIRS) hyperscanning was employed to measure wavelet transform coherence (WTC) between parents and children during an emotional video task. The primary signals of interest were the concentration changes of oxy-hemoglobin (ΔHbO) and deoxy-hemoglobin (ΔHbR). ΔHbO and ΔHbR signals were preprocessed before WTC analysis. The WTC frequency band was set at 0.02-0.10 Hz to assess brain signal synchrony in time-frequency domains, providing higher sensitivity than traditional correlation coefficients. Higher coherence values indicated stronger neural synchrony.
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Deoxy-hemoglobin concentration change (ΔHbR)
Functional near-infrared spectroscopy (fNIRS) hyperscanning was employed to measure wavelet transform coherence (WTC) between parents and children during an emotional video task. The primary signals of interest were the concentration changes of oxy-hemoglobin (ΔHbO) and deoxy-hemoglobin (ΔHbR). ΔHbO and ΔHbR signals were preprocessed before WTC analysis. The WTC frequency band was set at 0.02-0.10 Hz to assess brain signal synchrony in time-frequency domains, providing higher sensitivity than traditional correlation coefficients. Higher coherence values indicated stronger neural synchrony.
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Heart rate variability (HRV)
Heart rate variability (HRV) metrics in parents and children were measured using wearable wristbands (Huawei Band 8) throughout both the emotional video task and group intervention sessions.
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Parenting styles
Using the Parenting Scale-7 to assess parenting styles. Parenting Scale-7 (PS-7): 7 items rated 1-7; the investigators report the mean score (range 1-7). Higher scores indicate more dysfunctional parenting practices (worse outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Parenting styles in children's view
Using the Egna Minnen av Barndoms Uppfostran to assess the parenting styles in children's view. Egna Minnen av Barndoms Uppfostran (EMBU; "My Memories of Upbringing"), 21-item version: items rated 1-4; the investigators report summed subscale scores for Rejection (items 1, 4, 7, 12, 14, 19), Emotional Warmth (items 2, 6, 9, 11, 13, 17, 21), and Overprotection (items 3, 5, 8, 10, 15R, 16, 18, 20), with item 15 reverse-scored. Higher Rejection and Overprotection indicate worse outcomes, whereas higher Emotional Warmth indicates better outcomes.
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Parent-child relationships in parents' view
Using the Child-Parent Relationship Scale, 10-item scale to assess the Parent-child relationships from the perspective of parents. Child-Parent Relationship Scale, 30-item version (CPRS): items rated 1-5; the investigators report mean subscale scores (range 1-5) for Closeness, Conflict, and Dependence. Higher Closeness indicates a better relationship (better outcome), whereas higher Conflict and higher Dependence indicate worse outcomes.
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Parent-child relationships in children's view
Using the Remembered Relationship with Parents, 10-item scale to assess the Parent-child relationships from the perspective of children. Remembered Relationship with Parents, 10-item scale (RRP10): 10 items rated 0-4; the investigators report the total score (range 0-40). Higher scores indicate more negative remembered relationships with parents (worse outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Nonclinging to Ego
Using the Nonclinging to Ego Scale to assess nonclinging to ego levels of parents and children respectively. Nonclinging to Ego Scale (NES): 33 items rated 1-6; the investigators report the total score (range 33-198). Higher scores indicate greater nonattachment to self (better outcome).
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Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Parental self-stigmatization
Using the Self-Stigma in Relatives of people with Mental Illness Scale to assess the parental self-stigmatization. Self-Stigma in Relatives of people with Mental Illness Scale (SSRMI): 30 items rated 1-5; the investigators report the mean score (range 1-5). Higher scores indicate greater self-stigma among relatives (worse outcome).
Time frame: baseline, immediately after the intervention, and 1, 3, 6 month follow-up
Perceived Criticism
Using the Perceived Criticism Measure to assess the parent' perceived criticism levels. Perceived Criticism Measure (PCM): items rated 1-10; the investigators report the mean score (range 1-10). Higher scores indicate greater perceived criticism (worse outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Family Expressiveness
Using the Family Expressiveness Questionnaire to assess the family expressiveness. Family Expressiveness Questionnaire (FEQ): 20 items rated 1-9; the investigators report the mean score (range 1-9). Higher scores indicate more frequent family emotional expressiveness; when reporting Positive vs. Negative Expressiveness subscales, higher Positive is considered better and higher Negative is considered worse.
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Emotion Regulation
Using the Emotion Regulation Questionnaire, 6-item version to assess the emotion regulation levels of parents and children respectively. Emotion Regulation Questionnaire, 6-item version (ERQ-6): items rated 1-7; the investigators report mean subscale scores (range 1-7) for Cognitive Reappraisal (4 items) and Expressive Suppression (2 items). Higher Reappraisal indicates more frequent use of cognitive reappraisal (typically better outcome), whereas higher Suppression indicates more frequent use of expressive suppression (typically worse outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Concise Chinese Level of Expressed Emotion
Using the Concise Chinese Level of Expressed Emotion Scale to assess the concise Chinese level of expressed emotion of children. Concise Chinese Level of Expressed Emotion Scale (CCLEES): 12 items rated 1-4; the investigators report the mean score (range 1-4). Higher scores indicate higher expressed emotion (typically associated with worse outcomes).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up
Parental Burnout
Using the Parental Burnout Assessment to assess the parental burnout level. Parental Burnout Assessment (PBA): 23 items rated 0-6; the investigators report the total score (range 0-138). Higher scores indicate greater parental burnout (worse outcome).
Time frame: baseline, immediately after the intervention, and 3, 6 month follow-up