Acoustic analysis of clients' expression of self-compassion, self-criticism, and self-protection within emotion focused therapy video sessions.

Introduction: When it comes to the non-verbal communication of emotions, it is apparent that the human voice is one of the main ways of expressing emotion and is increasingly important in psychotherapeutic dialog. There is ample research focusing on the vocal expression of emotions. However, to date the analysis of the vocal quality of clients' in-sessional emotional experience remains largely unexplored. Moreover, there is generally a gap within the psychotherapy literature in the understanding of the vocal character of self-compassion, self-criticism, and protective anger. Methods: In this study we investigated how clients vocally convey self-compassion, self-protection and self-criticism in Emotion Focused therapy sessions. For this purpose we investigated 12 commercially available Emotion Focused Therapy videos that employed a two chair or empty chair dialog. Praat software was used for the acoustic analysis of the most common features - pitch (known as fundamental frequency or F0) and intensity (voice amplitude, i.e., loudness). Results: Results showed that intensity was significantly higher for self-criticism and self-protection than for self-compassion. Regarding pitch the findings showed no significant differences between the three states. Discussion: More research analyzing acoustic features in a larger number of cases is required to obtain a deeper understanding of clients' vocal expression of self-compassion, self-protection and self-criticism in Emotion Focused Therapy.

The development of the revised COPE 68 inventory with English and Slovak versions.

Introduction: Although there have been several attempts at improving the COPE Inventory, the factor structure of the instrument is still in dispute. In addition, studies have shown low reliability coefficients for some of the first-order factors, with Mental Disengagement having the lowest factor loadings. In a recent study on the external validation of the instrument, two additional first-order factors were identified in the qualitative analysis, namely Self-care and Care for Others. Methods: Based on these arguments we created the Revised COPE 68 Inventory, changing some of the problematic items in the first order factor Mental Disengagement and adding items for the two new factors (Self-care and Care for Others). We then tested its reliability and performed factor analyses on the first and second-order factorial structure. The data were collected through social media in two languages, English and Slovak, using convenience and snowball sampling techniques. The English sample contained 834 participants with mean age 25.27 years (SD = 8.467) and the Slovak sample comprised 1,425 participants with mean age 33 years (SD = 14.59). For the statistical analyses we used Exploratory Structural Equation Model (ESEM) analyses with target rotation and WLSMV, Exploratory and second-order confirmatory factor analysis with the scores of the COPE Inventory and EFA. Results: The Revised COPE 68 inventory had a good fit for all 17 first-order factors in both languages, including for the new factors Self-care and Care for Others. It appears that the first-order factors form a three-factor solution in both samples, consisting of active coping, social-emotional coping and avoidant coping. The revised Mental Disengagement has better psychometric properties as well. Discussion: The Revised COPE 68 inventory was found to be a reliable multidimensional instrument for measuring various coping strategies in both the English and Slovak language versions.

Differences Between High and Low Self-Critics in Compassionate Facial Expression.

The goal of this study was to identify differences between high and low self-critical participants in relation to compassionate facial expressions. Our convenience sample consisted of 151 participants aged 18-59 years old (M = 25.17; SD = 7.81). The highest and the lowest scoring participants in self-criticism were selected for final analysis (N = 35). Participants, at home alone, watched a short video stimulus eliciting compassion while their facial expressions were recorded using webcams. Out of the sample we selected the highest 10% and the lowest 10% of self-critical participants according to the Slovak norms of The Forms of Self-Criticizing/Attacking and Self-Reassuring Scale. Two certified Facial Action Coding System raters (FACS) coded the participants' muscular activity according to facial action units. The FACS analysis revealed that action units 4 - brow lowerer, 7 - lids tight, 43 - eyes closed, 45 - blink, 55 - head tilt left, and 56 - head tilt right occurred significantly less often in high self-critical participants than in low self-critical participants, controlling for the difference between the baseline and compassionate moments in the video stimulus. Our research found that participants high in self-criticism were less facially expressive than those low in self-critical when watching compassionate video.

Automated facial expression analysis of participants self-criticising via the two-chair technique: exploring facial behavioral markers of self-criticism.

Introduction: As self-rating scales are prone to many measurement distortions, there is a growing call for more objective measures based on physiological or behavioural indicators. Self-criticism is one of the major transdiagnostic factor of all mental disorders therefore it is important to be able to distinguish what are the characteristic facial features of self-criticizing. To the best of our knowledge, there has been no automated facial emotion expression analysis of participants self-criticising via the two-chair technique. The aim of this study was to detect which action units of facial expressions were significantly more often present in participants performing self-criticism using the two-chair technique. The broader goal was to contribute to the scientific knowledge on objective behavioural descriptions of self-criticism and to provide an additional diagnostic means to the existing self-rating scales by exploring facial behavioral markers of self-criticism. Methods: The non-clinical sample consisted of 80 participants (20 men and 60 women) aged 19 years to 57 years (M = 23.86; SD = 5.98). In the analysis we used iMotions's Affectiva AFFDEX module (Version 8.1) to classify the participants' actions units from the self-criticising videos. For the statistical analysis we used a multilevel model to account for the repeated-measures design. Results: Based on the significant results the self-critical facial expression may therefore comprise the following action units: Dimpler, Lip Press, Eye Closure, Jaw Drop, and Outer Brow Raise, which are related to contempt, fear, and embarrassment or shame; and Eye Closure and Eye Widen (in rapid sequence Blink), which are a sign that highly negative stimuli are being emotionally processed. Discussion: The research study need to be further analysed using clinical samples to compare the results.

Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study.

During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.

The Effects of Virtual Reality on Enhancement of Self-Compassion and Self-Protection, and Reduction of Self-Criticism: A Systematic Review.

BACKGROUND: Virtual reality used for the treatment of mental health disorders is showing promising potential in clinical practice. Increasing self-compassion and self-protections and decreasing self-criticism have been identified as trans-diagnostic mechanisms helping to build a resilient self. The goal of this systematic review was to provide an overview of research studies about virtual reality while exploring its effectiveness in increasing self-compassion and self-protection and decreasing self-criticism. METHODS: On 6 December 2022, titles, abstracts, and, where available, keywords were searched in the following databases: PubMed, Scopus, and Web of Science. The inclusion criteria were: empirical study; quantitative methodology; outcomes measured, including self-compassion and/or self-protection, and/or self-criticism; pre/post and/or control group intervention measures of selected outcomes; participants aged 18 and above; application of virtual reality technology as part of the intervention; full study availability; and English language. Exclusion criteria were: ruminations related only to physical pain; self-protection in the context of physical survival; VR used to increase ruminations. RESULTS: Selection criteria were met by 19 studies (two randomized controlled trials, 16 longitudinal studies, and one case study) with an overall number of 672 participants. Results suggest that VR interventions targeting self-criticism, self-compassion, and self-protection might be effective for non-clinical (self-compassion) as well as clinical (self-criticism and self-protection) samples. DISCUSSION: The present systematic review partially supports the effectiveness of VR interventions on self-criticism, self-protection, and self-compassion. To properly answer the question of its effectiveness, more randomized control trials with larger samples from different populations are needed. The results are also limited by the variability of intervention protocols and the amount of exposure to VR. Other: This work was supported by the Vedecká grantová agentúra VEGA under Grant 1/0075/19. This systematic review has not been pre-registered.

Clients' Facial Expressions of Self-Compassion, Self-Criticism, and Self-Protection in Emotion-Focused Therapy Videos.

Clients' facial expressions allow psychotherapists to gather more information about clients' emotional processing. This study aims to examine and investigate the facial Action Units (AUs) of self-compassion, self-criticism, and self-protection within real Emotion-Focused Therapy (EFT) sessions. For this purpose, we used the facial analysis software iMotions. Twelve video sessions were selected for the analysis based on specific criteria. For self-compassion, the following AUs were significant: AUs 4 (brow furrow), 15 (lip corner depressor), and the AU12_smile (lip corner puller). For self-criticism, iMotions identified the AUs 2 (outer brow raise), AU1 (inner brow raise), AU7 (lid tighten), AU12_smirk (unilateral lip corner puller), and AU43 (eye closure). Self-protection was combined using the occurrence of AUs 1 and 4 and AU12_smirk. Moreover, the findings support the significance of discerning self-compassion and self-protection as two different concepts.

Short version of the Scale for Interpersonal Behavior: Slovak translation and psychometric analysis.

Assertiveness is a social communication skill and is related to the effectiveness of expressing oneself while respecting others. A lack of assertiveness is associated with various mental illnesses; hence the importance of being able to measure it reliably. The aim of the study was to translate the short version of the Scale for Interpersonal Behavior (s-SIB) into Slovak and subsequently test its factor structure and other psychometric properties. Our convenience sample consisted of 590 respondents from Slovakia, 22.71% of whom were men and 77.29% women. The data analysis consisted of a descriptive analysis, reliability analysis, factor structure analysis, Mokken analysis, and percentile norms. The scale showed good psychometric properties. Unlike the 4-factor solution for distress and performance in the original work, our findings showed that the general factor loadings were very good and that the bifactor model had the best fit in both cases (distress and performance). Mokken analysis indicated that the total scores for distress and perfromance and their constituent subscales can be used as proposed. In conclusion, the Slovak version of the s-SIB can be used as to measure the total score for assertiveness as well as the separate factors - Positive Assertion, Negative Assertion, Expression of and Dealing with Personal Limitations, and Initiating Assertiveness.

Let Us Take It into Our Own Hands: Patient Experience during the COVID-19 Pandemic.

The COVID-19 pandemic introduced new health situations for patients and health professionals alike and, with them, opportunities to study these new patient experiences, gain insights into changed healthcare practices, and propose potential new healthcare solutions. The aim of our study was to explore how people coped with their health issues during the pandemic. We utilized a consensual qualitative analysis. The convenience sample that was gathered online through social media comprised 1683 participants with a mean age of 31.02 years (SD = 11.99). The 50 participants from the convenience sample who scored the highest on subscales of the COPE inventory were selected for in-depth interviews. In-depth interviews with 27 participants from the convenience sample who reported a health issue were analyzed. The final sample in our study therefore comprised 17 women (63%) and 10 men (37%) with a mean age of 28.35 years (SD = 9.31). The results showed that behavioral coping with health problems was mentioned across all participants' accounts. However, participants facing a health issue during the COVID-19 pandemic mostly relied on their own self-help instead of on healthcare services. They utilized healthcare services only when absolutely necessary. Furthermore, the participants had two main sources of resilience: themselves and other people.

Emotion-Focused Mobile App for Promoting Self-Compassion, Self-Protection, and Self-Criticism.

The COVID-19 pandemic has changed our daily lives and restricted access to traditional psychological interventions. Hence there is an immediate and growing demand for accessible and scalable mental health solutions. Emotion-focused training for self-compassion and self-protection was developed and distributed using mobile phone technologies, and its effectiveness was tested. The available research sample consisted of 97 participants with a mean age of 26.06 years and a standard deviation of 10.53. Participants using the mobile app underwent a 14-day program aimed at reducing self-criticism while increasing self-compassion and self-protection. Pre- and post-measurements were collected. The results showed a statistically significant medium effect on self-compassion, self-criticism, and self-protection performance and a significant small effect on self-protection distress. The finding that a 14-day mobile app was able to foster well-being in the form of self-compassion, self-protection, and self-criticism is promising. It indicates the potential for individuals to obtain help through the use of remote tools such as MHapps for a fraction of the usual cost, at their own pace, and without other restrictions.

There must be a way out: The consensual qualitative analysis of best coping practices during the COVID-19 pandemic.

Despite the continuous efforts to understand coping processes, very little is known about the utilization of best coping strategies during the COVID-19 pandemic. In this study, we aimed to analyze the coping strategies of individuals who scored high on an adaptive coping questionnaire in order to understand the most adaptive coping strategies during the COVID-19 pandemic. We used consensual qualitative analysis in a team of four researchers and one auditor. The convenience sample from which we identified the high scorers comprised 1,683 participants (67% women, 32.35% men, and 0.65% did not report their gender) with a mean age of 31.02 years (SD = 11.99) ranging between 18 and 77 years old. Based on their scoring in the COPE Inventory, nine participants were selected from the sample with the highest scores in coping skills in at least two out of its 15 subscales. In-depth repeated interviews with six participants for the main analysis were conducted, and three were added to check the data saturation. The results showed that the most adaptive coping strategies used during the COVID-19 pandemic could be categorized into four main domains: self-compassion, compassion to others, compassion from others, and mutual compassion. The most frequently mentioned and the most elaborated upon by our respondents was the domain of self-compassion. The most interesting finding was the emergence of the fourth type of compassion, labeled mutual compassion, which referred to deliberate attempts to take care of oneself and others while suffering together in order to elevate the suffering for both. This kind of compassion might arise in the situations of collective suffering, such as a catastrophe or a pandemic and might have the additional benefit of bringing people closer to each other in difficult times.

Psychometric Properties and Factor Structure of the Slovak Version of the Copenhagen Burnout Inventory.

BACKGROUND: Burnout is clinically significant because it has adverse consequences in the form of mental and physical illnesses and economic losses. The goal of the research study was to translate the Copenhagen Burnout Inventory (CBI) into Slovak and then assess its factor structure, reliability, validity, and psychometric properties. METHODS: We collected two convenience samples: one for the psychometric properties analysis and factor analysis, which consisted of 4789 participants, and the other for the validity analysis, which consisted of 458 participants. Data were collected online. The participants filled out the following questionnaires: Copenhagen Burnout Inventory (CBI), Oldenburg Burnout Inventory (OLBI), Professional Quality of Life Scale (PROQOL), and Secondary Traumatic Stress Scale (STSS). RESULTS: The CBI had very good reliability in both samples, calculated using Cronbach alpha coefficients (between 0.839 and 0.908). In terms of CBI validity, all the correlation coefficients between the scale and subscales were between moderately high and high and ranged from 0.505 to 0.859. Except for two items, CBI7 and CBI10, all the items fall into the original factors of the scale. CONCLUSIONS: The Slovak version of the Copenhagen Burnout Inventory is a statistically sound instrument with high coefficients of reliability as well as validity and has an acceptable factor structure.

Qualitative Analysis of Chair Tasks in Emotion-Focused Therapy Video Sessions.

One of the key elements of Emotion-Focused Therapy (EFT) is decreasing self-criticism as a secondary, maladaptive emotion within two-chair interventions while simultaneously increasing self-compassion and self-protection as primary, adaptive emotions. Though the concepts of self-compassion, self-protection, and self-criticism are highly acknowledged within psychotherapy research, the verbal articulation of these constructs within therapy sessions is underinvestigated. Thus, this qualitative study aims to examine how self-criticism, self-protection, and self-compassion are articulated by clients in EFT video sessions. Consensual qualitative research was used for data analysis performed by two core team members and one auditor. Three similar domains were considered for all three concepts: behavioural, emotional, and cognitive aspects. The number of self-protection statements was the highest among the states. The behavioural aspect was the most dominant domain for self-protection with the major subdomain 'I tell you what I need'. For self-compassion, the cognitive aspect was the most significant domain containing eight subdomains, such as 'I see your bad circumstances'. The most frequent domain for self-criticism was the behavioural aspect consisting of the two subdomains 'I point out your wrong behaviours and I give you instructions'. The findings demonstrate the significance of promoting both self-compassion and self-protection to combat self-criticism. More studies of categorising a broader number of cases among various therapy approaches are necessary to develop a more detailed understanding of clients' verbalisation of self-compassion, self-protection, and self-criticism within therapy.

Qualitative analysis of compassion fatigue and coping strategies among nurses.

Objectives: Nurses are considered to be at risk of experiencing compassion fatigue, which can affect their personal and professional lives. The aim of this study was to investigate stressful factors contributing to the development of compassion fatigue in nurses, their experiences of compassion fatigue, and the coping strategies they used to cope with compassion fatigue. Methods: The convenience sample of 86 nurses from Central Europe was recruited via social networking sites during the pandemic of COVID-19. Data collection was conducted via an online battery of questionnaires which included open-ended questions on the stressful factors, experiences, and coping strategies for compassion fatigue. The data were analysed using a theoretical thematic analysis based on Figley's descriptions of compassion fatigue. The initial data was read several times to identify recurring statements. Each statement was then categorized into the emerging domains, subdomains, categories, and subcategories. Results: The results of our study show that stressful factors, experiences, and coping strategies for compassion fatigue in nurses in Central Europe could be related to cognitive, emotional, behavioural, somatic, personal relations, spiritual, and work-related symptoms of compassion fatigue as identified by Figley and that these may resemble experiences of nurses in North America, Japan, and Spain. Conclusion: This study provides a detailed overview of the stressful factors, experiences, and coping strategies for compassion fatigue, which could be used to develop an early screening tool and interventions for alleviating compassion fatigue and for preventive adaptation of the health care system.

Stressful Factors, Experiences of Compassion Fatigue and Self-care Strategies in Police Officers.

Police officers routinely face stressful and possibly traumatic events in their work which may result in them experiencing compassion fatigue. The aim of this study was to explore compassion fatigue experiences in police officers, along with the stressful factors that may lead to compassion fatigue and the coping strategies they use in combating compassion fatigue. The convenience sample of 41 police officers was recruited via social media focused on police work. Data were collected using an online battery of questionnaires with open-ended questions prompting them to share their experiences of compassion fatigue, stress factors and self-care strategies. The data were analysed using deductive (theoretical) thematic analysis. After identifying recurring statements, statements were coded using pre-existing individual codes, and each statement was categorized into the emerging domains, subdomains, categories and subcategories. The results described the stressful factors and experiences of compassion fatigue as well as coping strategies in the 7 domains described by Figley in Front Psychol 9:2793, 2002b: emotional, behavioural, personal relations, somatic, spiritual, cognitive and work performance.

Prevalence of compassion fatigue among helping professions and relationship to compassion for others, self-compassion and self-criticism.

INTRODUCTION: Helping professionals are at high risk of being affected by the negative aspects of helping such as compassion fatigue. To date, no study has provided a comprehensive overview of compassion fatigue and compared the prevalence among different helping professions. OBJECTIVES: The aim of this study was to explore the prevalence and differences in compassion fatigue among different helping professions. We also wanted to explore the relationship between compassion, self-compassion, self-criticism and compassion fatigue. METHODS: Six hundred and seven participants working in the helping professions were recruited. The sample consisted of 102 nurses, 44 doctors, 57 paramedics, 39 home nurses, 66 teachers, 103 psychologists, 40 psychotherapists and coaches, 76 social workers, 39 priests and pastors and 41 police officers. The data were collected using an online questionnaire battery measuring levels of compassion, self-compassion, self-criticism, compassion fatigue and compassion satisfaction. RESULTS: We found significant differences in compassion fatigue levels among various helping professions. No large differences were found in the compassion and self-compassion levels exhibited by professionals with medium versus low compassion fatigue scores. However, participants with higher levels of compassion fatigue scored higher in self-criticism. Self-criticism was found to be the best predictor of compassion fatigue. The effect of profession on compassion fatigue as mediated by self-criticism and self-compassion was significant. CONCLUSIONS: Based on the results, we recommend designing programs to combat compassion fatigue that teach helping professionals to better manage their work time and workload (hours per week with clients/patients) and learn healthier inner talk (less self-critical and more self-compassionate).

Compassion Protects Mental Health and Social Safeness During the COVID-19 Pandemic Across 21 Countries.

Objectives: The COVID-19 pandemic is having an unprecedented detrimental impact on mental health in people around the world. It is important therefore to explore factors that may buffer or accentuate the risk of mental health problems in this context. Given that compassion has numerous benefits for mental health, emotion regulation, and social relationships, this study examines the buffering effects of different flows of compassion (for self, for others, from others) against the impact of perceived threat of COVID-19 on depression, anxiety, and stress, and social safeness. Methods: The study was conducted in a sample of 4057 adult participants from the general community population, collected across 21 countries from Europe, Middle East, North America, South America, Asia, and Oceania. Participants completed self-report measures of perceived threat of COVID-19, compassion (for self, for others, from others), depression, anxiety, stress, and social safeness. Results: Perceived threat of COVID-19 was associated with higher scores in depression, anxiety, and stress, and lower scores in social safeness. Self-compassion and compassion from others were associated with lower psychological distress and higher social safeness. Compassion for others was associated with lower depressive symptoms. Self-compassion moderated the relationship between perceived threat of COVID-19 on depression, anxiety, and stress, whereas compassion from others moderated the effects of fears of contracting COVID-19 on social safeness. These effects were consistent across all countries. Conclusions: Our findings highlight the universal protective role of compassion, in particular self-compassion and compassion from others, in promoting resilience by buffering against the harmful effects of the COVID-19 pandemic on mental health and social safeness. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-021-01822-2.

The impact of Emotion-focused training for emotion couching delivered as mobile app on self-compassion and self-criticism.

Introduction: Being self-compassionate is considered a beneficial emotion regulation strategy. Therefore, the acquisition of emotional skills can raise self-compassion levels and consequently reduce self-criticism. Methods: Hence, the goal of the current study was to develop a mobile app based on the empirically proven group version of Emotion-Focused Training for Emotional Coaching (EFT-EC) and test its effectiveness in reducing self-criticism and raising self-compassion and self-protection. The sample consisted of 85 participants, of whom 22.4% were men and 77.6% were women. The mean age was 32.53 (SD = 14.51), ranging from 18 to 74 years. The participants filled out the following scales immediately before and after using the fourteen-day mobile app: The Forms of Self-Criticizing/Attacking & Self-Reassuring Scale (FSCRS), The Sussex-Oxford Compassion for the Self Scale (SOCS-S), and The Short-form Version of The Scale for interpersonal behaviour (s-SIB). Results: Use of the 14-day EFT-EC mobile app significantly improved self-compassion and self-reassurance and significantly reduced self-criticism compared to pre- and post-measurements. Discussion: The results are promising as self-criticism is a transdiagnostic phenomenon observed in various kinds of psychopathology and reducing it may prevent the emergence of psychopathologies. Moreover, the mobile app intervention can easily be accessed by a wide range of users, without requiring the services of a mental health professional, and thereby reduces the potential risk of shame or stigmatization.

Randomized controlled trial of emotion-focused training for helping professionals.

Introduction: The aim of this study was to examine the short- and long-term effectiveness of the novel Emotion-focused Training for Helping Professions on levels of compassion fatigue (secondary traumatic stress & burnout), self-criticism, self-compassion, and compassion for others. Methods: A randomized controlled trial study was conducted. A total of 253 participants were recruited and randomly assigned to either the experimental group or the control group. The experimental group attended a 14-day online training. The control group did not perform any tasks. Results: Results showed that after completing the intervention the experimental group participants reported significantly lower scores for secondary traumatic stress, burnout and self-criticism, and higher scores for self-compassion and that these lasted for two months after completion. Compared to the control group, the experimental group participants had significantly lower scores of secondary traumatic stress, burnout, self-criticism, and higher scores of self-compassion after the intervention. No significant changes were found for the control group, except a significant increase in time in the reported score for one dimension of burnout - exhaustion. Discussion: The novel EFT-HP training was shown to be effective in reducing levels of compassion fatigue (secondary traumatic stress and burnout) and self-criticism and increasing self-compassion.

The role of social connection on the experience of COVID-19 related post-traumatic growth and stress.

BACKGROUND: Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense of social disconnection and loneliness. This study explores how people's experience of compassion and feeling socially safe and connected, in contrast to feeling socially disconnected, lonely and fearful of compassion, effects the impact of perceived threat of COVID-19 on post-traumatic growth and post-traumatic stress. METHODS: Adult participants from the general population (N = 4057) across 21 countries worldwide, completed self-report measures of social connection (compassion for self, from others, for others; social safeness), social disconnection (fears of compassion for self, from others, for others; loneliness), perceived threat of COVID-19, post-traumatic growth and traumatic stress. RESULTS: Perceived threat of COVID-19 predicted increased post-traumatic growth and traumatic stress. Social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. These effects were consistent across all countries. CONCLUSIONS: Social connection is key to how people adapt and cope with the worldwide COVID-19 crisis and may facilitate post-traumatic growth in the context of the threat experienced during the pandemic. In contrast, social disconnection increases vulnerability to develop post-traumatic stress in this threatening context. Public health and Government organizations could implement interventions to foster compassion and feelings of social safeness and reduce experiences of social disconnection, thus promoting growth, resilience and mental wellbeing during and following the pandemic.