The Mechanisms Underlying the Relationship Between Self-Compassion and Psychological Outcomes in Adult Populations: A Systematic Review.

Self-compassion has emerged as a protective factor for psychological health and well-being. Interest has grown in understanding the mechanisms that explain how self-compassion contributes to improved psychological outcomes. This systematic review aimed to identify and synthesise the results of studies that investigated the mediators underlying the relationship between self-compassion and psychological outcomes. Potential eligible studies were searched on Embase, APA PsycINFO, PubMed, and Web of Science (search up till January 2025). Included were peer-reviewed, English-language studies investigating mediators between self-compassion and psychological outcomes. Study quality was assessed using the Mediation Quality Checklist. A total of 113 studies were included, and most were cross-sectional and focused on psychological symptoms rather than well-being. Repetitive negative thinking, such as worry and rumination, was the most studied process and found to be significantly mediating self-compassion and reduced psychological symptoms across studies. There is also growing evidence for experiential avoidance and mindfulness as significant mediators. Limited studies precluded drawing conclusions about other coping strategies, self-concept, and social factors. This systematic review points toward a significant mediational role of maladaptive (e.g. repetitive negative thinking, experiential avoidance) and adaptive (e.g. mindfulness) emotion regulation and coping strategies, that explain the association of self-compassion with psychological outcomes. Future studies with more rigorous designs including intensive longitudinal and experimental designs are needed to clarify causality.