The role of self-criticism and self-compassion in psychotic experiences and associated distress - Risk or resilience? A systematic literature review.

In 30 seconds

This systematic literature review examined associations between self-criticism, self-compassion and psychotic experiences—including their frequency, severity, endorsement and associated distress—in clinical and non-clinical populations. A narrative synthesis of 17 quantitative studies found high-quality evidence linking both self-criticism and self-compassion with broad psychotic experiences, voice-hearing, unusual beliefs and paranoia. Self-criticism appeared most strongly associated with distress related to these experiences, while self-compassion may be protective. The review identifies longitudinal research as important for clarifying whether these factors contribute to the development of psychosis.

Key findings

• The narrative synthesis included 17 empirical quantitative studies.
• High-quality evidence linked self-criticism and self-compassion with overall psychotic experiences, voice-hearing, unusual beliefs and paranoia.
• Self-criticism appeared most strongly linked to distress associated with psychotic experiences.
• The review suggests self-compassion may be protective, while noting that longitudinal studies are needed to clarify its role.

Why it matters

Psychotic experiences can be distressing, and the review highlights self-criticism as a factor associated with that distress. The findings also suggest self-compassion may be relevant to how people experience psychotic phenomena. These associations offer a framework for understanding distress alongside psychotic experiences, but do not establish that either factor causes or prevents psychosis.

What to keep in mind

The evidence was synthesised narratively from quantitative studies; the review notes that longitudinal research is needed to clarify the role of self-criticism and self-compassion in psychosis development.