The Effectiveness of Mindful Self-Compassion Intervention on Cognitive Ability in Abused Older Adults

Among the phenomena that threaten the aged population, one is abuse, which leads to serious physical and psychological consequences, cognitive decline, and even premature death. Therefore, the present study was conducted to investigate the effectiveness of mindful self-compassion (MSC) intervention on cognitive ability in aged individuals who have experienced abuse. The research method was quasi-experimental with a single group pretest-posttest-follow-up design. The statistical population included all abused individuals living in nursing homes in Rasht, Iran in 2023, among whom 12 (60 to 80 years old) were selected by the convenience sampling method and based on the eligibility criteria. To collect data, Rodriguez & Carrasco’s Geriatric Mistreatment Scale and Nejati’s Cognitive Ability questionnaire were used. The participants underwent Germer and Neff’s MSC intervention for 8 weekly 90-minute sessions. The data were analyzed using repeated measures analysis of covariance and Bonferroni post hoc test in SPSS-24 software. The results illustrated that the MSC intervention increased the cognitive ability of the abused individuals (P<.05). In other words, the MSC intervention is effective in increasing the cognitive ability of the abused aged population. According to the findings of this study, therapists and centers specializing in geriatrics can use the MSC intervention as an effective solution to increase cognitive ability and prevent its decline in combination with other methods in older adults.
EXTENDED ABSTRACT
 Introduction
Abuse and neglect in older adults is associated with various negative consequences such as depression, cognitive decline, financial problems, numerous psychological issues, and increased risk of hospitalization in nursing homes. Research evidence indicates the presence of impairment in executive and cognitive functions in old age. Considering the existence of harassment among older adults and the role of psychological variables in increasing it, one of the interventions that can play an important role in the psychological state of older adults is the mindful self-compassion (MSC) intervention. This intervention uses acceptance and compassion strategies along with mindfulness-based strategies to enhance being in touch with one’s own experiences of suffering with a compassionate attitude. The goal of this mindfulness-based intervention is to increase self-compassion, common human experience, and a balanced and non-judgmental attitude towards one’s experiences. Research results indicate the effectiveness of mindfulness-based interventions on attention and cognitive flexibility in older adults. Therefore, the aim of the present study was to determine the effectiveness of the MSC intervention on cognitive ability in abused older adults.
Method
This quasi-experimental research was conducted with a single-group pretest-posttest-follow-up design. The participants of the research were 12 older adults who had experienced abuse, selected from people living in nursing homes in Rasht, Iran in 2023. Identification of the older adults with experiences of abuse was done based on the Geriatric Mistreatment Scale and clinical interview. The inclusion criteria were (1) consent to participate in the research, (2) having experiences of harassment based on the score of the elder abuse questionnaire and interview, and (3) being at least 60 years old. The exclusion criteria were (1) suffering from a chronic psychological and physical illness, and (2) simultaneously participating in other educational or therapeutic programs. The elimination criteria during the implementation of the intervention were (1) unwillingness to cooperate and continue participating in the research, (2) failure to complete the questionnaires at each stage of the research, and (3) absence from more than two sessions during the intervention. The pre-test stage was carried out by completing the cognitive abilities questionnaire, and after a week, the intervention sessions started. The participants received eight weekly 90-minute sessions of Germer and Neff’s MSC Intervention at a nursing home. The intervention was implemented by the researcher in the form of a group therapy. One week after the completion of the intervention sessions, the post-test phase was implemented, and three months later, the participants were asked again to complete the cognitive abilities questionnaire as the follow-up phase. Finally, the data of 12 participants were analyzed through analysis of variance with repeated measures and Bonferroni post hoc test. Data were analyzed using SPSS-24 software.
Results
The mean (and standard deviation) age of the participants was 69.25 (4.36). Before analyzing the data, it was found that the distribution of the scores for the studied variable is normal. The results of Mauchly’s Test showed that the assumption of sphericity for within-group variances is confirmed (p>0.05). According to Table 1, there is a significant difference between the three stages of pre-test, post-test, and follow-up in terms of cognitive ability. In other words, based on the mean scores of participants in the pre-test stage (112.92) compared to their mean scores in the post-test (115.50) and follow-up (124.92) stages, the MSC intervention has caused a significant increase in cognitive ability (P<0.05). These results show that 59% of the variance of the social cognition component and 33% of the changes in cognitive ability are due to the effect of the MSC intervention. The results of the Bonferroni post hoc test showed that the mean of social cognition in the pre-test is lower than its mean in the post-test and the follow-up (P<.05). Additionally, the average of cognitive ability in the pre-test is lower than the follow-up (P<.01). The results also indicated that this intervention did not significantly affect other components such as decision-making, planning, and flexibility.
Conclusion
The results demonstrated that the MSC intervention has an effect on improving overall cognitive ability and the component of social cognition. This intervention strengthens a person’s ability to be present in the moment and helps them clear their memory of unnecessary thoughts, focusing on the here and now. Therefore, performing self-compassion and mindfulness exercises by freeing the capacity of active memory improves the function of this part and by creating more stability in attention, they help the person experience more success in cognitive ability. This intervention was not effective for the components of memory, inhibitory control, selective attention, decision-making, planning, sustained attention, and flexibility. This result can be explained by the fact that these components are in the category of deep cognitions that are based on logic, and thus, they did not show significant effects. Additionally, to improve these cognitive dimensions, more challenging tasks may be needed to engage participants beyond their current cognitive abilities and overcome their limitations, which the educational protocol of this research may not have been sufficient to address. It is suggested that therapists and counselors in the field of geriatrics and care centers for older adults include the mindful self-compassion intervention in their programs, especially for abused older adults
Ethical Consideration
Ethical Code
Permission was obtained, and the plan was approved by the Vice-Chancellor of Graduate Education at the Faculty of Literature and Humanities, Guilan University, Iran.
Financial Support
This study received no financial support.
Authors’ Contributions
K.E: Conceptualization, Writing – Original Draft, Data Curation; A.A: Methodology, Software, Validation, Formal Analysis, Visualization; I.Sh: Project Administration, Supervision
Conflict of Interest
The authors had no conflicts of interest.
Acknowledgments
The researchers thank all the participants who took part in the study.
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