Self-compassion and post-stroke depression symptoms in acute stroke survivors

Post-stroke depression affects approximately one-third of stroke survivors. Self-compassion has emerged as a protective factor against depression in chronically ill populations, yet has received limited investigation in stroke survivors.

This study examined the factorial structure and reliability of the German Self-Compassion Scale Short Form (SCS-D-KF) in stroke survivors and investigated whether self-compassion is associated with depressive symptoms beyond established risk factors.

This cross-sectional study examined 407 patients (60.4% male) with acute stroke. Participants completed the SCS-D-KF and PHQ-9 within the first week post-stroke. Factor structure was tested using exploratory and confirmatory factor analysis. Associations with depressive symptoms were examined using hierarchical latent structural equation modeling (SEM) with full information maximum likelihood estimation.

Factor analysis revealed a two-factor structure: Compassionate Self-Responding (CS; ω_cat = 0.63) and Uncompassionate Self-Responding (UCS; ω_cat = 0.82). In separate hierarchical latent SEM models controlling for sociodemographic and clinical risk factors (R² = 0.312), UCS demonstrated the strongest incremental validity (ΔR² = 0.057, β = -0.316, p < .001), followed by total self-compassion score (ΔR² = 0.036, β = -0.290, p < .001) and CS (ΔR² = 0.013, β = -0.201, p = .048).

Both uncompassionate and compassionate self-responding demonstrated incremental validity beyond established risk factors, with uncompassionate self-responding showing particular salience in the acute phase. Results warrant consideration of self-compassion in post-stroke depression assessment and may serve as a potential intervention target pending longitudinal validation.