A survey of 207 US adults with self-identified physical disabilities found that people reporting higher self-compassion and psychological flexibility also reported fewer depressive symptoms.
The findings point to a relationship between how people respond to painful thoughts and feelings and their mental health. They do not show that self-compassion or psychological flexibility prevents or treats depression.
Shame was the strongest statistical predictor
Shame showed the strongest association with depressive symptoms in the analysis. It uniquely accounted for about 37% of the variation in depressive symptoms, with a reported coefficient of β = .55 and p < .001.
Self-compassion remained associated with fewer depressive symptoms after the analysis accounted for shame. It uniquely explained about 8% of the variation, while psychological flexibility uniquely explained about 4%.
The researchers also examined whether these traits changed the relationship between shame and depressive symptoms. That relationship was about 40% weaker among people with high self-compassion or high psychological flexibility than among those with lower levels.
For psychological flexibility, the shame–depression association was β = .58 at low flexibility and β = .33 at high flexibility. For self-compassion, it was β = .48 at low self-compassion and β = .27 at high self-compassion. Each interaction effect added about 2% of explained variation.
Shame still predicted depressive symptoms at every level of both traits. In other words, higher self-compassion or flexibility was not linked to the disappearance of the association.
What the traits mean
In the study, self-compassion meant treating oneself with the kindness one might offer a friend during pain or failure. It included self-kindness, recognizing that suffering is part of being human, and noticing painful feelings without becoming overwhelmed by them.
Psychological flexibility referred to noticing difficult thoughts and feelings without becoming stuck in or avoiding them, while continuing to act on what matters.
These ideas may be especially relevant in the context of disability, where people can encounter stigma, staring and inaccessible spaces. The fact sheet distinguishes those social and environmental causes from a person’s response to them: self-compassion may relate to how someone responds, while accessibility and inclusion address barriers themselves.
What the survey can—and cannot—show
Participants were between 18 and 71 years old, with an average age of 44, and were recruited through a Qualtrics online survey panel. The survey-panel recruitment took place in June 2022, although the study was described as a 2026 US survey and published in PLOS Mental Health in 2026.
The sample was 44% women, 40% men, 14% nonbinary and 3% transgender. About half of participants were White; 18% were Black and 18% were multiracial.
Researchers used standard self-report questionnaires to measure shame, depressive symptoms, psychological flexibility and self-compassion. Depressive symptoms were assessed with the depression scale of the DASS-21.
Because the study was cross-sectional, all measures were collected once. The results therefore show associations rather than cause and effect. Depression could also make it more difficult to treat oneself kindly or remain psychologically flexible.
The study did not record disability type, severity or duration, and disability was self-identified. People who take paid online surveys may also differ from adults with physical disabilities who do not participate in them. In addition, self-report measures can share reporting biases.
Broader mental-health context
A 2018 CDC survey reported frequent mental distress in 32.9% of US adults with any disability, compared with 7.2% of adults without a disability. Frequent distress was reported 2.4 times as often among adults with only a mobility disability and 8.8 times as often among adults with both mobility and cognitive disabilities, compared with adults without a disability.
Earlier research has also found a large inverse association between self-compassion and symptoms of depression, anxiety and stress. A meta-analysis of 22 randomized trials found that therapies designed to build self-compassion improved depressive symptoms compared with control conditions, but did not clearly outperform other active treatments. Those trials were not limited to people with physical disabilities.
The researchers suggest that mindfulness-based programs and acceptance and commitment therapy could be examined for adults with physical disabilities, while calling for longer-term studies. Whether specifically building self-compassion or psychological flexibility lowers depression in this population has not yet been tested in a trial.
The source article states that ongoing low mood, loss of interest or hopelessness warrants direct care from a doctor or mental-health professional.
AI tools were used to assist with the preparation of this article under our editorial standards.
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