Healing through self-kindness: Efficacy of compassion-based intervention in enhancing self-esteem,reducing rumination,and alleviating loneliness in primiparous women with postpartum depression

Abstract

Postpartum depression (PPD) is associated with low self-esteem, heightened rumination, and loneliness, which represent key cognitive-emotional vulnerability factors perpetuating symptoms, especially in primiparous women. This randomized controlled trial aimed to evaluate the efficacy of an 8-week group Compassion-Focused Therapy (CFT) in enhancing self-esteem and reducing rumination and loneliness among primiparous women diagnosed with PPD. Forty-eight participants in a large city in Iran were randomly allocated to CFT (n = 24) or waitlist control (n = 24) using a pretest-posttest design with 2-month follow-up. Outcomes were measured with the Rosenberg Self-Esteem Scale, Ruminative Response Scale, and UCLA Loneliness Scale; data were analyzed via repeated-measures ANOVA. The CFT group showed significant improvements relative to controls (p < 0.001 for Group × Time interactions; η²p = 0.59–0.63), with higher self-esteem and lower rumination and loneliness maintained at follow-up. These results suggest CFT effectively targets core vulnerabilities in PPD, supporting its potential role in perinatal mental health care.