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. 2026 Oct 26;17:1750895. doi: 10.3389/fpsyg.2026.1750895

In light of cognitive flexibility and unconditional self-acceptance: the association between self-compassion and depression

Beyza Nur Turgut 1, Eyüp Çelik 1,*
PMCID: PMC13745334  PMID: 43005196

Abstract

Introduction

This study examined the relationship between self-compassion and depressive symptoms, focusing on the mediating roles of cognitive flexibility and unconditional self-acceptance. Although self-compassion is recognized as a protective factor against depression, the underlying psychological mechanisms remain insufficiently understood.

Methods

A quantitative relational design was employed with a sample of 318 Turkish adults aged 18–65 years (76.1% female). Participants were recruited using convenience and snowball sampling methods, and data were collected via online surveys. Participants completed validated scales measuring self-compassion, depression, unconditional self-acceptance, and cognitive flexibility. Mediation analyses were conducted using the PROCESS macro (Model 4) in SPSS to test direct and indirect effects.

Results

Correlation analysis indicated a significant negative relationship between self-compassion and depressive symptoms (r = −0.56, p < 0.001). Mediation analyses showed that cognitive flexibility significantly mediated this relationship, whereas unconditional self-acceptance demonstrated a weaker indirect effect.

Discussion

Higher self-compassion was associated with lower depressive symptoms, partly through cognitive flexibility and, to a lesser extent, unconditional self-acceptance. These findings highlight the role of cognitive and self-evaluative processes in understanding the relationship between self-compassion and depression.

Keywords: cognitive flexibility, depression, mediation analysis, self-compassion, unconditional self-acceptance

Introduction

Depression has been recognized throughout human history and remains an important construct widely studied in the literature. Depression is a mood disorder characterized by persistent sadness, loss of interest or pleasure, cognitive impairments, and functional difficulties (Simon et al., 2024). Although these factors may vary across individuals, some factors may increase the risk of depression, whereas others may serve protective functions. When we look at the etiology, it is known that medical illnesses, loneliness, loss of a loved one, low socioeconomic level, unemployment, separation from spouse, loneliness, childhood traumas, difficulties in working life, problems in the family, and substance use cause depression (Ólafsdóttir et al., 2018; Levola et al., 2020; Kafes, 2021; Bischof et al., 2022; Fan et al., 2023). The prevalence of depression may increase as the number or intensity of contributing factors increases. According to the World Health Organization (2023), an estimated more than 300 million people worldwide are affected by depression, corresponding to approximately 4–5% of the global population. Its high prevalence worldwide and chronic course indicate that depression remains an important public health concern (Remes et al., 2021; Goodwin et al., 2022). Depression leads to significant functional impairments, making it difficult for individuals to cope with daily life. Depression is also associated with impaired functioning and interpersonal difficulties, and its prevalence varies according to gender and age (Fukuzaki and Takeda, 2022). This disorder, which can be seen at any age, occurs more frequently in middle age, especially between the ages of 25 and 50, and the lifetime prevalence rate is reported as 30% in women and 17% in men (Simon et al., 2024). Women are approximately twice as likely as men to experience depression. Didin and Yavuz (2022) stated that girls experience higher levels of depression than boys.

Previous studies have shown that depression is associated with various psychological and psychosocial variables, including emotion regulation difficulties, loneliness, life satisfaction, and self-esteem (Achterbergh et al., 2020; Kagan and Tleubayev, 2020; Cunningham et al., 2021; Dogan, 2021; Gao et al., 2022; Bhattacharya et al., 2023; Saldivia et al., 2023; Luo et al., 2024; Haehner et al., 2025). Examining depression in relation to psychological variables may help clarify factors associated with depressive symptoms.

Positive psychology has gained increasing attention in recent literature, focusing on individuals' strengths and wellbeing (Ergün, 2020; Kulbaş, 2021; Alam, 2022; Ciarrochi et al., 2022). Within this framework, self-compassion is considered an important construct associated with psychological growth and wellbeing (Pyszkowska, 2020). Rather than focusing solely on psychological difficulties, self-compassion involves a balanced and kind attitude toward one's own experiences, particularly in the face of personal shortcomings and distress. In this context, self-compassion may contribute to greater resilience and self-acceptance when individuals encounter psychological challenges. Self-compassion is conceptualized as an attitude that involves recognizing human imperfection and responding to oneself with understanding rather than self-criticism (Neff, 2023). According to Germer and Neff (2013), self-compassion consists of three interrelated components: self-kindness, common humanity, and mindfulness. These components reflect a balanced and non-judgmental awareness of personal experiences rather than over-identification with negative thoughts and emotions. Self-compassion promotes a balanced awareness of distressing experiences without suppression, denial, or over-identification (Neff, 2008; Germer and Neff, 2013).

Previous research has linked self-compassion to a range of positive psychological outcomes, including psychological wellbeing, emotional intelligence, resilience, and mindfulness, while demonstrating negative associations with depression and anxiety (Brophy et al., 2020; de Souza et al., 2020; Küçük, 2020; Pandey et al., 2021; Di Fabio and Saklofske, 2021; Tafarojei and Yousefi, 2021; Lou et al., 2022; Bailey et al., 2023; Li et al., 2024). These findings suggest that self-compassion may function as an important psychological resource associated with adaptive functioning and reduced psychological distress.

The understanding, compassion, and unconditional acceptance that individuals show toward themselves have a significant effect on their depression levels (Deniz and Sümer, 2010). It has been stated that individuals who have compassion and acceptance toward themselves, when they fail, do not criticize themselves harshly, but think that this situation is something that can happen to everyone, and they can approach it positively without making harsh judgments toward themselves (Neff, 2023). Self-compassion is protective in preventing depressive symptoms by providing individuals with a strong resilience against feelings of inadequacy and enabling them to be more attentive to themselves in difficult times (Warren et al., 2016). Previous studies consistently report a negative association between self-compassion and depressive symptoms (Altay, 2022; Çeştan, 2020; Han and Kim, 2023; Serrão et al., 2023; Wang et al., 2024). Similarly, unconditional self-acceptance prevents individuals from looking at themselves negatively, blaming themselves, and falling into depression (Acun Kapikiran and Kapikiran, 2010). In this context, Chamberlain and Haaga (2001b) stated that individuals who accept themselves unconditionally develop a healthier perspective and are more protected against depression and anxiety.

Gabrys et al. (2018) highlighted cognitive flexibility as an important variable in relation to depressive symptoms. Cognitive flexibility refers to the ability to adapt cognitive processes, modify thinking patterns, and generate alternative strategies in response to changing environmental demands (Braem and Egner, 2018; Dennis and Vander Wal, 2010). This capacity enables individuals to adjust to new situations and reinterpret experiences in a more adaptive way (Canas et al., 2006). Cognitive flexibility enables individuals to reinterpret distressing experiences and generate alternative responses to challenging situations, thereby supporting more adaptive cognitive and emotional processes (Dennis and Vander Wal, 2010; Marshall and Brockman, 2016). These processes are closely related to self-compassion and unconditional self-acceptance, as individuals with higher cognitive flexibility are more likely to adopt a non-judgmental and accepting attitude toward themselves and to recognize shared human experiences of suffering (Zhang et al., 2024).

On the other hand, lower cognitive flexibility may increase vulnerability to depression by limiting individuals' ability to reinterpret experiences and consider alternative perspectives (Dajani and Uddin, 2015; Yu et al., 2020). This restriction in cognitive processing can lead individuals to focus rigidly on specific interpretations, which is associated with increased depressive symptoms. Conversely, higher cognitive flexibility facilitates adaptive thinking, supports effective coping with stressful situations and interpersonal difficulties, and is linked to lower levels of depression (Fukuzaki and Takeda, 2022; Güler, 2022). Overall, cognitive flexibility appears to play a protective role in emotional adjustment and depressive symptomatology.

Otherwise, when individuals fail to recognize their strengths, their ability to show compassion to themselves and their level of self-acceptance decrease, and their tendency toward depression increases (Popov, 2019). Furthermore, unconditional self-acceptance enhances self-compassion and strengthens its protective effect against depressive symptoms (Crisan et al., 2023). Indeed, unconditional self-acceptance has been shown to support self-compassion in protecting against depression (Chamberlain and Haaga, 2001a). Therefore, unconditional self-acceptance may represent an important mechanism linking self-compassion to lower depressive symptoms.

Individuals with high cognitive flexibility have been found to have higher problem-solving abilities, are more likely to forgive themselves for mistakes they make, and are more compassionate toward themselves (Martin et al., 2011). Neff et al. (2007) stated that cognitive flexibility helps individuals evaluate themselves positively and adopt an accepting attitude toward themselves. However, individuals lacking cognitive flexibility are at risk for depression because they are unable to accept themselves with their shortcomings and mistakes, are unable to approach themselves compassionately, and are unable to adapt to new processes (Çeştan, 2020; Reis, 2020). In other words, it is thought that high cognitive flexibility facilitates flexible thinking in the face of negative life events, supports individuals in showing compassion to themselves, and thus prevents the risk of developing depressive symptoms (Marshall and Brockman, 2016). Therefore, cognitive flexibility may function as a mediating mechanism through which self-compassion is associated with lower depressive symptoms.

Consistent with positive psychology and self-compassion theory, self-compassion can be conceptualized as an adaptive psychological resource that may reduce depressive symptoms by promoting more flexible cognitive processing and greater unconditional self-acceptance. Self-compassion can be associated with lower depressive symptoms by supporting emotion regulation processes, cognitive and self-evaluation mechanisms. Individuals with high levels of self-compassion tend to be more emotionally accommodating when experiencing personal failure and distress, approaching themselves with less self-criticism and acting with mindful awareness (Viskovich and De George-Walker, 2019). This approach may support cognitive flexibility by enabling individuals to re-evaluate negative experiences and adopt more adaptive perspectives in stressful situations. Similarly, self-compassion can promote unconditional self-acceptance by reducing the tendency to base self-worth on performance, failure, or external approval. In turn, both cognitive flexibility and unconditional self-acceptance have been associated with lower depressive symptoms through less rumination, self-criticism, and psychological rigidity (Popov, 2019; Faustino et al., 2020; Jouybari and Ghoreishi, 2025). Accordingly, in this study, cognitive flexibility and unconditional self-acceptance are conceptualized as potential pathways that can explain the relationship between self-compassion and depression.

The current study aimed to examine the mediating roles of unconditional self-acceptance and cognitive flexibility in the relationship between self-compassion and depression. Although previous research has linked these variables to depressive symptoms, limited evidence has examined them simultaneously within a single model. Investigating these relationships among Turkish adults may provide culturally relevant insight into how self-related cognitive and emotional processes are associated with depressive symptoms. In collectivist cultural contexts, self-acceptance and emotional coping processes may be shaped by interpersonal expectations and social evaluation.

The hypotheses of the research are as follows:

  1. H1: Self-compassion is significantly and negatively associated with depression.

  2. H2: Unconditional self-acceptance may statistically account for the association between self-compassion and depression.

  3. H3: Cognitive flexibility may statistically account for the association between self-compassion and depression.

To test the proposed hypotheses, the following methodology was employed.

Methods

In the current study, a quantitative research design, the relational screening model, was used to explore the relationships among depression, self-compassion, unconditional self-acceptance, and cognitive flexibility. Relational screening models are studies conducted to reveal the relationship between two or more variables and to determine the degree and direction of the relationship (Karasar, 2014). The study examined the mediating roles of unconditional self-acceptance and cognitive flexibility in the relationship between depression and self-compassion. A multiple mediation model was used to test direct and indirect effects.

Participants

The study group consisted of 318 individuals between the ages of 18 and 65 (M = 31.16, SD = 9.89). The sample was selected using a convenience sampling method that met the inclusion criteria for participants who were willing to participate in the study. Participation in the study was voluntary. Three individuals who participated in the study but were under the age of 18 were excluded from the study group, resulting in a dataset of 318, down from 321. Snowball sampling was used to collect data from 318 Turkish adults. Convenience and snowball sampling methods were used to facilitate participant recruitment and increase participant reach through online networks, allowing access to a broader adult sample during the data collection process. The sample consisted of 242 females (76.1%) and 76 males (23.9%). 162 of the participants were single (50.9%) and 156 (49.1%) were married. Among the participants, 3 people (0.94%) were primary school graduates, 7 people (2.2%) were secondary school graduates, 37 people (11.6%) were high school graduates, 227 people (71.4%) were undergraduate graduates, and 44 people (13.8%) had postgraduate (master's-doctoral) education.

Ethical approval for this study was obtained from the Education Research and Publication Ethics Committee of [Sakarya University]. The study was approved at the committee meeting held on April 9, 2025 (Meeting No. 44, Decision No. 58).

Measures

The Depression Anxiety Stress Scale-21 (DASS-21) is a 21-item self-report instrument developed by (Lovibond and Lovibond 1995). The Turkish adaptation of the scale was conducted by Yilmaz et al. (2017). The scale is a four-point Likert-type instrument ranging from 0 (“did not apply to me at all”) to 3 (“applied to me very much or most of the time”). It consists of three subscales: depression, anxiety, and stress, each containing seven items. In this study, raw (unmultiplied) scores were used; therefore, subscale scores range from 0 to 21. Cronbach's alpha coefficients were 0.86 for depression, 0.79 for anxiety, and 0.80 for stress. Confirmatory factor analysis supported the original three-factor structure (RMSEA = 0.06, CFI = 0.93, GFI = 0.92). Evidence for criterion validity was supported by significant correlations among the subscales (Yilmaz et al., 2017).

Self-Compassion Scale: The self-compassion scale developed by Neff (2003) was adapted into Turkish by Deniz et al. (2008). The original version consists of 26 items and 6 sub-dimensions. The self-compassion scale, adapted to Turkish by removing two items from the original, consists of a total of 24 items and exhibits a single-factor structure. The scale is a five-point Likert-type scale ranging from 1 “almost never” to 5 “almost always.” The internal consistency coefficient of the scale was 0.89, and the test-retest correlation was 0.83. The fit indices obtained from confirmatory factor analysis (CFA) indicate that the model overlaps the data at an acceptable level. Furthermore, criterion validity was supported by examining the scale's correlations with similar scales (Deniz et al., 2008).

Unconditional Self-Acceptance Scale: The unconditional self-acceptance scale developed by Chamberlain and Haaga (2001a) was adapted into Turkish by Acun Kapikiran and Kapikiran (2010). The Turkish adaptation of the original 20-item scale consists of 19 items. The scale, which consists of two sub-dimensions: conditional self-acceptance and unconditional self-acceptance, is a seven-point Likert-type scale ranging from 1 (almost always not true) to 7 (almost always true). The Cronbach's alpha value of the scale, which explains 36.77% of the total variance, is 0.76, the test-retest correlation is r = 0.62, and the item-total score correlations range from 0.40 to 72. Furthermore, the scale's significant and expected correlations with other scales measuring similar concepts support criterion validity (Acun Kapikiran and Kapikiran, 2010).

Cognitive Flexibility Scale: The cognitive flexibility scale developed by Martin and Rubin (1995) was adapted into Turkish by Altunkol (2011). The 12-item scale is a six-point Likert-type scale ranging from 1 (strongly disagree) to 6 (strongly agree). The validity of the scale was tested using both construct validity and criterion-related validity methods. Factor analysis conducted to assess construct validity revealed a unidimensional structure for the scale. Criterion-related validity revealed significant correlations with psychological wellbeing, problem solving, and adaptation levels, which are thought to be related to cognitive flexibility. The Cronbach alpha value of the scale was found to be 0.81, and it was seen that it met the validity criteria as a result of criterion-related validity and construct validity studies (Altunkol, 2011).

Permissions for the scales described above were obtained by the researcher.

Procedure

In the current study, data were collected through an online survey design. The questionnaire was created using Google Forms to ensure easy accessibility and efficient data collection. Prior to data collection, the survey link was reviewed and finalized by the researchers. The survey was initially distributed by the researchers through multiple online channels, including email and social media platforms such as WhatsApp, Facebook, and Instagram. These platforms were selected to reach a diverse adult population in a time- and cost-efficient manner. In addition to initial distribution, a snowball sampling technique was employed to increase participant reach. Participants who completed the survey were asked to share the survey link with other individuals who met the inclusion criteria (i.e., being 18 years of age or older and voluntarily agreeing to participate). This approach allowed the study to access a wider pool of respondents beyond the initial networks of the researchers. Participation in the study was entirely voluntary and anonymous. At the beginning of the survey, participants were presented with an informed consent form explaining the purpose of the study, confidentiality of responses, and their right to withdraw at any time without penalty. Only participants who provided informed consent were able to proceed to the questionnaire. Ethical approval for the study was obtained from the relevant institutional ethics committee prior to data collection. No personally identifiable information was collected, and all responses were stored securely and used solely for research purposes.

Data analysis

In the current study, Pearson correlation analysis was conducted to examine the relationships among depression, self-compassion, unconditional self-acceptance, and cognitive flexibility. Prior to regression analyses, assumptions of normality and linearity were evaluated, and skewness and kurtosis values were examined. The results indicated that the data met the assumptions for regression analysis. The mediating roles of unconditional self-acceptance and cognitive flexibility in the relationship between self-compassion (X) and depression (Y) were tested using SPSS PROCESS macro (Model 4; Hayes, 2013). CF and unconditional self-acceptance were examined as parallel mediators in a multiple mediation model to estimate direct and indirect effects. Moreover, a post hoc sensitivity power analysis was conducted using G*Power 3.1 to assess sample size adequacy. With N = 318, α = 0.05, and power = 0.80, the study was sufficiently powered to detect small effect sizes in the proposed mediation model. The minimum detectable effect size for a multiple regression model with three predictors was approximately f2 = 0.03–0.04, indicating adequate statistical sensitivity according to Cohen's criteria (Table 1).

Table 1.

Descriptive statistics of the variables.

Variables N Min. Max. Means SD Skew. Kurt. VIF Tolerance
Depression 318 0.00 21.00 6.47 5.77 0.67 −0.55
Self-compassion 318 27.00 119.00 78.88 18.56 −0.09 −0.43 1.789 0.559
Self-acceptance 318 28.00 123.00 78.92 14.58 −0.00 0.24 1.781 0.561
Cognitive flexibility 318 29.00 64.00 50.55 6.37 −0.18 −0.24 1.176 0.850
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DASS-21 subscale scores are presented as raw (unmultiplied) scores ranging from 0 to 21.

Results

Relationships between variables were calculated using the Pearson Correlation Coefficient and the results are shown in Table 2.

Table 2.

The relationships between variables.

Variables 1 2 3 4
1 = Depression 1
2 = Self compassion −0.56** 1
3 = Self-acceptance −0.45** 0.65** 1
4 = Cognitive flexibility −0.41** 0.41** 0.37** 1
M
SD
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**p < 0.01.

Mediation analysis

As shown in Table 3, simple linear regression prior to the mediation analysis indicated that self-compassion significantly predicted depression (β = −0.18, 95% CI: −0.20 to −0.14; p < 0.001). The mediating roles of unconditional self-acceptance and cognitive flexibility in the relationship between self-compassion and depression were then examined.

Table 3.

Regression coefficients, standard errors, and significance tests for the regression model.

Predictor Coeff. SE p F R 2
Constant 20.28 1.17 0.0000 146.30 0.32
Self-compassion −0.18 0.01 < 0.001
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The mediating roles of unconditional self-acceptance and cognitive flexibility in the relationship between self-compassion and depression were tested with the mediation model, and the results are presented in Table 4.

Table 4.

The serial multiple mediational model coefficients.

Predictors Consequent
Self-acceptance Cognitive Flexibility Depression
Path Coeff. SE p Coeff. SE p Coeff. SE p
Self-compassion a 0.51 0.03 < 0.001 0.10 0.02 < 0.001 c′ −0.13 0.02 < 0.001
Self-acceptance – – – 0.08 0.03 < 0.001 b 1 −0.05 0.02 0.05
Cognitive flexibility – – – – – – b 2 −0.18 0.05 < 0.001
Constant i 1 36.24 1.80 < 0.001 i 2 29.44 2.19 < 0.001
R2 = 0.42 R2 = 0.19 R2 = 0.36
F(1, 316) = 232.42, p= < 0.001 F(2, 315) = 37.19, p= < 0.001 F(3, 314) = 60.11, p = < 0.001
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Italicized values indicate statistically significant regression coefficients (p < 0.05).

The mediation model is presented in Figure 1, where self-compassion is the independent variable, depression is the dependent variable, and unconditional self-acceptance and cognitive flexibility are parallel mediators.

Figure 1.

The figure presents a mediation model illustrating the relationships between self-compassion, cognitive flexibility, unconditional self-acceptance, and depression. Self-compassion is shown as the predictor variable, while depression is the outcome variable. Cognitive flexibility and unconditional self-acceptance are presented as mediators. Arrows indicate the direct association between self-compassion and depression and the indirect pathways through cognitive flexibility and unconditional self-acceptance. Path coefficients and statistical significance levels are displayed along the arrows. The model illustrates how cognitive flexibility and unconditional self-acceptance may help explain the association between self-compassion and depression.

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The mediating role of unconditional self-acceptance and cognitive flexibility.

As shown in Figure 1 and Table 4, the result of the mediation analysis showed that cognitive flexibility (Coeff. = 0.18, 95% CI: −0.28 to −0.10; p < 0.001) significantly predicted depression, but self-acceptance (Coeff. = −0.05, 95% CI: −0.09 −0.00; p = 0.05) didn't significantly predict depression. Self-compassion predicted the depression (Coeff. = 0.13, 95% CI: −0.16 to −0.09; p < 0.001), cognitive flexibility (Coeff. = 0.10, 95% CI: 0.06 −0.15; p < 0.001), and self-acceptance (Coeff. = 0.51, 95% CI: 0.45 −0.58; p < 0.001) significantly. Self-acceptance significantly predicted the cognitive flexibility (Coeff. = 0.08, 95% CI: 0.02 −0.14; p < 0.01). Furthermore, cognitive flexibility decreased the effect of self-compassion on depression (from −0.18 to −0.13). Finally, the relationship between self-compassion and depression was mediated by cognitive flexibility.

In the mediation analysis, the indirect, total, and direct effects of self-compassion on depression, mediated by unconditional self-acceptance and cognitive flexibility, were examined and presented in Table 5.

Table 5.

Direct and indirect effects of self-compassion on depression via unconditional self-acceptance and cognitive flexibility.

Path Effect SE LLCI ULCI
Direct influence −0.13 0.02 −0.16 −0.09
Indirect effect −0.05 0.01 −0.08 −0.02
Ind1: Self-compassion → self-acceptance → depression −0.02 0.01 −0.05 0.00
Ind2: Self-compassion → cognitive flexibility → depression −0.02 0.01 −0.03 −0.01
Ind3: Self-compassion → self-acceptance → cognitive flexibility → depression −0.01 0.00 −0.01 −0.00
Total effect −0.18 0.01 −0.20 −0.15
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Ind, indirect effect.

As seen in Table 5, the indirect effect of self-compassion on depression through cognitive flexibility was statistically significant, whereas unconditional self-acceptance demonstrated a weaker mediating effect. Furthermore, self-compassion continued to have a significant direct effect on depression after the mediators were included in the model, indicating partial mediation.

Discussion

The current study examined the mediating roles of unconditional self-acceptance and cognitive flexibility in the relationship between depression and self-compassion. The findings indicate a significant negative relationship between depression and self-compassion. This finding suggests that individuals with high self-compassion are at less risk for depression. This result supports previous research results (Çeştan, 2020; Adie et al., 2021; Hughes et al., 2021; Altay, 2022; Egan et al., 2022; Etemadi Shamsababdi and Dehshiri, 2024). Self-compassion is defined as individuals having a kind, understanding, and non-judgmental attitude toward themselves (Neff, 2023). Having high self-compassion prevents individuals from developing a critical attitude toward themselves as a result of negative events experienced, enables them to cope with their negative emotions, thus reducing the risk of developing depressive symptoms (Abdollahi et al., 2020; Han and Kim, 2023). Germer and Neff (2020) stated that individuals with self-compassion are less affected by troublesome processes, are more resilient to psychological disorders, and have higher levels of happiness and life satisfaction. Especially when mistakes and interpersonal problems occur in life, a more understanding attitude by preventing individuals from being cruel to themselves allows them to experience their emotions in a balanced way and protect themselves against mental disorders (Brophy et al., 2020). However, the three components of self-compassion—self-understanding, common humanity, and awareness—are also effective in preventing the development of depression (Germer and Neff, 2020). When the literature is examined, it has been revealed that individuals with high self-compassion levels have reduced anxiety and stress levels along with depression, and self-compassion contributes to an increase in the psychological wellbeing of individuals (Ko et al., 2018; de Souza et al., 2020; Kroshus et al., 2021). High self-compassion allows individuals to accept themselves, to recognize their own feelings and thoughts objectively, to improve their self-esteem, and to develop healthy coping skills for their problems (Tran et al., 2022). In this way, self-compassion may be considered a psychological resource that is associated with lower depressive symptoms and may inform intervention approaches targeting emotional wellbeing. However, some researchers have suggested that the strength of the association between self-compassion and depressive symptoms may vary across populations and cultural contexts, indicating that the protective role of self-compassion may depend on contextual and individual factors (MacBeth and Gumley, 2012; Neff and Germer, 2013).

Other findings of the study revealed a significant negative correlation between depression and unconditional self-acceptance and cognitive flexibility. The current results support research in the literature (Guo et al., 2022; Naderi et al., 2023; Altan-Atalay and Boluvat, 2024). In light of this finding, increased depressive symptoms may be associated with lower levels of self-acceptance and cognitive flexibility. When individuals accept themselves unconditionally, without depending on any external process, they develop a more resilient personality toward distressing processes and are less likely to experience depressive symptoms (Chamberlain and Haaga, 2001a). Indeed, Hilbert et al. (2019) stated that the most important way to protect mental health is for individuals to accept themselves free from problematic life events and mistakes and to develop self-esteem. Individuals who value themselves conditionally feel worthless when faced with life's challenges, which can lead to symptoms of depression (Sanghvi et al., 2023). Furthermore, individuals who are cognitively inflexible are also more likely to experience depression (García-Fernández et al., 2025). Cognitive flexibility is defined as the ability to develop alternative solutions to problems, to think flexibly, and to develop a constructive and realistic mindset (Dajani and Uddin, 2015). In this context, individuals with cognitive flexibility skills can think more constructively about problems, allowing their depression levels to decrease (Fukuzaki and Takeda, 2022). Similarly, Gao et al. (2025) stated that a high level of cognitive flexibility is a general factor that reduces the likelihood of experiencing depression and facilitates adaptation to changing processes in daily life. The ability of cognitive flexibility to support adaptation, promote healthier interpretations of experiences, and facilitate flexible responses, together with the role of unconditional self-acceptance in enhancing self-evaluation, may represent protective processes against depressive symptoms. However, these protective processes may not operate in the same way across all individuals and contexts. Some studies have suggested that the associations between cognitive flexibility, self-acceptance, and depressive symptoms may vary depending on individual and contextual factors, such as psychological characteristics and environmental conditions (Dajani and Uddin, 2015; Gabrys et al., 2018; Chamberlain and Haaga, 2001a,b).

Other findings of the current study suggest that the relationship between self-compassion and depressive symptoms may be partially explained by cognitive flexibility and, to a lesser extent, unconditional self-acceptance. It is stated that one of the factors supporting self-compassion is unconditional self-acceptance (Zou et al., 2025). Unconditional self-acceptance is the acceptance of individuals without the need for success, approval from others, or appreciation (Yilmaz Bingöl and Vural Batik, 2018). Unconditional self-acceptance may contribute to the development of self-compassion by increasing individuals' awareness that they are valuable because of their existence (Faustino et al., 2020; Crisan et al., 2023). However, unconditional self-acceptance, like self-compassion, is a fundamental element of being a psychologically healthy individual (Muris and Otgaar, 2023). Because people with high levels of self-compassion are more understanding of themselves, they have no difficulty accepting their flaws (Faustino et al., 2020). On the other hand, individuals with unconditional self-acceptance accept themselves without judgment, allowing them to understand their personalities and thus feel better mentally (Zipagan and Galvez Tan, 2023). Kicali (2015) noted that unconditional self-acceptance and self-compassion, which have a self-esteem-enhancing function, are linked to lower negative affect. Individuals with higher levels of unconditional self-acceptance may demonstrate greater resilience in coping with difficulties and adopt a kinder attitude toward themselves, which may be associated with lower depressive symptoms. As a matter of fact, there are studies in the literature that support the findings of the current research showing that self-respect, acceptance and understanding are effective in preventing mental disorders such as depression (Moksnes et al., 2016; Dinger et al., 2017; Bae et al., 2021; Sayin and Karaaziz, 2024; Yilmaz, 2024). Therefore, the relationship between self-compassion and lower depressive symptoms may be partly explained by unconditional self-acceptance. Interventions aimed at enhancing self-compassion and unconditional self-acceptance may contribute to reducing vulnerability to depressive symptoms.

Cognitive flexibility appears to play a more prominent mediating role in the relationship between self-compassion and depressive symptoms. Cognitive flexibility is the ability to accept changing circumstances, evaluate options, and increase problem-solving skills (Dennis and Vander Wal, 2010). Cognitive flexibility, which facilitates adaptation to new processes, reveals alternative ways of thinking, enables individuals to forgive themselves when they make mistakes, and paves the way for them to develop self-compassion (Martin et al., 2011). However, cognitive flexibility has been identified as positively associated with psychological health (Yelpaze, 2020). When the literature is examined, it has been revealed that cognitive flexibility is effective in increasing wellbeing and reducing depression (Yazar and Meterelliyoz, 2019; Yu et al., 2020; Asici and Sari, 2021; Circir and Tagay, 2024; García-Fernández et al., 2025). It can be stated that cognitive flexibility is of may play an important role in coping with distressing events and plays an active role in preventing mental disorders. While individuals who are cognitively flexible and can consider different options adapt more quickly to the challenges in life, individuals who cannot think flexibly are more likely to develop pathological reactions and experience psychological problems (Okan Er and Deniz, 2022). When viewed within the framework of Beck's cognitive model, cognitive flexibility is an important factor in the process of revealing and evaluating the real and unconstructive cognitions of individuals with depressive symptoms (Aslan and Türk, 2022). It has been shown that individuals with flexible thinking can more easily transform their negative automatic thoughts into constructive thoughts, are more understanding toward themselves, and thus, their depression symptoms decrease (Curtiss and Klemanski, 2014; Yadavaia et al., 2014). Indeed, Topkaya et al. (2022) stated that the effect of self-compassion in reducing depression may be mediated by cognitive flexibility. Similarly, it has been determined that self-compassion and cognitive flexibility are interrelated and that they are effective together in reducing the level of negative self-esteem and depression (Güler, 2022). Therefore, improving cognitive flexibility may be beneficial in psychological interventions aimed at reducing depressive symptoms by supporting self-compassion processes. At the same time, the mediating role of cognitive flexibility should be interpreted cautiously, as previous findings have suggested that its contribution may depend on other cognitive and emotional processes involved in depression (Dajani and Uddin, 2015; Gabrys et al., 2018; Yu et al., 2020). Accordingly, the present findings suggest that cognitive flexibility and unconditional self-acceptance may represent potential pathways through which self-compassion is associated with depressive symptoms. Both cognitive flexibility and unconditional self-acceptance may function as cognitive and self-evaluative mechanisms underlying this association.

Limitations

The study has some limitations. Firstly, it is a cross-sectional study. Because the study was conducted in a cross-sectional manner, the variables cannot be interpreted within the framework of a causal design. In this context, the narrower scope of the topic affected the selected sample and the generalizability of the results. Data for the study were collected via an online survey. In this context, the representativeness of the sample may be limited since the study does not include people who cannot access online platforms. Research data were collected based solely on participants' responses to survey questions. This situation may cause participants to present themselves in a socially acceptable and positive manner rather than providing realistic information about themselves, thus creating limitations in terms of the accuracy of the data obtained. Furthermore, the sample was predominantly female (76.1%) and highly educated (85.2% holding at least a bachelor's degree), which may limit the generalizability of the findings. Given evidence of gender differences in depression prevalence, this imbalance should be considered when interpreting the results. In addition, the broad age range of the sample (18–65) may have introduced age-related differences in depressive experiences and psychological processes.

Implications for future research

The current study used a cross-sectional design. As a result of this cross-sectional design, causal relationships between variables could not be revealed. For this reason, this research can be conducted with longitudinal and experimental designs. In this study, unconditional self-acceptance and cognitive flexibility were used as mediating variables. Future research could examine different concepts as mediating variables. In addition, since the study sample is limited to a certain age group and culture, conducting the study in different age groups and cultural groups may increase its generalizability. Future studies may consider controlling for potential covariates such as age, gender, and education level. In terms of practice, it may be beneficial to develop psychoeducation programs aimed at increasing individuals' self-compassion, unconditional self-acceptance, and cognitive flexibility levels and to offer them as a preventive or supportive intervention for individuals at risk of depression. Future research may also examine the subdimensions of self-compassion to provide a more detailed understanding of their differential relationships with depression and related psychological constructs.

Funding Statement

The author(s) declared that financial support was not received for this work and/or its publication.

Footnotes

Edited by: Eirini Karakasidou, Panteion University, Greece

Reviewed by: Samson Femi Agberotimi, University of Ibadan, Nigeria

Maor Shani, Osnabrück University, Germany

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

Ethics committee approval was obtained from the Sakarya University Education, Research, and Publication Ethics Committee (Approval Number: 58, Date: April 9, 2025) before the study began. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Author contributions

BNT: Writing – original draft. EÇ: Writing – review & editing.

Conflict of interest

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Generative AI statement

The author(s) declared that Generative AI was used in the creation of this manuscript. Generative AI tools (ChatGPT) were used only for minor language refinement and for generating non-scientific editorial text such as the scope statement during manuscript preparation. No AI tools were used to generate, analyze, or interpret data, develop the study design, conduct statistical analyses, or produce any scientific content. All scientific reasoning, analyses, interpretations, and conclusions were fully developed by the author(s).

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References

  1. Abdollahi A., Allen K. A., Taheri A. (2020). Moderating the role of self-compassion in the relationship between perfectionism and depression. J. Rational Emotive Cogn. Behav. Ther. 38, 459–471. doi: 10.1007/s10942-020-00346-3 [DOI] [Google Scholar]
  2. Achterbergh L., Pitman A., Birken M., Pearce E., Sno H., Johnson S. (2020). The experience of loneliness among young people with depression: a qualitative meta-synthesis of the literature. BMC Psychiatry 20:404. doi: 10.1186/s12888-020-02818-3 [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Acun Kapikiran N., Kapikiran S. (2010). Koşulsuz kendini kabul ölçeginin Türk üniversite ögrencileri için geçerligi ve güvenirligi. Kriz Dergisi 18, 33–44. doi: 10.1501/Kriz_0000000309 [DOI] [Google Scholar]
  4. Adie T., Steindl S. R., Kirby J. N., Kane R. T., Mazzucchelli T. G. (2021). The relationship between self-compassion and depressive symptoms: avoidance and activation as mediators. Mindfulness 12, 1748–1756. doi: 10.1007/s12671-021-01637-1 [DOI] [Google Scholar]
  5. Alam A. (2022). Investigating sustainable education and positive psychology interventions in schools towards achievement of sustainable happiness and wellbeing for 21st century pedagogy and curriculum. ECS Trans. 107, 19481–19494. doi: 10.1149/10701.19481ecst [DOI] [Google Scholar]
  6. Altan-Atalay A., Boluvat M. F. (2024). Cognitive flexibility and depression: the moderator roles of humor styles. Curr. Psychol. 43, 20814–20823. doi: 10.1007/s12144-024-05931-8 [DOI] [Google Scholar]
  7. Altay E. (2022). Üniversite ögrencilerinde depresyon, kendini affetme ve öz-şefkat arasindaki ilişkilerin incelenmesi (Yayimlanmamiş yüksek lisans tezi). Maltepe Üniversitesi, Istanbul, Türkiye. [Google Scholar]
  8. Altunkol F. (2011). Üniversite ögrencilerinin bilişsel esneklikleri ile algilanan stres düzeyleri arasindaki ilişkinin incelenmesi (Yayimlanmamiş yüksek lisans tezi). Marmara Üniversitesi, Istanbul, Türkiye. [Google Scholar]
  9. Asici E., Sari H. (2021). The mediating role of coping strategies in the relationship between cognitive flexibility and well-being. Int. J. Scholars Educ. 4, 38–56. doi: 10.52134/ueader.889204 [DOI] [Google Scholar]
  10. Aslan S., Türk F. (2022). Bilissel esneklik ve esnek esneklik kavramlarinin karsilanmasi. Psikiyatride Güncel Yaklasimlar 14, 119–130. Available online at: https://dergipark.org.tr/en/download/article-file/1710158 [Google Scholar]
  11. Bae G., Park S., Jin Y., Yoon M. (2021). Study on the mediating effect of self focused attention and depression in the relationship of effect between the HUMAN's self esteem and inter personal problems. Int. J. Hum. Disaster 6, 1–16. doi: 10.22471/disaster.2021.6.4.01 [DOI] [Google Scholar]
  12. Bailey N. W., Comte W., Chambers R., Bartlett L., Connaughton S., Hassed C. (2023). Participation in online mindfulness was associated with improved self-compassion and prosocial attitudes. Mindfulness 14, 1735–1750. doi: 10.1007/s12671-023-02168-7 [DOI] [Google Scholar]
  13. Bhattacharya S., Kennedy M., Miguel C., Tröger A., Hofmann S. G., Cuijpers P. (2023). Effect of psychotherapy for adult depression on self-esteem: a systematic review and meta-analysis. J. Affect. Disord. 325, 572–581. doi: 10.1016/j.jad.2023.01.047 [DOI] [PubMed] [Google Scholar]
  14. Bischof G., Bischof A., Velleman R., Orford J., Kuhnert R., Allen J., et al. (2022). Bagimlilik bozukluklarindan etkilenen aile üyelerinin yayginligi ve kendi kendine degerlendirilen saglik ve depresyonu: ülke çapinda kesitsel bir çalişmanin sonuçlari. Bagimlilik 117, 3140–3147. doi: 10.1111/add.15960 [DOI] [Google Scholar]
  15. Braem S., Egner T. (2018). Getting a grip on cognitive flexibility. Curr. Dir. Psychol. Sci. 27, 470–476. doi: 10.1177/0963721418787475 [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Brophy K., Brähler E., Hinz A., Schmidt S., Körner A. (2020). The role of self-compassion in the relationship between attachment, depression, and quality of life. J. Affect. Disord. 260, 45–52. doi: 10.1016/j.jad.2019.08.066 [DOI] [PubMed] [Google Scholar]
  17. Canas J. J., Fajardo I., Salmeron L. (2006). Cognitive flexibility. Int. Encycl. Ergon. Hum. Fact. 1, 297–301. [Google Scholar]
  18. Çeştan E. (2020). Öz-şefkat ve psikolojik esnekligin depresyon ile arasindaki ilişki (Yüksek Lisans Tezi). Hasan Kalyoncu Üniversitesi; YÖK Tez Merkezi. Available online at: https://tez.yok.gov.tr/UlusalTezMerkezi (Accessed October 6, 2026). [Google Scholar]
  19. Chamberlain J. M., Haaga D. A. (2001a). Unconditional self-acceptance and psychological health. J. Rational Emot. Cogn. Behav. Ther. 19, 163–176. doi: 10.1023/A:1011189416600 [DOI] [Google Scholar]
  20. Chamberlain J. M., Haaga D. A. (2001b). Unconditional self-acceptance and responses to negative feedback. J. Rational Emot. Cogn. Behav. Ther. 19, 177–189. doi: 10.1023/A:1011141500670 [DOI] [Google Scholar]
  21. Ciarrochi J., Hayes S. C., Oades L. G., Hofmann S. G. (2022). Toward a unified framework for positive psychology interventions: evidence-based processes of change in coaching, prevention, and training. Front. Psychol. 12:809362. doi: 10.3389/fpsyg.2021.809362 [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Circir O., Tagay Ö. (2024). The relationships between cognitive flexibility, perfectionism, optimism, self-compassion and psychological well-being: a mixed study. Curr. Psychol. 43, 19830–19846. doi: 10.1007/s12144-024-05775-2 [DOI] [Google Scholar]
  23. Crisan S., Canache M., Buksa D., Nechita D. (2023). A comparison between self-compassion and unconditional self-acceptance: interventions on self-blame, empathy, shame-, guilt-proneness, and performance. J. Rational Emot. Cogn. Behav. Ther. 41, 64–80. doi: 10.1007/s10942-022-00451-5 [DOI] [Google Scholar]
  24. Cunningham S., Hudson C. C., Harkness K. (2021). Social media and depression symptoms: a meta-analysis. Res. Child. Adolesc. Psychopathol. 49, 241–253. doi: 10.1007/s10802-020-00715-7 [DOI] [PubMed] [Google Scholar]
  25. Curtiss J., Klemanski D. H. (2014). Teasing apart low mindfulness: differentiating deficits in mindfulness and in psychological flexibility in predicting symptoms of generalized anxiety disorder and depression. J. Affect. Disord. 166, 41–47. doi: 10.1016/j.jad.2014.04.062 [DOI] [PubMed] [Google Scholar]
  26. Dajani D. R., Uddin L. Q. (2015). Demystifying cognitive flexibility: implications for clinical and developmental neuroscience. Trends Neurosci. 38, 571–578. doi: 10.1016/j.tins.2015.07.003 [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. de Souza L. K., Policarpo D., Hutz C. S. (2020). Self-compassion and symptoms of stress, anxiety, and depression. Trends Psychol. 28, 85–98. doi: 10.1007/s43076-020-00018-2 [DOI] [Google Scholar]
  28. Deniz M., Kesici S., Sümer A. S. (2008). The validity and reliability of the Turkish version of the self-compassion scale. Social Behav. Pers. Int. J. 36, 1151–1160. doi: 10.2224/sbp.2008.36.9.1151 [DOI] [Google Scholar]
  29. Deniz M. E., Sümer A. S. (2010). Farkli özanlayiş düzeylerine sahip üniversite ögrencilerinde depresyon, anksiyete ve stresin degerlendirilmesi. Egitim Bilim 35, 115–127. doi: 10.15390/ES.2010.895 [DOI] [Google Scholar]
  30. Dennis J. P., Vander Wal J. S. (2010). The cognitive flexibility inventory: instrument development and estimates of reliability and validity. Cognit. Ther. Res. 34, 241–253. doi: 10.1007/s10608-009-9276-4 [DOI] [Google Scholar]
  31. Di Fabio A., Saklofske D. H. (2021). The relationship of compassion and self-compassion with personality and emotional intelligence. Pers. Individ. Dif. 169:110109. doi: 10.1016/j.paid.2020.110109 [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Didin M., Yavuz B. (2022). Covid-19′un ögrencilerin stres, anksiyete, depresyon, korku düzeylerine etkisi: Sistematik derleme. Psikiyatride Güncel Yaklaşimlar 14, 38–45. doi: 10.18863/pgy.931572 [DOI] [Google Scholar]
  33. Dinger U., Ehrenthal J. C., Nikendei C., Schauenburg H. (2017). Change in self-esteem predicts depressive symptoms at follow-up after intensive multimodal psychotherapy for major depression. Clin. Psychol. Psychother. 24, 1040–1046. doi: 10.1002/cpp.2067 [DOI] [PubMed] [Google Scholar]
  34. Dogan M. V. (2021). Üniversite ögrencilerinde sosyal medya bagimliligi belirtilerinin ve sosyal medya bagimliligi ile depresyon arasindaki ilişkinin incelenmesi (Yüksek Lisans Tezi). Istanbul Gelişim Üniversitesi; YÖK Tez Merkezi. Available online at: https://tez.yok.gov.tr/UlusalTezMerkezi (Accessed October 6, 2026). [Google Scholar]
  35. Egan S. J., Rees C. S., Delalande J., Greene D., Fitzallen G., Brown S., et al. (2022). A review of self-compassion as an active ingredient in the prevention and treatment of anxiety and depression in young people. Admin. Policy Mental Health Mental Health Serv. Res. 49, 385–403. doi: 10.1007/s10488-021-01170-2 [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Ergün K. (2020). Pozitif psikoloji penceresinden ergenlerde benlik saygisinin yeme bozuklugu ve metabolik sendrom ile ilişkisi (Yüksek Lisans Tezi). Üsküdar Üniversitesi; YÖK Tez Merkezi. Available online at: https://tez.yok.gov.tr/UlusalTezMerkezi (Accessed October 6, 2026). [Google Scholar]
  37. Etemadi Shamsababdi P., Dehshiri G. R. (2024). Self-compassion, anxiety and depression symptoms; the mediation of shame and guilt. Psychol. Rep. 129, 127–143. doi: 10.1177/00332941241227525 [DOI] [PubMed] [Google Scholar]
  38. Fan L., Chen Y., Zhu M., Mao Z., Li N. (2023). Correlation between childhood trauma experience and depressive symptoms among young adults: the potential mediating role of loneliness. Child Abuse Neglect 144:106358. doi: 10.1016/j.chiabu.2023.106358 [DOI] [PubMed] [Google Scholar]
  39. Faustino B., Vasco A. B., Silva A. N., Marques T. (2020). Relationships between emotional schemas, mindfulness, self-compassion and unconditional self-acceptance on the regulation of psychological needs. Res. Psychother. Psychopathol. Process Outcome 23:442. doi: 10.4081/ripppo.2020.442 [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Fukuzaki T., Takeda S. (2022). The relationship between cognitive flexibility, depression, and work performance: employee assessments using cognitive flexibility tests. J. Affect. Disord. Rep. 10:100388. doi: 10.1016/j.jadr.2022.100388 [DOI] [Google Scholar]
  41. Gabrys R. L., Tabri N., Anisman H., Matheson K. (2018). Cognitive control and flexibility in the context of stress and depressive symptoms: the cognitive control and flexibility questionnaire. Front. Psychol. 9:2219. doi: 10.3389/fpsyg.2018.02219 [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Gao W., Luo Y., Cao X., Liu X. (2022). Gender differences in the relationship between self-esteem and depression among college students: a cross-lagged study from China. J. Res. Pers. 97:104202. doi: 10.1016/j.jrp.2022.104202 [DOI] [Google Scholar]
  43. Gao W., Yan X., Chen Y., Yang J., Yuan J. (2025). Situation covariation and goal adaptiveness? The promoting effect of cognitive flexibility on emotion regulation in depression. Emotion 25, 18–32. doi: 10.1037/emo0001410 [DOI] [PubMed] [Google Scholar]
  44. García-Fernández M., Fuentes-Sánchez N., Escrig M. A., Eerola T., Pastor M. C. (2025). Gender, emotion regulation, and cognitive flexibility as predictors of depression, anxiety, and affect in healthy adults. Curr. Psychol. 44, 5685–5694. doi: 10.1007/s12144-024-07240-6 [DOI] [Google Scholar]
  45. Germer C., Neff K. (2020). Mon cahier d'autocompassion en pleine conscience: comment apprendre à s' aimer. De Boeck Supérieur. [Google Scholar]
  46. Germer C. K., Neff K. D. (2013). Self-compassion in clinical practice. J. Clin. Psychol. 69, 856–867. doi: 10.1002/jclp.22021 [DOI] [PubMed] [Google Scholar]
  47. Goodwin R. D., Dierker L. C., Wu M., Galea S., Hoven C. W., Weinberger A. H. (2022). Trends in US depression prevalence from 2015 to 2020: the widening treatment gap. Am. J. Prev. Med. 63, 726–733. doi: 10.1016/j.amepre.2022.05.014 [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Güler K. A. (2022). The relationship between self-compassion, cognitive flexibility and psychological symptoms. Pakistan J. Med. Health Sci. 16, 454–458. doi: 10.53350/pjmhs22161454 [DOI] [Google Scholar]
  49. Guo J., Huang X., Zheng A., Chen W., Lei Z., Tang C., et al. (2022). The influence of self-esteem and psychological flexibility on medical college students' mental health: a cross-sectional study. Front. Psychiatry 13:836956. doi: 10.3389/fpsyt.2022.836956 [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Haehner P., Driver C. C., Hopwood C. J., Luhmann M., Fliedner K., Bleidorn W. (2025). The dynamics of self-esteem and depressive symptoms across days, months, and years. J. Pers. Social Psychol. 128, 930–948. doi: 10.1037/pspp0000542 [DOI] [PubMed] [Google Scholar]
  51. Han A., Kim T. H. (2023). Effects of self-compassion interventions on reducing depressive symptoms, anxiety, and stress: a meta-analysis. Mindfulness 14, 1553–1581. doi: 10.1007/s12671-023-02148-x [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Hayes A. F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York, NY: The Guilford Press. [Google Scholar]
  53. Hilbert S., Goerigk S., Padberg F., Nadjiri A., Übleis A., Jobst A., et al. (2019). The role of self-esteem in depression: a longitudinal study. Behav. Cogn. Psychother. 47, 244–250. doi: 10.1017/S1352465818000243 [DOI] [PubMed] [Google Scholar]
  54. Hughes M., Brown S. L., Campbell S., Dandy S., Cherry M. G. (2021). Self-compassion and anxiety and depression in chronic physical illness populations: a systematic review. Mindfulness 12, 1597–1610. doi: 10.1007/s12671-021-01602-y [DOI] [Google Scholar]
  55. Jouybari F. T., Ghoreishi M. K. (2025). Predicting rumination based on spiritual intelligence, cognitive flexibility, and self-esteem. J. Fundament. Mental Health 27, 131–138. doi: 10.22038/JFMH.2024.81765.3153 [DOI] [Google Scholar]
  56. Kafes A. Y. (2021). Depresyon ve anksiyete bozukluklari üzerine bir bakiş. Uluslararasi Psikolojik Danişma Rehberlik Araştirmalari Dergisi 3, 186–194. doi: 10.47793/hp.867111 [DOI] [Google Scholar]
  57. Kagan M., Tleubayev R. (2020). Türkiye' de ve Kazakistan' da ögrenim gören üniversite ögrencilerinin depresyon ve yasam doyumu düzeylerinin karsilastirilmasi. Premium e-J. Soc. Sci. 4. doi: 10.37242/pejoss.10 [DOI] [Google Scholar]
  58. Karasar N. (2014). Bilimsel araştirma yöntemleri, 26. Basim. Ankara: Nobel Yayinevi. [Google Scholar]
  59. Kicali Ü. (2015). Öz-şefkat ve tekrarlayici düşünmenin olumsuz duygulanim ve depresyon ile ilişkilerinin incelenmesi (Yüksek Lisans Tezi). Maltepe Üniversitesi; YÖK Tez Merkezi. Available online at: https://tez.yok.gov.tr/UlusalTezMerkezi (Accessed October 6, 2026). [Google Scholar]
  60. Ko C. M., Grace F., Chavez G. N., Grimley S. J., Dalrymple E. R., Olson L. E. (2018). Effect of seminar on compassion on student self-compassion, mindfulness and well-being: a randomized controlled trial. J. Am. Coll. Health 66, 537–545. doi: 10.1080/07448481.2018.1431913 [DOI] [PubMed] [Google Scholar]
  61. Kroshus E., Hawrilenko M., Browning A. (2021). Stress, self-compassion, and well-being during the transition to college. Soc. Sci. Med. 269:113514. doi: 10.1016/j.socscimed.2020.113514 [DOI] [PubMed] [Google Scholar]
  62. Küçük M. (2020). Yetişkinlerin öz şefkat, baglanma stilleri ve psikolojik iyi oluş özelliklerinin incelenmesi (Yüksek Lisans Tezi: ). Istanbul Gelişim Üniversitesi; YÖK Tez Merkezi. Available online at: https://tez.yok.gov.tr/UlusalTezMerkezi (Accessed October 6, 2026). [Google Scholar]
  63. Kulbaş E. (2021). Pozitif psikoloji temelli çevrimiçi grupla psikolojik danişma programinin zihinsel yetersizligi olan çocuga sahip annelerin psikolojik iyi oluş, öz anlayiş ve umut düzeylerine etkisi (Doktora Tezi: ). Eskişehir Osmangazi Üniversitesi; YÖK Tez Merkezi. Available online at: https://tez.yok.gov.tr/UlusalTezMerkezi (Accessed October 6, 2026). [Google Scholar]
  64. Levola J., Eskelinen S., Pitkänen T. (2020). Associations between self-rated health, quality of life and symptoms of depression among Finnish inpatients with alcohol and substance use disorders. J. Subst. Use 25, 128–134. doi: 10.1080/14659891.2019.1664667 [DOI] [Google Scholar]
  65. Li X., Malli M. A., Cosco T. D., Zhou G. (2024). The relationship between self-compassion and resilience in the general population: protocol for a systematic review and meta-analysis. JMIR Res. Protoc. 13:e60154. doi: 10.2196/60154 [DOI] [PMC free article] [PubMed] [Google Scholar]
  66. Lou X., Wang H., Minkov M. (2022). The correlation between self-compassion and depression revisited: a three-level meta-analysis. Mindfulness 13, 2128–2139. doi: 10.1007/s12671-022-01958-9 [DOI] [Google Scholar]
  67. Lovibond P. F., Lovibond S. H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav. Res. Ther. 33, 335–343. Available online at: https://www.sciencedirect.com/science/article/abs/pii/000579679400075U [DOI] [PubMed] [Google Scholar]
  68. Luo J., Wong N. M., Zhang R., Wu J., Shao R., Chan C. C., et al. (2024). A network analysis of rumination on loneliness and the relationship with depression. Nat. Mental Health 3, 1–12. doi: 10.1038/s44220-024-00350-x [DOI] [Google Scholar]
  69. MacBeth A., Gumley A. (2012). Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology. Clin. Psychol. Rev. 32, 545–552. doi: 10.1016/j.cpr.2012.06.003 [DOI] [PubMed] [Google Scholar]
  70. Marshall E. J., Brockman R. N. (2016). The relationships between psychological flexibility, self-compassion, and emotional well-being. J. Cogn. Psychother. 30, 60–72. doi: 10.1891/0889-8391.30.1.60 [DOI] [PubMed] [Google Scholar]
  71. Martin M. M., Rubin R. B. (1995). A new measure of cognitive flexibility. Psychol. Rep. 76, 623–626. doi: 10.2466/pr0.1995.76.2.623 [DOI] [Google Scholar]
  72. Martin M. M., Staggers S. M., Anderson C. M. (2011). The relationships between cognitive flexibility with dogmatism, intellectual flexibility, preference for consistency, and self-compassion. Commun. Res. Rep. 28, 275–280. doi: 10.1080/08824096.2011.587555 [DOI] [Google Scholar]
  73. Moksnes U. K., Bradley Eilertsen M. E., Lazarewicz M. (2016). The association between stress, self-esteem and depressive symptoms in adolescents. Scand. J. Psychol. 57, 22–29. doi: 10.1111/sjop.12269 [DOI] [Google Scholar]
  74. Muris P., Otgaar H. (2023). Self-esteem and self-compassion: a narrative review and meta-analysis on their links to psychological problems and well-being. Psychol. Res. Behav. Manag. 16, 2961–2975. doi: 10.2147/PRBM.S402455 [DOI] [PMC free article] [PubMed] [Google Scholar]
  75. Naderi H., Alizadeh S., Alipour Z., Azdin S. M., Khalilnezhad M. (2023). Negative spontaneous thoughts and depression in adolescents with suicidal ideation: mediating role of cognitive distortion and cognitive flexibility. Int. J. Health Stud. 9, 31–39. doi: 10.22100/qknmhd94 [DOI] [Google Scholar]
  76. Neff K. D. (2003). The development and validation of a scale to measure self-compassion. Self Identity 2, 223–250. doi: 10.1080/15298860309027 [DOI] [Google Scholar]
  77. Neff K. D. (2008). “Self-compassion: moving beyond the pitfalls of a separate self-concept,” in Transcending Self-interest: Psychological Explorations of the Quiet Ego, eds. Wayment H. A., Bauer J. J. (Washington, DC: American Psychological Association; ), 95–105. doi: 10.1037/11771-009 [DOI] [Google Scholar]
  78. Neff K. D. (2023). Self-compassion: theory, method, research, and intervention. Annu. Rev. Psychol. 74, 193–218. doi: 10.1146/annurev-psych-032420-031047 [DOI] [PubMed] [Google Scholar]
  79. Neff K. D., Germer C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. J. Clin. Psychol. 69, 28–44. [DOI] [PubMed] [Google Scholar]
  80. Neff K. D., Kirkpatrick K. L., Rude S. S. (2007). Self-compassion and adaptive psychological functioning. J. Res. Pers. 41, 139–154. doi: 10.1016/j.jrp.2006.03.004 [DOI] [Google Scholar]
  81. Okan Er Y., Deniz M. E. (2022). The mediating role of self-compassion and cognitive flexibility in the relationship between differentiation of self and subjective well-being. Cukurova Univ. Facul. Educ. J. 51, 1642–1680. doi: 10.14812/cuefd.1074927 [DOI] [Google Scholar]
  82. Ólafsdóttir J., Hrafnsdóttir S., Orjasniemi T. (2018). Depression, anxiety, and stress from substance-use disorder among family members in Iceland. Nordic Stud. Alcohol Drugs 35, 165–178. doi: 10.1177/1455072518766129 [DOI] [PMC free article] [PubMed] [Google Scholar]
  83. Pandey R., Tiwari G. K., Parihar P., Rai P. K. (2021). Positive, not negative, self-compassion mediates the relationship between self-esteem and well-being. Psychol. Psychother. Theory Res. Prac. 94, 1–15. doi: 10.1111/papt.12259 [DOI] [PubMed] [Google Scholar]
  84. Popov S. (2019). When is unconditional self-acceptance a better predictor of mental health than self-esteem?. J. Rational Emot. Cogn. Behav. Ther. 37, 251–261. doi: 10.1007/s10942-018-0310-x [DOI] [Google Scholar]
  85. Pyszkowska A. (2020). Personality predictors of self-compassion, ego-resiliency and psychological flexibility in the context of quality of life. Pers. Individ. Dif. 161:109932. doi: 10.1016/j.paid.2020.109932 [DOI] [Google Scholar]
  86. Reis N. (2020). Ödüle/cezaya duyarlilik, bilişsel esneklik ve depresyon arasindaki ilişki: duygu düzenleme güçlüklerinin araci rolü (Yüksek Lisans Tezi). Istanbul Sabahattin Zaim Üniversitesi; YÖK Tez Merkezi. Available online at: https://tez.yok.gov.tr/UlusalTezMerkezi (Accessed October 6, 2026). [Google Scholar]
  87. Remes O., Mendes J. F., Templeton P. (2021). Biological, psychological, and social determinants of depression: a review of recent literature. Brain Sci. 11:1633. doi: 10.3390/brainsci11121633 [DOI] [PMC free article] [PubMed] [Google Scholar]
  88. Saldivia S., Aslan J., Cova F., Bustos C., Inostroza C., Castillo-Carreño A. (2023). Life satisfaction, positive affect, depression and anxiety symptoms, and their relationship with sociodemographic, psychosocial, and clinical variables in a general elderly population sample from Chile. Front. Psychiatry 14:1203590. doi: 10.3389/fpsyt.2023.1203590 [DOI] [PMC free article] [PubMed] [Google Scholar]
  89. Sanghvi D. E., Zainal N. H., Newman M. G. (2023). Trait self-acceptance mediates parental childhood abuse predicting depression and anxiety symptoms in adulthood. J. Anxiety Disord. 94:102673. doi: 10.1016/j.janxdis.2023.102673 [DOI] [PMC free article] [PubMed] [Google Scholar]
  90. Sayin P., Karaaziz M. (2024). Üniversite Ögrencilerinde Çocukluk Çagi Travmasinin Depresif Belirtiler ile Öz-Sefkat Ilişkisinin Incelenmesi. Int. J. Social Sci. Uluslararasi Sosyal Bilimler Dergisi 8, 181–201. doi: 10.52096/usbd.8.34.11 [DOI] [Google Scholar]
  91. Serrão C., Valquaresma A., Rodrigues A. R., Duarte I. (2023). Mediation of self-compassion on pathways from stress and anxiety to depression among portuguese higher education students. Healthcare 11:2494. doi: 10.3390/healthcare11182494 [DOI] [PMC free article] [PubMed] [Google Scholar]
  92. Simon G. E., Moise N., Mohr D. C. (2024). Management of depression in adults: a review. JAMA 332, 141–152. doi: 10.1001/jama.2024.5756 [DOI] [PubMed] [Google Scholar]
  93. Tafarojei A., Yousefi F. (2021). Relation of emotional intelligence to subjective vitality: mediating role of self-compassion. J. Psychol. Sci. 20, 283–294. [Google Scholar]
  94. Topkaya N., Köksal Z., Bayram S. (2022). Ergenlerde iyi oluşun yordanmasinda bilişsel esneklik ve öz-şefkatin rolü. Bati Anadolu Egitim Bilimleri Dergisi 13, 646–662. doi: 10.51460/baebd.1084576 [DOI] [Google Scholar]
  95. Tran M. A. Q., Vo-Thanh T., Soliman M., Khoury B., Chau N. N. T. (2022). Self-compassion, mindfulness, stress, and self-esteem among Vietnamese university students: psychological well-being and positive emotion as mediators. Mindfulness 13, 2574–2586. doi: 10.1007/s12671-022-01980-x [DOI] [PMC free article] [PubMed] [Google Scholar]
  96. Viskovich S., De George-Walker L. (2019). An investigation of self-care related constructs in undergraduate psychology students: self-compassion, mindfulness, self-awareness, and integrated self-knowledge. Int. J. Educ. Res. 95, 109–117. doi: 10.1016/j.ijer.2019.02.005 [DOI] [Google Scholar]
  97. Wang Y., Fu T., Wang J., Chen S., Sun G. (2024). The relationship between self-compassion, coping style, sleep quality, and depression among college students. Front. Psychol. 15:1378181. doi: 10.3389/fpsyg.2024.1378181 [DOI] [PMC free article] [PubMed] [Google Scholar]
  98. Warren R., Smeets E., Neff K. (2016). Self-criticism and self-compassion: risk and resilience: being compassionate to oneself is associated with emotional resilience and psychological well-being. Curr. Psychiatr. 15, 18–28. [Google Scholar]
  99. World Health Organization (2023). Depression. Available online at: https://www.who.int/news-room/fact-sheets/detail/depression (Accessed October 6, 2026).
  100. Yadavaia J. E., Hayes S. C., Vilardaga R. (2014). Using acceptance and commitment therapy to increase self-compassion: a randomized controlled trial. J. Contextual Behav. Sci. 3, 248–257. doi: 10.1016/j.jcbs.2014.09.002 [DOI] [PMC free article] [PubMed] [Google Scholar]
  101. Yazar M. S., Meterelliyoz K. S. (2019). Klinik olmayan populasyonda depresif semptomatoloji, bilişsel esneklik ve umutsuzluk ilişkisinin incelenmesi. Bilişsel Davranişçi Psikoterapi Araştirmalar Dergisi 8, 155–163. doi: 10.5455/JCBPR.24354 [DOI] [Google Scholar]
  102. Yelpaze I. (2020). Üniversite ögrencilerinde psikolojik saglamligin yordayicisi olarak bilişsel esneklik: Öz şefkatin aracilik rolü. Erzincan Üniversitesi Egitim Fakültesi Dergisi 22, 535–549. doi: 10.17556/erziefd.631767 [DOI] [Google Scholar]
  103. Yilmaz Bingöl T., Vural Batik M. (2018). Psikolojik danişman adaylarinin koşulsuz kendini kabul düzeyleri. Insan ve Toplum Bilimleri Araştirmalari Dergisi 7, 2438–2453. doi: 10.15869/itobiad.444355 [DOI] [Google Scholar]
  104. Yilmaz M. S. (2024). Ergenlerde beden algisi ile psikolojik belirtiler arasindaki ilişkide benlik saygisi ve öz şefkatin araci rolü (Yüksek Lisans Tezi: ). Istanbul Sabahattin Zaim Üniversitesi. Available online at: https://tez.yok.gov.tr/UlusalTezMerkezi (Accessed October 6, 2026). [Google Scholar]
  105. Yilmaz Ö., Boz H., Arslan A. (2017). Depresyon anksiyete stres ölçeginin(dass 21) türkçe kisa formunun geçerlilik-güvenilirlik çalişmasi. Finans Ekonomi ve Sosyal Araştirmalar Dergisi 2, 78–91. [Google Scholar]
  106. Yu Y., Yu Y., Lin Y. (2020). Anxiety and depression aggravate impulsiveness: the mediating and moderating role of cognitive flexibility. Psychol. Health Med. 25, 25–36. doi: 10.1080/13548506.2019.1601748 [DOI] [PubMed] [Google Scholar]
  107. Zhang X., Wang J., Wang Y., Wang J., Luo F. (2024). The effects of mindfulness on shame: exploring mediation by cognitive flexibility and self-compassion in a Chinese adult population. PsyCh J. 14, 155–312. doi: 10.21203/rs.3.rs-4217802/v1 [DOI] [PMC free article] [PubMed] [Google Scholar]
  108. Zipagan F. B., Galvez Tan L. J. T. (2023). From self-compassion to life satisfaction: examining the mediating effects of self-acceptance and meaning in life. Mindfulness 14, 2145–2154. doi: 10.1007/s12671-023-02183-8 [DOI] [Google Scholar]
  109. Zou Y., Wang R., Xiong X., Bian C., Yan S., Zhang Y. (2025). Effects of acceptance and commitment therapy on negative emotions, automatic thoughts and psychological flexibility for depression and its acceptability: a meta-analysis. BMC Psychiatry 25:602. doi: 10.1186/s12888-025-07067-w [DOI] [PMC free article] [PubMed] [Google Scholar]

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