Beyond Self-Stigma in Bipolar Disorder: Self-Compassion as a Target for Mental Health Nursing Interventions-Conditional Indirect Effects by Treatment Adherence and Age

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dc.contributor.authorYildiz, Erman
dc.contributor.authorOrum, Gamze
dc.date.accessioned2026-04-04T13:33:22Z
dc.date.available2026-04-04T13:33:22Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractSelf-stigma profoundly impacts psychological well-being in individuals with bipolar disorder, yet the mechanisms underlying this relationship remain unclear. This study examined whether self-compassion mediates the relationship between self-stigma and psychological well-being, whether treatment adherence moderates this mediating pathway, and whether age moderates the direct relationship. A cross-sectional study was conducted with 121 outpatients diagnosed with Bipolar Type I Disorder receiving care at two hospitals in Eastern T & uuml;rkiye between January 2024 and February 2025. Participants completed validated measures of self-stigma, self-compassion, and psychological well-being during clinical remission. Data were analysed using mediation, moderated mediation, and simple moderation models with bootstrap procedures. Self-stigma demonstrated a strong negative total effect on well-being. Self-compassion partially mediated this relationship, explaining 27% of the total effect. Critically, moderated mediation analysis revealed that treatment adherence significantly altered the strength of this mediating pathway. Among individuals with poor treatment adherence, self-stigma more severely compromised self-compassion, resulting in a substantially stronger indirect effect on well-being compared to those with good adherence. The difference between these conditional indirect effects was statistically significant. Additionally, age moderated the direct relationship between self-stigma and well-being, with younger adults showing greater vulnerability than older adults, though age did not moderate the self-compassion pathway. These findings identify self-compassion as a key but conditionally effective protective mechanism against self-stigma. Treatment adherence emerges as a critical factor that preserves this protective mechanism, suggesting that adherence promotion represents both a clinical and psychosocial intervention target for mental health nurses.
dc.identifier.doi10.1111/inm.70239
dc.identifier.issn1445-8330
dc.identifier.issn1447-0349
dc.identifier.issue1
dc.identifier.orcid0000-0002-6544-4847
dc.identifier.pmid41714148
dc.identifier.scopus2-s2.0-105030603466
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1111/inm.70239
dc.identifier.urihttps://hdl.handle.net/11616/109098
dc.identifier.volume35
dc.identifier.wosWOS:001702150000015
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofInternational Journal of Mental Health Nursing
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectbipolar disorder
dc.subjectmental health nursing
dc.subjectmoderation analysis
dc.subjectself-compassion
dc.subjectstigma
dc.titleBeyond Self-Stigma in Bipolar Disorder: Self-Compassion as a Target for Mental Health Nursing Interventions-Conditional Indirect Effects by Treatment Adherence and Age
dc.typeArticle

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