|Year : 2021 | Volume
| Issue : 1 | Page : 22-28
Procrastination and self-compassion in individuals with anxiety disorders
Pratishtha Petwal, Paulomi Matam Sudhir, Seema Mehrotra
Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
|Date of Submission||29-Apr-2021|
|Date of Decision||10-May-2021|
|Date of Acceptance||22-May-2021|
|Date of Web Publication||18-Jul-2021|
Dr. Paulomi Matam Sudhir
Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
Background and Aim: Literature on procrastination suggests that it is related to varied negative outcomes in the nonclinical population; however, there is a paucity of studies examining procrastination in the clinical population. We examined procrastination and self-compassion in persons with anxiety disorders.
Methods: Forty-nine individuals diagnosed with an anxiety disorder, between 18 and 50 years of age, were recruited from a tertiary care center. Participants were assessed using the Decisional Procrastination Scale, the Adult Inventory of Procrastination, the Self-Compassion Scale, the Overall Anxiety Severity and Impairment Scale, and the Beck Depression Inventory-II.
Results: Results indicated that individuals with anxiety disorders reported elevated procrastination and low self-compassion. Self-compassion and decisional procrastination were significantly negatively correlated. The subjective distress due to procrastination reported by the participants was significantly positively correlated with decisional procrastination. Self-compassion and anxiety severity were found to be negatively correlated. Self-compassion was a significant predictor of decisional procrastination and anxiety severity.
Conclusion: The findings of the present study highlight the significance of assessing procrastination in anxiety disorders and indicate that self-compassion-based interventions may be helpful in alleviating anxiety symptoms and in reducing decisional procrastination.
Keywords: Anxiety disorders, depression, procrastination, self-compassion
|How to cite this article:|
Petwal P, Sudhir PM, Mehrotra S. Procrastination and self-compassion in individuals with anxiety disorders. Telangana J Psychiatry 2021;7:22-8
|How to cite this URL:|
Petwal P, Sudhir PM, Mehrotra S. Procrastination and self-compassion in individuals with anxiety disorders. Telangana J Psychiatry [serial online] 2021 [cited 2021 Oct 23];7:22-8. Available from: http://www.:tjpipstsb.org/text.asp?2021/7/1/22/321768
| Introduction|| |
Procrastination is the voluntary delaying of a planned task despite the knowledge of its negative consequences, and is related to several negative psychological outcomes., Procrastination has been studied both in the context of a delay in acting (behavioral procrastination) and a delay in decision-making or decisional procrastination. It has been conceptualized as both a trait and a state variable. Despite a vast amount of research, there is a want of agreement about the nature of procrastination and it is sometimes considered a personality variable. Trait procrastination is defined as the likelihood to delay a task that is otherwise essential to attain goals. Task procrastination can involve various psychological factors, such as task aversiveness, fear of failing, emotional disturbance, tendency to rebel, impulsivity, difficulties managing time, external aspects, as well as a tendency to enjoy working in pressure. These factors may be understood as failures in self-regulation and an attempt at temporary mood regulation.
Procrastination has drawn considerable attention from researchers, largely with respect to academic procrastination. In clinical populations, procrastination has been found to be positively related to anxiety and depression. Procrastination has also been considered to be an attempt at temporary mood repair, achieved by delaying decision-making or the task. However, it is ineffective in the long run and linked with increased negative affect., Thus, negative mood may result in task delays, further prolonging negative affect, therefore not only resulting from procrastination but also leading to it.
From a regulatory framework, procrastination is seen as a failure of one's self-regulatory ability, and in monitoring and prioritizing goals, eventually leading to a sense of failure and criticality toward self. This perspective has led to the exploration of the relationship between procrastination and self-compassion. Self-compassion refers to an individual's attitude toward self and plays an important role in how people engage in problem-solving in everyday situations. Self-compassion is defined as kindness to oneself in the face of inadequacy and failures, and acceptance of one's negative emotions, as part of collective human experience. Greater level of self-compassion has been related to lesser self-conscious emotions such as shame or guilt, greater self-forgiveness, and reduction in future procrastination and negative mood., Self-compassion may thus act as a buffer in the experience of negative events and enhance positive feelings toward oneself when encountering difficulties. Studies examining self-compassion and anxiety across clinical samples suggest that self-compassion reduces the severity of anxiety and functions as a buffer.,,
Recent evidence indicates that the distress connected with procrastination may be due to intrapersonal processes linked to negative self-evaluations and self-criticality that procrastinators experience, when dealing with difficult tasks, in addition to failure in task completion., Procrastinators report a “downward spiral” that begins once they begin procrastinating, this adds more unfinished work for future, increases urgency, and at the same time affects self-evaluation, resulting in increased anxiety and stress. A meta-analysis investigating self-compassion as a mediator of the trait procrastination-distress link revealed procrastination and self-compassion to be moderately negatively related. Self-compassion is a resilience factor.It promotes adaptive self-regualtory skills and thereby reduces distress related to negative self-evaluation and it impact on self. Self-compassion indicates reduced self-criticality and harshness toward self, thereby reduced negative affect, including those emotions associated with procrastination.
Anxiety disorders have high prevalence and are categorized as significantly contributing to global disease burden of disability-adjusted life years. A national mental health survey in the Indian subcontinent reported a lifetime prevalence of anxiety disorders as 3.7%. Anxiety disorders are heterogeneous in nature and may often have a waxing and waning course and tend to be chronic. Individuals with anxiety disorders use a variety of behavioral and cognitive strategies to reduce their anxiety. In addition, they also experience significant difficulty in decision-making and problem-solving,, which may often result in procrastination. There is considerable impairment in functioning, often as a result of factors such as task avoidance, procrastination, perfectionism, and fear of failure.
Studies indicate that individuals who tend to procrastinate may be more self-critical, contributing to their distress and anxiety, and they further procrastinate as a way of coping with emotions. While individuals who procrastinate experience considerable stress and negative emotions, factors contributing to this relationship of mitigating the experience of stress are not clear. There is a dearth of studies in clinical populations and few examine this relationship in the context of anxiety disorders. Understanding factors contributing to these outcomes of procrastination and distress or anxiety, would help in identifying specific treatment components. There is some evidence supporting the finding that the procrastination-stress link may be mediated by self-compassion, which is considered to be the antithesis of self-criticality., Therefore, in the present study, we examined procrastination in persons with anxiety disorders, and the relationship between procrastination and self-compassion. Specifically, our study attempted to address the following questions, namely what is the nature of procrastination reported by persons with anxiety disorders, and the role of self-compassion with negative mental health outcomes of anxiety, depression, and procrastination in this sample.
| Methods|| |
The present study was a cross-sectional study, and a nonprobability convenience sampling method was used. Forty-nine treatment-seeking adults, fulfilling criteria for a primary diagnosis of agoraphobia, panic disorder, specific phobia, social phobia, generalized anxiety disorder, obsessive–compulsive disorder, mixed anxiety and depressive disorder, other specified anxiety disorder, or anxiety disorder unspecified as per ICD 10 (F40-42), aged between 18 and 50 years were recruited into the study. Those with a diagnosis of bipolar affective disorder, schizophrenia, current psychoactive substance dependence (except nicotine), and those who had received psychotherapy in the last 6 months were excluded.
Participants were assessed on measures of procrastination, self-compassion, and severity of anxiety and depression. Permission was sought from authors for the use of measures that were not available in the public domain, and copyrighted measures were purchase from publishers.
Decisional Procrastination Scale
Decisional Procrastination Scale (DPS) is a 5-item scale that examines procrastination in the context of conditions where one is required to make decisions. Participants are asked to rate the items on a Likert scale from 1 (not true for me) to 5 (true for me). A single score computed by summing all items indicates the propensity to engage in procrastination. It has also shown good internal consistency (α = 0.80).
Adult Inventory of Procrastination
The Adult Inventory of Procrastination (AIP) is a 15-item scale that assesses procrastinatory behaviors manifesting in various day-to-day activities. The extent of disagreement (1) or agreement (5) with the items is rated along a Likert scale. Seven of the statements are reverse scored, and a sum of all these items gives a single score. The alpha coefficient for the AIP is 0.79 and it has a test–retest reliability of 0.71.
The self-compassion scale
The Self-Compassion Scale (SCS) assesses diverse components of self-compassion, namely “self-kindness, self-judgment, common humanity, isolation, mindfulness, and overidentification” through 26 items. In this present study, subscale scores were also utilized, in addition to the total self-compassion score. The measure has demonstrated adequate psychometric properties.
Overall anxiety severity and impairment scale
The Overall Anxiety Severity and Impairment Scale (OASIS) includes five self-report items that evaluate the occurrence of anxiety, how intense the symptoms are, consequent avoidant behaviors, and resulting dysfunction. Participants consider varied anxiety-related experiences when responding to the items. Therefore, it simultaneously assesses across different disorders how severe the symptoms are and the extent of impairment resulting from it. Its reliability and validity is established across clinical samples.
Beck depression inventory-II
It is a self-report scale comprising 21 items that measure the thoughts, emotions, and biological symptoms occurring in depressive disorders. It has been used to distinguish individuals that have and those who do not have a depressive disorder, and is found to be a valid and reliable measure for the same.
Subjective procrastination-related distress
Patients also reported another procrastination rating before the administration of the scales. In this, respondents were instructed to rate on a scale of 0–10 how much their tendency to delay affects their or others' functioning, Respondents were instructed to rate on a scale of 0–10, the extent to which their tendency to delay affected their functioning and that of others (0=does not affect at all and 10= interferes functioning completely).
Participants meeting study criteria were recruited from a tertiary government mental health-care facility in southern India. The study was reviewed and approved by the National Institute of Mental Health and Neurosciences Institute Ethics Committee (NO. NIMH/DO/IEC (BEH.Sc.DIV)/2016). Written informed consent was sought from all participants, following which they were screened on MINI Neuropsychiatric Interview Schedule (MINI). Participants who met the criteria were assessed on other study measures individually. All measures and clinical interviews were administered by the first author in English.
Data were analyzed using the SPSS version 20.0 IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. for Windows. Bivariate correlations were carried out between procrastination, self-compassion, severity of anxiety, and depression. Simple linear regression analysis was also used to examine the predictors of procrastination, depression, and anxiety severity.
| Results|| |
Demographics and clinical features of sample
The average age of the sample was 30 years (standard deviation [SD] = 6 years). There were a greater percentage of males (71%) than females, and more than 90% of the sample was from an urban background and had completed graduation. More than half the sample was unmarried, and belonged to nuclear families [Table 1]. Majority reported procrastination for different activities. A little more than ½ (57.1%) reported procrastination in more than one life domain, whereas more than 14 (28.6%) reported procrastinating on at least one of the domains of work, academic, personal activities, or decision-making.
The scores on measures of procrastination, self-compassion, and symptom severity indicate high mean scores on both DPS and the AIP, compared to adult samples in other studies, indicating high tendency to delay tasks related to decision-making and other domains. On the SCS, the mean total self-compassion score was 68.51 (SD = 13.6). Participants scored higher on self-judgment, overidentification, and isolation on the SCS, than on positive dimensions of self-kindness, mindfulness, and common humanity, respectively, indicating higher self-criticality and harshness toward self. Sample had moderate levels of both depression and anxiety severity [Table 2].
|Table 2: Mean, standard deviations, and range of scores on procrastination, self-compassion, anxiety severity, and depression|
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Relationship between procrastination, self-compassion, anxiety severity, and depression in the clinical group
Correlations carried out between procrastination, self-compassion, severity of anxiety, and depression [Table 3] indicated that self-compassion and decisional procrastination were significantly negatively correlated. AIP and DPS scores had low positive correlations with anxiety severity, with no significant correlations with depression. Scores on SCS and the OASIS were significantly negatively correlated and anxiety severity and depression scores were positively significantly correlated. Subjective distress due to procrastination was significantly correlated with greater decisional procrastination, and had a low positive correlation with behavioral procrastination scores [Table 4], indicating that they had greater distress due to delays in decision-making than with actual task delays.
|Table 3: Correlations among procrastination, self-compassion, anxiety severity, and depression|
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|Table 4: Correlations between subjective procrastination rating and Adult Inventory of Procrastination and Decisional Procrastination Scale scores|
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On the linear regression analysis, self-compassion was found to be a significant predictor of decisional procrastination (R2 = 0.220, F (1,47) =13.253, P < 0.001). An adjusted R2 = 0.203 indicated that self-compassion accounted for 20% of the variance in decisional procrastination (B = −0.469; P < 0.001), indicating that self-criticality contributed to delays in decision-making. Another stepwise linear regression showed significance for a model with self-compassion as a predictor of anxiety severity (R2 = 0.119, F (1,47) =6.346, P < 0.05). The adjusted R2 = 0.100 for this model suggests that self-compassion accounted for 11% of the variance in anxiety severity (B = −0.345; P < 0.05). These findings indicate that self-compassion was a predictor of procrastination and anxiety severity in the present sample.
| Discussion|| |
We studied procrastination in individuals presenting with anxiety disorders, and further examined its relationship with self-compassion and symptom severity. Our findings indicated a high tendency to delay decision-making, and delay tasks in domains such as academics, work, and personal activities.
Procrastination has extensively been examined in the academic context, however, few studies have examined it in clinical samples. Clinical observations suggest that procrastination is not limited to academic contexts. Procrastination can be seen as underlying cognitions that can affect decision-making as well. Decisional procrastination is the strong predisposition to delay decision-making. When individuals have to make a decision, they may go through a process of assessing their ability to handle the situation and required resources. Negative self-appraisals regarding one's decision-making abilities are likely to lead to anxiety and delays in decision-making. Thus, decisional procrastination is also seen as strategy to regulate anxiety by delaying decision-making.
Decisional procrastination was significantly positively correlated with the subjective distress due to procrastination, indicating that while persons with anxiety tend to delay making decisions in order to regulate anxiety, they experience significant distress as a result of this delay, setting up a vicious cycle. Procrastination is thus seen as both a failure of self-regulation and a coping strategy to temporarily regulate negative affect. While procrastinating decisions may lead to mood repair, it eventually worsens it, placing increased pressure on oneself, in future to manage both mood and incomplete tasks, leading to a spiral of symptoms. Literature on decisional procrastination indicates that indecision is related to difficulties in self-regulation and processing all pertinent material required for decision-making.
On the measure of self-compassion, participants reported greater levels of self-judgment, isolation, and overidentification. Self-compassion is associated with improved psychological states, and greater levels of self-compassion are related to lesser distress and psychopathology, as self-compassion involves taking a balanced view of one's emotions and experiences., Literature on self-compassion in clinical conditions indicates that the strength of the relationship between negative subscales and psychopathology is stronger than that of positive subscales. The negative dimensions of self-compassion share similarities with characteristics seen in anxiety disorders, with increased self-criticality, isolation being closely linked to loneliness and socially avoidant behavior, and overidentification involving increased focus and attention on oneself.
The negative relationship between self-compassion, decisional procrastination, and anxiety severity is consistent with literature on self-criticality and decisional procrastination. Self-compassion, which involves the acceptance of one's failures and reduced self-criticality, enables individuals to be less distressed in the face of failures, thereby reducing the use of maladaptive strategies such as avoidance and procrastination in emotion regulation. Analysis of the two distinct types of procrastination, indicated that decisional procrastination had significant correlations with such conflicting beliefs about oneself. Differences observed between one's real self and ideal self, have also been shown to predict maladaptive procrastination. The results of the current study with self-compassion as a predictor of decisional procrastination corroborate this.
The self-regulatory framework of procrastination and self-compassion further aids in understanding the results of the present study. Persons with greater self-compassion have greater self-acceptance, with respect to their experiences and a supportive nonjudgmental attitude, while connecting with others, thus experiencing less isolation. A compassionate response toward self, in the face of difficulties, enhances positive affect, while reducing negative affect, thereby increasing their ability to mobilize resources and use adaptive coping responses. This also reduces the likelihood of using procrastination as a strategy for temporary mood repair. Thus, the results of the present study are consistent with findings that greater self-compassion is associated with reduced anxiety severity and reduced use of procrastination, a strategy that perpetuates negative affect and self-depreciatory cognitions. Our findings also underscore the importance of using strategies that enhance self-compassion and reduce self-criticality in psychological interventions in persons with anxiety disorders, while working to enhance adaptive coping strategies.
The study was not without limitations. The sample size was small and heterogeneous with respect to clinical diagnosis; a larger sample size would have allowed more rigorous statistical analysis for mediation and permitted comparisons across subgroups of anxiety disorders. Inclusion of only self-report scales in assessing procrastination was another limitation. The inclusion of interviews in addition to self-report measures to evaluate procrastination would have strengthened the study. This was partially addressed by the subjective ratings of procrastination across domains in life.
Despite the links between procrastination and negative health outcomes, there are few studies in clinical samples. The findings of the present study contribute to our understanding of procrastination in a clinical sample. An attempt was made to examine both cognitive and behavioral dimensions of procrastination. Although the sample was heterogeneous, it was clinically representative and thus helped in the understanding of procrastination and self-compassion as being transdiagnostic.
| Conclusion and Future Directions|| |
Our findings with respect to self-compassion and procrastination and anxiety severity highlight the need to include strategies to enhance self-compassion in therapy, when working with mood and procrastination. While we used the SCS to assess self-compassion as conceptualized by Neff, self-compassion encompasses other aspects such as motivational capacities and intentionality. These need to be examined in more detail in future studies on self-compassion. There is also a need to use clinically validated measures of procrastination that are relevant for clinical samples as available measures have been developed in the context of academic tasks or nonclinical samples.
This study was ethically approved by the Institute Ethics Committee (NO. NIMH/DO/IEC (BEH.Sc.DIV)/2016), National Institute of Mental Health and Neurosciences, India.
Financial support and sponsorship
The first author was awarded a junior research fellowship from the University Grants Commission, India (Ref. no. 460/December 2015), for her MPhil Program in Clinical Psychology, and this research was part of the academic fulfillment of the program.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4]