Compassion Questionnaire towards Self (CQS)

1. Abstract

The Compassion Questionnaire towards Self (CQS) is a 20-item psychometric instrument developed by Bassam Khoury, Rodrigo C. Vergara, and Christina Spinelli (2023) designed to operationalize self-directed compassion as a trainable, multi-component psychological competency. Constructed alongside its sister instrument, the Compassion Questionnaire towards Others (CQO), the CQS decouples self-compassion from mindfulness constructs to isolate the distinct affective, cognitive, behavioral, and interpersonal mechanisms underlying self-directed caring. Initial scale development utilized a rigorous item-generation phase involving subject-matter experts and graduate researchers, culminating in an initial pool of 36 balanced positive and negative indicators assessed across three extensive Canadian adult community and university samples (totaling over 1,000 participants). Exploratory and confirmatory factor analyses demonstrated that while the theoretical framework posited four separate domains, cognitive and emotional components collapsed into a single robust factor. Consequently, the final instrument exhibits a tripartite structure encompassing 20 items distributed across three distinct dimensions: Thinking and Feeling Compassionately, Connection with Others, and Acting Compassionately.

Psychometric evaluations have demonstrated excellent structural validity, with confirmatory factor analysis yielding superior model fit indices (Comparative Fit Index [CFI] = .95, Tucker-Lewis Index [TLI] = .95, Root Mean Square Error of Approximation [RMSEA] = .06, Standardized Root Mean Squared Residual [SRMR] = .04). Internal consistency reliability across the subscales is notably robust, with Cronbach’s alpha and McDonald’s total omega coefficients ranging between .77 and .94 across split-half validation samples. Criterion-related and convergent validity assessments reveal moderate-to-strong inverse associations with established psychological distress indicators, including the Perceived Stress Scale (PSS), the Depression Anxiety Stress Scales (DASS-21), the Difficulties in Emotion Regulation Scale (DERS), and the Negative Affect schedule of the PANAS. In contrast, positive associations were observed with subjective well-being and positive affect. By providing an unconfounded, skill-focused assessment of self-compassion, the CQS presents clinicians and researchers with an empirically rigorous tool for evaluating baseline self-regulatory capacities, monitoring treatment efficacy in compassion-focused interventions, and delineating the distinct mechanistic pathways through which self-directed benevolence preserves psychological health.

2. Keywords

Compassion Questionnaire towards Self, CQS, self-compassion, prosocial behavior, emotional state measures, social connectedness, thinking and feeling compassionately, acting compassionately, connection with others, psychometrics, compassion-focused therapy, affective regulation

3. Authors

The Compassion Questionnaire towards Self (CQS) was conceptualized, developed, and psychometrically validated by an international team of clinical psychology researchers specializing in mindfulness, compassion, and emotional regulation:

• Bassam Khoury, Ph.D. (Corresponding Author)
  Affiliation: Associate Professor, Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, Quebec, Canada.
  Correspondence Address: McGill University, Department of Educational and Counselling Psychology, 3700 McTavish Street, Montreal, Quebec, Canada, H3A 1Y2.
  Email: [email protected]
  Research Focus: Clinical applications of mindfulness, compassion-based interventions, systematic reviews, and psychometric operationalization of contemplative constructs.
• Rodrigo C. Vergara, Ph.D.
  Affiliation: Researcher and Faculty Member, Facultad de Psicología y Humanidades, Universidad San Sebastián, Santiago, Chile.
  Research Focus: Quantitative psychometrics, structural equation modeling, psychological measurement, and cognitive neuroscience.
• Christina Spinelli, M.A.
  Affiliation: Doctoral Candidate / Researcher, Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.
  Research Focus: Compassion development, perinatal mental health, socio-emotional skill cultivation, and clinical assessment methodologies.

4. Purpose

The primary purpose of the Compassion Questionnaire towards Self (CQS) is to provide an empirically grounded, structurally unconfounded, and skill-based operationalization of self-compassion. For over two decades, the psychological measurement of self-compassion was predominantly dominated by Kristin Neff’s pioneering Self-Compassion Scale (SCS). While the SCS catalyzed clinical and empirical interest in self-directed kindness, substantial psychometric debates emerged regarding its factor structure and conceptual boundaries. Specifically, researchers repeatedly pointed out that the SCS inherently embeds mindfulness (versus over-identification) as an intrinsic constituent of self-compassion, while also conflating compassionate attributes with uncompassionate responses (e.g., self-judgment, isolation) that often load onto separate distress-related factors rather than reflecting an authentic bipolar continuum of compassion. The CQS was deliberately engineered to resolve these psychometric and theoretical conundrums by defining self-compassion as an independent, learnable constellation of competencies distinct from mindfulness, attentional control, or general neurotic distress.

In clinical practice, the CQS serves as a specialized diagnostic and progress-monitoring instrument within evidence-based third-wave cognitive-behavioral therapies, notably Compassion-Focused Therapy (CFT), Mindful Self-Compassion (MSC), and Acceptance and Commitment Therapy (ACT). Clinicians frequently encounter patients presenting with severe inner-criticism, shame-based affective disorders, and chronic self-blame. By delineating self-compassion into actionable cognitive-affective, behavioral, and interpersonal domains, the CQS enables practitioners to identify specific target deficits. For example, a patient may demonstrate an abstract cognitive awareness of their suffering while lacking the pragmatic behavioral skills required for self-soothing or self-care, or they may feel entirely isolated from humanity during distress. Pre- and post-intervention administration of the CQS allows clinicians to quantify targeted skill acquisition throughout the therapeutic trajectory.

From a research perspective, the CQS facilitates rigorous investigation into the structural and causal mechanisms of prosocial psychology. Because the instrument was validated in direct parallel with the Compassion Questionnaire towards Others (CQO), it provides an unprecedented methodological framework for conducting cross-directional comparative research. Behavioral scientists can examine whether interventions directed at self-compassion generalize into outward altruism, test whether compassion toward the self precedes or follows compassion toward others, and map structural differences across clinical, community, and developmental demographics. Furthermore, by disentangling self-compassion from mindfulness, the CQS enables structural equation modeling that treats mindfulness and self-compassion as separate predictors, mediators, or moderators of psychological resilience, emotion regulation, and subjective well-being.

5. Psychological Construct

The construct of self-compassion operationalized by the CQS is defined as an active, multidimensional orientation toward one’s own suffering, characterized by the recognition of distress, affective resonance with warmth and kindness, intentional behaviors aimed at alleviating distress, and an experiential sense of interconnectedness with broader humanity. Rather than viewing self-compassion as a passive emotional state or a static personality trait, Khoury and colleagues (2023) conceptualize it as a dynamic set of cultivable psychological skills. Although the original operational model posited four distinct theoretical dimensions—affective, cognitive, behavioral, and interpersonal—extensive psychometric evaluation revealed that human self-directed cognitions and emotions operate in tandem, producing a consolidated three-factor structure consisting of 20 items:

1. Thinking and Feeling Compassionately (Cognitive-Affective Dimension)

This subscale represents the synthesis of cognitive appraisal and emotional attunement toward personal distress. Cognitively, it involves the capacity to non-defensively acknowledge personal shortcomings, failures, and pain without descending into catastrophizing, punitive self-reproach, or denial. It reflects constructive cognitive reframing, where the individual views their challenges through an understanding, forgiving, and patient cognitive lens. Affectively, this dimension captures emotional warmth, self-directed tenderness, and internal soothing. Instead of generating feelings of coldness, contempt, or disgust toward oneself when mistakes occur, the compassionate individual generates emotional care and empathy. In daily life, this is exemplified by someone who, upon failing a crucial career examination, experiences internal feelings of kindness and reassurance rather than engaging in abusive self-talk or despair.

2. Connection with Others (Interpersonal Dimension)

The interpersonal dimension captures the individual’s profound recognition of the shared human condition. Experiencing personal suffering, trauma, or imperfection frequently induces an acute sense of alienation, leading individuals to believe that they are uniquely defective, isolated, or alienated from society. The Connection with Others construct reflects the psychological realization that struggle, vulnerability, and inadequacy are universal aspects of human existence rather than solitary anomalies. This experiential sense of belonging buffers against pathological isolation and encourages social connectedness. For instance, when an individual undergoes relational grief, this construct enables them to remember that millions of other human beings have traversed similar terrain, transforming personal sorrow from an isolating prison into a bridge of empathy connecting them to collective human resilience.

3. Acting Compassionately (Behavioral Dimension)

The behavioral dimension captures the explicit, proactive manifestations of self-care and distress alleviation. While cognitive and emotional components reflect internal processing, the behavioral facet operationalizes concrete actions taken to protect, nurture, and support oneself during challenging circumstances. This includes active problem-solving, behavioral pacing, boundary-setting, somatic self-soothing, and resisting behaviors that compound psychological harm. An individual with high behavioral self-compassion does not simply feel sympathy for their exhaustion; they actively disengage from toxic demands, seek medical or psychological support, maintain healthy nutritional and restorative practices, and take practical steps to resolve life difficulties. This behavioral skill is fundamental in preventing burnout, operationalizing the pragmatic assertion that compassion is an active endeavor rather than passive rumination.

6. Theoretical Framework

The Compassion Questionnaire towards Self is founded upon integrative psychological, evolutionary, and contemplative theories of affective science, evolutionary neurobiology, and clinical psychology. Historically, Western psychology addressed human distress primarily through cognitive restructuring or behavioral activation. However, third-wave psychological frameworks expanded this focus by identifying the quality of an individual’s emotional relationship with their internal experiences as a vital determinant of mental health.

Evolutionary Affect Regulation and Compassion-Focused Theory

The conceptual foundation of the CQS aligns closely with the evolutionary model of affect regulation articulated by Paul Gilbert, the founder of Compassion-Focused Therapy. Gilbert posited that human neurobiology incorporates three major evolved emotional regulation systems:

• The Threat and Self-Protection System: Governed by the amygdala and hypothalamic-pituitary-adrenal (HPA) axis, this system is oriented toward survival, triggering fight, flight, freeze, or self-critical responses when danger (physical or social) is detected.
• The Drive, Seeking, and Resource Acquisition System: Mediated by dopaminergic pathways, this system motivates individuals to achieve goals, attain status, and secure resources.
• The Soothing, Affiliative, and Contentment System: Mediated by oxytocin, endogenous opioids, and parasympathetic (vagal) tone, this system induces states of peace, safety, connection, and restorative well-being.

In many clinical conditions, such as chronic depression and anxiety, the threat system becomes hyper-sensitized, redirecting threat responses inward against the self via severe self-criticism, shame, and punitive vigilance. The CQS’s theoretical framework posits that self-compassion is the intentional activation of the soothing/affiliative system to down-regulate internal threat responses. The three dimensions of the CQS represent the psychological expressions of this neurobiological shift: soothing affect reduces threat reactivity, cognitive acceptance interrupts ruminative threat loops, common humanity re-establishes affiliative social bonds, and compassionate behavior reflects active protective mammalian caregiving.

Contemplative Psychology and Conceptual Disentanglement

The theoretical architecture of the CQS also draws from Buddhist contemplative traditions, which define compassion (karuṇā) as the mental disposition wishing for suffering to cease, paired with the active motivation to alleviate it. Contemplative frameworks clearly distinguish compassion from mindfulness (sati), which is defined as bare, non-judgmental present-moment awareness. Khoury and colleagues addressed a major gap in the empirical literature: prior scales had operationalized self-compassion as inherently including mindfulness, making it impossible to evaluate mindfulness as a distinct prerequisite or mechanistic antecedent. By anchoring the CQS strictly within cognitive, affective, behavioral, and interpersonal skills, the scale establishes a conceptually independent model suitable for rigorous structural equation modeling and clinical tracking.

7. Validity

The psychometric validity of the Compassion Questionnaire towards Self has been rigorously demonstrated across multiple validation studies involving diverse Canadian adult samples, encompassing community-dwelling adults, working professionals, and university populations.

Content and Face Validity

Content validity was established during initial instrument design through an iterative qualitative evaluation process. Khoury et al. (2023) collaborated with graduate clinical researchers and internationally recognized experts in mindfulness and compassion science. An initial item pool of 36 candidate items was drafted to evenly represent the hypothesized dimensions (affective, cognitive, behavioral, and interpersonal), incorporating balanced positively and negatively keyed indicators. Expert panellists evaluated each candidate statement for linguistic clarity, conceptual distinctiveness, readability, and structural correspondence with the companion scale (CQO). Items exhibiting cognitive-emotional ambiguity or redundant overlap were systematically revised or eliminated, confirming that the retained items precisely reflected core self-compassionate competencies.

Construct and Structural Validity

Structural validity was confirmed through cross-validation techniques. EFA and CFA procedures supported a robust 20-item, three-factor model. The empiric emergence of the three-factor solution provided structural evidence for the unicity of cognitive and emotional compassionate processing toward oneself, demonstrating high factor loadings and minimal cross-loadings across samples.

Convergent and Criterion Validity

Convergent validity was evaluated by correlating CQS subscale scores with validated measures of psychopathology, stress, emotional dysregulation, and affect. As theoretically predicted, all CQS subscales exhibited significant, negative correlations with indicators of psychological distress:

• Perceived Stress Scale (PSS): The CQS subscales demonstrated statistically significant inverse relationships with perceived stress, with the Thinking and Feeling Compassionately subscale showing the strongest inverse correlation (coefficients reaching moderate-to-strong levels, $r \approx -.40$ to $-.55$).
• Depression Anxiety Stress Scales (DASS-21): CQS dimensions correlated negatively with overall distress, depression, and anxiety subscales. Greater self-compassion was systematically linked to lower self-reported depressive symptomatology, illustrating the protective role of self-directed warmth against affective disorders.
• Difficulties in Emotion Regulation Scale (DERS): Moderate-to-strong negative correlations were observed between CQS dimensions and emotion dysregulation scores, demonstrating that individuals who score high on self-compassion possess superior regulatory capacities for accepting negative emotions and accessing regulatory strategies.
• Positive and Negative Affect Schedule (PANAS-GEN): CQS subscales displayed robust positive correlations with the Positive Affect schedule and pronounced negative correlations with the Negative Affect schedule.

Importantly, differential pattern analysis indicated that the Thinking and Feeling Compassionately dimension consistently exhibited the highest inverse associations with clinical symptoms, highlighting that cognitive reframing and emotional self-kindness serve as direct front-line buffers against emotional distress. In contrast, the Connection with Others dimension showed lower, albeit significant, inverse correlations ($r le -.20$) with acute psychiatric symptoms, supporting its distinct role as an interpersonal resilience factor rather than an acute emotional regulator.

Discriminant Validity

Discriminant validity was established through distinct correlation magnitudes across subscales and criterion variables. The Acting Compassionately subscale demonstrated low-to-moderate associations with internal distress markers, demonstrating that overt behavioral actions represent an active, distinct facet of self-compassion that is not redundant with affective or cognitive distress mitigation. Furthermore, the deliberate exclusion of mindfulness items ensured that the CQS did not display collinearity with trait mindfulness measures, confirming that the scale assesses self-compassion as an independent construct.

8. Reliability

The Compassion Questionnaire towards Self demonstrates high internal consistency and measurement precision across independent participant cohorts and split-half sample replications.

Internal Consistency Metrics

Across the development and validation studies, internal consistency reliability was assessed using both traditional parametric indices (Cronbach’s alpha, $\alpha$) and modern latent variable indices (McDonald’s total omega, $\omega_t$). Across the total scale and its individual subscales, coefficients ranged between .77 and .94, confirming high structural reliability that surpasses typical psychometric thresholds for psychological assessment:

• Thinking and Feeling Compassionately: This primary subscale displayed excellent internal consistency, with $\alpha$ and $\omega_t$ coefficients consistently falling between .88 and .94 across validation samples, demonstrating cohesive measurement of self-directed cognitive-affective warmth.
• Connection with Others: This interpersonal subscale exhibited solid internal consistency, maintaining $\alpha$ and $\omega_t$ values ranging from .82 to .87, reflecting high stability in assessing universal humanity and belongingness.
• Acting Compassionately: This behavioral subscale demonstrated adequate-to-good internal reliability across both split-half samples. In the first half of the cross-validation sample, Cronbach’s $\alpha$ was .78 and McDonald’s $\omega_t$ was .78. In the second cross-validation half, the coefficients were replicated at $\alpha = .79$ and $\omega_t = .79$. Although lower than the affective-cognitive dimension, these values meet accepted standards for brief behavioral inventories.

Bootstrap Cross-Validation and Structural Stability

To rigorously examine parameter stability and guard against sample-specific overfitting, Khoury et al. (2023) conducted split-half cross-validation combined with non-parametric bootstrap resampling procedures. The parameter estimates, item factor loadings, and reliability coefficients remained remarkably stable across replicated bootstrap draws. Standard errors were minimal, confirming that the CQS produces reliable, reproducible scores across independent adult cohorts.

9. Factor Analysis

The structural composition of the Compassion Questionnaire towards Self was determined through an empirical sequence combining Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) across split-half cross-validation samples.

Exploratory Factor Analysis (Sample 1)

In the calibration phase, an initial pool of 36 candidate items was administered to the first half of the Canadian adult participant sample. Prior to factor extraction, sample adequacy diagnostics confirmed data factorability, yielding a Kaiser-Meyer-Olkin (KMO) measure of .93—well above the accepted .80 benchmark—and a statistically significant Bartlett’s Test of Sphericity ($p < .001$). Exploratory factor extraction was executed using robust maximum likelihood estimation paired with oblique (promax/geomin) rotation, allowing underlying dimensions to correlate naturally.

Although the initial theoretical matrix posited four independent factors, the exploratory factor solutions demonstrated that candidate items assessing cognitive understanding and affective warmth loaded strongly onto a single unified dimension. Iterative item pruning eliminated 16 items that exhibited poor primary loadings (< .40), ambiguous cross-loadings (> .30 on multiple factors), or conceptual redundancy. The resulting 20-item, three-factor solution demonstrated excellent fit to the calibration data:

• Tucker-Lewis Index (TLI): .92
• Root Mean Square Error of Approximation (RMSEA): .07
• Standardized Root Mean Square Residual (SRMR): .03

Confirmatory Factor Analysis (Sample 2)

To confirm the tripartite model derived from the EFA, a Confirmatory Factor Analysis was conducted on the second, fully independent split-half validation sample. The hypothesized 20-item, three-factor measurement model was tested without post-hoc modification indices or correlated error terms. The CFA confirmed the empirical integrity of the scale structure, yielding superior global fit indices:

• Comparative Fit Index (CFI): .95
• Tucker-Lewis Index (TLI): .95
• Root Mean Square Error of Approximation (RMSEA): .06 (90% Confidence Interval: [.052, .068])
• Standardized Root Mean Square Residual (SRMR): .04

All 20 standardized factor loadings were statistically significant ($p < .001$), with primary loadings ranging comfortably between .55 and .88. Inter-factor correlations revealed that Thinking and Feeling Compassionately shared a moderate positive correlation with Connection with Others, while Acting Compassionately displayed weak-to-moderate positive correlations with the other two factors. These results confirm that while the three subscales converge to represent the broader domain of self-compassion, each captures distinct, non-redundant psychometric variance.

10. Instrument / Measurement Tool

The specifications of the Compassion Questionnaire towards Self (CQS) are detailed below:

• Test Type: Original psychometric self-report questionnaire / psychometric rating inventory.
• Construct Assessed: Self-directed compassion operationalized through cognitive-affective, behavioral, and interpersonal skill domains.
• Item Count: 20 items in the validated final instrument (reduced from an initial 36-item developmental pool).
• Dimensional Structure (Subscales):
  • Thinking and Feeling Compassionately (Cognitive-Affective Dimension)
  • Connection with Others (Interpersonal Dimension)
  • Acting Compassionately (Behavioral Dimension)
• Response Format: 5-point Likert-type rating scale:
  • 1 = Almost never
  • 2 = Rarely
  • 3 = Sometimes
  • 4 = Often
  • 5 = Almost always
• Target Population: Human adults (male, female, non-binary) aged 18 years and older, spanning young adulthood (18–29), thirties (30–39), middle age (40–64), and older adulthood (65+).
• Administration Setting: Suitable for individual clinical assessment, group diagnostic screening, psychological research laboratories, and online survey environments.
• Completion Time: Approximately 4 to 7 minutes.
• Scoring Procedures:
  • Subscale scores are computed by calculating the arithmetic mean or raw sum of the items corresponding to each respective dimension.
  • Negatively formulated items (if retained in scoring protocols) are reverse-scored prior to aggregation so that higher numerical values systematically signify higher levels of self-compassion.
  • A Total CQS Compassion Score can be derived by averaging all 20 items, providing a global index of self-directed compassion.

11. Permissions & Fee and Test Year

• Publication Year: 2023.
• Original Copyright Holders: Bassam Khoury, Rodrigo C. Vergara, and Christina Spinelli (published in Cognitive Therapy and Research, Springer Nature).
• Usage Fee: Free of charge for non-commercial, academic, clinical, and scholarly research purposes.
• Permissions and Access Protocol: The scale is protected under academic copyright. Researchers and clinicians wishing to utilize, translate, or adapt the CQS must formally contact the corresponding author to obtain permission, the complete item list, and administrative scoring instructions:
  Bassam Khoury, Ph.D.
  Department of Educational and Counselling Psychology, McGill University
  3700 McTavish Street, Montreal, Quebec, H3A 1Y2, Canada
  Email: [email protected]

12. References

The following scientific literature provides the theoretical, empirical, and psychometric foundations for the Compassion Questionnaire towards Self:

• Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404
• Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6–41. https://doi.org/10.1111/bjc.12043
• Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94
• Khoury, B., Vergara, R. C., & Spinelli, C. (2023). Compassion Questionnaires: Scales development and validation. Cognitive Therapy and Research, 47(6), 1006–1032. https://doi.org/10.1007/s10608-023-10416-2
• Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Psychology Foundation of Australia. https://doi.org/10.1037/t01004-000
• Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860309027
• Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063

13. Items of the Scale