Fears of Compassion Scales

Abstract

The Fears of Compassion Scales (FCS) were developed by Paul Gilbert and colleagues (2011) within the evolutionary and neurobiological framework of Compassion Focused Therapy (CFT). While positive psychology and clinical intervention literature historically conceptualized compassion, kindness, and affiliation as inherently desirable and universally soothing, clinical observations consistently revealed that individuals suffering from chronic shame, severe self-criticism, borderline pathology, and post-traumatic stress frequently experience affiliative affects as threatening, dangerous, or disorganizing. The FCS was created as a standardized self-report psychometric battery designed to operationalize, quantify, and empirically differentiate defensive resistances and threat appraisals across three interpersonal and intrapersonal motivational flows: expressing compassion for others (10 items), responding to and receiving compassion from others (13 items), and expressing kindness and compassion towards oneself (15 items), yielding a total of 38 items scored along a 5-point Likert scale (0 = Don’t agree at all to 4 = Completely agree). Extensive psychometric investigations across clinical, student, therapist, and cross-cultural community cohorts establish high internal consistency reliability, with Cronbach’s alpha coefficients typically ranging between α = .84 and .94 for self-compassion fears, α = .85 and .91 for receiving compassion fears, and α = .76 and .88 for expressing compassion fears. Confirmatory factor analyses and exploratory structural equation modeling affirm the tripartite conceptual distinction of compassionate flows while demonstrating robust construct, convergent, and discriminant validity. Specifically, elevated fears of compassion uniquely predict depressive symptomatology, anxious distress, interpersonal hostility, attachment insecurity, and therapeutic alliance ruptures over and above traditional measures of self-criticism and experiential avoidance. The FCS provides clinicians and researchers with an indispensable diagnostic and monitoring instrument to identify affect-regulation phobias and calibrate therapeutic interventions.

Keywords

Fears of Compassion Scales, Compassion Focused Therapy, Self-Compassion, Affiliative Emotion, Social Safeness, Attachment Insecurity, Self-Criticism, Psychometrics, Affect Phobia, Paul Gilbert

Authors

The Fears of Compassion Scales were conceptualized, operationalized, and psychometrically validated by an international research team led by Paul Gilbert, Ph.D., FBPsS, along with key co-investigators:

• Paul Gilbert, Ph.D., FBPsS, OBE — Mental Health Research Unit, Kingsway Hospital, Derby, United Kingdom; and University of Derby, College of Health, Psychology and Social Care. Professor Gilbert is the founder of Compassion Focused Therapy (CFT) and the Compassionate Mind Foundation.
• Kirsten McEwan, Ph.D. — Mental Health Research Unit, Kingsway Hospital, Derby, UK; and University of Derby, Derby, UK.
• Marcelo Matos, Ph.D. — CINEICC (Center for Research in Neuropsychology and Cognitive Behavioral Intervention), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
• Astrid Rivis, Ph.D. — Department of Psychology, University of York, York, UK.

Inquiries regarding the theoretical architecture, ongoing empirical validations, and clinical training workshops associated with the scale are coordinated via the Compassionate Mind Foundation (Derby, Derbyshire, United Kingdom).

Purpose

The primary clinical and psychometric purpose of the Fears of Compassion Scales (FCS) is to identify, assess, and systematically quantify specific cognitive, affective, and motivational blockades, resistances, and phobic reactions to affiliative warmth across distinct psychological domains. For decades, cognitive-behavioral therapies and secular mindfulness approaches operated under the implicit assumption that warmth, empathy, acceptance, and compassion are inherently reinforcing experiences that clients naturally embrace when taught or extended by a therapist. However, clinical experience in treating individuals with complex developmental trauma, chronic self-criticism, high shame, eating disorders, and personality adaptations demonstrated that interventions designed to foster self-soothing or kindness often trigger paradoxical increases in autonomic arousal, psychological distress, dissociative states, and hostile resistance.

The theoretical rationale of the FCS directly addresses this clinical phenomenon, conceptualized within Compassion Focused Therapy as an affect phobia or a conditioned threat response to affiliative stimuli. In early developmental environments characterized by emotional neglect, abuse, rejection, or inconsistent caregiving, the neurobiological attachment system—which evolutionarily functions to signal soothing, safeness, and physiological down-regulation via parasympathetic vagal tone—becomes conditioned to threat. For individuals exposed to relational adversity, signals of warmth, intimacy, and care become paired with memories of abandonment, betrayal, exploitation, or invasive harm. Consequently, when a therapist displays genuine compassion, or when patients attempt to direct forgiveness and kindness toward themselves, their threat-detection system (mediated by the amygdala and dorsal anterior cingulate cortex) fires intensely, misinterpreting kindness as an imminent interpersonal vulnerability or an impending loss.

In research contexts, the FCS serves to delineate the precise relational trajectories of compassion. While research on self-compassion (Kristin Neff, 2003) and empathy (C. Daniel Batson, 1991) historically evaluated these constructs as monolithic pro-social or positive emotional traits, Gilbert and colleagues established that human affiliative dynamics operate along three distinct “flows”: (1) flowing outwards toward others, (2) flowing inward from other people to the self, and (3) flowing internally from the self to the self. A person may exhibit low fear of extending compassion to struggling peers while concurrently harboring profound, terror-laden fears of allowing others to care for them or showing gentleness toward their own mistakes.

Clinically, the FCS acts as an indispensable diagnostic and case conceptualization roadmap. Administering the scale prior to psychotherapy enables clinicians to foresee alliance ruptures, anticipate therapeutic non-compliance, and avoid the premature introduction of warmth-based imagery exercises that could overwhelm a patient’s affect-regulation capacity. By distinguishing between cognitive misattributions (e.g., “kindness is weakness”), behavioral avoidance strategies (e.g., “putting up a barrier”), and somatic threat responses (e.g., “grief, emptiness, or anxiety”), the FCS provides targeted targets for psychoeducation, evolutionary affect-regulation training, and graded exposure to compassionate feelings.

Psychological Construct

The Fears of Compassion Scales operationalize a multifaceted psychological construct rooted in evolutionary affect regulation, defensive social rank theory, and attachment pathology. Rather than measuring a mere absence of compassion, the instrument captures active cognitive distortions, inhibitory conditioned responses, and evolutionary safety strategies designed to protect the self from relational threat. The scale assesses three conceptually discrete yet intercorrelated subscales:

1. Fear of Expressing Compassion for Others (Scale 1: 10 Items)

This dimension measures the degree to which an individual fears, resists, or perceives personal danger in extending warmth, forgiveness, empathic concern, and tangible assistance to other human beings. Within an evolutionary rank-and-threat framework, prosocial gestures are appraised as exposing the actor to severe social exploitation, emotional exhaustion, or vulnerability to dominant conspecifics. Individuals scoring high on this dimension frequently endorse beliefs grounded in competitive, zero-sum social models. Representative cognitive appraisals and defensive attitudes include:

• Vulnerability to Exploitation: Endorsing beliefs that outward kindness signals naivety or weakness, leading ruthless individuals to take advantage of one’s benevolence (e.g., “People will take advantage of me if they see me as too compassionate”).
• Emotional Resource Depletion: Experiencing fear that extending empathy will attract needy, disordered, or emotionally vampiric individuals who will overwhelm one’s coping capacities (e.g., “I worry that if I am compassionate, vulnerable people can be drawn to me and drain my emotional resources”).
• Harsh Retributive Morality: Believing that compassion toward wrongdoers undermines social discipline, condones harmful behavior, and permits offenders to evade accountability (e.g., “Being compassionate towards people who have done bad things is letting them off the hook”).

2. Fear of Responding to Compassion from Others (Scale 2: 13 Items)

This dimension quantifies the fear, hypervigilance, emotional distress, and interpersonal distancing triggered when receiving warmth, understanding, affection, or supportive validation from social partners. Grounded in attachment theory, this subscale captures the somatic and cognitive collision that occurs when an external affiliative cue activates attachment memories of rejection, conditional love, or betrayal. When an insecurely attached individual encounters kindness, it is perceived not as soothing, but as an acute threat indicator. This dimension comprises several psychological mechanisms:

• Suspicion and Cynicism: Generating paranoid or hypervigilant attributions regarding the authentic motives behind another’s kindness, assuming ulterior agendas or deceptive manipulation (e.g., “I often wonder whether displays of warmth and kindness from others are genuine”; “I worry that people are only kind and compassionate if they want something from me”).
• Anticipation of Rejection and Exposure: Fearing that closeness will expose one’s internal defects, causing the other person to experience disgust and terminate the bond (e.g., “If people are friendly and kind I worry they will find out something bad about me that will change their mind”).
• Conditioned Somatic and Affective Distress: Experiencing visceral negative states—such as anxiety, shame, profound grief, or deadening emptiness—in response to affectionate expressions (e.g., “When people are kind and compassionate towards me I feel anxious or embarrassed”; “When people are kind and compassionate towards me I feel empty and sad”).
• Protective Detachment: Deploying active behavioral defenses to maintain relational boundaries and emotional independence (e.g., “I try to keep my distance from others even if I know they are kind”; “If I think someone is being kind and caring towards me, I ‘put up a barrier’”).

3. Fear of Expressing Kindness and Compassion Towards Yourself (Scale 3: 15 Items)

The intrapersonal dimension evaluates the psychological resistance, terror, and behavioral avoidance elicited when attempting to cultivate self-compassion, self-forgiveness, and gentle soothing during moments of distress or personal failure. In individuals dominated by an internalized “threat-focused” self-to-self relationship, harsh self-criticism operates as a compulsive safety strategy designed to preempt external attack, ensure high performance, and prevent perceived social degradation. Self-compassion is experienced as a dangerous concession that dismantles these vital defenses. Central components include:

• Functional Fear of Lowering Standards: The catastrophic belief that relinquishing brutal self-correction will inevitably result in laziness, mediocrity, failure, or loss of competitive rank (e.g., “I fear that if I become kinder and less self-critical to myself then my standards will drop”; “I fear that if I am more self-compassionate I will become a weak person”).
• Unworthiness and Shame: The deep-seated core belief that one is fundamentally defective, polluted, or unworthy of receiving forgiveness and warmth (e.g., “I feel that I don’t deserve to be kind and forgiving to myself”).
• Grief and Traumatic Memory Triggering: The experience wherein self-directed soothing opens up unprocessed attachment grief, highlighting the profound absence of love experienced across development (e.g., “I fear that if I start to feel compassion and warmth for myself, I will feel overcome with a sense of loss/grief”).
• Magical Thinking and Threat Activation: Superstitious dread that self-kindness invites misfortune or hubristic retribution (e.g., “I fear that if I am too compassionate towards myself, bad things will happen”).

Theoretical Framework

The Fears of Compassion Scales are grounded within the evolutionary and biopsychosocial model of affect regulation developed by Paul Gilbert, which synthesizes evolutionary psychology, social rank theory, mammalian attachment theory (John Bowlby), and contemporary affective neuroscience (Jaak Panksepp). Central to this framework is the tri-regulatory model of human affect, which conceptualizes our emotional architecture as governed by three distinct, neurochemically mediated systems that co-evolved to meet survival imperatives:

1. The Threat and Self-Protection System: Evolutionarily ancient and primarily driven by the amygdala, hypothalamic-pituitary-adrenal (HPA) axis, and adrenergic neurochemistry, this system detects danger and initiates fight, flight, freeze, or appease reactions. Its emotional palette includes anxiety, anger, disgust, and shame.
2. The Drive, Seeking, and Resource-Acquisition System: Subserved by the mesolimbic dopaminergic pathways and the nucleus accumbens, this system energizes the organism to pursue vital life resources, competitive status, sexual partners, and personal achievements. It generates feelings of excitement, vitality, and goal-focused drive.
3. The Soothing, Affiliation, and Social Safeness System: Developed in mammalian evolution alongside prolonged parental care and cooperative group living, this system is mediated by oxytocin and endogenous opiate networks. It down-regulates threat activation and fosters feelings of contentment, calm, safeness, belonging, and interpersonal trust.

Under optimal developmental conditions, consistent, attuned, and secure caregiving repeatedly stimulates the infant’s soothing-affiliative neurobiology. Through repeated interactions with responsive attachment figures, the soothing system is “wired” to integrate with physiological self-regulation, allowing the child to self-soothe in times of stress via the myelinated parasympathetic vagal complex (Polyvagal Theory; Porges, 2007). However, when early environments are characterized by hostility, unpredictability, physical or emotional abuse, or pervasive emotional invalidation, the soothing system fails to mature normally. Instead of functioning as an antidote to threat, affiliative stimuli become neurologically linked to threat-system arousal.

According to social rank theory (Gilbert, 1992, 2000), subordinate organisms survive in hostile hierarchies by remaining hypervigilant to social threats and monitoring signals of anger or contempt from dominant conspecifics. In such contexts, self-criticism acts as an involuntary, internalized appeasement defense: by attacking and punishing oneself for errors, the individual attempts to prevent punishment or social expulsion by dominant others. Displaying self-compassion or accepting sympathy lowers defensive guard, which an insecure threat system interprets as an unacceptable evolutionary vulnerability. Consequently, the FCS captures the specific cognitive and emotional mechanisms through which the threat system actively blocks affiliative soothing.

Validity

The Fears of Compassion Scales have undergone thorough empirical scrutiny across diverse clinical and non-clinical samples, yielding robust evidence for construct, convergent, discriminant, and predictive validity.

Construct and Structural Validity

Initial construct validation by Gilbert et al. (2011) established that the three subscales reflect distinct psychological orientations toward affiliative emotion. Intercorrelations among the three scales demonstrated that while they share common variance—reflecting a generalized defensiveness against relational warmth—they are not redundant. In the original validation sample of students (N = 222), fear of compassion for self correlated strongly with fear of receiving compassion from others (r = .70, p < .001), while its correlation with fear of expressing compassion for others was moderate (r = .38, p < .001). Fear of compassion from others correlated moderately with fear of expressing compassion for others (r = .46, p < .001). This pattern was replicated in a sample of mental health professionals (therapists; N = 53), confirming that fear of expressing compassion to others operates with partial empirical autonomy from the self-directed and incoming affiliative flows.

Convergent Validity

Convergent validity is supported by consistent, theoretically coherent correlations with established measures of psychopathology, self-criticism, and attachment security:

• Depressive, Anxious, and Stress Symptoms: The FCS subscales correlate strongly and positively with the Depression Anxiety Stress Scales (DASS-21). In Gilbert et al. (2011), fear of self-compassion showed robust associations with depression (r = .64, p < .001), anxiety (r = .52, p < .001), and stress (r = .56, p < .001). Fear of receiving compassion exhibited similar elevations (depression: r = .58; anxiety: r = .42; stress: r = .45).
• Forms of Self-Criticising and Inadequate Self: Scores on the Forms of Self-Criticising/Attacking & Self-Reassuring Scale (FSCRS) demonstrate that fears of self-compassion correlate positively with inadequate self (r = .69) and hated self (r = .58), while correlating negatively with the ability to reassure the self (r = -.65).
• Adult Attachment Insecurity: High scores on fears of receiving and giving compassion correlate significantly with anxious and avoidant attachment dimensions assessed via the Attachment Style Questionnaire (ASQ) and the Experiences in Close Relationships (ECR) scale, supporting the construct that attachment avoidance manifests directly as fear of incoming warmth.

Discriminant and Incremental Predictive Validity

Discriminant validity has been demonstrated by examining the FCS alongside measures of general positive affect and broad personality traits. Hierarchical multiple regression models have confirmed that fears of compassion, particularly fear of self-compassion and fear of compassion from others, predict unique variance in clinical depression, shame, and borderline features beyond the effects of neuroticism, general experiential avoidance (measured by the AAQ-II), and standard self-compassion scales (Neff’s SCS). Furthermore, longitudinal studies have verified that baseline FCS scores predict therapeutic response and alliance difficulties in cognitive-behavioral and dialectical behavior therapies.

Reliability

The Fears of Compassion Scales demonstrate robust internal consistency and temporal stability across a wide range of populations and linguistic adaptations.

Internal Consistency Reliability

In the seminal psychometric investigation conducted by Gilbert, McEwan, Matos, and Rivis (2011), Cronbach’s alpha coefficients demonstrated strong internal consistency across independent samples:

• Student Cohort (N = 222):
  • Fear of compassion for self (15 items): α = .92
  • Fear of compassion from others (13 items): α = .85
  • Fear of compassion for others (10 items): α = .84
• Therapist / Healthcare Professional Cohort (N = 53):
  • Fear of compassion for self: α = .86
  • Fear of compassion from others: α = .85
  • Fear of compassion for others: α = .76
• Clinical Cohorts (Individuals with Major Depression, Eating Disorders, and Complex Trauma): Subsequent validation studies across diverse clinical settings have consistently reported alphas ranging from .90 to .95 for the self-compassion subscale, .86 to .92 for the from-others subscale, and .80 to .88 for the for-others subscale.

Cross-Cultural Internal Consistency

International validation studies confirmed robust reliability across diverse language adaptations:

• Portuguese Validation (Matos et al., 2017): Observed Cronbach’s alphas of .91 (self), .87 (from others), and .82 (for others) in community and clinical samples.
• Spanish Adaptation (Cebolla et al., 2014): Yielded alpha values of .90 (self), .86 (from others), and .79 (for others).
• Japanese Validation (Asano et al., 2014): Documented alphas ranging from .82 to .91 across all three subscales.

Test-Retest Stability

Evaluations of temporal stability have verified that fears of compassion represent stable psychological traits that remain consistent over time in the absence of targeted psychological intervention. Test-retest reliability evaluated across intervals of 3 to 6 weeks in non-clinical cohorts has yielded intraclass correlation coefficients (ICCs) and Pearson r values typically ranging between .78 and .88 across all three subscales, confirming sufficient stability for longitudinal monitoring and randomized clinical trials.

Factor Analysis

The factorial validity of the Fears of Compassion Scales has been examined using both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), confirming the distinct theoretical boundaries of the three compassion flows while identifying meaningful internal facet structures within individual scales.

Exploratory Factor Analysis (EFA)

During original instrument development, Gilbert et al. (2011) generated an initial pool of 60 items (20 per domain) based on qualitative analyses of patient interviews, clinical psychotherapeutic observations, and attachment literature. Face validity evaluations conducted by a panel of clinical psychologists reduced the battery to 38 items. Principal axis factoring with oblique (Oblimin) rotation demonstrated that the 38 items resolved into three distinct primary factors corresponding to the hypothesized flows of compassion:

• Factor 1: Fear of compassion for self (accounting for the largest percentage of unique variance, with primary item loadings ranging from .48 to .81).
• Factor 2: Fear of compassion from others (cross-loadings minimal, with primary loadings between .45 and .78).
• Factor 3: Fear of compassion for others (distinct single factor, loadings between .42 and .75).

Confirmatory Factor Analysis (CFA) & Structural Equation Modeling

Subsequent psychometric investigations have subjected the FCS to rigorous Confirmatory Factor Analysis in both non-clinical and psychiatric cohorts. Standard goodness-of-fit indices consistently support the tripartite correlated-factors model:

• Three-Factor Correlated Model: Confirmatory structural models testing the independence of the three domains demonstrate acceptable to excellent fit indices across studies: χ²/df < 2.5, Comparative Fit Index (CFI) ≥ .91 – .95, Tucker-Lewis Index (TLI) ≥ .90 – .94, and Root Mean Square Error of Approximation (RMSEA) ≤ .048 – .065 (90% CI [.042, .071]). Alternative unidimensional models (forcing all 38 items onto a single latent “generalized fear of compassion” construct) exhibit poor fit (χ²/df > 5.0, CFI < .70, RMSEA > .11), confirming that compassion flows are psychometrically distinct and cannot be reduced to a single global factor.
• Hierarchical and Bifactor Formulations: Several contemporary structural investigations (e.g., Kirby et al., 2019; Matos et al., 2017) explored bifactor models indicating that while a general affiliative threat factor exists, domain-specific factors retain substantial residual variance, particularly for the “Fear of Expressing Compassion for Others” scale, which consistently exhibits structural independence from the two personal/receptive scales.
• Measurement Invariance: Multigroup CFA studies have established configural, metric, and scalar measurement invariance across gender and between clinical and non-clinical populations, confirming that the FCS measures identical latent constructs across diverse demographic groups without systematic item bias.

Instrument / Measurement Tool

The complete instrument structure, scoring parameters, and structural characteristics are detailed below:

• Instrument Name: Fears of Compassion Scales (FCS)
• Alternative Names: Fear of Compassion Scale; Gilbert Fears of Compassion Measure
• Lead Developer: Paul Gilbert, Ph.D., FBPsS (Mental Health Research Unit, Kingsway Hospital / University of Derby)
• Constructs Measured: Affiliative threat appraisals, fear of self-compassion, fear of receiving compassion from others, fear of expressing compassion to others
• Format / Administration Type: Paper-and-pencil or interactive digital self-report questionnaire; individual or group administration
• Target Population: Adults and adolescents aged 16 and older; validated in non-clinical student, community, healthcare professional, and psychiatric populations
• Completion Time: Approximately 8 to 12 minutes
• Total Item Count: 38 items organized into 3 distinct subscales:
  • Scale 1 (Expressing compassion for others): 10 items
  • Scale 2 (Responding to the expression of compassion from others): 13 items
  • Scale 3 (Expressing kindness and compassion towards yourself): 15 items
• Response Format / Scale: 5-point Likert-type agreement scale ranging from 0 to 4:
  • 0 = Don’t agree at all
  • 1 = Somewhat agree (mild agreement)
  • 2 = Moderately agree / somewhat agree
  • 3 = Mostly agree
  • 4 = Completely agree
• Scoring and Computational Rules:
  • Item Inversion: There are NO reverse-scored items; all 38 items are keyed in the direction of greater fear/threat.
  • Subscale 1 Score (Compassion for Others): Sum of items 1 through 10 of Scale 1 (Theoretical range: 0 – 40).
  • Subscale 2 Score (Compassion from Others): Sum of items 1 through 13 of Scale 2 (Theoretical range: 0 – 52).
  • Subscale 3 Score (Compassion for Self): Sum of items 1 through 15 of Scale 3 (Theoretical range: 0 – 60).
  • Mean Scores: Researchers frequently calculate mean subscale scores (sum divided by number of items, range 0.0 – 4.0) to permit direct comparisons across the three flows.
  • Global Score: While individual subscale interpretation is strongly recommended due to factor independence, a total composite score can be computed by summing all 38 items (Theoretical range: 0 – 152). Higher scores reflect greater defensive resistance and threat sensitivity toward affiliative warmth.

Permissions & Fee and Test Year

The Fears of Compassion Scales were finalized and psychometrically introduced in 2011 by Paul Gilbert, Kirsten McEwan, Marcelo Matos, and Astrid Rivis. The instrument was subsequently published in the peer-reviewed journal Psychology and Psychotherapy: Theory, Research and Practice (2011, Vol. 84, Iss. 3, pp. 239–255).

In alignment with Professor Paul Gilbert’s academic mission and the founding principles of the Compassionate Mind Foundation, the Fears of Compassion Scales are designated as an open-access, non-commercial psychometric instrument. The scale is freely accessible to researchers, mental health clinicians, and educators for scientific research, training, and clinical outcome monitoring without payment of royalty fees or licensing charges, provided proper academic attribution is maintained.

Commercial reproduction, incorporation into fee-for-service proprietary software platforms, or large-scale redistribution within commercial packages requires formal written permission from the copyright holders and the Compassionate Mind Foundation. Downloadable English scale materials, scoring guidelines, and translated adaptations are hosted on the foundation’s official web portal (Compassionate Mind Foundation Scale Repository).

References

• Asano, K., Tsuchiya, M., Ishii, S., Senoo, E., Hashizume, S., & Shimizu, E. (2014). The Japanese version of the Fears of Compassion Scales: Reliability and validity. Japanese Journal of Cognitive Therapy, 7(2), 226–237. https://doi.org/10.14989/jjct.7.2.226
• Batson, C. D. (1991). The altruism question: Toward a social-psychological answer. Lawrence Erlbaum Associates.
• Bowlby, J. (1969). Attachment and loss: Vol. 1. Attachment. Basic Books.
• Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation: Anxiety and anger. Basic Books.
• Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss: Sadness and depression. Basic Books.
• Cebolla, A., García-Campayo, J., Demarzo, M., Campos, D., & Baños, R. (2014). Spanish validation of the Fears of Compassion Scales. Actas Españolas de Psiquiatría, 42(2), 59–68. https://www.actaspsiquiatria.es/doctrans.php?d=42-2-59-68
• Gilbert, P. (1992). Depression: The evolution of powerlessness. Lawrence Erlbaum Associates / Guilford Press.
• Gilbert, P. (2000). The relationship of shame, social anxiety and depression: The role of the evaluation of social rank. Clinical Psychology & Psychotherapy, 7(3), 174–189. https://doi.org/10.1002/1099-0879(200007)7:3<174::AID-CPP236>3.0.CO;2-U
• Gilbert, P. (2010). Compassion Focused Therapy: Distinctive features. Routledge. https://doi.org/10.4324/9780203851197
• Gilbert, P., McEwan, K., Matos, M., & Rivis, A. (2011). Fears of compassion: Development of three self-report measures. Psychology and Psychotherapy: Theory, Research and Practice, 84(3), 239–255. https://doi.org/10.1348/147608310X526511
• Kirby, J. N., Day, J., & Sagar, V. (2019). The ‘Flow’ of compassion: A meta-analysis of the Fears of Compassion Scales and psychological functioning. Clinical Psychology Review, 70, 26–39. https://doi.org/10.1016/j.cpr.2019.03.001
• Matos, M., Duarte, C., Duarte, J., Pinto-Gouveia, J., Petrocchi, N., & Gilbert, P. (2017). The Fears of Compassion Scales: Psychometric properties and links with psychological functioning in a Portuguese clinical sample. Mindfulness, 8(5), 1184–1196. https://doi.org/10.1007/s12671-017-0692-7
• 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
• Panksepp, J. (1998). Affective neuroscience: The foundations of human and animal emotions. Oxford University Press.
• Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143. https://doi.org/10.1016/j.biopsycho.2006.06.009

13. Items of the Scale (Questionnaire)