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Electroceutical enhancement of self-compassion training using transcutaneous vagus nerve stimulation: results from a preregistered fully factorial randomized controlled trial

Kamboj, Sunjeev K; Peniket, Matthew; Norman, Jessica; Robshaw, Rosalind; Soni-Tricker, Amit; Falconer, Caroline; Gilbert, Paul; (2025) Electroceutical enhancement of self-compassion training using transcutaneous vagus nerve stimulation: results from a preregistered fully factorial randomized controlled trial. Psychological Medicine , 55 , Article e223. 10.1017/s0033291725101013. Green open access

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Abstract

Background: Physiological signals conveyed by the vagus nerve may generate quiescent psychological states conducive to contemplative practices. This suggests that vagal neurostimulation could interact with contemplative psychotherapies (e.g. mindfulness and compassion-based interventions) to augment their efficacy. // Methods: In a fully factorial experimental trial, healthy adults (n = 120) were randomized to transcutaneous vagus nerve stimulation (tVNS) plus Self-Compassion-Mental-Imagery Training (SC-MIT) or alternative factorial combinations of stimulation (tVNS or sham) plus mental imagery training (MIT: SC-MIT or Control-MIT). Primary outcomes were self-reported state self-compassion, self-criticism, and heart rate variability (HRV). Exploratory outcomes included state mindfulness and oculomotor attentional bias to compassion-expressing faces. Most outcomes were assessed acutely on session 1 at the pre-stimulation (T1), peri-stimulation (T2), and post-MIT + stimulation (T3) timepoints, and after daily stimulation+MIT sessions (eight sessions). // Results: During session 1, a significant Timepoint × Stimulation × MIT interaction (p = 0.025) was observed, reflecting a larger acute T1→T3 increase in state self-compassion after tVNS+SC-MIT, with similar rapid effects on state mindfulness. Additionally, significant Session × MIT and Session × Stimulation interactions (p ≤ 0.027) on state mindfulness (but not self-compassion) suggested that tVNS+SC-MIT’s effects may accumulate across sessions for some outcomes. By contrast, changes in state self-criticism and compassion-related attentional bias were only moderated by MIT (not stimulation) condition. HRV was unaffected by stimulation or MIT condition. // Conclusion: tVNS augmented the effects of SC-MIT and might, therefore, be a useful strategy for enhancing meditation-based psychotherapies. Our findings also highlight the value of oculomotor attentional metrics as responsive markers of self-compassion training and the continued need for sensitive indices of successful vagal stimulation.

Type: Article
Title: Electroceutical enhancement of self-compassion training using transcutaneous vagus nerve stimulation: results from a preregistered fully factorial randomized controlled trial
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/s0033291725101013
Publisher version: https://doi.org/10.1017/s0033291725101013
Language: English
Additional information: Copyright © The Author(s), 2025. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Keywords: Compassion; mindfulness; transcutaneous vagus nerve stimulation; neurostimulation; compassion-focused therapy; attentional bias; heart rate variability
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10211977
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