慈悲训练对青少年情绪调节与亲社会道德发展的追踪研究

摘要

这项整群随机试验在四所中国中学的34个班级共876名青少年中，比较了为期八周的慈悲训练与强度匹配的放松项目。评估在基线、干预后以及3个月和12个月随访时进行。三水平模型显示，在情绪调节（ER）和亲社会道德发展（PMD）方面，慈悲训练在所有基线后各波次中从基线到随访的变化均更大（所有p < 0.001）。在12个月时，ER的差异变化为2.203分（近似95% CI 1.266–3.140；以基线SD标准化的效应量为0.317），PMD的差异变化为2.649分（1.526–3.772；标准化效应量0.278）。分段模型显示干预期增益更大，随后出现部分衰减，支持H1和H2，并部分支持H3。在慈悲条件下，ER在全部三个时间间隔中均预测随后的PMD，而反向路径仅在前两个时间间隔中显著。条件间Wald检验对所有六个交叉滞后参数均不显著（p = 0.067–0.648），未为H4提供支持。12个月时的保留率为59.6%。在delta调整的敏感性情景中，差异变化仍为正且显著，但随着偏离MAR程度增加，其幅度下降。在本样本中，慈悲训练与持续的相对优势相关，但未发现其相互耦合强于放松训练的证据。

1 引言

在青春期，情绪调节和道德认知似乎沿着相互交织的路径成熟，亲社会参与的早期模式似乎也在此时期形成。在旨在支持这一发展的干预措施中，慈悲训练作为一种可能补充既有方法（如正念项目）的手段，日益受到关注。至少在原则上，慈悲训练的特点在于其明确关注从察觉他人痛苦到被推动采取行动之间的情感—动机联系。如果得到支持，这一机制可能使慈悲训练在情绪和道德能力仍在发展的时期尤其具有相关性（Maratos et al., 2024；Vaish and Grossmann, 2024；Vieten et al., 2024；Aguilera et al., 2025）。

然而，这种概念上的吸引力引发了更紧迫的实际关切。学校和临床医生日益寻求能够广泛实施、而不针对特定学生的干预措施，而不是仅保留给已被识别为有困难的学生。如果没有更强的纵向证据，慈悲训练可能仍处于证据的灰色地带：理论上合理，偶尔得到短期发现的支持，但尚未得到充分验证，因而无法自信地将其与那些几乎不共享其预期机制的更一般课堂活动区分开来（Hayes et al., 2025）。

现有文献只能提供部分答案。大多数慈悲训练研究依赖单时间点或双时间点设计，这类设计或许能捕捉干预后即刻的变化，却难以区分暂时性波动与更持久的发展。即便收集了纵向数据，研究者也很少清晰地区分稳定的个体间差异与更细粒度的个体内波动，而后者更直接地反映发展过程。使用惰性对照组——等待名单或无接触对照——也很常见，这使得任何观察到的益处都可能反映的是结构化的关注或参与课程的一般体验，而非慈悲培育特有的过程（Kander et al., 2024；Neuenschwander and von Gunten, 2025；Roberts et al., 2026）。

另一个相关空白涉及情绪调节与亲社会道德发展之间的关系。以往研究通常将这两个构念视为彼此分离、平行的结果，而非可能随时间共同展开的过程。因此，更为根本的方向性问题在很大程度上仍未解决：情绪调节的增益是否倾向于先于道德投入的增长，反向顺序是否更准确，抑或两者同步发展。这种不确定性至少部分反映了缺乏具有足够时间分辨率的设计和分析方法，例如随机截距交叉滞后面板模型，以将个体内顺序从稳定的特质水平共变中分离出来（Hamaker et al., 2015；van Meegen et al., 2024；Li et al., 2025b）。

综合来看，现有文献提供的整合性证据有限，尚缺乏这样的研究：既追踪干预在积极训练期及延长随访期内的效果，又通过积极的、强度匹配的对照组减少非特异性课堂效应，并在个体内考察情绪与道德发展之间的方向性相互作用，而不仅仅是它们各自在群体层面的轨迹（Juul et al., 2025；Roberts et al., 2026）。

本研究通过一项整群随机对照试验来填补这一空白，比较为期8周的慈悲训练课程与强度匹配的放松训练对照组。结果在四个时间点进行评估——基线、测试后即刻以及3个月和12个月随访——并采用分层分析策略进行检验：多层模型估计总体干预效果，分段潜变量增长曲线模型刻画干预期和随访期的变化模式，随机截距交叉滞后面板模型检验情绪调节与亲社会道德发展之间的双向个体内预测关系。

该设计结合了一个真正具有活性的对照条件、一个四波纵向结构，以及一个能够将特质层面的稳定性与发展过程区分开的分析框架。这一组合旨在提供一种初步但更有依据的说明，用以回答共情训练是否能带来超出普通课堂参与的益处，以及情绪与道德发展在青春期可能如何共同演化。反过来，这些发现或许能为基于共情的机制的理论理解，以及此类项目是否值得更广泛的校本投入这一实践问题，提供有限的指导（Ritgens et al., 2024；Ward-Seidel et al., 2025）。

2 文献综述

2.1 理论基础

在沉思科学与发展心理学中，共情（compassion）日益被与移情（empathy）和同情（sympathy）区分开来。移情指与他人内部状态产生情感共鸣的能力，而共情则被概念化为一种动机性构念，包含四个相互关联的成分：对痛苦的觉察、与该痛苦的情感共鸣、对共同人类脆弱性的认知评估，以及旨在缓解痛苦的行为或动机取向。这种动机上的特异性将共情训练与纯粹基于注意或觉察的练习（如正念）区分开来，使其成为一种针对情绪体验中的亲和与亲社会维度、而非仅针对注意调节的干预（Vaish and Grossmann, 2024；Vieten et al., 2024）。

本课程采用了一个整合性的校本框架，其依据来自共情聚焦疗法（CFT）与共情心智训练（CMT），并结合了自我共情、发展性社会—情绪学习以及青少年观点采择。Gilbert 的进化与生物心理社会论述将共情与照护动机以及威胁、驱力、安抚或安全系统的调节联系起来（Gilbert, 2014）。自我共情有助于对个人困难作出友善、平衡的回应，并认识到共同的人性（Neff, 2003）。在本课程中，共情被操作化为识别自身或他人的痛苦，并发展出以有益方式作出回应的动机与技能。情绪标注支持对痛苦的识别，共情式自我对话针对自我批评，而观点采择、意象与角色扮演则将对他人的关切与支持性行动联系起来。

这些原则通过情绪觉察任务、讨论、情境演练和家庭练习被改编以适应课堂学习。该项目将这些方法整合进一套为青少年改编的教育课程中。

在过程模型传统中，情绪调节被理解为个体用来调节情绪体验的发生、强度、持续时间和表达的一系列策略。这些策略包括前因聚焦策略，如认知重评，以及反应聚焦策略，如抑制。青春期的特点是边缘系统反应性与前额叶调节能力之间显著的神经发育不同步，使其既是一个情绪脆弱性升高的时期，也是一个获得调节技能具有巨大可塑性的窗口（Gill et al., 2024；Haag et al., 2024）。一项基于元素的青少年心理健康干预元分析发现，对情绪调节的总体效应较小，并识别出若干候选成分，尽管成分层面的关联并非因果检验（Helland et al., 2022）。

借鉴认知发展和社会领域两大理论传统，亲社会道德发展不仅被概念化为基于规则的道德推理，还被概念化为道德认知、道德情感和道德行为倾向的整合。当代模型日益强调，青春期的亲社会道德行为是由情感过程（包括共情关注和同情）所支撑的，而非仅源于抽象推理能力。这种情感—认知整合为基于同情的干预与后续道德发展结果之间提供了理论桥梁（Cirimele et al., 2024；Qiu et al., 2024；Li et al., 2025a）。来自中国青少年的近期个体内证据进一步表明，道德推脱的增加可能先于随后亲社会行为的减少，尽管道德推脱不应被视为等同于情绪调节（Wang et al., 2026）。

2.2 青少年同情与正念干预

大量干预研究考察了学校和社区环境中的正念项目，通常报告青少年在注意力控制、压力反应性和自我报告的情绪幸福感方面有中小幅改善。近期更大规模的证据结果不一：MYRIAD试验发现，一年后与常规学校课程相比无优势；一项三臂试验发现，与主动放松对照组相比压力更低，但与常规课程相比无差异，且自我友善未增加；一项多成分韧性项目在24周时显示出结果特异性的益处（Kuyken et al., 2022；Llistosella et al., 2024；Volanen et al., 2026）。然而，基于正念的课程主要强调当下觉察和非评判性注意，明确涉及人际同情或亲社会动机的内容相对有限（Kander et al., 2024；Shi and Cheung, 2024；Zhou and McLellan, 2024；Hayes et al., 2025；Juul et al., 2025）。

针对同情心的专项训练项目，包括认知取向的同情心训练和同情心培育训练，在成人群体中已有较多研究。研究结果表明，这些训练可改善情绪调节、减少自我批评，并增加亲社会行为，包括在经济学博弈范式中的慷慨表现。近期针对青少年的研究包括一项针对低龄儿童的整群随机同情心取向社会情感学习试验、一项针对青少年正念自我同情的小样本主动对照试验，以及一项在早期青少年中开展的无对照课堂试点研究；总体而言，这些研究证明了可行性，同时也凸显了在年龄可推广性、样本量和因果推断方面的局限（Seekis et al., 2023；Xavier et al., 2023；Bluth et al., 2024）。将这些方案推广至儿童和青少年仍相对处于起步阶段；现有研究受限于样本量小、仅进行单次干预后评估，以及依赖被动对照或等待名单对照条件，这些条件无法将同情心特异性机制与项目参与的非特异性效应（如教师关注增加、结构化同伴互动或期望效应）区分开来。此外，尽管干预以课堂为实施场景，大多数现有试验并未采用整群水平随机化，这引发了关于污染和因未建模的嵌套结构导致I类错误膨胀的担忧（Crompton et al., 2024；Maratos et al., 2024；Aguilera et al., 2025；Neuenschwander and von Gunten, 2025；Roberts et al., 2026）。

同情心训练对青少年的发展适宜性值得特别的理论关注。由于同伴关系和关于社会地位的担忧在这一时期变得尤为突出，当基于同情心的课程明确涉及观点采择并以共同人性来框定体验时，可能尤为有效。这些特征可能缓冲以自我为中心的反复思虑和社会比较，而这两者都是青春期情绪失调的突出风险因素（Ward-Seidel et al., 2025）。同伴情境也可能调节亲社会行为的发展：在一项两波青少年研究中，同伴拒绝预测了其后较低的亲社会行为，而特质正念缓冲了这一关联（Wang and Qi, 2023）。

2.3 情绪调节与道德发展的联系

关于情绪调节与道德发展之间关系的理论论述，历史上倾向于一种单向因果叙事，即将调节能力视为持续投入费力的、以他人为导向的道德推理和行为的前提条件。支持这一路径的证据表明，情绪失调，尤其是难以降低个人痛苦，与共情过度唤起以及随后从亲社会参与中退缩而非采取趋近取向的帮助行为有关（Qiu et al., 2024；Ritgens et al., 2024；Carrizales et al., 2025；Li et al., 2025b）。

一种替代性且日益受到支持的观点提出，亲社会道德行为本身的参与作为一种情绪调节策略，二者之间存在着互惠或双向关系。对他人痛苦的换位思考和共情投入可能会调动类似重评的认知过程，将注意力从自我参照的痛苦中转移开，从而有助于调节自身的情绪状态。这种双向表述与更广泛的理论模型一致，即社会情绪能力之间存在着相互强化的 developmental cascades。四波 RI-CLPM 证据表明，在青春期早期，有意自我调节与亲社会行为之间可能存在双向关系，而三波证据则表明，个体内共情水平的升高可以先于其后出现的亲社会行为（Memmott-Elison et al., 2020；Carrizales et al., 2021）。即便如此，直接可比的检验仍然很少，而构念、时间间隔和模型设定方面的差异限制了对互惠性作出强有力的结论（Hamaker et al., 2015；van Meegen et al., 2024；Li et al., 2025b）。

2.4 概念模型

基于上文回顾的理论和实证基础，本研究提出一个整合模型，其中慈悲训练相对于结构匹配的主动对照，对情绪调节和亲社会道德发展的 developmental trajectories 产生差异化影响，并进一步假设这两个发展领域随时间表现出个体内的互惠影响。以下假设指导本研究：

H1：被分配到慈悲训练条件的青少年在 T2、T3 和 T4 期间的情绪调节改善程度将显著大于主动对照条件中的青少年，表现为显著的组别 × 时间交互作用。

H2：被分配到慈悲训练条件的青少年在 T2、T3 和 T4 期间的亲社会道德发展改善程度将显著大于主动对照条件中的青少年。

H3：慈悲训练组将表现出分段增长模式，其特征是在干预阶段（T1–T2）呈陡峭的正斜率，随后在随访阶段（T2–T3–T4）呈较平缓但持续的正向轨迹，与主动对照组中观察到的轨迹显著不同。

H4：在个体内水平上，情绪调节和亲社会道德发展将在相邻时间点之间表现出显著的双向交叉滞后预测，且假设这些互惠效应的幅度在慈悲训练条件中大于主动对照条件。

图1在单一纵向框架内总结了该研究提出的四个假设。H1和H2路径分别代表慈悲训练在情绪调节和亲社会道德发展方面预期的特定条件优势。H3区分了八周干预期间（T1–T2）的快速变化与随后的随访轨迹（T2–T4），而H4则明确了相邻波次之间的个体内相互预测（ER_t → PMD_t+1 和 PMD_t → ER_t+1）。因此，该概念模型将干预相关的均值变化与两个发展领域中个体内波动的时间顺序区分开来。

图1

3 方法

3.1 研究设计

本研究采用了一项双臂、平行组整群随机对照试验（cRCT），嵌入四波纵向随访框架中，于2024年2月至2025年6月期间进行。选择整群设计而非个体水平随机化，是因为干预是在班级层面实施的。对同一班级内的个别学生进行随机化会产生很高的污染风险，因为接受慈悲训练的学生和处于积极对照条件的学生不可避免地会互动、讨论课程内容，并可能相互影响彼此的调节和亲社会反应。因此，班级构成随机化单位，而学生仍是分析单位；学生内的重复观测和班级内的学生被明确地纳入三水平结果模型（Campbell et al., 2012；Hopewell et al., 2025）。

纵向部分包括四个评估波次：干预前基线（T1）、八周项目结束时的干预后即时评估（T2）、干预完成后三个月的短期随访（T3），以及干预完成后十二个月的长期随访（T4）。这种四波结构服务于三个不同的推断目的，而非单一的总体比较。首先，T1–T2间隔在项目暴露最大的条件下分离出即时干预效果。其次，T2–T3间隔评估了在直接项目接触停止后任何观察到的效果的持久性，回应了心理社会干预效果在终止后迅速消散这一常见批评。第三，T3–T4间隔将这种持久性评估扩展到具有发展意义的时间段，使研究能够区分技能巩固与干预后短暂的积极性。将这种时间逻辑嵌入设计，使分段增长建模策略能够明确对应干预和随访阶段，而不是假设整个研究期间存在单一线性轨迹。

如图2所示，四个评估波次锚定于干预期而非固定日历时间，确保T2、T3和T4间隔在两个研究组中持续时间相等，尽管四所参与学校之间存在轻微的日程差异。鉴于整群设计，这种锚定策略至关重要，因为分布在四所机构的34个班级的干预开始日期无法完全同步。

图2

图2展示了34个班级集群被随机分配到两个在时长和接触次数上相匹配的条件中。两个研究组均在相同的四个波次接受评估，干预在T2结束。刻意不等的水平间距代表研究经过的时间：从T1到T2为八周，从T2到T3为三个月，从T3到T4再经过九个月。这种时间安排使得即时干预效应能够与短期和长期维持效果区分开来。

3.2 参与者和研究环境

参与者从中国的四所中学招募，所选学校在机构资源和区域特征上具有代表性差异，同时在课程结构上保持可比。参与班级中12至18岁的学生被考虑纳入，但须符合以下排除标准。排除标准包括：当前因确诊的精神科状况正在接受临床治疗、在过去六个月内经历过重大创伤事件，以及无法在四个计划波次中可靠完成自我报告评估。招募共获得876名学生，嵌套于34个班级中，与功效分析规划阶段设定的800至1000名学生和30至40个集群的规划目标范围一致。

该项目被设计为一项普遍性的校本发展性干预，而非针对精神障碍或创伤的治疗，并设有研究资格筛选。临床治疗和创伤排除旨在减少在反复进行情绪聚焦和慈悲练习期间可能出现的痛苦，并避免干扰正在进行的个体化治疗计划。重大创伤事件包括直系家庭成员死亡、严重事故或身体伤害、暴力、遭遇严重自然灾害，或由学校心理健康教师或监护人判断与持续显著痛苦相关的其他重大事件。筛选使用家长或监护人表格以及简短的学生自我报告，必要时由学校心理健康教师核实。学生未被要求详细叙述创伤经历。研究团队未做出新的精神科诊断。当前临床治疗根据现有的专业诊断和治疗状态确定。

符合这些排除标准的学生未被纳入研究评估或分析的试验队列。随机化单位仍为班级，而非个别学生。研究排除并未取消其获得常规学校教育和心理支持的机会。若活动属于学校正常教育安排的一部分，学校可决定适当的参与方式。如果学校心理健康教师认为某项练习不适合，可安排替代活动或转介。这些被排除学生的任何数据均未进入研究数据库。

在评估了950名学生的资格后，74名被排除，876名被随机分配到34个班级：17个慈悲训练班447名学生，17个主动对照班429名学生（图3）。在T2时，分别有423名和419名学生完成了评估；在T3时，分别为395名和386名；在T4时，分别为270名和252名。总体保留率在T2、T3和T4时分别为96.1%、89.2%和59.6%。T4的累计流失为每个条件下177名学生，对应39.6%和41.3%的流失率。ITT人群包括所有876名随机分配的学生，其中522名为四波次完成者。表1总结了评估完成情况和累计缺失评估。

图3

表1

按条件划分的评估完成情况和累计缺失评估。

缺失 = 随机分配 − 每个波次完成。计数指评估完成情况。失访原因包括转学、拒绝继续和无法联系。

3.3 随机化与分配隐藏

随机化在班级层面使用计算机生成的序列进行，并按学校和年级分层，以平衡机构背景和发展阶段，这两者均预期会影响基线情绪调节和道德推理能力。在每个学校-年级层内，班级按1:1比例分配到慈悲训练条件或主动对照条件。一名独立统计学家生成并实施分配序列，未参与招募、教学或评估。分配对班级教师隐藏，直到项目开始前即刻，从而最大限度地减少入组时的选择偏倚（Campbell et al., 2012）。

3.4 样本量与功效分析

样本量规划考虑了预期效应量d = 0.35–0.45、ICC为0.02–0.05、30–40个班级、平均班级规模22–25名学生以及25–35%的流失率（表2）。在簇大小相等的情况下，设计效应为1 + (m − 1)ICC；这些范围意味着设计效应约为1.42–2.20。蒙特卡洛规划模拟使用了5,000次重复、α = 0.05、ICC = 0.03、34个簇、平均簇大小25.8以及预期效应量d = 0.40。在这些假设下，估计功效约为80%或更高。实际达到的平均班级规模为25.76名学生。功效取决于班级的数量和分布以及个体样本量。

表2

样本量和功效估计的参数与假设。

在T4时，876名学生中有522名仍保留，产生59.6%的保留率和40.4%的流失率，超过了25–35%的规划假设。34个随机分配的班级决定了独立治疗单元的数量。ITT分析在相关缺失数据假设下纳入了不完整记录，但额外的流失减少了相对于规划情景的随访信息。

3.5 干预条件

3.5.1 慈悲训练组

被分配到共情训练条件的学生在连续八周内每周接受一次45分钟的课堂训练，并辅以结构化的家庭练习。该课程整合了CFT/CMT原则、自我共情、社会情感学习和观点采择，如第2.1节所述。课程从自我共情和非评判性自我觉察，逐步推进到对熟悉他人的共情关注，再通过共同人性框架推进到对不熟悉他人的共情关注。每次课程整合了引导式体验练习、情绪标注任务、观点采择以及将共情与亲社会决策联系起来的角色扮演。表3详细列出了每周内容。

表3

每周共情训练与主动对照课程。

每种条件均包括八次每周45分钟的课程，以及每天10–15分钟的规定家庭练习。共情活动和家庭作业按课程列出。主动对照组的家庭练习使用对照课程中的放松练习，该课程未明确教授共情、观点采择或道德推理。

3.5.2 主动对照组

主动对照组的学生每周接受八次45分钟的放松训练课程，并每日在家进行10–15分钟练习。接触频率、课程时长和规定的家庭练习时长均设计为与慈悲训练组相匹配（表4）。活动包括膈式呼吸、渐进式肌肉放松、引导式想象和综合放松练习，每周内容详见表3。该课程未明确教授慈悲、换位思考或道德推理。放松本身即可影响情绪体验；因此，该对照估计的是慈悲训练相对于放松项目的增量效应。

表4

干预组与主动对照组在结构参数上的比较。

表4总结了计划的结构匹配情况，表3呈现了每周课程。匹配减少了对接触不均或规定剂量不等的担忧，但并不能证明在期望、实施者倾向或实际家庭练习依从性方面具有等效性。

3.5.3 实施者、培训与家庭练习

共有四名实施者按照预先指定的课堂安排实施两种条件。他们包括两名学校心理健康教师、一名教育心理学研究人员和一名具有学校社会情感学习经验的教育教师。所有人均具有至少两年教授青少年或提供心理教育的经验。四人均完成了两种课程的标准化培训。

12小时的培训包括两个6小时的模块。第一个模块涵盖研究方案与安全保障（1小时）、慈悲与CFT理论（1.5小时）、八次课程（1.5小时）、引导练习演示（1小时）以及课堂风险管理（1小时）。第二个模块涵盖主动对照方案（1.5小时）、角色扮演与教学演练（2小时）、 fidelity检查表（1小时）、家庭练习管理（0.5小时）以及带反馈的标准化评估（1小时）。干预期间，项目负责人和一名具有青少年干预经验的心理专业人员共同提供每周督导。共有八次督导，每次约60分钟，总计约8小时。

两种条件均规定每日在家练习10–15分钟，并每周收集练习日志。慈悲组的日志回收率为88.6%，报告的练习平均为每周5.1天、每天12.4分钟。主动对照组的相应数值为87.9%、每周5.0天和每天12.1分钟。日志用于实施监测。个体练习剂量未纳入主要结局模型。

3.6 干预保真度

大约25%的干预课程被随机抽取用于保真度评估。两种条件下的课程均被录音，并由两名未参与干预实施的独立评分者进行评估。一份标准化的5点核查表评估了内容依从性、实施者胜任力和学生参与度。评分者间信度采用双向随机效应、平均测量组内相关系数ICC(2,k)进行估计，其中k = 2名评分者。评分者对研究假设设盲，但无法对干预内容设盲。

3.7 测量指标

3.7.1 情绪调节

情绪调节（ER）采用10个条目的情绪调节问卷（ERQ；Gross and John, 2003）进行评估，该问卷涵盖认知重评和表达抑制。认知重评（CR）包括第1、3、5、7、8和10题，表达抑制（ES）包括第2、4、6和9题。作答按1至7分计分。没有反向计分条目。子量表得分越高，表明相应策略的使用越频繁。

原始ERQ采用从“非常不同意”到“非常同意”的同意程度锚点。表达抑制的一个英文示例是“我通过不表达情绪来控制我的情绪”（Gross and John, 2003）。在一项纳入639名12–18岁中国青少年的研究中，Sai等（2016）报告重评的内部一致性为0.72，抑制为0.70。重评与抑郁症状呈负相关，而抑制与抑郁症状无显著相关。

CR在T1、T2、T3和T4的内部一致性分别为α = 0.84、0.86、0.85和0.87，ω = 0.85、0.87、0.86和0.88。ES的相应估计值分别为α = 0.78、0.80、0.79和0.81，ω = 0.79、0.81、0.80和0.82。

3.7.2 亲社会道德发展

亲社会道德发展（PMD）是一项研究特定结局，包括亲社会行为倾向、道德推理和道德认同。它涵盖道德功能的行为、认知和认同相关方面。亲社会行为倾向采用6个条目、5点作答量表进行评估。道德推理采用6个情境进行评估，行动理由按从自利到关注需求或价值的递进，从1至5分计分。道德认同采用8个条目、5点李克特作答量表进行评估。

对于亲社会行为，T1、T2、T3和T4的内部一致性分别为α = 0.82、0.84、0.85和0.84，ω = 0.83、0.85、0.86和0.85。对于道德推理，相应值为α = 0.76、0.79、0.78和0.80，ω = 0.77、0.80、0.79和0.81。对于道德认同，相应值为α = 0.85、0.87、0.86和0.88，ω = 0.86、0.88、0.87和0.89。

3.7.3 基线特征与协变量

基线特征包括年龄、性别、社会经济地位、共情关怀和社会赞许性。年龄、性别和社会经济地位作为协变量纳入三层结局模型。基线共情关怀和社会赞许性额外纳入插补模型。在T1时，共情关怀的内部一致性为α = 0.83和ω = 0.84，社会赞许性为α = 0.75和ω = 0.76。这些辅助变量仅在基线时测量。

3.8 缺失数据策略

主要分析遵循意向性治疗原则。FIML 是在结构方程框架内估计模型时的主要缺失数据处理方法。对于需要多重插补数据集的分析，生成了 50 次插补。插补模型纳入了治疗条件、评估波次、所有可用波次的 ER 和 PMD 得分、年龄、性别、社会经济地位、基线共情关注和社会赞许性。估计值采用 Rubin 规则进行合并。FIML 和主要插补分析假设，在给定观测信息的情况下，缺失性与未观测结局条件独立（MAR；Enders, 2022）。Delta 调整模式混合敏感性分析使用 δ = −0.25、−0.50 和 −0.75 SD 检验了对 MAR 的偏离。这些情景代表了逐渐降低的未观测结局，并评估了 Group × T4 估计值的敏感性。

3.9 分析策略

这些分析解决了三个互补的问题：差异性平均变化、阶段特异性增长以及个体内时间关联。它们并不提供可互换的干预机制检验。

3.9.1 分层线性模型

三层分层模型分别表示学生内的重复评估和班级内的学生。主动控制和 T1 为参照类别。每个 Group × Time 系数估计了从基线到该波次变化在条件之间的差异。在给定波次，条件之间结局水平的差异为组主效应加上相应的交互作用。差异性变化使用合并基线 SD 进行标准化：SD = sqrt[((447–1)SD_CT² + (429–1)SD_AC²)/(447 + 429–2)]。近似 95% 置信区间计算为 b ± 1.96 × SE；标准化区间界限除以合并基线 SD。这些正态近似区间将估计的基线 SD 视为固定值，并未纳入有限聚类自由度校正。

3.9.2 潜变量增长曲线模型

分段潜变量增长曲线模型将轨迹分解为干预阶段斜率（T1–T2）和随访阶段斜率（T2–T3–T4），以检验 H3。干预阶段因子在 T1–T4 分别编码为 0、1、1 和 1。随访因子编码为 0、0、0.25 和 1.00，反映从立即后测到 3 个月和 12 个月随访的相对经过时间。因此，干预斜率表示八周项目期间的变化，随访斜率表示 12 个月随访期间的变化。

3.9.3 测量不变性检验

形态、度量和标量不变性模型联合检验了四个波次和两种条件之间的测量等价性。不变性通过相邻模型之间 CFI 下降不超过 0.010 且 RMSEA 增加不超过 0.015 来评估。绝对拟合指数和顺序变化见表 5。这些检验评估了构念在不同波次和条件之间的可比性（Little, 2024）。

表 5

跨时间和组别的测量不变性模型拟合指数。

3.9.4 随机截距交叉滞后面板模型

采用RI-CLPM将稳定的个体间差异与个体内偏差分离，以检验H4（Hamaker et al., 2015）。自回归路径代表领域内的时间稳定性，交叉滞后路径代表连续评估间ER与PMD之间的预测关系。多组分析估计了各条件特定的交叉滞后系数、标准误、95%置信区间和p值。Wald检验比较了各条件间相应的交叉滞后参数。由于评估间隔时长不同，系数在各间隔内进行解释，而非作为可直接比较的发展变化速率。

图4形式化了RI-CLPM所需的分解。每个观测到的ER或PMD得分均与其时间特定的个体内潜变量偏差分开表示，而RI-ER和RI-PMD则捕捉四个波次中稳定的个体间差异。它们的双向协方差代表两个构念之间的特质水平关联。自回归路径估计每个领域内的时间延续性，交叉滞后路径估计一个领域的偏差是否预测另一领域随后的偏差，波内残差协方差则解释同时性耦合。在多组模型中，需要采用等值约束的参数比较，而非组内显著性的差异，来确定这些路径在各条件间是否存在差异（Mulder and Hamaker, 2021）。

图4

结构方程模型，包括增长模型、测量不变性模型和RI-CLPM分析，均在Mplus 8.11版本中使用稳健最大似然法（MLR）进行估计。班级依赖性通过TYPE = COMPLEX以班级作为聚类变量加以处理，提供聚类调整标准误和模型检验统计量。缺失结果在MAR假设下使用FIML处理。该设定考虑了班级聚类，但其本身并不能在34个班级的情况下确立小样本准确性。有限聚类敏感性和学校情境效应仍然相关；仅四所学校为估计总体水平的学校变异提供的信息有限。

3.10 伦理声明

研究方案经南京师范大学机构伦理委员会批准（批准号22JJD880031）。对于未成年参与者，已获得其父母或法定监护人的书面知情同意，参与学生提供了赞同。被分配到主动对照条件的参与者，在完成T4评估后获得了参加慈悲训练课程的机会。

4 结果

4.1 基线等效性

各条件的基线特征相似（表6）。基线比较均无统计学显著性。这些比较描述了分配时的样本情况，并未用作等效性检验。

表6

按组划分的基线特征。

后续结果分析考虑了基线到波次的变化和班级聚类。

4.2 流失分析

表7比较了完成全部四次评估波次的学生（n = 522）与未完成全部评估波次的学生（n = 354）在基线特征上的差异，以评估失访是否在人口学因素、治疗条件或基线结局水平方面存在系统性。

表7

四次波次完成者与未完成者在基线特征上的比较。

四次波次完成者比未完成者年龄更大、女性比例更高、社会经济地位更高（表7）。基线结局得分和治疗分配在这两组之间没有显著差异。这些模式表明存在基于所测量特征的选择。缺失数据分析纳入了这些特征，delta调整的敏感性分析考察了对未观测结局的潜在依赖性。

4.3 干预保真度结果

在抽样会话中，各条件的保真度评分相似（表8）。两名评分者平均分的总体评分者间信度为 ICC (2,2) = 0.86（95% CI 0.79–0.91）。条件间检验未发现保真度评分存在差异。这些发现表明抽样会话中的实施具有可比性，但抽样设计限制了对所有已实施会话和个体家庭练习的结论。

表8

按组别的保真度评分。

4.4 总体干预效果

在T2、T3和T4时正向的组别×时间项表明，慈悲训练条件下相对于T1的变化更大，支持H1和H2（所有p < 0.001；表9）。对于ER，T2时的差异变化为3.417分，T4时为2.203分；对于PMD，分别为4.216分和2.649分。在T2、T3和T4时，以基线SD标准化的差异变化对于ER分别为0.492、0.413和0.317，对于PMD分别为0.442、0.375和0.278（表10）。因此，相对优势在较晚的评估中较小，但仍为正向。班级ICC对于ER为0.027，对于PMD为0.029。

表9

三水平模型估计值和近似95%置信区间。

近似95% CI = b ± 1.96 × SE。这些正态近似区间未纳入有限聚类自由度校正。

表10

推导出的条件间水平差异和标准化差异变化。

正值有利于慈悲训练。水平差异 = 组别主效应 + 组别 × 时间项。标准化差异变化 = 交互作用/合并基线标准差（ER 6.944；PMD 9.529）。区间限值以基线标准差估计为条件。水平差异与差异变化是不同的估计量。

4.5 生长轨迹

图5A展示了情绪调节的分段轨迹。慈悲训练组在干预阶段表现出显著的上升（斜率1 = 3.52），而主动对照组仅有小幅正向变化（斜率1 = 0.184）；组间斜率差异显著（p < 0.001）。在随访期间，两条轨迹均下降，慈悲组的斜率更负（−0.318 vs. −0.089；p = 0.032）。这一模式表明在干预后即刻峰值之后出现部分衰减，尽管慈悲组仍高于其基线水平及T4时的主动对照轨迹。

图5

图5B展示了亲社会道德发展的相应模式。慈悲训练下干预阶段的上升明显大于主动对照（4.31 vs. 0.226；p < 0.001）。两组随访斜率均为负，且慈悲条件更负（−0.407 vs. −0.112；p = 0.039），表明即刻增益出现部分丧失，而非持续正向增长。尽管如此，估计的T4水平仍高于基线及主动对照轨迹。

图5C比较了四个分段斜率参数。干预阶段的两个组间对比均显著（p < 0.001）。随访阶段的对比在ER（p = 0.032）和PMD（p = 0.039）上也显著，反映出慈悲条件下干预后下降更陡。

图5D报告了两个分段模型的可接受拟合：情绪调节，χ²(58) = 142.60，CFI = 0.968，TLI = 0.958，RMSEA = 0.041，SRMR = 0.038；亲社会道德发展，χ²(58) = 149.30，CFI = 0.964，TLI = 0.953，RMSEA = 0.043，SRMR = 0.040。综合来看，图A–D表明仅H3的干预期成分得到支持；对随访期持续正向增长的预测未得到支持。负的随访斜率，尤其是在慈悲组中，描述的是衰减而非持续的有益增长。

表11总结了分段生长参数。干预期斜率对比在ER和PMD上均有利于慈悲训练（均p < 0.001）。随访斜率均为负，且在慈悲训练下更负（ER：−0.318 vs. −0.089，p = 0.032；PMD：−0.407 vs. −0.112，p = 0.039）。这些结果支持H3的干预期成分，但不支持其对随访期持续正向增长的预测。

表11

干预期和随访期阶段的潜变量生长参数。

4.6 测量不变性结果

不变性模型显示，在连续约束下拟合变化很小（表5）。对于ER，ΔCFI值为−0.002和−0.004，ΔRMSEA值为−0.001和0.000，ΔSRMR值为+0.002和+0.002。对于PMD，相应的变化为−0.003和−0.004、−0.001和0.000，以及+0.002和+0.003。CFI和RMSEA的变化符合指定标准，支持在拟合模型下跨波次和条件的测量等价性。

4.7 个体内交叉滞后关系

The RI-CLPM indicated a consistent ER-to-PMD temporal association in the compassion-training condition (Table 12). Within-person elevations in ER predicted higher subsequent PMD from T1 to T2 (β = 0.220, SE = 0.041, 95% CI [0.140, 0.300], p < 0.001), T2 to T3 (β = 0.190, SE = 0.041, 95% CI [0.110, 0.270], p < 0.001), and T3 to T4 (β = 0.150, SE = 0.051, 95% CI [0.050, 0.250], p = 0.003). The reverse PMD-to-ER paths were significant from T1 to T2 (β = 0.110, p = 0.017) and T2 to T3 (β = 0.090, p = 0.028), but not from T3 to T4 (β = 0.080, p = 0.117). In the active-control condition, the T1-to-T2 ER-to-PMD path had a rounded p value of 0.050; the other five paths had p values above 0.05.

Table 12

Condition-specific RI-CLPM cross-lagged estimates and between-condition Wald tests.

β = standardized within-person cross-lagged coefficient; SE = standard error; CI = confidence interval. Wald p compares corresponding coefficients between conditions. ER = emotion regulation; PMD = prosocial moral development. The T1-to-T2 control ER-to-PMD p value is rounded to 0.050. All six between-condition Wald p values exceed 0.05.

Although the cross-lagged coefficients were numerically larger under compassion training, Wald tests did not detect a significant between-condition difference in any of the six parameters (p = 0.067–0.648; Table 12). The results therefore did not support H4’s prediction of stronger reciprocal within-person coupling under compassion training. The lack of a significant final-interval PMD-to-ER path also indicated that bidirectionality was not consistent across all intervals (Figure 6).

Figure 6

4.8 Sensitivity analyses

FIML and multiple-imputation point estimates were numerically similar, with absolute differences of 0.003–0.061 across the selected parameters (Table 13). Delta-adjusted sensitivity analyses yielded smaller Group × T4 estimates as δ decreased, but the estimates remained positive and statistically significant throughout the examined range (Table 14). For ER, the estimate decreased from 2.203 under MAR to 1.47 at δ = −0.75 SD (p = 0.014); for PMD, it decreased from 2.649 to 1.73 (p = 0.018). Thus, the direction and statistical significance of the 12-month differential changes were retained across these scenarios, while their magnitudes were sensitive to the assumed departure from MAR.

Table 13

Sensitivity analysis comparing FIML and multiple imputation results.

Difference = FIML estimate − MI estimate. FIML = full-information maximum likelihood; MI = multiple imputation. Differences describe numerical agreement between point estimates.

Table 14

Delta-adjusted sensitivity analyses for 12-month differential change.

MAR = missing at random. Negative δ scenarios represent progressively lower unobserved outcomes. Group × T4 estimates are differences between conditions in change from baseline to 12 months. Results concern the specified sensitivity scenarios.

5 Discussion

Among adolescents from four Chinese schools, compassion training produced greater baseline-to-wave change in ER and PMD than relaxation training, including at 12 months. The piecewise results indicated larger gains during the intervention followed by attenuation during follow-up, partially supporting H3. Within-person ER predicted subsequent PMD across all three intervals in the compassion condition, whereas the reverse association was significant in the first two intervals only. However, formal between-condition tests did not support H4. The distinction between an intervention effect on average outcomes and an intervention effect on reciprocal temporal coupling is central to interpreting these findings.

Comparison with published trials calls for outcome-specific interpretation. In the MYRIAD trial, 84 schools and 8,376 participants contributed to an analysis that found no superiority of universal school mindfulness over usual provision at one year (Kuyken et al., 2022). In a smaller active-control trial of 59 adolescents with subsyndromal depression, Bluth et al. (2024) reported a 2.6-fold higher risk of clinically significant depression in the control condition across 36 weeks, while self-compassion increased in both conditions and continuation-session attendance was poor. Xavier et al. (2023) found no significant group-by-time interaction for emotional control, empathy, or cooperation despite some within-group improvements. Differences in age, clinical risk, outcomes, comparator, and follow-up may contribute to this variation in findings.

Baseline-SD-standardized differential changes were approximately 0.49 for ER and 0.44 for PMD at post-test, and 0.32 and 0.28 at 12 months. These estimates describe the magnitude of the relative changes, which were smaller at later assessments. Their practical importance should be considered alongside classroom functioning, student engagement, and implementation burden. Matching contact time and prescribed home practice strengthened the comparison with relaxation training, although expectancy, facilitator allegiance, and actual practice could still influence outcomes. The decline after the intervention suggests that maintenance strategies, including booster sessions or continued practice support, merit evaluation.

The observed pattern may reflect a process through which improved emotion regulation supports more stable prosocial engagement. Developmental research indicates that empathy and related socioemotional processes are closely associated with prosocial behavior during childhood and adolescence (Qiu et al., 2024), while longitudinal evidence suggests that empathy and prosocial behavior can develop in interconnected ways over time (Carrizales et al., 2025). When confronted with interpersonal tension or another person’s suffering, adolescents who can identify, tolerate, and reappraise their own emotional responses may retain more attentional capacity for perspective-taking and other-oriented decision-making. Empathy has also been identified as an important pathway linking social influences with adolescent prosocial behavior (Li et al., 2025a). Under these circumstances, personal distress and self-focused rumination may become less dominant, allowing empathic concern to be translated more readily into moral intention or action.

The temporal pattern was compatible with a continuing contribution of ER to later PMD within the compassion condition. A reverse association was present across the first two intervals but not the final interval. Compassionate engagement may also support reappraisal of personal distress, a possibility consistent with associations involving interpersonal emotion regulation and self-compassion in adolescent studies (Mu et al., 2025; Nguyen et al., 2025). These cross-lagged associations do not establish causal mediation, and their differences across intervals may partly reflect unequal lag durations. Future studies could test whether changes in practice, classroom climate, or compassion-related processes mediate longer-term outcomes.

The analytical strategy distinguished differential average change, phase-specific growth, and within-person temporal association. Three-level models accounted for repeated observations within students and students within classes. Piecewise growth models distinguished intervention-period gains from follow-up trajectories. The RI-CLPM separated stable between-person differences from within-person deviations, avoiding their conflation in conventional cross-lagged models (Hamaker et al., 2015). Measurement-invariance results supported longitudinal and between-condition comparisons under the fitted models (Little, 2024). The active control, classroom randomization, and ITT analyses further strengthened the design.

The nonsignificant Wald tests are particularly relevant to H4. Significant associations within the compassion condition, combined with weaker or nonsignificant associations in the active-control condition, did not translate into significant differences between conditions. Formal parameter comparisons are essential for this distinction (Mulder and Hamaker, 2021). The results support temporal associations within the compassion condition but not an intervention-specific strengthening of reciprocal coupling; nonsignificant differences also do not establish equivalence.

Several limitations warrant consideration. Attrition reached 40.4% at 12 months, and completers differed in age, gender, and socioeconomic status. Delta-adjusted analyses retained positive differential changes over the examined range, but smaller estimates under more negative δ values show that effect magnitude depends on assumptions about unobserved outcomes. Scenarios outside this range could yield different conclusions. Self-reported outcomes may be influenced by social desirability and shared-method variance. The 34 randomized classes and four participating schools limit precision and generalizability, even with classroom-cluster adjustment. Facilitator blinding was infeasible, fidelity assessment covered only a sample of sessions, and individual practice adherence may have varied. Finally, the absence of systematic adverse-effect assessment limits conclusions about tolerability. Replication with stronger retention, additional schools, multimethod assessment, and prospective monitoring would address these limitations.

The exclusion of adolescents receiving clinical treatment or reporting a major traumatic event within the preceding six months limits generalizability to these groups. Future studies should evaluate the program in more inclusive school samples with appropriate clinical support.

The next step should be replication in a preregistered, multisite trial involving more schools, stronger follow-up procedures, and fully prespecified longitudinal-model constraints. The need for replication is especially relevant because recent reviews of compassion-focused interventions with children and adolescents indicate promising outcomes but also substantial heterogeneity and continuing limitations in the evidence base (Roberts et al., 2026). Adding brief booster sessions after T2 would be especially informative because this would allow researchers to test whether the observed decline reflects reduced practice and whether limited reinforcement can maintain the initial gains. Future assessments should include self-report, behavioral, observational, peer-reported, and teacher-reported indicators, together with systematic monitoring of possible adverse responses and implementation burden. Mechanism-focused analyses examining whether reappraisal, personal distress, empathic concern, classroom climate, or practice adherence account for later changes in prosocial moral development would also be valuable. Before subgroup findings inform implementation, heterogeneity by age, baseline regulatory capacity, socioeconomic context, and school environment should be examined in adequately powered samples.

The findings support further evaluation of compassion training as a classroom approach to ER and PMD in comparable settings. Maintaining gains after the program and identifying the processes responsible for change remain priorities for future trials.

6 Conclusion

In this cluster-randomized trial of 876 adolescents, compassion training produced greater improvement in ER and PMD than relaxation training, with relative advantages remaining at 12 months. Gains were concentrated during the intervention and attenuated during follow-up. H1 and H2 were supported, H3 was partially supported, and H4 was not supported: cross-lagged coefficients did not differ significantly between conditions. Positive 12-month differential changes persisted across the delta-adjusted sensitivity scenarios, although their magnitudes decreased under stronger departures from MAR. These findings support further evaluation of the curriculum while highlighting the importance of maintaining gains, improving retention, and testing generalizability across school settings.

Statements

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

The studies involving humans were approved by Institutional Ethics Committee, Nanjing Normal University. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants’ legal guardians/next of kin.

Author contributions

YS: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Resources, Validation, Visualization, Writing – original draft, Writing – review & editing.

Funding

The author(s) declared that financial support was not received for this work and/or its publication.

Conflict of interest

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Generative AI statement

The author(s) declared that Generative AI was used in the creation of this manuscript. Generative AI was used solely to identify language and grammatical issues and to assist with linguistic editing of the manuscript. It was not used for study design, data analysis, interpretation of results, or generation of scientific content. The author reviewed and takes full responsibility for the final manuscript.

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References

• 1

  AguileraP.Navarro-GilM.Pérez-ArandaA.Armas-LandaetaC.Beltrán-RuizM.Rodríguez-FreireC.et al. (2025). Applying a school-based mindfulness and compassion program (“Escuelas Despiertas”) in Spanish secondary schools to reduce psychological distress in adolescents: a randomized controlled trial. Sch. Ment. Health17, 234–246. doi: 10.1007/s12310-024-09722-1

  • CrossRef
  • Google Scholar

• 2

  BluthK.LathrenC.ParkJ.LynchC.CurryJ.Harris-BrittA.et al. (2024). Feasibility, acceptability, and depression outcomes of a randomized controlled trial of mindful self-compassion for teens (MSC-T) for adolescents with subsyndromal depression. J. Adolesc.96, 322–336. doi: 10.1002/jad.12277

  • CrossRef
  • Google Scholar

• 3

  CampbellM. K.PiaggioG.ElbourneD. R.AltmanD. G.CONSORT Group (2012). CONSORT 2010 statement: extension to cluster randomised trials. BMJ345, e5661–e5661. doi: 10.1136/bmj.e5661

  • CrossRef
  • Google Scholar

• 4

  CarrizalesA.BranjeS.LannegrandL. (2021). Disentangling between- and within-person associations between empathy and prosocial behaviours during early adolescence. J. Adolesc.93, 114–125. doi: 10.1016/j.adolescence.2021.10.006,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 5

  CarrizalesA.CarloG.LannegrandL. (2025). A parallel-process analysis of the longitudinal associations between adolescents’ empathy and prosocial behaviors. Dev. Psychol.61, 1669–1683. doi: 10.1037/dev0001937,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 6

  CirimeleF.PastorelliC.RemondiC.ZuffianòA.ThartoriE.GerbinoM.et al. (2024). The development of prosocial behavior from late childhood to adolescence: a longitudinal and multicultural study. Front. Dev. Psychol.2:1472589. doi: 10.3389/fdpys.2024.1472589,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 7

  CromptonK.KaklamanouD.FasuloA.SomogyiE. (2024). The effects of a school-based mindfulness programme (paws b) on empathy and prosocial behaviour: a randomised controlled trial. Mindfulness15, 1080–1094. doi: 10.1007/s12671-024-02345-2

  • CrossRef
  • Google Scholar

• 8

  EndersC. K. (2022). Applied Missing data Analysis. 2nd Edn New York, NY: Guilford Press.

  • Google Scholar

• 9

  GilbertP. (2014). The origins and nature of compassion focused therapy. Br. J. Clin. Psychol.53, 6–41. doi: 10.1111/bjc.12043,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 10

  GillB. K.BalodisI. M.MinuzziL.ShahN.BoylanK. (2024). Neural correlates of emotion dysregulation in adolescents: a systematic review. Discov. Psychol.4:31. doi: 10.1007/s44202-024-00146-1

  • CrossRef
  • Google Scholar

• 11

  GrossJ. J.JohnO. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J. Pers. Soc. Psychol.85, 348–362. doi: 10.1037/0022-3514.85.2.348,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 12

  HaagA.-C.BagrodiaR.BonannoG. A. (2024). Emotion regulation flexibility in adolescents: a systematic review from conceptualization to methodology. Clin. Child. Fam. Psychol. Rev.27, 697–713. doi: 10.1007/s10567-024-00483-6,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 13

  HamakerE. L.KuiperR. M.GrasmanR. P. P. P. (2015). A critique of the cross-lagged panel model. Psychol. Methods20, 102–116. doi: 10.1037/a0038889,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 14

  HayesD.DenizE.NisbetK.ThompsonA.MarchA.MasonC.et al. (2025). Universal, school-based, interventions to improve emotional outcomes in children and young people: a systematic review and meta-analysis. Front. Child Adolesc. Psychiatry4:1526840. doi: 10.3389/frcha.2025.1526840,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 15

  HellandS. S.MellblomA. V.KjøbliJ.Wentzel-LarsenT.EspenesK.EngellT.et al. (2022). Elements in mental health interventions associated with effects on emotion regulation in adolescents: a meta-analysis. Admin. Pol. Ment. Health49, 1004–1018. doi: 10.1007/s10488-022-01213-2,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 16

  HopewellS.ChanA.-W.CollinsG. S.HróbjartssonA.MoherD.SchulzK. F.et al. (2025). CONSORT 2025 statement: updated guideline for reporting randomised trials. BMJ389:e081123. doi: 10.1136/bmj-2024-081123,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 17

  JuulL.FrydenbergM.BondeE. H.BeckM. S.GoetzscheK.NielsenH. B.et al. (2025). Mindfulness in the school curriculum? A nationwide cluster-randomized trial of the effectiveness of implementing a mindfulness-based intervention for 9–16-year-olds students in Danish elementary schools. Soc. Sci. Med.378:118117. doi: 10.1016/j.socscimed.2025.118117

  • CrossRef
  • Google Scholar

• 18

  KanderT. N.LawrenceD.FoxA.HoughtonS.BecerraR. (2024). Mindfulness-based interventions for preadolescent children: a comprehensive meta-analysis. J. Sch. Psychol.102:101261. doi: 10.1016/j.jsp.2023.101261,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 19

  KuykenW.BallS.CraneC.GanguliP.JonesB.Montero-MarinJ.et al. (2022). Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Evid. Based Ment. Health25, 99–109. doi: 10.1136/ebmental-2021-300396,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 20

  LiX.FuX.WangY.LiuC. (2025b). Longitudinal relationship between adolescent emotional self-regulation and prosocial behavior toward powerful people: disentangling between-person differences from within-person effects. J. Adolesc.97, 467–478. doi: 10.1002/jad.12432,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 21

  LiW.HeQ.-F.LanJ.-Z.Attiq-Ur-RehmanGeM.-W.ShenL.-T.et al. (2025a). Empathy as a mediator of the relation between peer influence and prosocial behavior in adolescence: a meta-analysis. J. Youth Adolesc.54, 682–703. doi: 10.1007/s10964-024-02079-3

  • CrossRef
  • Google Scholar

• 22

  LittleT. D. (2024). Longitudinal structural equation modeling. 2nd Edn New York, NY: Guilford Press.

  • Google Scholar

• 23

  LlistosellaM.CastellvíP.García-OrtizM.López-HitaG.TornéC.OrtizR.et al. (2024). Effectiveness of a resilience school-based intervention in adolescents at risk: a cluster-randomized controlled trial. Front. Psychol.15:1478424. doi: 10.3389/fpsyg.2024.1478424,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 24

  MaratosF. A.WoodW.CahillR.Tronco HernándezY. A.MatosM.GilbertP. (2024). A mixed-methods study of compassionate mind training for pupils (CMT-pupils) as a school-based wellbeing intervention. Mindfulness15, 459–478. doi: 10.1007/s12671-024-02303-y

  • CrossRef
  • Google Scholar

• 25

  Memmott-ElisonM.Padilla-WalkerL. M.YorgasonJ. B.CoyneS. M. (2020). Intra-individual associations between intentional self-regulation and prosocial behavior during adolescence: evidence for bidirectionality. J. Adolesc.80, 29–40. doi: 10.1016/j.adolescence.2020.02.001,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 26

  MuX.WangQ.WuN.LiuS. (2025). The influence of empathy on the interpersonal emotion regulation strategies of adolescents. Sci. Rep.15:17613. doi: 10.1038/s41598-025-00802-z

  • CrossRef
  • Google Scholar

• 27

  MulderJ. D.HamakerE. L. (2021). Three extensions of the random intercept cross-lagged panel model. Struct. Equ. Model.28, 638–648. doi: 10.1080/10705511.2020.1784738

  • CrossRef
  • Google Scholar

• 28

  NeffK. (2003). Self-compassion: an alternative conceptualization of a healthy attitude toward oneself. Self Identity2, 85–101. doi: 10.1080/15298860309032

  • CrossRef
  • Google Scholar

• 29

  NeuenschwanderR.von GuntenF. O. (2025). Self-compassion in children and adolescents: a systematic review of empirical studies through a developmental lens. Curr. Psychol.44, 755–783. doi: 10.1007/s12144-024-07053-7

  • CrossRef
  • Google Scholar

• 30

  NguyenA.GrummittL.BarrettE. L.BaileyS.GardnerL. A.ChampionK. E.et al. (2025). The relationship between emotion regulation and mental health in adolescents: self-compassion as a moderator. Ment. Health Prev.38:200430. doi: 10.1016/j.mhp.2025.200430

  • CrossRef
  • Google Scholar

• 31

  QiuX.GaoM.ZhuH.LiW.JiangR. (2024). Theory of mind, empathy, and prosocial behavior in children and adolescent: a meta-analysis. Curr. Psychol.43, 19690–19707. doi: 10.1007/s12144-024-05762-7

  • CrossRef
  • Google Scholar

• 32

  RitgensC.BondüR.WarschburgerP. (2024). Links between self-regulation patterns and prosocial behavior trajectories from middle childhood to early adolescence: a longitudinal study. Front. Psychol.15:1480046. doi: 10.3389/fpsyg.2024.1480046,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 33

  RobertsG.ParishN.SamuelV. (2026). The use and outcomes of compassion-focused group interventions with children and adolescent clinical populations: a systematic review and narrative synthesis. Clin. Psychol. Psychother.33:e70259. doi: 10.1002/cpp.70259,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 34

  SaiL.LuoS.WardA.SangB. (2016). Development of the tendency to use emotion regulation strategies and their relation to depressive symptoms in Chinese adolescents. Front. Psychol.7:1222. doi: 10.3389/fpsyg.2016.01222,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 35

  SeekisV.FarrellL.Zimmer-GembeckM. (2023). A classroom-based pilot of a self-compassion intervention to increase wellbeing in early adolescents. Explore19, 267–270. doi: 10.1016/j.explore.2022.06.003,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 36

  ShiJ.CheungA. C. K. (2024). Effective components of social emotional learning programs: a meta-analysis. J. Youth Adolesc.53, 755–771. doi: 10.1007/s10964-024-01942-7

  • CrossRef
  • Google Scholar

• 37

  VaishA.GrossmannT. (2024). How sharp is the compassion–sympathy distinction?Trends Cogn. Sci.28, 1051–1052. doi: 10.1016/j.tics.2024.08.006

  • CrossRef
  • Google Scholar

• 38

  van MeegenM.Van der GraaffJ.CarloG.MeeusW.BranjeS. (2024). Longitudinal associations between support and prosocial behavior across adolescence: the roles of fathers, mothers, siblings, and friends. J. Youth Adolesc.53, 1134–1154. doi: 10.1007/s10964-023-01885-5,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 39

  VietenC.RubanovichC. K.KhatibL.SprengelM.TanegaC.PolizziC.et al. (2024). Measures of empathy and compassion: a scoping review. PLoS One19:e0297099. doi: 10.1371/journal.pone.0297099

  • CrossRef
  • Google Scholar

• 40

  VolanenS.-M.HolopainenM.LahtiJ.VahlbergT.HintsanenM. (2026). The healthy learning mind project: does a universal mindfulness programme reduce stress symptoms and increase self-kindness among adolescents in schools?Psychol. Sch.63, 589–604. doi: 10.1002/pits.70112

  • CrossRef
  • Google Scholar

• 41

  WangX.CenY.WangP. (2026). Callous-unemotional traits, moral disengagement, and prosocial and bullying behaviors in adolescence: disentangling between- and within-person associations. J. Youth Adolesc.55, 674–689. doi: 10.1007/s10964-025-02235-3,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 42

  WangT.QiW. (2023). Mindfulness may buffer the longitudinal influence of peer rejection on adolescents’ prosocial behavior: a cross-lagged study. J. Soc. Pers. Relat.40, 3051–3064. doi: 10.1177/02654075231167550

  • CrossRef
  • Google Scholar

• 43

  Ward-SeidelA. R.Rimm-KaufmanS. E.BellB. A.SandilosL. E. (2025). Belonging contributes to compassion: a longitudinal study of middle school students’ prosocial competencies. J. Appl. Dev. Psychol.99:101834. doi: 10.1016/j.appdev.2025.101834

  • CrossRef
  • Google Scholar

• 44

  XavierA.VagosP.PalmeiraL.MenezesP.PatrãoB.MendesS. A.et al. (2023). The me and the us of emotions: a cluster-randomized controlled trial of the feasibility and efficacy of a compassion-based social-emotional learning program for children. Front. Psychol.14:1196457. doi: 10.3389/fpsyg.2023.1196457,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

• 45

  ZhouW.McLellanR. (2024). The effectiveness of taught, self-help mindfulness-based interventions on Chinese adolescents’ well-being, mental health, prosocial and difficult behavior, and coping strategy. Appl. Psychol. Health Well Being16, 1024–1045. doi: 10.1111/aphw.12517,

  • Pubmed Abstract
  • CrossRef
  • Google Scholar

Keywords

adolescence, cluster-randomized controlled trial, compassion training, emotion regulation, latent growth modeling, longitudinal analysis, prosocial moral development, RI-CLPM

Citation

Sun Y (2026) Longitudinal effects of compassion training on emotion regulation and prosocial moral development among adolescents. Front. Psychol. 17:1969277. doi: 10.3389/fpsyg.2026.1969277

Received

16 August 2026

Revised

27 September 2026

Accepted

30 September 2026

Published

13 October 2026

Volume

17 - 2026

Edited by

Lidia Scifo, Libera Università Maria SS. Assunta, Italy

Updates

Copyright

© 2026 Sun.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Yutong Sun, sunyt0827@163.com

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