The role of self-criticism in common mental health difficulties in students: A systematic review of prospective studies

Self-criticism is a trans-diagnostic construct that has been receiving considerable research and clinical attention. The purpose of this systematic review was to explore whether there is evidence from prospective studies that self-criticism is significantly associated with subsequent symptoms of psychopathology. Searches were carried out in four electronic databases: PsychInfo, Embase, Medline and The Web of Science Core Collection. The methodological quality of the included studies was assessed and data was extracted and synthesised. Sixteen studies were identified for inclusion in this review, investigating depression only (n = 12), depression and anxiety (n = 2), depression and terrorism-related perceived stress (n = 1) and social anxiety (n = 1). In terms of depression, ten studies observed self-criticism, with weak to moderate effect sizes, to significantly predict an increase in symptoms over time. In terms of anxiety, none of the three studies found self-criticism to significantly predict an increase in symptoms over time. The one study of terrorism-related perceived stress found self-criticism, with a weak effect size, to significantly predict an increase in symptoms over time. The methodological quality of studies ranged from fair to good, with study attrition, and its subsequent consideration in the analysis process, being a primary methodological flaw. The use of the Depressive Experiences Questionnaire (DEQ) to measure self-criticism was also problematic as this scale was designed to measure self-critical depression and includes items about depression. This systematic review provides some evidence that there is a significant prospective relationship between self-criticism and symptoms of psychopathology amongst a student sample, with the strongest evidence for depression.