Compassion-Based Family Intervention for Adolescents

Using the score of Perceived Emotional Synchrony Scale to assess perceived emotional synchrony of parents and children respectively.

Perceived emotional synchrony scale (16-item version): items rated 1-7; the investigators report mean subscale scores (range 1-7) for Emotional Communion (items 1, 4, 5, 7, 8, 11, 14, 15) and Felt Unity (items 2, 3, 6, 9, 10, 12, 13, 16). Higher scores indicate greater perceived emotional synchrony (better outcome).

Using the Self-Compassion Scale to assess self-compassion levels of parents and children respectively.

Self-Compassion Scale (SCS): 26 items rated 1-5; the investigators report the mean score (range 1-5). Higher scores indicate greater self-compassion (better outcome).

Using the Fears of Compassion Scales to assess fears of compassion levels of parents and children respectively.

Fears of Compassion Scales (FCS): three subscales rated 0-4 - Fear of Compassion for Self (15 items; total 0-60), Fear of Compassion for Others (10 items; total 0-40), and Fear of Receiving Compassion from Others (13 items; total 0-52). Higher scores indicate greater fear of compassion (worse outcome).

Using the Parenting Stress Index-Short Form to assess parenting stress. Parenting Stress Index-Short Form (PSI-SF): 36 items rated 1-5; the investigators report the total score (range 36-180). Higher scores indicate greater parenting stress (worse outcome).

Using the Children's Depression Inventory scale to assess children's depression levels.

Children's Depression Inventory (CDI): 27 items rated 0-2; the investigators report the total score (range 0-54). Higher scores indicate more severe depressive symptoms (worse outcome).

Using the Beck Anxiety Inventory to assess children's anxiety levels. Beck Anxiety Inventory (BAI): 21 items rated 0-3; the investigators report the total score (range 0-63). Higher scores indicate more severe anxiety (worse outcome).

Wavelet transform coherence (WTC) was computed from oxy-hemoglobin (ΔHbO) and deoxy-hemoglobin (ΔHbR) signals measured by fNIRS during an emotional video task. The primary outcome is the WTC value in the 0.02-0.1 Hz frequency band, reflecting brain-to-brain synchrony. Higher coherence indicates stronger neural synchrony.

Heart rate variability (HRV) metrics in parents and children were measured using wearable wristbands (Huawei Band 8) throughout both the emotional video task and group intervention sessions.

Using the Parenting Scale-7 to assess parenting styles. Parenting Scale-7 (PS-7): 7 items rated 1-7; the investigators report the mean score (range 1-7). Higher scores indicate more dysfunctional parenting practices (worse outcome).

Using the Egna Minnen av Barndoms Uppfostran to assess the parenting styles in children's view.

Egna Minnen av Barndoms Uppfostran (EMBU; "My Memories of Upbringing"), 21-item version: items rated 1-4; the investigators report summed subscale scores for Rejection (items 1, 4, 7, 12, 14, 19), Emotional Warmth (items 2, 6, 9, 11, 13, 17, 21), and Overprotection (items 3, 5, 8, 10, 15R, 16, 18, 20), with item 15 reverse-scored. Higher Rejection and Overprotection indicate worse outcomes, whereas higher Emotional Warmth indicates better outcomes.

Using the Child-Parent Relationship Scale, 30-item scale to assess the Parent-child relationships from the perspective of parents.

Child-Parent Relationship Scale, 30-item version (CPRS): items rated 1-5; the investigators report mean subscale scores (range 1-5) for Closeness, Conflict, and Dependence. Higher Closeness indicates a better relationship (better outcome), whereas higher Conflict and higher Dependence indicate worse outcomes.

Using the Remembered Relationship with Parents, 10-item scale to assess the Parent-child relationships from the perspective of children.

Remembered Relationship with Parents, 10-item scale (RRP10): 10 items rated 0-4; the investigators report the total score (range 0-40). Higher scores indicate more negative remembered relationships with parents (worse outcome).

Using the Nonclinging to Ego Scale to assess nonclinging to ego levels of parents and children respectively.

Nonclinging to Ego Scale (NES): 33 items rated 1-6; the investigators report the total score (range 33-198). Higher scores indicate greater nonattachment to self (better outcome).

Using the Self-Stigma in Relatives of people with Mental Illness Scale to assess the parental self-stigmatization.

Self-Stigma in Relatives of people with Mental Illness Scale (SSRMI): 30 items rated 1-5; the investigators report the mean score (range 1-5). Higher scores indicate greater self-stigma among relatives (worse outcome).

Using the Perceived Criticism Measure to assess the parent' perceived criticism levels.

Perceived Criticism Measure (PCM): items rated 1-10; the investigators report the mean score (range 1-10). Higher scores indicate greater perceived criticism (worse outcome).

Using the Family Expressiveness Questionnaire to assess the family expressiveness.

Family Expressiveness Questionnaire (FEQ): 20 items rated 1-9; the investigators report the mean score (range 1-9). Higher scores indicate more frequent family emotional expressiveness; when reporting Positive vs. Negative Expressiveness subscales, higher Positive is considered better and higher Negative is considered worse.

Using the Emotion Regulation Questionnaire, 6-item version to assess the emotion regulation levels of parents and children respectively.

Emotion Regulation Questionnaire, 6-item version (ERQ-6): items rated 1-7; the investigators report mean subscale scores (range 1-7) for Cognitive Reappraisal (4 items) and Expressive Suppression (2 items). Higher Reappraisal indicates more frequent use of cognitive reappraisal (typically better outcome), whereas higher Suppression indicates more frequent use of expressive suppression (typically worse outcome).

Using the Concise Chinese Level of Expressed Emotion Scale to assess the concise Chinese level of expressed emotion of children.

Concise Chinese Level of Expressed Emotion Scale (CCLEES): 12 items rated 1-4; the investigators report the mean score (range 1-4). Higher scores indicate higher expressed emotion (typically associated with worse outcomes).

Using the Parental Burnout Assessment to assess the parental burnout level. Parental Burnout Assessment (PBA): 23 items rated 0-6; the investigators report the total score (range 0-138). Higher scores indicate greater parental burnout (worse outcome).