Department of Psychology, University and Polytechnic La Fe Hospital, Valencia, Spain.
Department of Psychology and Sociology, Department of Psychiatry, University of Zaragoza, Zaragoza, Spain.
Depress Anxiety. 2021 Nov;38(11):1138-1151. doi: 10.1002/da.23198. Epub 2021 Jul 20.
To study the effectiveness of attachment-based compassion therapy (ABCT) for reducing affective distress in a sample of outpatients with depressive, anxiety, or adjustment disorders, and to explore its mechanisms of action.
This randomized controlled trial involved the assessment time points of pretreatment, posttreatment and 6-month follow-up. A total of 90 patients from three mental health units in Castellón, Spain, were recruited and randomly assigned to "ABCT + treatment as usual (TAU)," "Mindfulness-based stress reduction (MBSR) + TAU" or "TAU" alone. Affective distress, as measured by the "Depression, Anxiety and Stress Scales" (DASS-21) was the main outcome; self-compassion and mindfulness were also assessed. Multilevel mixed-effects models were used to estimate the effectiveness of the program, and path analyses were conducted to study the potential mechanistic role of mindfulness and self-compassion.
ABCT was not superior to MBSR in any outcome or at any assessment point. ABCT was superior to TAU alone both posttreatment (B = -13.20; 95% confidence interval [CI]: -19.57, -6.84) and at 6-month follow-up (B = -7.20; 95% CI: -13.63, -0.76) for reducing DASS-21, and MBSR was superior to TAU alone both posttreatment (B = -11.51; 95% CI: -17.97, -5.05) and at 6-month follow-up (B = -8.59; 95% CI: -15.09, -2.10), with large effects (d ≥ 0.90). Changes produced by ABCT in DASS-21 were mediated by self-compassion, whereas changes produced by MBSR were mediated by both mindfulness and self-compassion.
ABCT is effective for reducing affective distress in patients with anxiety, depressive and adjustment disorders, although its effect is not superior to that offered by MBSR. Self-compassion seems to be a significant mediator of the effects of ABCT.
研究基于依恋的同情治疗（ABCT）在减少抑郁、焦虑或适应障碍门诊患者情感困扰方面的有效性，并探讨其作用机制。
这是一项随机对照试验，评估时间点包括治疗前、治疗后和 6 个月随访。共招募了来自西班牙卡斯特利翁的三个心理健康单位的 90 名患者，并随机分配到“ABCT+常规治疗（TAU）”、“正念减压（MBSR）+TAU”或“TAU”单独治疗组。主要结局为“抑郁、焦虑和压力量表”（DASS-21）评估的情感困扰；还评估了自我同情和正念。采用多层次混合效应模型估计该方案的有效性，并进行路径分析以研究正念和自我同情的潜在机制作用。
ABCT 在任何结果或任何评估点上均不比 MBSR 更有效。ABCT 在治疗后（B=-13.20；95%置信区间[CI]：-19.57，-6.84）和 6 个月随访时（B=-7.20；95% CI：-13.63，-0.76）均优于 TAU 单独治疗，而 MBSR 在治疗后（B=-11.51；95% CI：-17.97，-5.05）和 6 个月随访时（B=-8.59；95% CI：-15.09，-2.10）均优于 TAU 单独治疗，效果较大（d≥0.90）。ABCT 对 DASS-21 的影响通过自我同情来介导，而 MBSR 对 DASS-21 的影响通过正念和自我同情来介导。
ABCT 对减轻焦虑、抑郁和适应障碍患者的情感困扰有效，尽管其效果不如 MBSR。自我同情似乎是 ABCT 效果的重要中介。
