Effectiveness of mindfulness-based stress reduction and attachment-based compassion therapy for the treatment of depressive, anxious and adjustment disorders in mental health settings: A randomized controlled trial

Abstract

Objectives: 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 action mechanisms.Methods: This randomised controlled trial involved assessment time points of pre-treatment, post-treatment, and 6-months 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 performed to estimate the efficacy of the programme, and path analysis were conducted to study the potential mechanistic role of mindfulness and self-compassion.Results: ABCT was not superior to MBSR in any outcome or assessment point. ABCT was superior to TAU both post-treatment (B=-13.20; 95% CI: -19.57, -6.84) and at 12-month follow-up (B=-7.20; 95% CI: -13.63, -0.76) for reducing DASS-21, and MBSR was superior to TAU both post-treatment (B=-11.51; 95% CI: -17.97, -5.05) and at 12-month follow-up (B=-8.59; 95% CI -15.09, -2.10), with large effects (d≥0.90). Changes produced in DASS-21 by ABCT were mediated by self-compassion, while changes produced by MBSR were mediated by both mindfulness and self-compassion.Conclusion: ABCT is efficacious for reducing affective distress in patients with anxiety, depressive or adjustment disorders, although its effect is not superior to MBSR’s. Self-compassion seems to be a significant mediator of the effects of ABCT.

Effectiveness of Mindfulness-Based Compassion Therapy on Despair and Rumination in Older Adults

“…Hopelessness is a negative feeling happening frequently among the older adults and is usually related to the failure of doing the activities they can't deal with as they did when they were younger (2).They soon stop working due to fear of failure (3). Old age is accompanied by feeling of rejection, depression, decrease of mood and social interaction and waiting for death (4). They feel hopeless about many things and are emotionally offended and discouraged (5).…”