Efficacy of “Attachment-Based Compassion Therapy” in the Treatment of Fibromyalgia: A Randomized Controlled Trial

Abstract

ObjectiveThere is a growing interest in evaluating the effectiveness of compassion interventions for treating psychological disorders. The present study evaluated the effectiveness of “attachment-based compassion therapy” (ABCT) in the treatment of fibromyalgia (FM), and the role of psychological flexibility as a mediator of improvements.MethodsA total of 42 patients with FM were randomly assigned to ABCT or relaxation (active control group). Both the intervention and control condition were combined with treatment as usual (TAU). The primary outcome was functional status (FIQ), and the secondary outcomes were clinical severity (CGI-S), pain catastrophizing (PCS), anxiety (HADS-A), depression (HADS-D), quality of life (EQ-5D), and psychological flexibility (AAQ-II). Differences between the groups were estimated using mixed-effects models, and mediation assessments were conducted using path analyses.ResultsThe ABCT group demonstrated superior outcomes compared to the relaxation group, including better FIQ values after treatment (B = −3.01; p = 0.003). Differences in FIQ were maintained at 3-month follow-up (B = −3.33; p = 0.001). The absolute risk reduction in ABCT compared to relaxation increased by 40.0%, with an NNT = 3 based on criteria of ≥50% FIQ reduction after treatment. Psychological flexibility had a significant mediating effect on improvements.ConclusionThese results suggest that ABCT combined with TAU appears to be effective in the treatment of FM symptoms.Clinical Trial Registration, identifier NCT02454244.

Cost-Utility of Attachment-Based Compassion Therapy (ABCT) for Fibromyalgia Compared to Relaxation: A Pilot Randomized Controlled Trial

“…However, the efficiency of ABCT as a FM treatment has not been previously analyzed. In this study, we extend the results of Montero-Marin et al [15] by examining the 3-month cost-utility of ABCT compared to Relaxation in terms of gains in QALYs from a healthcare perspective. ABCT and Relaxation were structurally equivalent, which provides a comparison of ABCT to a suitable active control that matches it in non-specific factors, but does not contain compassionand mindfulness-based components.…”

“…The same meta-analysis showed that compared to active control conditions, there was a significant moderate effect size for improvements in self-compassion (d = 0.60), mindfulness (d = 0.46), depression (d = 0.62), anxiety (d = 0.42), psychological distress (d = 0.40), and well-being (d = 0.48). Furthermore, Montero-Marin and colleagues [15] showed that ABCT as a coadjuvant of usual care produced greater improvements in the functional status of patients with fibromyalgia (FM) compared to relaxation practices at post-treatment (d = 1.33) and 3-month follow-up (d = 1.38). Significant improvements in the ABCT group were also observed in the following secondary outcomes at post-treatment and follow-up: clinical severity (d = 0.96 and d = 1.14), anxiety (d = 1.03 and d = 0.90), depression (d = 0.94 and d = 1.01), quality of life (d = 0.84 and d = 0.85), and psychological flexibility (d = 1.13 and d = 1.18).…”

“…A detailed description of the RCT protocol is provided elsewhere [15]. A RCT with 2 treatment arms and a pre-, post-and 3-month follow-up assessment was conducted.…”

Online self-compassion training to improve the wellbeing of youth with chronic medical conditions: protocol for a randomised control trial

“…For example, a randomised controlled trial comparing self-compassion training with waitlist control for adults with diabetes found significant improvements in mental health and metabolic outcomes among the intervention group [26]. In addition, a randomised controlled trial of self-compassion training compared with an active control (relaxation) reported a 40% absolute risk reduction for health status in the intervention group for patients with fibromyalgia [43]. Further, previous work has found that self-compassion interventions improve mental health and wellbeing among healthy adolescents [8,9,28].…”

The Bed Nucleus of the Stria Terminalis as a Brain Correlate of Psychological Inflexibility in Fibromyalgia

“…Similarly, higher PF has also been found to be associated with less pain intensity and interference, less anxiety and depressive symptomatology, and improved physical and mental functioning in patients with FM [17,23,24]. Furthermore, PF (and its individual components) have also been reported to mediate clinical changes in acceptance-and mindfulness-based interventions delivered to patients with chronic pain [22,25] and FM [26][27][28].…”