000119589 001__ 119589 000119589 005__ 20230519145459.0 000119589 0247_ $$2doi$$a10.1002/da.23198 000119589 0248_ $$2sideral$$a126134 000119589 037__ $$aART-2021-126134 000119589 041__ $$aeng 000119589 100__ $$aCollado-Navarro C. 000119589 245__ $$aEffectiveness 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 000119589 260__ $$c2021 000119589 5060_ $$aAccess copy available to the general public$$fUnrestricted 000119589 5203_ $$aObjectives: 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. Methods: 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. Results: 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. Conclusion: 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. © 2021 Wiley Periodicals LLC 000119589 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/CD20-00181 000119589 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/ 000119589 590__ $$a8.128$$b2021 000119589 591__ $$aPSYCHIATRY$$b15 / 144 = 0.104$$c2021$$dQ1$$eT1 000119589 591__ $$aPSYCHOLOGY$$b10 / 81 = 0.123$$c2021$$dQ1$$eT1 000119589 591__ $$aPSYCHIATRY$$b21 / 157 = 0.134$$c2021$$dQ1$$eT1 000119589 591__ $$aPSYCHOLOGY, CLINICAL$$b9 / 132 = 0.068$$c2021$$dQ1$$eT1 000119589 592__ $$a2.657$$b2021 000119589 593__ $$aPsychiatry and Mental Health$$c2021$$dQ1 000119589 593__ $$aClinical Psychology$$c2021$$dQ1 000119589 594__ $$a11.1$$b2021 000119589 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion 000119589 700__ $$aNavarro-Gil M. 000119589 700__ $$aPérez-Aranda A. 000119589 700__ $$0(orcid)0000-0002-1690-4130$$aLópez-del-Hoyo Y.$$uUniversidad de Zaragoza 000119589 700__ $$0(orcid)0000-0002-3797-4218$$aGarcia-Campayo J.$$uUniversidad de Zaragoza 000119589 700__ $$aMontero-Marin J. 000119589 7102_ $$14009$$2730$$aUniversidad de Zaragoza$$bDpto. Psicología y Sociología$$cÁrea Psicología Básica 000119589 7102_ $$11007$$2745$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Psiquiatría 000119589 773__ $$g38, 11 (2021), 1138-1151$$pDepress. anxiety$$tDepression and Anxiety$$x1091-4269 000119589 8564_ $$s1009928$$uhttps://zaguan.unizar.es/record/119589/files/texto_completo.pdf$$yPostprint 000119589 8564_ $$s2103716$$uhttps://zaguan.unizar.es/record/119589/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint 000119589 909CO $$ooai:zaguan.unizar.es:119589$$particulos$$pdriver 000119589 951__ $$a2023-05-18-14:54:09 000119589 980__ $$aARTICLE