Assessing mindfulness and self-compassion facets as mediators of change in patients with depressive, anxious and adjustment disorders: Secondary data analysis of a randomized controlled trial

Objective: Understanding how different psychotherapies produce their effect can lead to identifying mechanisms of change that could be enhanced to produce better outcomes. This study aims at exploring the potential mediating role of mindfulness and self-compassion facets in the effect of mindfulness-based stress reduction (MBSR) and attachment-based compassion therapy (ABCT) for reducing general affective distress in a sample of patients with anxiety, depressive, and/or adjustment disorders.Method: Ninety patients participated in a randomized controlled trial with three assessment points: baseline, posttreatment, and 6-months follow-up. The primary outcome was the 'Depression, Anxiety, and Stress Scale'. The 'Five Facets of Mindfulness Questionnaire', and the 'Self-Compassion Scale' were used for assessing the corresponding facets as potential mediating variables. Path analysis models were computed, comparing each treatment to the treated as usual control group.Results and conclusion: The three facets of self-compassion were mediators of the effect of MBSR on affective distress and, in the case of ABCT, 'Self-kindness' was the only mediator. Thus, self-compassion facets seem to be potential mediators of MBSR; 'Self-kindness' would be the intermediary variable for ABCT's effect. Nevertheless, these results are exploratory and need to be replicated.