Attachment-Based Compassion Therapy for Ameliorating Fibromyalgia: Mediating Role of Mindfulness and Self-Compassion

Jesus Montero-Marin, William Van Gordon, Edo Shonin, Mayte Navarro-Gil*, Virginia Gasión, Yolanda López-del-Hoyo, Juan V. Luciano, Javier Garcia-Campayo

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)


Objectives: The aim of this study was to evaluate the efficacy of Attachment-Based Compassion Therapy (ABCT)—a standardised programme that includes practices to improve compassionate awareness with the aim of addressing maladaptive attachment—for improving mindfulness and self-compassion in fibromyalgia (FM) patients, and to determine whether gains in mindfulness and self-compassion mediate improvements in FM functional status together with comorbid anxiety and depression. Methods: The study comprised a randomised controlled trial of individuals undergoing ABCT, with a Relaxation condition as an active control group. Baseline, post-test, and 3-month follow-up assessments were included. Participants (n = 42) were FM patients randomly assigned to ABCT or relaxation. Outcomes were functional status (FIQ), anxiety (HADS-A), depression (HADS-D), mindfulness (FFMQ), and self-compassion (SCS). Differences between groups were estimated using mixed-effects regression models, and mediation analyses were conducted using path analyses. Results: Compared with the Relaxation condition, the ABCT group was more effective for improving mindfulness and self-compassion, as it observed through changes in the FFMQ and SCS subscales. Effect sizes were in the moderately large to large range (Cohen’s d between 0.60–2.20). Reductions in FM functional status were not mediated by either mindfulness or self-compassion. However, the self-compassion facet of common humanity was a mediator for reductions in both anxiety (B = − 2.04; bootstrapped 95% CI = − 4.44, − 0.04) and depression (B = − 2.12; bootstrapped 95% CI = − 4.40, − 0.45). Conclusions: The improvement of common humanity via ABCT might be an active component for the reduction of comorbid anxiety and depression in FM patients. Trial registration: NCT02454244.

Original languageEnglish
Pages (from-to)816-828
Number of pages13
Issue number3
Publication statusPublished - 10 Mar 2020


  • ABCT
  • Anxiety
  • Depression
  • Fibromyalgia
  • Mindfulness
  • Self-compassion


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