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Aguilar-Raab C, Winter F, Warth M, Stoffel M, Moessner M, Hernández C, Pace TWW, Harrison T, Negi LT, Jarczok MN, Ditzen B. A compassion-based treatment for couples with the female partner suffering from current depressive disorder: A randomized-controlled trial. J Affect Disord 2023; 342:127-138. [PMID: 37661057 DOI: 10.1016/j.jad.2023.08.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Studies have shown that depression and interpersonal relationships are interdependently connected and that including the intimate partner in treatment for depression has beneficial effects. Given evidence that compassion is both an interpersonal quality and a promising treatment target, the goal of this study was to examine the effects of a compassion-based, contemplative treatment for couples employing a multi-method approach for evaluation. METHODS In a pre-post-follow-up design, n = 53 different-sex couples including women with current depression were randomly assigned to a 10-week-long CBCT®-fC (Cognitively-Based Compassion Training/intervention for couples) or treatment-as-usual (TAU) condition. Multi-level linear regression models and post-hoc contrasts were calculated to determine changes in depressive symptoms, mindfulness and self-compassion, interpersonal functioning and neuroendocrine markers collected during a partnership appreciation task (PAT) in the laboratory before and after CBCT-fC treatment. RESULTS While CBCT-fC led to a comparable decrease of depressive symptoms as TAU, the training specifically increased self-compassion and mindfulness versus TAU. Interestingly, interpersonal functioning did not improve, which was also reflected in participants' preferred self-focus in-between-session practices, instead of practices with interpersonal focus. There were no group-specific changes in psychobiological stress-marker reactivity. CONCLUSIONS CBCT-fC was effective in decreasing current depressive symptomatology and increasing mindfulness, and self-compassion. Especially the motivation to participate, such as improving interpersonal functioning, should be addressed and intrinsic motives of the partners to be involved. In highly burdened individuals, self-regulation may need to be improved before co-regulation can be addressed, which would requiring longer treatments. Facilitating factors for engaging in the practice between-sessions seem meaningful.
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Affiliation(s)
- Corina Aguilar-Raab
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
| | - Friederike Winter
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Marco Warth
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; School of Therapeutic Sciences, SRH University Heidelberg, Heidelberg, Germany
| | - Martin Stoffel
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Markus Moessner
- Institute of Psychosocial Prevention, Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Cristóbal Hernández
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; Escuela de Psicología - Universidad Adolfo Ibáñez, Chile
| | | | - Timothy Harrison
- Center for Contemplative Science and Compassion-Based Ethics, Emory University, Atlanta, GA, USA
| | - Lobsang Tenzin Negi
- Center for Contemplative Science and Compassion-Based Ethics, Emory University, Atlanta, GA, USA
| | - Marc N Jarczok
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany; Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
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