Effects of attachment-based compassion therapy on brain-derived neurotrophic factor and inflammation among fibromyalgia patients, 2019, Montero-Marin

[Andy]

Full title: Effects of attachment-based compassion therapy (ABCT) on brain-derived neurotrophic factor and low-grade inflammation among fibromyalgia patients: A randomized controlled trial

Fibromyalgia (FM) is a disabling syndrome characterized by chronic pain associated with fatigue. Its pathogenesis is unknown, but alterations in central sensitization, involving an imbalance of brain-derived neurotrophic factor (BDNF) and inflammatory biomarkers, appear to be implicated. The aim of this study was to evaluate the impact of attachment-based compassion therapy (ABCT) on levels of BDNF, the inflammatory markers TNF-α, IL-6, IL-10, and the C-reactive protein (CRP), analysing whether biomarkers play a mediating/moderating role in improvements in FM functional status.

Thirty-four female patients with FM participated in a RCT and were assigned to ABCT or relaxation therapy. Blood extractions were conducted at baseline and post-intervention, with self-report assessments of functional status (FIQ) at baseline, post-intervention and 3-month follow-up. A pro-inflammatory composite was obtained by summing up IL-6, TNF-α and CRP normalized values. Non-parametric tests, analysis of variance and regression models were used to evaluate treatment and mediation/moderation. Compared to relaxation therapy, ABCT showed significant improvements in FIQ and decreases in BDNF, CRP, and pro-inflammatory composite. Changes in BDNF had a mediating role in FIQ. ABCT seems to reduce BDNF and appears to have anti-inflammatory effects in FM patients. Reductions in BDNF could be a mechanism of FM functional status improvement.

Open access, https://www.nature.com/articles/s41598-019-52260-z

 

[shak8]

Nice introduction in the study, a review of what is known about fibromyalgia.

I would posit that the principles of attachment-based compassion develop organically in the person with fibro (in her own way and in her own time).

A sort of radical gratitude toward oneself and toward others occurs in the continuous quest to cope with the illness and the demands of living in the world outside it.

I'm not saying that this form of compassion therapy can't be taught, but I think it is a private personal journey of necessity.

 

[rvallee]

I thought Nature was better than this. Clearly not. Looking forward to studies on the effects of high-intensity Feng-shui on surgical outcomes or testing crystallized homeopathic astrologically-aligned fortune cookies as a prevention against, I don't know, headaches, or whatever.

Both ABCT and relaxation were presented as suitable active interventions and included 8 weekly 2-hour sessions and 3 monthly booster sessions (2 hours each) that were combined with treatment as usual (TAU) provided by the SNHS for FM patients. TAU was offered by the corresponding general practitioner and consisted of administering drugs for pain as well as antidepressants ‒ it could also include pharmacological treatments for insomnia and fatigue.

So multiple unaccounted-for effects were introduced. Good grief this is pathetic.

I cringe every time I see "booster sessions". You're not boosting shit, quit using marketing terms in poor attempts at medicine.

For giggles on ABCT:

The ABCT training program32 was especially adapted for FM patients26. In general, this intervention involved exercises of mindfulness and visualizations focused on augmenting the patients’ ability to be considerate and kind towards themselves as well as others’ experiences when facing suffering. Specifically, ABCT includes exercises of mindfulness breathing, compassionate body scan, connecting with affection and compassion with others, replacing the inner critical voice with a more tolerant one, awareness of the ability to receive affection and of one’s own capacity to give affection and forgiveness and to manage envy and others’ suffering in difficult relationships, equanimity and gratitude.

Almost fortunate that it falls outside of medicine but if economists and sociologists were allowed to get away with nonsense like this they would attempt to treat poverty by "teaching" people to get over it and just stop being envious that better people have more than them, or something like that. At least with economists you would get a minimal attempt at "all other things being equal", which this team clearly did not bother with.

Nature, why you gotta be like that and fluff up the quacks?

 

[Trish]

ABCT sounds to me very like a form of religious practice. I can imagine some people responding to it and finding it helpful, and that's fine for them. I'm afraid I would find it inappropriate and insulting having therapists thinking they need to teach me how to be grateful, compassionate etc.

 

[shak8]

You know, when I first read the title of this research, I said to myself: oh great, the health care professionals are going to be compassionate toward you and display attachment behaviors (like the concerned care of a good mother, always wanting the best for you).

Well, no.

Not only no, but that you have to muster the energy wrested from constant pain self-care to be compassionate to others. What? Huh?

Today I had to go see my new primary care doc because I need a renewal of a drug I've taken every day for 20 years. Every renewal now mandates a doc visit, due to the opioid crisis.

There was nothing for him to talk about, as I soon impressed him as knowing a hell of lot about my illness and associated research.

And in this way, I got to talk about my fibromyalgia for about ten minutes.

Being listened to was the compassion. I felt better after the appointment in a very lovely new way. I don't recall ever feeling this way from a doctor's appointment. Of course, it was a strictly gratuitous visit and I was not in any crisis; those days of tearful office visits are long gone, it seems.

I may contact the researchers of the above research and suggest that they turn it on its head and focus on the promoting the effects of compassion from the health care providers to the fibro patients, displaying attachment behaviors.