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Exploring the Relationship Between Compassion and Attachment in Individuals with Mental Health Difficulties: A Systematic Review

Amari, Nicola; Martin, Tasim; Mahoney, Adam; Peacock, Shona; Stewart, Janet; Alford, Erin Alexandra


Nicola Amari

Tasim Martin

Shona Peacock

Janet Stewart

Erin Alexandra Alford


The objective of the review was to explore the relevance of the relationship of compassion and attachment to mental health. APAPsycInfo, APAPsycArticles, CINAHL, MEDLINE, Social Science Database, Sociology Database, PTSDpubs, Pubmed, and Web of Science were searched from their inception until November 9, 2021. Peer-reviewed empirical studies exploring the compassion–attachment relationship in individuals with mental health difficulties through outcome measures were included. Studies were excluded if non-empirical, with non-clinical/subclinical samples, in a language other than English and if they did not consider the compassion–attachment relationship. Risk of bias was assessed through The Newcastle–Ottawa Scale and the Downs and Black Checklist. Seven eligible studies comprising 4839 participants were identified, with low to moderate risk of overall bias. Findings indicated a more straightforward relationship between self-compassion and secure attachment and confirmed the relevance of compassion and attachment to psychological functioning. Limitations concerned study design, the use of self-report measures, and low generalisability. While suggesting mechanisms underpinning compassion and attachment, the review corroborates the role of secure attachment and self-compassion as therapeutic targets against mental health difficulties. This study is registered on PROSPERO number CRD42021296279.

Journal Article Type Article
Acceptance Date Oct 24, 2022
Online Publication Date Nov 18, 2022
Publication Date 2023-09
Deposit Date Nov 19, 2022
Publicly Available Date Nov 21, 2022
Journal Journal of Contemporary Psychotherapy
Print ISSN 0022-0116
Electronic ISSN 1573-3564
Publisher Springer
Peer Reviewed Peer Reviewed
Volume 53
Issue 3
Pages 245-256
Keywords Compassion, Self-compassion, Attachment, Mental health, Clinical practice, Psychotherapy
Public URL


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