Pub Date : 2024-10-01DOI: 10.1016/j.jcbs.2024.100854
Francisco J. Ruiz , Javier M. Bianchi , Douglas M. Bastidas-Suárez , Eduar S. Ramírez , Valentina Peña-Hernández
The Acceptance and Action Questionnaire – II (AAQ-II) has been heavily criticized based on factor-analytic studies that analyzed its discriminant validity. These studies have suggested that the AAQ-II may measure trait negative emotion/neuroticism, which has led some authors to suggest that the studies utilizing the AAQ-II might be reread, changing "psychological flexibility” or "experiential avoidance” for "neuroticism,” "negative emotion,” or "distress.” We suggest most of these findings are due to the inconsistent use of the AAQ-II as a measure of psychological flexibility and experiential avoidance instead of psychological inflexibility. Additionally, we analyze the discriminant validity of the Spanish version of the AAQ-II in three Colombian samples. In Study 1, we conducted both exploratory graph analysis (EGA) and exploratory factor analysis (EFA) to determine the number of dimensions in a general online sample (N = 2398) and a treatment-seeking sample (N = 358) that responded to the AAQ-II and the Depression, Anxiety, and Stress Scale – 21 (DASS-21). In Study 2, we conducted the same analyses in a general online sample (N = 444) that responded to the AAQ-II, DASS-21, and the Big Five Inventory – 2 Neuroticism subscale. All analyses indicated that the AAQ-II items pertained to a unique community/factor and strongly supported the discriminant validity of the AAQ-II in Colombian samples. We recommend using the AAQ-II only as a measure of psychological inflexibility and argue that it is too adventurous to suggest the reinterpretation of thousands of studies and discourage journals from publishing articles using the AAQ-II.
{"title":"Is the AAQ-II that bad?","authors":"Francisco J. Ruiz , Javier M. Bianchi , Douglas M. Bastidas-Suárez , Eduar S. Ramírez , Valentina Peña-Hernández","doi":"10.1016/j.jcbs.2024.100854","DOIUrl":"10.1016/j.jcbs.2024.100854","url":null,"abstract":"<div><div>The Acceptance and Action Questionnaire – II (AAQ-II) has been heavily criticized based on factor-analytic studies that analyzed its discriminant validity. These studies have suggested that the AAQ-II may measure trait negative emotion/neuroticism, which has led some authors to suggest that the studies utilizing the AAQ-II might be reread, changing \"psychological flexibility” or \"experiential avoidance” for \"neuroticism,” \"negative emotion,” or \"distress.” We suggest most of these findings are due to the inconsistent use of the AAQ-II as a measure of psychological flexibility and experiential avoidance instead of psychological inflexibility. Additionally, we analyze the discriminant validity of the Spanish version of the AAQ-II in three Colombian samples. In Study 1, we conducted both exploratory graph analysis (EGA) and exploratory factor analysis (EFA) to determine the number of dimensions in a general online sample (<em>N</em> = 2398) and a treatment-seeking sample (<em>N</em> = 358) that responded to the AAQ-II and the Depression, Anxiety, and Stress Scale – 21 (DASS-21). In Study 2, we conducted the same analyses in a general online sample (<em>N</em> = 444) that responded to the AAQ-II, DASS-21, and the Big Five Inventory – 2 Neuroticism subscale. All analyses indicated that the AAQ-II items pertained to a unique community/factor and strongly supported the discriminant validity of the AAQ-II in Colombian samples. We recommend using the AAQ-II only as a measure of psychological inflexibility and argue that it is too adventurous to suggest the reinterpretation of thousands of studies and discourage journals from publishing articles using the AAQ-II.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100854"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jcbs.2024.100845
Kristiina Räihä, Henna Asikainen, Nina Katajavuori
Previous research in higher education has shown that Acceptance and Commitment Therapy (ACT) -based interventions have beneficial effects on students’ well-being. However, not much is known about the range of behaviour changes behind these outcomes.
In this mixed methods study, we explored the variety of the changes ACT-based course participating university students (N = 101) describe in their reflective learning reports. We did so by applying the Extended Evolutionary Meta Model (EEMM) in abductive content analysis, and by applying network visualisation of the various study burnout risk change groups.
The results showed that the largest proportion of students described changes in the EEMM dimension of overt behaviour (75%), especially time and effort management. Vitality, and decreased distress were the most described outcomes related to behaviour changes.
Study burnout risk decreased significantly at the course level. When observing the interrelations of behaviour changes in the networks of burnout risk change groups, alongside time and effort management, attentional and affective dimensions representing present moment awareness and acceptance were central changes in the group that had the greatest reduction in burnout risk. These findings contribute to the need to map out the variety of beneficial mechanisms and serve further idiographic research about changes during study-integrated ACT-based interventions.
{"title":"Changes in university students’ behaviour and study burnout risk during ACT-based online course intervention: A mixed methods study","authors":"Kristiina Räihä, Henna Asikainen, Nina Katajavuori","doi":"10.1016/j.jcbs.2024.100845","DOIUrl":"10.1016/j.jcbs.2024.100845","url":null,"abstract":"<div><div>Previous research in higher education has shown that Acceptance and Commitment Therapy (ACT) -based interventions have beneficial effects on students’ well-being. However, not much is known about the range of behaviour changes behind these outcomes.</div><div>In this mixed methods study, we explored the variety of the changes ACT-based course participating university students (N = 101) describe in their reflective learning reports. We did so by applying the Extended Evolutionary Meta Model (EEMM) in abductive content analysis, and by applying network visualisation of the various study burnout risk change groups.</div><div>The results showed that the largest proportion of students described changes in the EEMM dimension of overt behaviour (75%), especially time and effort management. Vitality, and decreased distress were the most described outcomes related to behaviour changes.</div><div>Study burnout risk decreased significantly at the course level. When observing the interrelations of behaviour changes in the networks of burnout risk change groups, alongside time and effort management, attentional and affective dimensions representing present moment awareness and acceptance were central changes in the group that had the greatest reduction in burnout risk. These findings contribute to the need to map out the variety of beneficial mechanisms and serve further idiographic research about changes during study-integrated ACT-based interventions.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100845"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jcbs.2024.100843
Wanting Zu , Fei Li , Xiaoxuan Ma , Shiyun Zhang , Wenbo Nie , Lisheng Wang
Background and objective
Anxiety, depression, and diabetes distress are three common psychological distresses among people with type 2 diabetes. Although previous research has explored factors associated with them, most studies have viewed these factors as independent constructs, overlooking the complex interactions between these factors, which can limit our understanding of psychological symptoms and associated factors from an integrated perspective. The purpose of this study was to explore the relationships between psychological distress outcomes and related psychological factors in people with diabetes from a network analysis perspective and further provide evidence for the selection of specific psychological intervention targets.
Design and setting
A cross-sectional study was conducted in person at diabetes centers of three tertiary hospitals in China.
Participants
481 adults with type 2 diabetes (62% male; mean age 51.91 ± 13.64 years; mean HbA1c 9.34 ± 2.23%) were recruited between December 2022 and April 2023.
Methods
Psychological distress outcomes and related factors analyzed included depression (PHQ-9), anxiety (GAD-7), diabetes distress (DDS), acceptance level (AADQ), cognitive fusion (CFQ), social support (PSSS), and self-efficacy (DMSES). Correlation analyses and network analyses were used to explore complex associations among these variables.
Results
The network included ten nodes, diabetes-related interpersonal distress, anxiety, and regimen-related distress were the most influential in the network. Significant relationships emerged in networks with five nodes, with both acceptance level and cognitive fusion associated with the general psychological distress and diabetes distress; social support demonstrated stable associations with all three psychological outcomes in each network.
Conclusion
After controlling for other factors, psychological flexibility and social support could still be significantly associated with psychological distress outcomes, indicating the potential to integrate them as transdiagnostic processes into psychological interventions for this population. However, the results of this study are based on the group level, and the dynamic networks of individuals need to be further explored in order to meet the needs of individuals in different contexts.
{"title":"Exploring the interconnectedness of depression, anxiety, diabetes distress, and related psychosocial factors in adults with type 2 diabetes: A network analysis","authors":"Wanting Zu , Fei Li , Xiaoxuan Ma , Shiyun Zhang , Wenbo Nie , Lisheng Wang","doi":"10.1016/j.jcbs.2024.100843","DOIUrl":"10.1016/j.jcbs.2024.100843","url":null,"abstract":"<div><h3>Background and objective</h3><div>Anxiety, depression, and diabetes distress are three common psychological distresses among people with type 2 diabetes. Although previous research has explored factors associated with them, most studies have viewed these factors as independent constructs, overlooking the complex interactions between these factors, which can limit our understanding of psychological symptoms and associated factors from an integrated perspective. The purpose of this study was to explore the relationships between psychological distress outcomes and related psychological factors in people with diabetes from a network analysis perspective and further provide evidence for the selection of specific psychological intervention targets.</div></div><div><h3>Design and setting</h3><div>A cross-sectional study was conducted in person at diabetes centers of three tertiary hospitals in China.</div></div><div><h3>Participants</h3><div>481 adults with type 2 diabetes (62% male; mean age 51.91 ± 13.64 years; mean HbA1c 9.34 ± 2.23%) were recruited between December 2022 and April 2023.</div></div><div><h3>Methods</h3><div>Psychological distress outcomes and related factors analyzed included depression (PHQ-9), anxiety (GAD-7), diabetes distress (DDS), acceptance level (AADQ), cognitive fusion (CFQ), social support (PSSS), and self-efficacy (DMSES). Correlation analyses and network analyses were used to explore complex associations among these variables.</div></div><div><h3>Results</h3><div>The network included ten nodes, diabetes-related interpersonal distress, anxiety, and regimen-related distress were the most influential in the network. Significant relationships emerged in networks with five nodes, with both acceptance level and cognitive fusion associated with the general psychological distress and diabetes distress; social support demonstrated stable associations with all three psychological outcomes in each network.</div></div><div><h3>Conclusion</h3><div>After controlling for other factors, psychological flexibility and social support could still be significantly associated with psychological distress outcomes, indicating the potential to integrate them as transdiagnostic processes into psychological interventions for this population. However, the results of this study are based on the group level, and the dynamic networks of individuals need to be further explored in order to meet the needs of individuals in different contexts.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100843"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jcbs.2024.100842
Narae Jeong , Eunjung Kim , Jonghoon Chun
As social costs rise due to the increasing prevalence of depression, there is a growing emphasis on cost-effective and evidence-based psychotherapeutic methods. Acceptance and Commitment Therapy (ACT) for depression is an effective approach that reduces depressive symptoms and helps prevent recurrence by enhancing psychological flexibility. This study developed a mobile app-based ACT and tested its effectiveness for college students with depression. Eighty college students with depression were randomly assigned to either a treatment group (n = 41) or a control group (n = 39). The treatment group received mobile app-based ACT for 4 weeks, the control group waited without treatment. The scores from pre, post, and follow-up assessments were compared between the two groups. Significant interaction effects of time and group were found for depression and anxiety symptoms, as well as for treatment process variables such as acceptance, inflexibility, defusion, values, commitment, and mindfulness. Acceptance and cognitive defusion emerged as significant mediators in the impact of mobile app-based ACT on depression. The mobile app-based ACT effectively reduced depression and improved treatment process variables, demonstrating its cost-effectiveness. The study also discusses the implications, limitations, and directions for future research.
{"title":"Effects of a randomized controlled trial of mobile app-based Acceptance and Commitment Therapy on depressive symptoms and process variables in college students - Focusing on the mediating effects of acceptance and cognitive defusion-","authors":"Narae Jeong , Eunjung Kim , Jonghoon Chun","doi":"10.1016/j.jcbs.2024.100842","DOIUrl":"10.1016/j.jcbs.2024.100842","url":null,"abstract":"<div><div>As social costs rise due to the increasing prevalence of depression, there is a growing emphasis on cost-effective and evidence-based psychotherapeutic methods. Acceptance and Commitment Therapy (ACT) for depression is an effective approach that reduces depressive symptoms and helps prevent recurrence by enhancing psychological flexibility. This study developed a mobile app-based ACT and tested its effectiveness for college students with depression. Eighty college students with depression were randomly assigned to either a treatment group (<em>n</em> = 41) or a control group (<em>n</em> = 39). The treatment group received mobile app-based ACT for 4 weeks, the control group waited without treatment. The scores from pre, post, and follow-up assessments were compared between the two groups. Significant interaction effects of time and group were found for depression and anxiety symptoms, as well as for treatment process variables such as acceptance, inflexibility, defusion, values, commitment, and mindfulness. Acceptance and cognitive defusion emerged as significant mediators in the impact of mobile app-based ACT on depression. The mobile app-based ACT effectively reduced depression and improved treatment process variables, demonstrating its cost-effectiveness. The study also discusses the implications, limitations, and directions for future research.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100842"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jcbs.2024.100841
Paul Sandery, John Baranoff, Diana Dorstyn
Third wave interventions have demonstrated efficacy as a treatment option to promote wellbeing in adolescents. Evidence of their effectiveness for chronic mental health disorders remains unclear. The PubMed, PsycINFO, ProQuest, Embase, and CINAHL databases were searched from inception until March 2024 for five established interventions: acceptance and commitment therapy (ACT), compassion focused therapy, dialectical behaviour therapy (DBT), mindfulness-based cognitive therapy, and mindfulness-based stress reduction (MBSR). Risk of bias was assessed (QualSyst tool), and standardized mean group differences (Hedges’ g) with associated p-values, 95% confidence intervals, and prediction intervals calculated. Three randomized controlled trials and 10 single-group designs, all assessing DBT and representing 700 adolescents (most with subthreshold or full syndrome borderline personality disorder), were included. All studies were of sound methodological quality. DBT was associated with large and significant reductions in mental health symptoms (depression, anxiety, emotional regulation, suicidal ideation, self-harm, and BPD symptoms; g range = 0.69 to 1.05) – although individual variability in treatment response was noted. Symptom improvements were maintained at follow-up (g range = 0.70 to 1.71), although based on limited data. Neither DBT intensity nor duration significantly moderated treatment effects. DBT is the most assessed intervention for adolescents with severe emotional or behavioral problems. Additional controlled studies with diverse samples are needed to confirm the unique effects of DBT relative to other promising third wave interventions. Protocol registration: Open Science Framework [https://osf.io/fgd2j/].
{"title":"Third wave interventions for adolescents with mental health disorders: A systematic review with meta-analysis","authors":"Paul Sandery, John Baranoff, Diana Dorstyn","doi":"10.1016/j.jcbs.2024.100841","DOIUrl":"10.1016/j.jcbs.2024.100841","url":null,"abstract":"<div><div>Third wave interventions have demonstrated efficacy as a treatment option to promote wellbeing in adolescents. Evidence of their effectiveness for chronic mental health disorders remains unclear. The PubMed, PsycINFO, ProQuest, Embase, and CINAHL databases were searched from inception until March 2024 for five established interventions: acceptance and commitment therapy (ACT), compassion focused therapy, dialectical behaviour therapy (DBT), mindfulness-based cognitive therapy, and mindfulness-based stress reduction (MBSR). Risk of bias was assessed (QualSyst tool), and standardized mean group differences (Hedges’ <em>g</em>) with associated <em>p</em>-values, 95% confidence intervals, and prediction intervals calculated. Three randomized controlled trials and 10 single-group designs, all assessing DBT and representing 700 adolescents (most with subthreshold or full syndrome borderline personality disorder), were included. All studies were of sound methodological quality. DBT was associated with large and significant reductions in mental health symptoms (depression, anxiety, emotional regulation, suicidal ideation, self-harm, and BPD symptoms; <em>g</em> range = 0.69 to 1.05) – although individual variability in treatment response was noted. Symptom improvements were maintained at follow-up (<em>g</em> range = 0.70 to 1.71), although based on limited data. Neither DBT intensity nor duration significantly moderated treatment effects. DBT is the most assessed intervention for adolescents with severe emotional or behavioral problems. Additional controlled studies with diverse samples are needed to confirm the unique effects of DBT relative to other promising third wave interventions. Protocol registration: Open Science Framework [<span><span>https://osf.io/fgd2j/</span><svg><path></path></svg></span>].</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100841"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jcbs.2024.100849
Hannah Taylor , Jessica Kingston , Michelle D. Taylor
A randomised multiple-baseline design assessed the preliminary efficacy of a low-intensity, minimally-guided, online, self-help Acceptance and Commitment Therapy (ACT) intervention for people affected by cancer on quality of life (QoL), psychological symptoms, psychological flexibility, and level of interference from pain and fatigue. Acceptability and feasibility was also assessed. Adult participants (n = 7) had either completed cancer treatment within the last 18 months or were currently receiving treatment. Participants were randomly assigned to a baseline length of 1–3 weeks prior to completing the six-week ACT intervention, followed by a one-month follow-up. At pre- and post-intervention, and one-month follow-up, cancer-specific QoL, psychological symptoms (anxiety and depression), and psychological flexibility were assessed using standardised questionnaires. Single-item daily ratings of mood, anxiety, psychological flexibility, and bother ratings of pain and fatigue were also assessed. Questionnaire data were analysed using reliable and clinically significant change. Daily measures were analysed using visual and Tau-U analysis. Participants reported less negative impact of cancer on QoL (n = 3: CancerDQoL), fewer depressive symptoms (n = 5: HADS depression), less anxiety (n = 3; HADS anxiety) and greater psychological flexibility (n = 3: MPFI) at follow-up. Daily measures showed improvements in self-reported mood (n = 3), anxiety (n = 3) and psychological flexibility (n = 5) across different phase comparisons. Most participants (n = 5) were significantly less bothered by fatigue at follow-up, and two were significantly less bothered by pain. Feedback from participants supported the acceptability of the intervention. The results provide preliminary support for the efficacy of the ACT intervention in reducing the negative impact of cancer on QoL, and improving self-reported psychological outcomes and psychological flexibility. Longitudinal studies utilising a larger sample are warranted.
{"title":"Web-based Acceptance and Commitment Therapy (ACT) for adults living with cancer: A single case experimental design (SCED)","authors":"Hannah Taylor , Jessica Kingston , Michelle D. Taylor","doi":"10.1016/j.jcbs.2024.100849","DOIUrl":"10.1016/j.jcbs.2024.100849","url":null,"abstract":"<div><div>A randomised multiple-baseline design assessed the preliminary efficacy of a low-intensity, minimally-guided, online, self-help Acceptance and Commitment Therapy (ACT) intervention for people affected by cancer on quality of life (QoL), psychological symptoms, psychological flexibility, and level of interference from pain and fatigue. Acceptability and feasibility was also assessed. Adult participants (n = 7) had either completed cancer treatment within the last 18 months or were currently receiving treatment. Participants were randomly assigned to a baseline length of 1–3 weeks prior to completing the six-week ACT intervention, followed by a one-month follow-up. At pre- and post-intervention, and one-month follow-up, cancer-specific QoL, psychological symptoms (anxiety and depression), and psychological flexibility were assessed using standardised questionnaires. Single-item daily ratings of mood, anxiety, psychological flexibility, and bother ratings of pain and fatigue were also assessed. Questionnaire data were analysed using reliable and clinically significant change. Daily measures were analysed using visual and Tau-U analysis. Participants reported less negative impact of cancer on QoL (n = 3: CancerDQoL), fewer depressive symptoms (n = 5: HADS depression), less anxiety (n = 3; HADS anxiety) and greater psychological flexibility (n = 3: MPFI) at follow-up. Daily measures showed improvements in self-reported mood (n = 3), anxiety (n = 3) and psychological flexibility (n = 5) across different phase comparisons. Most participants (n = 5) were significantly less bothered by fatigue at follow-up, and two were significantly less bothered by pain. Feedback from participants supported the acceptability of the intervention. The results provide preliminary support for the efficacy of the <span>ACT</span> intervention in reducing the negative impact of cancer on QoL, and improving self-reported psychological outcomes and psychological flexibility. Longitudinal studies utilising a larger sample are warranted.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100849"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jcbs.2024.100852
Jacob Schachter, Alex A. Ajayi, Jesus E. Delgado
Acceptance and commitment therapy (ACT) is based on the psychological flexibility model, underpinned by six core processes: contact with the present moment, acceptance, cognitive defusion, self as context, values, and committed action. The current study examined the roles of these processes in the first randomized controlled trial to examine the efficacy of a mental health promotion intervention for college students based on Trauma-Focused ACT (TFACT; Ajayi et al., 2024; Harris, 2021). The hybrid intervention combined web-based modules with peer coaching in a research laboratory setting. This current study aimed to extend those findings by empirically evaluating the theoretical components of the ACT model of psychological flexibility. Participants were 78 college students ranging between 18 and 32 years of age. It was found that the level of changes in awareness, self as context, values, and committed action were significantly different between the intervention and control groups, while psychological inflexibility, acceptance, and cognitive fusion were not. Simple regressions suggested that changes in psychological inflexibility significantly predicted changes in life satisfaction at post-intervention and 3-month follow-up. Whereas, changes in psychological inflexibility predicted changes in psychological distress only at follow-up. Furthermore, penalized regressions suggested awareness and cognitive fusion significantly predicted changes in psychological distress, but did not predict changes in psychological inflexibility or life satisfaction. The current study adds to the knowledge base regarding the process of change in ACT interventions to inform the design and implementation of more targeted and effective mental health interventions.
{"title":"Evaluating the core processes of a hybrid trauma-informed acceptance and commitment therapy intervention for college students","authors":"Jacob Schachter, Alex A. Ajayi, Jesus E. Delgado","doi":"10.1016/j.jcbs.2024.100852","DOIUrl":"10.1016/j.jcbs.2024.100852","url":null,"abstract":"<div><div>Acceptance and commitment therapy (ACT) is based on the psychological flexibility model, underpinned by six core processes: contact with the present moment, acceptance, cognitive defusion, self as context, values, and committed action. The current study examined the roles of these processes in the first randomized controlled trial to examine the efficacy of a mental health promotion intervention for college students based on Trauma-Focused ACT (TFACT; Ajayi et al., 2024; Harris, 2021). The hybrid intervention combined web-based modules with peer coaching in a research laboratory setting. This current study aimed to extend those findings by empirically evaluating the theoretical components of the ACT model of psychological flexibility. Participants were 78 college students ranging between 18 and 32 years of age. It was found that the level of changes in awareness, self as context, values, and committed action were significantly different between the intervention and control groups, while psychological inflexibility, acceptance, and cognitive fusion were not. Simple regressions suggested that changes in psychological inflexibility significantly predicted changes in life satisfaction at post-intervention and 3-month follow-up. Whereas, changes in psychological inflexibility predicted changes in psychological distress only at follow-up. Furthermore, penalized regressions suggested awareness and cognitive fusion significantly predicted changes in psychological distress, but did not predict changes in psychological inflexibility or life satisfaction. The current study adds to the knowledge base regarding the process of change in ACT interventions to inform the design and implementation of more targeted and effective mental health interventions.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100852"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jcbs.2024.100846
Elisabet Casellas-Pujol , Joaquim Soler , Carlos Schmidt , Anna Soria-Madrid , Matilde Elices , Juan Carlos Pascual
Long-term follow-up studies have shown that the symptoms of borderline personality disorder (BPD) tend to remit over time. However, many patients present long lasting symptoms (LLS), including low mood, emptiness, and persistent impairment in psychosocial adjustment. Given the high rate of LLS in BPD patients, new treatment strategies are needed. We conducted a randomized clinical trial (RCT) to evaluate the efficacy of a novel intervention that combines self-compassion and contextual-based skills for patients with persistent symptoms. Sixty BPD individuals with LLS who had received dialectical behavior therapy skills training (DBT-ST) in the previous six months were recruited and randomized to receive the experimental intervention or treatment as usual (TAU) for 12 weeks. All participants were evaluated pre- and post-intervention and at 3-months follow-up. The primary outcome measure was self-reported well-being. Other clinical variables were also evaluated, including depressive symptoms, BPD symptoms, functionality, self-compassion, and self-criticism. Participants in the experimental arm showed a significant increase in indicators of well-being (e.g., happiness and quality of life) and a significant decrease in depressive symptoms. These results were sustained—and even continued to improve—at the three-month follow-up. No significant changes were observed in BPD severity, self-criticism, or self-compassion. More RCTs are needed to test the efficacy of new interventions targeting this population with persistent symptoms, not only to reduce symptoms but also to promote well-being and personal recovery.
{"title":"Contextual-compassion training for borderline personality disorder with long lasting symptoms: A randomized clinical trial","authors":"Elisabet Casellas-Pujol , Joaquim Soler , Carlos Schmidt , Anna Soria-Madrid , Matilde Elices , Juan Carlos Pascual","doi":"10.1016/j.jcbs.2024.100846","DOIUrl":"10.1016/j.jcbs.2024.100846","url":null,"abstract":"<div><div>Long-term follow-up studies have shown that the symptoms of borderline personality disorder (BPD) tend to remit over time. However, many patients present long lasting symptoms (LLS), including low mood, emptiness, and persistent impairment in psychosocial adjustment. Given the high rate of LLS in BPD patients, new treatment strategies are needed. We conducted a randomized clinical trial (RCT) to evaluate the efficacy of a novel intervention that combines self-compassion and contextual-based skills for patients with persistent symptoms. Sixty BPD individuals with LLS who had received dialectical behavior therapy skills training (DBT-ST) in the previous six months were recruited and randomized to receive the experimental intervention or treatment as usual (TAU) for 12 weeks. All participants were evaluated pre- and post-intervention and at 3-months follow-up. The primary outcome measure was self-reported well-being. Other clinical variables were also evaluated, including depressive symptoms, BPD symptoms, functionality, self-compassion, and self-criticism. Participants in the experimental arm showed a significant increase in indicators of well-being (e.g., happiness and quality of life) and a significant decrease in depressive symptoms. These results were sustained—and even continued to improve—at the three-month follow-up. No significant changes were observed in BPD severity, self-criticism, or self-compassion. More RCTs are needed to test the efficacy of new interventions targeting this population with persistent symptoms, not only to reduce symptoms but also to promote well-being and personal recovery.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100846"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jcbs.2024.100853
Alberto Misitano , Giovanni Michelini , Annalisa Oppo
Background
psychological flexibility and inflexibility represent complex sets of modifiable processes that may influence suicidal ideation, a major risk factor for suicide in clinical and non-clinical populations. The relationship between each psychological (in)flexibility process, suicidal ideation, and two ideation-specific risk factors (thwarted belongingness and perceived burdensomeness) was investigated.
Methods
409 Italian participants from the general population (Mage = 30.1, SD = 12.3, 76.5% female; 24.7% reporting recent suicidal ideation) completed an online battery of questionnaires, including the Multidimensional Psychological Flexibility Inventory, the Patient Health Questionnaire-9, and the Interpersonal Needs Questionnaire-15. Relationships between variables were explored using network analysis.
Results
cognitive fusion (responding to mental contents as objectively true) and Self-as-Context (flexible perspective-taking) emerged as the most central inflexibility and flexibility processes, respectively. Both processes were directly connected to suicidal ideation.
Conclusion
cognitive fusion and Self-as-Context may be suitable processes to be targeted in future research about suicidal ideation. Further long-term studies, possibly conducted with larger and more diverse samples and including a wider range of suicide-specific risk factors, are warranted to better elucidate the role of psychological (in)flexibility processes in suicidal individuals and to inform clinical practice.
{"title":"Understanding suicidal ideation through psychological flexibility and inflexibility: A network analysis perspective","authors":"Alberto Misitano , Giovanni Michelini , Annalisa Oppo","doi":"10.1016/j.jcbs.2024.100853","DOIUrl":"10.1016/j.jcbs.2024.100853","url":null,"abstract":"<div><h3>Background</h3><div>psychological flexibility and inflexibility represent complex sets of modifiable processes that may influence suicidal ideation, a major risk factor for suicide in clinical and non-clinical populations. The relationship between each psychological (in)flexibility process, suicidal ideation, and two ideation-specific risk factors (thwarted belongingness and perceived burdensomeness) was investigated.</div></div><div><h3>Methods</h3><div>409 Italian participants from the general population (M<sub>age</sub> = 30.1, SD = 12.3, 76.5% female; 24.7% reporting recent suicidal ideation) completed an online battery of questionnaires, including the <em>Multidimensional Psychological Flexibility Inventory</em>, the <em>Patient Health Questionnaire-9</em>, and the <em>Interpersonal Needs Questionnaire-15</em>. Relationships between variables were explored using network analysis.</div></div><div><h3>Results</h3><div>cognitive fusion (responding to mental contents as objectively true) and Self-as-Context (flexible perspective-taking) emerged as the most central inflexibility and flexibility processes, respectively. Both processes were directly connected to suicidal ideation.</div></div><div><h3>Conclusion</h3><div>cognitive fusion and Self-as-Context may be suitable processes to be targeted in future research about suicidal ideation. Further long-term studies, possibly conducted with larger and more diverse samples and including a wider range of suicide-specific risk factors, are warranted to better elucidate the role of psychological (in)flexibility processes in suicidal individuals and to inform clinical practice.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100853"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1016/j.jcbs.2024.100840
Ross G. Menzies , Rachel E. Menzies
This article reviews the central theoretical claims found in the various psychotherapeutic approaches broadly referred to as the existential therapies. Despite substantial differences across existential packages, these therapies broadly arise from the theoretical position that the pain and suffering common to our species arises, not from illnesses hypothesized in traditional medical and psychiatric accounts, but rather from a set of existential concerns that all humans must face. These ‘givens’ of existence include death, identity, isolation, meaning, and freedom. From this theoretical perspective, all branches and brands of psychotherapy need to include some procedures to address these issues. Evidence for the importance of these constructs in human experience is presented, followed by evidence for existential therapies themselves. A dearth of quality research trials establishing a strong evidence base for this branch of therapy was noted. Further, process-based research in this area was shown to be weak. That is, few researchers have sought to show that the hypothesized processes are responsible for the changes observed in existential therapy. We describe how viewing existential therapy through a Process-Based Therapy (PBT) framework and the Extended Evolutionary Meta-Model (EEMM) will encourage: (1) a greater examination of the processes of change occurring; (2) an expansion in the way in which existential therapies operate, enabling the inclusion of procedures drawn from other therapeutic modalities; and (3) more nuanced targeting of existential processes in any given case.
{"title":"Existential therapies and the extended evolutionary meta-model: Turning existential philosophy into process-based therapy","authors":"Ross G. Menzies , Rachel E. Menzies","doi":"10.1016/j.jcbs.2024.100840","DOIUrl":"10.1016/j.jcbs.2024.100840","url":null,"abstract":"<div><p>This article reviews the central theoretical claims found in the various psychotherapeutic approaches broadly referred to as the existential therapies. Despite substantial differences across existential packages, these therapies broadly arise from the theoretical position that the pain and suffering common to our species arises, not from illnesses hypothesized in traditional medical and psychiatric accounts, but rather from a set of existential concerns that all humans must face. These ‘givens’ of existence include death, identity, isolation, meaning, and freedom. From this theoretical perspective, all branches and brands of psychotherapy need to include some procedures to address these issues. Evidence for the importance of these constructs in human experience is presented, followed by evidence for existential therapies themselves. A dearth of quality research trials establishing a strong evidence base for this branch of therapy was noted. Further, process-based research in this area was shown to be weak. That is, few researchers have sought to show that the hypothesized processes are responsible for the changes observed in existential therapy. We describe how viewing existential therapy through a Process-Based Therapy (PBT) framework and the Extended Evolutionary Meta-Model (EEMM) will encourage: (1) a greater examination of the processes of change occurring; (2) an expansion in the way in which existential therapies operate, enabling the inclusion of procedures drawn from other therapeutic modalities; and (3) more nuanced targeting of existential processes in any given case.</p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100840"},"PeriodicalIF":3.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212144724001200/pdfft?md5=63409ce5a89376292fe26f1b78d62ed2&pid=1-s2.0-S2212144724001200-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号