Pub Date : 2025-04-01DOI: 10.1016/j.jcbs.2025.100894
L. Brooke Short, Rong Xia, William H. O'Brien
The COVID-19 pandemic was a significant stressor that posed threats to life and ways of living. The harmful psychological effects of the COVID-19 pandemic have been well documented, but positive psychological changes can also follow significant stressors. These changes are referred to as post-traumatic growth (PTG). The present study explored how PTG may develop from a contextual behavioral science perspective. Intolerance of uncertainty and cognitive fusion were longitudinally examined as predictors of PTG from the COVID-19 pandemic in a national United States sample. Self-report data were collected from Amazon Mechanical Turk Workers (MTurk) at three time points between April and November of 2020 as part of a larger study. Results indicated that higher levels of PTS, higher intolerance of uncertainty, and lower cognitive fusion in April 2020 each predicted greater PTG in June 2020 but did not predict change in PTG the next four months. Intolerance of uncertainty and cognitive fusion interacted to predict PTG from June to November with intolerance of uncertainty predicting more growth when cognitive fusion was high and less growth when cognitive fusion was low. Cognitive fusion and intolerance of uncertainty were thus found to be significant predictors of PTG that interacted with each other and varied as a function of time. Explanations for their involvement in the development of PTG across time are offered.
{"title":"Post-traumatic stress, cognitive fusion, and intolerance of uncertainty as longitudinal predictors of post-traumatic growth from the COVID-19 pandemic","authors":"L. Brooke Short, Rong Xia, William H. O'Brien","doi":"10.1016/j.jcbs.2025.100894","DOIUrl":"10.1016/j.jcbs.2025.100894","url":null,"abstract":"<div><div>The COVID-19 pandemic was a significant stressor that posed threats to life and ways of living. The harmful psychological effects of the COVID-19 pandemic have been well documented, but positive psychological changes can also follow significant stressors. These changes are referred to as post-traumatic growth (PTG). The present study explored how PTG may develop from a contextual behavioral science perspective. Intolerance of uncertainty and cognitive fusion were longitudinally examined as predictors of PTG from the COVID-19 pandemic in a national United States sample. Self-report data were collected from Amazon Mechanical Turk Workers (MTurk) at three time points between April and November of 2020 as part of a larger study. Results indicated that higher levels of PTS, higher intolerance of uncertainty, and lower cognitive fusion in April 2020 each predicted greater PTG in June 2020 but did not predict change in PTG the next four months. Intolerance of uncertainty and cognitive fusion interacted to predict PTG from June to November with intolerance of uncertainty predicting more growth when cognitive fusion was high and less growth when cognitive fusion was low. Cognitive fusion and intolerance of uncertainty were thus found to be significant predictors of PTG that interacted with each other and varied as a function of time. Explanations for their involvement in the development of PTG across time are offered.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"36 ","pages":"Article 100894"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873131","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 : 2025-04-01DOI: 10.1016/j.jcbs.2025.100889
Golnaz Atefi , Wolfgang Viechtbauer , Sara Czaja , Rosalie J.M. van Knippenberg , Lieve Van den Block , Joran Geeraerts , Frans R.J. Verhey , Marjolein E. de Vugt , Sara Laureen Bartels
Objectives
Family caregivers of people with dementia are at risk of chronic stress, which can adversely affect their mental well-being. Understanding how daily stressors impact caregivers is crucial for developing effective support strategies.
Methods
This experience sampling study involved spousal caregivers of home-dwelling individuals with dementia. Data on caregivers' appraisals of daily events and their emotional and behavioural responses were collected over six weeks. The association between perceived controllability and unpredictability of events and caregivers' responses, and how these responses predicted future mental well-being outcomes was analysed using a multi-level modelling.
Results
Family caregivers who perceived events as less controllable experienced higher momentary negative affect (B = −.10, SE = .01, p < .001) and lower momentary positive affect (B = .18, SE = .02, p < .001). Similarly, more unpredictable events were associated with lower positive (B = −.05, SE = .01, p < .01) and higher negative momentary affect (B = .03, SE = .01, p < .05). These stressors were also related to reduced engagement in meaningful activities (B = −.09, SE = .02, p < .001) and lower social participation (B = −.03, SE = .01, p < .01). Greater affective reactivity to unpredictable events was linked to increasing stress (B = −24.62, SE = 12.10, p < .05) and decreasing sense of competence (B = −24.86, SE = 11.29, p < .05) over time. Within- and between-person variability of variables was observed.
Conclusion
Uncontrollable and unpredictable events seem to significantly impact some mental well-being outcomes of dementia caregivers. Future research should further investigate the cause of these stressors and whether they are dementia-specific, also using idionomic methods.
痴呆症患者的家庭照顾者面临慢性压力的风险，这可能对他们的心理健康产生不利影响。了解日常压力如何影响照顾者对于制定有效的支持策略至关重要。方法对居家痴呆患者的配偶照顾者进行经验抽样研究。在六周内收集了护理人员对日常事件的评估数据以及他们的情绪和行为反应。事件的可控性和不可预测性与照顾者的反应之间的关系，以及这些反应如何预测未来的心理健康结果，使用多层次模型进行了分析。结果认为事件不可控的家庭照顾者瞬时负性情绪较高（B =−）。10, SE = .01, p <；.001)和较低的瞬间积极情绪(B = .18, SE = .02, p <；措施)。同样，更多不可预测的事件与较低的阳性（B =−）相关。05, SE = .01, p <；.01)和较高的负性瞬间情感(B = .03, SE = .01, p <；. 05)。这些压力源也与减少参与有意义的活动有关（B =−）。09, SE = .02, p <；.001)和较低的社会参与度(B =−。03, SE = .01, p <；. 01)。对不可预测事件的更大情感反应与压力增加有关(B = - 24.62, SE = 12.10, p <；.05)、能力感下降(B = - 24.86, SE = 11.29, p <；.05)随着时间的推移。观察了人内部和人之间变量的可变性。结论不可控制和不可预测的事件似乎对痴呆症照顾者的一些心理健康结果有显著影响。未来的研究应该进一步调查这些压力源的原因，以及它们是否具有痴呆症特异性，也应该使用习惯方法。
{"title":"Momentary appraisals of uncontrollable and unpredictable events predict caregiver well-being: Evidence from an experience sampling study","authors":"Golnaz Atefi , Wolfgang Viechtbauer , Sara Czaja , Rosalie J.M. van Knippenberg , Lieve Van den Block , Joran Geeraerts , Frans R.J. Verhey , Marjolein E. de Vugt , Sara Laureen Bartels","doi":"10.1016/j.jcbs.2025.100889","DOIUrl":"10.1016/j.jcbs.2025.100889","url":null,"abstract":"<div><h3>Objectives</h3><div>Family caregivers of people with dementia are at risk of chronic stress, which can adversely affect their mental well-being. Understanding how daily stressors impact caregivers is crucial for developing effective support strategies.</div></div><div><h3>Methods</h3><div>This experience sampling study involved spousal caregivers of home-dwelling individuals with dementia. Data on caregivers' appraisals of daily events and their emotional and behavioural responses were collected over six weeks. The association between perceived controllability and unpredictability of events and caregivers' responses, and how these responses predicted future mental well-being outcomes was analysed using a multi-level modelling.</div></div><div><h3>Results</h3><div>Family caregivers who perceived events as less controllable experienced higher momentary negative affect (B = −.10, SE = .01, p < .001) and lower momentary positive affect (B = .18, SE = .02, p < .001). Similarly, more unpredictable events were associated with lower positive (B = −.05, SE = .01, p < .01) and higher negative momentary affect (B = .03, SE = .01, p < .05). These stressors were also related to reduced engagement in meaningful activities (B = −.09, SE = .02, p < .001) and lower social participation (B = −.03, SE = .01, p < .01). Greater affective reactivity to unpredictable events was linked to increasing stress (B = −24.62, SE = 12.10, p < .05) and decreasing sense of competence (B = −24.86, SE = 11.29, p < .05) over time. Within- and between-person variability of variables was observed.</div></div><div><h3>Conclusion</h3><div>Uncontrollable and unpredictable events seem to significantly impact some mental well-being outcomes of dementia caregivers. Future research should further investigate the cause of these stressors and whether they are dementia-specific, also using idionomic methods.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"36 ","pages":"Article 100889"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821107","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 : 2025-04-01DOI: 10.1016/j.jcbs.2025.100892
Elizabeth C. Neilson, Daniel W.M. Maitland
Loneliness—the discrepancy between actual and desired levels of social connection—is a pervasive public health concern. Research suggests that many men report loneliness and desire more intimate relationships. The Interpersonal Process Model of Intimacy posits that intimacy, the meaningful connection between two individuals, is a critical variable in preventing loneliness and develops through a bidirectional process of vulnerable self-disclosure, responsiveness, and perceived partner responsiveness. This manuscript applies the Interpersonal Process Model of Intimacy, as interpreted from a contextual behavior science lens, to contextualize the existing research on masculinity and men's social relationships to inform future research and clinical practice. We review the research on men's engagement in different components of the model (vulnerable self-disclosure, responsiveness, perceived partner responsiveness), emphasizing how masculinity informs men's behavior. Research indicates that men often do not engage in behaviors essential to a contextual behavioral model of intimacy (e.g., vulnerable emotions, distress, or asking for help) because such behaviors are inconsistent with masculinity. Research also indicates men often do not acknowledge others' disclosures or respond with judgment or confusion. Men may also perceive responsiveness as stressful due to social proscriptions regarding receiving help. We discuss implications for research and clinical interventions to ameliorate men's loneliness.
{"title":"Masculinity, social connection, and loneliness: A contextual behavioral science approach to men's social relationships and intimacy","authors":"Elizabeth C. Neilson, Daniel W.M. Maitland","doi":"10.1016/j.jcbs.2025.100892","DOIUrl":"10.1016/j.jcbs.2025.100892","url":null,"abstract":"<div><div>Loneliness—the discrepancy between actual and desired levels of social connection—is a pervasive public health concern. Research suggests that many men report loneliness and desire more intimate relationships. The Interpersonal Process Model of Intimacy posits that intimacy, the meaningful connection between two individuals, is a critical variable in preventing loneliness and develops through a bidirectional process of vulnerable self-disclosure, responsiveness, and perceived partner responsiveness. This manuscript applies the Interpersonal Process Model of Intimacy, as interpreted from a contextual behavior science lens, to contextualize the existing research on masculinity and men's social relationships to inform future research and clinical practice. We review the research on men's engagement in different components of the model (vulnerable self-disclosure, responsiveness, perceived partner responsiveness), emphasizing how masculinity informs men's behavior. Research indicates that men often do not engage in behaviors essential to a contextual behavioral model of intimacy (e.g., vulnerable emotions, distress, or asking for help) because such behaviors are inconsistent with masculinity. Research also indicates men often do not acknowledge others' disclosures or respond with judgment or confusion. Men may also perceive responsiveness as stressful due to social proscriptions regarding receiving help. We discuss implications for research and clinical interventions to ameliorate men's loneliness.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"36 ","pages":"Article 100892"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876729","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 : 2025-04-01DOI: 10.1016/j.jcbs.2025.100903
Jennifer Krafft, Ashley C. Middleton, Natalie Tadros
The Multidimensional Psychological Flexibility Inventory (MPFI), and its short form, the MPFI-24, have demonstrated strong psychometric properties in assessing all components of psychological flexibility and inflexibility (Gregoire et al., 2020; Rolffs et al., 2018). However, these measures have not been validated for their use in ecological momentary assessment (EMA), a methodology that is important for understanding within-person change processes and furthering the progress of contextual behavioral science. Therefore, we conducted a preliminary psychometric investigation of the MPFI-EMA, a version of the MPFI-24 adapted for EMA, in a U.S. college student sample (n = 126). Our results provide support for the validity and reliability of the MPFI-EMA. However, validity for assessing within-person variability remained unclear, psychometric limitations were observed for some subscales, and reactivity over time occurred for the MPFI-EMA Psychological Inflexibility scale and specific subscales. Limitations include the use of novel cutoffs, as criteria for psychometric validation within EMA are not well-established, and the need for replication in diverse samples, including clinical populations.
多维心理灵活性量表（MPFI）及其简短形式MPFI-24在评估心理灵活性和不灵活性的所有组成部分方面显示出强大的心理测量特性(Gregoire et al., 2020；Rolffs et al., 2018)。然而，这些措施还没有在生态瞬间评估（EMA）中得到验证，这是一种对理解人体内变化过程和促进环境行为科学进步很重要的方法。因此，我们在美国大学生样本（n = 126）中对MPFI-EMA进行了初步的心理测量调查，这是一种适用于EMA的MPFI-24版本。本研究结果为MPFI-EMA的效度和信度提供了支持。然而，评估个人内部变异性的有效性仍然不清楚，在一些子量表中观察到心理测量的局限性，并且随着时间的推移，MPFI-EMA心理不灵活性量表和特定子量表会出现反应性。局限性包括使用新的截止点，因为EMA内的心理测量验证标准尚未建立，并且需要在包括临床人群在内的不同样本中进行复制。
{"title":"Is the Multidimensional Psychological Flexibility Inventory Short Form valid for ecological momentary assessment? A preliminary psychometric investigation","authors":"Jennifer Krafft, Ashley C. Middleton, Natalie Tadros","doi":"10.1016/j.jcbs.2025.100903","DOIUrl":"10.1016/j.jcbs.2025.100903","url":null,"abstract":"<div><div>The Multidimensional Psychological Flexibility Inventory (MPFI), and its short form, the MPFI-24, have demonstrated strong psychometric properties in assessing all components of psychological flexibility and inflexibility (Gregoire et al., 2020; Rolffs et al., 2018). However, these measures have not been validated for their use in ecological momentary assessment (EMA), a methodology that is important for understanding within-person change processes and furthering the progress of contextual behavioral science. Therefore, we conducted a preliminary psychometric investigation of the MPFI-EMA, a version of the MPFI-24 adapted for EMA, in a U.S. college student sample (n = 126). Our results provide support for the validity and reliability of the MPFI-EMA. However, validity for assessing within-person variability remained unclear, psychometric limitations were observed for some subscales, and reactivity over time occurred for the MPFI-EMA Psychological Inflexibility scale and specific subscales. Limitations include the use of novel cutoffs, as criteria for psychometric validation within EMA are not well-established, and the need for replication in diverse samples, including clinical populations.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"36 ","pages":"Article 100903"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107613","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 : 2025-03-12DOI: 10.1016/j.jcbs.2025.100886
Atiyya Nisar , Richard C. Watkins , Duncan Gillard , Corinna F. Grindle , Paul A. Thompson , Jane Pegram , Richard P. Hastings
Implementation support is a key factor in the success of school-based well-being programmes. To assess the impact on children's well-being of providing additional implementation support for staff delivering a universal Acceptance and Commitment Therapy informed well-being curriculum (‘Connect PSHE’) compared to delivery without support. Twenty schools were recruited and randomised to deliver Connect PSHE with additional support (n = 10; n = 323 children) or Connect PSHE with the standard support (n = 10; n = 422 children). A two-arm, parallel-group cluster-randomised (schools as clusters) controlled trial design was utilised. Additional implementation support had no impact on the primary well-being measure (Me and My Feelings scale) at post-test (β = 0.22, 95 % CI [-0.59, 1.03], p = 0.59). Small improvements were observed in the additional support arm for two subscales of the Strengths and Difficulties Questionnaire. Overall, both trial arms were associated with improvements in children's well-being. Connect PSHE is a promising well-being programme suitable for testing in additional research.
{"title":"Adding implementation support to a universal Acceptance and Commitment Therapy-based school well-being intervention: A cluster-randomised controlled trial","authors":"Atiyya Nisar , Richard C. Watkins , Duncan Gillard , Corinna F. Grindle , Paul A. Thompson , Jane Pegram , Richard P. Hastings","doi":"10.1016/j.jcbs.2025.100886","DOIUrl":"10.1016/j.jcbs.2025.100886","url":null,"abstract":"<div><div>Implementation support is a key factor in the success of school-based well-being programmes. To assess the impact on children's well-being of providing additional implementation support for staff delivering a universal Acceptance and Commitment Therapy informed well-being curriculum (‘Connect PSHE’) compared to delivery without support. Twenty schools were recruited and randomised to deliver Connect PSHE with additional support (<em>n</em> = 10; n = 323 children) or Connect PSHE with the standard support (<em>n</em> = 10; n = 422 children). A two-arm, parallel-group cluster-randomised (schools as clusters) controlled trial design was utilised. Additional implementation support had no impact on the primary well-being measure (Me and My Feelings scale) at post-test (<em>β</em> = 0.22, <em>95 % CI</em> [-0.59, 1.03], <em>p</em> = 0.59). Small improvements were observed in the additional support arm for two subscales of the Strengths and Difficulties Questionnaire. Overall, both trial arms were associated with improvements in children's well-being. Connect PSHE is a promising well-being programme suitable for testing in additional research.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"36 ","pages":"Article 100886"},"PeriodicalIF":3.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629110","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 : 2025-03-07DOI: 10.1016/j.jcbs.2025.100888
Yash Bhambhani , Laurie Gallo , Emily O. McNamara , Angela L Stotts , Vilma Gabbay
Opioid use disorder (OUD) and chronic pain (CP) are commonly comorbid health conditions that cause significant disability, distress, and mortality. Treatment for these conditions is impacted by drop out and presence of other psychiatric conditions. Acceptance and Commitment Therapy is an effective intervention to treat chronic pain and substance use disorders, however this intervention has not been systematically evaluated for treatment of comorbid OUD and CP, especially in a racially and economically marginalized population. In this paper we describe development of such an ACT manual, using an intervention mapping approach. While the manual pays close attention to opioid use and chronic pain, it includes transdiagnostic principles that target overall psychological well-being including a deep emphasis on expanding valued living. We incorporated trauma informed care, cultural humility, and harm reduction principles in the development of nine ACT skills that are easy to understand and scalable. The treatment manual centers economically and racially marginalized patients who are traditionally underrepresented in psychological research. This manual is currently being evaluated in clinical trial NCT05039554 with funding from the NIH HEAL project #RM1DA055437. The treatment manual and handouts are freely available for use and included.
{"title":"Persisting with purpose: Using acceptance and commitment therapy to target comorbid opioid use disorder and chronic pain in a racially and economically marginalized population","authors":"Yash Bhambhani , Laurie Gallo , Emily O. McNamara , Angela L Stotts , Vilma Gabbay","doi":"10.1016/j.jcbs.2025.100888","DOIUrl":"10.1016/j.jcbs.2025.100888","url":null,"abstract":"<div><div>Opioid use disorder (OUD) and chronic pain (CP) are commonly comorbid health conditions that cause significant disability, distress, and mortality. Treatment for these conditions is impacted by drop out and presence of other psychiatric conditions. Acceptance and Commitment Therapy is an effective intervention to treat chronic pain and substance use disorders, however this intervention has not been systematically evaluated for treatment of comorbid OUD and CP, especially in a racially and economically marginalized population. In this paper we describe development of such an ACT manual, using an intervention mapping approach. While the manual pays close attention to opioid use and chronic pain, it includes transdiagnostic principles that target overall psychological well-being including a deep emphasis on expanding valued living. We incorporated trauma informed care, cultural humility, and harm reduction principles in the development of nine ACT skills that are easy to understand and scalable. The treatment manual centers economically and racially marginalized patients who are traditionally underrepresented in psychological research. This manual is currently being evaluated in clinical trial NCT05039554 with funding from the NIH HEAL project #RM1DA055437. The treatment manual and handouts are freely available for use and included.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"36 ","pages":"Article 100888"},"PeriodicalIF":3.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629109","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 : 2025-03-04DOI: 10.1016/j.jcbs.2025.100887
Anna Ryan , Nuno Ferreira , Helen Moffat , Maria Eugenicos , William Howson , Anna Casburn-Jones , Francesca Moroni , Perdita Stevens , Maria Wolters , David Gillanders
Background
Irritable Bowel Syndrome (IBS) significantly impacts patients and healthcare systems. While digital therapeutics show promise for IBS self-management, the feasibility of an Acceptance and Commitment Therapy (ACT) smartphone app remains unexplored.
Methods
This feasibility study recruited 53 participants across three UK Health Services to use an ACT app over 8 weeks. Pre- and post-treatment outcomes were assessed using standardized self-report questionnaires and analyzed with repeated-measures t-tests.
Results
Of 53 participants, 44 downloaded the app, and 29 completed follow-ups. Participants were predominantly female, with an average IBS duration of 14.6 years, and 90.9% had moderate-to-severe symptoms. Feasibility was demonstrated through successful recruitment (64% of identified eligible participants) and retention (66% of those who accessed the app). Acceptability showed variability, in terms of user engagement and attrition rates. Significant improvements were observed in IBS acceptance, quality of life, and gastrointestinal-related anxiety, though changes in IBS-related behaviours were not significant. Improvements in physical symptoms were noted but did not reach statistical significance.
Discussion
ACT-based self-help apps may benefit individuals with mild-to-moderate IBS symptoms. Recommendations include enhancing intervention acceptability through gamification, improved content delivery, and tailoring to symptom severity. Baseline screening of gastrointestinal symptoms could inform a stepped-care approach, optimizing intervention intensity. Despite limitations such as a small sample size and attrition, this study supports the feasibility of ACT apps for IBS and highlights their potential to improve access to psychological therapies while reducing healthcare burdens.
{"title":"Investigating the delivery of an acceptance and commitment therapy (ACT) smartphone app intervention on symptomology in adult IBS patients: A feasibility study","authors":"Anna Ryan , Nuno Ferreira , Helen Moffat , Maria Eugenicos , William Howson , Anna Casburn-Jones , Francesca Moroni , Perdita Stevens , Maria Wolters , David Gillanders","doi":"10.1016/j.jcbs.2025.100887","DOIUrl":"10.1016/j.jcbs.2025.100887","url":null,"abstract":"<div><h3>Background</h3><div>Irritable Bowel Syndrome (IBS) significantly impacts patients and healthcare systems. While digital therapeutics show promise for IBS self-management, the feasibility of an Acceptance and Commitment Therapy (ACT) smartphone app remains unexplored.</div></div><div><h3>Methods</h3><div>This feasibility study recruited 53 participants across three UK Health Services to use an ACT app over 8 weeks. Pre- and post-treatment outcomes were assessed using standardized self-report questionnaires and analyzed with repeated-measures t-tests.</div></div><div><h3>Results</h3><div>Of 53 participants, 44 downloaded the app, and 29 completed follow-ups. Participants were predominantly female, with an average IBS duration of 14.6 years, and 90.9% had moderate-to-severe symptoms. Feasibility was demonstrated through successful recruitment (64% of identified eligible participants) and retention (66% of those who accessed the app). Acceptability showed variability, in terms of user engagement and attrition rates. Significant improvements were observed in IBS acceptance, quality of life, and gastrointestinal-related anxiety, though changes in IBS-related behaviours were not significant. Improvements in physical symptoms were noted but did not reach statistical significance.</div></div><div><h3>Discussion</h3><div>ACT-based self-help apps may benefit individuals with mild-to-moderate IBS symptoms. Recommendations include enhancing intervention acceptability through gamification, improved content delivery, and tailoring to symptom severity. Baseline screening of gastrointestinal symptoms could inform a stepped-care approach, optimizing intervention intensity. Despite limitations such as a small sample size and attrition, this study supports the feasibility of ACT apps for IBS and highlights their potential to improve access to psychological therapies while reducing healthcare burdens.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"36 ","pages":"Article 100887"},"PeriodicalIF":3.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682213","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 : 2025-02-25DOI: 10.1016/j.jcbs.2025.100885
Matthew S. Herbert , Mara Tynan , Alexandra Higdon , Autumn Backhaus , Gage M. Chu , Niloofar Afari
To maximize the delivery and efficacy of acceptance and commitment therapy (ACT), there is a need to better understand the lived experiences of individuals undergoing ACT-based interventions. This can be helpful to determine what was perceived as effective and examine shifts in perspectives that influence daily functioning. The current study examined qualitative feedback among 21 U.S. Veterans (Mage = 57.43, SD = 12.94) with chronic pain one month after completing the Acting with Mindfulness for Pain (AMP) protocol, an 8-week, group-delivered ACT intervention that integrates formal mindfulness meditation practice as a principal treatment component. We analyzed responses to semi-structured interviews performed at 1-month post-treatment using an inductive thematic approach and found four overarching themes: Shift in Internal State, Engaging in Life, Symptom Relief, and Group Dynamics. The Shift in Internal State and Engaging in Life themes and sub-themes reflected important elements of psychological flexibility as defined within ACT, including pain acceptance, change in the experience of thoughts and emotions, improvement in daily functioning and movement towards personal values. The Symptom Relief theme was primarily supported by descriptions of the utility of mindfulness meditation for pain and stress relief. The Group Dynamics theme highlighted the importance of member-member and member-facilitator relationships. These data provide insights into the lived experiences of Veterans undergoing the AMP protocol and provide support for future research examining the efficacy of AMP. While theoretically consistent themes were identified, the Symptom Relief theme provides important considerations on the inclusion of mindfulness meditation within ACT-based approaches.
{"title":"Perspectives on an integrated acceptance and commitment therapy and mindfulness meditation program: A qualitative study of veterans with chronic pain","authors":"Matthew S. Herbert , Mara Tynan , Alexandra Higdon , Autumn Backhaus , Gage M. Chu , Niloofar Afari","doi":"10.1016/j.jcbs.2025.100885","DOIUrl":"10.1016/j.jcbs.2025.100885","url":null,"abstract":"<div><div>To maximize the delivery and efficacy of acceptance and commitment therapy (ACT), there is a need to better understand the lived experiences of individuals undergoing ACT-based interventions. This can be helpful to determine what was perceived as effective and examine shifts in perspectives that influence daily functioning. The current study examined qualitative feedback among 21 U.S. Veterans (M<sub>age</sub> = 57.43, SD = 12.94) with chronic pain one month after completing the Acting with Mindfulness for Pain (AMP) protocol, an 8-week, group-delivered ACT intervention that integrates formal mindfulness meditation practice as a principal treatment component. We analyzed responses to semi-structured interviews performed at 1-month post-treatment using an inductive thematic approach and found four overarching themes: Shift in Internal State, Engaging in Life, Symptom Relief, and Group Dynamics. The Shift in Internal State and Engaging in Life themes and sub-themes reflected important elements of psychological flexibility as defined within ACT, including pain acceptance, change in the experience of thoughts and emotions, improvement in daily functioning and movement towards personal values. The Symptom Relief theme was primarily supported by descriptions of the utility of mindfulness meditation for pain and stress relief. The Group Dynamics theme highlighted the importance of member-member and member-facilitator relationships. These data provide insights into the lived experiences of Veterans undergoing the AMP protocol and provide support for future research examining the efficacy of AMP. While theoretically consistent themes were identified, the Symptom Relief theme provides important considerations on the inclusion of mindfulness meditation within ACT-based approaches.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"36 ","pages":"Article 100885"},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511174","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 : 2025-01-01DOI: 10.1016/j.jcbs.2024.100868
Yaping Zhou , Xiaochen Wen , Yinan Li , Lu Liu , Qiushan Li
College students are susceptible to psychological and sleep problems in the face of interpersonal, academic, financial, and uncertain pressures, which are exacerbated by the limited resources available at universities for psychological or sleep interventions and the negative help-seeking attitudes of college students. Therefore, there is a need to design and apply university-based interventions that are easily accessible to college students. Transdiagnostic Internet-based Acceptance and Commitment Therapy (TACT) has been widely utilized due to its low cost and scalability; however, to date, its effectiveness and cross-cultural adaptation in mainland China remain to be studied. University students were recruited and randomly assigned to either a) the intervention group (n = 48, Student COMPASS Enhanced Course), which received the I-ACT intervention course with cross-cultural adaptation modifications, or b) the control group (n = 48, Student COMPASS Course), which received the Student COMPASS Course, in a randomized controlled trial design. The Student COMPASS Enhanced Course is a program that has undergone cultural adaptation improvements. The course utilizes the Theoretical Model of Confucian Self-Development as the ethical guideline, while mapping Zeng Guofan's (1811–1872) experience of self-cultivating to the six sub-processes of psychological flexibility and become the essential part of the course. Participants all received a post-intervention assessment after 7 weeks and a follow-up assessment after 15 weeks. The results indicated time effects across all symptom measures (ISI, GHQ-12, PPFI, ESS, DASS-21, and AAQ-II), suggesting significant improvements in mental health, sleep health, and psychological flexibility over time in both the intervention and control groups. Additionally, between-group main effects were observed for PPFI, ESS, DASS-21, and AAQ-II scores. However, the Generalized Estimating Equations (GEE) analysis revealed no group by time interaction effects for scores on any of the measures. Therefore, the Student COMPASS Enhanced Course is an effective Transdiagnostic Internet-based Acceptance and Commitment Therapy for college students in mainland China, with cross-cultural adaptation modifications to the I-ACT and incorporation of the Social workers and counselors are important for the design of psychological intervention programs and subsequent research on I-ACT in mainland Chinese universities.
{"title":"Confucian-informed ACT for psychological flexibility, mental health, and sleep in college students: A randomized controlled trial","authors":"Yaping Zhou , Xiaochen Wen , Yinan Li , Lu Liu , Qiushan Li","doi":"10.1016/j.jcbs.2024.100868","DOIUrl":"10.1016/j.jcbs.2024.100868","url":null,"abstract":"<div><div>College students are susceptible to psychological and sleep problems in the face of interpersonal, academic, financial, and uncertain pressures, which are exacerbated by the limited resources available at universities for psychological or sleep interventions and the negative help-seeking attitudes of college students. Therefore, there is a need to design and apply university-based interventions that are easily accessible to college students. Transdiagnostic Internet-based Acceptance and Commitment Therapy (TACT) has been widely utilized due to its low cost and scalability; however, to date, its effectiveness and cross-cultural adaptation in mainland China remain to be studied. University students were recruited and randomly assigned to either a) the intervention group (n = 48, Student COMPASS Enhanced Course), which received the I-ACT intervention course with cross-cultural adaptation modifications, or b) the control group (n = 48, Student COMPASS Course), which received the Student COMPASS Course, in a randomized controlled trial design. The Student COMPASS Enhanced Course is a program that has undergone cultural adaptation improvements. The course utilizes the Theoretical Model of Confucian Self-Development as the ethical guideline, while mapping Zeng Guofan's (1811–1872) experience of self-cultivating to the six sub-processes of psychological flexibility and become the essential part of the course. Participants all received a post-intervention assessment after 7 weeks and a follow-up assessment after 15 weeks. The results indicated time effects across all symptom measures (ISI, GHQ-12, PPFI, ESS, DASS-21, and AAQ-II), suggesting significant improvements in mental health, sleep health, and psychological flexibility over time in both the intervention and control groups. Additionally, between-group main effects were observed for PPFI, ESS, DASS-21, and AAQ-II scores. However, the Generalized Estimating Equations (GEE) analysis revealed no group by time interaction effects for scores on any of the measures. Therefore, the Student COMPASS Enhanced Course is an effective Transdiagnostic Internet-based Acceptance and Commitment Therapy for college students in mainland China, with cross-cultural adaptation modifications to the I-ACT and incorporation of the Social workers and counselors are important for the design of psychological intervention programs and subsequent research on I-ACT in mainland Chinese universities.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"35 ","pages":"Article 100868"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174509","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 : 2025-01-01DOI: 10.1016/j.jcbs.2024.100848
Wen Zhao , Xiangping Liu , Yanhe Deng , Anise M.S. Wu
This study tested the effect and mechanism of acceptance and commitment therapy (ACT) on young adults’ appearance-based rejection sensitivity (ARS) and social comparison based on appearance (SCBA). A sample of 190 university students (Mage = 18.35, SD = 0.78; 56.62% female) was randomly assigned to either the ACT group (n = 94) or an active control group (n = 96), which focused on interpersonal discussions about experiences of appearance-based rejection. Participants completed six weekly group interventions, as well as three surveys: a baseline assessment before the intervention (T1), a post-test immediately after the intervention (T2), and a 3-month follow-up (T3). Clinically significant decreases in ARS and SCBA were observed in the ACT group from baseline to both the post-test and follow-up. Comparisons at each phase indicated that the ACT group outperformed the control group in reducing ARS and SCBA, as well as in improving psychological inflexibility and cognitive fusion. Furthermore, the parallel mediation models supported the mediating roles of psychological inflexibility and cognitive fusion between the ACTintervention and ARS /SCBA. These findings suggest that ACT is effective in reducing ARS and SCBA by improving psychological inflexibility and cognitive fusion. Future research should further explore the effects and mechanisms of ACT on ARS and its related constructs using diversified samples and multiple long-term follow-ups.
{"title":"The effect and mechanism of acceptance and commitment therapy for young adults’ appearance-based rejection sensitivity and social comparison based on appearances: A randomized controlled trial","authors":"Wen Zhao , Xiangping Liu , Yanhe Deng , Anise M.S. Wu","doi":"10.1016/j.jcbs.2024.100848","DOIUrl":"10.1016/j.jcbs.2024.100848","url":null,"abstract":"<div><div>This study tested the effect and mechanism of acceptance and commitment therapy (ACT) on young adults’ appearance-based rejection sensitivity (ARS) and social comparison based on appearance (SCBA). A sample of 190 university students (Mage = 18.35, SD = 0.78; 56.62% female) was randomly assigned to either the ACT group (n = 94) or an active control group (n = 96), which focused on interpersonal discussions about experiences of appearance-based rejection. Participants completed six weekly group interventions, as well as three surveys: a baseline assessment before the intervention (T1), a post-test immediately after the intervention (T2), and a 3-month follow-up (T3). Clinically significant decreases in ARS and SCBA were observed in the ACT group from baseline to both the post-test and follow-up. Comparisons at each phase indicated that the ACT group outperformed the control group in reducing ARS and SCBA, as well as in improving psychological inflexibility and cognitive fusion. Furthermore, the parallel mediation models supported the mediating roles of psychological inflexibility and cognitive fusion between the ACTintervention and ARS /SCBA. These findings suggest that ACT is effective in reducing ARS and SCBA by improving psychological inflexibility and cognitive fusion. Future research should further explore the effects and mechanisms of ACT on ARS and its related constructs using diversified samples and multiple long-term follow-ups.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"35 ","pages":"Article 100848"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174507","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}
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