Journal of Contextual Behavioral Science最新文献

Contextual Behavioral Science (CBS) and Acceptance and Commitment Therapy or Training (“ACT” in either case) are arguably entering their 5th decade of development. This paper describes features of their early history and divides development into three phases, plus a fourth that is just beginning. In the context of that review, it examines what can be learned by a content analysis of the first ∼1000 randomized controlled trials on ACT-based interventions, from 1986 through 2022. The expansive vision of CBS and the early ACT research base defined their breadth as far wider than psychological intervention targeting traditional psychiatric syndromes, emphasizing instead the principles, processes, and components needed for a more generally applicable approach. After an era of scientific establishment, ACT research has expanded globally and topically. Many RCTs now take place in lower- and middle-income countries with cultural and policy environments that give rise to unique research priorities. Finally, based on the ACBS Task Force Report and new research findings, we suggest that ACT research may be entering a new era of personalized and process-based intervention based on new “idionomic” forms of functional analysis.

This bibliometric study examined the current state, publication trends, key authors and counties, inter-country collaboration, and research themes of the Acceptance and Commitment Therapy (ACT) publications produced globally and in low-to-middle-income countries (LMIC) from 1998 to 2023. 1458 ACT publications, with 287 (19.68%) publications from LMIC, were extracted from the Scopus database and analyzed using biblioMagika, OpenRefine, VOSviewer, and Biblioshiny. The global publications received 41,357 citations over 25 years, while the LMIC publications received approximately 4% (n = 1,713) of the total citations since its first publication in 2010. Most ACT publications were written in English (92.80%) and focused on the fields of psychology and medicine. Publication output rose over time, yet citation trends varied globally and in LMIC. Michael Twohig was the most prolific author with 71 publications, whereas Steven Hayes was the most highly cited author with 6,115 total citations. The US, UK, Iran, and China were the most productive contributors in the global and LMIC contexts, accounting for 51.9% (n = 757) and 76.3% (n = 219) of total publications, respectively. Additionally, the US was the central hub of international scholarly collaboration while limited inter-country collaboration existed in some parts of Asia and Europe. Co-word and factorial analyses identified thematic clusters, knowledge evolution, and potential research opportunities for ACT scholars.

Background

The Process-Based Assessment Tool (PBAT), is an item pool showing promising results in assessing psychological processes of change relevant for both psychotherapy and research in its original English version. However, further research focusing on translation and validation in other languages is needed for broader applicability. This study aims to translate and validate the PBAT in Swedish, and to examine the relationship with common clinical outcome variables.

Methods

The PBAT and STOP-D were translated and culturally adapted to Swedish. The study included 427 Swedish-speaking participants recruited online, with a mean age of 48. The PHQ-4 and Single Item Stress Scale were used as criterion variables. Correlational analyses and the Boruta feature selection algorithm were employed for data analysis.

Results

The translated PBAT demonstrated significant correlations with clinical outcomes, indicating its effectiveness in a Swedish context. Positive PBAT items correlated with higher vitality and health, while negative items were predictive of sadness, anxiety, and stress. The Boruta analysis highlighted the importance of specific PBAT items to different clinical outcomes, underscoring the tool's validity.

Conclusion

The Swedish version of the PBAT shows strong validity and reliability in assessing psychological health. This study contributes to the cross-cultural applicability of the PBAT, offering a valuable tool for psychological assessment in the Swedish context.

Students in flight training programs experience high levels of stress and anxiety that may impede their performance on practical exams. The restrictive nature of Federal Aviation Administration (FAA) regulations and perceived negative consequences of seeking mental health treatment further exacerbates these challenges. This study examined the efficacy of performance-based acceptance and commitment training (ACT) in enhancing psychological flexibility, resilience, and mental well-being as well as improving FAA practical examination outcomes among collegiate flight training students. A randomized controlled trial was used to compare outcomes between students receiving a six-week ACT intervention (n = 23) and a control group (n = 27). The planned sample size of 100 was not achieved, thus, the analyses were underpowered and should be cautiously interpreted. Results indicate significant improvements among intervention participants in anxiety sensitivity (g = 0.43) and psychological flexibility (g = 0.58) compared to those in the control group. However, no significant differences in examination pass rates or time to completion were found between groups. To examine idiographic differences, individual change scores were plotted, demonstrating the heterogeneity of effects between participants. Potential explanations for the intervention's lack of effect on practical exam performance are discussed and suggestions are given to improve future performance-based interventions in this unique context.

Family dementia caregiving has been commonly associated with psychological distress for caregivers. Cognitive fusion, that is, the tendency to become too entangled in thoughts, beliefs, or judgments (in the absence of objectivity) that may often lead to rigid thinking and impact psychological distress, is a transdiagnostic and central process of psychological inflexibility. Cross-sectional studies have shown that family caregivers of people with dementia who could present high levels of stress may be vulnerable to experiencing psychological symptoms such as depression and anxiety (even comorbidity) if they present this rigid way of thinking without seeing the objectivity of their thoughts, which could be related to aspects of the family member's dementia or helplessness in being a caregiver, for example. Specifically, studies in the caregiving field, as well as in other populations, suggest that cognitive fusion could play a mediating role in the relationship between stress and psychological symptoms. However, the predictive role of caregivers' cognitive fusion on psychological distress has not been analyzed in longitudinal studies. The objective of this study was to analyze the longitudinal effect of cognitive fusion in depressive and anxious symptoms after controlling for other relevant variables in a sample of Spanish family caregivers. Face to face assessments were conducted with a total of 176 Spanish family dementia caregivers. The study involved three assessments in a two-year period (baseline, 12 and 24 months). Linear mixed model analysis was used to analyze the associations between time-varying values of frequency and reaction to care-recipient behavioral problems, cognitive fusion, and caregivers' depressive and anxiety symptoms. Increases in cognitive fusion significantly predicted depressive and anxious symptoms (p < 0.01). In addition, reaction to care-recipients’ behavioral problems and being a female caregiver predicted increases in anxiety symptoms over time (p < 0.05). These results suggested that cognitive fusion may constitute a core dysfunctional mechanism involved in depressive and anxious symptoms. Psychological strategies aimed at reducing cognitive fusion and stress levels may be especially helpful for reducing caregivers' distress.

Anxiety and depression are believed to be associated with increased use of maladaptive emotion regulation (ER) strategies and decreased use of adaptive strategies; nonetheless, most work on this topic has been approached using static perspectives on measuring ER, which may overlook the dynamic interplay between ER and emotional experiences. We combined ecological momentary assessment and dynamic structural equation modeling in two independent college-student samples (N₁ = 202; N₂ = 213) to investigate bidirectional relationships between ER and daily affect. In Study 1, we examined reciprocal associations between negative affect and two ER strategies characterized by repetitive negative thinking (rumination and worry), while in Study 2, we explored reciprocal relationships between both negative and positive affect and two context-dependent and cognitively demanding ER strategies (reappraisal and distraction). We then explored associations of these reciprocal relations with laboratory questionnaires of anxiety and depression. Results indicated both anxiety and depression were associated with greater average negative affect in daily life, greater use of worry, and greater variability in positive affect. However, anxiety was related specifically to difficulties in maintenance of distraction, whereas depression showed unique associations with negative affect inertia, average use of rumination, and difficulties in maintenance of cognitive reappraisal. Findings collectively reveal commonalities and differences in dynamics of ER and daily affect experience related to depression and anxiety. These insights can inform future research into targeted interventions for these negative emotions.

Introduction

Difficulties in emotion regulation (ER) are transdiagnostic in eating disorders (EDs). Self-compassion impacts ED-related outcomes by either preventing their initial establishment or interrupting/modifying their ongoing detrimental impact. Studies conducted in mixed samples found significantly lower levels of self-compassion in ED clinical samples. The main goal in this study was to explore the clinical profile presentation (in terms of transdiagnostic psychological processes) of participants within a continuum of eating psychopathology levels, through a two-step cluster analysis.

Methods

The ED clinical sample comprised 94 women aged between 18 and 60 years old (M = 29.5, SD = 10.2). The college sample included 274 female students aged between 18 and 56 years old (M = 21.2, SD = 4.7).

Results

Self-compassion facets significantly predicted overall difficulties in ER in both samples (clinical, F(6, 81) = 20.57, p < 0.001; R² = 0.60; college, F(6, 267) = 22.64, p < 0.001; R² = 0.34). The two-step cluster analysis resulted in an optimal solution of three clusters: low profile – C1; intermediate profile – C2; and severe profile – C3. Self-criticism and self-compassion were the strongest predictor variables, contributing 100% and 98%, respectively, to clustering membership. Self-compassion was a significant moderator on the relationship between difficulties in ER and eating psychopathology (b = −0.02, t(357) = 3.38, p < 0.001; R² = 0.43).

Discussion

Fostering self-compassionate skills and addressing self-criticism and experiential avoidance (including experiential therapeutic components) as they become prominent during the therapeutic process, may be influential to successfully implement specific ER skills and enhance therapeutic gains.

Family caregivers of people with neurodevelopmental disabilities (NDDs) experience high levels of stress, anxiety, and depression, yet few interventions target their wellbeing. Moreover, most evidence-based interventions fail to include caregivers in their design and delivery despite evidence that caregivers can play a vital role in enhancing the success of interventions to other caregivers. The present study explored the experiences of caregivers and clinicians who worked in partnership to co-deliver an Acceptance and Commitment Training (ACT) intervention to caregivers of people with NDDs in the community.

Caregiver and clinician facilitators completed an open-ended survey asking about their experiences co-facilitating an evidence-based, group ACT intervention. Thematic analysis was used to analyze the data. Elements of successful partnerships, the benefits and challenges co-leading the intervention, and considerations for future implementation efforts were explored. Findings revealed the complementary contributions of facilitators’ diverse perspectives, experiences and skills, as well as how regular communication, trust, and flexibility supported successful partnerships. Benefits of co-facilitating included connection with others and personal growth, while challenges included emotional costs, capacity and compensation. Taken together, results highlight ways to support the successful implementation of an ACT intervention co-led by caregivers and clinicians, as well as other partnered interventions.

Functional Analytic Psychotherapy (FAP) is an efficacious but complex treatment. Despite a solid empirical foundation, research on the treatment is limited. While five process-focused rules guide the treatment, developers made an early statement that they believed only the first rule of FAP, watching for the occurrence of daily life problems occurring in the therapy session, was needed to guide treatment effectively. The current study was designed to assess this claim through the use of a FAP analog procedure in hopes of increasing the accessibility of the treatment and thus facilitating implementation efforts. In this study, 81 undergraduate participants engaged in a closeness-generating class in which they were randomized into two groups. In the experimental condition, research assistants had access to a self-report measure regularly used to inform clinicians about potential daily life problems that may occur in the therapy room. No such information was available to the research assistants in the control condition. Findings indicated that while fear of intimacy, a core construct in FAP, decreased on average following the procedure, the experimental condition had no impact on this change. Further, when research assistants had access to the daily life problem information, participants found them less effective at responding to disclosures. These findings suggest the importance of a nuanced case conceptualization, the limitations of the first rule of FAP, and the strengths and limitations of the use of an analog paradigm to study FAP.