Journal of Contextual Behavioral Science最新文献

In this paper we present emotionally focused individual therapy (EFIT; Johnson & Campbell, 2022) within a process-based therapy (PBT) framework. A case presentation follows detailed descriptions of the theoretical underpinnings of EFIT, of the specific interventions involved in the approach, and of the evidence upon which the therapeutic processes in EFIT are based. We conclude that the Extended Evolutionary Meta-Model (EEMM) perspective, with its common language; nonpathologizing stance on psychological suffering; and attention to intrapsychic, interpersonal, and sociocultural aspects of change provides an excellent context for learning and practicing EFIT.

Stress is one of the leading risk factors for mental health problems. The attention training technique (ATT), developed in the context of metacognitive therapy, is a method for increasing flexible control of attention and might thus reduce the impact of stressful events on mental health. Developed as a 12-min exercise, ATT is primarily used in a clinical context. To ensure low-threshold implementation by the general population in everyday life, we developed an abbreviated 5-min version of the ATT. The present study examined the effectiveness of this abbreviated ATT in reducing stress in a three-armed randomized controlled trial by comparing the abbreviated version (ATT_abbr; n = 74) with the long version (ATT_long; n = 67) and a waitlist control group (WCG; n = 77) in a non-clinical sample. The primary outcome was change on the Depression, Anxiety, and Stress Scale (DASS-21). In the intention-to-treat analysis of changes from baseline to follow-up, both the abbreviated ATT version and the long ATT version were superior to the WCG in the reduction of stress (d = 0.67 for the abbreviated version and d = 0.44 for the long version). From post to follow-up, reductions in stress were greater for the abbreviated version than the long version (d = 0.37). We also observed effects of both ATT versions on depression and anxiety but no effect on attention control, perseverative thinking, or quality of life. For the abbreviated version, we found preliminary evidence of a dose-response relationship. Participants with access to the abbreviated version conducted the training twice as often compared with those with access to the long version. These results suggest that the abbreviated version of the ATT is associated with greater adherence and possibly greater effects on stress than the long version. If these results are confirmed, the abbreviated version could be used to reduce stress and increase mental well-being in the general population.

Contextual behavioral science (CBS) is the guiding philosophy of practice and research in Acceptance and Commitment Therapy (ACT). CBS research is directed by a functional contextual paradigm that is based on empirical research with a steadfast commitment to situating the object of study in its context. However, the CBS community is still primarily quantitative in its outlook on research and qualitative research is not an active component of the CBS strategy. This paper argues that qualitative research has much to offer to CBS: 1) a better appreciation of context; 2) understanding processes of change; 3) shedding light on complex private events; 4) recognizing the values and biases of the researcher; 5) contributing to the transfer of knowledge and to the clinical relevance of research. This paper proposes adopting a pluralistic perspective to include qualitative methodology more actively in the CBS research strategy, which can unlock doors that are left unopened by quantitative empirical methodology. After providing a brief description of qualitative research, quantitative research and functional contextualism, the dominance of quantitative research will be presented. Following this, a narrative review of 36 qualitative studies in CBS will offer an overview of how qualitative research can contribute to the CBS strategy. It is hoped that a strong case can be made for making qualitative research complementary to quantitative methods and an essential part of the research plan for CBS.

Perspective taking is important for effective interpersonal functioning. According to Relational Frame Theory (RFT), perspective taking is underpinned by deictic relational framing. It has been proposed that individuals with Borderline Personality Disorder (BPD) may have deficits in perspective taking. A mixed experimental design (N = 112) was used to assess whether individuals with a diagnosis of BPD displayed impaired perspective taking on a computerised RFT deictic relational task (DRT) and a self-report measure, compared to a control sample. There was no significant difference between groups on the computerised DRT. Within the clinical group, overall distress and relational distress were not found to be significantly associated with DRT performance or self-reported perspective taking. However, those with BPD self-reported significantly worse perspective taking ability compared to the control sample. This finding indicates a discrepancy between perceived perspective taking ability and direct perspective taking performance in persons with BPD.

The current study sought to ground exploratory network analyses on 12 dimensions of psychological flexibility (PF) within the conceptual framework of the Unified Flexibility and Mindfulness (UFM) Model, organizing aspects of psychological flexibility into distinct stepwise stages of responding to difficult thoughts, feelings, and experiences. Toward that end, psychological network analyses were conducted within a sample of 276 undergraduate students (62% White, 61% female, M_age = 19) with a wide range of psychological distress and wellbeing in order to comprehensively explore the relationships between psychological flexibility and inflexibility processes as well as their unique links to various individual outcomes. The results offered new insights to the PF model. Whereas dimensions of flexibility demonstrated robust links to wellbeing, dimensions of inflexibility demonstrated more robust links to forms of distress. The models also highlighted cognitive fusion, inaction, contact with values, and self-as-context as notably central processes demonstrating strong links to many other forms of PF and to both psychological distress and wellbeing. Visualizing the results within the UFM conceptual framework offered tentative support for that model, as the results suggested that maintaining mindful present moment awareness was proximally linked to greater use of decentering strategies (i.e., acceptance, self-as-context, defusion) in response to difficult experiences, which were in turn proximally linked to more value-driven behavior (i.e., maintaining contact with values and engaging in committed action despite any setbacks or difficulties), which were proximally linked to various forms of wellbeing (i.e., psychological, social, environmental, and physical health wellbeing, flourishing). Additional links emerged (albeit relatively weaker) suggesting an even higher level of interconnectivity among mindful flexibility processes than suggested by the stages of the UFM. In fact, although most of the links were in the expected directions, experiential avoidance was linked to greater self-as-context, suggesting possible adaptive forms of that behavior. Implications are discussed.

Latine adults who smoke have a low probability of receiving evidence-based smoking cessation interventions. Acceptance and Commitment Therapy (ACT) has shown to be efficacious for treating tobacco dependence, but its usefulness for Latine populations is just emerging and has not been studied in the context of a culturally tailored treatment. This single-arm study evaluated the feasibility of recruitment and retention, and treatment acceptability of the PRESENT Wellness Program: a culturally relevant ACT-based smoking cessation treatment for Latine adults who also experience psychological distress. Secondary objectives were the examination of smoking rates and levels of depression, anxiety, and psychological inflexibility (ACT core target) among Latine adults. Taking place during the COVID-19 pandemic, the treatment entailed 8 sessions delivered via telehealth (1 in-person/video and 7 by phone), and nicotine patches. Participants (N = 23) completed baseline assessments and follow-ups 1-week post-end of treatment (EOT) and 2-months post EOT. Most participants were women (70%), ranging from young adult to middle-aged, born in the US (57%), working full time (52.2%), and reporting financial strain (70%). Average number of sessions completed was 5.5. Follow-up rates were 61% at both follow-ups. The program was acceptable as indicated by quantitative and qualitative measures. Point-prevalence smoking abstinence was 35% at both follow-ups. Participants reported an average decline across time [% or M(SD)] in all secondary measures, as follows: everyday smoking [Baseline = 87%; 1-wk post EOT = 13%; 2 mo post EOT = 8.7%]; depression [Baseline = 13.7(6.3); 1-wk post EOT = 9.9 (6.6); 2 mo post EOT = 7.4 (5.8)]; anxiety [Baseline = 12.7 (5.4); 1-wk post EOT = 9.7 (6.4); 2 mo post EOT = 8.1 (5.2)]; and psychological inflexibility [Baseline = 50.6 (7.2); 1-wk post EOT = 33.0 (10.7); 2 mo post EOT = 32.6 (12.4)].

Conclusion

The current study observed that implementation of an acceptance-based smoking cessation treatment delivered in a hybrid mode is feasible and acceptable for English-speaking Latine persons. The PRESENT Wellness Program shows promise to address smoking and behavioral health challenges in the Latine community. Replication and expansion of the study is warranted, including the linguistic adaptation and evaluation of the program among Spanish-preferring Latine persons who smoke.

Health-related anxiety is an under-researched and pressing issue to understand in adolescents, particularly given the COVID-19 pandemic. The present study is a randomized, waitlist-controlled trial of 10 weekly, 50-min sessions of telehealth ACT targeting health-related anxiety in adolescents as compared to a waitlist. A sample of 30 adolescents (ages 12–17), plus one caretaker each (N = 60), currently struggling with clinical levels of health-related anxiety were enrolled. The majority of caretakers and adolescents were White, non-Hispanic/Latine, and female. Data were analyzed using multilevel modeling across pre-, mid-, post-treatment, and one-month follow-up. Adolescents reported small, significant decreases in health-related anxiety as compared to the waitlist. Caretakers reported small to medium significant decreases in child general anxiety and small to medium improvements in parental psychological inflexibility. No additional significant differences were found between groups for caretaker- or adolescent-rated variables. Both adolescents and caretakers reported positive acceptability of the treatment. Limitations of this study include a small, homogenous sample, a lack of an active comparison group, and a short period of intervention and measurement. However, this study is the first randomized controlled trial examining ACT as a potential treatment for health-related anxiety in adolescents, and thereby adds to the growing literature supporting the use of ACT as a potential treatment option for youth with anxiety and related problems.

Existing measures of psychological flexibility have demonstrated certain limitations, highlighting the critical need for the development of a more comprehensive assessment tool that encompasses all facets of psychological flexibility. In response to this necessity, we have developed the 6-item Psychological Flexibility Scale (C-Psy-Flex) as a concise instrument designed to evaluate individuals' psychological flexibility comprehensively. The objective of this study was to assess the reliability and validity of the Psy-Flex among Chinese college students and teachers. A total of 1511 valid responses were collected, and participants completed the Chinese version of the Psy-Flex, along with several other questionnaires. Exploratory factor analysis with 6 factors and 6 items was conducted on Sample 1 (n = 756). Confirmatory factor analysis on Sample 2 (n = 755) demonstrated good fit for a single-factor structure (χ2 = 21.17, df = 8, P < 0.001, CFI = 0.989, TLI = 0.980, RMSEA = 0.047, RMSEA 90% CI [0.023, 0.071], SRMR = 0.020). Measurement invariance testing indicated strict equivalence of the Chinese version of Psy-Flex across different gender and sample groups. Psychological flexibility was significantly positively associated with life satisfaction, indicators of physical and mental health, and value questionnaire scores, and significantly negatively associated with negative emotions (depression, anxiety, stress) and experiential avoidance. Network analysis visualization techniques were used to further confirm the factor structure of the scale, providing additional evidence of the scale's structural consistency and internal coherence. The Chinese version of the psychological flexibility scale demonstrated good internal consistency, with a Cronbach's α coefficient of 0.82, 95% CI [0.810, 0.840], and a McDonald's ω coefficient of 0.83, 95% CI [0.811, 0.841]. Overall, the study found that the Chinese version of the Psychological Flexibility Scale demonstrated good reliability and validity.

Previous research has emphasized the importance of identifying the core mechanisms underlying eating disorder psychopathology. However, processes that bridge psychological flexibility (PF) and psychological inflexibility (PI) with eating disorder symptoms have yet to be fully clarified, particularly for racially diverse emerging adult women. To address this empirical gap, the current study employed network analysis to explore the interconnections among PF, PI, and eating disorder symptoms in a racially diverse sample of emerging adult women (N = 389). Analyses produced a sparse network, with bridge nodes identified using bridge expected influence (EI). Multiple bridge nodes were identified within the clusters of PI (i.e., lack of awareness), and eating disorder symptoms (i.e., body dissatisfaction). Specifically, results suggested that lack of awareness (PI) and body dissatisfaction (eating disorder symptoms) play essential roles in connecting eating disorder symptoms with PI, even after accounting for PF. In contrast, PF did not appear to be uniquely associated with the deactivation (or activation) of eating disorder symptoms above and beyond PI. These findings contribute to the development of nuanced treatment and prevention models, especially in process-based cognitive behavioral therapy (PB-CBT). Our study also highlights specific processes as primary targets that, when intervened on, could help alleviate eating disorder symptoms, especially for racially diverse emerging adult women.