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WC2021 Virtual Posters

Image denotes ACBS Junior Investigator Poster Award Recipients

Friday, 25 June 2021, 9:05 a.m. - 9:45 a.m. CEST - Poster Session 1

Friday, 25 June 2021, 1:20 p.m. - 2:00 p.m. CEST - Poster Session 2

Friday, 25 June 2021, 6:50 p.m. - 7:30 p.m. CEST - Poster Session 3

Poster Session 1

A case study of evaluation and training of RFS for atypical developing children using PCA Japanese version and MMSTs based on PEAK
Primary Topic: Educational settings
Subtopic: Relational Frame Theory, Children, PEAK, PCA

Kana Shimoyama, C.Psychol., Startline CO.,LTD.
Hiroko Kagawa, Startline CO.,LTD.
Ken Iwamura, Startline CO.,LTD.
Fumiki Haneda, Startline CO.,LTD.

We have used ACT-based approaches to support employees with disabilities and deal with their communication problems caused by misunderstandings in the workplace. In some cases, it was thought that the cause of the problems was the lack of relational frame skills, which are the basis of ACT, in the workers. Therefore, it will be helpful to use systematic relational frame skill training and evaluation methods in the workspaces. The PEAK Relational Training System is a well-sophisticated system for training the cognitive and linguistic abilities of children with disabilities, including autism. Besides, the PCA (PEAK Comprehensive Assessment) is a comprehensive assessment tool for language skills, including relational frame skills. Our purpose is to develop the improved Japanese version of PCA and PEAK and then research the effectiveness of these tools in children as a first step of applying for workplaces.
We improved the original PCA for Japanese-version. We also developed hundreds of types of the improved Japanese-version PEAK tasks using our software, Multipurpose Matching to Sample Training tasks (MMSTs), which can be implemented on touch screens. We intervened atypical developing children using our systems.
We will examine the effects of our training system on the children in their relational frame skills, intellectual ability, and daily life skills.
We will introduce the details of our training and evaluation system based on PEAK and discuss the changes in the relational frame skills and daily life behavior of the children.

A pioneering study: Applying Acceptance and Commitment Training (ACT) for junior high school students in Japan
Primary Topic: Educational settings
Subtopic: Acceptance and Commitment Training, ACT, junior high school students

Kotaro Shindo, Waseda University
Honoka Muramatsu, Waseda University
Kazuya Inoue, Ph.D., Waseda university
Tomu Ohtsuki, Ph.D., Waseda University

This present study aim an effectiveness of psychological intervention that called Acceptance and Commitment Training(ACT)for junior high school students in Japan. Japanese Ministry of education suggests bringing up “strength to live through one’s life” that Preventative Training with psychological basis is demanded on the school. In preceding study, ACT for 15 to 16 years(9th grade)student attempted and got findings. Though, Effectiveness of ACT for 12 to 13years (7th grade) students are little known.Then we conducted psychological education program that mainly constituted by 4 of 6 core-process of ACT(values, acceptance, commitment, mindfulness.
116 students, 62 male and 54 female (M age =12.75, SD = 0.435) data were applied for analysis. Two-way repeated measures ANOVA were used to compare within and between subject differences for the dependent measures, with period (post intervention, pre intervention) as within subject measure, and group type (intervention, wait-list) as between subject measure. Outcome was measured by AFQ, Stress Response scale for Junior High School Students, RSES-J and VOYAGE.Consequently, there were main effect of period over“bad mood” “depression” as lower item of Stress Response scale for Junior High School Students, but any major effect and interaction couldn’t get on other outcomes.
Consequently, there were main effect of period over“bad mood” “depression” as lower item of Stress Response scale for Junior High School Students, but any major effect and interaction couldn’t get on other outcomes. This study raise necessity to improve and to optimize the program.

Acceptance and Commitment Therapy for Climacteric Symptoms: A Multiple Baseline Evaluation
Primary Topic: Clinical Interventions and Interests
Subtopic: Behavioral medicine, Acceptance and Commitment Therapy, Menopause, Climacteric

Kazuki Hashiguchi, Doshisha University
Takashi Muto, Doshisha University

Background: Climacteric symptoms experienced by women around menopause significantly decrease health-related quality of life (HRQoL) and their management includes biological (e.g. hormone replacement therapy) and psychological approaches (e.g. cognitive-behavioural therapy). Aims: This study aimed to examine the effectiveness of acceptance and commitment therapy in improving HRQoL and reducing the severity of climacteric symptoms in a concurrent multiple-baseline across-participants design.
Method: Six middle-aged women with moderate-to-severe climacteric symptoms participated in the study. Participants completed 3- to 6-week baselines without showing improvement trends in the severity of climacteric symptoms. Afterwards, they received four 90-min weekly sessions, wherein participants learned to accept unavoidable events such as climacteric symptoms and focus on actions directed towards valued goals. The primary outcome was HRQoL. The secondary outcomes were the severity of climacteric, depressive, and anxiety symptoms. The processes comprising ACT, such as experiential avoidance, were also measured.
Results: ACT improved certain subscales of HRQoL and reduced the severity of climacteric symptoms. Improvements were also observed in questionnaires measuring ACT processes.
Conclusions: ACT intervention could improve HRQoL and alleviate climacteric symptoms. Further randomized studies are thus warranted.

Acceptance and Commitment Therapy on Procrastination in University Students
Primary Topic: Clinical Interventions and Interests
Subtopic: Procrastination, Behavioral indicator

Moeko Imori, Graduate School of Psychology, Doshisha University
Yushi Tsunekawa, Graduate School of Humanities and Social Sciences, Nagoya City University
Masataka Ito, Organization for Research Initiatives and Development, Doshisha University/Faculty of Psychology, Doshisha University
Aiko Oya, Faculty of Psychology, Doshisha University

This study aims to examine the effects of acceptance and commitment therapy (ACT) on procrastination in university students and analyze the psychological and behavioral measures of procrastination.
We assigned 22 participants to an experimental group that received a 60-minute ACT program, and 25 participants to a control group that did not receive the ACT program. We assessed the task achievement rate for 7 days for the behavioral indicator and the procrastination rate for the psychological indicator. We also administered Five Facet Mindfulness Questionnaire (FFMQ) and Acceptance and Action Questionnaire-II (AAQ-II) to assess the effect of ACT. All measures were assessed before and after the program.
Analysis of changes in the four indices showed that the experimental group reported an improvement in both the task achievement rate and the procrastination rate over the 7-day period, but did not report any significant difference in the scores of FFMQ and-AAQ-II. Therefore, ACT-based programs are effective for improving the psychological and behavioral aspects of procrastination, but it is necessary to examine the effects of each intervention program.

Acceptance and Resilience Among Working Adults in Malaysia
Primary Topic: Performance-enhancing interventions
Subtopic: Resilience, Acceptance, Work place

Ceri Lan, B.S., Mindfulness Training/HELP University

Working adults make or break a country’s economic prosperity. Malaysia, as a thriving nation has a shared increasing growth in worker’s mental challenges and resilience become a crucial interest. Resilience is the ability to adapt, and bounce back despite adversity. Acceptance and Commitment Therapy (ACT) believes adversity is in the cognitive activity, not the situation itself. ACT aims to expand the psychological flexibility (PF). PF is the capacity of the individual’s ability to adapt, so they can pursue their value driven goals despite the limiting cognitive content. The ultimate goal is to make room for these unwanted cognitive contents, without any form of avoidance. Non avoidance is acceptance. Acceptance refers to both behavioral willingness to not get in the way of the cognitive content as the individual continue with their value-based choices, while adapting in open, receptive, flexible and non-judgmental posture with respect to moment to moment experience.
The present study examines acceptance as a means for psychological flexibility and its relation to resilience in the workplace, primarily focusing on a research question “Is there a relationship between acceptance and resilience among working adults in Malaysia?” As the mental rigidity opens up to more flexibility, we hypothesis that the individuals who exhibit relatively higher levels of acceptance will also exhibit higher levels of resilience. Acceptance may have a positive relationship with resilience, specifically to Malaysian working adults. Acceptance may have a positive relationship with resilience, specifically to Malaysian working adults.

An exploratory study of the effects of ACT on stuttering symptoms and psychological problems in adults who stutter
Primary Topic: Clinical Interventions and Interests
Subtopic: Other, Stuttering, Mindfulness

Risa Matsuoka, Doshisha University
Takashi Muto, Doshisha University

The purpose of this study was to explore the effects of Acceptance & Commitment Therapy on stuttering symptoms and psychological problems in adults who stutter. Recently, the effects of ACT on stuttering have been examined, but there are few intervention studies in Japan. Therefore, we examined whether or not ACT is effective for people who stutter in Japan.
In this experiment, we used a multiple baseline design and followed the changes of five adult participants(sub1-sub5). The participants took part in six intervention programs. Participants completed the OASES-A (about stuttering symptoms), AAQ-Ⅱ, VQ, and FFMQ surveys each time they participated in the program. These results were analyzed qualitatively(drawing a diagram) and quantitatively using Tau-U method.
There were no statistically significant differences between baseline and intervention periods in AAQ-Ⅱ and VQ. Sub1 and sub2 showed a statistically significant difference in general perspectives about stuttering(Sub1;Tau=-1.00, p<.05 Sub2;Tau=-0.79, p<.05) and Non-judging(Sub1;Tau=0.88, p<.05 Sub2;Tau=0.83, p<.05) . Sub3 showed that a statistically significant difference in affective, behavioral and cognitive reactions to stuttering (Tau=-0.96, p<.05) and Acting with Awareness (Tau=0.88, p<.05) . There was no statistically significant difference in Sub4. Sub5 showed no statistically significant difference in OASES-A, but there was a difference in Observing (Tau=0.72, p<.05) and Non-reactivity (Tau=0.78, p<.05).
The results of this study showed that some changes in OASES-A and FFMQ were observed within the participants. However, not all of the participants showed changes. Therefore, it is necessary to the examine content of the intervention program and then experiment again.

Defusion Exercise On Mental Illness Stigma: A behavioral measure using seating arrangement
Primary Topic: Clinical Interventions and Interests
Subtopic: Educational settings, Stigma, Mental illness

Natsumi Tsuda, M.A., Doshisha University
Takashi Muto, Ph.D., Doshisha University

The purpose of this study was to measure the effects of defusion intervention on stigma by using a behavioral measure of seating arrangement. One of the aims of ACT for Stigma is not to remove negative thoughts, but to reduce their influence on behavior. Therefore, in this study, the word repeatition was used to exam the effects on behavior in contact situations.
Twenty-seven undergraduate students participated (control: 14, defusion: 13; age average(SD)=19.74 (0.90)). The intervention consisted of a 2 (control, defusion) x 2 (Pre, Post) design. The defusion group was given a word repetition, while the control group was asked to read a text on Japanese culture. The main outcome was the difference in distance within the seating arrangements between Pre- and Post-intervention, which was explained as “having a conversation with a person with mental illness.” In addition, the VAS(discomfort, believability) and Stigma inventory were taken.
The analysis revealed following the intervention was a significant tendency of members in the intervention group to move their chairs closer to each other (t(25)=1.95, p=.06, d=0.75). For discomfort, there was a significant trend in interaction(F(1, 25)=3.47, p=.07, η2=0.12), the results of multiple comparisons showed no significant difference. In terms of believability and stigma inventory, there was no effect of intervention.
The results suggest that the defusion intervention may cause changes in behavior. The fact that no change was observed in the questionnaire suggests that the defusion intervention may have influenced behavior without changing thought such as the stigma inventory, as it was intended.

Development of the Japanese version of AIM and practice of AIM for pre-employed adults
Primary Topic: Clinical Interventions and Interests
Subtopic: Functional contextual approaches in related disciplines, ACT, AIM

Yuko Kikuchi, CBS Human Suppot Laboratory, Startline CO.,LTD.
Gen Ogura, Licensed Psychologist, CBS Human Support Laboratory, Startline CO.,LTD.
Fumiki Haneda, Licensed Psychologist, Vocational Counselor, CBS Human Support Laboratory, Startline CO.,LTD.

In recent years, various ACT programs have been developed, not only for individual therapy, but also for group therapy. AIM (Accept, Identify, Move) is developed by Dr. Mark R. Dixon for school-aged children has been successful in the U.S.. AIM is a comprehensive ACT program for use in classrooms and other group settings. It is designed to integrate elements of mindfulness practices, ACT, and ABA. AIM emphasizes a functional approach to behavior and consists of programs such as ACT exercises and a point system called reinforcer stores that can be used in groups to shape positive behaviors that lead to psychological flexibility. In addition, workbooks are provided for the exercises so that children can engage in them in an experiential and fun way. AIM is intended to have intervention effects on improving psychological flexibility and generating and maintaining behaviors in children, but there are few studies in adults.
To implement AIM for Japanese people (especially pre-employed adults), we developed the Japanese version of AIM, based on an understanding of the essence of exercise, by brushing up the content to make it easier for Japanese to engage in the program. Using it developed above, we tested a part of the ACT exercises for pre-employment adults. In this presentation, we will examine that Japanese version of AIM has intervention effects on improving psychological flexibility in adults. We will introduce the details of our training system based on AIM and discuss the changes of psychological flexibility and daily life behavior in the adults.

Does God Protect the Naïve?: Spiritual Health Locus of Control Beliefs and Mental Health during COVID-19
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Coping

Aaron Cherniak, M.A., Stockholm University
Steven Pirutinsky, Touro College
David Rosmarin, Harvard Medical School/McLean Hospital

COVID-19 has caused mass death and economic devastation. Health crises and responses to them are intertwined with scientific and religious beliefs, sociocultural identity, and societal engagement, which has far-reaching implications for disseminating health information, enlisting cooperation with health directives, and coping with the pandemic and its consequences.
A sample of 1,374 American Jews, who had experienced disproportionately elevated rates of COVID-19, rated their levels of concern, exposure, and impact, as well as adherence to health guidelines, risk for severe symptoms, and mental health. We compared these reports with respondents’ scientific beliefs and religious factors including spiritual health locus of control, trust in various leaders (doctors, scientists, religious leaders, God), identity, and cognitive-affective elements of religiosity.
Preliminary results indicate that faith may moderate the impact of COVID-19-related stress on mental and physical health. Analyses of trust, adherence, and beliefs are still being conducted. Especially in uncertain times, individuals’ beliefs influence how they may seek, accept, and act on information. These processes influence the experience of COVID-19-related stressors, coping responses, as well as attitudes and commitment to health directives. In describing social, behavioral, and emotional responses to COVID-19, our study may contribute to effective science communication and psychoeducation, especially regarding religious/scientific beliefs and coping. Tension between religion and science has increased during COVID-19, but our study shows that religion may facilitate coping responses during the pandemic and also improve culturally competent science communication to encourage health behaviors and foster positive societal engagement (World Health Organization, 2020).

Evaluation of an Acceptance and Commitment Therapy-Based Program for Managers: A preliminary pre-post test
Primary Topic: Performance-enhancing interventions
Subtopic: Organizational behavior management, Workplace, Mindfulness, Perspective taking, Hierarchical Bayesian model, Clinical trial registration

Anna Tozawa, C.Psychol., ADVANTAGE Risk Management Co., Ltd.
Masao Tsuchiya, ADVANTAGE Risk Management Co., Ltd.
Takuto Doi, ADVANTAGE Risk Management Co., Ltd.
Yuki Kiura, ADVANTAGE Risk Management Co., Ltd.

This study aimed to examine the effect of a program for managers based on Acceptance and Commitment Therapy. A group program consisting of a total of three 90-minute sessions was implemented with the participation of 63 managers. The purpose of this study was to examine whether the program would increase the work performance (WP) of organizational units (hypothesis 1) and decrease the psychological inflexibility of individual managers (hypothesis 2).
Taking a Bayesian approach, organizational unit WP was evaluated before and after as the primary outcome, and individual managers’ psychological inflexibility was indicated parenthetically as a form of process outcome.
The results of the pre/post comparison showed no improvement regarding the WP of 18 organizations (d=-0.26 [95% confidence interval -0.92, 0.40]). On the other hand, a decrease in psychological inflexibility was observed 25 managers who were evaluated (d=-0.27 [-0.5, -0.03]).
The primary outcome, WP of organizational units, was lower after the program than before the program, which did not support the hypothesis 1. On the other hand, the process outcome, psychological inflexibility of individual managers, showed a tendency to decrease after the intervention, supporting the hypothesis 2. In addition, the secondary outcomes, stressors and stress reactions of the organizational unit, WP and psychological distress of individual managers showed a negative trend after the intervention. On the other hand, the support around organizational units, well-being and leadership of individual managers' showed a positive trend after the intervention.

Experience on CHF self-management among patients with CHF and their caregivers: preliminary observations and potential clinical applications
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic illness management

Xuelin Zhang, the hong kong polytechnic university
Yim Wah Mak, Ph.D., RN, The Hong Kong Polytechnic University

Chronic heart failure (CHF) is an age-dependent, chronic progressive disease with poor prognosis and multiple readmission, which generates an unavoidable situation of increasing dependence of patients on their family caregivers.
The first author was attached to nurses at a cardiac ward of the tertiary hospital in Hubei province, Mainland, China for a clinical update during November 23-29, 2020. She met four patient-caregiver dyads of patients who readmitted to the hospital due to CHF. This paper narratively summarized the author’s clinical observation log regarding the experience of self-management.
The struggles among patients and caregivers usually arise from unpredictable disease trajectory, the side-effects of medications, complex self-care regimen and interdependent relationship between patient and his / her caregiver. The patients normally disturbed by the feeling of being punished, fear, helplessness, hopelessness, anxiety, or depression, unwanted thoughts of being loser, useless or burdensome, along with unpleasant body sensation including fatigue, swelling, frequency and urgency of urination. Meanwhile, their caregivers distressed with self-blame, fear, guilty and being out of control. Furthermore, patients were worried if recommended CHF self-care behaviors will be compromised when staying at home. Besides, patients and caregivers tend to suppress their feelings and thoughts, and overreact to the distresses, thus stay away from original intention of loving each other.
Given adoption of ACT could facilitate individual’s acceptance of inner experiences and reconnect to meaningful life directions actively, a patient-caregiver based ACT, may help to promote patients’ CHF self-care and decrease caregivers’ perceived burden, then simultaneously improved their quality of life.

Impact to work engagement on AI-based interventions to psychological flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: Performance-enhancing interventions, ACT, Work engagement, AI, Psychological flexibility

Honoka Muramatsu, Waseda University
Nao Ozawa, waseda university
Kotaro Shindo, waseda university
Saori Chikami, emol inc.
Daiki Takegawa, emol inc.
Tomu Ohtsuki, waseda university

In recent years, mental health problems among workers have become one of the most important issues in Japan (Hiro, 2016). Work engagement is gaining attention as an indicator to support workers' mental health and is effective for stress management in the workplace; ACT has also been shown to improve mental health in the workplace (Bond et al., 2008). Therefore, this study examines the effects of an exercise to increase psychological flexibility using an AI chat tool.
Participants in the experiment: 20 university students (10 in the intervention group: 10 in the control group) Participants were recruited from the general public. The intervention group received psycho-education and exercises via AI chat for one week. The control group was given certain tasks every day. Questionnaires were measured at midpoint and after the intervention.
A two-factor analysis of variance was conducted for each measure. a main effect of the number of experiments was found for the AAQ-II. In the intervention group, the difference between the first and third experiments and the difference between the second and third experiments were significant. Since the interaction effect was significant, a simple main effect test was conducted and a main effect of the number of experiments was found in the intervention group.
The results of this study did not confirm the impact of psychological flexibility on work engagement. However, it was confirmed that AI chat can increase psychological flexibility and has a significant effect on stress reduction, which is expected to lead to a new psychotherapy.

Perception of Psychological Flexibility Treatment of the Parents of Young People with Chronic Pain
Primary Topic: Clinical Interventions and Interests
Subtopic: Behavioral medicine, Chronic Pain

Sook Huey Lee, M.A., UCSI University
Jia Hang Lim, UCSI University
Ji Kwan Lee, Naluri
Yen Teng Tan, Ph.D., UCSI University

Acceptance and Commitment Therapy (ACT) is a form of psychological treatment targeting Psychological Flexibility (PF) which have been found to be effective for young chronic pain patients. To develop a treatment protocol that fits well into the Malaysian context, this survey study aims to explore parents' perception towards the intervention for themselves and their children with chronic pain.
A total of 48 Malaysian parents who are having children in pain condition were recruited through purposive sampling. The online questionnaire consisted of brief descriptions about ACT for chronic pain and asked parents to rate their preferences of treatment modes, perception on the effectiveness of the program, and their motivation and barriers to join the proposed program.
Descriptive analysis showed that parents preferred face to face (79.2%) compared to online method (20.8%); individual session (52.1%) compare to group session (47.9%) and continuous (72.9%) compared to intermediate (25%) session. In addition, 56.3% of participants believed the treatment would be effective, and 81.3% reported they are motivated to attend the program with the intention to help their child (31.3%). With regard to the barriers, 18.8% reported the reason of not having heard about the treatment and 16.7% reported being unsure about the effectiveness of the program.
The current sample suggests that parents of children with chronic pain conditions are open to Acceptance and Commitment based intervention targeting psychological flexibility. As such, a treatment protocol tailored to the Malaysian population should be developed and tested.

Relationship between value and self-care behavior in type 2 diabetes patients
Primary Topic: Clinical Interventions and Interests
Subtopic: Value, Type 2 diabetes, self-care behavior

Aiko Oya, Ph.D., Doshisha University, Faculty of Psychology
Hisashi Makino, National Cerebral and Cardiovascular Center, Division of Endocrinology and Metabolism
Mayu Tochiya, National Cerebral and Cardiovascular Center Division of Endocrinology and Metabolism
Tamiko Tamanaha, National Cerebral and Cardiovascular Center Division of Endocrinology and Metabolism
Yoko Ohata, National Cerebral and Cardiovascular Center, Division of Endocrinology and Metabolism
Ryo Koezuka, National Cerebral and Cardiovascular Center, Division of Endocrinology and Metabolism
Miki Matsuo, National Cerebral and Cardiovascular Center, Division of Endocrinology and Metabolism
Kyoko Kohmo, National Cerebral and Cardiovascular Center, Division of Endocrinology and Metabolism
Noriko Fujii, National Cerebral and Cardiovascular Center, Division of Endocrinology and Metabolism
Harue Kaneko, National Cerebral and Cardiovascular Center, Division of Endocrinology and Metabolism
Naoki Manpuku, National Cerebral and Cardiovascular Center, Division of Endocrinology and Metabolism
Kiminori Hosoda, National Cerebral and Cardiovascular Center, Division of Endocrinology and Metabolism
Takashi Muto, Doshisha University, Faculty of Psychology

This study examined the relationship between values and self-care behaviors in Japanese patients with type 2 diabetes. A total of 124 patients with type 2 diabetes responded to questionnaires. First, based on the Values Clarification Questionnaire, the domains that Japanese patients with type 2 diabetes value were investigated. Second, we examined the degree of committed action, avoidance of type 2 diabetes, self-care behaviors, and treatment distress to see if they differed by each value domain's score.
The results showed that 40% of the participants placed value on health and 37% on family relationships. Additionally, those who placed more value on family relationships were committed to their value compared to those who valued personal growth. Furthermore, those who placed more value on family relationships followed a specific diet compared to those who valued intimate relationships. These results suggest that family relationships could motivate self-care behaviors in Japanese patients with type 2 diabetes.

The "PROSOCIAL" Approach - A Practical Development for Organizational Activities in Japan
Primary Topic: Organizational behavior management
Subtopic: Supervision, Training and Dissemination, PROSOCIAL

Fumiki Haneda, Licensed Psychologist, Vocational Counseler, CBS Human Support Laboratory, Startline CO.,LTD.
Gen Ogura, Startline CO.,LTD.CBS Human Suppot Laboratory

Startline Co. Ltd. provides consulting and operates satellite offices and indoor farms for employment support for people with disabilities. Currently, 200 companies are using the our service, and about 1,300 people with disabilities are working there every day. Startline’s CBS Human Support Research Institute has been conducting research on RFT and ACT. As one such initiative, we are researching and preparing for the practical development of the PROSOCIAL approach. For Japanese companies, employment of people with disabilities has two aspects: compliance with laws and regulations, and the realization of ideals such as the concept of diversity. In any case, companies need to accept and build a different way of thinking from the conventional way of corporate management, but many companies are struggling in the early stages of their efforts. Therefore, we are aiming to apply our services through PROSOCIAL, one of the practices of CBS.
Our institute started to learn about the theory and practice of PROSOCIAL by participating in the Workshop of the 17th ACBS World Conference. Immediately after the publication of the book "PROSOCIAL", we started to translate it into Japanese, and with the permission of Dr. Atkins, we are now making arrangements for the publication of the Japanese version of "PROSOCIAL". And now, as a step toward such efforts, we are planning to conduct in-house trials of the PROSOCIAL approach and to conduct PROSOCIAL facilitator training organized by Dr. Atkins. In this presentation, I will report on the status of some of the PROSOCIAL approaches that we are implementing.

The Effect of a Defusion Technique with the Negative and Positive Self-Statements: Using FAST to Explore the Defusion Process in Terms of RFT and the DAARRE Model
Primary Topic: Relational Frame Theory
Subtopic: Other, DAARRE, FAST

Maho Konda, Ristumeikan University
Shinji Tani, Ritsumeikan University

The study investigated the effect of a defusion technique on the believability of negative and positive self-statements, and its detailed process was explored in terms of RFT and the DAARRE model by using Function Acquisition Speed Test (FAST) and several questionnaires.
23 participants were randomly assigned to either Defusion (DF) or Non-Defusion (NDF) condition. In Experiment Day 1, participants reported negative and positive self-statements. Only DF participants completed a defusion exercise "I am having a thought..." and practice it until the data collection in Experiment Day 2 while NDF participants did not. In Experiment Day 2, FAST and a questionnaire for rating self-statement believability were administrated.
The believability of both negative and positive self-statements in DF condition was significantly lower than in NDF. Also, there were positive correlation between the believability of negative and positive self-statements in NDF condition but not in DF condition. Yet, no significant difference in FAST's index was found between the conditions. At the individual level, the tendency in FAST for DF condition was only 50% consistent with the prediction made by RFT and the DAARRE model, nonetheless, the effect for NDF condition was 70 % consistent with the prediction.
The finding suggested that the defusion technique could reduce the believability of both negative and positive self-statements and allow one to observe the self-statements as statements although the defusion process were remained unclear. In addition, the finding suggest that the DAARRE model may potentially useful to investigating the defusion process, especially at the individual level.

The Impact of ACT Intervention on the Goal Setting and Quality of Life of Home Rehabilitation Patients
Primary Topic: Clinical Interventions and Interests
Subtopic: Home rehabilitation, Acceptance & commitment therapy (ACT), QOL, Goal setting

Kyoko Nakaue, Ritsumeikan University
Shinji Tani, Ritsumeikan University
Naoki Nakashika, Ritsumeikan University

Nowadays, home rehabilitation for the elderly in Japan lacks an approach to improving motivation and quality of life (QOL). A factor behind this is the difficulty of setting goals due to a specific psychological condition of the elderly and their resistance to rehabilitation. In this study, we conducted a psychological intervention using acceptance and commitment therapy (ACT) for a home rehabilitation patient and examined changes in QOL and goal setting.
The case is a man in his 70s with chronic low back pain since his diagnosis of polymyositis 20 years ago. He refused to exercise and his rehabilitation failed. The intervention included 12 sessions, provided twice a week in the participant’s home, and 1 booster session. Changes in QOL were evaluated by SF-12, and the Acceptance and Action Questionnaire-II (AAQ) and the Cognitive Fusion Questionnaire (CFQ) were used as process assessments.
Results showed that QOL improved following improvement in psychological flexibility, and rehabilitation content and goal setting were modified. The Reliable Change Index (RCI) was higher than 1.96 for both the CFQ and the AAQ. Moreover, in the SF-12, RCI was higher than 1.96 in items other than Mental Health and Physical Function.
Examination of the function and effect of "sleep" observed avoidance behavior in the context of daily life and rehabilitation, and strengthening "Shogi" as an alternative behavior. Then he was still in pain, but he noticed that he was approaching the value of "active". Furthermore, commencing rehabilitation with “walking” as a value-based action reduced his refusal to exercise.

The Review of the Use of Acceptance and Commitment Therapy in Supporting People With Disabilities
Primary Topic: Clinical Interventions and Interests
Subtopic: People with disabilities, Group therapy

Yuanjun Tao, Ritsumeikan University

The use of ACT-informed interventions for people with disabilities offers another alternative to solely behavioral approaches but it remains relatively understudied and in need of further exploration. This study reviewed the use of ACT in supporting people with disabilities in current 30 years.
The current systematic review, which searched three databases, PsychInfo, Spycharticles, Google Scholoar, aimed to collate all ACT interventions that included therapeutic components in the treatment of various people with both mentally and physically disabilities. Currently including 5 Inclusion Criteria and 3 exclusion criteria. Each study was reviewed using the Quality Assessment Tool for Studies with Diverse Deigns (QATSDD).
20 individual studies covering a broad spectrum of presenting problems were included, comprising of 855 participants. Overall 10 studies demonstrated the effectiveness of the program, 4 of these using quasi-experimental research designs and 6 studies through pre-experimental research designs. A large proportion of studies were within-group designs with a smaller number using randomized controlled trials. A large proportion of studies were within-group designs with a smaller number using randomized controlled trials. QATSDD was used as quality ratings. Ten studies fell in the high(over 74%) or good range (50%-74%) of methodological range. Ten studies were rated as poor (under 50%).
The current review highlights the potential utility of ACT in Supporting People With Disabilities. Although with many limitations, ACT is a trans-diagnostic intervention that can help with the parenting of children with a range of psychological and physical difficulties.

The role of Acceptance and Commitment Therapy for Palliative Patients Quality of Life
Primary Topic: Clinical Interventions and Interests
Subtopic: Palliative Care

Christopher Martin, BPsych(Hons); MPsych(Clin), Sunshine Coast Hospital and Health Service, Qld, Australia
Kenneth Pakenham, Ph.D., University of Queensland, Australia
Fiona Maccallum, Ph.D., University of Queensland, Australia

Palliative care aims to improve quality of life (QoL) across physical, spiritual, and psychosocial life domains. Acceptance and Commitment Therapy’s (ACT) model of Psychological Flexibility (PF) has demonstrated improvements in QoL across multiple health conditions but is yet to be explored in palliative care. The aim of this research was to understand the relationships between PF and four palliative outcomes: QoL, psychological morbidity, physical pain, death attitudes. It was hypothesized that higher psychological flexibility would be associated with increased QoL, improved death attitudes, and decreased psychological morbidity and physical pain.
A short-term longitudinal survey design was utilized with 81 patients from a Specialist Palliative Care Service. Participants completed a questionnaire assessing PF and the four palliative outcomes at two time points, one-month apart. A 33% attrition rate resulted in 54 patients completing the Time 2 questionnaire.
There were no significant changes between Time 1 and 2 in PF or palliative outcomes. At both Time 1 and 2 higher PF was significantly associated with: increased QoL (Total, Psychological, and Existential), decreased psychological morbidity (Total and Anxiety), decreases on two death attitude dimensions (Fear of death, and Death avoidance), and increases in one death attitudes dimension (Acceptance-neutral).
Findings are consistent with broader ACT literature showing greater PF is associated with increased QoL and lower psychological morbidity; and provide new evidence of associations with improved death attitudes. The provision of an ACT intervention is indicated to improve PF and palliative outcomes which otherwise remained stable in the short-term. A trial is underway.

Understanding what makes us human as the context for functional living and effective therapy
Primary Topic: Clinical Interventions and Interests
Subtopic: Theoretical and philosophical foundations, Process-based models

Penny Brabin, B.Sc., M.Ed., Ph.D., FAPS, Registered Psychologist - Clinical; Education and Developmental

From a practice-based theory a process model is presented describing: 1. how our unique human capacity for bi-directional learning provides us with an ability to comprehend our world – beginning with the context of our experience, the derived view of self from our experience of living which is the core of all mental health problems, 2. the evolution of another capacity to embrace the adaptive non-rated concept of Self-as-context associated with the values, that as humans, we can bring to our experience of living to prevent or manage mental health problems.
A 90-item questionnaire reflecting beliefs, emotion and behavior was developed discriminating the low and high esteemed view of self from the non-rated view of Self and posted on Survey Monkey. From 100 questionnaires returned for the pilot study a Factor Analysis was completed and a 4-factor solution was chosen loading 89 of the 90 items above a .30 loading on one or more factors. A low self-esteem factor, loaded in the same direction as the two high self-esteem factors. In contrast these factors loaded in the opposite direction to the non-rated Self factor, supporting the process model described. Application of the model is described: 1. in education by promoting a shift in language from the predominant self-esteeming focus, still prevalent, to that supporting the non-rated Self-as-context, 2. in therapy by adding mindful techniques to engage the non-rated Self-as-context to promote a conceptual shift away from the emotion and behavior problems of the esteemed self.

Poster Session 2

A preventive eHealth ACT module for positive aging: feasibility results
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Positive aging

Jennifer Reijnders, Ph.D., Open University
Tim Batink, Ph.D., Open University
Marianne Simons, Ph.D., Open University
Sanne Peeters, Ph.D., Open Universiteit
Mayke Janssens, Ph.D., Open Universiteit
Johan Lataster, Ph.D., Open Universiteit
Nele Jacobs, Open Universiteit

Positive aging involves maintaining an adequate level of wellbeing in older age, when inevitable changes and challenges are met. Psychological flexibility can help dealing with these challenges and consequently help preserve wellbeing. An eHealth ACT-module was developed to foster both flexibility and wellbeing in the general population. As part of a longitudinal effectiveness study, this current study investigates the feasibility of the eHealth ACT-module.
The eHealth ACT-module is a stand-alone module of 8 weekly sessions, each containing a short introduction of a specific ACT-skill, followed by several exercises to practice the new skills. For the current study adults aged 40 and over from the general population were given access to the module and were asked to answer questions afterwards regarding acceptability and usability.
276 participants (75.7% female), varying in age from 40-75 (Mean=54.7, SD=9.4) and mostly higher educated (75.8%) completed the feasibility questionnaire. 93.5% of the participants reported completing between 50-100% of the module. The mean evaluation of the module of these participants was 7.5 (SD=.97) and participants spent on average 3.7 hours (SD=6.2) per week on the module and practicing the skills they learned in daily life. Regarding the content of the module, most participants indicated the video’s (76%), exercises (81%) and metaphors (81%) as useful and 82% stated that they now have a good understanding of the principles of ACT.
Additional results on active participation (time spent online, number of completed sessions), self-evaluation and aspects mostly appreciated and points for improvements will be presented at the congress.

A qualitative inquiry of the potential benefits of psychedelic use for mental health professionals
Primary Topic: Professional Development
Subtopic: Supervision, Training and Dissemination, Psychedelic Science

Ioana Ivan, BSc, Babeș-Bolyai University, Faculty of Psychology and Educational Sciences
Eugen-Călin Secară, Babeș-Bolyai University, Faculty of Psychology and Educational Sciences

Before psychedelic substances were classified as illicit, mental health professionals’ use of psychedelic substances was an acknowledged practice in mental health institutions (Winkler and Csemy, 2014; Winkler et al., 2016). Nowadays, psychedelics are still used by this group for self-exploration. In spite of this, only a handful of studies have investigated the way in which psychedelic experiences undergone in a context that facilitates introspection impact the day-to-day practice of mental health professionals. The aim of this study is to fill this knowledge gap.
Semi-structured interviews were conducted online with 13 mental health professionals. Thematic analysis was used to identify central themes (Braun and Clarke, 2013).
The results show an increase in perceived empathy toward the client’s suffering; reduced judgement of clients and; enhanced present moment awareness in session; increased tolerance of clients' maladaptive coping strategies; increased acceptance of clients' ambivalence and non-compliance; increased trust in the efficiency of empirically tested techniques due to having successfully applied them during the experience; increased self-compassion for struggles related to practicing psychotherapy; enhanced trust in clients' ability to thrive in spite of psychosocial stress. The qualitative part of the study represents only the first step in elaborating and testing a psychedelic assisted protocol for enhancing the ability of psychotherapists to foster genuine therapeutic alliance and therefore to stand a better chance to improve the lives of their clients or patients. This would be a major step in opening a new avenue of applicability for psychedelic assisted-psychotherapy.

Acceptance and Commitment Therapy for insomnia: a systematic review
Primary Topic: Clinical Interventions and Interests
Subtopic: Behavioral medicine, Sleep, Insomnia, ACT, Systematic Review, PRISMA

Léo Guarnieri, Faculdade de Medicina da Universidade de São Paulo
Ila Linares, Ph.D., Universidade de São Paulo da Faculdade de Medicina
Renatha Rafihi-Ferreira, Ph.D., Instituto de Psiquiatria, Universidade de São Paulo

Cognitive-behavioral therapy for insomnia (CBT-I) is the golden treatment, but some don’t respond to this intervention. Acceptance and Commitment Therapy (ACT) presents itself as an useful intervention, for which, instead of focusing on controlling the symptoms, ACT focuses on accepting the feelings and thoughts associated, through value-based actions. This systematic review evaluated the effectiveness of interventions using ACT for insomnia as primary outcome.
Following PRISMA protocol, PubMed, PsyInfo and Scopus databases were searched. Key words were: (“acceptance and commitment therapy”) AND (“insomnia” OR “sleep problems''). Papers using ACT for insomnia in English were included. Theoretical studies and treatments with insomnia as secondary outcome were excluded.
105 articles were identified, 11 were included: 6 randomized and 5 non-randomized trials. 7 articles combined behavioral components with ACT and 4 used only ACT. Regarding sleep-related results, decrease of the insomnia severity, sleep latency and number of wakes and increase in the subjective sleep quality, total time of sleep and sleep efficiency were found. Results also showed decrease of experiential avoidance, thought suppression, dysfunctional beliefs, use of hypnotics and levels of anxiety, depression and chronic pain and increase in psychological flexibility, acceptance to sleep and quality of life. Only 1 study compared ACT plus behavioral components with CBT-I, no significant difference between groups were found.
Despite the promising results, studies with more subjects, quantitative measures, randomized designs and comparison groups mainly with CBT-I are needed. It is also important to distinguish between the role of the ACT and the behavioral components in the outcomes.

ACT and Broad Form of Enhanced Cognitive Behavioral Therapy (CBT-Eb) in Clients with Eating Disorders and Clinical Perfectionism: a Pilot Study
Primary Topic: Clinical Interventions and Interests
Subtopic: Prevention and Community-Based Interventions, perfectionism, eating disorders, psychological flexibility, ACT, CBT-Eb

Rosa Bruna Dall’Agnola, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
Chiara Bonetto, Università degli Studi di Verona, Italy
Mirella Ruggeri, Università degli Studi di Verona, Italy
Cristiana Patrizi, Scuole di Specializzazione in Psicoterapia Cognitiva APC–SPC, Italy
Valeria Semeraro, Scuole di Specializzazione in Psicoterapia Cognitiva APC–SPC, Italy
Elena Cirimbilla, Scuole di Specializzazione in Psicoterapia Cognitiva APC–SPC, Italy
Caterina Villirillo, Scuole di Specializzazione in Psicoterapia Cognitiva APC–SPC, Italy
Emily Boifava, Scuola di Specializzazione in Psicoterapia Cognitiva APC, Verona, Italy
Martina Nicolis, Scuola di Specializzazione in Psicoterapia Cognitiva APC, Verona, Italy
Emanuele Rossi, Scuole di Specializzazione in Psicoterapia Cognitiva APC–SPC, Italy

The literature highlights a direct correlation between perfectionism and symptoms related to eating disorders (Bardone-Cone, 2007) and the role that perfectionism can play in maintaining these symptoms (Egan et al., 2011).
The purpose of this study is to investigate the effects of ACT combined with CBT-Eb on a sample of clients (aged 15 to 18 years) with eating disorders and clinical perfectionism. The present poster will present the study protocol and the research project.
Taking into account that ACT is configured as a particularly suitable model of intervention for adolescents - since it offers a transdiagnostic approach to psychopathology focused on psychological flexibility processes and provides appropriate intervention strategies also related to prevention - we expect that the application of the CBT-Eb and ACT protocols can significantly attenuate the severity of eating disorder compared to CBT-Eb alone, primarily in clients who showed high levels of clinical perfectionism.
Our starting hypothesis is that we will be able to observe: significant reduction of scores in Clinical Perfectionism subscale (MPS-F and EDI-3); significant improvement with respect to the ability to observe internal experiences, behave with awareness and accept internal experiences without judgment (CAMM-10); reductions in experiential avoidance and cognitive fusion (AFQ-Y8); enhanced awareness of personal values and a growing engagement in committed actions driven by them.

ACT And Prosocial for Positive Change
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT And Prosocial

Jamie Nyaa, Commit and Act Foundation in Sierra Leone

Commit and Act Foundation was established in Sierra Leone in 2010 and officially opened in 2013 shortly before the outbreak of the Ebola Viral Disease (EVD), to provide ongoing psychosocial support from local counselors in the area. CAF-SL is the leading organization in Bo district that offers training and development programmes for service providers, including legal and medical practitioners, educators, counselors, law enforcement agents, and community-based counselors. In September 2019 Commit and Act foundation open its second office in Makeni the Northern part of Sierra Leone to provide Support services for women and girls that have experienced Sexual Gender Based Violence and babies born as a result of Sexual Gender Based Violence.

Major challenges in the country • Sexual Gender Based Violence • Teenage pregnancy • Increase in girls dropping out from school • Poverty • Poor Water and sanitation facilities • Corruption
What has been done by Commit and Act Foundation? • Protection of girls that have been sexually abused • Provision of dignity kits to clients while at the shelter • Proper documentation of clients • Provision of three meals while at the shelter • Individual and group counselling session • Provision of medical support to clients • Legal education and communication • ACT and Prosocial training for girls • Family tracing and reunification • Livelihood and educational support • Community sensitization and awareness raising on Sexual gender Based violence

ACT in Assisted Living: A Literature Review Supporting a Potential Intervention to Improve Mental Health in Older Adults
Primary Topic: Clinical Interventions and Interests
Subtopic: Prevention and Community-Based Interventions, Mental Health

Emily Jewell, B.A., MSW, University of Prince Edward Island
Jessica Strong, Ph.D., University of Prince Edward Island

Mental health symptomology among older adults varies by living environment. Because mindfulness is beneficial in older populations, mindfulness-based interventions may represent a promising avenue for improving mental health in residential settings. Group-based mindfulness interventions may be especially appropriate in residential settings and this treatment format is typically found to be as effective as individual therapy.
A literature review was conducted to ascertain differences in depression and anxiety symptomology among older adults in community and residential settings. Literature related to group-based interventions and mindfulness-based therapies with older adults was also reviewed to determine the effectiveness and use of these interventions.
Rates of depression and anxiety in older adults rise with increased intensity of care. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) have been well studied in older populations and appear to be both feasible and effective. Literature on Dialectical Behaviour Therapy (DBT) is much scarcer. Literature on the use of ACT with older adults is less well-researched than with MBSR or MBCT but more developed than with DBT.
MBSR, MBCT, and ACT have an evidence-base to support their use with older adults. ACT may be particularly well-suited to work with older adults due to its transdiagnostic nature, emphasis on values-based living, and lack of medicalized language (Petkus & Wetherall, 2013). However, no studies of group-based ACT to address depression and anxiety symptoms among ALF residents could be located. A proposed project would fill that gap in hopes of identifying group-based ACT as an effective intervention for implementation in ALFs.

ACT in the workplace: a survey of the use of ACT by BACB clinicians in the field of applied behavior analysis
Primary Topic: Functional contextual approaches in related disciplines
Subtopic: BCBA, BCaBA, RBT

Lisa Jacovsky, M.S., The Chicago School of Professional Psychology
Laura Kruse, The Chicago School of Professional Psychology

Acceptance and Commitment Therapy, also known as ACT, utilizes techniques to promote mindfulness and psychological flexibility. Working on psychological flexibility can help people with anxiety induced stress encouraging them to be more mindful of their thoughts and how it effects their emotions. The techniques promoted in ACT are gaining popularity with those who work in high stress fields.
To understand how well-known ACT is, who is providing training to those utilizing ACT in their clinical practice, and whether the techniques have proven useful for the individual a survey was created for professionals who work 1:1 in various settings with children with an Autism Spectrum Disorder.
The results of the survey provide support to the ever-growing research on ACT and its possible use in the field of ABA. The use of ACT can provide psychological flexibility when working in a high stress field. In addition, many BCBA's are seeking out training on ACT to utilize it in their practice. There are few BCBa's that are training other certificants in the use of ACT.

ACT interventions for parents of children with an Autism Spectrum Disorder: A systematic review
Primary Topic: Clinical Interventions and Interests
Subtopic: Clinical Interventions and Interests, Parents

Hannah Dardis, B.A., M.Sc., University College Dublin
Lisa Murphy, University College Dublin
Louise McHugh, Ph.D., University College Dublin

Parents of children with Autism Spectrum Disorder (ASD) experience higher levels of parenting stress than other parents. Having a child with ASD is also associated with difficulties in terms of parental mental health, marital relationships, and overall family wellbeing, indicating a need for efficacious interventions. Acceptance and Commitment Therapy (ACT) is a therapeutic approach which has received promising empirical support for use with this population.
To identify relevant studies, searches were conducted using the following electronic databases: PubMed, Embase, Scopus, PsychInfo and PsychArticles. The methodology was informed by the PRISMA 2009 guidelines and registered with PROSPERO (CRD42020131947).
Ten papers were included in this narrative review, representing nine unique studies (n=199). Most of the included studies found a significant improvement in the outcomes measured. The quality of the studies included was variable, with small sample sizes a common feature.
The evidence for ACT-based interventions is not yet well established, though there are some encouraging findings which provide tentative evidence for the viability of ACT with this population. Further investigation using more rigorous methodological designs is needed.

An ACT perspective on adolescent social anxiety disorder
Primary Topic: Clinical Interventions and Interests
Subtopic: Theoretical and philosophical foundations, Adolescence, Social anxiety disorder

Paula Vagos, Universidade Portucalense Infante D. Henrique
Diana Figueiredo, Universidade de Coimbra
Daniel Rijo, Universidade de Coimbra
Luiza Nobre Lima, Universidade de Coimbra
Maria do Céu Salvador, Universidade de Coimbra

Adolescence is a life stage particularly prone to feelings of social anxiety that persists throughout adulthood, associating with severe functional impairment. An ACT perspective may be useful to understanding social anxiety disorder in adolescence. Efforts to avoid, control, or modify inner experiences and an inability to modulate behavior consistently with valued goals are proposed to predict psychological inflexibility (PI) which, as is the case with other psychopathological symptoms, should impact on social anxiety.
Forty adolescents (Mage = 16.13, SD = .76) recruited within school settings with a primary diagnosis of social anxiety disorder (SAD) assessed through MINI-KID completed a set of self-report measures assessing social anxiety, acceptance, committed action, and psychological inflexibility. Data analysis relied on a mediation model linking acceptance and committed action to social anxiety via PI; the moderating role of gender was investigated.
A total mediation linking acceptance and committed action to social anxiety through PI was found explaining 61.8% of the variance of social anxiety. This model was equally applicable to boys and girls, though boys had significantly lower levels of acceptance, which could reflect how boys and girls are thought to deal with internal experiences from a young age.
Acceptance and committed action were confirmed to be central processes to PI and all these processes have a key role in social anxiety in adolescent boys and girls. Overall, this work implies that ACT could be applied as a comprehensive model to understand and intervene in adolescents with SAD.

Associated factors of playing video games as experiential avoidance in adolescence

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Clinical Interventions and Interests, Adolescents

Luiza Brandão, M.S., Universidade de São Paulo
Zila Sanchez, Ph.D., Universidade Federal de São Paulo
Márcia Melo, Ph.D., Universidade de São Paulo

Problematic video game playing in adolescents is associated with an array of mental health and behavioral problems. Little effort has been made to understand the comorbidities. Understanding functions to video game playing that are associated with poorer outcomes may help better understand the problem. Escapism, that may be understood as experiential avoidance (EA), is one function commonly associated to mental health and behavior problems. The aim of the present study is to access whether sociodemographic factors, drug use, bullying victimization and perpetration and mental health symptoms are associated with playing video games to forget or alleviate problems among Brazilian eighth grade students.
This study was a cross-sectional survey nested in a cluster randomized controlled trial. The study sample included 3,939 eighth grade students who answered to an anonymous self-report questionnaire. Weighted logistic regressions were used to investigate the associated factors.
The results show that 57% (CI=55.85; 58.15) of the adolescents played as a form of EA. Playing to forget about problems is associated with being male, using tobacco, bullying victimization and perpetration, healthy levels of prosocial behavior and emotional symptoms. Playing video games as a form of EA has shown to be a relevant aspect to be investigated among this public, as it is related to impairing conditions in adolescence.

Bienestar eudaimónico y mindfulness en el trabajo: revisión sistemática
Primary Topic: Organizational behavior management
Subtopic: Mindfulness

Isaac Carmona Rincón, M.S., Universidad Jaime I de Castellón / Ítaca, Psicología y Lenguaje
Azucena García Palacios, Universidad Jaime I de Castellón
Santiago Segovia Vázquez, Elea, Instituto Psicoeducativo Integral

Antecedentes: La mayor parte de los estudios que han analizado los efectos de mindfulness sobre el bienestar lo han hecho desde una perspectiva hedónica, sin que se haya explorado suficientemente la perspectiva eudaimónica, íntimamente relacionada con la flexibilidad psicológica. El objetivo de este estudio fue analizar los efectos de las intervenciones basadas en mindfulness (IBMs) sobre variables relacionadas con el bienestar eudaimónico en contextos laborales. Para ello, seguimos las instrucciones del método Cochrane (Higgins y Green, 2012) e incluimos únicamente ensayos controlados aleatorizados.
Método: Se efectuó una búsqueda de publicaciones relevantes en las bases de datos PsycInfo, Pubmed y ProQuest, acotando desde enero de 2009 a diciembre de 2019. Los términos de búsqueda incluyeron aquellas variables relacionadas con el modelo de Bienestar Eudaimónico (Ryff, 2017) (p. ej. resilience, maturity, wisdom, autonomy, will to meaning, self-compassion, etc.).
Resultados: Un total de 9006 estudios fueron revisados, de los que 16 fueron incluidos finalmente. Se identificaron un total de 9 variables psicológicas relacionadas con la eudaimonia. Los estudios diferían en el tipo de IBM, duración de la intervención, tiempo de práctica personal y variables eudamónicas evaluadas.
Discusión: En general, las IBMs son eficaces, con tamaños de efecto medios, para mejorar variables vinculadas a la autoaceptación, las relaciones positivas y el crecimiento personal. No obstante, los resultados han de considerarse con cautela, debiendo realizarse estudios tanto de replicación como de mayor calidad (i.e. con muestras más amplias y equivalente proporción entre sexos, controles activos, seguimientos a medio y largo plazo, etc.).

Burnout and Intimacy in a Sample of Health-care Workers: The Mediational Role of Psychological Flexibility
Primary Topic: Organizational behavior management
Subtopic: Professional Development, Burnout

Maria Del Carmen Ortiz-Fune, Psychiatry and Mental Health Service of the University Assistance Complex of Salamanca
Maria Arias, Ph.D., University of Seville
Rafael Martínez-Cervantes, Ph.D., University of Seville

The predominant model of Burnout comprises three dimensions: Emotional Exhaustion (EE), Depersonalization (D) and lack of Personal Accomplishment (PA). Recent approaches from Contextual Behavioral Sciences (CBS) considered the role that variables such as Psychological Flexibility and Intimacy can play in understanding Burnout. This study explored the role of Intimacy, as described in the Awareness, Courage and Responsiveness (ACR) behavioral model, and the mediating role of Psychological Flexibility in Burnout.
A non-probabilistic intentional sample of 120 health workers (77.5% women) from Spain’s National Health System was recruited. Participants completed an online survey with validated measures for Burnout, Intimacy, and Psychological Flexibility. To examine the relationships between these variables, mediation analyzes and multiple linear regression were performed.
Courage was the only ACR variable that predicted the three dimensions of Burnout, although Others-Awareness (a skill related with Awareness) also showed a role in PA. The role of Psychological Flexibility as a mediator was only found when analyzing PA, increasing the contributions of Courage and Others- Awareness.
These results contribute to understand the role of CBS related variables to explain burnout. At least two of the intimacy dimensions predict Burnout, mediated by Psychological Flexibility in the case of lack of personal accomplishment. These results contribute to understand the role of contextual behavioral variables in Burnout.

Can self-compassion mitigate the impact of COVID-19 on mental health? A multinational study across 21 countries
Primary Topic: Compassion
Subtopic: COVID-19 pandemic

Marcela Matos, Ph.D., University of Coimbra, Portugal
Kirsten McEwan, University of Derby, United Kingdom
Martin Kanovský, Comenius University, Slovakia
Júlia Halamová, Comenius University, Slovakia
Stanley Steindl, University of Queensland, Australia
Nuno Ferreira, University of Nicosia, Cyprus
Mariana Linharelhos, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Portugal
Daniel Rijo, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Portugal
Kenichi Asano, Mejiro University, Japan
Sónia Gregório, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Portugal; Universidad Europea de Madrid, Spain
Margarita Márquez, Universidad Europea de Madrid, Spain
Sara Vilas, Universidad Europea de Madrid, Spain
Gonzalo Brito-Pons, Pontificia Universidad Católica de Chile
Paola Lucena-Santos, University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Portugal
Margareth da Silva Oliveira, Pontifical Catholic University of Rio Grande do Sul, Evaluation and Treatment in Cognitive and Behavioral Psychotherapies - Research Group (GAAPCC), Brazil
Erika Leonardo de Souza, Conectta: Mindfulness & Compassion, Brazil
Lorena Llobenes, Motivación Compasiva, Argentina
Natali Gumiy, Motivación Compasiva, Argentina
Maria Ileana Costa, Motivación Compasiva, Argentina
Noor Habib, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Saudi Arabia
Reham Hakem, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Saudi Arabia
Hussain Khrad, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Saudi Arabia
Ahmad Alzahrani, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Saudi Arabia
Simone Cheli, University of Florence, Italy
Nicola Petrocchi, John Cabot University, Italy
Elli Tholouli, National and Kapodistrian University of Athens, Greece
Philia Issari, National and Kapodistrian University of Athens, Greece
Gregoris Simos, University of Macedonia, Greece
Vibeke Lunding-Gregersen, Mindwork Psycological Center, Denmark
Ask Elklit, University of Southern Denmark
Russell Kolts, Eastern Washington University, USA
Allison C Kelly, University of Waterloo, Canada
Catherine Bortolon, Grenoble Alpes University, France; Centre Hospitalier Alpes Isère, France
Pascal Delamillieure, CHU de Caen, France; University of Normandy, France
Marine Paucsik, Grenoble Alpes University, France
Julia E. Wahl, The Mind Institute Poland; SWPS University of Social Sciences and Humanities, Poland
Mariusz Zieba, SWPS University of Social Sciences and Humanities, Poland
Mateusz Zatorski, SWPS University of Social Sciences and Humanities, Poland
Tomasz Komendziński, Nicolaus Copernicus University, Poland
Shuge Zhang, University of Derby, United Kingdom
Jaskaran Basran, University of Derby, United Kingdom
Antonios Kagialis, University of Nicosia, Cyprus
James Kirby, University of Queensland, Australia
Paul Gilbert, University of Derby, United Kingdom

The world is facing an unprecedented crisis due to the COVID-19 pandemic, with detrimental effects on psychosocial wellbeing. Thus, examining factors that may buffer the detrimental impacts of the pandemic on mental health is critical. Mounting research has documented the numerous benefits of compassion has for mental health, emotion regulation and social relationships. The current study explores the moderator effect of self-compassion against the impact of perceived threat of COVID-19 on depression, anxiety and stress across 21 countries worldwide.
A sample of 4057 adult participants from the general community population was collected across 21 countries from Europe, Middle East, North America, South America, Asia and Oceania. Participants completed self-report measures of perceived threat of COVID-19, self-compassion and mental health indicators (depression, anxiety, stress).
Perceived threat of COVID-19 predicted higher scores in depression, anxiety and stress, and self-compassion predicted lower scores in these mental health indicators. Self-compassion moderated the impact of perceived threat of COVID-19 on depression, anxiety and stress. These effects were consistent across all countries.
The findings suggest that being able to be compassionate towards oneself in the face of suffering can mitigate the harmful impact of the COVID-19 pandemic on mental health, and offer evidence supporting the universality of this buffering effect of self-compassion. Public health policy-makers and providers should consider the implementation of compassion-based interventions and communication strategies to promote resilience and address mental health problems during and in the aftermath of the COVID-19 pandemic.

Commit And Act Foundation Using ACT To Strengthen Community Structures In The Fight Of COVID-19
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Using ACT To Strengthen Community Structures

Edmond Brandon, B.S., Commit and Act Foundation in Sierra Leone

Sierra Leone has experienced substantial economic growth in recent years, although the ruinous effects of the civil war continue to be felt. The country is beautiful but with multiple problems such as violence against women, poverty, corruption, lack of water and sanitary facilities, increase in maternal and morbidity rate, and many more. Government and other NGOs are doing their best to overcome some of the challenge faced by the country. Commit and Act has played integral role by using ACT to train all categories of individual, groups in the prevention of COVID-19 transmission.
What was done by Commit and Act Foundation? • Provision of support services for girls that have experienced sexual Gender based violence • ACT training for community members to help them break the Chain of Covid-19 transmission.(using the Matrix) • Provision Covid -19 prevention materials to community members • Strengthen chiefdom level bye laws and monitoring of law and action plans developed • Counselling services for individuals and couples
What needs to be done by Commit and Act Foundation? • Continue to provide support services for girls that have experienced sexual gender Based violence • Provision of counselling services for those in need. • Monitor activities of trained groups • Continue with ACT trainings for children and couples at chiefdom and community levels • Advocate with government and other partners for the provision of quality drinking water for community members • Support girls to achieve quality education • Source funding opportunity for the continuity of its projects

Comparative Efficacy of ACT and CBT for Chronic Insomnia: A pilot randomized controlled trial
Primary Topic: Clinical Interventions and Interests
Subtopic: Insomnia

Renatha El Rafihi-Ferreira, Ph.D., Instituto de Psiquiatria, Universidade de São Paulo
Charles Morin, Ph.D., Laval University
Andrea Toscanini, M.D., Ph.D., Hospital das Clínicas, Universidade de São Paulo
Rosa Hasan, M.D., Hospital das Clínicas, Universidade de São Paulo
Franscisco Lotufo Neto, Ph.D., Universidade de São Paulo

Cognitive Behavior Therapy for Insomnia (CBT-I) is recognized as the therapy of choice for insomnia, with several studies reporting and supporting its effectiveness. With a divergent approach to the cognitive strategy present in CBT-I, Acceptance and Commitment Therapy (ACT) represents a paradigm shift in the management of insomnia since it focuses on the participants from a macro perspective, aiming to increase their psychological flexibility, not concentrating exclusively on symptom control. Objective: To evaluate a protocol for acceptance and commitment therapy for insomnia (ACT-I) in adults compared to cognitive behavioral therapy for insomnia (CBT-I).
Participants were 37 adults (74.3% women; M = 43.7 years, SD = 10.7) with chronic insomnia. They were randomized to 6 weekly, group sessions consisting of ACT-I (n=19) or CBT-I (n=18). The evaluation occurred in three moments - pre-treatment, post-treatment and six-month follow-up, through the instrument Insomnia Severity Index (ISI).
CBT-I was associated with a higher proportion of treatment responders immediately after the intervention, the improvements in insomnia associated with CBT were faster but not as sustained and the improvements associated with ACT was slower and sustained. The proportion of treatment responders and insomnia remission were higher in the CBT (64.7% and 58.8%) relative to ACT-I (50% and 22.2%) groups at post treatment, while 6 months later ACT-I made further gains (55.6% and 33.3% respectively) and CBT-I had loss (58.8% and 41.2%). Conclusions: Both CBT and ACT therapies are effective, with a more rapid effect for CBT and a delayed action for ACT treatment. These different trajectories of changes provide possibilities into the process of behavior change via cognitive versus contextual approach.
Both CBT and ACT based therapies are effective, with a more rapid effect for CBT and a delayed action for ACT based treatments. These different trajectories of changes provide possibilities into the process of behavior change via cognitive versus contextual approach.

Contextual-behavioral model of self predicts borderline personality disorder symptoms

Primary Topic: Clinical Interventions and Interests
Subtopic: Relational Frame Theory, Borderline Personality Disorder, BPD, Mindfulness, Self as Context, Self as Process, Self as Content

Jan Topczewski, SWPS University of Social Sciences and Humanities
Paweł Ostaszewski, SWPS University of Social Sciences and Humanities

Dysregulation of self is argued to be at the core of borderline personality disorder (BPD). It is linked to symptoms such as identity disturbance and chronic feelings of emptiness. Mainstream models of self dysregulation often lack either strong theoretical foundations or ecological validity, hence it is difficult to address this problem in clinical research and psychotherapy. From a contextual-behavioral perspective, there are three behavioral repertoires with important implications for a healthy self: self-as-content, self-as-process, and self-as-context. The aim of this study was to investigate if, and how well the specific elements of the contextual-behavioral model of self predict BPD symptoms.
348 participants completed a demographic questionnaire and self-report measures of self-as-content flexibility (three subscales from SCS-SF), self-as-process (MAAS), self-as-context (SEQ), and BPD symptoms (BPD checklist). To answer the research questions, multiple regression analysis was performed. In addition, to check for potential moderating effects of demographic variables, moderation analysis was applied.
Multiple regression analysis revealed that the contextual-behavioral model of self is predictive of borderline personality disorder symptoms, with self-as-process being the strongest predictor. A series of moderation analyses revealed that self-as-process has a stronger impact on BPD symptoms in younger participants than in older participants, and that self-as-content flexibility predicts BPD symptoms only in females.
This study is the first to suggest that all three behavioral repertoires related to self may be relevant targets in interventions for people with BPD. Potential clinical implications and further research directions are discussed.

Coping with the COVID-19 Pandemic and Quality of Life in the Context of Psychological (In)Flexibility Processes: A Test of Two Multiple-Mediation Models
Primary Topic: Clinical Interventions and Interests
Subtopic: COVID-19 Pandemic

Eric Tifft, M.A., University at Albany, SUNY
Max Roberts, M.A., University at Albany, SUNY
Shannon Underwood, B.S., University at Albany, SUNY
John Forsyth, Ph.D., University at Albany, SUNY

The COVID-19 pandemic is associated with numerous disruptions to daily life, unique stressors, increased mental health concerns, and decreased quality of life (QoL; Gallagher et al., 2020; White & Van Der Boor, 2020). The extent to which individuals are able to respond flexibly to pandemic-related stressors may, in turn, account for relations between coping and QoL. The present study aimed to elucidate such relations.
Undergraduates (N = 531) completed measures of psychological (in)flexibility, QoL, and how well they were coping with pandemic-related stress and anxiety. In two models, ACT inflexibility and flexibility processes were evaluated as mediators of relations between coping and QoL.
Individuals who reported more effective coping with pandemic-related stress and anxiety had greater QoL (c = 8.40, SE = 1.08, t(592) = 7.77, p < .001), and this relation was partially mediated by contact with values (abest = 1.26, 95% CI [.33, 2.34]) and committed action (abest = 1.41, 95% CI [.42, 2.62]). In the second model, lack of present moment awareness (abest = 1.16, 95% CI [.37, 2.07]) and weak committed action (abest = 2.58, 95% CI [1.00, 4.28]) partially mediated relations between coping and QoL.
Findings suggest that the impact of coping on QoL during the pandemic is accounted for, in part, by unique psychological inflexibility and flexibility processes. Implications of these findings will be discussed in terms of role of psychological flexibility when discussing the utility of coping strategies for navigating significant stressors and life challenges.

Couple schemas, cognitive fusion, and interactions in the relationship
Primary Topic: Clinical Interventions and Interests
Subtopic: Theoretical and philosophical foundations, Couples

Lidia Baran, Ph.D., University of Silesia in Katowice
Joanna Dudek, Ph.D., SWPS University of Social Sciences and Humanities
Avigail Lev, Bay Area CBT Center
Jadwiga Jagódka, University of Silesia in Katowice
Magdalena Krasińska, University of Silesia in Katowice
Marta Potuczko, University of Silesia in Katowice
Agata Serwaczak, University of Silesia in Katowice
Kamil Zając, University of Silesia in Katowice

Several studies show that early maladaptive schemas are related to couple satisfaction (Dumitrescu & Rusu, 2012) and may predict divorce (Yousefi et al., 2009). Maladaptive schemas are activated in the adult romantic relationship, and they may lead to avoidance of schema pain through schema coping behaviors (McKay, Lev & Skeen, 2012). Acceptance and Commitment Therapy may prove its potential effectiveness to help partners become aware of the existing interpersonal schemas and defuse from them to engage in more workable couple interactions (Lev & McKay, 2017).
The ongoing project aims to analyze relations between relationship schemas, fusion, and interactions in romantic relationships. The survey is conducted online among people over 18 and in a romantic relationship. Couples participating in the study complete the Couples Schema Questionnaire, the Cognitive Fusion Questionnaire, and the Interactions in Relationship Scale (based on The Functional Idiographic Assessment Template-Questionnaire).
We will present preliminary results obtained from 139 couples concerning: a) associations between relationship schemas (abandonment/instability, mistrust/abuse, emotional deprivation, defectiveness/shame, social isolation/alienation, dependence, failure, entitlement/grandiosity, self-sacrifice/subjugation, and unrelenting standards) and interactions in the relationship (assertion of needs, bidirectional communication, conflict, disclosure and interpersonal closeness, emotional experience, and expression), b) cognitive fusion as a moderator of the relation between relationship schemas and interaction in the relationship. The study results will allow us to better understand associations between schemas and behaviors in romantic relationships and respond to relationship problems during counseling or therapy.

Efectos psicológicos del Programa Mindfulness-based Mental Balance
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness

Isaac Carmona Rincón, M.S., Universidad Jaime I de Castellón / Ítaca, Psicología y Lenguaje
Azucena García Palacios, Universidad Jaime I de Castellón
Santiago Segovia Vázquez, Elea, Instituto Psicoeducativo Integral, Spain

Antecedentes: El presente trabajo se centra en el análisis preliminar de los beneficios psicológicos del Nivel 1 del Mindfulness-Based Mental Balance (MBMB), una intervención basada en mindfulness, de tres años de duración por nivel. El nivel 1 está orientado a reducir los pensamientos intrusivos y alcanzar el estado mindful de consciencia (yo-contexto, en términos de ACT). Nuestra hipótesis fue que se producirían aumentos en las puntuaciones de mindfulness y satisfacción vital, así como en variables del Modelo de los Cinco Grandes de la Personalidad: «apertura», «extraversión», «amabilidad» y «responsabilidad». Igualmente, la puntuación de «neuroticismo» se vería reducida positivamente, como también la fusión cognitiva, el estrés percibido y la ansiedad (estado y rasgo).
Método: Se evaluó la intervención siguiendo un diseño controlado de línea base múltiple entre sujetos, con la participación de nueve personas (población no clínica). El entrenamiento se ajustó a la estructura estandarizada y manualizada del MBMB (Segovia, 2017), con una duración de 41 semanas. Los datos fueron obtenidos en la fase pre-tratamiento y post-tratamiento.
Resultados: los resultados apoyan la eficacia del Nivel 1 de MBMB para producir mejoras en gran parte de las variables dependientes, obteniendo resultados estadísticamente significativos en mindfulness, fusión cognitiva, neuroticismo, extraversión, responsabilidad, ansiedad estado, estrés percibido y satisfacción con la vida. En general, los tamaños de efecto encontrados fueron medianos.
Discusión: Tomando con cautela los resultados, el Nivel 1 de MBMB podría ser un entrenamiento prometedor para mejorar el bienestar y el desarrollo personal, es decir, aumentar la flexibilidad psicológica.

Effect of an ACT Protocol Focused on the Most Problematic Self-Beliefs or the “Big Ones”: Improving Psychological Inflexibility in Adolescents
Primary Topic: Relational Frame Theory
Subtopic: Performance-enhancing interventions, Adolescents, Psychological Flexibility, Big Ones, Relational Frame Theory, ACT

Katia Barrutia, M.Sc., Madrid Institute of Contextual Psychology(MICPSY)
Bárbara Gil-luciano Gil-Luciano, Ph.D., Madrid Institute of Contextual Psychology(MICPSY)
Beatriz Sebastian, M.Sc., Madrid Institute of Contextual Psychology(MICPSY)

Although there has been an increase in studies regarding the efficacy of Acceptance and Commitment Therapy (ACT; Hayes, Strosahl & Wilson, 1999, 2014; Wilson & Luciano, 2001) with young clinical population, studies in school settings are rare. In addition, recent research shows the importance of addressing the Big Ones (most problematic self-beliefs, or self-concepts) (Gil-Luciano et al., 2019; Ruiz et al., 2016, 2018; Luciano, 2017), in that they unleash an inflexible class of behaviors that produce multiple limitations. To our knowledge, no prior studies have addressed psychological inflexibility with teenagers this way. The aim of this pioneer study was to develop an ACT-based protocol focused on the Big Ones and assess its impact on academic performance.
A single case design with a sample of 16 adolescents with poor academic performance, 50% male, aged 14-17 years old. Firstly, participants filled in several questionnaires and a functional assessment was performed. Secondly, the protocol was tailored to each participant. Finally, all measures were taken again. The ACT-based protocol consisted on a multiple exemplar training on discriminating private events as they emerged in several academic tasks, learning to frame them in hierarchy with the deictic I, so that flexible reactions could take place.
Results show clinically relevant improvements in psychological flexibility. Results are discussed in terms of psychological flexibility improvement from the impact of directly addressing the Big Ones.

Electronically Mediated Acceptance and Commitment Therapy and Chronic Illnesses: A Systematic Research Synthesis

Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Chronic Illness

Amelia Welch, MSMFT, Florida State University
Tom Su, Florida State University

Electronically mediated ACT approaches have been associated with high completion and high adherence to protocol (Brown et al., 2016). ACT has been identified as an effective and cost-effective treatment (Kerns et al., 2011) for chronic pain in a variety of clinical settings and patient samples (McCracken et al., 2007). The purpose of this study is to systematically review existing research linking electronically mediated ACT interventions and chronic illnesses.
A literature search was conducted using the keywords acceptance and commitment therapy, online, internet, web, telephone, smartphone, arthritis, asthma, cancer, COPD, diabetes, chronic, and pain. 9 studies remained after incorporating the inclusion criteria to confirm that each article covered an (a) intervention study (b) addressing an electronically mediated, ACT-based approach as treatment for (c) a sample of participants who are living with a chronic illness, (d) published between 2006 and 2020 in a (e) peer-reviewed (f) English-language journal.
The results revealed key patterns between studies, including types of chronic illness studied, gender demographics, attrition rates, location, and measurement tools. The average attrition was 2.3% for samples that are 95-100% female, as compared to a rate of 16.7% for more representative samples. Six studies reported significant decreases in patient-reported pain, seven reported improvements in patient functioning measures, and 8 studies reported significant psychological improvements.
Clinicians may consider this review as they incorporate electronically mediated approaches. The nine studies, individually and when compared, provide support for the use of ACT-based therapy for chronic conditions, electronically mediated ACT approaches, and collaborative care.

eLIFEwithIBD - Living with Intention, Fullness and Engagement with Inflammatory Bowel Disease: Presenting an ICT-delivery format of a novel contextual behavioural intervention for IBD
Primary Topic: Clinical Interventions and Interests
Subtopic: IBD, Mindfulness, Compassion, Acceptance

Cláudia Ferreira, Ph.D., University of Coimbra, CINEICC
Joana Pereira, Ph.D., University of Coimbra, CINEICC
Sérgio Carvalho, University of Coimbra, CINEICC
Ana Galhardo, Instituto Superior Miguel Torga; University of Coimbra, CINEICC, FPCE
Paola Lucena-Santos, University of Coimbra
Nuno Ferreira, Ph.D., University of Nicosia
Francisco Portela, Department of Gastroenterology, Coimbra University Hospital
Bárbara Rocha, M.D., Ph.D., Faculty of Pharmacy, University of Coimbra
Inês Trindade, Ph.D., University of Coimbra

Living with Intention, Fullness and Engagement with Inflammatory Bowel Disease (IBD) is an ICT-delivery format (eLIFEwithIBD) of an acceptance, mindfulness, and compassion-based intervention adapted to people with IBD that aims to add to the traditional medical approach of IBD treatment. This intervention’s pertinence emerges from the lack of acceptance and compassion-based psychological interventions for IBD. Moreover, digital technologies offer promising means of delivering behaviour change approaches at low cost and on a wide scale. The present work aims to present an ICT-delivered contextual behavioural intervention for IBD to improve mental health and quality of life in people with IBD.
This toolkit comprises eight self-guided online sessions, each delivered weekly. eLIFEwithIBD addresses IBD education, and acceptance, mindfulness, cognitive defusion, compassion, values clarification, and committed action modules, adapted for the IBD context. These contents are offered through text, video, audio and experiential exercises. All sessions follow a similar structure: overview of the core competency/concept, metaphors and/or exercises to support participants learn the targeted ability/concept and its application, an invitation to complete between-session exercise(s), and a brief session summary. Between-session exercises encompass mindfulness and compassion practices.
It is expected that the eLIFEwithIBD intervention will produce improvements in perceived physical and mental health, and the quality of life of people with IBD. If effective, this intervention will allow a larger proportion of people with IBD to access a self-help tool. The ICT-based delivery format’s flexibility can be appealing for this population and may remove barriers usually encountered in face-to-face interventions.

Enhancing University Students’ Well-Being with Psychological Flexibility and Organized Study Skills Training
Primary Topic: Educational settings
Subtopic: Performance-enhancing interventions, Higher education

Kristiina Räihä, M.Sc. (Health Sci.), University of Helsinki
Nina Katajavuori, Ph.D., University of Helsinki
Henna Asikainen, Ph.D., University of Helsinki

As there are increasing, and long-effecting problems with higher education students’ well-being, the development of effective study-integrated well-being enhancing interventions is important. There is preliminary evidence of various positive results of ACT-based interventions targeted to students, but a lack of knowledge of the effects of combining psychological flexibility and study skills training. This study aimed to determine the effects of an online intervention course on university students’ psychological flexibility, stress, study-related burnout risk, and organized study skills.
74 university students participated in an eight-week online ACT and study skills training combining intervention that was conducted with an experimental control setting. Changes in students’ well-being were measured by questionnaires and heart rate variability (Firstbeat) at the beginning and the end of the intervention.
The data were analyzed with Pearson's correlation coefficient, repeated-measures t-test, and repeated measures analysis of variance (ANOVA). The results showed that students’ psychological flexibility and organized study skills increased as stress and study-related burnout risk decreased. The results of the heart rate variability measurements will be discussed at the conference.
The effects of the intervention suggest that well-being of university students can be supported by an online course combining ACT practices and study skills training. More research is needed on the individual-level changes and the long-term effects of the intervention on well-being and study-related burnout.

Establishment and maintenance of equivalence classes and transfer of function in depressed and nondepressed individuals
Primary Topic: Relational Frame Theory
Subtopic: Depression,Transfer of function, IRAP

Heloisa Ribeiro Zapparoli, Federal University of São carlos
Mariéle Diniz Cortez, Federal University of São Carlos

The present study assessed the formation and maintenance of equivalence classes as well as the transfer of function among stimuli of different valences and abstract stimuli in depressed and nondepressed individuals.
Sixty-four participants were administered the Beck Depression Inventory II, and distributed into groups. Two experimental groups (depressed and nondepressed) underwent matching-to-sample procedure to establish three four-member classes, containing faces expressing emotions (e.g., sadness, happiness and neutrality) and abstract stimuli. The transfer of function among stimuli were assessed by means of a semantic differential and an Implicit Relational Assessment Procedure (IRAP). Thirty days later those participants were resubmitted to equivalence tests, to the semantic differential device and to the IRAP. Two control groups (depressed and nondepressed) only evaluated experimental stimuli using the semantic differential (they weren’t exposed to other procedures).
Data collection is still in progress and statistical analysis has not yet been done. By now, twenty-six of 41 participants in the experimental groups demonstrated class formation, 11 depressed and 15 nondepressed. Participants from both experimental groups similarly evaluated the abstract stimuli from the happy, sad and neutral classes as positive, negative and neutral, respectively, demonstrating the transfer of function among stimuli. IRAP data suggest that depressed participants responded faster on Sad-Negative/True and Happy-Positive/True trials while nondepressed participants responded faster only on Happy-Positive/True trials. The mean D-IRAP scores for other trial types for both groups doesn’t seem to present differences compared to zero. Follow-up data collection is still in progress and must be finished and analyzed soon for further discussion.

Evaluating the novel Mask Delay Discounting Task: Concurrent validation with monetary delay discounting and association with self-reported mask use
Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Theoretical and philosophical foundations, Delay Discounting

Matthew Dwyer, M.S., Rowan University
Connor Burrows, M.A., Rowan University
Schyler Newman, B.S., Rowan University
Bethany Raiff, Ph.D., Rowan University

Underutilization of face masks has continued to be a problem within the United States. Several factors may explain why individuals do not wear a mask, however, impulsive choice (defined by how much individuals discount delayed vs. immediate outcomes) has not been evaluated. Therefore, the development of a delay discounting measure could prove to be useful in investigating the role of impulsive choice on mask-wearing behavior.
We developed a novel instrument called the Mask Delay Discounting Task (MDDT). Participants (n=300) were asked to imagine a scenario where they are entering a grocery store and measures how long the person is willing to wait to obtain a mask before choosing to enter without one. The goal was to examine the relationship between performance on the MDDT (i.e. the decision to wear a mask across a range of time delays) and a monetary delay discounting task. Performance on both measures was correlated with self-reported mask use in seven contexts using a logistic generalized linear model.
Analysis of performance on the MDDT compared to a monetary delay discounting task. found the odds ratio for the low discounting group differed from the high discounting group. Odds-ratios and the inflection point of the logistic curve differed between these groups in predicting mask-wearing across six of seven contexts.
These results demonstrate the potential for impulsive choice defined by delay discounting as a possible influence on mask-wearing. The MDDT may be a useful tool to facilitate more research in this area to inform policy and intervention development.

Fusion and self-compassion as moderators of self-stigma in parents of children with autism spectrum disorder
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Theoretical and philosophical foundations, Parenting

Anna Pyszkowska, MA, University of Silesia in Katowice, Poland
Krzysztof Rożnawski, University of Silesia in Katowice
Zuzanna Farny, University of Silesia in Katowice
Ada Stasiak, University of Silesia in Katowice
Weronika Szubert, University of Silesia in Katowice

Research shows that stigma occurs in the lives of people with autism spectrum disorder (ASD) as well as their parents. Parents experience stigma, the internalization of which can lead to the occurrence of self-stigma. It can lead to a cognitive fusion with negative thoughts – especially those about oneself. Previous studies show that self-compassion reduces feelings of suffering, shame and self-stigma. The aim of this study was to test the relationship between self-stigma and cognitive fusion among parents of children with ASD. The moderating role of self-compassion as a protective factor was also verified.
The following questionnaires were used: Perceived Public Stigma Scale, Perceived Courtesy Stigma Scale, Self-Compassion Scale Short-Form, Cognitive Fusion Questionnaire and Depression, Anxiety and Stress Scale. The study included parents of children with ASD (Nf233, including 218 women).
Results showed that there is a positive correlation between fusion and both affiliate (r = .31, p < .001) and public stigma (r = .33, p < .001). Fusion and self-compassion were significant predictors of affiliate stigma. Self-compassion moderated the relationship between fusion and depression (β = -.11, p < .05) and a relationship between fusion and stress (β = -.11, p < .05).
Cognitive fusion with negative beliefs about oneself can contribute to self-stigma. Defusion-oriented actions may allow one to distance oneself from negative thoughts and eliminate their consequences. Self-compassion manifests itself in a compassionate and accepting attitude towards oneself hence actions taken to strengthen it could contribute to reduce suffering experienced by parents of children with ASD.

How do Acceptance and Commitment Therapy interventions work for informal caregivers? A Systematic Review
Primary Topic: Clinical Interventions and Interests
Subtopic: Other, Family caregivers

Golnaz Atefi, M.Sc., Maastricht University
Sara L. Bartels, Maastricht University
Rosalie J.M. Van Knippenberg, Maastricht University
Michael Levin, Utah State University, Department of Psychology
Tessa O.C. Kilkens, Lionarons ggz Heerlen
Frans R.J. Verhey, Maastricht University
Marjolein E. De Vugt, Maastricht University

Acceptance and commitment therapy (ACT) as a transdiagnostic and evidence-based approach has shown promise in improving mental health and overall wellbeing. One promising area that has been growing is ACT for informal, family caregivers outside the context of parenting.
This systematic review following the PRISMA protocol, examined the feasibility, acceptability and efficacy of ACT for family caregivers of adult patients. Potentially relevant publications were identified through a systematic search of 5 databases (n = 1668).
A total of 11 articles (10 individual studies) were finally selected and reviewed. The quality of studies was also assessed. Generally, ACT appeared to be feasible and acceptable for caregivers. Intervention efficacy varied and effects on negative psychological symptoms were more often assessed (7/10 studies).
Various types of study designs, interventions, and informal caregiving contexts highlighted the applicability of ACT in caregiving and areas for future research. Future studies should be conducted to measure the positive psychological outcomes of ACT such as quality of life, and for various family caregiver populations with chronic conditions.

Improvement in nonjudgment during the first week of treatment as a predictor of treatment outcome
Primary Topic: Clinical Interventions and Interests
Subtopic: Performance-enhancing interventions, Nonjudgment

Lori Eickleberry, Ph.D., ABPP, Institute for Life Renovation, LLC
Benjamin Shepherd, M.Ed., Nova Southeastern University & Institute for Life Renovation, LLC

Nonjudgment has been indicated in the literature as an important variable related to outcomes. Increases in nonjudgment during the first week of treatment were examined as a predictor of significant increases in quality of life.
Participants (n=48) consisted of individuals presenting with multiple comorbidities who were receiving treatment from an intensive, individualized outpatient program completed the Five Facet Mindfulness Questionnaire (FFMQ) and the Quality Of Life Inventory (QOLI; Mean age=31.08, SD=12.09; Caucasian=77%; Female=62%). Paired sample t-tests were conducted to explore changes in mindfulness from pre-treatment to the first week of treatment and significant differences were found in only the nonjudgment factor. Those participants were divided into two groups and a linear regression was conducted on both groups to determine whether changes in FFMQ scores during the first week of treatment predicted changes in QOLI scores.
Non-judgment was the only facet of mindfulness that significantly differed from pre-treatment to the first day of treatment, t(47) = -.520, Mean = -2.36, SD = 6.36, p < .014. For the group with improved non-judgment, quality of life was significantly higher at the first month of treatment compared to pre-treatment, t(31) = -4.18, Mean = -7.66, p < .001, d = -.739. Furthermore, changes in nonjudgmental mindfulness significantly predicted changes in QOL for the group with improved non-judgment, b = 1.26, p = .008 (p < .01), R² = .215. Longitudinal findings suggest non-judgment is a unique dimension of mindfulness and that if increased early in treatment, could lead to better treatment outcomes.

Measuring self-authenticity in lesbian, gay, and bisexual people: a novel measure of authentic living
Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Other, Lesbian, gay, and bisexual psychological wellbeing, Authentic living/valued living

Tim Cartwright, University of Chester
Nick Hulbert-Williams, B.Sc., Ph.D., University of Chester
Lee Hulbert-Williams, University of Chester
Gemma Evans, University of Chester

Self-authenticity is an important psychological construct, given that knowing and being oneself is considered as necessary to achieve greater happiness and wellbeing in life. However, being one’s self may be difficult for specific groups, for example, sexual minorities, due to potential stigma and discrimination which could be experienced. We wanted to understand the relationships between being one’s self and sexuality-related constructs such as outness, discrimination, and internalised homonegativity, as well as consider if self-authenticity could be increased through the psychological flexibility model of Acceptance and Commitment Therapy.
As such, we developed the novel Self-Authenticity Measure to improve on existing measures of authenticity. Exploratory factor analysis (n = 1,152) suggested two-factors: knowing and being oneself (internal self-authenticity) and being oneself around others (external self-authenticity). The measure demonstrated good to excellent internal consistency (α = .83 to .86), test-retest reliability (r = .87 and .89), convergent (r = -.69 and .84), concurrent (r = -.61 and .74), incremental, and construct validity (CFI = .92, TLI = .91, SRMR = .05, RMSEA = .07). We found weak to moderate correlations with discrimination, internalised homonegativity, and outness (r = -.22 to -.54) and moderate to strong correlations between self-authenticity and psychological flexibility constructs (r = .63 to .83).
Our findings suggest we have developed a valid and reliable measure of self-authenticity and that self-authenticity may in some way regulate sexuality-based constructs. Furthermore, psychological flexibility may be helpful in increasing self-authenticity in sexual minorities.

Mindfulness-based Mental Balance Teacher Training: Beneficios psicológico
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness

Isaac Carmona Rincón, M.S., Universidad Jaime I de Castellón / Ítaca, Psicología y Lenguaje
Azucena García Palacios, Universidad Jaime I de Castellón
Santiago Segovia Vázquez, Elea, Instituto Psicoeducativo Integral

Antecedentes: en este estudio evaluamos los efectos del primer año de entrenamiento de instructores del programa Mindfulness-based Mental Balance (MBMB). Se trata de una formación de 41 semanas de duración, con prácticas destinadas al desarrollo de la serenidad y la ecuanimidad, a través de la meditación de concentración. Posteriormente, se lleva el estado mindful de consciencia a la vida diaria y se entrena la autorregulación emocional e intencional (compasión y autocompasión).
Método: se empleó un diseño controlado de línea base múltiple, donde participaron 12 sujetos no clínicos. El entrenamiento se ajustó a la formación oficial del programa MBMB (Segovia, 2017). Los datos fueron obtenidos en la fase pre y postratamiento.
Resultados: la comparación de medias con la prueba t de Wilcoxon evidenció beneficios significativos en las puntuaciones de mindfulness, autocompasión, defusión cognitiva, ansiedad (estado) y estrés percibido. Los tamaños de efecto oscilaron entre medianos y grandes, aunque la potencia estadística no resultó suficiente para inferir generalizaciones (salvo en la variable mindfulness).
Discusión: el entrenamiento sistemático propuesto por el MBMB resultó eficaz para aumentar la flexibilidad psicológica, dando lugar a una mejora del bienestar personal en sujetos no clínicos. Estos hallazgos son similares a los encontrados anteriormente (Carmona-Rincón et al. 2021), No obstante, es necesario realizar otros estudios de replicación, además de ensayos controlados aleatorizados. Cabe mencionar, por otro lado, que el estudio coincidió con la crisis del SARS-CoV-2, dando lugar a fluctuaciones en la adherencia al tratamiento que podrían haber reducido sus potenciales efectos.

My Aspirations for CBS in South Africa
Primary Topic: Spreading CBS
Subtopic: Contextual Behavioral Science in South Africa

Nevern Subermoney, M.A., HPCSA

I was introduced to the world of CBS only last year, but since then I have digested multiple books, articles, and completed various training courses. All of this was because of the power I saw in this approach to link science to human suffering. It was amazing to me that hardly anyone in my country knew about this approach, and so I feel very committed to spreading this knowledge in my corner of the world and using these techniques to help the people around me.

Negative self-referential thoughts of university students in a Irish context: A thematic analysis
Primary Topic: Clinical Interventions and Interests
Subtopic: Educational settings, Negative self-referential thoughts

Joseph Lavelle, M.Sc., University College Dublin
Neil Dunne, University College Dublin
Louise McHugh, Ph.D., University College Dublin

The Contextual Behavior Science (CBS) literature has given particular focus to negative self-referential thoughts with research within this sphere giving particular focus to processes and brief-interventions that target such thoughts (see Duff, Larsson, & McHugh, 2016; Larsson, Hooper, Osborne, Bennet, & McHugh, 2016; Masuda, Hayes, Sackett, & Twohig, 2004; Masuda, Feinstein, Wendell, & Sheehan, 2010). Said studies routinely ask participants to select and state a negative self-relevant thought that they experience but give focus to evaluations of these thoughts and rarely, if ever, treat the rich qualitative data generated as the unit of analysis. Therefore, the present study intends to remedy this by subjecting this data to qualitative methods of investigation.
Participants were 87 students in an Irish university context with a mean age of 21.93 years (SD=4.75). 63 participants identified as female, 22 identified as male, and two identified as non-binary or gender fluid. Participants reported negative self-referential thoughts via The Target Thought Questionnaire (Larsson, Hooper, Osborne, Bennett, & McHugh, 2015). The chosen method of qualitative analysis was thematic analysis which was conducted per Braun and Clark (2006).
This analysis divulged four themes: dissatisfaction with body and appearance, issues around self-worth; perception of being undeserving of friendship and love; and feelings of failure. These findings may inform future interventions ranging from brief interventions that target negative self-referential thoughts to self-directed interventions such as bibliotherapy or e-mental health.

Online Acceptance and Commitment Therapy For A Burnout Physician During Covid-19 pandemic: A Case Report
Primary Topic: Clinical Interventions and Interests
Subtopic: Burnout

Mohamed Abdelalem Aziz, M.D., Omar Shahin mental hospital

The physicians working in Isolation hospitals all over the world especially in the developing countries was under a great work Stress during Covid-19 pandemic. Hereby, we are introducing a case of Physician suffering from Burnout symptoms during his presence in the isolation hospital.
• Male patient, 27 years old, From Egypt • A physician in Isolation hospital for Covid-19 cases • Positive history of OCD and depression 7 years ago • Positive family history of anxiety disorders • Complaint: moderate anxiety, agitated, thoughts of helplessness and hopelessness, feeling physically exhausted, decrease concentration for two weeks. • Medication: Prozac 40 mg daily for one week. • First time to have psychotherapy sessions.
We did six session (two sessions per week) every session about one hour and thirty minutes. During the six session, the patient was trained for the core processes of ACT. After two weeks, the patient showed a great improvement during the follow-up session. I talked to my Psychiatry colleague in the Isolation hospital and he gave a good feedback about the patient work and communication with the patients and his colleagues.
The obstacles we faced were 1) The internet bad connection which sometimes affects the quality of the sessions, 2) Lack of ACT protocol for dealing with burn out syndrome cases, 3) Patient resistance regarding psychotherapy due to the fear of Stigma. For conclusion, ACT showed a promising result for dealing with burnout syndrome cases using teletherapy.

Parent-implemented naturalistic language intervention: Systematic literature review of parent’s teaching methods
Primary Topic: Clinical Interventions and Interests
Subtopic: Prevention and Community-Based Interventions, children with intellectual disabilities, language delay or impairment, parent training

Lívia Balog, Universidade Federal de São Carlos
Luiz Ricardo Ribeiro, Universidade Federal de São Carlos
Ana Luísa Libardi, Universidade Federal de São Carlos
Camila Domeniconi, Universidade Federal de São Carlos

This review aimed to identify the current state-of-art in the parent’s teaching methods of parent-implemented naturalistic language interventions applied with children who show either one of the following traits: intellectual disabilities, language delay or communication impairments.
Full-text research published from 2011 to 2020 in journals in the fields of Psychology and Social Science were searched in three databases (Scopus, Web of Science and PsycINFO). The articles were filtered to meet the following criteria a) studies describing an intervention directed at parents, b) involving language teaching stimulation strategies to be used in the family's routine, c) with the participation of children who have intellectual disabilities, language delay or communication impairment. 19 articles were selected and categorized according to a) characteristics of participating children,b) type of intervention performed with parents and c) duration of intervention.
Ten studies had as participants children with language delay or communication impairment, followed by five studies with children diagnosed with autism spectrum disorder and four studies worked with intellectual disabled children. It was observed that most studies included three-year-old children and most interventions lasted more than two months (12). A large part (12) of the selected methods carried out the teaching individually for the parents, some studies used both group and individually teaching (4) and a few only groups (2). Further information about the studies and the strategies used were described.
The different ways of teaching naturalistic language strategies to parents found within the research are discussed, including the increasing use of technology to assist the intervention.

Population screening of gambling behavior: Identifying key characteristics of at-risk players
Primary Topic: Population screening
Subtopic: Other, Gambling

Klavdia Neophytou, Ph.D., University of Cyprus
Georgia Panayiotou, University of Cyprus

The increase of gambling availability and the inclusion of Gambling disorder as an addiction in DSM-5 highlight the importance of brief screening measures aiming to identify at-risk gamblers.
The current study using a brief telephone survey assessed demographic characteristics and gambling behaviors in 2118 adults. Questions were developed based on DSM-5 criteria for Gambling Disorder, and common assessment tools.
A percentage of 6% was identified as at-risk gamblers. Male gender, low monthly income, high frequency of gambling behavior, large amounts of money spent and gambling to escape from everyday problems or for amusement, specifically for men, were found to be characteristics that can help in the early identification of at-risk gamblers. Gambling for financial gain and as a way to socialize, birth date (age range), and employment status were not significant predictors of gambling severity.
This study shows that the above characteristics can be assessed easily through phone screening of large populations, aiding in prevention practices to reduce the problematic use of gambling activities.

Primeros pasos en un centro educativo terapéutico especializado en trastornos del espectro autista en modelos contextuales
Primary Topic: Clinical Interventions and Interests
Subtopic: Centro terapéutico, TEA, Jóvenes

Javier Brenlla, licenciado

Primeros pasos en un centro educativo terapéutico especializado en trastornos del espectro autista en modelos contextuales. Cetip es un centro educativo terapéutico que se dedica al trabajo con jóvenes y niños dentro del espectro autista, se encuentra ubicado en Buenos Aires, Argentina. Diariamente concurren 20 jóvenes y 19 profesionales de diferentes disciplinas, fonoaudiologas, psicólogos, terapistas ocupacionales y medica especialista en neurodesarrollo, de lunes a viernes de 9 a 16 hs. Las investigaciones han demostrado una gran eficacia de la terapia cognitivo conductual (TCC) en personas dentro del espectro autista , se observó que nuestro mayor trabajo hacía foco en las diferentes terapias con el niño o el joven y se perdia de vista su contexto interpersonal. Con respecto a los los profesionales se comenzó a trabajar sobre la flexibilidad, vulnerabilidad, valores, su auto cuidado y su mirada compasiva, en el aquí de su trabajo diario con los jóvenes. Se comenzaron a realizar los primeros pasos en los modelos contextuales, en la institución, que consistieron en: Reuniones con el equipo terapéutico para desarrollar cuales eran los objetivos y el porque del cambio a las terapias contextuales . Se invitaron a profesionales expertos para realizar diferentes charlas sobre ACT. Se les brindaron materiales de lectura sobre ACT , análisis funcional , conducta verbal y diferentes materiales de tercera ola. Se comenzaron a trabajar sobre diferentes conceptos e intervenciones sobre la familia Se brindaron sesiones de mindfulness en donde se pudieron indagar procesos internos de los profesionales (flex. psicológica , valores, auto cuidado, amabilidad). El poder ver desde el trabajo con pacientes dentro del espectro autista con la combinación de ACT con otras perspectivas psicológicas de tercera generación nos puede brindar realizar intervenciones funcional, contextual y amorosa con el paciente y su contexto.

Promoting ACT in a group intervention for parents of children with developmental disabilities
Primary Topic: Clinical Interventions and Interests
Subtopic: Parents of children with developmental disabilities

Emina Osmanovic Basic, Psychological counseling ABC

When it comes to children and adults with disabilities, support for parents and other family members is very rarely mentioned. Parents are mentioned only in the context of their important role in the child’s early intervention. Due to the lack of understanding of parents' need for support, we send the message that parents should always be strong. If parents have not adapted to the child's difficulty and have not achieved a balanced image of the child, they will have difficulty in recognizing the signs sent by the child and in providing a safe base. After the initial shock, parents deal with painful truth through a grieving process. With each new developmental stage in which the child cannot achieve developmental goals, they can go through a new process of grief. Parents are able to adapt to varying degrees to the new circumstances related to developmental difficulties. If parents suppress this process of grieving, it can lead to difficulties in adaptation to the child's disability. ACT with its philosophy of non-judgmental, non-pathological, and compassionate approach can greatly help in the process of grief and successful adaptation. The plan is to do future research on the effects of ACT therapy in group interventions for parents of children with disabilities.

Protective factors predicting quality of life in family carers of people with dementia: the role of psychological flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: Theoretical and philosophical foundations, Dementia family caregivers

Milena Contreras, M.Sc., CPsychol, University of East Anglia
Eneida Mioshi, Ph.D., University of East Anglia
Naoko Kishita, Ph.D., University of East Anglia

The current study aimed to investigate the impact of protective factors (i.e., knowledge about dementia, psychological flexibility, self-compassion and hours of support from other family members) on the quality of life (QoL) of dementia family carers.
A multiple regression analysis was conducted with QoL as a dependent variable. All protective factors were entered into the model simultaneously as independent variables. Ninety-one family carers with a mean age of 69.5 years old were assessed. Participants were primarily female family members looking after a person with severe Alzheimer's disease. The model's R2 was 24%. The results demonstrated that psychological flexibility was the only significant independent variable predicting QoL (β = -0.46, p=0.00, 95% CI: -0.71 to -0.20). These results indicated that higher psychological inflexibility was associated with worse QoL.
These findings suggested that improving carer’s psychological flexibility may be particularly important in promoting QoL among family carers of people with dementia. Psychological interventions aimed at improving psychological flexibility such as ACT may have a strong potential as an effective intervention for improving the QoL of this population.

Psychological flexibility as a causal protective factor against predictors of suicide
Primary Topic: Clinical Interventions and Interests
Subtopic: Theoretical and philosophical foundations, Suicide

Rosina Pendrous, MRes, University of Chester
Lee Hulbert-Williams, University of Chester
Kevin Hochard, University of Chester
Nicholas Hulbert-Williams, University of Chester

Suicide is a leading cause of death worldwide. Current theories provide a relatively comprehensive overview of the statistical predictors of suicidality but have not yet produced highly effective interventions. Facilitating psychological flexibility may be useful in building resilience to suicidal thoughts, but few longitudinal studies exist which have established the theoretical basis for psychological flexibility as a safe, causal protective factor in this context. Indeed, to establish causality, one must demonstrate that variation in psychological flexibility precedes variations in suicidality temporally by way of longitudinal or experimental studies.
Our data result from a large, three-wave longitudinal study (N1 = 1395; N2 = 512; N3 = 352) of the general population, recruited using social media.
Longitudinal latent model analyses to test for temporal precedence were planned; however, our auxiliary assumption tests — that these variables would change over time — were unsupported. The three factors of the CompACT remained stable over time thus making longitudinal latent modelling of the impact of psychological flexibility on suicidality inappropriate. Instead, we ran regression models exploring whether earlier psychological flexibility predicted later suicide predictors and behaviours, finding mixed support for psychological flexibility.
Overall, we present an argument that before we can establish a strong theoretical basis for the causal role of psychological flexibility in suicidality, we need to correct for measurement issues, consider time invariance, and explore the boundaries in which we observe naturally occurring change in psychological flexibility – the key process of change in ACT – using different methodologies (e.g., ecological momentary assessment).

Psychological Flexibility Exercises and Metaphors: A Review of ACT English Language Books
Primary Topic: Clinical Interventions and Interests
Subtopic: Prevention and Community-Based Interventions, Psychological Flexibility, Metaphors, Exercises, Worksheets, Books

Emanuele Rossi, Università degli Studi Guglielmo Marconi, Rome, Italy
Francesco Mancini, Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy; Università degli Studi Guglielmo Marconi, Rome, Italy

The purpose of the present study is to offer a general overview of Acceptance and Commitment Therapy psychological flexibility processes on ACT books (1999-2018) with the aim of outlining a comprehensible and user-friendly profile of the use of metaphors, exercises, and worksheets within them.
In order to realize the profile, books were divided into two main groups: (1) ACT Books for professionals and (2) ACT Books for clients. We have created easy-to-read summary tables which provide a basic overview of acceptance, defusion, present moment, self-as-context, values, and committed action metaphors, exercises and worksheets.
This review was carried out with the purpose of providing an universally accessible, clear and intuitive cataloging tool of practical and experiential resources for ACT learners and practitioners. The summary tables briefly describe the way every metaphor, exercise or worksheet is presented and a reference to external resources as well.
This poster is aimed to summarize and evaluate the results of previous works presented at ACBS World Conference 17 and ACBS World Conference 18 related to a pilot project which involved all the processes of psychological flexibility.

Psychological Inflexibility and its Relation to Performance Anxiety, Flow, & Perfectionism in University Musicians
Primary Topic: Performance-enhancing interventions
Subtopic: Educational settings, Music Performance Anxiety, Flow, Musicians

Joanna Roman, M.A., ACT with Music, London, UK
David Juncos, Psy.D., Hornstein, Platt & Associates, Counseling & Wellness Centers, Philadelphia PA; Voice Workshop, East Bergholt, UK
Margaret Osborne, Ph.D., University of Melbourne
Dana Zenobi, D.M.A., Butler University

Thus far, no studies have examined the relationship between psychological inflexibility and variables of interest with university musicians, like music performance anxiety (MPA), flow, and perfectionism. Several ACT for MPA studies have observed improvements in psychological flexibility and MPA as part of treatment (Juncos et al., 2017; Clarke, Osborne, & Baranoff, 2020), yet no analyses of the relationship between those variables were conducted. A recent study examined the role of psychological inflexibility in predicting MPA, but with a sample of community musicians (Singh & Dudek, 2020). Given the theorized role that psychological inflexibility plays in the development/maintenance of anxiety disorders (Eifert & Forsyth, 2005) and clinical perfectionism (Ong et al., 2019), it was hypothesized that psychological inflexibility would be significantly related to MPA, flow, and perfectionism for university musicians from two samples.
Two samples of university musicians (N = 127) participated in this research as part of a larger study assessing a new measure of psychological flexibility for musicians (Juncos et al., 2021). Students were music majors from an American university & an Australian conservatory, respectively. Students completed measures of psychological inflexibility, MPA, perfectionism, & flow. Demographic variables from both samples were also collected.
Multiple regression analyses were conducted to determine the relationship between psychological inflexibility and MPA, perfectionism, and flow within performance and practice, within both samples of students, while controlling for demographic variables. A discussion of how well psychological inflexibility relates to MPA, perfectionism, and flow, and how the demographic variables accounted for the results, will be included.

Psychological inflexibility predicts symptoms of stress, depression and anxiety in international students
Primary Topic: Clinical Interventions and Interests
Subtopic: Educational settings, Symptoms predictors

Francesca Brandolin, M.A., University of Jyväskylä
Päivi Lappalainen, University of Jyväskylä
Ana Gallego, University of Jyväskylä
Simone Gorinelli, University of Jyväskylä
Raimo Lappalainen, University of Jyväskylä

This study aimed to investigate psychological inflexibility and distress of international students at a Finnish university. This cross-sectional research examined the common symptomatology of stress, depression, and anxiety while moving abroad to study.
The participants (n = 63) completed online questionnaires assessing their stress, depression, anxiety, psychological inflexibility, mindfulness skills, and engaged living.
Nearly 90% reported moderate to high stress levels. Approximately 40–45% of the students experienced moderate to high anxiety and depression levels. We observed that students with low psychological flexibility skills endured more stress, depression, and anxiety. Further, a regression analysis suggested that different components of mindfulness, engaged living and psychological inflexibility accounted for 20–45% of the variance in stress, depression, and anxiety among international students.
Interestingly, different combinations of these components predicted different symptoms. These findings underline the importance of enhancing psychological flexibility skills to improve international students’ mental health and general study experience.

Psychological quality of life after a marital rupture: The role of attachment and experiential avoidance
Primary Topic: Clinical Interventions and Interests
Subtopic: Prevention and Community-Based Interventions, marital ruptures, attachment, experiential avoidance, psychological quality of life

Joana Silva, Ph.D., Universidade Portucalense
Ana Xavier, Universidade Portucalense (Oporto, Portugal)
Bruna Gonçalves, Universidade Portucalense

Marital rupture often culminates in a diminished perception of psychological quality of life. Attachment anxiety and mistrust as well as experiential avoidance have been linked to poorer psychological and emotional adjustment to adverse life circumstances. Notwithstanding, empirical exploration of the indirect role of experiential avoidance between individuals’ attachment styles and psychological quality of life remains largely unexplored.
This cross-sectional study aims to test the indirect effect of experiential avoidance on the relationship between attachment styles (anxiety and mistrust) and psychological quality of life after a marital rupture. A convenience sample of 122 participants was assessed through an online protocol, comprising the short version of World Health Organization Quality-of-Life Scale, Adult Attachment Scale and Acceptance and Action Questionnaire.
Results showed that experiential avoidance has an indirect effect on the relationship between anxious attachment style and lower psychological quality of life (32% variance explained). The second mediation model accounted for 27% of the variance of psychological quality of life, indicating that experiential avoidance fully mediates the relationship between mistrust in others and lower psychological quality of life. Results show that individuals with an attachment style characterized by anxiety and mistrust report a poorer psychological quality of life, particularly when they present a rigid and inflexible behavioral repertoire. This highlights the importance to promote psychological flexibility, acceptance and emotional awareness in individuals who have experienced a marital rupture, particularly the ones with anxious and mistrusting forms of attachment, considering that this may positively influence their psychological quality of life.

Racial Diversity and Inclusion in Acceptance and Commitment Therapy Interventions for Chronic Pain
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Chronic Pain

Amelia Welch, MSMFT, Florida State University
Tom Su, Florida State University

An estimated 20% of the world is currently dealing with chronic pain (Boris-Karpel, 2010). While white, non-Hispanic individuals and Black, non-Hispanic individuals in the U.S. report experiencing pain at comparable rates (Nahin, 2015), current research in chronic pain treatment is overwhelmingly centered around white samples. The purpose of this study is to review the research linking ACT interventions and chronic pain and to assess the racial diversity and inclusivity of these studies.
A literature search was conducted using the keywords acceptance and commitment therapy, ACT, and chronic pain. 13 studies remained after incorporating the inclusion criteria to confirm that each article covered a (a) non-pilot intervention study (b) addressing the use of an ACT approach as treatment for (c) an original sample of participants with chronic pain that was (d) published in an English-language (e) peer-reviewed journal (f) between the years 2010 and 2020.
Of the articles included, one article provided subgroup analyses that included race. No other articles acknowledged racial demographic information outside of listing basic sample demographics and seven did not include any racial demographic information. One of the 13 studies did not support the use of ACT for individuals with chronic pain. This was also the only study that did not report a predominantly white sample.
Clinicians may consider this review as they utilize ACT in culturally diverse settings. Conclusions are limited by incomplete reporting of demographics. A key finding of this synthesis is the need for increased effort to improve the racial diversity of study samples.

Self-harm, shame and borderline features in adolescents: The mediating role of self-compassion
Primary Topic: Educational settings
Subtopic: Prevention and Community-Based Interventions, borderline features, adolescents, self-compassion, self-harm, shame

Marina Cunha, Ph.D., Instituto Superior Miguel Torga; University of Coimbra, CINEICC, FPCE
Ana Valente, M.Sc., ISMT
Diogo Carreiras, Ph.D. Student, University of Coimbra- CINEICC
Ana Galhardo, Ph.D., Instituto Superior Miguel Torga; University of Coimbra, CINEICC, FPCE
Paula Castilho, Ph.D., University of Coimbra FPCE

Borderline features can be identified in adolescents. Some studies suggest an association between shame and Borderline Personality Disorder (BPD) and self-harm. Self-compassion is an “antidote” for a critical, punitive and judgmental attitude towards the self. This study aimed to explore the mediator effect of self-compassion in the relationship between self-harm and borderline features and between shame and borderline features in adolescents.
The sample was composed of 432 adolescents, ageing between 12 and 19 years old, attending elementary and high school. Participants completed self-report questionnaires to assess Borderline features (BPFS-C), Self-harm (ISSIQ-A), Self-Compassion (SCS-A) and External an Internal shame (EISS-A). Data was analyzed on SPSS and PROCESS Macro.
Girls presented higher scores of borderline features, self-harm and shame than boys. Boys showed higher levels of self-compassion. Age and years of schooling were not associated with study variables. Borderline features were negative and moderately associated with self-compassion and positive and moderately correlated with self-harm and shame. The mediation models with self-compassion as a mediator were significant and explained 26% of the variance between self-harm and borderline features and 46% between shame and borderline features.
This study added an important contribution to the mediator role of self-compassion to understand borderline features in adolescents, considering self-harm and shame. Developing a compassionate and kind relationship with oneself might have a unique and positive effect between self-harm, shame and borderline features in adolescents.

Spanish adaptation of the Comprehensive Assessment of Acceptance and Commitment Therapy processes (COMPACT)
Primary Topic: Clinical Interventions and Interests
Subtopic: Clinical Interventions and Interests, Psychological Flexibility, Measures

Salvador Reyes-Martin, M.Sc., University of Jaén
Mónica Hernández-López, Ph.D., University of Jaén, Spain
Miguel Rodriguez-Valverde, Ph.D., University of Jaén

Psychological flexibility (PF) is the key process and target of intervention in Acceptance and Commitment Therapy. The most typically employed measures of PF, like the AAQ-II have been criticized in terms of their discriminant validity. In recent times, a number of multidimensional measures have been developed that seek to provide a more comprehensive examination of the different PF processes. There is a very limited number of such measures that have been adapted for use with Spanish-speaking population.
This study presents a Spanish adaptation of the Comprehensive Assessment of Acceptance and Commitment Therapy processes (COMPACT) (Francis et al., 2016), a 23-item instrument with three subscales: openness to experience, behavioral awareness and valued action. The COMPACT has shown good reliability and validity. The 23 items were translated to Spanish and back-translated following current standards for the adaptation of psychometric instruments. The COMPACT was administered online to a sample recruited through snowball sampling, together with the Spanish-validated version of the AAQ-II, as well as measures of anxiety, depression, and stress (DASS-21), general health and wellbeing (SF-12v2), social desirability (MCSD), and satisfaction with life (SWLS).
Data collection is currently ongoing. Analyses will examine the factor structure of the adapted version of the COMPACT, and well as its reliability and convergent and discriminant validity. The results will be discussed in terms of the potential of the COMPACT for the assessment of PF in Spanish-speaking population.

Stressless: A pilot study to promote compassion and gratitude skills among university students
Primary Topic: Clinical Interventions and Interests
Subtopic: College students, Burnout, Compassion, Gratitude

Lara Sofia Palmeira, Universidade Portucalense
Ana Xavier, Universidade Portucalense
Ana Barbosa, Universidade Portucalense
Marisa Moreira, Universidade Portucalense
Vilma Costa, Universidade Portucalense

The academic context is highly competitive and entails numerous challenges for students. A recent Portuguese study revealed that almost fifty percent of college students present significant burnout symptoms, which are consistently related to poor academic and psychological outcomes. Thus, there is a clear need for psychological interventions that promote student’s emotional well-being and reduce stress, self-criticism, and burnout. Developing compassion and gratitude skills may be important to reduce students' stress and burnout levels as these have been associated with well-being and decreased psychopathological symptoms. Brief and low-intensity interventions may be useful for college students, as they are economical, efficient and improve access, involvement, and availability compared to more intensive approaches, and are appropriate for the COVID-19 pandemic context.
This pilot study aims to test the feasibility and efficacy of two brief online interventions (one focused on compassion and another focused on gratitude) in college students in reducing stress, self-criticism, and burnout and increasing compassion and gratitude. Participants will be randomly allocated to one of the two interventions delivered through a website over the course of four weeks.
It is expected that by the end of the intervention participants from both interventions will present increased compassion/ gratitude levels, reduced stress, and burnout symptoms. Finally, results will reveal whether one of the interventions is more effective than the other. The clinical implications of the findings will be discussed.

The European Portuguese version of the Determinants of Meditation Practice Inventory-Revised: Preliminary results
Primary Topic: Behavioral medicine
Subtopic: Other, Assessment, Meditation Barriers

Bárbara Monteiro, M.Sc., University of Coimbra, CINEICC, FPCE
Ana Galhardo, Ph.D., Instituto Superior Miguel Torga; University of Coimbra, CINEICC, FPCE
Marina Cunha, Ph.D., Instituto Superior Miguel Torga; University of Coimbra, CINEICC, FPCE
José Pinto-Gouveia, M.D., Ph.D., University of Coimbra, CINEICC, FPCE

Although there is mounting evidence that meditation has beneficial effects on physical and mental health, several barriers to its regular practice have been recognized. In order to assess the perceived barriers to meditation, the Meditation Practice Inventory has been developed and more recently revised. This is a self-report instrument encompassing 12 items along four dimensions: Low perceived benefit, perceived inadequate knowledge, perceived pragmatic barriers and perceived socio-cultural conflict. The current study aimed to preliminarily investigate the psychometric properties of the European Portuguese version of the DMPI-R.
A general population sample comprising 79 (67 women and 12 men), presenting a mean age of 24.22 (SD = 6.01) years old and a mean of 13.86 (SD = 1.93) years of education, completed online the DMPI-R. A principal component analysis (PCA) was conducted. Reliability was examined through Cronbach alpha.
The DMPI-R PCA showed a four-factor solution, with an eigenvalue of 1.06, explaining 68.26% of the variance. Component loadings varied from .54 to .86, and communalities ranged from .45 to .78. Item-total correlations ranged from .24 to .52. A Cronbach alpha of .77 was found for the total score, and Cronbach alpha values for the four dimensions ranged between .61 and .83.
The European Portuguese version of the DMPI-R showed a similar structure to the one found in its original version. It revealed adequate reliability. These preliminary results seem promising, and further analyses should be conducted, in larger samples, to confirm this factor structure and assess the validity and test-retest reliability.

The Me and Us of Emotions: Preliminary results of a program to promote children’s empathy, compassion and cooperation
Primary Topic: Educational settings
Subtopic: Children, social-emotional skills, school setting, empathy, compassion

Ana Xavier, Universidade Portucalense (Oporto, Portugal)
Paula Vagos, Universidade Portucalense
Lara Palmeira, Universidade Portucalense
Sofia Mendes, SPO, Agrupamento de Escolas Gaia Nascente
Vanessa Rocha, Universidade Portucalense
Sónia Pereira, Universidade Portucalense
Marta Tavares, SPO, Agrupamento de Escolas Valadares
Paulo Menezes, University of Coimbra, ISR
Bruno Patrão, University of Coimbra, ISR
Rui Silva, University of Coimbra, ISR

Given the challenges of the modern world, specifically at schools, and the alarming increase in mental health difficulties in young people, it is crucial to universally foster social and emotional skills in the school context.
This study aims to present the development and preliminary results of a program to promote socioemotional skills for children in the 3rd and 4th grade. This program named “The Me and the Us of Emotions” is integrated in the Gulbenkian Academies of Knowledge 2020 and consists of 10 group sessions included in the school curriculum. The specific objectives are to promote the capacity for emotion recognition; to teach emotional self-regulation strategies focused on reassurance and compassion; and to encourage behaviors of social connection and cooperation. Digital technologies (e.g., interactive games) are complementarily used to promote these skills. An experimental design is used, and the efficacy measures address empathy, emotional skills, and cooperation, and emotional climate at classroom, based on a multi-informant perspective (children, parents, and teachers).
It is expected that the children show improved emotion regulation skills, as well as increased cooperation, empathy, and compassionate actions towards themselves and others reported by themselves, their parents, and teachers. This will contribute to foster children’s psychological well-being and, more broadly, to developing more positive and compassionate environment at schools.

The new era of digital-based research: Lessons learned with recommendations provided
Primary Topic: Digital Innovations
Subtopic: Professional Development, Technology and Digital Innovations

Pinelopi Konstantinou, M.Sc., University of Cyprus
Andria Trigeorgi, University of Cyprus
Chryssis Georgiou, Ph.D., University of Cyprus
Andrew Gloster, Ph.D., University of Basel
Maria Karekla, Ph.D., University of Cyprus

Interest in using digital methodologies and devices in research has grown immensely in the last years. The use of mobile applications during the daily life of individuals to assess behaviors, thoughts and feelings in real-time, namely ecological momentary assessment (EMA), is widely used as it appears to be a valid and reliable method for overcoming the problems caused by the standard, self-reported questionnaires. Using wearable technologies to measure individuals’ psychophysiological signals, such as heart rate, during daily life are also increasingly used in health and clinical research. Despite the various advantages of digital methodologies, researchers have to face many challenges and problems when conducting digital-based research and when using such methodologies e.g., the choice of a wearable device and missing data in real-time.To date, there have not been any recommendations to researchers and clinicians planning to conduct digital-based research.
This study aims to propose research informed recommendations in using wearable devices and EMA techniques in health and clinical research.
Recommendations are provided including the choice of a good wearable device, battery consumption of wearable devices, how to gain multiple measurements in real-time, and the ways to cope with the huge amount of missing data in real-time. These recommendations serve as a starting point for researchers and clinicians interested to conduct digital-based research with the potential to overcome, in the best way possible, the challenges and problems faced with digital means and provide higher quality of research.

The relationship between ACT processes and psychological functioning in postpartum women
Primary Topic: Clinical Interventions and Interests
Subtopic: Behavioral medicine, Perinatal Mental Health

Alexa Bonacquisti, Ph.D., Holy Family University
Kristin McMahon, M.S., Holy Family University
Laura Prader, M.S., Holy Family University
Elizabeth Becks, M.A., Holy Family University

Improving psychological functioning in postpartum women is an important goal, with potential benefits for both mothers and children. Postpartum mood and anxiety disorders may be well-suited to an Acceptance and Commitment Therapy (ACT) approach; however, increased understanding of the application of ACT during the postpartum period is warranted. The purpose of this study is to examine ACT process variables and psychological functioning in postpartum women. The study also addresses barriers to accessing mental health care in the postpartum period to inform clinical service delivery.
Postpartum women (N = 299) were enrolled in this study via online social media recruitment. They completed an electronic survey assessing their reproductive history, current psychological functioning, and a range of ACT process variables, such as experiential avoidance, mindfulness, and cognitive fusion. They also reported perceived barriers to mental health care during the postpartum period and their preferences regarding delivery of interventions.
Results indicated significant associations between ACT processes of experiential avoidance and cognitive fusion and symptoms of depression, traumatic intrusions, and panic. Descriptive analyses of treatment barriers and preferences indicated that participants experienced substantial barriers during the postpartum period, but that flexibility in treatment delivery could mitigate those barriers.
ACT has shown promise as a novel, innovative intervention for postpartum women experiencing psychological distress. This study furthers the empirical investigation of ACT as an evidence-based treatment for postpartum mood and anxiety disorders and highlights potential opportunities for reducing treatment barriers and improving engagement in mental health care for postpartum women.

The relationship between psychological flexibility and psychological distress in student-athletes in the US during COVID
Primary Topic: Clinical Interventions and Interests
Subtopic: Educational settings, Student-athletes, COVID-19 pandemic, Psychological flexibility, Mental health

Christina Galese, Kean University
Daniel Watson, M.S., Kean University
Kendahl Shortway, Psy.D., Kean University

Student-athletes are more susceptible to experiencing psychological difficulties compared to the general college population. Recently, this distress has been further compounded upon due to the unprecedented nature of the coronavirus (COVID-19) pandemic coupled with the effects of the sociopolitical climate within the U.S.; emerging research suggests student-athletes are experiencing distress at rates up to twice higher than historically reported (NCAA, 2021), and college senior-athletes are sensing greater loss compared to their teammates (NCAA, 2020). Previous literature has proposed psychological flexibility to be an important mechanism in effectively coping with transitional and stressful experiences for student-athletes.
Thus, this longitudinal study (May 2020-November 2020) aimed to ascertain the impact of the COVID-19 pandemic on psychological well-being of senior spring-sport athletes to better support them during this historical time. Our sample consisted of 95 senior athletes across all NCAA divisions and nine sports from the U.S. who completed online surveys.
Simple linear regression analyses indicated both emotion regulation (F(1, 76) = 70.773, p <.001) and psychological flexibility (F(1, 80) = 64.049, p<.001) significantly predicted psychological distress in May 2020; further, emotion regulation (F(1, 76) = 11.244, p = .001) and psychological flexibility (F(1,81) = 15.102, p<.001) predicted satisfaction with life in May 2020. A significant, positive correlation was found between psychological flexibility at the outset of the pandemic and psychological distress in November 2020 (r = .754, p = .019).
We advocate for those working with student-athletes to implement interventions targeted at increasing psychological flexibility as they navigate this tumultuous time.

The relationship between self-objectification, social comparison, eating disorders and self-concept clarity
Primary Topic: Clinical Interventions and Interests
Subtopic: Prevention and Community-Based Interventions, Self-objectification, social comparison, eating disorders and self-clarity

Florina Poenaru, Clinical Psychology Master's Student, Department of Clinical Psychology
Aurora Szentagotai Tătar, Ph.D., Babes Bolyai University/UBB

Self-objectification is a pervasive phenomenon which subsumes a variety of negative consequences, such as eating disorders, depression and sexual disfunction. Despite these negative psychological responses, not much is known about the factors that can affect this relationship. Empirical data shows that social comparison process has a mediator role in the relationship of self-objectification and eating disorders. Self-concept clarity represents a protective factor against social and cultural influences, which is associated with psychological adjustment. Therefore, the main purpose of this study is to investigate the self-concept clarity’s effect of moderated mediation in the relationship between self-objectification, social comparison and eating disorders.
Sample: The participants will be at least 89 females from a Romanian sample. Instruments: INCOM, Iowa-Netherlands Comparison Orientation Scale (Gibbons and Buunk, 1999); Self-Concept Clarity Scale (Campbel et. al., 1996); The Objectified Body Consciousness Scale OBCS (McKinley & Hyde, 1996); Eating Disorder Examination Questionnaire EDE-q (Fairburn & Beglin, 2008); Design: Cross-sectional moderated mediation.
We expect that : (1) social comparison process would be positively related to eating disorder symptomatology; (2) self-objectification would be positively associated with eating disorder symptomatology; (3) social comparison process will predict eating disorder symptomatology; (4) the relationship between self-objectification, eating disorders, mediated by social comparison process, will be moderated by self-concept clarity.
Limitations: Using a cross-sectional design, we could not infer causality; The instruments used in this research were self-report questionnaires. Future research: Longitudinal studies; Take into account other variables that can affect the relationship between self-objectification and eating disorders; Use instruments with increased validity;

The role of dispositional empathy in psychological inflexibility for partners of people with depression
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression

Elizabeth O'Brien, B.A., M.Mus., M.A., University College Cork
Raegan Murphy, B.A., M.A., Ph.D., HDip, University College Cork

Research suggests that high levels of empathy in individuals with partners with mental health difficulties such as depression can lead to improved outcomes for their partner while compromising their own mental health. Some studies propose that the affective dimension of empathy (AE) diminishes resilience to the distress of a partner whereas cognitive empathy (CE) can enhance it. Psychological flexibility is suggested to be an important feature of psychological resilience. The current study aimed to investigate the role of CE and AE in psychological inflexibility (PI) for people who live with a partner with depression.
A cross-sectional design was employed in which 148 participants living with a partner with depression and 45 participants for a comparison sample were recruited using online platforms. Participants completed an online survey with measures related to demographics and dispositional empathy (Cognitive Affective and Somatic Empathy Scale) as predictor variables and PI (AAQ-II) as the outcome variable. Scores were compared between the study and comparison samples. Exploratory and hierarchical regression analyses were run to examine associations between variables within the study sample.
The study sample scored significantly higher for PI, and significantly lower for CE and AE than the comparison sample. Analyses within the study sample revealed that whilst CE and AE were inversely associated with PI, only CE predicted the outcome variable.
The findings suggest that interventions for partners of people with depression that enhance psychological flexibility may bolster the cognitive dimension of empathy and improve mental health outcomes for both members of the couple relationship.

The role of psychological flexibility and cognitive fusion in compassion satisfaction, compassion fatigue and burnout in health-care professionals during the COVID-19 health crisis in Spain
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Clinical Interventions and Interests, Psychological Flexibility, Cognitive Fusion, Compassion Satisfaction, Compassion Fatigue, Burnout

Lidia Budziszewska, M.S., European University of Madrid & University of Almería
Paula Odriozola-González, University of Cantabria
Marta Villacieros, Centro de Humanización de la Salud, Centro San Camilo, Madrid

During COVID- 19 crisis health-care professionals all over the world were especially vulnerable to suffer from burnout and compassion fatigue. Spain has been one of the countries that were harder hit by the COVID- 19 crisis therefore health-care professionals were exposed to many particularly stressful situations, increase in workload and health risk during work. Psychological flexibility and cognitive fusion are processes derived from contextual- behavioral approach that are playing an important role in predicting anxiety, depression, stress and burnout. Our aim is to evaluate psychological flexibility (PF),cognitive fusion (CFU) as predictors of compassion satisfaction (CS), compassion fatigue (CF) and burnout (BO) in healthcare professionals during the COVID- 19 health crisis in Spain.
A total of 320 health professionals participated in the survey during the COVID-19 health crisis in Spain. Psychological flexibility was measured by AAQ-II, Cognitive fusion by CFQ, Professional Quality of Life Questionnaire and Self- Compassion by SCS. Socio-demographic and occupational variables were also analyzed.
Psychological flexibility and cognitive fusion predicts compassion satisfaction, compassion fatigue and burnout in healthcare professionals during COVID- 19 crisis emergency. Psychological flexibility and cognitive fusion predicts both positive and negative outcomes related to compassion in health- care professionals. Implications of these findings in designing of prevention and intervention programs for health-care professionals would be discussed.

Derived relations as a response transfer network for Cocaine Use Disorder: A Pilot Study
Primary Topic: Relational Frame Theory
Subtopic: Clinical Interventions and Interests, Substance Use Disorder

Kenneth Carpenter, Columbia University Irving Medical Center
Richard Foltin, Columbia University
Margaret Haney, Columbia University
Suzette Evans, Columbia University

Respondent elicitation has offered an important framework for understanding the etiology of several subjective and physiological indicators of Cocaine Use Disorders (CUD). However, treatments based on this process have not promoted prolonged reductions in substance use. The acquisition of respondent-eliciting functions via emergent relations (e.g., equivalence) may be another important avenue by which a range of stimuli can come to increase the probability of cocaine use. Unfortunately, this process is not adequately addressed in many interventions.
Match-to-sample (MTS) procedures were used to teach two four-member equivalence classes to five non-treatment seeking participants who met criteria for CUD. One member of one class was paired with 25mg of smoked cocaine and one member of the other class was paired with 0mg of smoked cocaine. All eight stimuli were then presented alone and under extinction. Changes in physiological responding (HR, BP, and Skin Temperature) from baseline assessed the transfer of these conditioned physiological responses.
Two of the five participants demonstrated the emergence of two four-member equivalence classes and a complete transfer of respondent-eliciting functions across select physiological measures. Three other participants, who did not demonstrate four-member equivalence classes, although evidenced other relations (i.e. three-member equivalence; transitivity), demonstrated a transfer of respondent-eliciting functions in accordance with emergent symmetry but with different physiological measures across participants.
These results documented the transfer of respondent-eliciting functions of smoked cocaine across emergent relations, and highlighted several processes by which drug use–stimulus interactions may influence cocaine use behavior.

Threat appraisals of teachers’ fear appeals and test anxiety: The mediating role of experiential avoidance and mindfulness skills
Primary Topic: Educational settings
Subtopic: Functional contextual approaches in related disciplines, Test anxiety, Teachers’ fear appeals, Experiential avoidance, Mindfulness, Adolescents

Cláudia Pires, M.Sc., University of Coimbra, CINEICC
David W. Putwain, Ph.D., Liverpool John Moores University, UK
Stefan Hofmann, Ph.D., Boston University, USA
Maria do Céu Salvador, Ph.D., University of Coimbra, CINEICC

Fear appeals are persuasive loss-focused messages to promote behavioral change, particularly to avoid an unwanted outcome. Secondary school teachers use this as a form of motivating students by stressing the consequences of examination failure (e.g., not able to engage in further education). Teachers’ fear appeals act as a potential trigger for students to engage in appraisal processes,especially threat-focused ones, which is known to be one of the predictors of test anxiety,a higher prevalent condition in these students. However, little remains explored about the processes that might mediate this relationship. Two of the processes known to play a role in test anxiety manifestation are experiential avoidance and mindfulness skills. Nevertheless, no study has yet explored if they intervened in the link between threat appraisals of teacher’s fear appeals and test anxiety.
A cross-sectional study was carried out with 328 adolescents, aged between 14 and 19, who completed a set of self-report questionnaires. A parallel multiple mediator model was estimated, testing the mediating role of experiential avoidance and mindfulness skills in the relationship between threat appraisals of teachers’ fear appeals and test anxiety.
The model explained 59% of variance in test anxiety. Threat appraisals of teachers’ fear appeals were directly and indirectly associated to test anxiety, through higher experiential avoidance and lower mindfulness skills. These results suggest that experiential avoidance and lack of mindfulness skills play an important role in students’ appraisal of teachers’ fear appeals and test anxiety, pointing out to their inclusion in psychological and educational interventions with students and teachers.

Veterans’ experience and preferences of incorporating valued life goals in addiction treatment
Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use Disorders, Veterans, Valued Life Goals, Recovery

Victoria Ameral, Ph.D., VA Bedford Healthcare System
Steven Shirk, Ph.D., VA Bedford Healthcare System
Benjamin Feldman, VA Bedford Healthcare System
Sophie Schuyler, M.A., VA Bedford Healthcare System
Megan Kelly, VA Bedford Healthcare System

Addiction treatment research is increasingly focused on functional outcomes beyond abstinence. Third wave therapies like Acceptance and Commitment Therapy hold promise in this area, as they are largely centered on improving one’s life functioning and quality of life. However, little is known about whether and when valued life goals are currently included in treatment, or patients’ experiences and preferences regarding this approach.
The current study is a planned secondary analysis of a cross-sectional, online investigation of Veterans’ (n≥50) addiction treatment experiences in the wake of COVID-19. Recruitment will begin in late March2021 and is expected to conclude by late May 2021 (based on recent experience in our group). Analyses will examine a series of questions on (1) the importance of personal recovery goals in addiction treatment (across established, empirically-derived valued life domains); (2) the extent to which past treatment has focused on these areas; (3) preferred timing of such discussions during care; and (4) the earliest these topics have arisen in actual treatment.
Results will include descriptive findings across the four questions and comparisons between preference and experience in the presence and timing of valued life goals in addiction treatment. Depending on the sample distributions, additional analyses will compare these questions as a function of sample characteristics including demographics, primary substance, and treatment experience history. Together, these findings will provide insight into the Veterans’ preferences with respect to incorporating their valued life goals into addiction treatment.

What if training away from threat reduces negative affect under stressor? The role of attentional avoidance
Primary Topic: Clinical Interventions and Interests
Subtopic: Other, Social Anxiety

Klavdia Neophytou, Ph.D., University of Cyprus
Georgia Panayiotou, University of Cyprus

According to cognitive models, attention to social threat is one of the principles that maintain social anxiety. Individuals with social anxiety are known to show attention biases to threat stimuli, although there is inconsistency in the literature with regards to the type of attentional biases they present. This study aims to examine Attention Bias Modification Treatment (ABMT) effectiveness.
Firstly, this experiment compares attention training away from threat, placebo group and a third group of training towards threat, investigating if extinguishing attentional avoidance can also affect anxiety levels. Secondly, this study assesses social anxiety changes with self-report measures, behaviourally (speech stressor) as well as physiologically. Participants were assessed with regards to AB changes as well. Participants were 82 adults with social phobia who were randomly allocated into 2 training and placebo groups. Both assessment and intervention were done under a stressor.
Results showed non-treatment effectiveness in all measures and all groups except the corrugator supercilii (frown) measure. This measure was decreased during a speech assessment only in training away from threat group. Corrugator supercilii reduction at this specific training was presented only for attentional avoiders. The reduction of negative affect (as indexed by the corrugator) can be considered as a useful result for socially anxious individuals in order for them to regulate negative affect and tolerate a stressful situation.
Future research may need to investigate more this result and the possible mechanism of its effectiveness. In addition, ABMT effectiveness and under which circumstances has positive results needs to be more investigated.

Poster Session 3

“I feel good!” Factors Related to Subjective Ratings of Health in Midlife Women Experiencing Menopausal Symptoms
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Clinical Interventions and Interests, Menopause, Acceptance, Mindfulness

Victoria Dickerson, Spalding University School of Professional Psychology
Caroline Kelley, Psy.D., VA Salt Lake City Health Care System
Jennifer Altman, Ph.D., Spalding University
Abbie Beacham, Ph.D., University of Louisville

Nearly 1.5 million U.S. women experience the menopausal transition each year. Most of these women report moderate symptoms, which have a negative impact on perceived health and quality of life. Recent research indicates that various factors such as subjective symptom severity impacts one’s perception of general health and wellness. The current study sought to identify predictors of health perception in midlife women experiencing menopausal symptoms.
The sample consisted of 225 women ages 39 to 59, most of whom identified as White/Caucasian (87.2%). The sample data was collected from online menopause support groups. Participants completed demographic items and measures of menopause status, self-rated health, and well-being as part of a larger survey study on menopause.
Within this sample, 13% of women fell in the pre-menopause stage, 27% in the perimenopause stage, and 31.4% in the post-menopause stage. Somatic symptom severity (p<0.001), but not psychological or urogenital symptom severity, predicted lower perceived health. Additionally, factors such as willingness acceptance, and mindfulness observance, predicted higher perceived health (All p’s < .05). Individually, menopause acceptance predicted self-rated health F(2,148) = 16.641, p < 0.001, and accounted for 17.3% of the variance. The regression model including all aforementioned variables accounted for 40% of variance, F(10,120) = 7.923, p < 0.001.
In our sample, subjective factors such as acceptance of menopause symptoms and mindfulness predicted the perception of one’s health. Given the documented association of self-rated health with lifestyle-related diseases and mortality, factors affecting self-rated health are worthy of further examination, especially in this understudied population.

A Behavior Analytic Approach to Promote Fact-Checking on Social Media
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Relational Frame Theory, Rule-governed behavior

Carol Williams, LPA BCBA, The Chicago School of Professional Psychology

Since at least 2017, Americans have turned to online sources for news and related information. Information propagated as false news has political, social, economic, and health implications which have potential collateral consequences of altering resource allocations, changing the status quo, and polarizing populations against one another based on interpretations of virally produced false information or identification with certain groups disseminating false narratives. To stem the flow of false information, online platforms such as Twitter, could utilize bilateral strategies, including analysis of response effort and individual behavior consequences.
This quasi-behavioral experiment examined variables related to the flexibility of rule-governed behavior specific to sharing information using a single subject reversal design. The research determined a relation between the availability of convenient fact-checking services and the rates of sharing behavior. Additionally, the study examined factors relative to implementation of a consequence, wherein participant’s shared information was rated according to percentage of factually checked information and resulting in a publicized percentage on each participant’s public profile.
The study results were that participants increased sharing of factual information with fact checking resources conveniently available; that sharing of false information was reduced with the introduction of a consequence; and that participants overall made use of a fact checking resource when it was conveniently available.
Knowledge regarding what factors motivate readers to determine the validity of shared information and what may deter the spread of false news may provide strategies to improve social outcomes and reduce the negative impact of false information.

A behavioral analysis of a mindfulness technique called RAIN
Primary Topic: Clinical Interventions and Interests
Subtopic: Other, Mindfulness

Maria Vuckovich, Private practice

RAIN is an acronym that stands for 4 steps (recognize, allow, investigate and nurture). There are two extra steps before and after the RAIN) which one can add to complete the practice. The RAIN technique which comes from traditional mindfulness practices, can be used by an ACT clinician to foster all proceses of the hexaflex and in so to create a context for counterconditioning of the aversive stimuli in order to change its function.

A Critical Systematic Review of ACT Interventions for Developmental Service Workers and Teachers to Address Work-Related Challenges
Primary Topic: Organizational behavior management
Subtopic: Prevention and Community-Based Interventions, Industrial Organization Psychology

Kristina Axenova, B.A., University of Western Ontario
Albert Malkin, M.A., BCBA, University of Western Ontario

The aim of this systematic review is to critically summarize the research on the application of ACT related interventions to work performance, psychological flexibility, and burnout in developmental service workers (DSWs) and teachers; as well as how these aspects pertain to the COVID-19 pandemic.
We searched multiple databases to include peer-reviewed empirical research assessing ACT-related interventions with at least three of the following four criteria: measures of psychological flexibility, burnout-related constructs, intervention targeting development of at least one core ACT process, and work performance in DSWs and teachers.
Results of the systematic review found that a variety of modes and durations of ACT interventions demonstrated effectiveness. However, ACT-interventions involving DSWs and teachers make up a small proportion of the entirety of ACT research.
We found conceptual and methodological issues that require further exploration, specifically related to the constructs of burnout, psychological flexibility, and relevant objective measures.

A Single-Session of Acceptance and Commitment Therapy to Promote Health-Related Behavior Change: A Single Case Design
Primary Topic: Clinical Interventions and Interests
Subtopic: Behavioral medicine, Single Session ACT

Thi Tran, M.A., Westen Michigan University
Scott Gaynor, Western Michigan University

A potentially cost-effective use of ACT is a 60-minute intervention, based on FACT (Barreto, Tran, & Gaynor, 2019). This intervention consists of four components. First, a research therapist begins by implementing a focused clinical interview to yield useful clinical information on the targeted behavior. Second, the research therapist and the client use the information collected to complete the matrix formulation identifying internal and external barriers to making a change in the target behavior, and internal and external facilitators of change. Third, the research therapist introduces ACT exercises to assist the participant when identified barriers arise. Lastly, to help promote motivation for change participants are asked to create a commitment statement based on his or her desired behavior change, including a 24-hour goal, a one-week goal, and a 30-day goal. The project is a multiple baseline between subjects AB research design.
In analysis. Overall, the efficacy of Acceptance and Commitment Therapy as a brief intervention is still in its early stages. This study will provide the field with information related to the efficacy of this approach to an important area of mental health. Benefits of the study include providing further support through brief interventions and promoting lifestyle changes. Indirect benefits include general health assessments, participation in ongoing research, and identification of health-related behaviors including tobacco use, alcohol use, marijuana use, exercise, eating habits, and sleep. All of these indirect benefits have the potential to enhance therapeutic and research outcomes.

Acculturative Stress Across Disordered Eating Behaviors: A Meta-Analysis
Primary Topic: Clinical Interventions and Interests
Subtopic: Behavioral medicine, Eating Disorder

Maria Kalantzis, B.S., Bowling Green State University
(Sam) Chung Xiann Lim, B.S., Bowling Green State University
Aubrey Dauber, M.A., Bowling Green State University
Emma Studer-Perez, Bowling Green State University
Zachary Silverman, Bowling Green State University

The relationship between Acculturative Stress (AS) and Disordered Eating Patterns (DE) remains ambivalent due to the lack of a uniform construct, theoretical framework, and standardized measurements for AS. The present meta-analysis aimed to address the quantitative gap in the literature by examining the correlation between AS and DE reported by past studies.
The r-values were converted to Zr with Fisher’s r-z transformation. To examine the overall relationship, we used a random-effects model which produced more conservative r-values in our analyses (Hunter & Schmit, 2008). Additionally, the random-effects model considers both within-study and between-study variability. Finally, moderation and linear regression analyses were calculated to assess heterogeneity within the data.
The overall weighted effect size of AS and DE was r = .186. Subgroup and moderation analyses were run to investigate the substantial heterogeneity detected between studies (Q = 72.16, I2 = 77.8%). Studies that used the Social, Attitudinal, Familial, and Environmental (SAFE) scale to measure AS differed significantly from those that used other scales (p = 0.002). Studies that used the SAFE versus Non-SAFE scales revealed a significant moderator for the correlation between AS and DE (r = -0.2, p = 0.001) and were responsible for 55% of the variances between studies (R² = 0.55). - AS is significantly associated to DE - SAFE is recommended for measurement of acculturative stress in relation to disordered eating behaviors due to its heightened sensitivity and predictive validity.

An Exploration of the Utility of ACT to Increase Tolerance to Induced Pain
Primary Topic: Relational Frame Theory
Subtopic: Induced Pain

Madison Dirickson, Registered Behavior Technician, University of Nevada, Reno
Sara White, University of Nevada, Reno
Kelsey Brendlen, University of Nevada, Reno
Valentina Olarte-Mesa, University of Nevada, Reno

Few studies have addressed ACT when pain is induced. A preliminary finding of current research suggests that ACT increases mental toughness among high-performance athletes. The present study will address gaps in the literature by utilizing college students rather than athletes. Our research aims to determine if acceptance will have an impact on the tolerance to induced pain. We aim to help build a foundation that will inform specific populations of techniques that can increase pain tolerance in aversive situations.
We will measure the duration that participants hold ice against their tongue and soft palate while utilizing the ACT-based technique, acceptance. We will compare baseline and acceptance conditions. In the baseline condition, we will ask participants on a variable time schedule, “are you holding the ice in place?” In the acceptance condition, participants will be asked, “are you willing to continue while experiencing what comes up?”
We anticipate seeing longer durations in the experimental acceptance condition based on previous literature. We also expect data levels across all baseline conditions will stay relatively stable across sessions.
Our study is ongoing, but we note the following limitations, (a) the experiment runs on an accelerated time frame, limiting the number of trials we can run, (b) due to the COVID-19 pandemic, all participants will be run online. Future investigators should better generalize the effects of acceptance on induced pain tolerance to real-world situations. Researchers should maximize these effects when prompting from someone is impossible to optimize this research line for military and hostage situations.

Be Gentle with Yourself: The Impact of Self-Compassion on Fear of Evaluation in Social Anxiety
Primary Topic: Clinical Interventions and Interests
Subtopic: Social anxiety disorder

Brooke Short, Murray State University

Self-compassion entails showing oneself kindness instead of judgement, recognizing one’s experiences to be part of a shared human experience instead of isolating oneself, and being mindfully aware of painful thoughts and feelings instead of over-identifying with them (Neff, 2003). The process enjoys considerable conceptual overlap with facets of the psychological flexibility model (e.g., selfing; Hayes et al., 2012). Self-compassion has been explored in a variety of areas, one area being social anxiety; Harwood and Kocovski (2017) found that those higher in social anxiety who completed a self-compassion writing exercise experienced less anticipatory anxiety before a social stressor. The present study aims to replicate and extend these findings. Fear of negative evaluation is recognized as an integral feature of social anxiety disorder (APA, 2013), and fear of positive evaluation has also been linked to social anxiety disorder (Heimberg et al., 2014). Both fear of negative evaluation and fear of positive evaluation have displayed negative correlations with self-compassion (Long & Neff, 2018; Werner et al., 2012).
The present study randomized participants to a self-compassion or control writing exercise to explore the interactive role of self-compassion and fear of evaluation experienced before a social stressor. We hypothesized that self-compassion writing will reduce fear of negative and positive evaluation for those higher in social anxiety. Data collection with undergraduate participants is in progress. Future research directions and implications for the use of self-compassion exercises before socially anxious individuals are exposed to social stressors will be discussed.

Behaving Without a Head: Implications of the Headless Way for Behavior Analysis
Primary Topic: Theoretical and philosophical foundations
Subtopic: Clinical Interventions and Interests, Consciousness

Jessie Schindler, University of Nevada, Reno
Michael Bordieri, Ph.D., Murray State University

Douglas Harding’s 1974 book The Science of the 1st Person: Its Principles, Practice and Potential presented a re-envisioning of the scientific endeavor and a clue as to what it often overlooks: the subjective experience of first-persons. Through a synthesis of functional contextualism and Harding’s work, this poster builds the case for idiographic research that captures the experience of the individual while maintaining scientific rigor.
The features of Harding’s work and its implications for behavior analysis and science as a whole are discussed. Idiographic research is highlighted as a means for behavior analysts to incorporate Harding's vision of a more complete science into their work. Additionally, analogies between Harding's work and the philosophy of functional contextualism are discussed. Ultimately, this poster suggests the possibility for and benefits of a Headless behavior analysis.

Body Compassion during a Pandemic: The Intersection of Well-Being, Health Anxiety, and Body Compassion
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Well-Being, Health Anxiety, Body Compassion, Covid-19

Catherine Hackl, Spalding University School of Professional Psychology
Jennifer Altman, Spalding University School of Professional Psychology
Hillary Washington, Spalding University School of Professional Psychology
Marissa Lewis, Spalding University School of Professional Psychology
Christian French, Spalding University School of Professional Psychology
Amy Schaefer, Spalding University School of Professional Psychology
Abbie Beacham, University of Louisville

In 2019, a novel coronavirus (Covid-19) was detected and led to increased uncertainty, isolation, and distress across the globe. We hypothesized the pandemic would have an adverse impact on individual levels of health anxiety and well-being. Reductions in health anxiety and its impact have been demonstrated via the mechanism of acceptance (Hossmann et al., 2014). Furthermore, evidence has demonstrated acceptance-based constructs specific to the body, such as body compassion, are influential in supporting desirable psychological outcomes. To date, there has been no published research specifically examining the role body compassion may play in health anxiety and well-being.
The present study utilized data provided by a sample of adults from the general population (N = 93) to explore how one’s relationship to the body, measured via the construct of body compassion, may influence health anxiety and well-being. Study participants completed demographic items and measures of Well-Being (PERMA-H), the Health Anxiety Inventory and the Body Compassion Scale as part of a larger survey study conducted shortly after COVID-19 was categorized as a Pandemic.
Linear regression was conducted to ascertain salient predictors of Total Well-being accounting for 36% of variance (p <.001). Significant IVs (controlling for Age and COVID risk status) were Body Compassion Subscales – Defusion (β = .371, p=.033), Common Humanity (β=-.278, p=.044) and Acceptance (β=.481, p=.007) but not Health-Related Anxiety (ns).
Subjective Well-being may be influenced by enhancing one’s ability to engage in development of compassion with the body as opposed to efforts to reduce anxiety related to physical health.

Childhood Maltreatment and Borderline Personality Characteristics: The Moderating Role of Psychological Inflexibility
Primary Topic: Relational Frame Theory
Subtopic: Theoretical and philosophical foundations, Psychological flexibility, Borderline, Childhood maltreatment

Mahsa Mojallal, M.A., University of South Dakota
Raluca Simons, Ph.D., University Of South Dakota
Jeffrey Simons, Ph.D., University Of South Dokota
Surabhi Swaminath, B.S., University of South Dakota

Borderline personality disorder (BPD) has been linked to history of childhood maltreatment (Varnaseri et al., 2016). Victims of childhood maltreatment may use avoidance as a coping strategy to mentally escape distressing experiences, when physical escape from hostile environment is not possible (Reddy et al., 2006), which can cultivate psychological inflexibility (PI; Boykin et al., 2018). Studies suggest PI is a strong predictor of BPD symptoms (Iverson et al., 2012), with individuals with borderline symptoms tend to avoid a range of internal experiences even when doing so interferes with perusing value-directed life (Hayes et al., 1996). No study has evaluated distinct relation between types of childhood maltreatment (neglect, sexual abuse, punishment) and borderline characteristics with the moderating role of PI. Present study aimed to clarify the moderating role of PI in the association between types of childhood maltreatment and borderline characteristics.
College students (N = 610; Mage = 19.65; 71% Female, 87% White) at a midwestern university completed online cross-sectional survey. A moderation analysis was conducted in Stata (StataCorp. 2019).
The association between neglect and borderline symptoms was stronger at high levels of PI than at means or low levels (ß = 0.04, SE = 0.01, p < .01 ); However, the associations between sexual abuse (ß = –0.06, SE = 0.02, p < .01 ) and punishment (ß = –0.06, SE = 0.02, p < .0001 ) with borderline symptoms were stronger at mean and low levels of PI than at high levels. Theoretical and clinical implications will be discussed.

Citation Analysis of Empirical and Conceptual Applications of Interbehaviorism in Contemporary Research: 1984-2021
Primary Topic: Theoretical and philosophical foundations
Subtopic: Other, Interbehaviorism

Kristina Axenova, B.A., University of Western Ontario
Albert Malkin, M.A., BCBA, University of Western Ontario

J.R Kantor’s Interbehaviorism, introduced in the early 20th century, is a system which is characteristic of a naturalistic foundation to explain all scientific psychology, behavior, and activity. Consensus on the relative utility of Interbehaviorism in contemporary behavior science appears to be mixed (e.g., Dixon & Belisle, 2020; Hayes & Fryling, 2019; Jacobs, 2020; Rehfeldt et al., 2020). The aim of this citation analysis is to contribute a form of objective data to the above-mentioned discourse via an examination of the influence of Interbehaviorism between 1984 and 2021. This window of time entails contemporary research and extends Ruben (1984), who evaluated major trends in Interbehavioral psychology between 1937 and 1983.
Citations were organized according to the following categories: peer-reviewed Empirical (experimental) and Non-Empirical (reviews or conceptual) studies. Our key terms included Interbehavior-related search terms. The analysis was further organized by journal, topic, empirical details, and country of origin. Additional information was recorded on applicable non-peer reviewed work authored through university/graduate institutions. Databases searched included Web of Science, PsycInfo, and Google Scholar.
Our analysis revealed that the majority of published articles were Non-Empirical. These results shed light on the ongoing nature of the influence of Interbehaviorism on contemporary research.

Cognitive Fusion Mediates the Relation of Cognitive Anxiety Sensitivity and Rumination in Undergraduate College Students
Primary Topic: Clinical Interventions and Interests
Subtopic: Other, Depression

Jacey Anderberg, University of South Dakota
Lucas Baker, B.S., University of South Dakota
Emily Kalantar, B.A., University of South Dakota
Christopher Berghoff, Ph.D., University of South Dakota

Excessive rumination, defined as intrusive and repetitive self-focused thinking, is associated with cognitive difficulties (e.g., diminished concentration and problem-solving; Watkins & Roberts, 2020) and the onset, severity, and maintenance of depression symptoms (Galecki & Talarowska, 2017). Researchers indicate cognitive anxiety sensitivity (i.e., fear of losing internal control) is positively associated with rumination and suggest this may be due to cognitive vulnerabilities for depression (Brown et al., 2015). However, treatment of rumination in the context of depression has proved difficult and mechanisms responsible for change in cognitive anxiety sensitivity following treatment are not specified (Tull & Gratz, 2008). As such, identification of factors that mediate the cognitive anxiety sensitivity-rumination relation and are amenable to change through psychosocial intervention appears warranted. Cognitive fusion (i.e., behavior guided by cognition rather than environmental contingences) may mediate this relation, in that individuals who experience cognitive anxiety sensitivity may become attached to and influenced by their thoughts, leading to unhelpful rumination.
The present study investigated the influence of cognitive fusion on the cognitive anxiety sensitivity-rumination relation. College students (Nf244; Mage=19.5) completed a cross-sectional survey in exchange for course credit.
Bootstrap-based results indicated cognitive fusion significantly mediated the cognitive anxiety sensitivity-rumination relation, ab=1.14, 95% CI [0.92, 1.42], suggesting cognitive fusion may modify the association of cognitive anxiety sensitivity and ruminative behavior.
Cognitive fusion appears to be a productive target for intervention (Bramwell & Richardson, 2017) and may be especially relevant for individuals who struggle with anxiety sensitivity and rumination. Future directions and clinical implications will be discussed.

Cognitive Fusion Moderates Relations of COVID-19 Stress and Anxiety Symptomology
Primary Topic: Functional contextual approaches in related disciplines
Subtopic: COVID-19, Anxiety, Cognitive Fusion

Lucas Baker, M.A., University of South Dakota
Emily Kalantar, B.A., University of South Dakota
Rachel Bock, M.A., University of South Dakota
Jennifer Kuo, M.A., University of South Dakota
Christopher Berghoff, Ph.D., University Of South Dakota

COVID-19 has infected over 100 million individuals and contributed to nearly 2.3 million deaths worldwide as of February 2021 (John Hopkins University, 2021). COVID-19 related stress (e.g., contamination or financial concerns; Taylor et al., 2020) appears associated with increased anxiety (Jakovljevic et al., 2020), yet researchers have not identified factors that may modify this relation. Cognitive fusion, or becoming entangled in thoughts such that cognition guides behavior, is positively associated with anxiety in the context of negative life events (Bardeen & Fergus, 2016). Accordingly, cognitive fusion may influence the association between COVID-19 stress and anxiety, though researchers have not investigated such relations. The present study addressed this gap by evaluating cognitive fusion as a moderator of the COVID-19 stress-concurrent anxiety relation.
In so doing, cross-sectional self-report data from 232 midwestern US college students were collected from October-December 2020.
Results indicated cognitive fusion (Gillanders et al., 2014) significantly moderated relations of COVID-19 danger (i.e., worry about catching the virus) and compulsion (i.e., checking social media posts) subscales and anxiety symptoms (Lovibond & Lovibond, 1995; β=.18, p<.001; β=.11, p=.02, respectively). Simple slope analyses revealed stronger relations of COVID-19 stress and anxiety at high (vs. low) levels of cognitive fusion. However, other COVID-19 stress factors including financial concerns, contamination, traumatic stress, and xenophobia were not moderated by cognitive fusion. Results will be discussed in terms of future directions and implications for treatments for individuals who experience anxiety that is associated with specific forms of COVID-19 related stress.

Development and Implementation of Group-based ACT to Enhance Graduate Student Psychological Flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy

Rivian Lewin, M.S., University of Memphis
Samuel Acuff, M.S., University of Memphis
Kristoffer Berlin, Ph.D., The University of Memphis
Jeffrey Berman, Ph.D., The University of Memphis
Amy Murrell, Ph.D., University of Memphis

Graduate school is a challenging time for students who face a plethora of demands they have not encountered before. It is not surprising graduate students have higher levels of psychological distress than the general population, and recent reports show that universities may not have psychological services that fit their needs, underscoring the importance of interventions specifically tailored to graduate students.
To address the mental health concerns of graduate students, a group-based acceptance and commitment therapy (ACT) intervention was developed and implemented in a university psychological services center over the course of several semesters (summer 2019-summer 2020). The 8-week intervention covers the processes of psychological flexibility through experiential exercises, group discussions, didactic instruction, and homework activities and review. Graduate students are guided in breaking patterns of avoidance, contacting values that led them to their educational pursuits, and engaging meaningfully in fulfilling aspects of their lives despite the trials and tribulations that come with being a student. Clients (total N = 11; Semester 1 n = 4, Semester 2 n = 2, Semester 3 n = 5) completed measures of treatment acceptability.
Preliminary treatment acceptability evaluations show that the clients perceived the intervention positively and believed they benefited from participating.
The results support the social validity and acceptability of the treatment for this specific population and justify continuing to provide the group as well as conducting future studies assessing treatment efficacy and effectiveness.

Evaluating psychological inflexibility processes for anger in college students
Primary Topic: Clinical Interventions and Interests
Subtopic: Anger

Hannah Johnson, B.S., Utah State University
Jennifer Krafft, Utah State University
Woolee An, Utah State University
Michael Levin, Utah State University

Preliminary research suggests that Acceptance and Commitment Therapy (ACT) may be a successful treatment for problematic anger (Berkout, et al., 2019). However, research is needed to examine the relationship between anger and specific facets of psychological flexibility. The present study examined correlations between anger and psychological flexibility in order to identify the processes most relevant to mindfulness and acceptance-based treatment of anger.
386 college students completed self-report measures at baseline and 8-week follow-up. This study examined the relationship between the DAR and the Cognitive Fusion Questionnaire (CFQ; Gillanders et al., 2014), the Awareness and Acceptance subscales of the Philadelphia Mindfulness Scale (PHLMS; Cardaciotto et al., 2008), and the Progress subcale of the Valuing Questionnaire VQ-Progress; Smout et al., 2014).
The DAR was correlated with PHLMS-Acceptance (r = 0.13, p < .05), the CFQ (r = -0.22, p < .001, and VQ-Progress (r = -0.18, p < .01), but not PHLMS-Awareness (r = -0.08, p > .10. The CFQ approached significance in predicting the DAR at follow-up when controlling for baseline DAR (β = 1.78, p = .08) as did PHLMS-Acceptance (β = -1.69, p = .09).
These results show that specific facets of psychological flexibility including acceptance, cognitive fusion, and values progression are closely related to anger. These results support the utility of ACT as a treatment for problematic anger. In addition, techniques focusing on acceptance and cognitive fusion may be the most useful treatment.

Fatigue and avoidance among individuals with chronic disease: a meta-analysis
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Meta-analysis

Jenna Adamowicz, M.A., University of Iowa
Miriam Velez-Bermudez, M.A., University of Iowa

Fatigue is a common, debilitating symptom experienced by individuals with chronic disease. Avoidance, or the act of evading unwanted experiences, is associated with fatigue across chronic disease samples. This study sought to determine the strength of the association between fatigue and avoidance in individuals with chronic disease.
PubMed, PsycINFO, CINAHL, and ProQuest Dissertations and Theses databases were searched. Eligible studies measured fatigue and avoidance in chronic disease samples, or samples with a disease that has lasted or is expected to last 1-year or longer or result in the need for continuing medical care or impairment to daily living. Fifty-seven studies were included. Data analysis was conducted in Rstudio. A random-effects model was employed, and a single weighted main effect was computed for fatigue and avoidance. Mixed-effects meta-regression analyses were conducted to examine moderating variables (e.g., sex, age, illness duration, sample, country). Publication bias was examined using several methods.
A small, positive association was found between fatigue and avoidance (r = .21, p <.001). The association was stronger in measures of fatigue- and disease-specific avoidance than general avoidance. Moderation analyses of age, sex, illness duration, sample, and country were all non-significant. There was some indication of publication bias; however, the association between fatigue and avoidance remained significant following trim-and-fill analysis (r = .18, p <.001).
Results indicate individuals with chronic disease and increased fatigue experience increased avoidance as well. This suggest that the use of psychological interventions targeting avoidance might help with the treatment of fatigue among individuals with chronic disease.

Further examination of the factor structure of the Comprehensive assessment of ACT processes
Primary Topic: Clinical Interventions and Interests
Subtopic: Supervision, Training and Dissemination, Assessment of Psychological Flexibility

Ti Hsu, M.S., University of Iowa
Lesa Hoffman, Ph.D., University of Iowa
Emily Kroska, Ph.D., University of Iowa

Psychological flexibility, or the ability to focus on the present moment and to change one’s behavior in the pursuit of values even in the face of difficult situations or emotions, is a main target of intervention in Acceptance and Commitment Therapy (ACT; Hayes et al., 1999). The Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT; Francis et al., 2016) was developed to address the limitations of previous questionnaires assessing the construct (e.g., The Acceptance and Action Questionnaire II; Bond et al., 2011) and provide a more discriminating and comprehensive measure of psychological flexibility (Ong et al., 2020).
The current study aimed to further validate the three-factor structure proposed by previous studies examining the CompACT with a sample of a non-clinical U.S. sample of adults (N = 485). Confirmatory factor analyses were performed in Mplus v. 8.3 (Muthen & Muthen, 1998-2017) using robust maximum likelihood (MLR) estimation.
Preliminary results suggest that the original three-factor model provides inadequate fit for the data (chi-squared (df= 227, Nf 485) =1028.121, p < .001, TLI = .81, CFI = .83, RMSEA = .09 [CI: 0.08, 0.09], SRMR = 0.13), therefore, alternative factor structures will be evaluated. These data are part of a longitudinal study that examined psychological flexibility in the context of the COVID-19 pandemic (Kroska et al., 2020).
As such, if a structure with suitable fit is modeled, longitudinal measurement invariance will be examined. Results have implications for the assessment of psychological flexibility.

Getting Help from My Friends: Aversive Internal Experience and Social Support among LGBTQIA+ Individuals During COVID
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, LGBTQIA+, COVID-19

Marissa Lewis, Spalding University
Jennifer Altman, Spalding University
Catherine Hackl, Spalding University
Hillary Washington, Spalding University
Christian French, Spalding University
Amy Schaefer, Spalding University
Abbie Beacham, University of Louisville

Health-related anxiety and social isolation/loneliness are especially relevant during the COVID-19 pandemic and higher levels may place people at increased risk of medical/psychological conditions and illnesses. Social support and feelings of connection have been shown to mitigate negative effects of isolation and health anxiety. This may be especially important for people in the LGBTQIA+ community.
Our study sample consisted of LGBTQIA+ (Nf20) and non-LGBTQIA+ (Nf73) participants who completed demographic items and measures of Health Anxiety, Social Support and Loneliness as part of a larger survey study conducted shortly after COVID-19 was categorized as a pandemic and stay-at-home orders were in place.
When compared to those in our sample who identify as heterosexual, LGBTQIA+ participants scored appreciably higher on Health Anxiety [t(75) = -2.07, p = .042] and Loneliness [t(78) = -2.45, p=.015] and lower on Social Support from Family [t(87) = 4.67, p<.001] and a Significant Other [t(87) = 2.09, p=.04]. Social support from friends, however, did not differ between the groups.
Results indicate that periods of isolation, exacerbated by the pandemic and stay-at-home mandates, can be associated with higher levels of aversive internal experience, such as health anxiety, and feelings of loneliness especially among those who feel distant from family. Enhancing values-consistent connections with friends and within support communities may be especially important for further work with LGBTQIA+ individuals.

How does Attachment and Trauma severity impact ACT in those with Psychosis and Trauma histories?
Primary Topic: Clinical Interventions and Interests
Subtopic: Trauma, Psychosis

Alicia Spidel, Ph.D., Kwantlen University
Tania Lecomte, Ph.D., Université de Montréal

Background: Although Acceptance and Commitment Therapy (ACT) may be effective for individuals with psychosis and a history of childhood trauma, little is known about predictors of treatment response among such patients. Aims: The current study examined: (1) whether severity of trauma predicted treatment response, and (2) profiles of patients with regard to their responses to treatment.
Method: Fifty participants with psychosis and childhood trauma history were recruited and randomized to take part in either eight sessions of group-based ACT, or to be on a waiting list for the ACT group (i.e. treatment as usual group). The entire sample was used for the first part of the analyses (aim 1), whereas subsequent subsample analyses used only the treatment group (n = 30 for aim 2).
Results: Trauma severity did not moderate the effectiveness of ACT on symptom severity, participants’ ability to regulate their emotional reactions, or treatment compliance with regard to help-seeking. Among those receiving ACT, the results revealed three distinct and clinically relevant change profiles. Avoidant attachment style and number of sessions attended were predictive of belonging to the different clusters or profiles. Patients in the profile representing the least amount of clinical change attended an average of two sessions less than those in the other change profiles.
Conclusion: ACT offered in a group format appears to be a promising treatment for those with psychosis and history of trauma regardless of trauma severity. Given the brevity of the intervention, patients should be encouraged to attend each session for maximum benefit.

Is Dispositional Optimism Associated with Subjective Physical Health Across Demographics?
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Theoretical and philosophical foundations, Dispositional Optimism

David Giard, B.A., California Northstate University, College of Psychology

Quality of physical health is associated with increased longevity and decreased societal and individual costs. In previous literature, dispositional optimism has been shown to improve physical health, both subjectively and objectively. Differences in demographics have mainly not been studied. Understanding the generalizability of research into dispositional optimism could help develop future interventions designed to cultivate dispositional optimism, resulting in increased quality of life, increased longevity, and decreased individual and societal costs of healthcare.
Data used came from the fourth wave of the National Longitudinal Study of Adolescent Health (AddHealth). Nf5114. The first variable used is optimism, a secondary variable comprised of 4 questions taken from the LOT-R (Life Orientation Test, Revised). The response variable is subjective general health “In general, how is your health?” Demographic variables include biological sex, race and ethnicity, total household income, and the highest education level.
Optimism is associated with subjective general health (p=<.001, Rsquared of .082). Results indicate that Optimism accounts for 8.2% of the variance in general health. Potential confounds such as biological sex, total household income, and the highest education level were found to have independent relationships with subjective health. Race and ethnicity were found to moderate the relationship between optimism and subjective health in some races.
Dispositional Optimism is associated with subjective measures of health. Demographic differences, including sex, age, household income, and the highest level of education, were independent predictors of subjective health. Race/Ethnicity was a moderator of dispositional optimism on subjective health in races including American Indian and “Other” races.

Is Loneliness Impacted by the Judge and Jury Within?
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Clinical Interventions and Interests, Loneliness, Mindfulness, Non-Judgement

Aaron Carter, Spalding University School of Professional Psychology
Jennifer Altman, Spalding School of Professional Psycho
Christian French, Spalding School of Professional Psycho
Lauren Peterson, Spalding School of Professional Psycho
Amy Schaefer, Spalding School of Professional Psycho
Abbie Beachum, University of Louisville

Loneliness can adversely impact health at rates equivalent to or higher than obesity. The physical ramifications are startling, contributing significantly to mortality. Further, loneliness has a deleterious impact on mental health, leading to outcomes including depression, anxiety or suicide. The effects of COVID-19 have compounded these effects in subsets of the population. Interestingly, some studies have shown that certain mindfulness techniques can mitigate the impacts of loneliness and social isolation. Given the context of COVID-19 we hypothesized that Loneliness would be higher among those with high Anxiety Sensitivity and Health Anxiety and low Mindfulness. We surveyed a population of (n=93) individuals between the ages of (18-64+), primarily between the ages of 25-34 (50.3%), white (88.2%), heterosexual (78.5), and female gendered (77.4%).
Study participants completed demographic items and measures of Health Anxiety, Anxiety Sensitivity, Mindfulness and Loneliness as part of a larger survey study conducted shortly after COVID-19 was categorized as a pandemic and “stay-at-home” orders were in place.
Backwards linear regression was conducted to ascertain salient predictors of Loneliness. The final model accounted for 29% of variance [F (2, 70) = 14.85p <.001]. Significant IVs were Negative Consequences/Health Anxiety (β = .222, p<.049) and Mindfulness/Nonjudgement of Internal Experience (β= -.412, p<.001).
Contrary to our initial hypotheses, neither Anxiety Sensitivity nor other facets of Mindfulness were significant predictors of Loneliness in our sample. These findings do suggest that increasing focus on present moment awareness with emphasis on nonjudgement may influence aversive perceptions of loneliness during especially challenging times.

Is Nonjudging of Internal Experience a Key to Resilience in LGBTQIA+ Populations in Hard Times?
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Clinical Interventions and Interests, LGBTQIA+, perceived stress, flourishing, mindfulness, resilience, pandemic, COVID-19

Christian French, B.S., Spalding University School of Professional Psychology
Jennifer Altman, Ph.D., Spalding University
Lauren Peterson, M.A., Spalding University
Aaron Carter, Spalding University
Amy Schaefer, M.A., Spalding University
Abbie Beacham, Ph.D., University of Louisville

LGBTQIA+ people are largely invisible in existing research and disaster response in the United States (Salerno et al.,2020). Existing work suggests resilience is a protective factor during the pandemic (Zager Kocian et al.,2021), but gender diverse persons have comparatively lower resilience (Hunt et al.,2020). Further, perceived stress has shown to be higher in LGBTQIA+ adults (McElroy et al.,2016). Research on mindfulness in minority populations is sparse (Li et al.,2019) and no known work has studied mindfulness or flourishing in LGBTQAI+ populations during the pandemic.
Participants completed demographic items and measures of Resilience, Perceived Stress, Flourishing positivity ratio, and Mindfulness as part of a larger study conducted shortly after COVID-19 was categorized as a pandemic. Our sample included 93 participants who were predominantly female (n=72,77.4%), heterosexual (n=73,78.5%), white (n=82,88.2%), and young adults between the ages of 25-34 (n=47,50.5%).
Compared to heterosexuals, LGBTQIA+ (n=17,18.3%) participants scored appreciably lower on Resilience and Flourishing positivity ratio and higher on Perceived Stress (all p’s<.05). LGBTQIA+ participants did not differ on any of the facets of mindfulness except scoring much lower on Nonjudging of Internal Experience [t(86) = 2.99,p=.004].
In addition to more negative scores on symptom-based measures, LGBTQIA+ participants were appreciably lower on a facet of mindfulness fundamental to present moment awareness-Nonjudging of Internal Experience, suggesting LGBTQIA+ individuals not only already have a subjectively more unpleasant experience, but they also fight with and judge it more. This finding alone offers a necessity to foster acceptance-based skills among those LGBTQIA+ persons who may be experiencing distress.

Just Keep Moving: Positive Impact of Physical Activity During Pandemic Stress
Primary Topic: Behavioral medicine
Subtopic: Prevention and Community-Based Interventions, Covid-19, Perceived Stress, Physical Activity, Well Being

Yancy Nesbitt, Spalding University School of Professional Psychology
Jennifer Altman, Spalding University
Amy Schaefer, Spalding University
Tori Dickerson, Spalding University
Christian French, Spalding University
Abbie Beacham, University of Louisville

Physical activity as beneficial to well-being and coping with stress has been well established in the literature. At the onset of the COVID-19 pandemic, levels of well-being and stress were adversely impacted across the globe in response to uncertainty and isolation.
Study participants consisted of 93 adults, aged 18 and above. 77.4% identified as female, and 19.4% identified as male. Study participants completed demographic items and measures of Well Being (PERMA-H), Perceived Stress (PSS), and Physical Activity (Godin Leisure Time Questionnaire) as part of a larger survey study conducted shortly after COVID-19 was categorized as a pandemic.
Participants indicating levels of weekly participation in physical activity that meet or exceed recommended health guidelines scored appreciably higher on all five components of Well Being t(60) = -3.24, p=.002, and lower on Perceived Stress t(76) = 2.53, p=.014.
Results indicate the potential protective role of regular physical activity in support and maintenance of wellbeing in times of high stress, even in the context of the COVID-19 pandemic. We hypothesized that groups may not differ on these measures due to the exceptional stress levels in the context of COVID-19. However, this was not the case. These results provide support for committed action in regular physical activity as supportive of well-being in the context of external stressors.

Life Stressors and Coping in College Students: The Role of Experiential Avoidance and Humor
Primary Topic: Clinical Interventions and Interests
Subtopic: Prevention and Community-Based Interventions, Trauma, Experiential Avoidance, Humor

Marian Amundsen, B.A., Florida Institute of Technology
Kyla Jones, B.A., Florida Institute of Technology
Krishna Patel, B.S., Florida Institute of Technology
Giuliana Berry, B.A., Florida Institute of Technology
Victoria Follette, Ph.D., Florida Institute of Technolong

The goal of this study is to examine coping styles and trauma symptomology in college students. Specifically, the purpose of the present study is to examine the relationship between humor styles, trauma, and experiential avoidance among college students through the use of self-report questionnaires.
The sample will consist of approximately 120 undergraduate college students. Measures include a brief demographic survey, the Humor Styles Questionnaire, the Trauma Symptom Checklist, the Life Events Questionnaire, the Patient Health Questionnaire, the Acceptance and Action Questionnaire, and a question regarding COVID-19 stressors.
This study is currently in progress, and therefore results have not yet been determined. We are prepared to examine the relationships between maladaptive and adaptive humor styles with experiential avoidance, traumatic life events, psychological stress, and posttraumatic symptomology. We will also compare the humor styles against each other, to determine if there is a relationship between maladaptive and adaptive humor styles. The role of mediation using experiential avoidance with be examined in regression analysis.
This study will be complete by the time of the presentation, and is an important research project developed to further research this novel area. We hope to gain data on these relationships as it will benefit the field of clinical practice to have further answers on humor as it pertains to the healing process. This is pilot data for a larger study of the use of humor in first responders and medical personnel.

Medical Student Perceptions of an Acceptance and Commitment Training Curriculum
Primary Topic: Educational settings
Subtopic: Performance-enhancing interventions, Burnout, Acceptance and Commitment Training

Andrew Kim, University of Nevada, Reno School of Medicine
Ngantu Le, University of Nevada, Reno
Maebob Enokenwa, University of Nevada, Reno
Bryan Attridge, University of Nevada, Reno
Alison Szarko, M.A., University of Nevada, Reno
Kian Assemi, M.A., BCBA, University of Nevada, Reno
Nicole Jacobs, Ph.D., University of Nevada, Reno
Ramona Houmanfar, M.A., Ph.D., University of Nevada, Reno

Burnout is often defined as a prolonged state of emotional exhaustion and a reduced sense of personal accomplishment.1 The medical student population experiences significant rates of burnout,2 prompting medical educators to construct wellness programs that employ various methods to improve outcomes (e.g., social support, advising, and curricular modifications).3,4  Acceptance and Commitment Training (ACTraining) has demonstrated early signs of benefit in higher education settings.5,6  However, little research has been done to investigate ACTraining in medical education. While recent research suggests resilience training in medical education offers some benefit,7 the extent to which the current literature has incorporated training rooted in a Contextual Behavioral Science (CBS) approach is unclear. The primary goal of this project was to investigate medical students’ perceptions of an ACTraining curriculum at a Central Western U.S. medical school to better inform curricular changes.
An anonymous survey of open response and multiple choice questions was administered to a small group (n=25) of first and second year medical students at a Central Western U.S. medical school.
Preliminary results indicate student preferences for metaphors and exercises in present moment contact, acceptance, and perspective taking (i.e., self-as-context) over those in defusion, values clarification, and committed action.
It is important to target all six core processes within the ACT model for developing resilient physicians. Our data, however, suggest student preferences for 3 of the 6 skills taught, implying a need for further investigation regarding the selection and implementation of metaphors and exercises to best meet the needs of the medical student population.

Mindfulness and Health Anxiety – not Social Support – Associated with Resilience During COVID-19
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Clinical Interventions and Interests, Resilience, Mindfulness, Health Anxiety, Social Support, COVID-19

Lauren Peterson, Spalding University School of Professional Psychology
Jennifer Altman, Spalding University
Christian French, Spalding University
Aaron Carter, Spalding University
Amy Schaefer, Spalding University
Abbie Beacham, University of Louisville

The COVID-19 pandemic placed new and unforeseen stress on individuals, resulting in increased feelings of overwhelm, social isolation, and worry about health of ourselves and/or others. Coping with the effects of this ongoing stressful situation has the potential to cause diminished ability to bounce back or be resilient in the face of adversity (CDC, 2021). Resilience has been suggested to be a protective factor against adverse mental health outcomes after a disaster (Joohee et al., 2017) and has been shown to be influenced by behavioral, environmental, and cognitive processes. Given the context of COVID-19, our study examined factors associated with resilience.
Study participants completed demographic items and measures of Resilience, Health Anxiety, Mindfulness, and Perceived Social Support as part of a larger survey study conducted shortly after COVID-19 was categorized as a pandemic and “stay-at-home” orders were in place. Our sample included 93 adults who were primarily female (72%), and a majority of participants identified as White (82%). Many (50.5%) of our participants were young adults (Range 25-34 years).
Linear regression was conducted to ascertain salient predictors of Resilience accounting for 53% of variance (p <.001). Significant IVs (controlling for Age) were Health Anxiety (β = -.407, p<.001) and Mindfulness (β=.392, p<.001) but not Social Support (ns).
Although support from others is well documented, the ability to “bounce back” (i.e., be resilient) may be more related to an individual’s private internal experiences. Boosting individuals’ ability to work flexibly with internal experiences may increase resilience regardless of their social support level.

Multiple Dimensions of Social Support Buffer the Relationship Between States of Depression, Anxiety, and Stress and Suicidal Ideation
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Clinical Interventions and Interests, Depression

Kellyann Navarre, B.A., The University of Toledo
Kelsey Pritchard, M.A., The University of Toledo
Peter Mezo, Ph.D., The University of Toledo

Suicide is a leading cause of death among college students. College students encounter increased stressors and are prone to anxiety and depression symptoms. However, not everyone with these symptoms experience suicidality, and higher levels may precede or worsen suicidal ideation. Given that previous research has found robust associations between social support and decreased depression, we examined dimensions of perceived social support (family, friends, and significant others) as a buffer between three negative states (depression, anxiety, and stress) and suicidal ideation.
Data were collected from 725 undergraduate students (Mage = 19.63; 67% female). Participants completed the Multidimensional Scale of Perceived Social Support, Suicidality subscale of the Center for Epidemiologic Studies Depression Scale–Revised, and the Depression Anxiety Stress Scales–21. Moderation analyses were employed to test the strength of the relationship.
Analyses revealed dimensions of perceived social support significantly moderated the relationship between negative states and suicidal ideation, even after controlling for sex. These findings held for depression (b = -.243, 95% CI [-.335, -.151]), anxiety (b = -.265, 95% CI [-.372, -.158]), and stress (b = -.266, 95% CI [-.368, -.165]). Perceptions of higher quality support from friends, family, and significant others buffered the effects of negative states on increased suicidal ideation.
Results point to transdiagnostic implications for community-based suicide prevention in college students. Social support systems foster psychological well-being and are a suicidality protective factor during negative states. Future research should explore further variables of interest (e.g., positive affect) and potential contexts that impair real or perceived social support.

Outcomes as Mediators: A review
Primary Topic: Clinical Interventions and Interests
Subtopic: Theoretical and philosophical foundations, Mediation

Annelise Dankworth, University of Nevada Reno
Funmi Sheddy, University of Nevada Reno
Jessie Schindler, University of Nevada, Reno
Emily Faircloth, B.S., B.A., Capella University
Fredrick Chin, M.S., University of Nevada Reno

Recent calls have been to shift from syndromal approaches in psychology toward a process-based account, linked to evidence-based procedures. As an initial step towards process-based analyses, the present meta-analysis explores the mediating effects of outcomes of interest on other outcomes of importance. This strategy may reveal implications on the ways in which outcomes are functionally linked to one another, while helping practitioners identify the most important target of change, when generalized effects are desired.
Drawn from a larger ongoing study on all successful mediators identified in the psychosocial literature, the present dataset includes 69 outcome-based mediators from a total of 58 studies describing outcomes as mediating other outcomes of interest. Mediational data, including timing of measurements and mediational tests utilized were extracted from the studies.
The majority of studies examined mediators and outcomes at baseline, post-treatment, and at follow-up, rather than concurrently throughout treatment. Depressive symptoms emerged as the most commonly assessed outcome that mediates other outcomes, constituting nearly half of all mediators identified in the present dataset. Several studies examined bi-directional mediational relationships among outcomes and found significant mediation in both directions.
The present findings lend support to the importance of examining processes of change, but it extends that analytic approach to common treatment outcomes. In combination with emerging data on more proximal processes of change, these data suggest ways of prioritizing treatment targets in multi-problem cases. They also highlight a common shortcoming in the field, in that outcomes are generally measured only at discrete timepoints rather than continuously.

Pandemic-related adversity and distress: A longitudinal investigation of psychological flexibility as a mediator
Primary Topic: Clinical Interventions and Interests
Subtopic: Prevention and Community-Based Interventions, Psychological Flexibility

Manny Stegall, B.S., University of Iowa
Ti Hsu, M.S., University of Iowa
Alyssa Schneider, M.P.H., University of Iowa
Anne Roche, M.A., University of Iowa
Emily Kroska, Ph.D., University of Iowa

Research has demonstrated a strong positive association between COVID-19-related hardship and distress (Pierce et al., 2020). One potential mediating factor of this relation is psychological flexibility (PF), a modifiable transdiagnostic process (Hernández -López et al., 2021). The current study examined the mediating role of PF in the relation between pandemic adversity (PA) and distress.
Participants were recruited from MTurk in May 2020 (n = 485), with follow-up in June (n = 360) and July (n = 265) 2020. Self-report measures included PA, PF components (CompACT; openness to experience (OE), behavioral awareness (BA), valued action (VA)), and psychological distress (K10).
Parallel mediation analysis was conducted in SPSS using the PROCESS macro. Coefficients are unstandardized. PA predicted distress at two-month follow-up (β = 0.34, SE = .07, 95% CI: [0.22, 0.47], t(259) = 5.34, p < .001). A significant indirect effect of PA on distress operated through increases in OE (β = 0.11, Boot SE = 0.03, CI: [ 0.05, 0.19]) and BA (β = 0.26, Boot SE = 0.06, CI: [0.15, 0.39]), but not VA (β = 0.01, Boot SE = .01, 95% CI: [−.01, .03]). Overall, PF mediated the relation between PA and distress (β = 0.37, Boot SE = 0.06, CI: [0.27, 0.50].
OE and BA mediated the relation between PA and distress, and VA did not. ACT may be an appropriate intervention amidst adversity. Given that COVID-19 has acted as a global stressor, identification of transdiagnostic processes that account for the relation between adversity and distress is important.

Passing Time: Effects of Time Feedback on Runner's Pacing Behavior
Primary Topic: Performance-enhancing interventions
Subtopic: Other, Feedback

Patrick Smith, University of Nevada Reno
Michelle Forman, M.A., University of Nevada Reno
Ashlie Encinias, University of Nevada Reno

Feedback is an important aspect of athletic performance and is rated as impactful by athlete self-report. Additional research into self-report on feedback and on the various feedback types is needed. The purpose of this study was to assess the degree to which varying clock feedback, in the form of split times, influences running effort in trained runners. Secondarily, we looked to identify runners who would benefit from training designed to undermine overly rigid clock responding. In addition, potential demographic indicators and results on a AAQ-II and PFSS survey were analyzed.
Alternating Treatments Design (ATD) with four conditions during a continuous running effort. Feedback in the form of split times (pace) were provided to each runner for every 200m (half lap) of the effort where one of four semi-randomly alternating conditions was applied to the feedback. The dependent variable is each athlete’s split time for each split across the 5000m run.
Research results would provide more detailed, evidence-based analysis of performance outcomes based on feedback types, which would be useful for athletes and their coaches. Results from the AAQ-II and PFSS, and Demographics were also analyzed for trends and/or moderators.
Feedback type and rigid clock responding are important topics for athletic performance. However, little research has been done on analyzing the effects of varying feedback types on athletic performance. This study adds to that body of research and invites future research on performance and feedback.

Personal Technology Use, Social Media, And Daily Affect in Emerging Adults
Primary Topic: Clinical Interventions and Interests
Subtopic: Other, Social technology, Well-being, Affect, Emerging adults, Adolescence, Measurement, Screen time, Smartphone, Social media

William Crabtree, Murray State University
Sean Rife, Ph.D., Murray State University

With the widespread adoption of personal social and communication technology, significant controversy exists debating the effects these social technologies. Specifically, there is a strong debate in the scientific literature over the psychological effects of social technologies, smartphones, and social media usage. Some arguments are made that modern technology can help improve psychological well-being, whilst others claim it has destroyed a generation of adolescents and emerging adults. The present project aims to address this debate by exploring the current research from a variety of methodologies about social technology usage effects on psychological well-being, including severe discrepancies in survey-based correlational studies, meta-analyses, longitudinal designs, and random assignment experiments. There is also a systematic problem regarding literature in this area, particularly in the validity of self-report measurement instruments in comparison to actuarial assessments of technology use, including screen time. Specifically, there is evidence discussed for systemic over-reporting of technology use, in turn leading to false positive, statistically significant results that do not replicate when using actual screen time assessments.
This project will address these problems in the research literature by using actuarial assessments of screen time in order to see if positive and negative affective variation can be accounted for by utilizing a daily diary methodology.
Data collection is currently in progress, with 49 daily measurement observations (current Nf26; planned N of at least 100 participants).
Implications for clinical measurement and interventions will be discussed, with an emphasis on implications for contextual behavioral science informed conceptualization of psychological well-being.

Predictors of response to weight loss intervention: An examination of acceptance and mindfulness based variables
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Obesity and weight loss
Jason Lillis, Ph.D., Alpert Brown Medical School; California Northstate University
Lara Cummins, B.A., The Miriam Hospital; Lifespan Health

Individuals lose on average 7% of initial weight in response to standard behavioral weight loss treatments, however variability is high, with some losing 50 or more pounds while others lose nothing, or even gain weight. Little research has been done to assess whether variables typically associated with acceptance and mindfulness interventions are associated with response to weight loss intervention. The present study aimed to assess such associations.

This study is a secondary analysis of data from a large RCT testing two interventions for weight loss maintenance. In this RCT, all participants receive an initial, online, previously validated weight loss intervention and are then randomized to experimental weight loss maintenance conditions. The present study examines data from the initial online weight loss period (3 months) and looks at associations between weight loss and acceptance and mindfulness-based variables: psychological flexibility as measured by the AAQ-II, weight-related experiential avoidance as measured by the Acceptance and Action Questionnaire for Weight, food acceptance as measured by the Food Acceptance and Action Questionnaire, and openness to experience, behavioral awareness, and valued action as measured by the CompACT.

For each variable, we examined baseline score and 3-month change in relation to pre-to-post treatment weight loss using regression analyses. We found a mixed pattern of results indicating that there may be some role for these variables in response to standard behavioral weight loss intervention. We discuss implications, including pre-screening for additional support and the potential of treatment matching.

Preference for Zoom vs. In-Person Social Situations among those with Social Anxiety Disorder
Primary Topic: Clinical Interventions and Interests
Subtopic: Social Anxiety

Mila Popovic, Wilfrid Laurier University
Nancy Kocovski, Ph.D., C.Psych., Wilfrid Laurier University
Jan Fleming, M.D., F.R.C.P.C., The Mindfulness Clinic

Many social situations have shifted to virtual platforms during the pandemic. For those with social anxiety, this shift may be difficult or welcomed. The purpose of the present research was to examine preferences for experiencing social situations virtually versus in-person. It was hypothesized that participants would prefer Zoom for situations without an interaction component (being observed by others, presentations) but prefer in-person for social interactions.
Participants (n = 12 for preliminary analyses) with social anxiety disorder receiving group ACT via Zoom were asked to rate nine social situations regarding their format preferences.
Although some participants preferred an in-person format for some situations, an in-person format was not preferred on average for any situation. For two social interaction situations (e.g., talking with people you don’t know very well), the mean fell at the middle range indicating no preference. For the remaining seven situations, the mean indicated a preference for Zoom. The strongest preference for Zoom was for entering a meeting while others are already present, and consistent with hypotheses, this preference was significantly stronger compared to a social interaction situation, t(11) = 3.96, p = .002. Preferences may have been influenced by social anxiety severity; those with greater social anxiety were more likely to prefer Zoom overall (r = .51, p = .09).
These results support that the degree to which virtual social situations are preferred varies based on the type of social situation. Further research is needed to explore the extent to which these preferences are avoidance driven.

Psychological Flexibility Moderates the Relation of Distress Tolerance and Heavy Drinking Affective Avoidance
Primary Topic: Theoretical and philosophical foundations
Subtopic: Substance Use

Jennifer Kuo, M.A., University of South Dakota
Lucas Baker, University of South Dakota
Rachel Bock, University of South Dakota
Morgan Maples, University of South Dakota
Christopher Berghoff, University of South Dakota

Heavy alcohol consumption (i.e., drinking until blackout; consuming five or more drinks within three hours; Sadeh & Baskin-Sommers, 2017) is common among undergraduate students and associated with elevated health and academic problems, sexual assault, and accidental death (SAMHSA, 2019). Distress tolerance (DT) is inversely associated with alcohol related problems and individuals with low DT engage in excessive alcohol use to avoid distressing private experiences (Khan et al., 2018; Wahesh et al., 2020). However, not all individuals low in DT engage in affective avoidance drinking, suggesting other factors may moderate this relation. One candidate moderator is psychological flexibility (PF). For example, the deployment of flexible responses to unwanted affective states may support effective coping behavior, whereas low flexibility may underlie ineffective responses such as problematic drinking. Indeed, low PF and DT are associated with elevated substance-related problems (Levin et al., 2012; Shorey et al., 2017) and PF moderates psychiatric symptom-substance abuse relations (Bordieri et al., 2014). Yet, researchers have not evaluated PF as a moderator of the DT-affective avoidance relation.
This study aimed to clarify these relations in an undergraduate student sample (Nf297; Mage=19.2, SD=1.4) whom completed cross-sectional surveys.
DT was negatively correlated with affective avoidance drinking, r = -.272, p<.001. PF moderated this relation when controlling for age and sex, ΔR2=.018, F(1, 291)=5.99, p=.015. Specifically, high PF was associated with an inverse DT-affective avoidance drinking relation, b=-.022, p=.003, whereas no significant DT-affective avoidance drinking relation existed at moderate and low PF levels. Future directions and clinical implications will be discussed.

Psychological Inflexibility as a Transdiagnostic Process Across DSM-5 Anxiety and Obsessive-Compulsive and Related Disorders: Replication and Extension
Primary Topic: Clinical Interventions and Interests
Subtopic: Theoretical and philosophical foundations, Anxiety

Max Roberts, M.A., University at Albany, State University of New York
Eric Tifft, M.A., University at Albany, State University of New York
Shannon Underwood, B.S., University at Albany, State University of New York
John Forsyth, Ph.D., University at Albany, State University of New York

Psychological inflexibility (PI; Hayes et al., 2012) is a transdiagnostic process thought to account for diagnostic comorbidities across topographically distinct disorders. For example, PI is greater among those with comorbid hoarding and obsessive-compulsive disorder compared with either disorder alone (de la Cruz et al., 2013). PI is also greater among individuals with both depressive and anxiety disorders compared with either alone, even after controlling for distress (Levin et al., 2014). The present study aimed to replicate and extend this work by evaluating PI as a process underlying all DSM-5 anxiety and OC disorders, to specify how PI varies by number of diagnostic comorbidities after controlling for anxiety severity.
Community participants (N = 335; 80.9% female; Mage = 47.14) completed measures of PI (AAQ-II) and anxiety severity (DASS-21) and were asked to self-endorse lifetime anxiety and OC disorder diagnoses. Participants reported no diagnoses (58.2%), 1 diagnosis (24.2%), 2 diagnoses (10.1%), and 3 or more diagnoses (7.5%). PI was evaluated as a function of number of comorbid diagnoses, controlling for anxiety severity.
As anticipated, even after controlling for anxiety severity, PI significantly covaried by number of lifetime diagnoses [F (3,330) = 19.98, p <.001, PartialEtaSq = .15].
More comorbid anxiety and OC disorders is associated with greater PI after controlling for anxious distress. The present study shows how PI is potentiated as a function of greater anxiety-related comorbidities. These findings demonstrate PI is a transdiagnostic process underlying anxiety disorders and support the trend toward transdiagnostic approaches to understanding and treating anxiety problems.

Rebounding from Stress with Psychological Flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy

Sanela Kalakovic, B.S., Western Michigan University
Kenia Torres-Olson, M.A., Western Michigan University
Scott Gaynor, Ph.D., Western Michigan University

The goal of the current study was to examine if the overall psychological functioning of adolescents would improve using a novel 14-session Acceptance and Commitment Therapy protocol. The existing evidence supporting the use of ACT for adolescents is promising but limited. Stress management is one domain that is lacking evidence. Stress levels in adolescents have been shown to be higher than the population at large (Allen & Hiebert, 1991). This ACT protocol was adapted for adolescents using popular culture references to introduce skills and a group therapy format to foster social connections. COVID-19 provided a real world example of the utility of ACT for stress-management.
Using a pre-test/post-test design with an embedded repeated measures design, six adolescents (100% Hispanic or Latinx) struggling to manage stress were offered a 14-session Acceptance and Commitment Therapy group therapy protocol. Sessions 3-9 were the ACT intervention sessions and included homework review, skill introduction using popular culture references, orientation to skills, activities, and homework assignments.
Group-level statistically significant effects were found for quality of life and psychological flexibility. At the individual level, clinically significant changes varied depending on the participant. Most participants showed clinically significant changes for quality of life and ACT skills.
Participants were able to respond flexibly to the stresses and challenges that inevitably occur. These data suggest the potential utility of ACT for stress management and for adolescents from diverse backgrounds; however, given the difficulties with the small sample size, lack of control group, and inconsistent baseline, additional research is clearly warranted.

Regulatory Focus Theory and experiential avoidance: Examining relationships between focus strategies, treatment attitudes, and values
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Attitudes toward mental health services

Morgan Brewington, Murray State University
Michael Bordieri, Ph.D., Murray State University

Regulatory focus theory involves contrasting motivations—promotion focus, motivated by achievement of positive experiences; and prevention focus, motivated to avoid negative outcomes (Park, Swift & Penix, 2019). There are strong connections between prevention focus and experiential avoidance, and individuals high in experiential avoidance are less likely to behave in line with personal values, which is linked with psychological distress and negative attitudes toward mental health services (Chawla & Osta, 2007; Masuda et al., 2017; Smout et al., 2014).
The current study analyzes focus strategies in relation to valued living, psychological distress, and attitudes toward seeking mental health services. Additionally, previous experiences with psychotherapy were examined in relation to focus strategies. Prevention focus was expected to be negatively related to attitudes toward mental health services, with psychological distress as a moderator. Promotion focus was hypothesized to be positively related with valued living. Participants were undergraduate students (N = 129). The linear regression model for prevention focus and distress was significant, and distress was the greatest predictor of attitudes toward mental health services, though not a moderator, F (3, 125) = 5.01, p < 0.03, r2 = 0.11.
Prevention focus related to negative attitudes toward mental health services, while promotion strategies correlated with value-aligned living and less psychological distress. Additionally, prevention focus was related with more past experience with psychotherapy (Chawla & Osta, 2007; Masuda et al., 2017). Further research is needed on factors relating to attitudes toward mental health services and how this impacts who needs and will receive treatment.

Relationships Between Discrimination, Self-Compassion, and Anxiety

Primary Topic: Clinical Interventions and Interests
Subtopic: Self-Compassion

Rebecca Browne, M.S., Suffolk University
Brooke Duarte, M.S., Suffolk University
Sarah Schwartz, Ph.D., Suffolk University

Research has highlighted the negative impacts of racial discrimination on mental health outcomes among racial minorities in the U.S. (Carter et al. 2017). Positive aspects of self-compassion (e.g., self-kindness) have been shown to buffer against the impact of discrimination on mental health (Lui et al., 2020). However, limited research has examined how the negative aspects of self-compassion (i.e., self-judgment, over-identification, and isolation) may interact with experiences of discrimination. Thus, the present study examines relationships between experiences of discrimination, negative aspects of self-compassion, and symptoms of anxiety.
Participants were 348 college students, 67.3% female, with a mean age of 22.15 (SD = 5.65). Students were from diverse racial and ethnic minority backgrounds (1.4% Native American, 27.9% Asian, 38.8% Black, 27.0% Latinx, 2.6% Middle Eastern/North African, .6% Pacific Islander, 27.2%, 3.7% Multiracial/Multiethnic). Students completed surveys consisting of the General Ethnic Discrimination Scale, the Self-Compassion Scale-Short Form, and the Brief Symptom Inventory-18.
Multiple regression analyses revealed that discrimination (β = .26, p < .001), self-judgement (β = .28, p < .001), isolation (β = .28, p < .001), and over identification (β = .19, p = .019) were significantly associated with increased symptoms of anxiety. However, only self-judgement (β = .73, p = .023) moderated this effect: the relationship between the experience of discrimination and anxiety symptoms was stronger for individuals who endorsed higher self-judgement.
Findings provide preliminary evidence for the deleterious role of self-judgement in the context of experiences of discrimination among BIPOC. Implications and directions for future research will be discussed.

Relationships Between Discrimination, Valued Living, and Mental Health Outcomes
Primary Topic: Clinical Interventions and Interests
Subtopic: Values

Rebecca Browne, M.S., Suffolk University
Alexandria Miller, M.S., Suffolk University
Laura Austin, Suffolk University
Jessica Graham-LoPresti, Ph.D., Suffolk University
Sarah Schwartz, Ph.D., Suffolk University

Experiences of racism are associated with negative mental health outcomes (Carter et al. 2017). Theory and research both suggest that attending to, and making choices based on, one’s values may act as a buffer against the experiences of discrimination and promote positive mental health outcomes (Graham et al., 2015; Wilson & Murrell, 2004). The present study examines relationships between the experience of discrimination over the past year, engagement in valued-living, and symptoms of anxiety and depression.
Participants were 348 college students, 67.3% female, with a mean age of 22.15 (SD = 5.65). Students were from diverse backgrounds (1.4% Native American, 27.9% Asian, 38.8% Black, 27.0% Latinx, 2.6% Middle Eastern/North African, .6% Pacific Islander, 27.2%, 3.7% Multiracial/Multiethnic). Students were surveyed on discrimination (using the General Ethnic Discrimination Scale), values-based living (using the Engaged Living Scale), and symptoms of anxiety and depression (using the Brief Symptom Inventory-18).
Multiple regression analyses revealed that discrimination over the past year was significantly associated with both symptoms of depression (β = .26, p =.005) and anxiety (β = .28, p = .002). When engaged living was added to the model, it became the only significant predictor of depression (β = -.39, p = .015) but was not significantly associated with anxiety (β = -.18, p = .07). Surprisingly, results revealed no significant interaction between the experience of discrimination and engaged living on mental health outcomes.
Results highlight the need for additional research on the role of values-based living in the context of experiences of discrimination.

Runners, Planks, and Perseverance: An Exploration of Verbal Interventions to Improve Task Persistence
Primary Topic: Performance-enhancing interventions
Subtopic: Task Persistence

Jessie Schindler, University of Nevada, Reno
Ashlie Encinias, University of Nevada, Reno

Runners’ verbal behavior plays a key role in their capacity to persist under aversive conditions during competition and training. The current study examined the effects of Acceptance and Commitment Training (ACT) based verbal interventions on maximum plank holds in runners. 
This study utilized a within-subject, alternating treatments design. Nine sessions were conducted with each of the nine participants through recorded Zoom video calls where participants were asked to hold planks for as long as they could. Conditions consisted of baseline (previously learned verbal behaviors), willingness ("Are you willing to continue while experiencing what shows up?" on a VT 25s schedule), and defusion (sing about discomfort to the tune of a song). After the initial baseline session, subsequent sessions were randomized for condition. No condition was ran more than two times, consecutively.
Both intervention conditions resulted in longer plank holds than in the baseline condition for all but two participants. The willingness condition yielded the longest holds for 66% of participants and the defusion condition yielded the longest holds for 33% of participants.
This study demonstrates that ACT based verbal interventions are effective at increasing runners' task persistence. The willingness condition may have been most effective in that it closely resembles a coaching session with the participant being asked to check in on a VT 25s. Future research where this condition is changed to a covert verbal response could be beneficial in emulating realistic training and race settings where runners would not have a coach present.

School-based mindfulness program associated with teacher reports of decreased emotional, peer, and conduct problems
Primary Topic: Clinical Interventions and Interests
Subtopic: Educational settings, Mindfulness

Raegan Cupp, B.A., The University of Toledo
Wesley Bullock, Ph.D., The University of Toledo
Leah Kehler, University of Toledo

Mindfulness-based stress reduction (MBSR) programs have been successfully employed to promote physical, psychological, and behavioral benefits (Salmoirago-Blotcher et al., 2018; Beauchemin et al., 2008),including school-based mindfulness programs for children (Dimick et al., 2016; Saltzman, 2008; Semple et al., 2010; Weare, 2012). The objective of the current study was to evaluate a public school-based mindfulness program using a multi-modal, multi-informant outcome design to evaluate the effectiveness. The current study focuses on teacher reported outcomes for the students.
A waitlist control design with randomization to the mindfulness program or to a waitlist control was used. Half of the classes participated in the fall and the other half in the spring. The mindfulness program curriculum included twice weekly meetings for 30 minutes, for a total of 13 weeks (26 sessions). Teachers completed the Strength and Difficulties Questionnaire (SDQ); (Goodman, 1997) at pre- and post- participation. The SDQ includes a Total Problems score and five subscales: Conduct, Emotion, Hyperactivity, Peer Relationships, and Prosocial Behaviors.
A repeated measures ANOVA indicated a significant Group X Time interaction for Total Problems F (1,39) = 5.138, p<.05, with teachers also reporting a significant decrease in students’ difficulties with Emotion, Peer Relationships, and Conduct Problems, such that students who participated in the Mindfulness Program were significantly lower in these problem areas compared to those students who were in the waitlist control group. These results provide further support for the benefits of school-based mindfulness in reducing emotional and behavioral problems. Longer-term investigations of these benefits for school-aged children are needed.

Self-Care Strategies and Job Crafting Practices as Predictors of Work-Life Balance, Work Engagement, and Burnout
Primary Topic: Organizational behavior management
Subtopic: Professional Development, Behavior Analysis

Julie Slowiak, Ph.D., BCBA-D, University of Minnesota Duluth
Amanda DeLongchamp, University of Minnesota Duluth

Applied behavior analysis (ABA) practitioners report high levels of burnout, exhibited as exhaustion and disengagement. Turnover, a stressful and costly experience for individual practitioners and the human service organizations that employ them, is a potential consequence of burnout. Work-life balance and work engagement are associated with lower burnout and lower intention to quit. Research concerning behavioral predictors of work-life balance, work engagement, and burnout—all of which are associated with turnover intentions—among ABA service providers is scant. The purpose of the current study was to explore whether and how the use of self-care strategies and job crafting practices influence perceived levels of work-life balance, work engagement, and burnout among ABA practitioners.
We disseminated a recruitment message via email to relevant professional organizations and listservs and posted it on relevant social media pages and in relevant social media groups. We asked participants to complete a survey containing sociodemographic and job-related items, along with measures to assess self-care strategies, job crafting practices, work-life balance, work engagement, and burnout.
In a sample of 826 ABA practitioners, 72% reported medium-to-high levels of burnout. Hierarchical regression analyses revealed that the use of both self-care strategies and job crafting practices predicted work-life balance, work engagement, and burnout above and beyond gender and years experience.
Findings of this research provide implications for researchers, practitioners, and their employers/supervisor, graduate programs that prepare future ABA practitioners, and the profession at large. Findings can inform the development of effective organization- and individual-level interventions that support sustainable individual, organizational, and client-related outcomes.

Self-help for self-stigma?: Evidence from a randomized trial of ACT and traditional CBT for depression

Primary Topic: Clinical Interventions and Interests
Subtopic: Depression, stigma, self-help

Carter Davis, B.F.A., Utah State University
Leila Capel, Utah State University
Jennifer Krafft, Utah State University
Michael Twohig, Utah State University
M. Scott Deberard, Utah State University
Michael Levin, Utah State University

Self-stigma is the experience of persistent negative beliefs directed towards oneself (Barney et al., 2010), and is prevalent among individuals with depression (Vogel et al., 2017). We sought to understand whether a low-intensity depression treatment (online bibliotherapy) impacted levels of depression-related self-stigma, and which therapeutic processes are involved in this pathway.
A sample of 142 undergraduates were recruited for a randomized trial of Acceptance and Commitment Therapy (ACT) and traditional cognitive behavioral therapy (CBT) for depression, delivered in a bibliotherapy format over 10 weeks. In addition to self-stigma, we measured changes in therapeutic processes associated theoretically with ACT and CBT. We used a series of linear regression models to determine whether changes in therapeutic processes early in treatment were predictive of self-stigma outcomes at posttreatment.
Reductions in frequency of automatic thoughts, decreases in cognitive fusion, and increases in behavioral activation were all significantly predictive of self-stigma. Additionally, participants using the ACT book saw greater reductions in self-stigma associated with cognitive fusion than participants reading CBT. The effects of automatic thoughts and behavioral activation on self-stigma were not more associated with one book over the other.
Our findings indicate that a low-intensity and self-guided intervention for depression can effectively reduce self-stigma, with a number of therapeutic processes relevant to this pathway. Changes in cognitive fusion were more predictive of self-stigma for those using the ACT book, suggesting this particular therapeutic process which is central to ACT (Bramwell & Richardson, 2018) may more reliably influence self-stigma when an ACT approach is used.

Self-Rated Fidelity measure for ACT

Primary Topic: Professional Development
Subtopic: Other, Treatment Fidelity

Dustin Cox, PT, DPT, LSVT, CLT, ACBS
Anna Quigg, Ph.D., BCBA-D, ACBS

Measuring implementation fidelity helps evaluate practice integrity and ensures methods developed and tested under research conditions generalize to practice (McHugo et al, 2007; Joa et al, 2020). At this time, one peer-rated fidelity measure for Acceptance and Commitment Therapy (ACT) practice exists, however, not all ACT practitioners have access to professional peers who could rate their ACT practice fidelity. The purpose was to address concerns about lack of access to peer-reviewers and to ensure the ability of practitioners to engage in fidelity checks often, a self-rating system, the Self-Rated Fidelity measure for ACT (SRFACT), was developed and piloted.
Participants (Nf49) were recruited from social media and list-servs and completed measures of psychological flexibility, self compassion, and the SRFACT. A nonparametric analysis of the relations between the pilot measure SRFACT and other published assessments was conducted.
The following variables were positively correlated with SRFACT scores: number of years of practice (rT = .337 , p <.009, Time1) (rT = .323 , p <.013, Time2); psychological flexibility (rT = .257, p <.033, Time2); self-compassion (rT = .283, p <.018, Time 2); and ratings at Time1 and Time2 (rT = .373, p <.002).
The SRFACT was positively related to practitioners’ experience, psychological flexibility, and self-compassion, and remained stable over the short period. Further testing is needed to determine the reliability and validity of the SRFACT. The SRFACT may be a helpful tool for self-evaluation of ACT fidelity in practice.

Sleep and Perceived Stress during COVID-19: What’s mindfulness got to do with it?
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Mindfulness, Sleep, Stress, COVID-19

Hillary Washington, Spalding School of Professional Psychology
Jennifer Altman, Spalding University School of Professional Psychology
Catherine Hackl, Spalding University School of Professional Psychology
Marissa Lewis, Spalding University School of Professional Psychology
Amy Schaefer, Spalding University School of Professional Psychology
Christian French, Spalding University School of Professional Psychology
Abbie Beacham, University of Louisville

The National Institutes of Health report that an estimated 30% of adults complain of sleep disruption. Specifically, sleep latency – difficulty getting to sleep – has been associated with daytime functioning as well as anxiety, worry, and other psychological symptoms. To date, there has been minimal research considering sleep and facets of mindfulness. Some studies suggest that psychological distress may mediate the relationship between mindfulness and sleep quality. Conversely, mindfulness may also mediate this relationship. Evidence also suggests that mindfulness training may be associated with improvements in sleep quality and onset latency through greater acceptance of pre-sleep emotional arousal and ruminative thought.
Study participants (Nf93) completed demographic items and measures of Sleep Quality, Mindfulness, and Perceived Stress as part of a larger survey study conducted shortly after COVID-19 was categorized as a pandemic and stay-at-home orders were in effect.
In our sample, nearly 70% of participants reported “Poor” sleep scores. Among those participants, 45% had difficulty with sleep latency at least three nights a week. When “Good” versus “Poor” sleep groups were compared, there were overall differences in both Perceived Stress [t(70) = 4.06, p<.001] and Mindfulness [t(68) = 3.095, p=.003], with “Poor” sleepers scoring significantly lower on Mindfulness facets of Describe, Nonjudgment, and Acting with Awareness (all p’s <.05).
Persons struggling with sleep quality and perceived stress may benefit from mindfulness-based interventions with a focus on nonjudging of experiences (i.e., acceptance) associated with delayed sleep onset. These interventions may be especially useful in contexts with high levels of uncertainty.

Socioeconomic and Sex Differences in Psychological Flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: MPFI

Forrest Parker, B.S., Southern Illinois University - Carbondale
Morgan Franklin, M.A., Southern Illinois University - Carbondale
Chad Drake, Ph.D., Southern Illinois University - Carbondale

This study is a preliminary investigation into the potential effects of self-reported indicators of demographic variables (i.e., sex and socioeconomic status) on observed psychological flexibility and inflexibility as measured by the Multidimensional Psychological Flexibility Inventory (MPFI; Rolffs et al. 2016).
Levels of psychological flexibility and inflexibility as measured by a multidimensional self-report survey were analyzed for differences across gender/sex and annual income groups among 314 undergraduate students by using two-way between-subjects ANOVA.
Results indicated that sex differences were not statistically significant for either flexibility or inflexibility. An effect of annual income was found for levels of inflexibility, but not flexibility. Those reporting an annual income of $50,001-$75,000 evidenced significantly less inflexibility than those in the lowest income range. Those in the highest income range did not show significantly higher inflexibility levels than other groups.
The results of the current study provide evidence that differences in psychological flexibility and inflexibility among individuals do not differ significantly upon the basis of sex. The results regarding the effect of income may suggest that having a higher income may be associated with less inflexibility up to a certain threshold, whereupon high income may be associated with similar levels of inflexibility to those among lower SES.

Subjective versus Objective Sleep Quality and Wellbeing during COVID-19: Which matters most?
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Sleep Quality, Wellbeing, COVID-19

Victoria Dickerson, Spalding University School of Professional Psychology
Jennifer Altman, Ph.D., Spalding University
Amy Schaefer, M.A., Spalding University
Yancy Nesbitt, Spalding University
Christian French, Spalding University
Abbie Beacham, Ph.D., University of Louisville

COVID-19 pandemic stress has contributed to poor sleep in the average person. Evidence shows that poor sleep is associated with lower mood and decreased overall wellbeing. Most studies focus on objective sleep as a primary indicator of wellbeing. However, research argues that objective sleep measures may not be synonymous with wellbeing and that variability may be partially mediated by subjective sleep quality. The present study aims to explore the relationship between perceived sleep quality and well-being during COVID-19.
The sample consisted of 93 adults ages 18 to 64. Most participants identified as female (77.4%) and Caucasian (88.2%). In this study, participants completed demographic items and measures of sleep quality and well-being as part of a larger study conducted shortly after COVID-19 was categorized as a pandemic.
In our sample, nearly 70% had “Poor” objective sleep scores. Objectively “Good” sleepers had higher overall wellbeing scores [t(54) = 2.58, p=.013]. Despite these differences, 49% of “Poor” sleepers actually subjectively rated their sleep as “Good-to-Very Good”. When these sores were compared to those who rated their sleep as “Bad-to-Very Bad”, those who perceived their sleep to be better had higher scores on all Wellbeing components: Positive Emotion, Engagement, Positive Relationships, Accomplishment and Meaning (All p’s < .05).
Results suggest that the perception of sleep quality may be a more robust driver of wellbeing than objective sleep quality, even with the additional stressor of COVID-19. In addition, the experiences of engagement and meaning might be meaningful predictors of both perceived sleep and wellbeing.

Systemic Barriers to Implementing a FACT Intervention in Diverse Youth with Diabetes and their Caregivers during COVID
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, FACT, Type 1 Diabetes, Youth and Families

Rivian Lewin, M.S., University of Memphis
Mary Keenan, M.S., Clinical Psychology Doctoral Student
Jessica Cook, M.S., Clinical Psychology Doctoral Student
Katherine Semenkovich, M.S., Clinical Psychology Doctoral Student
Adora Choquette, Clinical Psychology Doctoral Student
Kristoffer Berlin, Ph.D., Licensed Psychologist
Amy Murrell, Ph.D., University of Memphis
Angelica Eddington, Ph.D.

Increasing quality of life in youth with type 1 diabetes (T1D) often requires personalized interventions tailored to individual characteristics (e.g. race, gender, age, family resources). Focused Acceptance and Commitment Therapy (FACT) is promising for this population, as FACT follows whole person care (including medical and behavioral health) through brief, targeted clinical interactions guided by client needs. To promote wellness among adolescents with T1D and their caregivers, a group telehealth FACT intervention with parallel adolescent and caregiver groups was developed. Implementation was planned in an outpatient endocrinology clinic. However, engagement in this clinical resource has progressed slowly and feasibility data was collected about reasons for not participating.
Data were collected from referred families including demographics, reasons for not participating, and contact attempts. The clinical research team evaluated the qualitative relations of barriers to treatment expressed by families and engagement with treatment within the context of systems of oppression present in the Black community which comprises ~50% of the clinic within the Mid-South, USA.
Several barriers to treatment were present including slow referral from medical providers, variable work schedules of mothers, preference for individual treatment, and misgivings about therapy and participation in clinical research.
Challenges implementing this intervention underscore the need for person-centered approaches tailored to this population that embody cultural humility and workable modalities for treatment delivery. Significant barriers to accessing care already present in the Black community in the Mid-South required additional focused attention to systems of oppression especially within the context of a worldwide pandemic.

The Trouble with Tasks: Exploring How Technology Can Help Us Create Prosocial Households
Primary Topic: Performance-enhancing interventions
Subtopic: Organizational behavior management, Cooperation

Neal Falletta-Cowden, M.A., BCBA, University of Nevada, Reno
Funmi Sheddy, University of Nevada, Reno
Jessie Schindler, University of Nevada, Reno

The challenges of shared household living are experienced by a range of populations such as married couples and college roommates. One of these challenges is the distribution of household labor such as cleaning the share living space and maintaining the home. In fact, problems with household labor have been exposed as a rising motive of divorce over the last several decades. Among college roommates, the methods that universities currently use to try to match similar individuals to a room are not very successful in terms of creating highly satisfying roommate relationships. The promise of behavioral science is that we can use our technologies and interventions to better the lives of people in any setting, and shared living spaces are rapidly becoming more common and thus require our attention.
This poster reviews the literature on household task distribution and the how dissatisfaction with this distribution can lead to catastrophic effects on the relationships between married couples, college roommates, and various other forms of housemates.
The results of the literature review show an increasing need for scalable behavioral interventions that can operate at the group level and bring housemate behavior under the control of a shared contingency. Results show how relationships of various kinds suffer when household labor is not distributed equitably.
Technological interventions such as apps have increased in popularity over the last decade in areas such as depression and anxiety, and mobile apps should also be developed using behavioral science to help people at the group level (i.e. shared households).

Thought Shape Fusion in a Residential Eating Disorder Sample
Primary Topic: Clinical Interventions and Interests
Subtopic: Other, Eating disorders

Eric Lee, Ph.D., Southern Illinois University
Myles Arendtson, Southern Illinois University
Andy Wall, Southern Illinois University
Jennifer Barney, M.S., Utah State University
Michael Twohig, Ph.D., Utah State University
Tera Lensegrav-Benson, Ph.D., Avalon Hills Eating Disorder Program
Benita Quakenbush-Roberts, Ph.D., Avalon Hills Eating Disorder Program

Thought shape fusion, a variant of thought action fusion, is a specific type of cognitive process that is associated with eating disorders. The Thought Shape Fusion Questionnaire (TSF; Shafran et al., 1999) is an 18-item measure used in these populations. The factor structure of the construct has been somewhat inconsistent depending on the sample and translated language of the measure. Therefore, further examination is needed in clinical samples.
173 patients diagnosed with an eating disorder completed an assessment battery at intake that included the TSF. All patients were admitted to a residential eating disorder facility. The sample included 73 adolescents and 100 adults. Construct validity, internal consistency, and the factor structure of the TSF was examined in both adults and adolescents.
Adolescent TSF mean scores were significantly lower (2.81, SD = 1.04) than adults (3.48, SD = 1.12) on average (t = 3.93(162), p < .001, d = .62). Large significant correlations were found between the TSF and eating disorder severity (r = .70, p < .001) and cognitive fusion (r = .71, p < .001). Further factor analyses will examine the factor structure.
Thought shape fusion appears to be a more significant factor in adults with eating disorders. It is a seemingly relevant construct in both adolescent and adult populations as it is highly associated with eating disorder severity. It is important for the field to establish the factor structure and psychometric properties of measures in clinical populations as they may interpret items differently than non-clinical populations.

Trauma Informed Treatment Within a Jail Setting: Potential Barriers and Advantages to Implementation
Primary Topic: Clinical Interventions and Interests
Subtopic: Supervision, Training and Dissemination, Trauma Informed Care

Victoria Visscher, M.A., The Chicago School of Professional Psychology
Nancy Bothne, Ph.D., The Chicago School of Professional Psychology

This study seeks to identify what obstacles have prevented a beneficial trauma informed treatment program from being implemented. In addition, this study hopes to create a list of factors that are viewed to facilitate trauma program effectiveness. Further, the proposed study will examine how perceptions about institutional factors may act as a deterrent or facilitator against effective trauma treatment. Lastly, this study will explore the negative impacts that working with traumatized individuals can have on correctional staff. Determining how best to include information regarding secondary traumatization in a training dedicated to trauma informed treatment would be beneficial for all. These factors are crucial for program development as they would assist with engaging correctional officers and other staff in employing trauma informed methods for their own benefit. Therefore, this study will attempt to establish what practices of trauma treatment should be integrated into the jail system.
Correctional officers were asked their opinions on a variety of topics related to mental health treatment and trauma informed practices within the jail using a semi-structured interview. These interview responses were then coded to determine themes and commonalities that will be used to inform future program development. At the present moment, the data has not been fully analyzed. At the time of the presentation, findings will be discussed.

Valued living and committed action on weight-related health behaviors: A secondary analysis of an RCT
Primary Topic: Behavioral medicine
Subtopic: Weight-related health behaviors

Marissa Donahue, M.A., Utah State University
Jennifer Krafft, M.S., Utah State University
Seth Seifert, Utah State University
Jason Lillis, Brown Alpert Medical School
Michael Levin, Utah State University

Poor nutrition can result in increased risk for overweight or obesity, heart disease, stroke, Type II diabetes, cancer, and brain function deficits. Acceptance and commitment therapy (ACT) can be an effective approach in promoting weight control strategies through behavioral commitment to values-based behavior. The present study aimed to assess the relationship of valued living and committed action on diet health behaviors among adults with overweight or obesity.
Secondary data analysis was performed of baseline and post-intervention data from 70 adults who participated in a randomized controlled trial comparing a Health Behavior Tracking app (HBT; n=21), HBT plus ACT matrix app (HBT+ACT; n=24), or waitlist condition (n=25) over the course of four weeks. Health behaviors related to weight management were assessed using the Weight Control Strategies Scale (WCSS), eating patterns were assessed using the Three Factor Eating Questionnaire-Revised (TFEQ), and satisfaction with life was assessed using the Satisfaction with Life Scale (SWLS). Process measures included the Values Living Questionnaire (VLQ) and the Committed Action Questionnaire (CAQ). Pearson’s correlations were used to assess baseline relationships across measures. Hierarchical regression analysis assessed predictions over time. Mediation model analyses assessed mechanisms of observed relationships between measures.
Findings will include baseline correlations found between committed action and valued living success and importance on weight control strategies. Baseline committed action predicted weight control strategies at 4 weeks, controlling for intervention condition and baseline weight control. Mediation analysis findings regarding weight control strategies, satisfaction with life and committed action will be presented.

What does it mean to “accept” chronic pain? Effects of acceptance on treatment outcomes in a multimodal pain rehabilitation program
Primary Topic: Behavioral medicine
Subtopic: Clinical Interventions and Interests, Chronic Pain

Sharlene Wedin, Psy.D., ABPP, Medical University of South Carolina
Bethany Pester, Medical University of South Carolina
Taylor Crouch, Medical University of South Carolina
Rebecca Kilpatrick, Medical University of South Carolina
Jeffrey Borckardt, Medical University of South Carolina
Kelly Barth, Medical University of South Carolina

Though pain acceptance has been shown to play an integral role in pain treatment outcomes, the function of acceptance is not well understood due to its multidimensional nature with both cognitive and behavioral components. This study examined if 1) acceptance is affected by multimodal pain rehabilitation, and 2) components of acceptance are related to treatment outcomes of distress, pain severity, and pain interference.
A retrospective cohort study was conducted on participants of a 3-week intensive outpatient pain rehabilitation program (Nf83). Patients completed a battery of measures at baseline and discharge measuring pain acceptance (Chronic Pain Acceptance Questionnaire), pain severity and interference (Brief Pain Inventory), and distress (Brief Symptom Inventory).
Patients’ pain acceptance total and subscale scores (pain willingness and activity engagement) increased significantly from baseline to discharge (p<.001). Change in pain acceptance was associated with changes in other treatment outcomes, including distress (BSI; depression: r=-.49, p<.001; anxiety: r=-.27, p=.013), pain interference (BPI; r=-.32, p=.004), and pain severity (BPI; r=-.40, p<.001), such that increases in acceptance were correlated with improvements in these other outcomes. Further examination revealed that strength of the correlations varied by outcome and component of acceptance.
Patients in multimodal pain rehabilitation showed significant increases in cognitive and behavioral components of pain acceptance (pain willingness and activity engagement despite pain). Increases in acceptance were associated with improvements in other important outcomes, such as distress, functioning, and pain severity. Treatments for pain may benefit from targeting certain components of acceptance based on patients’ presentation and needs.

Working out, Working within: The protective factor of exercise for flourishing & mindfulness at the start of a pandemic
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Clinical Interventions and Interests, Mindfulness, COVID-19

Amy Schaefer, Spalding University School of Professional Psychology
Jennifer Altman, Spalding University School of Professional Psychology
Yancy Nesbitt, Spalding University School of Professional Psychology
Tori Dickerson, Spalding University School of Professional Psychology
Christian French, Spalding University of Professional Psychology
Abbie Beacham, Spalding University School of Professional Psychology

Links between both exercise and mindfulness with each other and with positive mental health outcomes has been well established in the literature. Evidence suggests a bidirectional relationship between mindfulness and frequency of exercise engagement. The current study further examined these relationships in the context of the onset of a pandemic, specifically investigating the potential protective role of previously established regular exercise engagement in maintaining flourishing and mindfulness during broad and nebulous external stressors.
Study participants completed demographic/health behavior items and measures of Mindfulness and Positive/Negative Affect as part of a larger survey study conducted shortly after COVID-19 was categorized as a Pandemic. The sample consisted of 93 adults aged 18 to 64 who primarily identified as female (77.4%) and Caucasian (88.2%).
Participants answered retrospectively (prior to mandated stay-at-home order) how many days per week they exercised >15 minutes. Groups of Hi, Med, Low exercisers differed overall on mindfulness (F(2,83)= 4.78, p =.011) and Flourishing positivity ratio scores (F(2,87)=3.69, p =.029) with all scores increasing with higher frequency of exercise. Notably, mindfulness facets Nonjudging of Inner Experience and Acting with Awareness and Positive Affect were most salient contributors to overall model findings.
In a more “typical” scenario, these results may be expected. We hypothesized that groups may not differ on these measures due to the COVID-19 related context. Suggesting that well-established exercise and mindfulness habits may be able to withstand the impact of external widespread stressors. These results introduce interesting questions regarding state dependent nature of mindfulness and affect/mood.

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