Poster files will be added as we receive them. If you would like your poster file to be added to this list, please email it to Laura at acbsstaff@contextualscience.org.

Location: Saint Patrick's Cathedral

Thursday, 27 June, 2019, 18:45-19:45 - Poster Session #1 

Thursday, 27 June, 2019, 19:45-20:45 - Poster Session #2

Image denotes ACBS Junior Investigator Poster Award Recipients

 

Thursday, 27 June, 2019, 18:45-19:45 - Poster Session #1

1. Is satisfaction in valued living domains is a key to forestalling effects of burnout in healthcare providers?

Primary Topic: Behavioral medicine
Subtopic: Healthcare Provider Burnout
Abbie Beacham, Ph.D., Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar (VR), Italy
Jennifer Reese, M.D., Childrens Hospital of Colorado

Background. Healthcare provider burnout, recently identified as a public health crisis, is associated with satisfaction in valued areas of life and a sense of flourishing and perceived resilience. The interrelatedness of values consistent living and higher levels of resilience may be especially salient. Method. We examined Importance and Satisfaction in valued life domains in healthcare professionals (N=133; Physicians=43%) who completed online surveys. Surveys included the Positive and Negative Affect Schedule, Brief Resilience Scale and Valued Directions Questionnaire. Results. Among those who rated high importance(I) in valued domains, less than half rated satisfaction(S) at least equal to importance (I-SDifference Range=1.21-2.6). Highest I-SDifference was in the Health/Self-care domain with 87.9% rating importance >7/10 but 18.8% rated satisfaction > importance. Linear regressions predicting Resilience scores, conducted for each of 10 value domains, accounted for significant variance in Resilience scores (all p’s < .001). Discussion. In our sample of busy health care professionals, it may not be surprising that levels of satisfaction in important life domains were less than desired. Notably, as flourishing ratios increased the I-SDiff scores decreased, suggesting that an effective avenue for enhancing resilience may be through targeting valued areas of living and positive activities in those domains. An effective avenue for enhancing resilience and mitigating burnout effects may be to target enhanced valued living. Results from data collection (underway) regarding Acceptance of work-related stress(ors), valued living and resilience in healthcare providers will also be presented.

2. The development of the Psychological Inflexibility Scale – Infertility and study of its psychometric properties

Primary Topic: Behavioral medicine
Subtopic: Infertility; Psychological inflexibility assessment; Psychometric properties
Ana Galhardo, Ph.D., Instituto Superior Miguel Torga; Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC) -UC
Marina Cunha, Ph.D., Instituto Superior Miguel Torga; Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC) -UC
Bárbara Monteiro, M.Sc., Instituto Superior Miguel Torga
José Pinto-Gouveia, M.D., Ph.D., Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC) -UC

Background: Infertility is described as an emotionally challenging condition and the identification of emotion regulation processes such as the ones involved in psychological inflexibility may be relevant for psychological intervention programs targeting people with fertility issues and for research purposes in this particular population. Considering that general measures may not capture specificities of the infertility context, the current study aimed to develop a new self-report instrument, the Psychological Inflexibility Scale – Infertility (PIS-I), and explore its factor structure and psychometric properties. Method: An initial pool of 14 items was developed based on literature review and clinical expertise. The sample included 313 subjects presenting an infertility diagnosis (287 women and 26 men). Participants were recruited through the national patients association, gave their informed consent and completed online the following self-report questionnaires: PIS-I; Acceptance and Action Questionnaire (AAQ); Depression, Anxiety and Stress Scales (DASS-21); Fertility Problems Inventory (FPI) and the Infertility Self-efficacy Scale (ISE). Results: Principal Component Analysis revealed a single-component accounting for 63% of variance. Factor loadings ranged from .69 to .87. Cronbach alpha was .95. PIS-I showed a significant positive association with AAQ, DASS-21, and FPI and a significant negative association with ISE. Discussion: To our knowledge this is the first self-report measure aiming to assess psychological inflexibility within the specific context of infertility. The PIS-I showed to be a reliable and valid measure of psychological inflexibility targeting people who are dealing with an infertility diagnosis.

3. Patient complexity factors among people with pain who smoke cigarettes: Psychological flexibility, nicotine dependence, and pain relationships

Primary Topic: Behavioral medicine
Subtopic: Psychological flexibility, nicotine dependence, and pain
Anayansi Lombardero, Ph.D., University of Alaska, Anchorage
Annika Flynn, University of Alaska Anchorage
Andrew Richie, University of Alaska Anchorage

Background: Patient complexity is becoming increasingly prevalent in health settings. Multiple co-occurring medical and psychological conditions can negatively impact treatment outcomes. Research indicates that psychological flexibility plays a role in improving pain outcomes among people with chronic pain. Given these promising findings, it is important to investigate its associations with tobacco use disorder and other comorbid disorders among people who experience chronic pain. Methods: Cross-sectional survey. Results: Participants (N = 45) were all cigarette smokers (M = 15 cigarettes per day, SD = 9.19) recruited from multidisciplinary pain treatment centers. The mean age was 48 (SD = 12.6), 62% of participants were female, 89% were White, 7% had a college degree, and 22% were employed. Forty percent screened positive for depression, 18% had a positive PTSD screen, and 11% screened positive for alcohol misuse. Psychological inflexibility was associated with nicotine dependence (r = .33, p = .025), pain interference (r = .38 p = .010), pain related anxiety (r = .77, p < .001), depression (r = .73, p < .001) and PTSD (r = .79, p < .001). Nicotine dependence was associated with depression (r = .30, p = .045), pain related anxiety (r = .40, p = .006), and PTSD (r = .32, p =.033). Discussion: Psychological, tobacco use, and pain-related factors appear to interact with each other with implications for the care of complex patients in multidisciplinary pain treatment centers. Future studies should examine the role of psychological inflexibility in the development and maintenance of these disorders.

4. Self-Compassion, Disease Acceptance and Psychological Flexibility in Quality of Life and Body Image of Dermatological Patients

Primary Topic: Behavioral medicine
Subtopic: Mindfulness
Diana Constante, CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies
Ana Teixeira, Ph.D., CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies
José Rocha, Ph.D., CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies
Vera Almeida, CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies

Psoriasis is an inflammatory, chronic skin disease with high prevalence and negative physical and psychological repercussions. This study aims to evaluate the importance of self-compassion, disease acceptance and psychological flexibility in quality of life and body image of the dermatological patients. The Sociodemographic and Clinical Questionnaire, the Self-Compassion Scale, the Cognitive Fusion Questionnaire – Body Image (CFQ-BI), the Acceptance and Action Questionnaire – II (AAQ-II) and the Psoriasis Disability Index (PDI), were administered to 75 individuals diagnosed with psoriasis. The t-test for one sample, the Pearson correlation coefficient test and the multiple linear regression were used. Results demonstrate associations between quality of life and body image with clinical and mindfulness variables. The disease acceptance, psychological flexibility and self-judgment predicted 34.1% of quality of life. Additionally, over-identification and self-kindness predicted 43.4% of body image. Clinical strategies should include these dimensions in order to facilitate a better and integrated care to dermatological patients.

5. Mindful-Kids Project

Primary Topic: Behavioral medicine
Subtopic: Mindfulness
Edurne Maiz, Ph.D., University of the Basque Country (UPV/EHU)
Ignacio de Tomas, Basque Culinary Center, Mondragon Unibertsitatea
Uxune Etxeberria, BCC Innovation, Technological Center of Gastronomy

Background: In the last few years, great attention has been paid to the mindful eating technique as an approach derived from mindfulness to address unhealthy eating behavior. Recent studies have demonstrated the effectiveness of an induction to the mindful eating as a strategy to reduce food and fat intake in adults. However, there is limited information in relation to mindful eating interventions in children. Therefore, the aim of this study was to investigate whether a brief session of mindful eating could promote healthier dietary food choices in children. Method: A sample of 101 children ranging from ages 8-11 were recruited. 50 children (Mindful eating group) participated in a session with mindful eating exercises aimed at being conscious of how the five senses are linked with consumption of food. 51 children (Control group) participated in a creative workshop. Statistical analyses were conducted using Chi-square tests and an ANCOVA test (p< 0.05). Results: No statistically significant differences were found between groups on subjective hunger and satiety score, food intake, food choices and liking variables. However, statistically significant differences were found in the level of dominance. Discussion: A higher independence sensation was detected in the control group comparing to the Mindfulness group. It is suggested that a mindful eating session could be a less familiar activity than a creativity workshop. In conclusion, more sessions of mindful eating would be recommended to assess the effects of a mindful eating intervention in children’s eating behavior, in their emotional dimensions and food intake.

6. Examining the relationship between facets of mindfulness and holistic health

Primary Topic: Behavioral medicine
Subtopic: Mindfulness, health, well-being, self-care
Elizabeth Tish Hicks, B.A., Utah State University
Kristin Jay, Ph.D., Marist College

The current study investigates whether, without a specific meditation intervention, higher baseline levels of mindfulness are significantly related to and predictive of higher levels of holistic health, which was operationally defined as mindful self-care, physical/mental health, and well-being. Method: Mindfulness was measured via the Five Facet Mindfulness questionnaire (FFMQ; Baer et al., 2006), mindful self-care was measured via the Mindful Self-Care Scale- SHORT (MSCS; Cook-Cottone & Guyker, 2016), health was measured via the MOS 36-item short form health survey (SF-36; Ware & Sherbourne, 1992), and well-being was measured via the Scales of Psychological Wellbeing inventory (SPW, Ryff & Singer, 1998). Participants (92 undergraduates; 71 women; mean age 18.99 ± 1.22 years) completed the FFMQ, MSCS, SF-36, and SPW in the lab. Results: Pearson correlations will be used to examine the relationship between baseline levels of mindfulness and self-care, health, and well-being. Regression models will also be calculated to examine the predictive power of mindfulness on self care, health, and well-being. The researchers expect that higher baseline levels of mindfulness will predict higher levels of reported self-care, health, and well-being. This research will clarify the relationship between mindfulness and holistic health, and may provide further evidence to support the use of mindfulness practice to promote holistic health in terms of physical/mental health, well-being, and self-care behaviors.

7. Psychological Inflexibility predicts greater symptom interference in cancer survivors

Primary Topic: Behavioral medicine
Subtopic: Cancer
Emily Cox-Martin, Ph.D., University of Colorado
Elissa Kolva, Ph.D., University of Colorado
Matthew Cox, Ph.D., Mental Health Institute, Colorado Department of Human Services
Levi Bonnell, MPH, University of Colorado

Background: Side effects related to a cancer diagnosis and its treatment can impact treatment adherence, quality of life, distress, and disability in patients across the cancer continuum. It is important to understand what factors might impact a patient's ability to cope and adjust to these difficulties in order to design effective psycho-oncology interventions. We investigated associations between cancer-related symptom interference and psychological flexibility in cancer survivors seeking psychological care. Methods: Participants had mixed solid tumor diagnoses, across the cancer continuum, with one or more psychology appointments at a large comprehensive cancer center. Psychological flexibility, measured by the Acceptance and Action Questionnaire-II, and symptom interference, measured by the MD Anderson Symptom Inventory, were evaluated cross-sectionally. A multiple linear regression model predicted symptom interference based on psychological flexibility, controlling for symptom severity, physical functioning, age and gender. Results: Participants (n = 63) were mostly white (89%) and female (81%) with an average age of 51 (SD = 14.65). Overall, the model was significant (F(5, 54) = 27.36, p < 0.001), with an R2 of .71. Psychological inflexibility significantly predicted symptom interference (B = .074, p = .001). Discussion: These findings highlight psychological flexibility as a factor for clinical intervention in cancer survivors who may be experiencing high disease-related symptom interference.

8. Acceptance and Commitment Therapy as an Intervention for Adolescent Chronic Pain Related to Pectus Excavatum: A Case Study

Primary Topic: Behavioral medicine
Subtopic: Pediatric Chronic Pain
Hayley N Roberts, Psy.D., Children's Hospital Colorado, University of Denver

Background:Pectus Excavatum(PE) is a congenital chest-wall deformity where the sternum and chest-wall cave inwards toward the spine. While corrective surgery has shown positive effects on physical and psychosocial well-being of PE patients, it can often result in Chronic Post-Surgical Pain(CPSP). Surgery may positively alter the deformity’s aesthetic; however, physical and emotional recovery is likely post-surgery. This study reviews how Acceptance and Commitment Therapy(ACT) can effectively address CPSP during recovery. Method:I present a case report of an adolescent male with CPSP and pain-related anxiety. He had begun to withdraw from preferred activities and avoided potentially pain-inducing situations. He attended individual ACT-based psychotherapy as a part of a multidisciplinary pain team. Data was gathered through the Numeric Pain Rating Scale, Patient-Specific Functional Scale, and clinical observation. Results:The patient demonstrated improvements in valued choices and acceptance of physical and emotional struggle during treatment. An overall decrease in rating of pain and disability was seen. Furthermore, his perceived ability to engage in valued activities increased even when pain increased. Discussion:Although psychosocial struggles may begin with PE, simply removing the cause may not suffice to repair the psychological damage that develops over time. Some PE patients have dealt with a lifetime of emotional stressors and engagement in avoidant behaviors, which cannot be expected to resolve with surgery. Therefore, including psychotherapy within a patient’s reparative journey is critical to help patients shift their focus away from restrictive, avoidant behaviors towards values-based behaviors which can continue post-surgery. Fortunately, ACT provides an added benefit in addition to surgery.

9. Association of psychological flexibility, affect, and symptom interference with engagement in self-management activities in Multiple Sclerosis

Primary Topic: Behavioral medicine
Subtopic: multiple sclerosis
Jennifer K. Altman, Ph.D., University of Washington
Anne Arewasikporn, Ph.D., University of Washington; VA Puget Sound Health Care System
Aaron Turner, Ph.D., VA Puget Sound Health Care System; University of Washington
Kevin Alschuler, Ph.D., University of Washington
Dawn Ehde, Ph.D., University of Washington

BACKGROUND: When living with chronic illness, optimizing symptom self-management is important to support engagement in values-based activities. Psychological flexibility, affect and symptom interference have been associated with levels of engagement in meaningful activities in persons with chronic illnesses. This study explored the relationship among these variables on actions taken to manage multiple sclerosis (MS) by individuals enrolled in a self-management intervention study. METHOD: Participants (N=163; 87% female; Mage=51.7, SD=10.1) consisted of individuals diagnosed with MS who completed demographic items, Acceptance and Action Questionnaire-2, Positive and Negative Affect, Modified Fatigue Impact, and Pain Interference scales. Linear regression (controlling for age and years since diagnosis) was conducted to ascertain the most salient predictors of MS Management actions in this sample. RESULTS: The final model accounted for one-fifth of total variance (F(7, 146)=6.28, p<.0001, Adj R2=.195) with higher levels of positive affect (β=1.15, p<.0001), and higher levels of fatigue impact (β=.307, p=.019) significantly associated with higher total number of MS Management actions. Notably, psychological flexibility, negative affect and pain interference were not significantly associated with number of MS Management actions (all p’s>.05). DISCUSSION: Participants with higher levels of positive affect and fatigue impact reported higher frequency of engagement in self-management activities. Results suggest that outcomes may be enhanced with increased focus on enhancing positive affect, and fatigue impact may be a motivating factor to engage in more self-management activities. Interventions focused on enhancing positive affect may promote engagement in self-management.

10. ACT with Military Members and Veterans: A Systematic Review

Primary Topic: Clinical Interventions and Interests
Subtopic: Military Service Members
Jeremiah E. Fruge, M.S., Utah State University
Felicia J. Andresen, M.S., Utah State University
Michael P. Twohig, Ph.D., Utah State University

Service members and veterans (SM/Vs) of the United States military represent a large population and culture within our country.SM/Vs experience high prevalence rates of a variety of psychological disorders and disabilities that are detrimental to quality of life. Utilizing an evidence-based treatment that seeks to improve quality of life and is useful across diagnoses prevalent among SM/Vs is essential. Acceptance and Commitment Therapy (ACT) represents a treatment that may satisfy this need. The present study examines the current state of the literature of ACT for SM/Vs. A systematic review of 198 separate papers found three RCT’s, 11 non-randomized multi-subject studies, and one case study that met inclusion criteria. Overall,results suggest ACT is a promising intervention for SM/Vs across multiple disorders(e.g. anxiety disorders, depression, chronic pain)as well as intervention delivery (e.g., in-person and telehealth) and type(e.g., group and individual therapy). While extant literature suggests ACT may be an effective intervention among SM/Vs,future research should (1) continue to examine which psychological disorders respond to ACT and (2) seek to understand what types of adaptations may be necessary to increase the effectiveness of ACT for SM/Vs.

11. Psychological flexibility, loneliness and body appreciation among women with lipoedema in Poland

Primary Topic: Clinical Interventions and Interests
Subtopic: lipoedema, lipedema, weight stigma, body apprecation, loneliness
Joanna Dudek, Ph.D., SWPS University of Social Sciences and Humanities

Background: Lipoedema, a type of Subcutaneous Adipose Tissue Disorders that affects mainly women, manifests itself with an accumulation of the fat in lower parts of the body and associated pain and bruising (Buck, Herbst, 2016). Despite the growing number of studies and treatment guidelines in a number of European countries, it is still little known and often misdiagnosed and mistreated in Poland. The aim of the study was to investigate psychological factors that might affect the quality of life in Polish women with lipoedema. Method: Ninety-eight women with lipoedema completed an Internet-based survey. They were asked to fill in a number of questionnaires, to assess i.a.: symptom severity, quality of life (WHOQOL-BREF), psychological flexibility (Acceptance and Action Questionnaire-II), loneliness (UCLA Version 3), and body appreciation scale (BAS-2). Results: Multiple hierarchical regression analyses showed that a higher level of quality of life was predicted by higher levels of psychological flexibility and body appreciation, and lower level of loneliness while controlling for symptom severity. Discussion: Future studies should investigate factors affecting the level of body appreciation in women with lipoedema, especially in the context of the level of knowledge of lipoedema and weight stigma associated with the misunderstanding that surrounds the disorder (Torre, Wadeea, Rosas, Herbst, 2018). Moreover, it might be interesting to look into the effectiveness of separate interventions to improve quality of life in women with lipoedema targeting either psychological flexibility, or loneliness, or body appreciation.

12. The Role of Psychological Flexibility in the Relationship Between Childhood Abuse and the Quality of Adult Dating Relationships in Female University Students

Primary Topic: Clinical Interventions and Interests
Subtopic: Childhood abuse
Johanna Terry, M.A., Kean University
Adrienne Garro, Ph.D., Kean University
Donald Marks, Psy.D., Kean University
Aaron Gubi, Ph.D., Kean University

Past research has suggested childhood abuse can have lasting effects, which impact later romantic relationships (Cherlin, Burton, Hurt, & Purvin, 2004; Colman & Widom, 2004). This study aimed to shed light on how psychological flexibility potentially impacts this relationship between childhood abuse and quality of adult dating relationships in a female university population. Psychological flexibility can be defined as the ability to consciously contact the present moment and take part in valued-driven behavior (Biglan, Hayes, & Pistorello, 2008). The sample was comprised of female undergraduate students at a university in the Northeastern United States who are currently involved in a dating relationship. These participants were administered measures assessing the prevalence and intensity of childhood traumatic events, psychological flexibility and romantic relationship quality. Researchers hypothesized that the component of psychological flexibility would mediate the relationship between childhood abuse and quality of adult dating relationships, such that participants who have higher levels of psychological flexibility would endorse greater relationship quality. Although a predictive relationship was not found between overall childhood abuse/neglect and adult relationship quality, psychological flexibility was still found to significantly mediate the relationship. Results from this research support the utility of interventions that aim to increase psychological flexibility in individuals who have experienced childhood abuse.

13. Conscience and emotion: Does mindfulness improve performance in Emotional Stroop?

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Jose Errasti, Ph.D., University of Oviedo
Emilio López Navarro, Ph.D., University of Balearic Islands
Susana Al-Halabi, Ph.D., University of Oviedo
Carmen Rodríguez Muñiz, University of Oviedo
Hugo Martínez, University of Oviedo
Jennifer Marquez, University of Oviedo

Background: Mindfulness is a technique broadly used in clinical practice and research. Its effects over well-being are well-stablished, but it remains unclear until what extent the underlying process is an attentional or emotional one. Our study tests if a mindfulness brief induction can improve participants’ performance in a classic experimental task, comparing their execution with two active controls. Method: 120 psychology grade students were randomly allocated to the intervention conditions: mindfulness, relaxation, and control text. Mindfulness induction was performed following Eifert & Forsyth recommendations, while relaxation induction was an adaptation of Jacobsen’s instructions. Control text is based on the relevance about estimate other people. After randomization, participants fulfilled a sociodemographic questionnaire, State-Trait Anxiety Inventory, Five Facet Mindfulness Questionnaire and Prague Spirituality Questionnaire. Participants heard the audio of the intervention condition. After intervention, an Emotional Stroop task was launched. Emotional Stroop consisted in 240 trial presented in two blocks. Results: There were no differences between groups in FFMQ, STAI or PSQ. Although the results are not fully analysed, our first data show that there were no differences between groups in Emotional Stroop performance, but reaction time of mindfulness group was lesser in error trials of emotional words when compared with the other intervention groups. Discussion: Our results point to a differential effect of mindfulness that lessens the emotional reactivity to own perceived errors. Further research should address until what extent the relationship between the word and the clinical manifestations may mediate the effect of mindfulness.

14. Dismantling Mindfulness: Mechanisms involved in emotional awareness

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, transdiagnostic mechanisms, medidas fisiológicas
Juan Camilo Vargas Nieto, Fundación Universitaria Konrad Lorenz

Background: In recent years there has been a growing explosion of therapeutic proposals based on Mindfulness, a type of contemplative meditation whose foundations date back to Eastern traditions (Bodhi, 2011). Mindfulness-based interventions have been recognized for their ability to reduce psychological distress in a wide variety of clinical disorders and have been effective in promoting adaptive emotional regulation in affective disorders such as anxiety and depression (Gross, 2014). I tried to decipher which are the "active ingredients" of the mindfulness-based workouts, the relationship between the skills associated with mindfulness and the psychological mechanisms involved. Method: For this reason, the present investigation aims to propose a protocol to evaluate the effects of a training program based on mindfulness on the skills of mindfulness, attentional control and its physiological correlates through the use of biofeedback and eye tracking equipment. . Expected results: It is expected to determine through a series of studies, the changes associated with mindfulness training on emotional awareness skills, as well as in basic psychological processes such as attention and in mechanisms such as emotional regulation, taking as a reference the physiological indicators obtained through biofeedback equipment.

15. Contextual case formulation model as a tool for understanding parental distress

Primary Topic: Clinical Interventions and Interests
Subtopic: Parental distress
Juho M. Strömmer, Ph.D., University of Jyväskylä
Päivi Lappalainen, Ph.D., University of Jyväskylä
Raimo Lappalainen, University of Jyväskylä

Background: Parental distress and burnout symptoms are common among parents with chronically ill or disabled children. Without support parents with chronically ill children may be susceptible to burnout and other psychological symptoms. This may have negative effects on welfare of both the child and the parent, as well as the relationship between the caregivers. The aim of this study was to use contextual case formulation model in purpose to understand and describe parental distress related to parenthood of children with special needs. Methods: The participants were 21 Finnish parents with chronically ill or disabled children taking part in a randomized intervention trial. The data was collected during the pre-measurement phase. Individual case formulation models were constructed based on the data collected during a webcam interview. Results: The contextual case formulation models revealed three key themes common to all of the participants. These themes included relationship problems between the caregivers, the health care service providers ignorance of the parents’ wellbeing, and limited or non-existent personal time or personal space reported by the parents. Examples of the contextual case formulation models will be presented in the poster. Discussion: Contextual case formulation models can increase service providers’ understanding of parental distress especially among parents with chronically ill children, and could help to design effective preventative intervention and services.

16. Don’t worry, be flexible: Change in parent psychological flexibility predicts well-being in intensive interdisciplinary pediatric chronic pain treatment

Primary Topic: Clinical Interventions and Interests
Subtopic: Pediatric Chronic Pain
Julia Benjamin, Ph.D., Department of Psychiatry and Psychology, Mayo Clinic
Cynthia Harbeck-Weber, Ph.D., LP, Department of Psychiatry and Psychology, Mayo Clinic
Leslie Sim, Ph.D., LP, Department of Psychiatry and Psychology, Mayo Clinic

Background: Chronic pain affects 11-38% of youth (King et al., 2011), contributing to depression and poorer quality of life for patients and their parents. Interdisciplinary ACT-based programs with parental involvement foster improved youth functioning (Wicksell, Melin, Lekander, & Olsson, 2009). However, scant research has explored the benefit of these programs for parents’ adjustment. The present study sought to better understand changes in parent mental health following a 3-week interdisciplinary pediatric chronic pain program. Methods: Patients and parents completed measures at intake and three-month follow-up assessing parent depression (CES-D), quality of life (SF-36), pain catastrophizing (PCSP), and psychological flexibility (PPFQ), and child disability level (FDI). Using SPSS, we conducted paired t-tests and multiple regression analyses. Results: Our sample included 268 patient-parent dyads. Parents showed significant increases in mental health-related quality of life (t (262) = -6.88, p < .001) and decreases in depression (t (264) = 9.60, p < .001). Parent pain catastrophizing was not a significant predictor of parent mental health at follow-up, but change in psychological flexibility did predict parent mental health at follow up (CES-D: t = -5.36, p < .000). Discussion: These results highlight the potential of pediatric chronic pain treatment programs to support improved well-being for parents participating along with their child in an interdisciplinary pain program. Interventions targeting psychological flexibility, or the willingness to be present in the moment and make values-based decisions, have the potential to bolster the resilience of parents caring for a child with chronic pain.

17. Flexible Security: Psychological flexibility and attachment in romantic partnerships

Primary Topic: Clinical Interventions and Interests
Subtopic: Attachment
Karen Twiselton, University of Edinburgh
Sarah Stanton, Ph.D., University of Edinburgh
David Gillanders, Ph.D., University of Edinburgh

Attachment style is found to impact on social functioning, and attachment insecurity is associated with poorer wellbeing and more difficult relationships. People with insecure attachment patterns are more likely to be more self-critical and lower in self-compassion. The current study investigated whether psychological flexibility buffers the relationship between insecure attachment and outcomes such as relationship quality and wellbeing. 1479 people in romantic partnerships (62% female, 18 - 76 years of age, mean age: 37 years, (SD = 11)) completed an online survey measuring attachment avoidance and attachment anxiety, self-compassion/self-criticism, psychological flexibility, relationship quality and both eudaemonic and hedonic wellbeing. Results showed a differential pattern of responding among those with anxious or avoidant attachment styles. For people with anxious attachment, psychological flexibility significantly predicted lower levels of self-criticism. Psychological flexibility moderated the relationship between avoidant attachment and self-compassion. Reductions in self-criticism and increases in self-compassion were associated with higher levels of eudaimonic wellbeing. Higher self-compassion also predicted higher levels of hedonic wellbeing. Psychological flexibility directly moderated the relationship between attachment avoidance and relationship quality for high levels of avoidant attachment. These data suggest that psychological flexibility could be a useful treatment target in improving the relationship quality and wellbeing of people who have experienced insecure attachment histories.

18. Novice therapist competence: Association to treatment outcome and early sudden gains

Primary Topic: Clinical Interventions and Interests
Subtopic: Novice therapists
Katariina Keinonen, Ph.D. Student, University of Jyväskylä
Heidi Kyllönen, University of Jyväskylä
Raimo Lappalainen, Ph.D., University of Jyväskylä

Objective: The aim of the current study was to explore the association between novice therapists’ competence and adherence ratings and outcome in a six-session ACT intervention for diagnosed depression. Additionally, the association between early sudden gains and competence was explored. Method: A total of 37 novice therapists were evaluated for competence and adherence using the ACT Adherence Scale. Two randomly selected sessions for each novice therapist were included in the sample (n = 74 sessions). The ratings were then analyzed in relation to the treatment results and early sudden gains. Results: The results reflected significant correlation between competence and adherence and the treatment result on the BDI-II (r = .37, p = .013 and r = .39, p = .009, respectively). However, only competence ratings were associated with larger early changes (r = .31, p = .032). In explaining the variation in treatment outcome, competence significantly contributed to the model only, when early sudden gains were not included. Conclusions: These preliminary results suggest that novice therapist competence is associated with outcome in a brief intervention for depression, but early sudden gains can explain more variation than competence.

19. Investigating the Psychometric Properties of the Values Wheel with a Clinical Cohort: A Validation Study

Primary Topic: Clinical Interventions and Interests
Subtopic: Values, ACT
Kate Barrett, University College Dublin
Martin O'Connor, University College Dublin
Louise McHugh, University College Dublin

Background: Previous research demonstrated the psychometric properties of a novel, idiographic values-measure: the Values Wheel (VW). This study reports on the psychometric properties of the VW with a clinical cohort. Method: Fifty-one adult clients who were engaged with the mental health services attended an assessment session comprising a battery of questionnaires measuring mental health, well-being, life satisfaction, ACT processes, as well as a values card sort task and the VW. Results: The VW demonstrated partial evidence of structural validity, such that scores were positively related to well-being and life satisfaction outcomes, and negatively related to depression. Significant positive correlations were observed with alternative values-measures, suggesting the VW demonstrates good convergent validity. The discriminant validity of the VW was partially supported, as no significant correlations with two unrelated constructs were found. Evidence for the incremental validity of the VW was also indicated, as scores accounted for unique proportions of variance in well-being and life satisfaction outcomes, beyond psychological flexibility alone. Conclusions: Outcomes provide preliminary support for the psychometric properties of the VW with a clinical population.

20. A couple's crossroad: a new way of conceptualizing couples integrating ACT and FAP

Primary Topic: Clinical Interventions and Interests
Subtopic: couple
Katia Manduchi, Private Practice
Domenica Pannace, Psychologist - Psychotherapist, Private Practice
Lorenzo Pellegrini, Psychologist - Psychotherapist, Private Practice

We introduce a new way of conceptualizing couples integrating ACT and FAP. This is possible because both models refer to functional contextualism and because functions, in behavioral analysis, facilitate the conceptualization of the case. In fact, the clinically relevant behaviors (CRB) identified through the FAP can be complementary to the Hexaflex. The six processes of psychological inflexibility can prevent the person from noticing and moving in the direction of "what is important", both individually and in the couple relationship, as well as in the therapeutic relationship. We will present two cases with couple problems that have allowed the development of a model of conceptualization of the couple following a third-generation approach of Cognitive Behavioral Therapy. Using ACT we have conceptualized the cases with the application of the Hexaflex for each partner, for the couple and for the complete situation (he-she-couple). The integration of the FAP (Functional Analytic Psychotherapy) model with the Hexaflex for the couple allowed to conceptualize the clinically relevant behaviors of the couple (CRB) and of the therapist (T) in session.

21. Nonsuicidal Self-Injury and a Multidimensional Assessment of Psychological Inflexibility: Concurrent and Prospective Associations

Primary Topic: Clinical Interventions and Interests
Subtopic: Nonsuicidal Self-Injury
Katie Callahan, B.A., University of Baltimore
John J Donahue, Psy.D., University of Baltimore
Shane Stori, B.A., University of Baltimore

Background: Nonsuicidal self-injury (NSSI) is a form of behavioral dysregulation reflecting the intentional destruction of bodily tissue without suicidal intent and has been suggested to serve an experiential avoidance (EA) function. However, EA is one psychological inflexibility facet, and while research supports the association between EA and NSSI (Armey & Crowther, 2008; Bentley et al., 2015), limited research has examined NSSI in relation to the broader psychological inflexibility construct. The primary aim of this study was to examine concurrent and prospective associations between psychological inflexibility and NSSI. Method: Participants with a history of NSSI (N = 106) completed measures of NSSI, psychological inflexibility, negative urgency, and depression at baseline, and three months later (N = 85). Results: Preliminary multivariate analyses suggest psychological inflexibility concurrently predicts NSSI recency (∆R2 = .04, p = .028), and longitudinally predicts NSSI intent (∆R2 = .07, p = .01), over-and-above established predictors. Dimensions of psychological inflexibility in relation to differing NSSI functions will also be explored. Discussion: Results will be discussed in relation to the utility of the psychological inflexibility model in understanding NSSI.

22. Psychological flexibility moderates the relationship between negative affect and alcohol use

Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use, Alcohol Use, Psychological Flexibility
Kaylie Green, B.A., Pacific University
Joshua Kaplan, M.S., Pacific University
Andi M. Schmidt, M.Sc., Pacific University
Ashley Eddy, B.A., Pacific University
Candice Hoke Kennedy, M.S., Pacific University
Michael S. Christopher, Ph.D., Pacific University

Background: Problematic alcohol consumption has drawn attention within the field of contextual behavior science. Negative affect is a risk factor for problematic alcohol use. Research has suggested psychological flexibility may decrease problematic alcohol use, but it is unclear whether psychological flexibility can mitigate the impact of negative affect on alcohol use. Method: The current study investigated whether psychological flexibility moderates the relationship between negative affect and alcohol use in a representative sample of alcohol using American adults (N = 394), who were instructed to complete the Positive and Negative Affect Schedule Short Form (PANAS-SF) (Watson, Clark, & Tellegen,1988), Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT) (Francis, Dawson, & Golijani-Moghaddam, 2016), and the Alcohol Use Disorders Identification Test Self-Report Version (AUDIT) (Saunders, Aasland, Babor, De la Fuente, & Grant, 1993). It was hypothesized that participants high in psychological flexibility will display weaker relationships between negative affect and alcohol use than those with low psychological flexibility. Results: The interaction between negative affect and alcohol use was tested using bias-corrected bootstrapping based on 10,000 resamples and generated a confidence interval that did not contain zero (LCI= -.323, UCI= -.104), providing evidence for moderation (β= -.213 SE = .056, p < .001). Discussion: Psychological flexibility may protect against the development of problematic alcohol use among those who experience elevated negative affect. Potential clinical implications for addressing problematic alcohol use will be discussed.

23. Effects of Dyadic Coping and Psychological Flexibility on Stress in Parents of Children with Disabilities

Primary Topic: Clinical Interventions and Interests
Subtopic: Disability, Parents, Dyadic Coping, Psychological Flexibility, Stress
Kristen Maglieri, Ph.D., National University of Ireland, Galway
Denis O’Hora, Ph.D., National University of Ireland, Galway
Brian Hughes, Ph.D., National University of Ireland, Galway

Background: Despite the many challenges parents of children with disabilities face, some parents’ cope well with these stressors. Such parents are known to employ a range of coping strategies, but it is less clear how much support parents provide to one another (dyadic coping) and the impact this has on each partner’s health and wellbeing. The current study investigated the effects of dyadic coping and psychological flexibility on the wellbeing of mothers and fathers of children with disabilities. Method: In a sample of mothers and fathers (n =385), four hierarchical multiple regressions tested whether dyadic coping predicted stress and outcome variables over and above established predictors. Using the Actor-Partner Interdependence Model, a dyadic data analysis on couples’ data (n = 57), examined the specific actor-partner effects of dyadic coping, stress, and psychological flexibility on stress, physical health symptoms, depression and anxiety. Results: Dyadic coping explained additional variance over and above several predictors for stress and depression, but not for physical health and anxiety. Specific gender effects of positive dyadic coping were observed for men on stress, depression and anxiety. Finally, dyadic analysis revealed a significant actor-partner relationship for psychological inflexibility on stress for both mothers and fathers. Discussion: These findings indicate the relevance of the couple in understanding and treating stress in parents of children with disabilities. Dyadic coping influences stress and depression and positive dyadic coping is an important coping mechanism for men. Psychological inflexibility negatively affects one’s partner’s stress, possibly due to a failure to provide coping resources.

24. Mindfulness and Couple Conflict De-Escalation: Using a brief mindfulness exercise to decrease arousal and negative affect in couples

Primary Topic: Clinical Interventions and Interests
Subtopic: Couple Therapy, Mindfulness, Conflict/Aggression
Kyle Horst, Ph.D., CSU CHICO
Paige Roberts, CSU CHICO
Mary Parker, CSU CHICO
Allison Urban, CSU CHICO

Few practical tools exist to aid couples in the de-escalation of conflict. Despite the growing body of research demonstrating the effectiveness of mindfulness-based treatments for a variety of issues, there is little to no evidence suggesting the use of mindfulness for couple conflict. This poster will outline a study of the impact of a brief mindfulness exercise on couple conflict. Study participants consisted of 10 couples who were asked to participate in a brief conflict discussion. Midway through this conversation, couples were asked to participate in a 10 minute mindfulness exercise. After the exercise couples were asked to continue their original conflict conversation. Couples were measured for negative affect, conflict resolution tactics, and other related couple process outcomes using both observational coding (Rapid marital interaction coding system (RMICS) and psychophysiological methods (facial electromyography (EMG) and skin conductance). Results indicate that the brief mindfulness exercise reduced levels of negative affect . These results indicate a potential utility of using mindfulness with couples in conflict.

25. Influence of personality traits and cognitive flexibility on the confidence of speaking in public

Primary Topic: Clinical Interventions and Interests
Subtopic: Personality traits, confidence of speaking in public and Psychological Inflexibility
Laura Acuña, European University of Madrid, Spain
Lidia Budziszewska, European University of Madrid, Spain

Background: Anxiety and fear when speaking in public is one of the most frequent problems among the university population. The lack of confidence to speak in public correlated positively with neuroticism and negatively with extraversion. Literature speaks only of these two personality traits. No others have been explored. This study wants to identify the relationship that exists between personality traits, the confidence of speaking in public and the experiential avoidance of university students of Madrid, Spain. Method: Measures of psychological infexibility or experiential avoidance Acceptance and Action Questionnaire II (AAQ-II) (Bond et al., 2011) Measures of Personality traits: NEO Revised Personality Inventory or NEO PI-R (Costa & McCrae, 1999). Measures of Confidence as Speaker: The shortened Spanish version of the Personal Report of Confidence as Speaker, PRCS (Hidalgo, Inglés & Méndez, 1999) Results and discussion: 1. The lack of confidence to speak in public correlates positively with the personality trait Neuroticism and negatively with Extroversion. 2. Cognitive inflexibility correlates positively with the trait Neuroticism, and negatively with the feature extraversion, openness to experience and agreeableness. 3. The personality trait Neuroticism is one of the dimensions of the personality that maintains a significant association and positive correlation with the difficulty to speak in public and cognitive inflexibility. It means that a person with difficulty speaking in public will have cognitive inflexibility. 4. Females reported higher psychological infexibility than males. Females also showed greater difficulty in speaking in public than men.

26. Assessing the efficacy of an ACT hybrid intervention for anxiety disorders and the added value of a weekly phone call: Preliminary results from a randomized controlled trial

Primary Topic: Clinical Interventions and Interests
Subtopic: Anxiety, Psychological Flexibility, Mindfulness, Acceptance and Commitment Therapy
Lauriane Lapointe, D.Ps. Candidate, Université du Québec à Trois-Rivières
Joel Gagnon, Ph.D. Candidate, Université du Québec à Trois-Rivières
Guillaume Foldes-Busque, Ph.D., School of Psychology, Université Laval
Nadia Gagnon, M.Ps., Integrated Center of Health and Social Services of Chaudière-Appalaches
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières

One-third of the general population will be affected by an anxiety disorder in their life. An increasing number of studies demonstrates the benefits of Acceptance and Commitment Therapy (ACT) in the treatment of anxiety disorders, but more studies are needed to assess the efficacy of ACT in various formats. This research sought to analyse the preliminary results from a 12-weeks ACT hybrid intervention (group therapy combined with a web-based component) on anxiety symptoms and psychological flexibility, and to verify if a weekly phone call to assist patients in their learning of web-based material would improve outcome. 58 outpatients suffering from anxiety disorders were randomly assigned to one of three conditions: ACT hybrid intervention supplemented by 6 weekly phone calls (n=24), ACT hybrid intervention (n=15) and waiting list (n=19). Mixed ANOVAs revealed a significant interaction effect between active conditions and time for anxiety symptoms (Hospital Anxiety and Depression Scale; F(2,55)=8.17, p=.0008, η2G=.068) and psychological flexibility (Acceptance and Action Questionnaire; F(2,55)=3.76, p=.030, η2G=.034). Post-hoc comparisons indicated that, compared to the ACT hybrid intervention without phone calls and the waiting list, participants in the ACT hybrid intervention with phone calls reported a significant reduction in anxiety symptoms and a significant increase in psychological flexibility. These preliminary results support the potential efficacy of an ACT hybrid intervention for anxiety and highlights the incremental value of a therapeutic contact during such interventions. The limitations of the study, the implications for the elaboration of hybrid interventions, and future development of this project are discussed.

27. Can technology distance us from our emotions?: An investigation into biofeedback and ACT for stress recovery

Primary Topic: Clinical Interventions and Interests
Subtopic: Stress
Leticia Martinez Prado, Ph.D., IE University, IEU Wellbeing Centre
Masa Micunovic, IE University

Stress is often thought to be merely a routine part of everyday life. However, many are unaware of how detrimental failure to recover from stress can be - both to one's mental and physical health. This has even more relevance nowadays, with most people living faster paced and highly stressed lifestyles. There has been strong evidence to suggest that both biofeedback and ACT are effective in managing and reducing stress in a variety of populations. Although, notably there is far more research focused on biofeedback than on ACT. In order to explore the effectiveness of these approaches to stress recovery and cognitive diffusion, this study used three groups of ten students each to administer different tools through stress management workshops. The first group received a biofeedback workshop, the second an ACT workshop, and the third a combined approach. The study highlights the value of both approaches to stress recovery, demonstrating that both biological and psychological tools can be useful. However, the study also indicates that a combined approach is most effective for stress recovery and cognitive diffusion, and thus supports the movement towards more holistic and empirically sound therapies. The study also suggests that in this ever-evolving technological society, technology can actually provide an additional form of treatment and stress management, alongside more contextual therapies such as ACT.

28. ACT in crisis intervention: A critical review

Primary Topic: Clinical Interventions and Interests
Subtopic: Crisis Intervention
Lidia Budziszewska, European University of Madrid, Spain
Pablo Ruisoto, University of Salamanca

Recently number of lab-controlled studies in ACT have multiplied supporting the validity of the core therapeutic processes of ACT (A-Tjak, Davis, Morina, Powers, Smits, & Emmelkamp, 2015), but more naturalistic approaches such as brief interventions in crisis remains a challenge, although successful experiences keep building up (Stroshal, Robinson, Gustavsson, 2012). For example, brief interventions working with former child soldiers, street children and victims of violence (Dahl, 2011, 2012). Two main reasons justify this study: first, dose/effect studies have found that most change in therapy happens before session (Strosahl, 2010); second, some context, such as currents interventions with refugees. The aim of this paper is twofold: 1) to critically review studies focused on brief interventions for high distress situations outlining key principles of brief ACT intervention in crisis, and 2) to review the available data about its efficacy and effectiveness. Key concepts, such as suffering and change, and the relevance of developing value-based brief interventions in multicultural contexts with limited funds. Hopefully, this study will foster new efforts to increase public investment to address crisis.

29. The role of psychological (in)flexibility when facing highly stressful situations

Primary Topic: Clinical Interventions and Interests
Subtopic: Crisis Intervention
Lidia Budziszewska, European University of Madrid, Spain
Pablo Ruisoto, University of Salamanca

Background. The current humanitarian crisis in Mediterranean countries and its psychological consequences demand an affective answer. In recent decades, a large number of lab-controlled studies have supported the validity of psychological inflexibility as a core therapeutic processes involved in psychopathology and acceptance and commitment therapy. However, a more naturalistic approaches such the importance of this process while coping with highly stressful situations or humanitarian crisis remains understudied, although successful experiences keep building up. The aim of this paper is to critically review studies focused on process-based brief interventions for high distress situations outlining their key principles. Methods. A systematic review of full-text articles published in English in the last decade was conducted from Web of Science, using psychological inflexibility, stress, and crisis as keywords. Results. Results indicate first, that according to dose/effect studies, most change in therapy happens before session; second, that psychological flexibility may play a protective role when coping with highly stressful situations and humanitarian crisis. Key concepts, such as suffering and change, and the relevance of developing value-based brief interventions in multicultural contexts with limited funds, instead of expensive pathology centered long-term therapy will be further discussed underlying differences with biomedical model approach. Hopefully, this study will foster new efforts to increase public investment to address crisis.

30. An integrated treatment planning model for the simultaneous treatment of complex patients with multiple comorbidities

Primary Topic: Clinical Interventions and Interests
Subtopic: Treatment Planning
Lori Eickleberry, Ph.D., ABPP, Institute for Life Renovation, LLC
Christina Doro, Psy.D., Institute for Life Renovation, LLC
Rachael Unger, Psy.D., Institute for Life Renovation, LLC
Amy Simler, Psy.D., Motivational Institute for Behavioral Health, LLC
Courtney Purdy, Psy.D., Institute for Life Renovation, LLC
Huda Abu-Suwa, M.S., Nova Southeastern University

Background: Recommended treatment planning for individual outpatient treatment of patients often includes a biopsychosocial and treatment targeting specific goals or outcomes pertaining to a few problem areas. Little research or guidelines have been presented for systematic methodology for treatment planning of highly complex patients presenting with multiple comorbidities in need of individualized, intensive, and integrated outpatient care. An individualized comprehensive intensive outpatient program for complex patients that has demonstrated effectiveness with complex cases outlines treatment planning methodology for treating these complex cases. Method: Existing treatment planning models have been adapted for the simultaneous treatment of multiple disorders and problems using a model of integrated care. Flow-chart diagrams are presented and highlighted with case examples. Results: Results indicated significant decreases in Beck depression Inventory (BDI) scores (t=4.96, p<.001), and State-Trait Anxiety Inventory (STAI) state (t=4.90, p<.001) and trait scores (t=5.70, p<.001). Significant increases were found in quality of life measured by the Quality of Life Inventory (QOLI) overall t-scores (t=-6.10, p<.001) and skills measured by the Five Factor Mindfulness Questionnaire (FFMQ) observe (t=-3.22, p=.006), describe (t=-3.01, p=.009), act with awareness (t=-3.05, p=.008), nonjudge (t=-3.39, p=.004), and nonreact (t=-2.69, p=.02) scores were also found. Discussion: Published observations about treatment planning are limited. Effective treatment planning of complex cases is especially multifaceted and intricate. While this provides methodology for systematic treatment of complex patients with multiple comorbidities and problems, more research is needed to validate the extent of its effectiveness and to continue to evolve its utility.

31. Development and analysis of ACT/RFT-based Group and Brief Individual Interventions for a Rheumatology population

Primary Topic: Clinical Interventions and Interests
Subtopic: Anxiety, depression, rheumatology, brief intervention, group intervention
Lorraine Maher-Edwards, CPsychol, Guys and St Thomas NHS Trust
Alex Quigley, ClinPsy, Guys and St Thomas NHS
Nora Ng, Guys and St Thomas NHS Trust

Background: Psychiatric comorbidities are common in patients living with rheumatological conditions (estimates suggest 20-25% point prevalence of depression and anxiety). Moreover, baseline and persistent symptoms of affective disorders are associated with poorer health outcomes and treatment response in these patients (Matcham et al., 2016). A recent systematic review concluded that, in this population, mood disorders are difficult to treat and the evidence base for psychological intervention is poor (Feist et al., 2017). Psychological inflexibility has been shown to be associated with poorer function and psychological wellbeing in chronic pain populations and more recently juvenile idiopathic arthritis (Feinstein et al., 2011) specifically. No studies have examined the effects of contextual based interventions for a rheumatology population. Methods: Rheumatology Patients with a variety of diagnoses received an ACT/clinical RFT based group intervention (6 weeks 3.5 hours/week) OR a 6-session one to one brief intervention with an experienced ACT-therapist. Participants completed a number of questionnaires including Chronic Pain Acceptance Questionnaire-8 (CPAQ-8), work and social adjustment scale, mood measures, and the COMPACT measuring psychological flexibility. Results: The Reliable Change Index/Clinically significant change (RSI/CSC) method was used to compute individual scores for 10 participants who attended the group treatment and 10 who attended brief interventions (Jacobsen & Truax, 1991). Individual and summary effect sizes and scores will be presented in tabular and tramline graph format. Discussion: Format and efficacy of these 2 ACT/RFT-based interventions will be discussed and implications for development of Psychology Services for Rheumatology populations and directions for research will be discussed.

32. Journeys of recovery from alcohol dependence: a thematic analysis of personal accounts viewed through the lens of CBS
Applying ACT to Addictions SIG Sponsored
Primary Topic: Clinical Interventions and Interests
Subtopic: Addiction
Lucy Dorey, University of Southampton
Judith Lathlean, University of Southampton

Semi-structured interviews were conducted with twenty-four participants who completed alcohol detoxification, at several points over a year. Participants were asked about the changes they had made, and specific examples of change were elicited. Interviews were analysed using thematic analysis, and principles compatible with a contextual behavioural perspective were used to develop a theoretical model of change. Active change often followed a crisis event, and involved changes in awareness, behaviour and decision making towards three common purposes: not drinking, day to day living and facing problems. Professional, family and peer-group relationships were central to this process, providing opportunities to open up, validation of expressions of vulnerability, and experiences of commonality with others. New `rules’ were adopted in order to initiate abstinence, which involved avoiding alcohol and triggers; avoidance based rules were gradually replaced by those that led to engagement with rewarding aspects of living. Contextual behavioural science combined with personal accounts of recovery offers insight into common processes of change underlying recovery from alcohol dependence across different routes to recovery; these processes warrant further research.

33. The Efficacy of Cultivating Self-Compassion (a healthy way of relating to oneself motivated by a desire to help not harm)

Primary Topic: Clinical Interventions and Interests
Subtopic: Self-compassion
Madeleine Ferrari, D.Clin.Psy., Ph.D. Candidate, The University of Sydney and Australian Catholic University
Caroline Hunt, The University of Sydney
Ashish Harrysunker, Australian Catholic University
Maree J. Abbott, The University of Sydney
Alissa P. Beath, Macquarie University
Danielle A. Einstein, Macquarie University

Background/ Objectives: Self-compassion is a healthy way of relating to one’s self motivated by a desire to help rather than harm. Novel self-compassion based interventions have targeted diverse populations and outcomes. This meta-analysis identified randomized-controlled trials of self-compassion interventions, and measured their effects on psychosocial outcomes. Methods: This meta-analysis included a systematic search of six databases, and hand-searches of the included study’s reference lists. Twenty-eight randomized-controlled trials that examined validated psychosocial measures for self-compassion based interventions met inclusion criteria. Pre-post and follow-up data was extracted for the intervention and control groups and study quality was assessed using the PRISMA checklist. Results: Self-compassion interventions led to significant improvement across 11 diverse psychosocial outcomes compared to controls. Notably, the aggregate effect size Hedge’s g was large for measures of eating behavior (g = 1.76) and rumination (g = 1.37). Effects were moderate for self-compassion (g = 0.75), stress (g = 0.67), depression (g = 0.66), mindfulness (g = 0.62), self-criticism (g = 0.56), and anxiety (g = 0.57) outcomes. Further moderation analyses found that the improvements in depression symptoms continued to increase at follow-up, and self-compassion gains were maintained. Results differed across population type, and were stronger for group over individual delivery methods. Intervention type was too diverse to analyze specific categories and publication bias may be present. Discussion: This review supports the efficacy of self-compassion based interventions across a range of outcomes and diverse populations. Future research should consider mechanisms of change.

35. Study Protocol and Preliminary Findings from a One-Day ACT Workshop for Emotional Eating

Primary Topic: Clinical Interventions and Interests
Subtopic: emotional eating
Mallory Frayn, Ph.D. Candidate, McGill University
Sabrah Khanyari, McGill University
Bärbel Knäuper, Ph.D., McGill University

Emotional eating is the tendency to overeat in response to negative emotions and has been linked to both physical health concerns and psychological distress, regardless of weight status. However, emotional eating has only been addressed in the context of weight loss programs, so emotional eating interventions are not available for those who do not struggle with weight. The present study aimed to test the feasibility and acceptability of a one-day ACT workshop that teaches skills to reduce emotional eating regardless of weight. The workshop was delivered in a single day (~ 6 hours) and aimed to reduce emotional eating by improving values clarification, acceptance, and mindfulness. Preliminary results suggest both feasibility and acceptability; participants described appreciating the brevity of the program and its applicability to their everyday lives. Decreases in emotional eating were also observed at 2 weeks and 3 months post-intervention. The results from this study can be used to inform a larger scale randomized controlled trial (RCT) to determine the efficacy of the program in a larger sample.

36. Can self-compassion protect against the impact of early shame and safeness memories on later depressive symptoms and safe affect?

Primary Topic: Clinical Interventions and Interests
Subtopic: Emotional memories
Marcela Matos, Ph.D., Center for Research in Neuropsychology and Cognitive and Behavioural Interventions (CINEICC), University of Coimbra
Stanley R. Steindl, Ph.D., Compassionate Mind Research Group, University of Queensland
Alison Creed, Compassionate Mind Research Group, School of Psychology, University of Queensland

Background: Psychological interventions that aim to promote compassion have gathered support for their effectiveness in the treatment of psychopathology. Compassion focused therapy (CFT), in particular, is a promising treatment for depression, especially for patients presenting high levels shame. CFT works to cultivate compassion competencies and reduce fears of compassion, to promote mental health and positive affect, and alleviate distress. Although there is empirical support for the association between fears of compassion, early emotional memories and depression, this study aims to explore the role of compassion competencies in these associations. Method: 223 participants recruited from the general population completed self-report questionnaires measuring traumatic qualities and centrality of shame memories, early memories of warmth and safeness, compassion for others, from others and self-compassion, and depressive symptoms and safe affect. Results: Results revealed that shame memories’ traumatic qualities and centrality to identity were positively correlated with depressive symptoms and negatively with safe affect, compassion from others and self-compassion, while early memories of warmth and safeness were negatively correlated with depressive symptoms and positively with safe affect and self-compassion. Self-compassion had the strongest correlations with depressive symptoms and safe affect. Path analysis revealed self-compassion as the only significant mediator on associations between early emotional memories, depressive symptoms and safe affect. Discussion: Targeting shame memories directly is important, however the current study supports the added benefit of developing compassion competencies, and therefore developing the compassionate self, to reduce depressive symptoms and enhance safe positive affect.

37. Would YOU buy a used car from this man? Teaching deception to autistic children

Primary Topic: Clinical Interventions and Interests
Subtopic: autism
Maria Josè Sireci, Università Kore di Enna
Francesca Mongelli, Università Kore di Enna
Martina Leuzzi, Università Kore di Enna
Siana Saddemi, Università Kore di Enna
Giovambattista Presti, Università Kore di Enna

Background: Individuals diagnosed with autism spectrum disorder (ASD) show severe deficits in understanding deceptions, both in the ability to lie to others and in the ability to understand when someone lies. Method: The study used multiple exemplar training to teach the generalized skill of identifying deceptive comments and responding appropriately to them to two subjects diagnosed with ASD (F. 9 yrs and B. 8 yrs). In a baseline phase interspersed during natural environment training (NET) sessions, a more natural form of utilizing ABA conducted in the child's typical environment, 8 deceptive comments were proposed by ABA trained therapists without offering any feedback after each child's response. In the training phase, therapists proposed four misleading comments in the same setting as baseline, offering social reinforcements after a correct answers and a prompt in the form of a question-guide for an incorrect answer. In the post-training phase, the comments proposed in baseline were re-tested. Results: Increasing trends in the data on first trials of novel deceptions were used as the primary indicator of the desired behavior change. Results show a rapid increase in the frequency of correct responses and generalization of the trained repertoire in the natural environment was also observed. Discussion: This pilot study extends the results of Ranick, Persicke, Tarbox , & Kornack (2012) to another language and social environment. These encouraging results provide further evidence that non-literal language deficits can be remediated using simple behavioral teaching procedures such as the provision of rules and multiple exemplar training.

38. What is said is not what is meant: Teaching irony to autistic kids

Primary Topic: Clinical Interventions and Interests
Subtopic: autism
Maria Josè Sireci, Università Kore di Enna
Francesca Mongelli, Università Kore di Enna
Martina Leuzzi, Università Kore di Enna
Siana Saddemi, Università Kore di Enna
Giovambattista Presti, Università Kore di Enna

Background: Individuals diagnosed with autism spectrum disorder (ASD show difficulties in using and understanding irony and sarcasm because the meaning is the opposite of what is said. Method: This study used rules, video clips, and in vivo training in multiple exemplars to teach two highly functioning children with autism (B. 8 years and F .9 years) to detect and respond appropriately to sarcastic comments. At baseline, 3 sarcastic and 3 real comments were embedded into a conversation, without giving any feedback or prompt, if a correct or incorrect response was given. Only when the children did not respond the therapist checked the listener behavior by saying “Have you heard what I have said?” or other similar comments. Short videos were showed in the training phase using sarcastic/real comments. The child was then asked to identify if the comment was sarcastic or real and every correct answer was followed by a social or tangible reinforcer. A correction procedure was implemented when the child failed. Results: A rapid increase in the frequency of correct response between baseline and treatment. Generalization of the trained repertoire was observed in the natural environment and across people, by including two people in post-training sessions who were never present during training. Discussion: Data extends Persicke, Tarbox, Ranick & St. Clair (2018) results to a new language and social environment. These encouraging results provide further evidence that non-literal language deficits can be remediated using simple behavioral teaching procedures such as the provision of rules and multiple exemplar training.

39. Involving in parenting practices in a more active and flexible way: Study on the Parental Acceptance and Action Questionnaire (PAAQ)

Primary Topic: Clinical Interventions and Interests
Subtopic: Parenting
Marina Cunha, Ph.D, ISMT - Coimbra, Portugal; CINEICC - University of Coimbra
Ana Xavier, Ph.D., CINEICC - University of Coimbra; Oporto Global University
Ana Galhardo, ISMT - Coimbra, Portugal; CINEICC - University of Coimbra
Adeline Navega, ISMT- Coimbra

Background: During childhood years, parents face several transitions and challenges with their children. Although these developmental transitions are normative, they may also be difficult. Experiential avoidance (EA) may occur in parenting context when parents are unwilling to experience psychological distress and make deliberate efforts to avoid, stop, minimize or control that emotional distress. Literature shows EA have a negative impact on both parents and children and their interaction, thus it seems important to identify the presence of EA. This study aims to explore the factor structure of the Parental Acceptance and Action Questionnaire (PAAQ), which assess parental EA when confronting with negative emotions of their children, and to analyse its psychometric properties in a sample of Portuguese parents of school-aged children. Method: The sample includes 381 parents (350 women and 31 men). All participants completed the following self-report questionnaires: PAAQ; Acceptance and Action Questionnaire; Depression, Anxiety and Stress Scales; Strengths and Difficulties Questionnaire. Results: The Portuguese version of the PAAQ showed a bi-factor structure similar to the original one (Inaction and Unwillingness) with satisfactory internal consistencies for both subscales. An adequate test-retest reliability for one-month interval was found. PAAQ revealed a significant positive association with experiential avoidance, negative emotional states and the perception children’s psychological difficulties. Discussion: Despite some limitations, this study highlights the importance of assessing EA in the parenting context (when dealing with children’s negative emotions). Our results may encourage further studies for development and refinement of psychological assessment tools in parenting context.

40. Fight with Mike: Bobo Doll experience to increase psychological flexibility

Primary Topic: Clinical Interventions and Interests
Subtopic: ACT
Matteo Giansante, IRCSS Don Calabria Sacro Cuore Hospital Negrar Italy
Giuseppe Deledda, IRCSS Don Calabria Sacro Cuore Hospital Negrar, Italy
Dr.ssa Sara Poli, IRCSS Don Calabria Sacro Cuore Hospital Negrar, Italy
Eleonora Geccherle, IRCSS Don Calabria Sacro Cuore Hospital Negrar, Italy

The experience of the "standing doll", called Bobo Doll, can be very useful in clinical practice with facing life with some degree of psychology and inflexibility pugnacity. Already tried by Bandura and collaborators in the 1960s to study behavior childish, the Bobo Doll, which we will call Mike, can also be a valid ally in the third-generation behavioral psychotherapy. In line with the ACT (Acceptance and Committment Therapy) therapy, every living being, in fact, tries to instinctively escape the internal experience of suffering by implementing strategies of avoidance. The struggle, however, does nothing but create further emotional suffering by adding to the clean pain (biological) also considerable psychological suffering (dirty pain). This suffering is often linked to a shrinking of the customer's behavioral buffet compared to its own sphere of values. Mike offers a series of experiential exercises through which it is possible to conduct ours patient through all the six processes of ACT therapy, to achieve greater flexibility functional mental to the management of stressful events such as chronic pain. Starting from creative hopelessness the patient can recognize the uselessness of the fight against pain or emotions such as the anger in the goal of creating a life worth living.

41. Function over Form: Experiential Avoidance Explains Difficulties on Two Stressful Tasks Beyond DSM Symptoms

Primary Topic: Clinical Interventions and Interests
Subtopic: Experiential avoidance, anxiety disorders
Meaghan Lewis, Western Michigan University
Amy Naugle, Western Michigan University
Tabitha DiBacco, Western Michigan University
Kyra Bebus, Western Michigan University
Allie Mann, B.S., Western Michigan University
Karissa Scholten, Western Michigan University
Sydney Tasker, Western Michigan University

Categorical models of psychopathology commonly conceptualize in terms of topography with little attention devoted to understanding the underlying function of processes that drive common psychiatric disorders such as mood/affective and anxiety disorders. While these disorders are commonly associated with impaired functioning in many domains (e.g., problem drinking, Levin et al., 2012) the function of these behaviors may be better conceptualized as a form of experiential avoidance (Boulanger, Hayes, & Pistorello, 2010). The goals of the present study were to evaluate the predictive validity of general psychiatric symptoms including state and trait anxiety symptoms, likely anxiety/depressive disorder diagnoses, and experiential avoidance strategies in a sample of university students who completed several challenging tasks. Trait experiential avoidance predicted difficulties on these stressful tasks above and beyond state and trait anxiety, depression, and paranoia, and was predictive of increased heart rate during these tasks. Non-parametric bootstrapping analyses revealed a significant indirect effect of experiential avoidance on the link between overall distress and electing to stop the stressful tasks early. Findings will be discussed with recommendations for improving assessment and treatment of psychopathology within an experiential avoidance paradigm.

42. Self-as-Context: A Laboratory-Based Component Analysis in a Stress-Exposed Population

Primary Topic: Clinical Interventions and Interests
Subtopic: Self as Context
Megan Godbee, Macquarie University
Associate Professor Maria Kangas, Macquarie University

Background: Self-as-Context (SAC) is one of the six core components of the Acceptance and Commitment Therapy model (ACT) (Hayes, Strosahl & Wilson, 1999). SAC refers to an awareness of an enduring sense of self that is distinct from, and higher than, internal experiences such as thoughts, emotions and physical sensations. Analysis of this component has only recently begun to gain momentum, with a recent systematic review identifying seven laboratory-based studies, two intervention studies and four correlational studies (Godbee & Kangas, 2018, in press). Results were mixed and research with larger sample sizes, random allocation and assessing the effectiveness of SAC in response to internal experiences other than thoughts and pain. Method: The current study was a laboratory-based study with an undergraduate university sample (N = 105) randomly allocated to a SAC, Cognitive Restructuring (CR) or Control condition. Participants were taught the intervention strategy corresponding to their group allocation in an individualised but standardised brief therapy session. They were then asked to use the strategy while listening to an audio-recording of themselves discussing a personal, distressing event and rate their emotional distress over time. Results: Participants in the SAC group reported significantly less distress than participants in the control group, while the CR group did not differ from the control participants. Discussion: The study provided preliminary evidence that SAC is effective in reducing distress in a stress-exposed sample. Strengths and limitations of the study, particularly the use of reduction in distress as an outcome measure for an ACT intervention, are discussed.

43. ACT for Psychosis in Community-Based Mental Health Institutions

Primary Topic: Clinical Interventions and Interests
Subtopic: psychosis, group therapy
Mehmet Emrah Karadere, Hitit University Corum Training and Research Hospital
Hüseyin Şehit Burhan, Psychiatry Clinic, Karaman State Hospital

Background: in our study, our aim was to conduct a preliminary study on examining the efficacy and applicability of acceptance comitment therapy (ACT) in psychotic patients in the community based mental health center. Method: we applied ACT-based group therapy for psychosis with 18 clients in 2 groups of the mental health institution. Each groups (10 and 8 people) participated in 6 group therapy sessions for 6 weeks. Socio-demographic Characteristics Form, Acceptance and Action Form-2, PSYRATS Psychotic Symptoms Assessment Scales, and Quality of Life Scale for Schizophrenic Patients were completed. The pre and post-therapy values of the patients were compared with the pair sample t-test. Results: We worked with data from 16 people 18 patients completed the procedure. 87.5% (14) of the patients were male, the mean age was 44.44 ± 10.02 and the mean education period was 9.25 ± 3.57. 58.2% (11) of the patients were single and 43.8% (7) were married The baseline and outcome measures of the patients were statistically different between the delusions (p <0.001), AAQ (p <0.005) and life characteristics (p <0.001). There was no statistically significant difference in hallucination scale (p = 0.126). Discussion: The presence of 16 patients from 18 patients in the sessions was thought to be acceptable and feasible by 6 weeks of ACT application in psychotic patients. In addition, decreases in the AAQ, delusion and quality of life scale suggest that 6-week ACT application is effective in psychotic patients.

44. A Linguistic Inquiry Approach to the Assessment of Psychological Flexibility

Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological Flexibility, assessment
Melissa Miller, University of Louisiana at Lafayette
Emily Sandoz, Ph.D., University of Louisiana at Lafayette

Psychological flexibility seems to be an important dimension of the behavioral repertoire that involves the ability to learn and to engage in effective and personally significant behavior in the presence of unwanted private events. As it involves aspects of behavior-behavior relations between overt and covert events, however, psychological flexibility has proven difficult for the behavior analyst to directly observe. While some have suggested that qualitative self-report might eliminate bias caused by questionnaires, it does not generally lend itself to quantitative analysis at the individual or group level. Linguistic Analysis involves transforming qualitative data so that quantitative analysis is possible. This paper will present data from several attempts to create a linguistic analysis “dictionary” that will allow for direct observation and quantification of psychological flexibility. Results suggest that linguistic analysis may be a promising approach to assessing psychological flexibility and other complex aspects of the repertoire. Implications for the continued use of linguistic analysis to assess psychological flexibility and related constructs will be discussed.

45. Effect of a brief, RNT-focused ACT protocol in obesity

Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy; Repetitive negative thinking
Miguel A. Acuña, Fundación Universitaria Konrad Lorenz
Pablo Vallejo-Medina, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

Obesity is a growing health problem in the 21st century as recognized by the World Health Organization. This has led to design interdisciplinary efforts to generate interventions aimed at weight loss. However, the long-term results of these programs are limited, with the recovery of the lost weight being frequent. Acceptance and commitment (ACT) is based on the principles of accepting physical discomfort, without the need to get rid of them through the consumption of food, learning to notice that they are transitory, connecting with important values for the individual such as healthy habits. This research aims to analyze the effect of a three-session protocol based on ACT on weight loss in overweight people through a multiple baseline design across participants. Additionally, it will be analyzed the effect of the protocol on the promotion of healthy behaviors such as engaging in physical activities, as well as the acceptance of body image, experiential avoidance related to body weight and feeding, the suppression of thoughts and the increase in valued actions related to a healthy lifestyle.

46. Predictive factors of depression, anxiety and quality of life in family carers of people with dementia: The role of psychological flexibility

Primary Topic: Clinical Interventions and Interests
Subtopic: Dementia family carers
Milena Contreras, M.Sc., University of East Anglia
Eneida Mioshi, Ph.D., University of East Anglia
Naoko Kishita, Ph.D., University of East Anglia

Background: Family carers of people with dementia often experience elevated levels of depression and anxiety as well as lower levels of quality of life (QoL). Care recipient’s neuropsychiatric symptoms, their level of independence in activities of daily living (ADL) and carer’s objective burden (hours devoted to caregiving) are considered to have an impact on such important carer outcomes. However, the role of psychological flexibility has not been widely studied yet. This study aimed to investigate the impact of key care recipient’s factors (neuropsychiatric symptoms and ADL) and carer factors (objective burden and psychological flexibility assessed by Acceptance and Action Questionnaire) on carer depression, anxiety and QoL. Methods: Forty family carers with a first-degree relationship with a person with dementia (Mean age=69.60, SD=13.2; 70% female) were recruited. Results: A separate multiple regression analysis was conducted with depression, anxiety and QoL as a dependent variable. Neuropsychiatric symptoms, ADL, objective burden, and psychological flexibility were entered to the model as independent variables. Psychological flexibility was the only significant predictor of carer depression (β=.52) and QoL (β=.40). Both psychological flexibility (β=.42) and neuropsychiatric symptoms (β=.32) significantly predicted variation in anxiety. Discussions: These findings suggest that psychological flexibility may be more important in improving depression, anxiety and QoL in family carers than other potential risk factors such as ADL and objective burden. Acceptance and Commitment Therapy may have a strong potential as effective treatment for this population. Family carers with elevated anxiety may also benefit from receiving the training for managing neuropsychiatric symptoms of dementia.

47. The efficacy of RNT-focused ACT in renal patients with emotional difficulties

Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy; Repetitive negative thinking
Mónica J. Rozo, Fundación Universitaria Konrad Lorenz
Pablo Vallejo-Medina, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

Acceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of emotional distress resulting from a wide range of situations, including chronic diseases. Chronic kidney disease has a high prevalence in Colombia and in high stages requires renal replacement therapy, hemodialysis or peritoneal dialysis. These procedures usually cause multiple emotional alterations in these patients, thus decreasing their quality of life. The aim of the present study is to analyze the effect of ACT in renal patients on hemodialysis with emotional problems. For this purpose, a brief ACT protocol focused on repetitive negative thinking (RNT) specifically adapted to the characteristics and situation of these patients was designed. Subsequently, the effect of the protocol on emotional symptoms, rumination, valuable actions and quality of life was analyzed through a concurrent multiple-baseline design across 5 participants in renal replacement therapy for at least one year.

48. Pain is like a naughty pixie that gets in the way. Why should I have to stop doing things because it says no?
Pain SIG Sponsored
Primary Topic: Clinical Interventions and Interests
Subtopic: Long-term health conditions and persistent pain
Natalie Bidad, Surrey and Borders Partnership NHS Foundation Trust
Dr Lorraine Nanke, Surrey and Borders Partnership NHS Foundation Trust

ACT is a principles-based approach which works with evidence-based processes in context to promote psychological flexibility. Much evidence supporting ACT-based group interventions analyses pre-post change in outcome measures following standardised intervention. This research strategy does not directly address whether the intervention was associated with change in evidence-based processes. Furthermore, as flexibility-related processes are proposed to underlie human well-being, they are likely to be influenced by the whole range of interactions with healthcare systems, including formal intervention and informal communication. The current study was designed as an exploration of patients’ experience of living with long-term health conditions. Semi-structured interviews were conducted with 10 patients who had completed either an ACT-based resilience or mindfulness group in an NHS outpatient setting. Data were analysed using thematic analysis. Patients reported dynamic ongoing shifts in sense of agency, or the ability to do something to improve their health and well-being. Most reported increased acceptance of their condition, and willingness to experiment with different ways of engaging with their body, other people, and the healthcare system. Ambivalence in experiences of engagement with the healthcare system were reported; for some taking control over their health was associated with increased collaboration, whilst others disengaged from aspects of the healthcare system, depending on individuals’ perceptions of the workability and willingness to take the risk of acting differently. In conclusion, ACT is an agile therapeutic approach which can contribute towards meeting UK NICE guidelines for a personalised and integrative approach to the management of multi-morbidity and long-term health conditions.

49. ELIZA - A Small Protocol for Big Choices

Primary Topic: Clinical Interventions and Interests
Subtopic: Brief Intervention
Nicola Maffini, M.D., Casa Gioia Research Centre
Rob Cattivelli, Psy.D., Ph.D., Istituto Auxologico Italiano; Catholic University of the Sacred Heart

ELIZA is a short therapeutic protocol (3-4 sessions) that integrates ACT strategies (Hayes, Strosahl, & Wilson, 2012), FACT (Strosahl, Robinson, & Gustavsson, 2012) and borrowed from Behavioral Economics (choice, value, discounting, nudging), in order to model a flexible and oriented style of pragmatic success. ELIZA specifically focuses on choice as the singular behavioral and existential unit. Despite being based on the development of the Matrix ACT (Polk & Schoendorff, 2014) over time it has taken on specific characteristics such as: a) being based on the "three logics of existence" (having, doing and being), b) being structured in recurrent cycles of discrimination, c) focusing on on the functional selection of the environment. ELIZA promotes discrimination processes between what is possible and what can't to be done and facilitates the development of a realistic synthesis between these two poles. ELIZA aims at radical and immediate results favoring empowerment (cycle of control), increasing motivation by reducing ambivalence (motivation cycle), and reducing avoidance (cost cycle). Structure, perspectives and promising data are illustrated.

50. Mindfulness in archery - Can archery be used in psychotherapy?

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Nina Schulze, Neuropsychiatric Center Hamburg Germany
Peter Tonn, Neuropsychiatric Center, Hamburg
Silja Reuter, Neuropsychiatric Center Hamburg, Germany

Archery is a sport that requires a high level of attention and concentration. In addition to competitive sports, archery also includes the area of intuitive archery, which also includes aspects of mindfulness and equanimity. Archery is already used in therapy in many psychiatric hospitals in Germany. However, there is little to no research in this area. In a study including archers and non-archers, we are currently collecting data to measure whether the level of mindfulness of archers is higher than that of non-archers. This study will be completed by May and I can present the results. So far, more than 300 archers took part in the study!

51. The Meta-Analytic Evidence of Acceptance and Commitment Therapy: A Review

Primary Topic: Clinical Interventions and Interests
Subtopic: Meta-Analysis, Review, ACT
Noemi Walder, B.Sc., University of Basel
Michael Levin, Ph.D., Utah State University, USU ACT Research Group
Michael Twohig, Ph.D., Utah State University, USU ACT Research Group
Maria Karekla, Ph.D., University of Cyprus
Andrew Gloster, Ph.D., University of Basel

Over 200 clinical trials have examined Acceptance and Commitment Therapy(ACT) to date. This has led to numerous meta-analysis and reviews across various disorders and in comparisons to numerous treatments. With this critical mass of studies, it is possible to reflect upon and critically examine the fundus of knowledge in order to guide further steps in ACT research. Consequently, this poster aims to summarize and review current published meta-analysis in ACT. Method: We conducted a literature search yielding 30 reviews and meta-analyses. After a screening process, 17 meta-analysis were included in the review. Results: Most meta-analyses showed that ACT is effective for a variety of psychological and physical disorders. Meta-analyses showed small effect sizes of ACT compared to active controls; medium effect sizes compared to WL, placebo and TAU. No differences were observed across diagnoses. Discussion: Findings will be considered for their adequateness based on the ACT theory of psychological flexibility.

53. Factors Impacting Completion of a Targeted Online Acceptance-Based Behavioural Treatment for Chronic Pain

Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain
Pamela L. Holens, Ph.D., University of Manitoba
Kris Klassen, University of Winnipeg
Michelle Paluszek, University of Regina
Jeremiah Buhler, University of Manitoba
Brent Joyal, University of Manitoba

Chronic pain is a serious health issue in Canada, and its prevalence in military and police personnel is even greater than in the general population. Online psychological treatments have been growing in popularity as a means to meet the growing need to provide treatment to those suffering from disorders such as chronic pain. The purpose of this study was to determine characteristics of those more likely to complete an online chronic pain treatment program that was designed specifically for military and police personnel. The charts of 80 individuals with a military or police background who had participated in an 8-week online acceptance-based behavioural treatment for chronic pain were reviewed. Nearly 65% of those who started the online program were considered to have completed it. Seven independent variables were examined using hierarchical logistic regression to determine their impact on program completion. These variables included demographic variables as well as pre-treatment measures of pain-related concerns, depression, and posttraumatic stress symptoms. In the final model, greater age, degree of pain acceptance, and severity of depressive symptoms predicted those more likely to complete the program.

54. Values and Committed Action (Engagement) Exercises and Metaphors: A Review of ACT English Language Books

Primary Topic: Clinical Interventions and Interests
Subtopic: Metaphors, Exercises, Worksheets, Books
Emanuele Rossi, Psy.D.; Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy; Università degli Studi Guglielmo Marconi, Rome, Italy
Paola Lioce; Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy
Natalia Glauser; Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy
Francesco Mancini, M.D., Psy.D.; 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 values and committed action processes on ACT books (1999-2018) in order to outline a clear and user-friendly profile of the use of values and committed action metaphors, exercises and worksheets within them. Values and committed action processes constitute one of the three pillars of psychological flexibility: engagement. The books were divided into two groups: (1) ACT Books for professionals and (2) ACT Books for clients. An easy-to-read summary table provides a quick overview of values and committed action metaphors, exercises and worksheets. This review was conducted with the purpose of offering a universally accessible, clear and intuitive cataloging tool of practical and experiential resources for ACT learners and practitioners. For each metaphor, exercise or worksheet the summary table also provides a brief description of how it is presented and a reference to external resources. This poster related to values and committed action is part of a more general pilot project that also involved other processes of psychological flexibility and could be further extended in the future.

55. Does identifying oneself in long, online surveys reduce careless responding: A partial replication

Primary Topic: Clinical Interventions and Interests
Subtopic: Careless Responding, methods
Rachel Carlson, Metropolitan State University of Denver
Ryan Moses, Metropolitan State University of Denver
Tori Lich, Metropolitan State University of Denver
Tyler Burwell, Metropolitan State University of Denver
Maureen Flynn, Ph.D., Metropolitan State University of Denver

Sometimes participants do not answer items in online questionnaires accurately or consistently (Meade & Craig, 2012). Careless responding has been shown to misrepresent data and increase Type I and II errors (Credé, 2010; Holzman & Donnellan, 2017; Huang & Bowling, 2015; Maniaci & Rogge, 2014; McGrath, Mitchell, Kim, & Hough, 2010). As such, it is important to develop interventions that reduce careless responding. The current study is a partial replication of Meade and Craig’s research (2012), which found that participants who wrote their name on each page of an online survey answered more bogus items correctly and reported higher levels attention when completing the study. Participants in the current study consisted of 414 undergraduate students, who were randomly assigned to either an anonymous or self-identification condition. In the self-identification condition, participants were instructed to write their name at the end of each page of the online survey. Those in the anonymous condition just completed the online survey. Dependent variables included number of bogus items passed and self-reported effort and attention given to the survey. Results from a one-way MANOVA showed that there was not a significant difference between the anonymous and self-identification condition on self-reported attention or effort. Results from a chi-square distribution found no significant difference between conditions on passing all eight bogus items. There was small but significant difference between conditions on answering seven or eight attention bogus items correctly, with participants in the self-identification group answering more correctly. Further implications and limitations are then discussed.

56. Evaluating Acceptance and Commitment Therapy for Public Stigma Towards Veterans

Primary Topic: Clinical Interventions and Interests
Subtopic: Military Veterans
Robyn L. Gobin, Ph.D., University of Illinois at Urbana Champaign

Despite the wide availability of evidence-based treatments for mental disorders, many Veterans with treatable mental disorders avoid seeking treatment due, in large part, to concerns about being stigmatized by family, co-workers, and community members. Although the stigma of mental illness is a significant barrier to mental health care among Veterans, few stigma-reduction interventions have been developed targeting the public stigma that is so detrimental to Veterans' health and well-being. Ninety community members who have regular interactions with Veterans are being recruited to participate in one of two workshop conditions: Acceptance and Commitment Therapy (ACT) or a combined face-to-face contact and education intervention (C+E). All participants will complete pre- and post-workshop assessments in addition to 1-, 3-, and 6-month follow-up assessments. This presentation will describe an ongoing pilot clinical trial designed to compare how effectively the two conditions (ACT vs. C+E) reduce stigma towards military Veterans. Preliminary results from the ACT condition will be presented. Implementation challenges and successes will be discussed and implications of hypothesized findings will be addressed.

57. The Unified Model of Mindful Flexibility: A Multi-stage Process Model for Understanding Change in Treatment across the Mindfulness and ACT-based Interventions

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Ronald D. Rogge, Ph.D., University of Rochester
Jennifer S. Daks, University of Rochester
Jenna Macri, University of Rochester

OBJECTIVES: The study tested the Unified Model of Mindful Flexibility: a new model that organizes the 5 main dimensions of mindfulness and 12 main dimensions of psychological flexibility into a multistage, process-oriented framework. METHODS: A sample of 2,742 online respondents (68% female, 81% Caucasian, Mage = 42yo) completed a 30-minute online survey, and 1,905 have completed a 4-month follow-up. RESULTS: IRT analyses selected items for two new mindfulness subscales that, when added to the MPFI, created the Unified Measure of Mindful Flexibility (UMMF). A path model supported the proposed model suggesting that mindful/mindless lenses (describing thoughts/feelings, observing sensations, attentive awareness, inattention) predicted flexible/inflexible responses to uncomfortable thoughts and feelings (acceptance, defusion, self-as-context vs. experiential avoidance, fusion, self-as-content), which predicted life-enriching/diminishing behaviors (maintaining contact with values, committed action vs. losing touch with values, becoming trapped in inaction), which predicted both current life satisfaction and depressive symptoms and change in those outcomes over 4 months. CONCLUSIONS: The findings provide a conceptual framework for understanding the processes of change in ACT. Underscoring this, a clinical example is given of using the UMMF to track clinically meaningful change with an individual client using the MindFlex Assessment System (MindFlex.org): a free online clinical tool that combines the UMMF with well-validated measures of psychological distress and well-being in a short (15-20min) online survey for clients that generates normed profiles for therapists (shown with clinical example).

58. Decreasing careless responding: The effectiveness of an intervention targeting compassion

Primary Topic: Clinical Interventions and Interests
Subtopic: Values, Compassion, Careless Responding
Ryan Moses, Metropolitan State University of Denver
Rachel Carlson, Metropolitan State University of Denver
Tyler Burwell, Metropolitan State University of Denver
Tori Lich, Metropolitan State University of Denver
Maureen Flynn, Ph.D., Metropolitan State University of Denver

Technological advances have increased the amount of data being collected using online surveys. While online data collection can be significantly faster and easier, it can also be accompanied by careless responding, which can impact the quality of data being collected (Clark, Gironda, & Young, 2003; Johnson, 2005). It is important we find ways to reduce careless responding to ensure more accurate data. The purpose of the current study was to examine whether an intervention that focused on linking a value (compassion towards strangers) to survey responding decreases careless responding. The study also aimed to investigate whether those who scored higher on a compassion towards strangers measure are more impacted by the values intervention. Approximately 581 undergraduate participants completed a series of questionnaires online, which contained attention check items (e.g., “If you are reading this item, select C”). Respondents were randomly assigned to a values group or a control condition. Those in the values condition watched a brief, 45-second video prior to completing the survey. Participants in the control condition completed the survey without watching a video. Results indicated there was not a significant difference in careless responding between participants in the values condition and those in the control group. Additionally, compassion towards strangers did not moderate the relationship between condition and careless responding. Implications and future directions will be discussed.

59. Acceptance and commitment therapy as a trans-diagnostic approach to treatment for psychological distress: A concurrent multiple baseline design across participants

Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and commitment therapy
Samuel D. Spencer, M.A., University of Hawaii at Manoa
Akihiko Masuda, Ph.D., University of Hawaii at Manoa

Alleviating the impact of mental health concerns is a primary goal within clinical psychology, and especially important for individuals within ethnic and cultural minority groups, as these individuals often tend to underutilize psychological services and experience poorer behavioral health outcomes when compared to Caucasian-Americans. These disparities are also found within Asian/Native Hawaiian/other-Pacific Islander populations, suggesting that more research is needed to adapt and transport interventions for diverse populations. Acceptance and Commitment Therapy (ACT) is an approach that seeks to increase adaptive functioning and improve values-based living for afflicted individuals. This study examined the effectiveness of a ten-week course of ACT within a culturally-diverse sample in Honolulu, Hawai’i. Participants endorsed an elevated level of experiential avoidance as measured by the Acceptance and Action Questionnaire-II (AAQ-II >26), an important transdiagnostic process underlying psychopathology. A concurrent multiple baseline design (MBD) across three participants was used to establish experimental control and track individual progress throughout the study. Daily self-report data on clinically-relevant behavioral excesses and deficits and weekly measures of ACT-specific process variables were tracked throughout the study to evaluate the effectiveness of treatment. Questionnaires measuring symptomology, quality of life, and other salient mechanisms of change were collected at pre-/mid-/post-treatment/3-month follow-up assessments. Data collection is currently ongoing, and the first and second participants in the MBD have both entered the treatment phase with preliminary data suggesting treatment efficacy. Through an in-depth analysis of participants’ progress throughout treatment, the current study aims to better understand ACT and evaluate its impact within a diverse Hawai’ian sample.

60. Individual CBT and ACT Group Therapy: A Pilot Study About Integration

Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, CBT, group therapy
Sara Di Biase, Psy.D., Associazione Culturale Studi Cognitivi Pandora, Lucca
Emanuele Rossi, Psy.D., Scuola di Psicoterapia Cognitiva, APC-SPC; AISCC
Marco Saettoni, M.D., Scuola di Psicoterapia Cognitiva, APC-SPC, Grosseto

Aims of this poster are to investigate: (a) the potential efficacy of combining individual CBT and ACT group therapy; (b) how the group therapy enhances defusion and acceptance; (c) how the group therapy influences individual therapy. Participants were administered the following measures: SCID-5-CV, AAQ-2, ASI, BDI-II, CFQ13, SF-36. At the end of the cycle (12 sessions delivered every other week), the therapists that conduct the individual therapies were asked to respond to a questionnaire about these topics: How does the group therapy influence the client’s opinion about the definition of therapeutic goals?; How does the group therapy influence the client’s opinion about the definition of therapeutic strategies? The results of this pilot study showed lower scores on clinical measures and higher scores on measures of acceptance, defusion, valued living and quality of life.

61. The role of early memories of warmth and safeness, depression and self-compassion in well-being in institutionalized adolescents

Primary Topic: Clinical Interventions and Interests
Subtopic: Depression; Self-compassion; Children; Institutionalized adolescents; Well-being
Sara Santos, Faculty of Psychology and Educational Sciences, University of Coimbra
Maria do Céu Salvador, Cognitive-Behavioral Center for Research and Intervention(CINEICC); University of Coimbra

External shame and self-criticism have been related to several indicators of psychological maladjustment. Self-compassion seems to be a protective factor in the emergence of psychopathology. This study aimed to explore, in a sample of institutionalized adolescents, the effect of early memories of warmth and safeness (EMWS) on depression and well-being. More specifically, if this relation with depression would be mediated by external shame and self-criticism, and if self-compassion would mediate, in the same model, the relationship between depression and well-being. The sample included 171 institutionalized adolescents (Mage=15.56; SD=1.49). Well-being, depression, EMWS, external shame, self-criticism and self-compassion were assessed. EMWS showed a direct effect on well-being, and an indirect effect through the mediating variables. The relationship between EMWS and depression was fully mediated by external shame and self-criticism together, and the relationship between depression and well-being was fully mediated by self-compassion. These results seems to show that the way in which the adolescents relates to themselves influences his psychological adjustment, emphasizing the relevance of compassion-focused therapies in preventive and therapeutic approaches with institutionalized adolescents.

62. Self-Compassion as a Moderator of the Relationship Between Cognitive Fusion and Anxiety in College Students

Primary Topic: Clinical Interventions and Interests
Subtopic: Anxiety
Shannon B. Underwood, B.S., University at Albany, SUNY
Eric Tifft, B.A., University at Albany, SUNY
Glenn A. Phillips, B.A., University at Albany, SUNY
Emily Padula, University at Albany, SUNY
John P. Forsyth, Ph.D., University at Albany, SUNY

Background: College students continue to report anxiety as a pervasive and inhibiting concern. In order to address to address this crisis, we must identify possible protective factors and points of intervention for these individuals. Cognitive fusion has been found to be a strong predictor of anxiety. Individuals high in cognitive fusion buy into their thoughts, feelings, and bodily sensations, rather than recognizing them as fleeting states integral to the human experience. A possible point of intervention for college students is increasing self-compassion, as self-compassion increasingly has been associated with adaptive psychological functioning. Method: A sample of college students (n=395; 69% female; Mage = 18.99, SDage = 2.36) completed a series of questionnaires as part of a larger study examining mindfulness in college students. Results and Discussion: Self-compassion was found to moderate the relation between cognitive fusion and anxiety. Individuals high in self-compassion reported significantly lower scores of anxiety, despite reporting high levels of cognitive fusion. Individuals low in self-compassion and high in cognitive fusion were found to report the highest levels of anxiety. These results highlight the protective role self-compassion can play for individuals who overidentify with their thoughts, feelings, and physical states. Implications for future research and treatment strategies will be discussed.

63. Case Presentation: ACT Matrix for a ASD

Primary Topic: Clinical Interventions and Interests
Subtopic: ASD, ACT Matrix、IRAP
Shinji Tani, Ph.D., Ritsumeikan University

ACT Matrix is a well-known useful tool for conducting ACT and is expected to be a useful therapy or psycho-education for the ASD. This research showed a case report of participant with ASD using ACT Matrix. The participant is a university student diagnosed ASD at his childhood. He has difficulties of attention-focusing and social relationships and volunteered to join our project, ACT Matrix for ASD. Four sessions which each of them lasted 1.5 hour were conducted. FFMQ, AAQ-II, CFQ were used to assess the effect of ACT Matrix and the self-esteem IRAP was conducted before and after sessions. Matrix Diagram worksheet, a hook exercise, and Verbal Aikido exercise, etc were used to introduce ACT. Self-monitoring to his behaviors relating a toward move and noticing behavior was also used. The frequency of a toward move and noticing behavior was increased through a session. The results showed that the scores of three questionnaires changed a little after the session; AAQ-II (pre; 24, post 30), FFMQ total ( pre; 109, post; 113) and CFQ (pre; 43, post 39). IRAP score also changed between pre-assessment (total D-IRAP=0.51) and post (0.10). While IRAP score of the post session showed any bias was not found among trial types, others-positive type in pre-assessment showed a significant bias (p=.036) which means denial of that others are positive. We will discuss how to introduce ACT Matrix to Japanese ASDs and the way of evaluation of it.

64. Eastern Wisdom and Western Knowledge of Mindfulness

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Stephanie Lin, B.A., Eastern Michigan University
Jennifer A. Battles, M.S., Eastern Michigan University
Tamara Loverich, Ph.D.

Background: Research suggest that mindfulness-based interventions such as ACT and MBSR are effective for treating both psychological and physical suffering. While mindfulness practices hold roots in Eastern countries that practice Buddhism, many self-report measures were derived from Western operationalizations of mindfulness. As demand for culturally relevant evidence-based psychotherapies grows, more research is also needed to understand the unique ways in which ethnicity relates to conceptualizations of mindfulness and its measurement. Our hypothesis was that Asian Americans and White participants would perceive mindfulness differently, as seen in significant differences among item endorsements. Method: Community and student participants (N= 876) completed an online battery of questionnaires including the State Mindfulness Attention Awareness Scale, Toronto Mindfulness Scale, and the Philadelphia Mindfulness Scale. Results: A series of independent t-tests were conducted comparing Asian American participants (n=108, Mage= 30.68, SD = 9.57; 35.8% Female) and White/European American participants (n= 506, Mage = 28.78, SD = 13.29; 61.9% Female) on all mindfulness measures. Asian American participants endorsed significantly lower trait awareness t(606) = -4.62, p<.001, d = .48 while also endorsing significantly more decentering t(606) = 3.577, p<.001, d = .37. No other significant differences were observed. Discussion: One’s awareness may not equate to mindfulness skills utilization and vice-versa. Additionally, important differences in how these two groups define and perceive the constructs of mindfulness may exist. Implications of these findings will be discussed as part of a larger program of study investigating the invariant measurement of mindfulness cross-culturally.

65. Cognitive fusion and experiential avoidance mediate the relationship from maladaptive perfectionism to depression and anxiety

Primary Topic: Clinical Interventions and Interests
Subtopic: Perfectionism, Depression, Anxiety
Susannah C. Johnston, Ph.D., University of Edinburgh
Christopher Hardy, M.Sc.

Background: Perfectionism presents a risk factor for depression and anxiety disorders. Current therapeutic interventions typically target the content of the perfectionistic thinking, with varying results. Viewing this issue from a contextual behavioural science approach, it can be theorised that how the individual relates to their perfectionistic thoughts is more critical than their content. Acceptance and Commitment Therapy (ACT) may therefore present a suitable therapeutic approach, yet there is little empirical evidence demonstrating whether psychological flexibility interacts with the perfectionism-clinical disorder dynamic. This study aimed to provide evidence of two key processes, cognitive fusion and experiential avoidance, being mediating factors in this relationship. Methods: A sample of 129 university students (age: 19-25 years; female: 79%) completed an online battery of validated measures, including, the Child-Adolescent Perfectionism Scale (CAPS), Cognitive Fusion Questionnaire (CFQ), Brief Experiential Avoidance Questionnaire (BEAQ), and the Depression Anxiety Stress Scale (DASS-21). Two subscale scores were extracted from the CAPS to represent maladaptive perfectionism (socially-prescribed perfectionism and critical self-oriented perfectionism). Results: Mediational analyses showed both cognitive fusion and experiential avoidance to at least partially mediate the relationship between the maladaptive presentations of perfectionism and both depression and anxiety. Cognitive fusion fully mediated the relationship between both types of maladaptive perfectionism and depression. Discussion: Findings suggest that therapy involving techniques to encourage cognitive defusion and acceptance/willingness may prove beneficial in reducing levels of depression and anxiety in perfectionistic individuals. The findings support the use of ACT as a therapeutic framework for this population.

66. Body Image Psychological Inflexibility and Aging Anxiety

Primary Topic: Clinical Interventions and Interests
Subtopic: Mental Health and Psychological Inflexibility
Synne Sandberg, European University of Madrid, Spain
Lidia Budziszewska, European University of Madrid, Spain

Background: High levels of psychological inflexibility have been associated with increased psychological vulnerability. Inflexibility in body image is likely related to aging anxiety, particularly to the physical process of aging, as such a process often is equated with decreased physical attractiveness. However, studies examining the relationship between Body Image Inflexibility and Aging Anxiety are scarce at best. This cross-sectional and cross-cultural study looked into this relationship, also determining gender differences. Method: Body image inflexibility was assessed using the Body Image Psychological Inflexibility Scale (BIPIS) (Callaghan et al., 2015). Measures of Aging Anxiety was obtained using the Anxiety About Aging Scale (AAS) (Lasher & Faulkender, 1993). Results and discussion: Body image inflexibility and aging anxiety were strongly associated. This relationship was the strongest between body image flexibility and the factor of Physical Appearance of the AAS. In relation to gender, women were in general more affected by both body image inflexibility and aging anxiety. However, women that were married or in domestic partnerships were less affected. Moreover, older adults (55 years and up) were less preoccupied with appearance and showed more body image flexibility than younger adults. However, the same group was more preoccupied with fear of loss than were younger participants.

67. Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-month Follow-up

Primary Topic: Clinical Interventions and Interests
Subtopic: Depression
Tom Østergaard, University of Oslo
Tobias Lundgren, Karolinska Institutet
Ingvar Rosendahl, Karolinska Institutet
Robert Zettle, Wichita State University
Rune Jonassen, University of Oslo
Nils Inge Landrø, University of Oslo
Vegard Øksendal Haaland, University of Oslo

Background and objectives: Depression is a highly recurrent disorder with limited treatment alternatives aimed at reducing risk of subsequent episodes. This study investigates the effect of group-based Acceptance and Commitment Therapy (ACT) following Attention Bias Modification (ABM) on residual symptoms in depression in a 12-months follow-up. Methods: This multisite study consisted of two phases. In phase 1, participants with a history of depression, currently in remission (N = 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, only participants from the Sørlandet site next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. Results: At 12-months follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. Conclusions: Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse. ABM did not augment group-based ACT treatment.

68. Psychological flexibility moderates the relationship between depressive symptoms and problematic marijuana use

Primary Topic: Clinical Interventions and Interests
Subtopic: Marijuana use and depression
Tori Lich, Metropolitan State University of Denver
Tyler Burwell, Metropolitan State University of Denver
Ryan Moses, Metropolitan State University of Denver
Rachel Carlson, Metropolitan State University of Denver
Maureen Flynn, Ph.D., Metropolitan State University of Denver

An increasing number of undergraduate students experience depressive symptoms. For example, Eisenberg, Gollust, Golberstein, and Hefner (2007) found that 13.8% of undergraduate students showed high levels of depression. Additionally, a study that surveyed over 500 university counseling center directors found that depression is a presenting concern among 34.5% of students (LeViness, Bershad, & Gorman, 2017). There is a relationship between depression and marijuana use (e.g., Crane et al., 2015; Hayatbakhsh et al., 2007). Furthermore, results from a study conducted by Dierker, Selya, Lanza, Li, and Rose (2018) showed that among marijuana users, those with depression were more likely to have marijuana use disorder symptoms and greater symptom severity than those without. Although there is a relationship between depression and problematic marijuana use, there must be moderators involved because not everyone with depressive symptoms engages in problematic marijuana use. One possible moderator may be psychological flexibility. The aim of the current study was to examine whether psychological flexibility moderates the relationship between depressive symptoms and problematic marijuana use among college students. Approximately 961 undergraduates completed an assessment battery online. Of the 961, 402 reported using cannabis in the past 6 months and were used in the subsequent analyses. Results showed that problematic marijuana use was significantly, positively, and weakly correlated with both depressive symptoms and psychological inflexibility. Additionally, psychological flexibility moderated the relationship between depressive symptoms and problematic marijuana use. Implications and future directions will be discussed.

69. Psychological Flexibility and Valued Living Predict Depression, Anxiety, Stress, Trauma Symptoms, and Satisfaction with Life across Cultural Dimensions in College Students

Primary Topic: Clinical Interventions and Interests
Subtopic: ACT Model
Troy DuFrene, California School of Professional Psychology/AIU
Lauren Griffin, University of Louisiana, Lafayette
Emily Sandoz, University of Louisiana, Lafayette

Studies have shown that psychological flexibility (PF) and valued living (VL) predict a wide range of mental health and related conditions. And in these studies, the AAQ-II and VQ are commonly used used measures of PF and VL. As a contextual therapy, ACT is theoretically well-suited to cross-cultural application. But the ACT model and its components require broader examination in culturally diverse samples. This exploratory study questioned whether a model predicting common psychopathologies and global satisfaction using PF and dimensions of VL would perform similarly among different cultural dimensions of a fairly large sample of college undergraduates. Results showed significant prediction with medium to medium-large effect sizes on common screeners for depression, anxiety, stress, and trauma, and on a global satisfaction with life measure. Effects were calculated for PF and VL interactions with sex, ethnicity, and sexual orientation. Only sexual orientation had a small yet significant interaction with PF, and only for depression, anxiety, and stress. As we anticipated, predictive effects were consistent across sex, ethnicity, and sexual identity, suggesting that model is robust to differences in cultural dimensions. Further exploration with culturally diverse samples is recommended.

70. Integrating Motivational Interviewing with Acceptance and Commitment Therapy for New Mothers of Infants Exposed to Prenatal Substance Use

Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use
Yolanda Villarreal, Ph.D., University of Texas Health Science Center at Houston, McGovern Medical School
Mackenzie L. Spellman, M.A., University of Texas Health Science Center at Houston, McGovern Medical School
Jasmin P. Wong, M.H.Ed., University of Texas Health Science Center at Houston, McGovern Medical School
Michelle R. Klawans, M.P.H., University of Texas Health Science Center at Houston, McGovern Medical School
Thomas F. Northrup, Ph.D., University of Texas Health Science Center at Houston, McGovern Medical School
Angela L. Stotts, Ph.D., University of Texas Health Science Center at Houston, McGovern Medical School

Prenatal substance use poses health risks to mothers and their infants, who often require NICU hospitalization. Mothers of NICU infants are motivated to engage in health-seeking behaviors; however, no intervention has capitalized on this to promote treatment. We propose an adapted MI+ACT intervention will be efficacious in linking this population with substance-use treatment and reproductive care. This study introduces an adapted MI+ACT intervention, via case description, from an ongoing longitudinal clinical trial. The intervention consists of three hospital-based sessions to promote NICU mothers’ motivation and psychological flexibility (PF), as measured by the Readiness Ruler (RR) and AAQ-II respectively. RR and PF scores are measured at baseline, intervention sessions, and follow-up. During baseline, the client reported a 1 on the RR, indicating a disinterest in treatment and reproductive care, and a PF score of 24. During session 1 the client stated using birth control was “killing a life.” The therapist combined MI and ACT processes across two sessions. The clients’ PF scores during treatment dropped 16 points. During session 2 the client reported a 10 on the RR, indicating high-interest in both outcomes. Before the third session the client was inpatient at a substance-use treatment facility and had an intrauterine device placed; both were facilitated by the counselor. This study presents an MI+ACT intervention for substance-using mothers of NICU infants. This case presentation addresses the gap in linking this population with treatment by highlighting the effectiveness of a combined MI+ACT intervention to capitalize on motivation and engage women in health-seeking behaviors.

71. Developing a brief Acceptance and Commitment Therapy Intervention in a Secondary School: A feasibility study

Primary Topic: Educational settings
Subtopic: Children
Emma Harris, Cardiff University
Victoria Samuel, Cardiff University
Chloe Constable, Children and Young People Service, 2GETHER NHS Foundation Trust

Background: The majority of mental health difficulties develop during childhood and adolescence, however mental health services in the UK struggle to meet demand. To help increase the mental well-being of young people, preventive mental health work in schools has been recommended. Aim: This study assessed the feasibility and acceptability of delivering a brief Acceptance and Commitment Therapy (ACT) intervention to secondary school students. Method: Ninety 12 to 13-year-old students were allocated to an ACT skills group, a Cognitive Behaviour Therapy (CBT) skills group or a control group (lessons as usual). There were three, one-hour workshops in each condition. Students completed questionnaires measuring mental health symptoms, well-being, quality of life, stress, psychological flexibility, avoidance, acceptance and mindfulness. Measures were completed at each workshop and at an eight-week follow-up. Focus groups with young people, interviews with school staff and questionnaire data from the workshop facilitators was also used to assess feasibility and acceptability of the workshops. Results: Questionnaire data indicated that at the eight-week follow-up students in the ACT group had the most favourable scores for the majority of measures, followed by the CBT group, with students in the control group having the least favourable scores. Qualitative findings found the workshops to be acceptable to staff and students and feasible to deliver within the school timetable. Discussion: Implications of findings for a randomised control trial assessing the efficacy of acceptance and commitment therapy in a school setting are discussed.

72. Cultivating Compassionate Schools: Pilot study of a compassion focused intervention to foster teachers’ emotion regulation and wellbeing

Primary Topic: Educational settings
Subtopic: Compassion-based interventions
Marcela Matos, Ph.D., Center for Research in Neuropsychology and Cognitive and Behavioural Interventions (CINEICC), University of Coimbra
Isabel Albuquerque, Ph.D., Center for Research in Neuropsychology and Cognitive and Behavioural Interventions (CINEICC), University of Coimbra
Lara Palmeira, Ph.D., Center for Research in Neuropsychology and Cognitive and Behavioural Interventions (CINEICC), University of Coimbra
Marina Cunha, Ph.D., Center for Research in Neuropsychology and Cognitive and Behavioural Interventions(CINEICC), University of Coimbra
Margarida Pedroso Lima, Ph.D., Center for Research in Neuropsychology and Cognitive and Behavioural Interventions (CINEICC), University of Coimbra
Ana Galhardo, Ph.D., Center for Research in Neuropsychology and Cognitive and Behavioural Interventions(CINEICC), University of Coimbra
Paul Gilbert, Ph.D., OBE, Centre for Compassion Research and Training, University of Derby

Background: Growing research has supported the efficacy of mindfulness and compassion-based interventions in diverse populations and contexts, particularly to the development of adaptive emotional regulation skills central to the promotion of mental health and wellbeing. Teachers present a high risk of professional stress, which negatively impacts their mental health and professional performance. In addition, there is a high prevalence of mental health problems in the school context, involving both teachers and students. Therefore it is crucial to promote adaptive cognitive and emotional processes that support teachers in dealing with the challenges of the school context and promote their mental wellbeing. This study aims at testing the effectiveness of the Compassionate Schools Program, a six module compassionate mind training (CMT) group intervention for teachers to improve wellbeing and mental health. Method: A pilot study was conducted in a sample of 41 teachers, employing a mixed-measures quantitative and qualitative design. Results: Regarding qualitative assessment, the CMT intervention was well received. Furthermore, results revealed that there were significant decreases in depression, stress, and fears of compassion to others, as well as significant increases in compassion to others, self-compassion, and compassionate motivations and actions after the CMT intervention. When self-criticism was controlled for, a decrease in burnout and an increase in satisfaction with teachers’ life were additionally found. Discussion: As a pilot study, our results demonstrate the possible benefits of CMT in education settings and suggest that the Compassionate Schools intervention is effective to promote teachers’ mental health, wellbeing and emotion regulation skills.

73. The role of social disadvantage in high school dropout: unequal futures, different processes of change

Primary Topic: Educational settings
Subtopic: Children, youth, school dropout prevention
Melissa Schellekens, Institute of Positive Psychology and Education ACU

Should all dropout prevention programs target the same processes of change, in the same way that all ACT interventions might target the process ¨experiential avoidance¨? For example, should dropout prevention programs seek to improve student confidence and exposure to educational materials, such as books and computers? Most interventions assume that the processes of change are equally influential in different subpopulations. In this research, a systematic review was conducted to examine the role of variables including socioeconomic status, self-confidence and ethnic group, in predicting high school dropout. We were interested in whether the link between self-confidence and high school dropout was moderated by the nature of the environment in which young people live, grow and learn. We found that the effect of self-confidence on dropout does appear to be moderated by the social and cultural contexts of young people. This research raises interesting questions for intervention research. Should interventions target a universal set of processes of change? Or should the active ingredients of an intervention be tailored to students´ socioeconomic status and cultural environments? For example, should confidence be an important target of change amongst advantaged but not disadvantaged youth? Future research is needed to answer these important questions.

74. Foreign language, dialogue and well-being: ACTing mindfully in higher education

Primary Topic: Educational settings
Subtopic: Well-being
Mirja Hämäläinen, M.A., Tampere University
Päivi Lappalainen, Ph.D., University of Jyväskylä

Background: Academic educators worldwide are increasingly aware of the high levels of stress and distress experienced by university students. An optional English course Dialogue: Constructive Talk at Work Tampere University will help students deal with their uncertainties in the global work market using English as a lingua franca. The course is based on David Bohm’s (1996) philosophy of dialogue, which promotes ethical thinking and being though such practices as suspending judgement, checking assumptions, inquiry, listening and voicing. Each session starts with a mindfulness session.' Methods: Students from four groups (n=70) participated in measurements of satisfaction with life, psychological flexibility, mindfulness skills and self-compassion before and after the dialogue course. SPSS and Mplus were used to analyse the quantitative data. Results: Dialogue: Constructive Talk at Work has potential to promote the well-being of university students in a higher education language pedagogy context. (Exact results are not yet available.) Discussion: Higher education language courses for working life purposes can be developed to support students’ well-being. Ethical dialogue and mindfulness provide a container for accepting awareness of being.

75. Depressive symptoms and grade point average among college students: An examination of psychological flexibility as a moderator in a largely Latino sample

Primary Topic: Educational settings
Subtopic: depression
Tyler Burwell, Metropolitan State University of Denver
Tori Lich, Metropolitan State University of Denver
Rachel Carlson, Metropolitan State University of Denver
Ryan Moses, Metropolitan State University of Denver
Maureen Flynn, Ph.D., Metropolitan State University of Denver

College students with depressive symptoms have lower grade point averages (GPA) than those without (DeRoma, Leach, & Leverett, 2009; Eremsoy, Celimli, & Gencoz, 2005). According to a survey completed by over 500 university counseling center directors across the United States, depression is a presenting concern among 34.5% of students (LeViness, Bershad, & Gorman, 2017). The prevalence of depression is often higher than 50% among freshmen (Ruthig, Haynes, Stupnisky, & Perry, 2009). Although there is a relationship between depressive symptoms and GPA, it is important to identify possible moderators. The aim of the current study was to examine whether psychological flexibility moderates the relationship between depressive symptoms and GPA among college students. Approximately 332 participants completed a series of questionnaires via pencil and paper. Participants’ semester GPAs were obtained from the registrar. Results showed that psychological flexibility was significantly and negatively related to depressive symptoms. Psychological flexibility was not related to GPA in the current sample. Furthermore, both psychological flexibility and depressive symptoms independently predicted GPA but psychological flexibility did not moderate the relationship between depressive symptoms and GPA. Implications and future directions will be discussed.

76. Evolving A More Nurturing Capitalism

Primary Topic: Evolution
Subtopic: Cultural Evolution
Anthony Biglan, Oregon Research Institute

This poster provides a preview of my forthcoming book: A More Nurturing Capitalism: Evolving an Economic System Works for Everyone. Capitalism is an excellent system for promoting innovation and efficiency in products and services. However, as practiced in the United States, and increasingly around the world, capitalism has many deleterious consequences, including climate change; deaths due to tobacco use, guns, obesity, and drug overdose; high levels of poverty and economic inequality; and the erosion of prosocial values. Free-market ideology fails to acknowledge the great harm that market systems can cause. Furthermore, under the thrall of this narrative, people have come to accept the idea that unregulated markets benefit everyone as if it were a natural law. This has led to ineffective approaches to social, political, environmental, and economic change -- and to resignation and hopelessness. I employ evolutionary principles to show how we can create a new society that ensures the well-being of all of its members by changing the conditions under which capitalism operates. I describe the reforms needed in every sector of society and the social movement that will make those reforms a reality. I also show how the pursuit of such a social movement requires the psychological flexibility that the CBS movement has delineated.

77. Training reading as a derived relational response in dyslexic individuals

Primary Topic: Evolution
Subtopic: dyslexia
Martina Leuzzi, Università Kore di Enna
Giovambattista Presti, Università Kore di Enna

Background: Specific Learning Disorders (SDL) is an umbrella term for a range of frequently co-occurring difficulties, mainly reading-related (dyslexia) and math-related (dyscalculia). Dyslexia is characterized by difficulties in reading despite normal intelligence. Reading is usually conceptualized as a cognitive process of decoding symbols to get meaning. Intervention to enhance reading skills, mainly based on cognitive theories, are aimed to develop phonemic awareness, fluency, text comprehension and vocabulary. From a behavior analytic point of view misreading can be conceptualized as a weak stimulus control. Method: We present results of a conditional discrimination procedure based on frame of coordination used to train three individuals diagnosed with SDL, A. (11 years), E. (7 years) and M. (18 years) to match picture to printed words both in uppercase (AB) and lower case (AC). Ten triplets of words for E. and M. and 17 for A. were carefully chosen to replicate the errors the subjects made when reading. After testing for derivation of matching uppercase to lower case words and viceversa, reading emerged as derived responding. Pre-post reading levels were assessed with standardised achievement tests. Results: Children showed marked improvements and some scores, especially correctness, went back within the limits of the normal range for age. Discussion: Trainings based on frame of coordination has been shown effective in teaching reading. Preliminary data show that few hours of same training can help overcome some basic difficulties in dyslexic individual, with the advantage of not being averse because they are never required to read directly.

78. Preliminary validation of Argentinian version of the Psychological Inflexibility in Pain Scale (PIPS) in a chronic pain sample

Primary Topic: Measurement and assessment
Subtopic: psychometry
Maria J. Lami Hernandez, Universidad Catolica de Santiago del Estero
Victoria Zambolin, Universidad Católica de Santiago del Estero
Maria J. Carabajal
Lance McCraken, Uppsala University

The Psychological Flexibility model results as a useful theoretical tool that integrates knowledge in behavioural analysis and offer effective treatment approach. This construct through the Psychological Inflexibility in Pain Scale (PIPS) developed by Wicksell et al. (2010) makes possible to measure the processes of changes within ACT. There is not a study of the PIPS´s psychometrics proprieties neither in Latina American, nor in Argentina. The aim of this study is analysis construct validity and internal consistency of PIPS in an Argentinian sample of chronic pain patient. Materials and methods Participants: Seventy five women and 8 men recruited from rheumatology service of the regional hospital were evaluated. The inclusion criteria were 1- from 18 to 70 years; 2- diagnosis of rheumatic arthritis, osteoarthritis or fibromyalgia. The participants give their informed consent. Measures Socio-demographical information was evaluated in the interview. The self-report measures were: The PIPS evaluates through 20 items the disposition and willingness towards activities and the acceptance of pain. The items are rated in seven-point scale. We used the translation into Spanish from Rodero et al., 2013. Also we used the Pain catastrophizing scale (PCS), Pain Vigilance and Awareness Questionnaire (PVAQ) , Chronic Pain Acceptance Questionnaire (CPAQ) and Mindful Attention Awareness Scale (MAAS). Statistical analysis It is proposed to perform criterion validity of the PIPS-Spanish by calculating the correlations (Pearson´s r) between the total PIPS-Spanish score with the PCS, PVAQ, CPAQ, and the MAAS. The internal consistency of the questionnaire will be estimated using Cronbach’s alpha and item-total correlations.

79. Psychometric Properties of the Smoking Self-Efficacy Questionnaire (SEQ-12) in a Greek-Cypriot Sample of Young Adults
Greece-Cyprus ACBS Chapter Sponsored
Primary Topic: Measurement and assessment
Subtopic: Smoking
Marianna Zacharia, M.Sc., ACThealthy laboratory, University of Cyprus
Maria Karekla, Ph.D., ACThealthy laboratory, University of Cyprus

The Smoking Self-Efficacy Questionnaire (SEQ-12) constitutes a widely utilized measure that assesses the confidence of former and present smokers in their ability to refrain from smoking. Even though such measures have been validated worldwide, most of them have not been adapted for use among Greek-speaking populations. Additionally, well-validated measures that assess smoking self-efficacy across various groups and populations are needed to be able to investigate this construct and examine any changes in smoking self-efficacy as a result of psychotherapeutic interventions. The purpose of this paper is to examine the factor structure and psychometric properties of the SEQ-12 in a Greek-speaking population. The sample (N=105; 68 female, Mage=22.44) was derived from undergraduate and postgraduate students of various programs of study from the University of Cyprus. Initially, an exploratory factor analysis (EFA) was conducted. Results supported a single-factor solution based on Kaiser’s criterion (KMO=.88), explaining 76.04% of the total variance. The Eigenvalue of this factor was 9.13. This finding was consistent with the sudden change on the scree plot chart emerging following the first factor. Parallel Analysis was employed to verify the factor structure. Parallel Analysis also recommended a single-factor solution (only one factor with a Raw Data Eigenvalue=9.01 above the 95th Percentile Eigenvalue=1.34). The Greek Smoking Self-Efficacy Questionnaire (G-SEQ) exhibited excellent internal consistency (Cronbach’s α=.97). Overall, the current study suggests that the G-SEQ shows good reliability for this population and indicates its appropriateness as a single factor measure. Directions for future research and clinical implications are discussed.

80. Psychometric Properties of the Fagerstrom Test for Nicotine Dependence (FTND) in a Greek-Cypriot Sample of Young Adults

Primary Topic: Measurement and assessment
Subtopic: Smoking
Spyridon Demosthenous, M.Sc., University of Cyprus
Marianna Zacharia, M.A., University of Cyprus
Maria Karekla, Ph.D., University of Cyprus

Background: The Fagerstrom Test for Nicotine Dependence (FTND; Heatherton et al., 1991) is a widely utilized measure of Nicotine Dependence, which serves as an improved version of the initial Fagerstrom Tolerance Questionnaire. Well-validated measures that examine nicotine dependence across various groups and populations are essential for the assessment of this construct and investigate any changes in nicotine dependence as a result of psychological treatment. The purpose of this paper is to examine the factor structure and psychometric properties of the FTND in a Greek-speaking sample of young adults. Method: The sample (N=165; Mage= 18.73) was derived from high school and undergraduate students from the University of Cyprus. Initially, an exploratory factor analysis was conducted. Results: Results supported a single-factor solution based on Kaiser’s criterion (KMO=.88), explaining 64.19% of the total variance. The Eigenvalue of this factor was 3.85. This finding was consistent with the sudden change on the scree plot chart emerging after the first factor. Additionally, Parallel Analysis was conducted to verify the factor structure. Parallel Analysis also recommended a single-factor solution (only one factor with a Raw Data Eigenvalue=3.42 above the 95th Percentile Eigenvalue=.44). Consistent with the reported structure of the original English version, a single-factor solution seems to be suitable. The Greek Fagerstrom Test for Nicotine Dependence (G-FTND) showed good internal consistency (Cronbach’s α=.87). Discussion: Overall, the current study suggests that the G-FTND demonstrates good reliability for this population and indicates its appropriateness as a single factor measure. Directions for future research and clinical implications are discussed.

81. Acceptance and Action Questionnaire II: Measurement Invariance and Construct Validity among a non-clinical ethnically diverse sample

Primary Topic: Measurement and assessment
Subtopic: Psychological Inflexibility, Adults
Virmarie Correa-Fernández, Ph.D., University of Houston
J. Robert Sandoval, M.S., University of Houston
Niloofar Tavakoli, M.Ed., University of Houston
Morgan McNeel, B.A., University of Houston
Amanda Broyles, M.Ed., University of Houston
Hanjoe Kim, Ph.D., University of Houston

Background: Psychological inflexibility has been associated with symptoms of mental illness as well as behavioral problems. A self-report survey measure, the Acceptance and Action Questionnaire (AAQ-II), has been proposed to assess psychological inflexibility, and its psychometric properties has been reported in the literature. However, empirical evidence for the measurement invariance and construct validity of the scale across ethnically diverse populations is scarce. Method: Using an ethnically diverse non-clinical sample (N=538), this study examined factorial invariance of psychological inflexibility across sex and ethnic/race groups (i.e., White, African American, Hispanic, and Asians). Also, construct validity was examined by looking at relationships between psychological inflexibility and emotional distress tolerance, measured by the Distress Tolerance Scale (DTS). Results: The fitting the model of configural invariance across the male and female groups indicated adequate model fit [ χ^2 (38) = 153.65 (p < .001), RMSEA = .107, SRMR = .039, CFI = .938, TLI = .932], as well as the model across the race/ethnicity groups [χ^2 (88) = 201.965 (p < .001), RMSEA = .101, SRMR = .053, CFI = .938, TLI = .941]. A strong negative correlation was found between the AAQ-II factor and the mean DTS total score (r = -0.533, p < .001), and individual subscales (all ps < .001). Discussion: The AAQ-II demonstrated measurement invariance across sex and race/ethnicity, and displayed good criterion validity with distress tolerance, a theoretically relevant construct. The AAQ-II is a valid measure of psychological inflexibility and can be used across different ethnic groups.

82. Managing Occupational Stress Across various work contexts in Uganda: Randomized group comparison of Acceptance and Commitment Therapy (ACT) and Traditional Stress Management Employee Assistance Programs

Primary Topic: Organizational behavior management
Subtopic: Occupational Stress
Khamisi Musanje, Makerere University

This paper presents a research proposal for evaluating impact of Acceptance and Commitment Therapy (ACT) on management of occupational stress across various work contexts in Uganda in comparison to Traditional Stress Management Employee Assistance Programs (SMEAPs). Participants will respond to the General Health Questionnaire (GHQ-12; Goldberg & William, 1998) to determine suitability of inclusion. Using a randomized control trial design, participants will be assigned to either experimental or control group before completing a Work Acceptance and Action questionnaire (WAAQ, Hayes, Strosahl, Wilson, 2004). The delivery of ACT will follow a six-session version by Flaxman, Bond and Livheim (2013) protocol, while the delivery of SMEAPs will follow the selected organizations’ procedures. After three months, participants in both groups will for the second time respond to the GHQ-12 and WAAQ to assess impact of interventions. At post assessment, the ACT group is expected to show reduced levels of stress at post intervention (basing on their responses to the GHQ-12). On contrary, the control group will show little or no change in the levels of stress at post assessment. This result will portray ACT to be a more superior intervention in managing occupational stress. Secondly, Participants who will score high on psychological flexibility at post intervention are expected to show reduced levels of stress regardless of which group they will be assigned to. This result will portray psychological flexibility as the mechanism for effecting change in the levels of stress experienced.

83. Mindfulness in context: A daily diary study of within- and between-person effects of trait mindfulness as a personal resource in the JD-R model

Primary Topic: Organizational behavior management
Subtopic: Mindfulness
Lucie Zernerova, City, University of London
Paul Flaxman, City, University of London

Background: This study investigated influence of trait mindfulness as a personal resource in context of the Job Demands–Resources (JD-R) model (Bakker & Demerouti, 2014; 2017), a well-established work-related stress and motivation model in occupational health literature. Mindfulness was proposed to buffer the effect of high-strain work episodes and job conditions on burnout and boost the effect of active job episodes and job conditions on work engagement. Method: A 5-day diary study with 1083 measurement occasions nested in 144 employees of various UK-based organisations. Multilevel modelling was used to disentangle both episodic (within-) and chronic (between-person) effects. Results: Trait mindfulness (FFMQ total) did not moderate within-person reactivity to stressful work episodes: regardless of trait mindfulness, high strain (high demand-low control) work episodes were associated with higher burnout and lower work engagement. However, trait mindfulness moderated the between-person effects. Specifically, mindfulness prevented burnout in employees exposed to high demand-low control working conditions. A more complex pattern of results emerged with respect to work engagement. Mindfulness boosted work engagement in low demand-high control working conditions but was negatively associated with work engagement in low demand-low control conditions. Discussion: Different patterns of results found for within- and between-person level of analysis. Cultivation of mindfulness may be useful for preventing employee burnout. However, it may not be able to buffer the impact of job stressors on work engagement. This is the first study to report both within- and between-person results for trait mindfulness as a moderating personal resource in a work-related stress model.

84. Analyzing resilience from a functional perspectiva

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Resilience
Mari Luz Vallejo Pérez, University of Almeria
Carmen Luciano
Beatriz Sebastián

Background: literature shows a wide variety of definitions of resilience. Most of the authors agree that it is a protective factor for psychopathology. (Rutter, 1987, Luthar, 2000, Bonanno, 2004). Recent studies of resilience are carried out from three approaches: those who consider it as a trait, as a result or as a process (Hu, Zhang, and Wang, 2015) It Seems that a conceptual clarification is needed in order to promote adaptative behavioral patterns in difficult situactions in life. This research aims to investigate the repertoire of resilience from a contextual perspective, as a pattern of psychological flexibility. Method: A sample of undergraduate students (N=30) with and without psychological problems participated in the study to respond several questionaires and an empirical task of change of contingencies too. As well as they respond to a task to evaluate their sensitivity to changing contingencies. Results and discussion: the study shows a positive correlation between the four measures, suggesting that all these behaviours belong to the same category of resilience, perhaps a functional class.

85. A brief Acceptance and Commitment Therapy (ACT) – based group program for unemployed individuals with mental health problems
German Speaking Chapter Sponsored
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Unemployment and chronic mental illness
Marie Christine Dekoj, Ph.D., Private Practice, Bad Saulgau & Ulm
Lisa Gabriel, University of Ulm
Tobias Staiger, University of Ulm
Tamara Waldmann, University of Ulm
Thorsten Brosch, Kolping Werk Augsburg
Nicolas Ruesch, University of Ulm

Background: People with mental illness often choose not to use mental health services and not to seek help with jobsearch and other psychosocial problems. This has harmful consequences for individuals, their families and society. An improvement on measures of depression, general health, and quality of life has been shown in former studies. Aim: To evaluate the acceptability, feasibility and efficacy of a brief ACT-based group program for unemployed individuals with mental health problems. Program participants should learn to behave flexibly in different situations and decide to live a value-based life. This is expected to reduce barriers to help-seeking among unemployed people with mental health problems. Methods: A pilot randomized controlled trial (RCT) with approximately 100 unemployed people with mental health problems was conducted. Interested individuals are screened via telephone. Inclusion criteria are being between 18 and 64 years of age, currently unemployed and psychological distress as indicated by a score ≥13 on Kessler’s K6 Psychological Distress Screening Scale. Participants are randomly allocated to the ACT intervention or a TAU control group. The ACT-based intervention consists of four sessions, covering ACT methods, help-seeking and disclosing mental health problems. Results: Despite no intervention effects on primary outcomes (job search self-efficacy, help-seeking), program participants showed significant improvements in depressive symptoms and recovery at T2. Trend-level positive effects were found for self-stigma, hopelessness and secrecy. Discussion: This peer-led group program could improve symptoms and recovery among unemployed participants with mental health problems. The reasons for no intervention effect on primary outcomes will be discussed.

86. Peerspicuity(TM): Prototyping a Verbal Behaviour Classifier to Make Sense of Online Peer Support

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Depression, Peer Support
Mat Rawsthorne CGMA, University of Nottingham

Background: Depression involves Theory of Mind deficits, rigid thinking, loss of non-judgmental awareness of present moment experience and other avoidant coping strategies. Online support by ‘experts by experience’ is promising innovation that may help close the mental health treatment gap, however, there are concerns about who it does and doesn’t work for and what are the mechanisms behind this. How does participation in Internet Support Groups (ISGs) allow a step back from the ‘closed response style’ so upset is not taken personally-permanently-pervasively and behaviour governed by perfectionist rules? ISGs can be characterised as a Social Learning environment in which shared experience and perspective-taking allows reappraisal and development of response-ability through sensitivity to different opportunities (via contextual and social cues) and updating behavioural repertoires to match altered contingencies. CBS proposes that deictic framing combined with other forms of increasingly complex response networks generates three different patterns of self-discrimination, and pragmatically conceptualises the self (and other) in terms of a) content (stories), b) a flow of experiences (process) or c) as awareness (context) itself. Method: Analysis of Big White Wall forum interactions to identify the relational frames connected with sense of self/other and psychological flexibility. Particular attention will be paid to social comparison, utilising Buunk’s Identification-Contrast Model to identify empathy and emotional contagion. 1. Create feature dictionaries of relational frames 2. Use natural language statements from clinical questionnaires and collaborative machine learning to bootstrap annotation and aid transparency 3. Extract psychological insight from dialogues to differentiate between non-therapeutic and therapeutic interactions

87. Pilot RCT of Group Based ACT on Well being following Primary Breast Cancer Intervention

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Cancer
May Chi, University of Southern Queensland
Nancey Hoare, University of Southern Queensland
Eliza Whiteside, University of Southern Queensland
Gaye Foot, St Andrews Hospital, Toowoomba
Genevieve Baratiny, Southern Queensland Rural Health (SQRH), The University of Queensland
Gavin Beccaria, University of Southern Queensland
Catherine Gardner, University of Southern Queensland

Handout

The aim of this study was to evaluate the effect of group-based Acceptance and Commitment Therapy on quality of life, fear of recurrence, and mood in women post primary breast cancer intervention. 24 women were randomly assigned to three groups, two of which received both therapy and education conditions, and a third group as a control group who received only the therapy condition. The results of 20 women who completed the interventions were analysed. Preliminary findings suggest generally good psychological health and quality of life in this group of regional and rural women who had accessed to private health care. Participation in therapy may decrease experiential avoidance and improve quality of life, whereas participation in education may increase quality of life but also increase experiential avoidance. There is a correlation between experiential avoidance and quality of life, and a correlation between experiential avoidance and fear of cancer recurrence, with some suggestion that this correlation becomes stronger when experiential avoidance approaches clinically relevant levels.

88. Combining Acceptance and Commitment Therapy (ACT) and Creative Expression Therapy (CET) to Empower Women and Transform their Lives

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Women/Young Professional Women, Creativity, Self-confidence, Self-esteem, Ignite Transformation
Meryem Hajji Laamouri, M.A., MerCi Life Change

Background: Acceptance and Commitment Therapy helps us interact differently with our thoughts and emotions, develop a psychological flexibility, connect with our values and take action towards what gives meaning to our lives. Yet, since ACT is mainly a verbally based therapy, it is sometimes very challenging to invite unpleasant emotions, to observe and accept them. Therefore, in my work with women, I integrated Creative Expression Therapy (CET) in ACT therapy practice to enhance women’s empowerment results and ignite transformation. Method: I am currently developing an ACT-CET program which I will be implementing in April and May 2019 with a sample group of 10 women. I will be presenting the program and sharing the results at the ACBS poster presentation session. Results: In 2018 I have worked with a small group of women using ACT to increase their self-confidence and empower them. Having difficulties to cope with their emotions, I integrated two sessions of CET using colors painting to help them feel safe to express their emotions and build trust. The results were amazing and the women were able to develop a psychological flexibility and interact positively with their emotions. Discussion: These preliminary results demonstrate that ACT is an efficient therapy to empower women. Yet, when combined with a Creative Expression Therapy activity, it becomes more powerful. Besides, results and transformation are remarkable. Therefore, the goal of the present work is to develop an ACT-CET program that can be used as a vehicle for women’s empowerment and transformation.

89. Dublin, We Have Contact? Analysis of Preventative and Community-Level Interventions in the Contextual Behavioral Sciences

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Preventative Health
Michelle Forman, University of Nevada, Reno
Patrick Smith, University of Nevada, Reno

The science-based practice model visualizes the levels, phases, and feedback channels for interaction with, and iteration of, science informed technologies intended for dissemination. At the base of the model are three concentric rings describing increasingly widespread applied levels of contact as the technology disperses from a client-clinician relationship to the community at large. While beneficial contact at the individual level is most likely to occur at the innermost ring (Awareness of Problem), the requirement to be aware of an issue constrains dissemination and is inherently reactive to any systemic problems at more general levels. Disseminating technology at the preventive health-level, as depicted by the science-based practice model second rings, or community-level, the outermost ring, are ways to target systemic issues proactively. This poster compiles and presents the current research on preventative health and community-level interventions with the goal of highlighting research trends and opportunities for future research.

90. Psychological inflexibility and alcohol consumption in a large sample of college students in Ecuador

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Psychological Flexibility and alcohol
Pablo Ruisoto, University of Salamanca, Spain
Lidia Budziszewska, European University of Madrid, Spain
Víctor López, Universidad Técnica Particular de Loja
Belén Paladines, Universidad Técnica Particular de Loja
Raúl Cacho, Public University of Navarra
Silvia Vaca, Universidad Técnica Particular de Loja

Background. Psychological inflexibility has been proposed as a transdiagnostic process in which behavior is rigidly guided by psychological reactions rather than direct contingencies or personal values, and it is involved in a wide range of psychological disorders. Objective. The goal of this study is to evaluate the psychometric properties and factor structure of an Ecuadorian adaptation of a Spanish translation of the AUDIT in a large sample of college students in Ecuador. Methods. A total of 7905 students, 46.26% males, and 53.75% females, from 11 universities of Ecuador were surveyed using gold standards questionnaires. Psychological inflexibility was assessed using the Acceptance and Action Questionnaire II and harmful alcohol intake using the Alcohol Use Disorders Identification Test (AUDIT). Results. Both, psychological inflexibility and alcohol consumption were unevenly distributed among men and women. In addition, both, the AAQ II and the AUDIT showed good reliability, internal consistency and correlates with other health related measures, proving to be valid and reliable tools that can be used by researchers and clinicians to screen the risk of psychopathology and hazardous alcohol intake in college students in Ecuador.

91. Development of Japanese version of the Brief Experiential Avoidance Questionnaire

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Experiential avoidance Experiential avoidance, ACT
Ryuya Sakaguchi, Ritsumeikan University
Seguchi Atsushi, Ritsumeikan University
Takashi Mitamura, Ritsumeikan University

Experiential avoidance has been defined as an unwillingness to sustain contact with specific personal events such as distressing thoughts, emotions, and so on. Previously, the Acceptance and Action Questionnaire (AAQ) and the Multidimensional Experiential Avoidance Questionnaire (MEAQ) were developed to assess a broad range of experiential avoidance contents such as behavioral avoidance, distress aversion, procrastination and so on. But these assessment tools had a few problems. For example, it may be impractical to use the AAQ and the Acceptance and Action Questionnaire-Ⅱ (AAQ-Ⅱ) since it has lower discriminant validity and the MEAQ has 62 items. In this study the Japanese version of the Brief Experiential Avoidance Questionnaire (BEAQ) was developed to measure people’s behavior about experiential avoidance. This scale was developed using back translation and then its reliability and validity were evaluated using a sample of 200 college and graduate students. Factor analysis revealed that the BEAQ consisted of 15 items and showed a one-factor structure and had sufficient internal consistency (α=.78). The correlations between the BEAQ and Behavioral Activation for Depression Scale-Short Form (BADS-SF), AAQ-II, and Kessler 10 (K10) showed adequate validity. These results indicate that the BEAQ can be used to measure people’s behavior about experiential avoidance. In addition, BEAQ can be utilized for research and clinical practice related to Acceptance and Commitment Therapy (ACT).

92. Fostering flexibility to face lifespan challenges - an preventive eHealth ACT-intervention

Primary Topic: Prevention and Community-Based Interventions
Subtopic: eHealth
Tim Batink, Ph.D., Open University of the Netherlands
Nele Jacobs, Ph.D., Open University of the Netherlands
Sanne Peeters, Ph.D., Open University of the Netherlands
Mayke Janssens, Ph.D., Open University of the Netherlands
Johan Lataster, Ph.D., Open University of the Netherlands
Jennifer Reijnders, Ph.D., Open University of the Netherlands

Background: During our lifespan we will face a lot of changes. Dealing with those changes can often be challenging, especially as we get older, and can lead to a substantial decline in subjective wellbeing. Developing psychological flexibility could be beneficial in dealing with the inevitable changes in life and can have a positive effect on wellbeing. An eHealth ACT-intervention was developed to foster flexibility in the general population. The aim of the study is to assess both feasibility and effectiveness of the eACT-intervention. Method: Middle aged and older adults (40-75) were recruited from the general population and were assigned to the experimental group (eACT) or the waiting-list condition. Both groups completed a pretest, a posttest and a follow-up survey (8 weeks after finishing the eACT-training) to assess short and long-term effectiveness with measures on wellbeing (e.g. MHC-SF) and psychological flexibility (e.g. AAQ-II). The eHealth ACT intervention includes 8 sessions. Every online session consists of a short introduction of a specific ACT-skill, followed by a variety of exercises supporting participants in their development of these new skills. Participants can work through the sessions at their own pace. Results & Discussion: The eHealth intervention will be described in more detail and the first results regarding user experience and feasibility of this eACT intervention will be presented at the congress, using qualitative and quantitative data . This eACT intervention may represent new opportunities to provide online psychological health services to a broad public, irrespective of their location.

93. Preliminary data on the effectiveness of In This Moment program: Investigation of its impact on Romanian high school students' stress management abilities

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents, Mindfulness, Stress-reduction
Timea Madár Barabási, M.A., Babes Bolyai University
Carmen Costea Bărluţiu, Ph.D., Babes Bolyai University, Cluj
Jenő-László Vargha, Ph.D., Babes Bolyai University, Cluj

Learning to be mindful – as supported by an impressive body of empirical evidence – develops our ability to more effectively manage stress. Based on Baer’s five facets mindfulness model, and on recent findings from neuroscience research, the In This Moment program, developed by Strosahl and Robinson (2015), proposes an effective intervention for managing stress. The first five steps of the program are designed to train the five components of mindfulness; four other steps help the trainees apply their mindfulness skills to important areas of their lives. Our aim was to investigate the effectiveness of the program, translated and adapted for Romanian high school students. 164 high school students (93 females, mean age 16.46) completed the program. Participants had weekly meetings with the trainer, who presented them the exercises of the forthcoming step; participants practiced then each step on their own, for one week. On the whole, the program entailed 9 weeks of practice. Our control group consisted of 217 high school students (112 females, mean age 16.01). AAQ-II, FFMQ, the Satisfaction with Life Scale, DASS-21, Test Anxiety Scale, Revised Cheek and Buss Shyness Scale, and Ghent Multidimensional Somatic Complaints Scale were administered before and after implementation of the program. A follow up assessment will also be performed. Significantly higher levels of psychological flexibility and satisfaction with life, and a slight improvement of their level of mindfulness were reported by participants after the intervention. Such significant differences were not found in the control sample at posttest.

94. Acceptance and Commitment Training (ACT) in Dementia Care Workers: 12 month follow-up

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Burnout
Xavier Montaner Casino, Universitat Autònoma de Barcelona (UAB)

BACKGROUND: Dementia care workers (DCWs) are at high risk of suffering from burnout, which in turn can lead to a worsened quality of care. There is a need to create intervention programs aimed at providing DCWs with effective tools for managing the unpleasant emotions associated with the workplace. OBJECTIVES: To design and implement an intervention based on ACT for DCWs that reduces the levels of burnout and increases the work and life satisfaction of the workers. METHODS: 110 DCWs of the CSSV Hospital (Barcelona) were randomly assigned to Intervention group (IG) or waiting list (CG). - Scales: AAQ-II, SWLS, MBI, (STAI-R). - Intervention: An intervention based on ACT was carried out weekly (6 weeks) to work with each one of the hexaflex components. RESULTS: The EG decreased 4.34 (p <0.001) in the MBI and 3.4 (p <0.001) in the STAI. The EG also increased 4.36 (p <0.001) in the SWLS and 4.27 (p <0.001) in the MBI Realization scale. At the 3 and 12 month follow-up, changes observed in STAI, SWLS and MBI Realization scale remained significant. CONCLUSIONS: The Acceptance and Commitment Training not only reduced the levels of perceived emotional exhaustion associated with work, but also significantly increased the level of job and life satisfaction of the participants. An intervention of 6 weeks, allows to put into practice the knowledge acquired in the sessions. On the other hand, unlike 2 + 3 interventions, it allows its benefits to crystallize and to be maintained after 12 month of follow-up.

95. Encouraging young therapists to explore - Finding your own blueprint (REBT – ACT – CFT – integration)

Primary Topic: Professional Development
Subtopic: Self – exploration, integration of ACT&REBT
Dario Lipovac, M.A., Association for psychological assessment, support and counceling "Domino", Sarajevo

Many young, unexperienced therapists are having fears of not being effective in working with their clients. At the same time, they are trying to find their own professional identity and blueprint. Therefore, they choose to stick only with one therapeutic approach or therapy modality in what they have been trained in helping their clients, something that is completely normal and expected. Sometimes, they are not encouraged and being open to explore and combine different therapeutic modalities, which would bring them new perspectives, more tools, authenticity and more effectiveness in working with clients. On the other hand, it would be very helpful to their personal development as well. Main aim of this poster presentation is to encourage young or unexperienced therapists to explore different therapeutic modalities or approaches. I think this kind of psychological flexibility is important in finding our own authenticity. To do so, I will present my own way of working with clients and how I successfully integrate REBT with ACT and CFT through real case presentations. Being aware of the fact there are different opinions that are not praising combining REBT and ACT specifically, I think that being comfortable in doing more modalities gives us flexibility to adapt and make tailor-made conceptualization for every client. Moreover, I will share experiences of leading one of the first ACT peer-to-peer supervision groups in Bosnia and Herzegovina as well, since it is important for mutual support between fellow ACT practitioners who are learning to integrate ACT into their practice.

96. The Relationship Between Burnout and Experiential Avoidance, Self and Valued-living in Healthcare Professionals
Türkiye Chapter Sponsored
Primary Topic: Professional Development
Subtopic: Healthcare Professionals,
Hasan Turan Karatepe, Assist Prof. M.D., Istanbul Medeniyet University

Backgrounds: Burnout syndrome occurs in all types of health care professionals and is especially common in individuals who works in a closer relation with patients. Being self-critical, engaging in unhelpful coping strategies, sleep deprivation, and a work-life imbalance were reported as risk factors for burnout in literature . Organizational factors associated with include increasing workload, lack of control over the work environment, insufficient rewards, and a general breakdown in the work community were the other main risk factors for burnout reported in many studies . In this study, we aimed to compare the effects of organizational factors and the processes related to psychological flexibility on burnout sendrome. Method: 226 healthcare professional volunteers who participated in the study were administered valued life questionnaire (VLQ), self-as-context scale (SACS), Action and Acceptance Questionnaire (AAQ-II) and Maslach Burnout Invantory(MBI). Results: MBI scores were found to be significantly lower in participants who have children than participants without children (p<0.03). In the correlation analysis, we found that MBI parameters decreased with increasing in age (p<0.05), and MBI scores increased with the number of patients per week (r=0.242, p<0.01) and number of monthly night-working duty (r=0.189 p<0.01). AAQ-II scores show positive correlation with the scores of MBI (r=0.456 p=0.00) SACS (r=-0.323, p=0.000) and VLQ scores –both Importance (r=-0.175 p<0.01) and Consistency (r=-0.210 p<0.01)—show negative correlation with MBI scores. Discussion: Our data shows that relationship between burnout and experiential avoidance, burnout and self-as-context is more strong than the relation between work environment factors and burnout.

97. How to act with narrative: A single case experimental design pilot study using a process-based psychotherapy informed by RFT

Primary Topic: Relational Frame Theory
Subtopic: Transdiagnostic, Functional, Process based
Daniel Wallsten, Karlstad University
Thomas Parling, Ph.D., Karolinska Institutet
Ciara McEnteggart, Ph.D., University of Ghent
Yvonne Barnes-Holmes, Ph.D., University of Ghent
Colin Harte, University of Ghent

From a relational frame theory (RFT) perspective, the human capacity for arbitrarily applicable relational responding (AARR) allows individuals to not only navigate their physical and psychological worlds in complex ways, but also to form painful and inflexible narratives that inevitably leading to psychological suffering. Recently, RFT researchers proposed the hyper-dimensional multi-level (HDML) framework for analyzing AARR, with the ROE (relating, orienting and evoking) as the core process of all human psychological acts. The current study outlines four ongoing interventions that are conducted using a process-based approach to psychotherapy that is specifically guided by the HDML. Using a multiple-baseline single-case experimental design, in a primary healthcare care setting, the study aims to assess the acceptability, feasibility, and effectiveness of using this process-based approach using a number of standardized measures. Preliminary findings are discussed and the feasibility of developing a process-based treatment protocol is explored.

98. Evaluation of Relational Frame Skills in Normal Adults -Evaluation by small group using PEAK Relational Training System Pre Assessment (Japanese version)

Primary Topic: Relational Frame Theory
Subtopic: PEAK
Fumiki Haneda, Startline Co., Ltd.

So far, Research Center at Startline Co., Ltd. has developed ACT-online and original ACT exercises in Japanese. And, while using them to prepare the implementation environment of ACT in Japan, we practice ACT for many people. On the other hand, in practicing ACT for people with developmental and mental disabilities, not only mental problems but also many more cognitive problems (lack of number concepts, time concepts, perspective taking skills.)were seen. We were aware of the need to assess and train on Relational Frame skills. Therefore, we have studied, analyzed and translated into Japanese about PEAK Relational Training System, which is a structured training system of Relational Frames. As a result, it is difficult to say that structured training of Relational Frames is carried out even in normal adults, so we try to perform statistical data with the assessment of the Relational Frame skills of normal adults. First , we translated the following five PEAK Relational Training System PreAssessment flip books and various forms into Japanese: 1)Direct Training Module and 2) Generalization Module, 3)Equivalence Module, 4)Expressive Subset and 5)Receptive Subset of Transformation Module. Next, for 1,2,4,5, we created PowerPoint that presents the stimulus of tasks, and an answer sheet that can be answered by choice selection and description, so that it can be implemented for small groups. And, at present, 1,2,4,5 is conducted for normal adults and the results are organized. In this poster presentation, we report on these research results.

99. Another step in analyzing hierarchical framing

Primary Topic: Relational Frame Theory
Subtopic: Hierarchical Framing
Lidia Budziszewska, European University of Madrid, Spain
Carmen Luciano, University of Almeria
Enrique Gil, University of Almeria
Zaida Callejon Ruiz, University of Almeria

The published evidence concerning transformation of functions in accordance with the relational frame of hierarchy is still very scarce; Gil, Luciano, Ruiz and Valdivia (2011) Gil, Luciano, Ruiz, Valdivia (2014) and Slattery & Stewart (2014).The aim of this study is to advance in such a track to provide more precise learning procedures. Participants were given two types of experimental histories prior to testing transformation of function according to hierarchical framing. In one condition the relational hierarchical cues were trained while in the other case they were trained. Results show that participants reorganized stimuli according to the previous learning especially in an instructed condition. Further research is discussed.

100. Humor responses in different contexts

Primary Topic: Relational Frame Theory
Subtopic: Humor
Matheus Bebber, University of Almeria
Carmen Luciano

Background: Humor occurs in virtually any social situation. A suitable context is necessary: it might be an overall state which is a relatively secure or intimate (Ritche, 2018; Morreall 2009). The present study aims to manipulate the context of security and insecurity to evaluate whether some interactions, typically evaluated as jokes, generate humor responses. Method: 20 Spanish-speaking undergraduate students are randomly distributed in two groups that only differ in the order where the four jokes are presented. All them were exposed first to a pair of jokes in the one context condition and then to the other pair of jokes in the other condition. The experiment have four phases. In Phase I, participants fill out two tests (an standard intelligence test and a psychological flexibility tests). In Phase II, all participants are introduced in a distracting conditions that aims to establish a neutral emotional feeling before introducing the jokes. In Phase III, half of the participants respond to jokes 1 and 2 in the security condition and subsequently, they do the same with jokes 3 and 4 in the insecurity condition. The other half part of participants do the same except they respond to the jokes in an inverse order. In Phase IV, participants filled a humor questionnaire. Results are discussed in terms of impact of the four combinations between the different jokes and two contextual/establising operations looking for the analysis of replication effects across participants and looking for relational framings that might be involved in the process.

101. Virtual Reality acceptance and value-based training for social and public speaking skills of University students

Primary Topic: Relational Frame Theory
Subtopic: Social Anxiety
Simone Gorinelli, University of Jyväskylä
Päivi Lappalainen, University of Jyväskylä
Ana Gallego, University of Jyväskylä
Markku Penttonen, University of Jyväskylä
Raimo Lappalainen, University of Jyväskylä

Background: Relatively large number of University students experience substantial stress when performing in public and generally in social situations. Given that stress is a risk factor for general well-being, process-based interventions could be useful for university students. Virtual Reality (VR) and other technological solutions offer new and flexible ways to provide psychological training. Aim: This study’s purpose is to develop and investigate the effectiveness of Virtual Reality training based on Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT) principles for social and public speaking anxiety. Method: using an experimental clinical design, University students are prompted to follow the VR training, which combines different types of RFT-based exercises, and apply their skills while immerse in a social VR exposure context. Outcome measures include social anxiety symptoms, well-being, processes measures and physiological responses (heart rate & electrodermal activity). Moreover, Ecological momentary assessment (EMA) is adopted to assess how behavior varies over time and across context, through a cell phone app to evaluate their current behaviour and mood in real life. Results: Our design and preliminary data will be presented. Conclusions: This study will offer an example of modern process-based interventions. Our finding will advance our knowledge on how to use VR as instrument to offer process-based training.

102. Does a religious context alter the way in which we “react” to faces? An IRAP analysis.

Primary Topic: Relational Frame Theory
Subtopic: IRAP
Valeria Squatrito, Ph.D. Student, University of Enna "Kore"
Annalisa Oppo, Psy.D., Sigmund Freud University
Giovambattista Presti, M.D., Ph.D., Psy.D., University of Enna "Kore"

Prejudice, as a verbal behavioral pattern, is the result of processes of derivation and transformation of stimulus function. Three studies aimed to empirically investigate implicit relational responses to emotions in the context of the Catholic and Islamic symbols using the IRAP. Self-report questionnaires assessed psychological flexibility, cognitive fusion, empathy, values, authoritarianism. In the first study, we investigated the relationships between religious symbols and facial expressions of joy and fear to test the hypothesis that the facial expression depicting joy was more quickly associated with the symbol of the Catholic cross and the facial expression depicting fear was more quickly associated with the symbol of Islam. In the second study we have proposed the same procedure investigating facial expressions of joy and anger. In the third study we investigated the relationships between religious symbols, the expression of joy and a neutral expression to test the experimental model. In the first and in the second study participants were significantly faster to respond to the relation between joy to Catholics symbol than to the Islamic ones. In the third study participants were significantly faster to associate Catholics symbol with joy than neutral expression, but they were also significantly slower to associate Islamic symbol with joy than neutral expression. In summary, in our university sample results showed a positive picture in which no negative bias with regard to the Catholic and Islamic religions is observed. Despite the fact that in the Italian mass-media context Islam has often lately been associated with violence.

103. The influence of the Portland peer consultation group on practice, knowledge, skills and wellbeing in Acceptance and Commitment Therapy practitioners

Primary Topic: Supervision, Training and Dissemination
Subtopic: experiential learning, case conceptualisation, skills building, community building
David Gillanders, D.Clin.Psy., University of Edinburgh
Michael Sinclair, DCounsPsy, CPsychol, City Psychology Group
Joseph Oliver, Ph.D., CPsychol, University College London
Sandro Voi, M.Sc., NHS Hertfordshire

Supervision is fundamental to ensure good practice, by supporting practitioners and promoting their professional development. Whilst there is extensive research in 1:1 clinical supervision, there is a lack of studies investigating the effect of supervision using other formats. Recently, there are a growing number of studies highlighting the importance of experiential training to facilitate learning a specific therapy (Bennett-Levy, & Lee, 2014). The Portland peer consultation model (Thompson et al., 2015) is an approach to peer supervision developed to promote skill development and a sense of community. The spirit of the group is egalitarian, and as opposed to traditional verbal-dependent forms of supervision, the focus is on doing ACT rather than talking about ACT via participation in role-plays and peer feedback. Aims: The current study is an online survey that explores the difference between ACT practitioners who attend a Portland peer supervision group from those who don’t. Areas investigated are: ACT skills, ACT knowledge, self-care, sense of perceived community and wellbeing. Methods: The survey requires participants to complete six questionnaires, measuring: knowledge about ACT (ACT Knowledge Questionnaire-revised, adapted from Luoma & Vilardaga, 2013), psychological flexibility (Mindful Healthcare Scale, Kidney, 2017), inclusion in the community (Inclusion of Community in Self Scale, Mashek, Cannaday, & Tangney, 2007), self-evaluation of ACT skills (Acceptance and Commitment Skills Self Evaluation Scale; newly developed, being tested in this study), wellbeing (Short Warwick Edinburgh Well Being Scale, Stewart-Brown et al., 2009) and self-compassion (The Short version of the Self-Compassion Scale, Raes, Pommier, Neff, & Van Gucht, 2011).

104. FORCE: A proposal for assessment and clinical skills training therapists from a contextual model

Primary Topic: Supervision, Training and Dissemination
Subtopic: Clinical formulation, clinical competences
Juan Camilo Vargas-Nieto, Fundación Universitaria Konrad Lorenz
Claudia Liliana Valencia Granados, Fundación Universitaria Konrad Lorenz

FORCE (Clinical formulation based on evidence by its acronym in Spanish) is a proposal of clinical formulation based on the contextual model developed by clinical psychologists Juan Camilo Vargas Nieto and Claudia Liliana Valencia Granados, as a support strategy for the training of psychologists who work in the clinical field. FORCE is a pragmatic clinical formulation that integrates functional analysis, maintenance hypothesis, patient values and therapeutic goals. It is useful both for clinical psychologists who are training in contextual models and for supervisors and teachers, so that facilitates the evaluation and training of specific clinical competences. The present proposal includes the description of the pilot study carried out during a year with 60 postgraduate students. the model was adjusted to the real needs of the context. Then, an evaluation was carried out by expert judges to determine the validity of FORCE content. Finally, a design of a protocol is proposed to evaluate the predictive validity of the model as well as to establish quantitative parameters on its reliability and usefulness in educational and clinical scenarios with psychologists who perform psychological interventions.

105. Effects of Acceptance and Commitment Therapy (ACT) Training on Psychiatrists
Türkiye Chapter Sponsored
Primary Topic: Supervision, Training and Dissemination
Subtopic: Psychiatrists
Kaasim Fatih Yavuz, M.D., Istanbul Medipol University
Sevinc Ulusoy, M.D., Istanbul Bakirkoy Training and Research Hospital for Psychiatry and Neurology
Ahmet Nalbant, M.D., Adiyaman University Training and Research Hospital

Background: Acceptance and Commitment Therapy (ACT) training often includes experiential techniques and aims to increase the psychological flexibility levels of the therapist besides improving their ACT related intervention skills also. Improvement in the psychological flexibility of the therapists not only provides an improvement in therapy skills but also increases the meaning at work, reduces the burnout and stigmatization attitudes. Method: This study aimed to examine the effects of 4-day structured ACT training on psychological flexibility, burnout, and attitudes towards mental disorders among psychiatrists. Participants assessed with Maslach Burnout Inventory (MBI), Acceptance and Action Questionnaire-II (AAQ-II) and Mental Illness: Clinicians’ Attitudes Scale-v4 (MICA-v4) before training, at first and 3rd months after training. Repeated measures ANOVA was used to interpret the obtained data. Results: 25 of the 40 participants agreed to participate in the study. The mean age of the participants was 36.3 (+ -5.5) and 14 of them (60.9%) were female. One-way repeated measures ANOVA was conducted to compare scores on the AAQ-II, MBI, and MICA-v4 with Statistics. There were improvements on both scales with significant (p<0.05) and not significant (p>0.05) levels. Discussion: It is noteworthy that only a 4-day training would provide some progressive improvement for three months on psychological flexibility, burnout and stigmatization attitudes in participants. More studies need to be done for improving the effects of ACT trainings.

106. Bridging between ABA and ACT: Data and Direction

Primary Topic: Supervision, Training and Dissemination
Subtopic: Behavior Analysis and ACT
Natalie Savage, University of Bangor, UK-SBA
Gina Skourti, University of Kent, UK-SBA
Katie Parker, University of Swansea, UK-SBA
Karolina Gburczyk, UK-SBA

Background: The UK Society for Behaviour Analysis (UK-SBA) is constructed to develop and disseminate applied behaviour analysis within the UK. The Special Interest Group (SIG) for professionals who use Behaviour Analysis and are interested in ACT was established in October 2018. Method: An online survey questionnaire was shared. The aim of this questionnaire was to direct the SIG of how best to utilise the coming together of professionals with commonalities in interests and practices. Results: The themes of the questionnaire include; qualifications and professional practice (45% had a Master’s degree, 44% had a BCBA, 34% worked within early/intensive intervention and 46% worked within positive behaviour support), opinions of ACT within ABA (eg, professionals need sufficient training to competency and supervision), affiliated groups (50% were member of the ACBA and 43% were member of the UK-SBA), practice including ACT (60% implement ACT), populations worked with (61% work with individuals with ASD, LD and behaviours that challenge, 54% work with 5-19 year olds, 57% work with 19-65 year olds), trainings (55% have attended 1-2 day training events, 78% showed a preference for these events, 47% showed a preference for online training, 64% wanted more 1-2 day training, 58% wanted a UK based bootcamp event and 52% wanted more online training), supervision (53% have not received supervision and 77% want or would consider seeking supervision) and connecting with others (75% want to connect with others in their area). Discussion: This data identifies and informs direction for bringing the gap between ABA and ACT

107. The relationship between personality and psychological flexibility, self-compassion and ego-resiliency, regarding quality of life

Primary Topic: Theoretical and philosophical foundations
Subtopic: Psychological Flexibility, Self-Compassion, Ego-Resiliency, Personality, Quality of Life
Anna Pyszkowska, University of Silesia in Katowice

Background. Psychological flexibility, self-compassion and ego-resiliency are one of the most frequently used and developed internal resources during acceptance and commitment therapy. All of them enhance quality of life, adaptation and life satisfaction, but they are vastly varied in terms of psychological and functional mechanisms. The aim of this study was to establish the relationship between personality and psychological flexibility, self-compassion and ego-resiliency, regarding quality of life in a Polish sample. Method. 379 participants (50% female, mean age: 29,04) took part in a questionnaire survey. The following research tools were used: HEXACO Personality Inventory, Ego-Resiliency Scale, Self-Compassion Scale Short Form, Acceptance and Action Questionnaire–II, SWLS, LOT-R, Quality of Life Questionnaire. Results. Despite the fact that all three resources correlated with personality dimensions: emotionality, extraversion and agreeableness, it was established that they varied in terms of specific components. Personality established 42% of variance explained for self-compassion, 28% for ego-resiliency, and 20% for psychological flexibility. Regression and mediation analyses indicated that all three resources were relevant predictors of quality of life and life satisfaction, reducing the influence of neurotic aspects of personality. Discussion. The data gathered in this study indicated that, despite similar significance for quality of life, psychological flexibility, self-compassion and ego-resiliency have different personality background. It has important implications for the selection of therapeutic tools, where psychological flexibility, least conditioned by personality, seems to be the most accessible and learnable resource, regardless of the personality structure.

108. Comparing Mindfulness with Self-Compassion and Acceptance as Predictors of Middle-aged Females’ Health Status

Primary Topic: Theoretical and philosophical foundations
Subtopic: Mindfulness, Self-compassion, Acceptance, Menopausal Symptoms, Midlife
Kazuki Hashiguchi, Doshisha University
Sho Yoshikawa, Doshisha University
Kakuichi Hasebe, Doshisha University
Mitsuki Nakamura, Doshisha University
Muto Takashi, Doshisha University

Middle-aged females experience significantly lower levels of psychosomatic health than other members of the general population. Mindfulness has been shown as a modifiable predictor of psychological distress among middle-aged females. However, prior research has suggested that acceptance and self-compassion, which are mindfulness-related factors, may serve as better predictions than mindfulness. Therefore, we examined whether acceptance and self-compassion can significantly predict psychosomatic health of females after controlling the for influence of mindfulness. 200 middle-aged women completed self-reported measures of menopausal symptoms, depressive symptoms, somatic-related quality of life, mental-related quality of life, and well-being. Correlation analysis showed that mindfulness, self-compassion, and acceptance were also significantly associated with all variables of psychosomatic health. Hierarchical regression analysis revealed that after controlling for mindfulness, only acceptance significantly predicted menopausal and depressive symptoms. Additionally, after controlling for mindfulness, self-compassion and acceptance significantly predicted mental-related quality of life and well-being. Acceptance predicted mental-related quality of life more highly than self-compassion, whereas self-compassion predicted well-being. These findings suggest that acceptance is an important predictor of negative aspects of health and that self-compassion is an important predictor of positive aspects.

109. Stressful tasks, state levels of experiential avoidance and emotion regulation: How are they related?

Primary Topic: Theoretical and philosophical foundations
Subtopic: Experiential avoidance, behavior analogue research, emotion regulation
Kyra Bebus, B.S., Western Michigan University
Meaghan Lewis, M.S., Western Michigan University
Amy Naugle, Ph.D., Western Michigan University
Tabitha DiBacco, B.A., Western Michigan University
Allie Mann, B.S., Western Michigan University

Experiential avoidance (EA), an unwillingness to experience undesirable private events, is quickly becoming a critical transdiagnostic variable for behavioral scientists to consider because it is associated with many different forms of psychopathology. Due to the many limitations inherent in self-report methodology, the aim of the present study was to study the relationship between two behavior analogue tasks of EA in a laboratory setting. Performance on the cold pressor task (Zettle et al., 2012) and Trier Social Stress Test (TSST; Kirschbaum et al. 1993) was therefore assessed across four dimensions (threshold, tolerance, endurance, and intensity) among a convenience sample of undergraduates to assess their levels of EA. The State Measure of Experiential Avoidance (SMEA; Kashdan et al., 2014) and State-Difficulties in Emotion Regulation Scale (S-DERS; Lavender, Tull, DiLillo, Messman-Moore, & Gratz, 2017) were given before and after each task to appraise levels of state EA and emotion regulation. The relationship between the four assessed dimensions of the two stressful tasks and state measures of EA and emotion regulation will be presented. Initial findings indicate that participants reported higher levels of state EA and state emotion dysregulation following exposure to the social stress task. Findings will be presented in relation to their clinical impact on the treatment of psychopathology from a dimensional framework.

Thursday, 27 June, 2019, 19:45-20:45 - Poster Session #2

1. Heart Rate Variability Predicts Mindfulness, Emotion Regulation Deficits, and Psychopathology

Primary Topic: Behavioral medicine
Subtopic: Mindfulness
Kelsey Pritchard, M.A., The University of Toledo
Hannah Herc, M.Sc., The University of Toledo
Peter Mezo, Ph.D., The University of Toledo

Background: Mindfulness and other emotion regulation (ER) constructs are implicated as transdiagnostic mechanisms of psychological flexibility in depression and anxiety. Physiological indices, such as heart rate variability (HRV), have also been associated with ER deficits and increased psychopathology. Increased HRV suggests more adaptability and flexible responding to stressors. Thus, the present study examined mindfulness, associated ER deficits, and psychophysiological mechanisms in the role of psychopathology. Methods: Ninety-three undergraduate students (Mean age = 19.99; 63% female) completed measures of mindfulness (Mindfulness Attention Awareness Scale), mood symptoms (Depression, Anxiety, & Stress Scale-21; DASS-21), Difficulties in Emotion Regulation Scale (DERS), and heart rate variability (HRV) measured at baseline. Mediation models were employed using SPSS PROCESS. Results: Increased HRV was associated with increased mindfulness, improved ER capabilities, and reduced depressive, anxiety, and stress symptoms. The findings of our mediation models suggest that increased HRV predicts reduced ER dysregulation via greater mindfulness. Further, these biomarkers also predicted reduced depressive symptoms as mediated by mindfulness. Conclusion: These findings provide further evidence of the role of psychophysiological mechanisms in psychological flexibility and reduced symptoms. Clinical implications and future directions for research will also be discussed.

2. Relevant Correlates of Suicide Ideation and Hopelessness Among People Living With HIV/AIDS: Further Support for ACT?

Primary Topic: Behavioral medicine
Subtopic: HIV/AIDS, Suicide, ACT
Lauren B. Johnson, M.Ed., M.S., Drexel University
C. Virginia O' Hayer, Ph.D., Drexel University College of Medicine
Chelsi Nurse, B.S., Drexel University College of Medicine

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and suicide are two of the most serious global public health concerns. Approximately 37 million people worldwide are living with HIV/AIDS, while close to 800,000 people complete suicide each year globally. HIV/AIDS often creates significant psychological distress and suicide rates are elevated among people living with HIV/AIDS (PLWHA). The interrelation between these two issues is complex, but empirical investigation into specific factors that may contribute to suicidal behaviors among PLWHA is imperative. The present study sought to identify theoretically relevant correlates of suicide ideation and hopelessness among PLWHA. It was hypothesized that there would be an inverse association with medication adherence, while there would be a positive association with variables representing rumination, cognitive fusion, general shame, and experiential avoidance. Participants (n=110) who have been diagnosed with HIV/AIDS presented to Drexel University’s Center City Clinic for Behavioral Medicine for psychological treatment. Participants completed a demographics questionnaire along with six validated self-report measures. The findings demonstrated that both suicide ideation and hopelessness were each positively correlated with rumination, cognitive fusion, general shame, and experiential avoidance, while only suicide ideation was inversely correlated with medication adherence. These significant correlations are promising as several defining components (e.g., defusion, acceptance) of Acceptance and Commitment Therapy (ACT), a transdiagnostic evidence-based intervention, target behaviors like rumination, cognitive fusion, shame, and avoidance. These findings suggest that more research is indicated, which may provide further support for the use of ACT among PLWHA who are at increased risk for suicide.

3. Self-Compassion Moderates Hopelessness in Predicting Suicide Ideation Among People Living With HIV/AIDS

Primary Topic: Behavioral medicine
Subtopic: Suicide, Self-Compassion, HIV/AIDS
Lauren B. Johnson, M.Ed., M.S., Drexel University
C. Virginia O' Hayer, Ph.D., Drexel University College of Medicine
Chelsi Nurse, B.S., Drexel University College of Medicine

Suicide is increasingly recognized as a significant public health concern and it has been suggested that people living with HIV/AIDS (PLWHA) experience increased rates of suicide. Hopelessness has been identified as a salient risk factor for suicide, while self-compassion has been cited as a meaningful protective factor for diverse psychopathology. More recently, there has been emerging evidence supporting the potential buffering effects of self-compassion with regards to suicidal behaviors, which makes additional research among PLWHA who experience elevated risk, particularly meaningful. The present study sought to examine the moderating effects of self-compassion between hopelessness and current suicide ideation. One-hundred participants who were previously diagnosed with HIV/AIDS presented for psychotherapy treatment in the Center City Clinic for Behavioral Medicine at Drexel University. Participants completed several validated self-report measures, including the Self-Compassion Scale-Short Form and the Beck Depression Inventory II. The findings supported the moderating role of self-compassion, demonstrating that when individuals reported low levels of self-compassion and high levels of hopelessness, they experienced significantly elevated rates of suicide ideation. Alternatively, individuals that reported high levels of self-compassion experienced similar rates of suicide ideation, regardless of their level of hopelessness. These findings highlight self-compassion as a potential protective factor against suicidal thoughts, particularly among PLWHA who are struggling with feelings of hopelessness. Additionally, these results encourage greater exploration into the construct self-compassion and may suggest the relevance of interventions like Mindful Self Compassion, Compassion Focused Therapy, and ACT in reducing suicidal behaviors among PLWHA and other populations at increased risk for suicide.

4. ACT for Migraine: Effect of Acceptance and Commitment Therapy (ACT) for High Frequency Episodic Migraine without Aura: A phase-II, multicentric, randomized, open-label study

Primary Topic: Behavioral medicine
Subtopic: ACT, migraine, chronic pain
Licia Grazzi, M.D., Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation
Caroline Bernstein, J Graham Headache Center, Brigham & Women Faulkner Hospital
Alberto Raggi, Ph.D., Neurological Institute "C. Besta" IRCCS Foundation
Emanuela Sansone, Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation
Eleonora Grignani, Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation
M Searl, J Graham Headache Center, Brigham & Women Faulkner Hospital
Paul Rizzoli, M.D., J Graham Headache Center, Brigham & Women Faulkner Hospital

Background: Patients with High Frequency Episodic Migraine without Aura (9/14 attacks per month) are exposed to the risk of chronification and medication overuse. These patients need a multidisciplinary approach before than a chronic condition is induced. Recently, non-pharmacological approaches as Mindfulness, Acceptance Commitment Therapy (ACT), showed encouraging results for pain & migraine. The goal is the psychological flexibility by cultivating positive psychological capacities to improve mental & physical states, disability, and impact of pain conditions. The aim of our study is to assess the feasibility of a novel ACT model for High Frequency Episodic Migraine without Aura (IHS beta 2013 criteria) and its effectiveness respect to a standard treatment. Methods: Twenty-four patients with High Frequency Episodic Migraine without aura were included and randomized for the study. Two treatment conditions: 1) TAU (Treatment as Usual): pharmacological prophylaxis. 2) TAU + ACT. ACT consisted of six, 90 minutes, weekly sessions, and two booster sessions, one every 15 days involving psycho-education, discussions, experiential exercises and home assignments Results: results at the 6month follow-up showed decrease of days of headache /month in the ACTgroup (10±2 vs 7.2±4.5), not in the TAUgroup (9.2±3.4 vs 9.4±5.2), and of medications intake /month in the ACTgroup (9.2±2.8 vs 5.5±4.4) not in the TAUgroup (9.9±3.6 vs 8.2+±5.5). Discussion: Although preliminary, results show ACT as suitable for this category of patients. An integrated and flexible treatment combining different approaches seems more effective than drugs alone to alleviate pain.

5. Mindfulness meditation for migraine in pediatric population: A pilot study

Primary Topic: Behavioral medicine
Subtopic: Mindfulness, children, headache, pain
Licia Grazzi, M.D., Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation
Emanuela Sansone, Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation
Eleonora Grignani, Neurological Institute "C. Besta" IRCCS Foundation
Alberto Raggi, Ph.D., Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation
Frank Andrasik, M.D., University of Memphis

Introduction: Chronic Migraine (CM) is a highly disabling condition characterized by at least 15 days with headache per month, impairing patients’ emotional, social, and work/school functioning. CM prevalence is around 2% among adolescents. In pediatric populations, the use of pharmacological prophylaxis should not be encouraged for side effects. Mindfulness demonstrated a clinical advantage in chronic pain in pediatric populations, but no clinical experience in juvenile migraine. Aims of this study were to examine the feasibility, acceptability, and effectiveness of a Mindfulness-based intervention in adolescents, aged 12-17, with CM. Methods: seven, 45 minutes weekly sessions of guided mindfulness-based meditation, were conducted. The group-based session aimed to teach and make direct practice with skills intended to enhance sustained nonjudgmental present moment awareness. The techniques include guided body scan, tension release, mindfulness meditation, breath-focused imagery, guided imagery and decentralization of thoughts. Participants were asked to practice at home for at least 10 min/day. The variables evaluated were: headache frequency/month, medication intake/month; catastrophizing attitude (Pain Catastrophizing Scale, PCS). Results: Twenty-two patients were enrolled. Ten patients completed all sessions and the 6month follow-up: the number of headache days/month decreased (16±9.3 vs 5±4.1), the medication intake/month (7±6.9 vs 2.8± 2.4 ) and the catastrophising attitude (PCS 29.3±6.4 vs 15.4±9.8). Discussion: Although the data are preliminary and the group of patients limited, the results seem to confirm the feasibility and acceptability of a Mindfulness intervention for chronic migraine in adolescents. No side effect was reported from patients.

6. Acceptance and Valued behavior change - a case study on a teambased ACT-model treating a young teen with persistant pain

Primary Topic: Behavioral medicine
Subtopic: Persistent Pain, Children, Adolescents, ACT, Team
Malin Lanzinger, M.Sc., Department of Pediatric Pain, Skane Univerity Hospital
Ulrika Ermedahl Bydairk, Department of Pediatric Pain, Skane University Hospital

BACKGROUND: Persistent pain in children and adolescents is a common and growing problem. Treatment addressing persistent pain involving behavioural interventions such as CBT and ACT has in other studies proven to be successful. This case study describes a team-based ACT-intervention model carried out on a teen age girl with persistent pain. METHOD: A 13-year-old girl, “Emma”, was referred to the Department of Pediatric Pain, Skane University Hospital, Sweden. She had suffered from joint and muscle pain since early childhood. Pain affected her quality of life and function in valued areas such as school, friends, family and exercising. The multi-professional treatment the clinic carry stem from a biopsychosocial model for persistent pain. The clinic’s ACT-intervention model for treatment divides into three major parts: 1) Initial behavioral analysis, psycho- and pain education, values work and creative hopelessness. 2) ACT-focused interventions toward increased psychological flexibility and behavioral change in valued directions. 3) Relapse prevention. The team consisted of a psychologist and physiotherapist. A medical doctor was responsible for pain education RESULTS: Treatment was evaluated with assessments of pain intensity, pain acceptance, psychological flexibility and ability to act toward values. Assessments showed improvement at end of treatment. Improvements remained at 3- and 12-months follow-up. DISCUSSION: The results indicate this ACT-intervention model and team work to be a successful way of helping a young person with persistent pain to live a valued life. The authors find a joint case-conceptualization and synchronized team interventions to be of importance.

7. Psychological flexibility’s impact on altered grey matter density and resting state functional connectivity among headache sufferers vs. matched controls
Greece-Cyprus Chapter Sponsored
Primary Topic: Behavioral medicine
Subtopic: Headache, Psychological Flexibility, MRI study
Maria Karekla, Ph.D., University of Cyprus
Vasilis S. Vasiliou, Ph.D., University of Cyprus
Savvas Papacostas, M.D., Institute of Neurology and Genetics
Yiolanta Christou, Institute of Neurology and Genetics
Marios Constantinou, Center for Cognitive Behavior Psychology & University of Nicosia
Andrew T. Gloster, University of Basel
Nikos Konstantinou, Cyprus University of Technology

Background: Imaging studies demonstrated localized anatomical and functional brain changes in headache sufferers. Use of magnetic resonance imaging (MRI) allows the exploration of brain activation in resting state connectivity alterations and how these relate to headaches. How behavioral variables and individual difference factors relate to anatomical and functional differences in headache patients is yet unknown. This study investigated differences in grey matter density and resting-state functional connectivity, and their interaction with individual difference variables (e.g., psychological inflexibility) previously found to contribute to pain suffering and psychopathology. Method: Participants (38 headache patients: M diagnosis years=18.09, SD=10.71 and 24 healthy age-and-gender-matched controls; 46 females, Mage=46.37, SD=13.73) completed measures and underwent brain MRI scanning. Voxel-based morphometry (VBM) analyses from segmented T1-weighted anatomical MR images were used to investigate differences in grey matter density. Also used were traditional seed-based and voxel-to-voxel analyses on functional MRI data to investigate functional connectivity during rest. Group differences were assessed and their associations with psychological flexibility measures investigated. Results: The two groups significantly differed in grey matter density and functional connectivity in several subcortical, frontal and temporal brain areas and differences were associated with the degree of psychological flexibility in pain. Some of the differences (e.g. in subcortical areas such as the amygdala) in structural brain changes and impaired functional connectivity between the groups were evident only when psychological flexibility was accounted for. Discussion: The way in which psychological flexibility interacts with brain regions can provide insight into understanding the neural correlates of the head-pain experience.

8. Impact of Acceptance and Body Compassion in Endometrial Cancer Patients

Primary Topic: Behavioral medicine
Subtopic: Mindfulness, Experiential Avoidance, Body Compassion, Cancer
Stefanie L. Denu, Psy.D., Xavier University
Christine M. Dacey, Ph.D., ABPP, Xavier University
Abbie O. Beacham, Ph.D., University of Colorado Denver
Renee Zucchero, Ph.D., Xavier University

Background: This study explored the predictive role of body-related components, such as body compassion and BMI, and components of the Acceptance and Commitment Therapy (ACT) model, such as mindfulness and experiential avoidance, on the experience of pain and quality of life in endometrial cancer survivors. Method: Surveys were sent to members of a national online support group for endometrial cancer patients who had completed treatment. Measures included the Five Facet Mindfulness Questionnaire – Short Form (FFMQ-SF), Acceptance and Action Questionnaire-II (AAQ-II), Body Compassion Scale (BCS), Brief Pain Inventory – Short Form (BPI-SF), Functional Assessment of Cancer Therapy – Endometrial Cancer (FACT-En), and the Positive and Negative Affect Schedule (PANAS). The study included 82 total women participants. Results: ACT components and body-related components, as a set, predicted pain interference and quality of life but not pain severity. Experiential avoidance was determined to be an independent predictor of quality of life. Negative affect, used as a covariate, independently predicted unique variance in pain severity, pain interference, and quality of life. Age, also a covariate, was an independent predictor of pain interference and quality of life. Lastly, obese endometrial cancer survivors endorsed higher experiential avoidance, lower mindfulness, and lower body compassion compared to non-obese endometrial cancer survivors. Discussion: Body-related and ACT components, taken together, may be predictive of pain interference and quality of life, while experiential avoidance may contribute uniquely to quality of life, rendering it a key target of future intervention for endometrial cancer survivors post-treatment.

9. Psychometric properties of the Portuguese versions of the Chronic Pain Acceptance Questionnaire (CPAQ-8) and the Psychological Inflexibility in Pain Scale (PIPS)

Primary Topic: Behavioral medicine
Subtopic: Mindfulness
Vera Almeida, Ph.D., Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)
José Rocha, Ph.D., Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)
Ricardo Teixeira, Ph.D., Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)
Susana Ferreira, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)
Sofia Rosas, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)
Maria Paço, Ph.D., Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)
Paula Chaves, Ph.D., Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)
Teresa Pinho, Ph.D., Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS)
José Pereira Monteiro, Ph.D., CGPP/IBMC/UP

Background: Chronic pain is a medical condition that affects a large number of people with a high impact in quality of life and psychological morbidity. Acceptance and commitment therapy has been investigated and used in several medical conditions including chronic pain with good empirical support (1). The aim of this study consists in analyzing the psychometric properties of two instruments: the CPAQ and the PIPS in a Portuguese sample of patients with chronic pain. Method: A sample of 79 voluntary participants (64.1% women), mean age of 44.0 years (SD=15.9) was assessed using a demographic and clinical pain description tool, the Portuguese versions of CPAQ and PIPS, based on a multiphase translation process. Both are Likert scales, CPAQ evaluates dimensions of «Activity Engagement» and «Pain Willingness» with 8 items, and PIPS evaluates dimensions of «Avoidance» and «Cognitive Fusion» with 12 items. Results: The reliability studies provide internal consistency Cronbach alpha of .945 for CPAQ and .937 for PIPS. The exploratory factor analysis solutions for both scales are consistent with original version results. Also, we clarified the discriminant value of both scales from different pain conditions and non-clinical pain. Discussion: These preliminary findings suggest that the Portuguese translations of CPAQ-8 and PIPS have good psychometric properties. These two versions are valid and adequate and may be used to explore the pain acceptance and the psychological in/flexibility in chronic pain patients.

10. Humour styles and mindfulness facets: A pilot study in patients with fibromyalgia

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Adrian Perez-Aranda, Group of Psychological Research in Fibromyalgia & Chronic Pain (AGORA), Institut de Recerca Sant Joan de Déu
Natalia Angarita-Osorio, Basic Psychology Unit, Universitat Autònoma de Barcelona
Albert Feliu-Soler, Group of Psychological Research in Fibromyalgia & Chronic Pain (AGORA), Institut de Recerca Sant Joan de Déu
Xavier Borràs, Basic Psychology Unit, Universitat Autònoma de Barcelona
Eva Dallarés-Villar, Universitat Autònoma de Barcelona
Laura Andrés-Rodríguez, Group of Psychological Research in Fibromyalgia & Chronic Pain (AGORA), Institut de Recerca Sant Joan de Déu
Juan V. Luciano, Group of Psychological Research in Fibromyalgia & Chronic Pain (AGORA), Institut de Recerca Sant Joan de Déu

Background: Fibromyalgia (FM) is a prevalent syndrome characterized by chronic pain, fatigue, stiffness, psychological distress, and cognitive disturbances. The role of coping strategies in conditions such as FM is crucial, and humor has been described as an effective strategy for emotion regulation. Humor styles have presented interesting associations with variables related to coping, such as self-efficacy, neuroticism, and mindfulness traits, which in turn have presented moderating effects on some clinical outcomes in cognitive-behavioral therapies and mindfulness-based interventions (MBIs). Considering the evidence for humor as a powerful strategy for emotion regulation, the present pilot study aims to examine the possible predictive effect of humor styles in the clinical changes after an MBI for FM. Method: The sample comprised 35 patients who were part of the EUDAIMON study. The Revised Fibromyalgia Impact Questionnaire scores indicated that the sample presented a moderate level of severity. Results: Linear regression analyses showed that “affiliative humor” and the humor style ratio (positive humor styles divided by negatives) had a predictive effect on perceived clinical changes in areas such as “physical activity”, “work activity”, “mood”, and “pain”. Significant correlations between humor styles and clinical severity, and between some facets of mindfulness and humor styles, particularly “self-enhancing humor”, were observed. Discussion: These preliminary findings consider, for the first time, the possible predictive role of humor styles in the response to MBIs and enhance existing evidence of their link with mindfulness. The implications and limitations of these results are discussed.

11. The relationship between avoidance of disease and self-care behavior in patients with type 2 diabetes

Primary Topic: Clinical Interventions and Interests
Subtopic: type 2 diabetes
Aiko Ohya, Doshisha University
Hisashi Makino, National Cerebral and Cardiovascular Center
Mayu Tochiya, National Cerebral and Cardiovascular Center
Yoko Ohata, National Cerebral and Cardiovascular Center
Ryo Koezuka, National Cerebral and Cardiovascular Center
Kiminori Hosoda, National Cerebral and Cardiovascular Center
Takashi Muto, Doshisha University

This study examined the relationship between avoidance of disease and self-care behavior in patients with type 2 diabetes mellitus (T2DM) and any differences in the self-care behavior based on the pattern of psychological flexibility. A hierarchical cluster analysis was performed with 124 patients with T2DM. Furthermore, an ANOVA was performed to examine if there is a significant difference in self-care variables based on the degree of avoidance or clusters. Patients with high avoidance of diabetes had more DM-distress, external eating behavior, and emotional eating behavior than did those with low avoidance of diabetes. A total of 124 patients with T2DM were classified into 3 clusters (C1–C3). C1 consisted of high cognitive fusion, low mindfulness, and high continuing behavior (CB). C2 consisted of standard CF and mindfulness and low CB. C3 consisted of low CF, high mindfulness, and slightly high CB. Patients in C1 did more exercises than did those in C2. On the other hand, patients in C1 had more DM-distress and emotional eating behavior than did those in C3. The characteristics of self-care behavior were in accordance with the balance of psychological flexibility. Accordingly, interventions should also be developed.

12. The “DIXIT” game cards and their role in valuing: An exploratory protocol
ACT Italia
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, Experiential Exercise, Values Exercises, Values Clarification, Adolescents, Adults
Alessandra Chiarelli, IESCUM, ACT Italia, ASCCO
Margherita Gurrieri, IESCUM, ACT Italia
Giovambattista Presti, KORE University, IESCUM, ACT Italia
Francesca Pergolizzi, IESCUM, ACT Italia, ASCCO
Paolo Moderato, IESCUM, ACT Italia, ASCCO

Valuing is a fundamental process of an Acceptance and Commitment Therapy (ACT) protocol to help clients to choose and behave in a valued pattern. In doing so the therapist helps the client to develop a meaningful life in spite of difficulties and sorrow that can emerge (Hayes & Harris, 2009). In the therapeutic ACT setting valuing is promoted through metaphors, experiential exercise and clinical conversation. Sets of cards have been found to useful in promoting the conversation with the client expecially with younger people (Hayes, 2012). In those sets evocative pictures are usually paired with questions that can help the client to explore his values with respect to many life domains. We present a protocol of how "DIXIT" cards can also be used to promote value based conversation and significatively impact on a client’s behavioral pattern. "DIXIT" is a card-based board game created by Jean-Louis Roubira, the cards reproduce pictures without words. The aim of the game is that players select cards illustrated with dreamlike images that match a title suggested by the "storyteller", and attempt to guess which card the "storyteller" selected. Our hypothesis was that the absence of verbal labels that prompt client valuing verbal behavior might be more useful to bypass obstacles to choices generated by a pliancing repertoire. The use of these cards may allow people to contact their values in more free and spontaneous ways and expand conversation about values. Implications for refining a value based conversational-exercise and future research will be discussed.

13. Acceptance and Commitment Therapy (ACT) in an Acute Care Hospital: A case report
ACT italia
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy (ACT)
Alessia Medioli Ph.D., ASCCO, ACT Italia, Fondazione Richedei
Giuseppina Majani, Ph.D., ASCCO, ACT italia
Luigina Scaglia, Fondazione Richiedei

Background: In acute care clinical conditions may change very rapidly. The psychological support should be flexible in order to follow the clinical changes. The present study aims at demonstrating the usefulness of ACT in helping a patient throughout the different stages of his illness. Method: R. is a 74 years old patient hospitalized for cachexia and dehydration. He was worried about an oncologic relapse (after 1 year since surgery for pharyngeal cancer) and the consequent impairment in daily life. R. was mutacic and slightly dysarthric. The MMSE was 30/30, GDS 3/15, Hamilton Scale 5/68. The diagnostic procedures showed a total dysphagia due to surgery, that made it necessary to try to place a asogastric tube or a Percutaneous Endoscopic Gastrostomy (PEG), which resulted actually not feasible and forced us to place a Peripheral Inserted Central Catheter (PICC). Almost daily psychological ACT sessions made it possible to shift from the fear of dying of cancer to the acceptance of dysphagia and finally of PICC, by focusing on concepts of flexibility, changing targets and choosing committed actions within R.’s values framework, and building acceptance according to the changing needs. Results: The R.’s perspective change, above described, is showed in ACT Hexaflex and Matrix obtained before and after the psychological sessions. Discussion: The ACT approach showed to be very useful in the medical practice, since its agile applicability suits the patients’ needs and help clinicians in offering targeted support.

14. Does Mindfulness Matter? The Role of Mindfulness on Emotion Dysregulation in Individuals with GAD in Two Independent Samples

Primary Topic: Clinical Interventions and Interests
Subtopic: GAD; Mindfulness
Alex Buhk, M.A., University of Toledo
Heather Schultz, M.A., University of Toledo

Generalized Anxiety Disorder (GAD) is a prevalent affective disorder (Hofmann et al., 2010) that is highly comorbid with unipolar mood disorders (Mennin et al., 2008), and is associated with emotion dysregulation (Mennin et al., 2009), emotional and behavioral avoidance (Mennin et al., 2009), and chronic anxiety/worry symptoms (Wittchen, 2002). While Cognitive Behavioral Therapies are common treatments for GAD, recent research suggests that mindfulness-based interventions could be efficacious in treating anxiety, depression, and stress, all characteristics of GAD (Khoury et al., 2013). The current study tested the explanatory power of mindfulness on the relation between GAD status using a strict clinical cutoff (GAD, No-GAD) and emotion dysregulation in two large independent samples (n1 = 499; n2 = 500). Participants completed the Generalized Anxiety Disorder Questionnaire-IV (GADQ; Newman et al., 2002), Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004), and the Freiburg Mindfulness Inventory (FMI; Walach et al., 2006). The current study employed mediation analyses (Preacher & Hayes, 2008). The results revealed a partial mediation in both samples, suggesting that GAD is significantly related to difficulties in emotion regulation, and that mindfulness has an important role in this relationship. These findings provide support for the role of mindfulness in GAD, as influencing one’s ability to effectively regulate emotion. Given the role of mindfulness in this relationship, incorporating mindfulness-based strategies in the treatment of GAD might be efficacious. Treatment and research implications of these findings will be discussed.

15. Do You Want to Talk About It? The Role of Social Interaction Anxiety on Reluctance Felt While Discussing Emotional Events in Individuals with GAD

Primary Topic: Clinical Interventions and Interests
Subtopic: GAD; Social Anxiety
Alex Buhk, M.A., University of Toledo
Amy Capparelli, M.A., University of Toledo
Jason Levine, Ph.D., University of Toledo

While research has shown that Generalized Anxiety Disorder (GAD) has high prevalence rates (Hofmann et al., 2010), relatively poor treatment outcomes (Borkovec et al., 2002), high comorbidity (Wittchen et al., 1994), and strong associations with worry (Wittchen, 2002), and emotion dysregulation (Mennin et al., 2009), far less is known about the source of threat in, and how individuals with GAD respond to emotional and social situations. Though minimal research has examined social-contextual factors in GAD, social concerns are rated as the most common worry topic among individuals with GAD (Borkovec, 1994). Individuals with GAD have also been linked to experiencing dysfunctional social cognition and maladaptive interpersonal behaviors (Erickson & Newman, 2007). The current study tested the explanatory power of interpersonal anxiety on the relations between GAD status using a strict clinical cutoff (GAD, No-GAD) and participant reluctance when discussing emotional events with an interviewer. 151 participants completed the Generalized Anxiety Disorder Questionnaire-IV (GADQ; Newman et al., 2002), and the Social Interaction Anxiety Scale (SIAS; Mattick & Clarke, 1998). Participants were interviewed and asked to describe an emotional life event in great detail. Participants then rated how reluctant they felt discussing the emotional event (reluctance). The current study employed mediation analysis (Preacher & Hayes, 2008). The results revealed an indirect effect suggesting that the effects of GAD status on reluctance are mediated by SIAS. This model suggests that reluctance is maintained by the way individuals with GAD interact in social situations. Treatment and research implications of these findings will be discussed.

16. A Biopsychosocial Review of Generalized Anxiety Disorder

Primary Topic: Clinical Interventions and Interests
Subtopic: GAD
Alex Buhk, M.A., University of Toledo

A complete understanding of Generalized Anxiety Disorder (GAD) will require the examination of several levels of analysis, including biological, psychological, and social-contextual factors. Research has shown that GAD has high prevalence rates (Hofmann et al., 2010), relatively poor treatment outcomes (Borkovec et al., 2002), high comorbidity (Wittchen et al., 1994), and strong associations with negative affectivity (Mennin et al., 2008), worry (Wittchen, 2002), and emotion dysregulation (Mennin et al., 2009). Despite being one of the most common anxiety disorders (Wittchen, 2002), GAD’s psychophysiology is still largely overlooked and poorly understood. There is limited research among patient samples regarding GAD and cardiac vagal activity (Friedman, 2007), and lab studies yield inconsistent results (Fisher & Newman, 2013; Levine et al., 2016). As such, the psychophysiological profile of GAD remains inconsistent and unclear. More importantly, there has been a non-consideration of social-contextual factors within the GAD literature. As these factors have been minimally examined, we do not understand how individuals with GAD respond or think in social situations. As social concerns are among the most worried topics for individuals with GAD (Borkovec, 1994), it seems essential to further examine these factors. While indirect evidence suggests that GAD is correlated with dysfunctional social cognition and maladaptive interpersonal behaviors (Erickson & Newman, 2007), these factors need to be examined in a controlled, laboratory-based setting among various levels of analysis. Taken together, it is essential for researchers to examine the biopsychosocial factors among individuals with GAD. Until then, our conceptualization of GAD remains incomplete.

17. Preliminary Correlates of Generalized Pliance in Adolescents Attending School in Ireland

Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents' Generalized Pliance
Alison Stapleton, University College Dublin
Louise McHugh, Ph.D., University College Dublin

The Generalized Pliance Questionnaire for Children (GPQ-C) was recently validated in a sample of Colombian children aged 8-13 (M = 9.57, SD = 1.1), with generalized pliance linked to psychological inflexibility and worry (Salazar et al., 2018). The present study administered the GPQ-C to a sample (n = 54) of female adolescents aged 15-17 (M = 15.43, SD = .536) attending school in Ireland to explore the relationships between generalized pliance, psychological inflexibility and affect. The GPQ-C was moderately correlated with avoidance and fusion, r = .553, p < .001, and negative affect, rs = .312, p = .022, but not positive affect, r = -.246, p = .073. Findings are compared to those of Salazar et al. (2018) and a need to assess the criterion validity of the GPQ-C against a behavioral task is highlighted.

18. Does parental psychological flexibility play a role in the relationship between anxiety/depression symptoms, parenting stress and parenting styles?

Primary Topic: Clinical Interventions and Interests
Subtopic: Parenting context - Parent-child relationships
Ana Fonseca, Ph.D., University of Coimbra
Helena Moreira, Ph.D., University of Coimbra
Catarina Silva, M.Sc., University of Coimbra
Maria Cristina Canavarro, Ph.D., University of Coimbra

Background:Higher levels of anxiety/depression symptoms may translate into higher parenting stress, which in turn was negatively associated with authoritative parenting, and positively associated with maladaptive parenting styles (authoritarian and permissive), negatively impacting the child’s outcomes. This study aimed to explore if parental psychological flexibility may play a role in the relationship between anxiety/depression symptoms, parenting stress and parenting styles. Methods:The sample comprised 250 mothers of children between 2 and 12 years old, recruited online and in-person, who answered to self-report questionnaires to assess anxiety/depression symptoms, parenting stress, parenting psychological flexibility, general psychological flexibility, and parenting styles. Results: The path model presented a very good fit to data [χ2(37) = 68.54, p < .001; CFI = .97; SRMR = .046; RMSEA = .059, p = .243, 90% CI = 0.036/0.080]. A sequential indirect effect was found, in which higher levels of anxiety or depression symptoms were associated with higher parenting stress, which in turn resulted in lower parental psychological flexibility who was translated into lower use of an authoritative parenting style and with a higher use of authoritarian and permissive styles of parenting. Discussion: Our results are innovative by highlighting the important role of parental psychological flexibility on parenting behaviors. Parental psychological flexibility can be seen as a self-regulatory skill in the parent-child context, as it influences the parent’s ability to regulate their emotions and behaviors in a way that promotes a sensitive response to the child’s needs and good parenting practices, even in the presence of stressful demands.

19. The Portuguese version of the Acceptance and Action Questionnaire for Substance Abuse: Psychometric characteristics

Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological inflexibility, Substance abuse, Exploratory factor analysis, Psychometric properties
Ana Galhardo, Ph.D., Instituto Superior Miguel Torga; Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC) -UC
Frederico Sequeira, M.Sc., Instituto Superior Miguel Torga
Margarida Couto, Ph.D., Private Practice
Marina Cunha, Ph.D., Instituto Superior Miguel Torga; Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC) -UC

Background: Psychological inflexibility (PI) is a relevant mechanism for the onset and maintenance of psychopathology. The Acceptance and Action Questionnaire for Substance Abuse (AAQ-SA) was developed and proved to be a valid and reliable measure for the assessment of PI specifically in substance abuse problems. The current study aimed to achieve a Portuguese version of the AAQ-SA, the AAQ-SA-PT, and investigate its psychometric characteristics. Method: A sample of 90 (71 men and 19 women) pursuing opioid replacement therapy completed the following self-report instruments: AAQ-SA-PT, Acceptance and Action Questionnaire-II (AAQ-II), and Depression, Anxiety and Stress Scales 21 (DASS – 21). Results: AAQ-SA-PT items analyses indicated that items 3, 13, and 15 showed item-total correlations < .40 and their removal would also improve reliability. These items were removed and a principal component analysis (PCA) was conducted. PCA results showed a one-factor structure accounting for 59.20% of the explained variance. Factor loadings ranged from .44 to .90. A Cronbach's Alpha's of .93 was found. Concerning the AAQ-SA-PT association with other measures, positive correlations with the AAQ-II (r = .91; p = <.001), depressive symptoms (r =. 64; p <. 001), anxiety symptoms (r = .29; p <.001) and stress symptoms (r = .43; p < .001) were found. Discussion: The AAQ-SA-PT showed a single component structure, high internal consistency, and adequate convergent and discriminant validity. The AAQ-SA seems to be a reliable and valid measure of EA in people facing substance abuse problems.

20. Examining the underlying Psychological Inflexibility/Psychological Flexibility model components by using network analysis
Greek & Cypriot ACBS Chapter Sponsored
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT model evaluation
Andria Christodoulou, M.A., University of Cyprus
Michalis P. Michaelides, Ph.D., University of Cyprus
Maria Karekla, Ph.D., University of Cyprus

Background: There is a growing interest in adopting innovative approaches to examine the Psychological Inflexibility/Psychological Flexibility (PI/PF) model and related components of the Acceptance and Commitment Therapy (ACT). Traditional approaches are useful for examining a model’s general structure, however they cannot evaluate interactions among its components. Network analysis might be a solution since it allows the examination of a psychological construct as a system of interconnected variables. The current study aimed to 1) construct the PI/PF component network and explore connections between the components; and 2) identify the most important components within the network. Method: 87 individuals with chronic pain, who participated in a larger study examining the effectiveness of an ACT intervention, constituted the study’s sample. Participants completed a battery of ACT measures assessing the different ACT components. Data were used to examine the model within a network analysis approach. A network of the six ACT components was computed. Results: The resulting network showed strong connections among certain ACT components. The strongest positive connection was between Mindfulness and Values-Clarification and the strongest negative connection was between Acceptance and Fusion. The components with the highest centrality indices were Acceptance and Mindfulness. Discussion: Findings showed that the components of Acceptance and Mindfulness hold key roles in the model, since they were more strongly and closely connected with the rest of the components. This indicates that a possible change on these two components might easily activate or cause quicker changes on all connected components.

21. Acceptance and Commitment Therapy-Based Interventions to Improve Wellbeing and Reduce Burnout in Healthcare Professionals: A Systematic Review and Meta-Analysis

Primary Topic: Clinical Interventions and Interests
Subtopic: Healthcare professionals
Arianna Prudenzi, University of Leeds
Christopher D. Graham, Queen's University Belfast
Faye Clancy, University of Leeds
Deborah Hill, University of Leeds
Ruairi O’ Driscoll, University of Leeds
Fiona Day, Fiona Day Consulting LTD
Daryl B. O' Connor, University of Leeds

Background: Several recent trials have assessed Acceptance and Commitment Therapy (ACT) for improving outcomes in healthcare professionals. This systematic review and meta-analysis aimed to collate evidence from these trials to investigate the overall efficacy and effect size of ACT for improving well-being and reducing work-related stress in healthcare professionals. Method: A comprehensive literature search (Ovid MEDLINE, EMBASE, Psych Info) following PRISMA guidelines, identified 20 studies that met the study eligibility criteria. Meta-analyses on primary (wellbeing and work-related stress combined) and secondary (mindfulness, values, cognitive fusion, experiential avoidance combined) outcomes were performed. Results: Although study quality was generally low, results from primary outcomes analyses indicated that ACT outperformed pooled control conditions with a small to moderate effect size (g = 0.48) at all time-points (post-intervention and follow-up combined), at post-intervention (g = 0.40) and at follow-up (g = 0.51). Results from subgroup analyses showed that ACT was superior to inactive and active controls but was not significantly more effective than comparison treatments. ACT interventions also showed slightly better post-intervention psychological flexibility relative to controls (g=.22). Conclusions: ACT interventions that aimed to increase wellbeing and reduce work-related stress in healthcare professionals were found to be more effective than active and inactive control conditions. However, higher quality studies are required and existing evidence suggests that ACT is no more effective than established treatments.

22. Acceptance-based exposure and behavioral measurement: A case study of an elderly woman with obsessive compulsive disorder

Primary Topic: Clinical Interventions and Interests
Subtopic: Behavioral Measurements
Atsushi Seguchi, M.A., Ritsumeikan University

Background: Recently, researchers have identified the importance of using behavioral measurements as dependent variables in the field of Contextual Behavioral Science (CBS). However, there are few reports implementing behavioral measurements as outcomes. This study reports observations from a case study using acceptance-based exposure for a woman in her early 70s who could not enter a supermarket or touch goods because she experienced obsessive compulsive disorder (OCD) related anxiety in the form of spreading candida from her hand. The study verified the effectiveness of the intervention by using behavioral measurements. Method: Client: Woman in her early 70s who experienced OCD related anxiety. Target Behavior: To enter supermarkets and touch goods with her bare hands. Behavioral Measurement: The frequency of entering supermarkets and the number of goods which was touched by her bare hands. Experimental Design: AB design. Intervention: Acceptance-based exposure to a stimulus which induced anxiety for spreading candida from her hand, coupled with a metaphor of square box about her feeling. Results: The client’s frequency of entering supermarkets, and the number of goods touched by her bare hands increased. She was able to go shopping alone. Discussion: The use of behavioral measurements allowed researchers to precisely measure and confirm the change of the client’s behaviors as a result of the acceptance-based intervention.

23. Brief ACT Protocol: Analysing a Child's Creativity

Primary Topic: Clinical Interventions and Interests
Subtopic: CHILDREN
Beatriz Harana, Ph.D. Student, University of Almeria
Beatriz Sebastián, Ph.D. Student
Mari Luz Vallejo, Ph.D. Student

Background: Several researchers have shown interest in the study of the main variables that determine the effectiveness and efficacy of the Acceptance and Commitment Therapy (ACT; Hayes, Strosahl & Wilson, 1999). In addition, some authors have achieved the development of new protocols for psychological intervention based on scientific evidence. However, the evidence available up to date of the implementation of ACT in children is modest, there is still a need to improve the methodology. On the other hand, no studies of ACT interventions in children and their impact on creativity in the Spanish population have been shown. The main aim of this case study is to develop an ACT protocol based in the three key therapeutic strategies (Törneke, Luciano, Barnes-Holmes, & Bond, 2016) and analyse its impact on the creativity and life of the child. Method: This case study consists of a design N=1. The ACT protocol was structured in 10 session (90-minute sessions each) based on the three key therapeutic strategies (Törneke, Luciano, Barnes-Holmes, & Bond, 2016): creative hopelessness, defusion, valued action. The instruments used as a pre- and post-intervention measure were: Cognitive Fusion Questionaire for Young (CFQ-Y), Diagrama Bull’s-Eye, Children Depression Inventory (CDI), Revised Children's Manifest Anxiety Scale (RCMAS) and Torrance Creative Thinking Test (TTCT). Result: The efficacy of the treatment in other clinical cases as well as its limitations are discussed. These results are in line with the single case studies previously performed under Acceptance and Commitment Therapy (ACT) in children.

25. The role of values in understanding the impact of health status on quality of life

Primary Topic: Clinical Interventions and Interests
Subtopic: Values
Brandon Sanford, M.S., University of Nevada, Reno
Cory Stanton, M.S., University of Nevada, Reno
Jonathan Singer, M.A., University of Nevada, Reno

Background: Values attainment is often cited as the ultimate goal of ACT interventions contributing to improvements in quality of life for patients (Wilson & Murrell, 2004). Advances in the approach to values measurement have enabled us to study functional processes as opposed to domains (Smout, Davies, Burns, & Christie, 2014). The current project examines the impact of values attainment and obstruction on the relationship between mental and physical health problems on quality of life. Methods: We recruited a sample of undergraduate college students as part of a larger measurement validation project. Participants completed the following measures at two time points one month apart: the Short-Form 36 (SF-36; Jenkinson, Coulter, & Wright, 1993), the Valuing Questionnaire (VQ; Smout, Davies, Burns, & Christie, 2014), and the Clinical Research Inventory, a novel quality of life measure currently under development. Statistics: This poster will present a moderator analysis testing the impact of overall health on quality of life moderated by values. We will use a regression-based approach to estimate an interaction term to represent the moderation effect. We predict that progress and obstruction in values will significantly moderate how physical and mental health impact participants’ quality of life. Discussion: The implications of this findings will be reviewed with an emphasis on the role of targeting barriers vs. clarification of values in behavioral interventions across both mental and physical health.

26. The impact of early memories of warmth and safeness on social anxiety: the mediating role of self-criticism and fears of compassion

Primary Topic: Clinical Interventions and Interests
Subtopic: Social Anxiety; Self-criticism; fears of compassion; early memories of warmth and safeness
Brígida Caiado, University of Coimbra
Maria do Céu Salvador, Faculty of Psychology and Educ. Sciences; Cognitive-Behavioral Center for Research and Intervention (CINEICC); University of Coimbra

Background: Early memories of warmth and safeness(EMWS) have been negatively associated with self-criticism and fears of compassion(FC). Early critical or negligent experiences (with parents and peers) and self-criticism have been positively associated with social anxiety(SA). Nevertheless, no studies established a relationship between EMWS, FC, and SA. This study explored the mediating role of self-criticism and FC in the relationship of EMWS (with parents and peers) with SA. Method: Sample: 766 Portuguese university students (63.8% females; Mage = 20,46; SD = 3,717). Instruments: Self-report questionnaires measuring EMWS with parents and peers, self-criticism, FC and SA. Results: EMWS with peers had a greater predictive effect on SA than EMWS with parents. FC for others had no association with SA. FC for the self and FC from others was associated with SA, but only the latter significantly mediated the relation between EMWS and SA. FC from others and self-criticism fully mediated the relationship between EMWS with parents and SA but partially mediated the relationship with EMWS with peers. Discussion: EMWS with peers was a best predictor of SA than EMWS with parents. Self-criticism was an important mediator in the relationship of EMWS with parents and peers with SA. The only fear of compassion that mediated this relation was FC from others. FC for the self lost its predictor effect, suggesting that FC from others may precede and originate FC for the self. These results emphasizes the importance of focusing SA interventions on promoting self-compassion, reducing self-criticism and FC, specifically FC from others.

27. Experiential Avoidance and Parent Engagement: How Parent Engagement Factors Contribute to Child Responsiveness in an Intensive Outpatient Program

Primary Topic: Clinical Interventions and Interests
Subtopic: Anxiety and Mood Disorders
Bronwyn Lehman, Ph.D., Children's Hospital Colorado
Clio Pitula, Ph.D., Children's Hospital Colorado

Background: Parental engagement in psychological interventions (i.e., behavioral and attitudinal processes) has been identified as an important predictor of treatment outcomes (e.g., Fjermestad, et al., 2009; Haine-Schlagel & Walks, 2015; Staudt, 2007). However, this engagement may be hindered by parental experiential avoidance (EA). Experiential avoidance is conceptualized by Cheron, Ehrenreich and Pincus (2009) as parent action derived from child emotional arousal designed to control the child’s experience. Experiential avoidance often manifests as parental distress in witnessing their child’s difficult emotional experiences, potentially leading to ineffective responses to the child (Cheron et al., 2009). It is believed that higher EA impacts engagement and predicts poorer treatment outcomes; the aim of the current study. Method: Parental engagement will be evaluated in an intensive outpatient program. Participants (expected N = 15) will be patients aged 13 to 18 years with a mood and/or anxiety disorder and their parent. Experiential avoidance (PAAQ, Cheron et al., 2009) and mood/anxiety symptoms (RCADS-25, Chorpita, Ebesutani, & Spence, 2015) will be assessed in weeks 1 and 6 of treatment, and engagement will be assessed in week 6 from a measure adapted from Hall et al. (2001). Results:At the time of submission, data collection is underway and will be complete prior to the presentation. Preliminary data supports the face validity of the engagement measure. The investigators hypothesize that results will demonstrate that lower EA predicts higher parental engagement and improvement in mood and anxiety scores. Discussion: Results are expected to contribute to understanding of parental engagement factors and may influence intervention components.

28. The effectiveness of FACT (Focussed Acceptance and Commitment Therapy) in primary care: An RCT

Primary Topic: Clinical Interventions and Interests
Subtopic: Focussed acceptance and commitment therapy
Bruce Arroll MBChB, Ph.D., University of Auckland
Helena Frischtak M.D., University of Auckland
Vicki Mount, MBChB, University of Auckland
Fred Sundram, University of Auckland
Susan Fletcher, University of Melbourne
Douglas Kingsford, Inland Health District, British Columbia
Jonathan Bricker, Ph.D., University of Washington

Aims: Is a focussed acceptance and commitment therapy intervention more effective than control for patients with distress in primary care at one week follow up. Methods: Ethics and registered with ANZCTR Location: Greenstone clinic; patients recruited from waiting room; if interested goes to private room. if PHQ 8 ≥ 2 and eligible if can understand info sheet. Consented and randomisation through remote computer. The intervention is a contextual interview (work/love/play) for both groups. The FACT group then gets up to 3 tasks to do with a behavioural likelihood of doing task score. Outcomes blinded by either participant emails in questionnaire or BA phones patient at one week. Results: 57 participants recruited with 28 in the intervention group and 29 in the control. The female/male ratio 38/19; Maori participants 10/28 in the intervention group and 10/29 in the control group; average age intervention group 50.3 years and control group 44.2 years. Baseline: PHQ-8 11 (FACT) vs 11.72 (control) Outcomes one week after intervention FACT Control PHQ-8 7.4 10.1* Emoqol100 67 70** % ≤ 6 on PHQ 8 14/28 (50%) 6/29 (21%)*** *p<0.02 **p>0.05 ***Numbers Needed To Treat = 3.4 Conclusion: The results suggest that the intervention is effective at one week at least for this interviewer and this population of patients with an effect size of 29%. The recruiting rate of 2 participants per half day will be helpful in future research grant applications. This is the first study to examine effectiveness of FACT in any population.

29. The Emoqol 100, an ultra ultra-brief case-finding tool for assessment of mood: a pragmatic diagnostic accuracy audit

Primary Topic: Clinical Interventions and Interests
Subtopic: low mood
Bruce Arroll MBChB, Ph.D., University of Auckland
Connor Mulcahy, University of Aberdeen
Vicki Mount MBChB, University of Auckland

Objective: To assess the diagnostic accuracy for low mood of a single verbally administered question on emotional quality of life (Emoqol 100). Methods: Retrospective audit of consecutive consultations. Participants: Eligible patients who had both a PHQ-9 inventory assessment and an Emoqol 100 recorded at the same consultation. The index test is the verbally asked Emoqol 100 which is the patient’s emotional quality of life now, with 100 being perfect emotional health and 0 being worst imaginable. Results: 102 patients were seen during the study period of which 76 met the eligibility criteria and there were 215 test results for them. For a cut point of <50 on the Emoqol 100 and the PHQ-9 ≥ 12 the sensitivity was 53% (95% CI 45-61) and the specificity was 92% (95% CI 86-98). Discussion: This is the first study of the Emoqol 100 which has a high specificity meaning a mood issue probably exists when the score is low. The test will be very useful for busy clinicians as it takes less than 15 seconds to verbally administer.

30. Psychological flexibility, body appreciation, and social appearance anxiety in Turkish young adults

Primary Topic: Clinical Interventions and Interests
Subtopic: social appearance anxiety, body acceptance, eating disorders
Burcak Kapar, SWPS University of Social Sciences and Humanities
Joanna Dudek, Ph.D., SWPS University of Social Sciences and Humanities

Background: Social appearance anxiety is a shared risk factor for the development of two common disorders namely: social anxiety disorders and eating disorders (Levinson et al., 2011). The study aimed to examine the relationship between psychological flexibility, body appreciation, body mass index (BMI) and the level of social appearance anxiety in Turkey. Method: A sample of 1903 respondents which consisted of 966 females (50.8 %) and 937 males (49.2 %) were included in the current study. Participants who were between the ages of 18 years old and 40 years old were recruited via social media to complete an online survey. We measured the participant’s level of social appearance anxiety, psychological flexibility, and body appreciation. Results: The higher psychological flexibility and body appreciation were related to the lower level of social appearance anxiety. Higher BMI was associated with higher social appearance anxiety. Regression analyses showed that psychological flexibility, body appreciation, and BMI explained 43.5% of the variance of social appearance anxiety. Discussion: These findings highlight the relationships between psychological flexibility, body appreciation, and social appearance anxiety. Extending the research on social appearance anxiety and BMI, the present study indicates that individuals with higher BMI might be more prone to develop appearance-related social anxiety due to weight stigma (Sanlier et al., 2017). Further research is needed to examine whether increasing psychological flexibility and enhancing body appreciation can lead to a decrease in social appearance anxiety and therefore minimize adult’s risk of developing appearance-related distress and eating disorders.

31. Posttraumatic Growth and Suicide in Combat Veterans: The Impact of Mental Health Stigma and Interpersonal Needs

Primary Topic: Clinical Interventions and Interests
Subtopic: Posttraumatic growth; PTSD; stigma; suicide; interpersonal needs
Cara Blevins, M.A., University of North Carolina at Charlotte
Richard G. Tedeschi, Ph.D., University of North Carolina at Charlotte
Amy B. Canevello, Ph.D., University of North Carolina at Charlotte
Christine Elnitsky, Ph.D., University of North Carolina at Charlotte
Elizabeth Malone, Ph.D., University of North Carolina at Charlotte

Background: Over the past 20 years, suicide rates within the US military have increased at unprecedented rates. According to Joiner’s (2005) Interpersonal-Psychological Theory of Suicide (IPTS), perceived burdensomeness and thwarted belongingness are direct risk factors for suicide, which may be exacerbated by self-stigma. Emerging research suggests that posttraumatic growth (PTG) may contribute to post-combat suicide resiliency; however, little is known about the mechanisms underlying its protective influence. Therefore, in an effort to identify intervention targets, the present study sought to test a model of specific mechanisms of suicide risk and resiliency in post-combat military personnel. Methods: Participants included 215 combat veterans of OEF/OIF. Statistical tests of simple mediation models utilizing bootstrapping techniques and analyses in AMOS were used to test the hypothesized model. Results: Self-stigma was positively related to thwarted belongingness, perceived burdensomeness, and PTG. Thwarted belongingness was related to perceived burdensomeness, and perceived burdensomeness was related to suicide risk. PTG was negatively related to thwarted belongingness, perceived burdensomeness, and overall suicide risk. Discussion: Results suggest that self-stigma may exacerbate suicide risk by increasing a sense of thwarted belongingness and perceived burdensomeness. Results also suggest that PTG may directly and indirectly protect against suicide risk by offsetting the risk conveyed through thwarted belongingness and perceived burdensomeness. Thus, when conducting research with combat veterans at risk for suicide, it may be beneficial to consider interactive rather than isolated factors, with an emphasis on potential explanatory mechanisms. Further, PTG, belongingness, and burdensomeness may be important variables to consider in suicide prevention efforts.

32. Protocol based on Acceptance and Commitment Therapy for overweight women

Primary Topic: Clinical Interventions and Interests
Subtopic: Overweight women
Carla Carolina Rodrigues de Melo, Pontifical Catholic University of Goiás
Ana Teresa Stival Coelho, Pontifical Catholic University of Goiás
Laura Saddi, Pontifical Catholic University of Goiás
Laís Melo Giglio, Pontifical Catholic University of Goiás
Nayara Lima, Pontifical Catholic University of Goiás
Ana Cláudia Rodrigues, Pontifical Catholic University of Goiás
Sônia Maria Mello Neves, Pontifical Catholic University of Goiás
Vivian Costa Resende Cunha, Pontifical Catholic University of Goiás

This protocol, based on the book “The Diet Trap” by Lillis, Dahl and Weineland (2016), proposes a group intervention for overweight women who have struggled with weight loss and dieting. The 1st session proposes understanding the effects of control and restriction. The 2nd and 3rd sessions aim to learn about saboteur thoughts and their interference on identifying values. The 4th session seeks acceptance of aversive events. The 5th and 6th sessions focus on the damaging effects of motivation through self-aversion and on promoting self-understanding with a compassionate posture. The 7th session focuses on the relationship with their inner thoughts. The 8th and 9th session encourage healthy life choices. The 10th and 11th sessions aim to understand the values and choose actions for a harmonious life, and the 12th session reviews all the skills learned thus far. The results will be evaluated through participants’ accounts, data obtained from the activities, scores in questionnaires and scales applied before and after intervention, as well as weight measurement.

33. Efficacy of RNT-focused ACT in Bulimia Nervosa

Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy; Repetitive negative thinking
Carlos M. Isaza, Fundación Universitaria Konrad Lorenz
Juan C. Vargas, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

Eating disorders are a global problem whose prevalence has been increased and being one of the main causes of disease in young women. A multifactorial etiology has been recognized in which the sociocultural variables impose an ideal figure model associated with success, beauty and youth. Bulimia Nervosa (BN) has an important prevalence and psychotherapy has been a useful tool in its treatment, mainly Cognitive-Behavioral Therapy, which became the first choice for its intervention due to the empirical evidence obtained. However, there is still a great margin to improve the clinical efficacy of psychological interventions for BN. Acceptance and Commitment Therapy has been very well received in the management of various problems because it is a transdiagnostic treatment, although few studies have been conducted in eating disorders. The aim of this study is to analyze the effect of a brief ACT protocol focused on dismantling patterns of repetitive negative thinking in people suffering from BN. Five women suffering from BN were recruited and a multiple-baseline design across participants was implemented.

34. Psychological Flexibility, Rejection Sensitivity and Loneliness

Primary Topic: Clinical Interventions and Interests
Subtopic: Mental Health and Psychological Inflexibility
Cathrine Saebo, European University of Madrid, Spain
Lidia Budziszewska, European University of Madrid, Spain

Background: High levels of Experiential Avoidance (EA) is often associated with poorer psychological well-being. The purpose of this study is to determine how EA increases an individual´s vulnerability to maladaptive outcomes, such as Rejection Sensitivity (RS) and loneliness. However, as studies looking into the mediational processes are scarce, more cross-sectional and cross-cultural studies are needed to understand the relationship better. The purpose of this study is to investigate the relationship between individuals´ experiential avoidance (EA), rejection sensitivity (RS), and loneliness levels. Method: EA or Psychological inflexibility was assessed using the Acceptance and Action Questionnaire II (AAQ-II) (Bond et al., 2011). Measures of RS was assessed using the Rejection Sensitivity Questionnaire- Adult version (ARSQ; Downey & Feldman, 1996). Measures of one’s subjective feelings of loneliness as well as feelings of social isolation were assessed using the revised UCLA Loneliness Scale (RULS; Russell, Peplau, & Cutrona, 1980). Results and discussion: According to the results, it was revealed that EA and RS were strongly associated with loneliness. Those results can indicate that RS is a significant predictor of peoples´ feelings of loneliness, likewise, of peoples´ tendency to cope with the possibility of rejection by engaging in EA. In relation to gender, females reported higher RS than males. However, we could not find any significant gender differences regarding EA nor loneliness.

35. Acceptance and Defusion (Openness) Exercises and Metaphors: A Review of ACT English Language Books

Primary Topic: Clinical Interventions and Interests
Subtopic: Metaphors, Exercises, Worksheets, Books
Emanuele Rossi, Psy.D.; Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy; Università degli Studi Guglielmo Marconi, Rome, Italy
Chiara Del Brutto; Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy
Daniele Ginex; Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy
Francesco Mancini, M.D., Psy.D.; Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy; Università degli Studi Guglielmo Marconi, Rome, Italy

In this study, the aim is offering a comprehensive overview of acceptance and defusion processes on ACT books (1999-2018) with the purpose to outline an understandable and user-friendly profile of the use of acceptance and defusion metaphors, exercises and worksheets within them. Acceptance and defusion processes represent one of the three pillars of psychological flexibility: openness. 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 an easy-to-read summary table which provides an essential overview of acceptance and defusion metaphors, exercises and worksheets. This review was conducted with the aim of offering a universally accessible, clear and intuitive cataloging tool of practical and experiential resources for ACT learners and practitioners. Furthermore, the summary table provides a brief description of how every metaphor, exercise or worksheet is presented and a reference to external resources. This poster related to acceptance and defusion is part of a more general pilot project that also entailed other processes of psychological flexibility and could be further extended in the future.

36. The effects of perspective-taking and writing supportive message to others on the state self-compassion

Primary Topic: Clinical Interventions and Interests
Subtopic: self-compassion, perspective-taking
Chisato Tani, Ritsumeikan University
Shinji Tani, Ritsumeikan University

Writing a supportive message to others contributes to enhance the self-compassion (Chisima et al., 2017). From Relational Frame Theory (RFT), writing a supportive message to others activates perspective-taking and, then that might contribute to enhance state self-compassion. The current study investigated the effects of perspective taking skill and writing supportive message on the state self-compassion. Japanese undergraduate students (n=50) participated in this study. The participants read an essay written by a student who had recently broken heart. After that, the participants were randomly assigned to one of the three conditions. In the perspective-taking condition (n=17), the participants performed a task that was designed to active perspective-taking for the student, and they wrote a supportive message to the student. In the message condition (n=17), the participants only wrote a supportive message to the student. In the control condition (n=16), the participants wrote about his shoes. The measurement of the state self-compassion questionnaire was used to assess the effects of the experiment. The results of an analysis of covariance (ANCOVA) showed that no difference was found on the state self-compassion score between groups at post-test. In all groups, means of state self-compassion score at post-test were higher than pre-test. These results suggest that state self-compassion is greatly affected by “reading an essay written by the person who had broken heart” in Japanese students.

37. Negative Affect and Binge Eating: The buffering effect of body image-related psychological flexibility

Primary Topic: Clinical Interventions and Interests
Subtopic: Disordered eating
Cláudia Ferreira, Ph.D., Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra
Margarida Barreto, M.S., Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra
Sara Oliveira, Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra

Objective: The scientific literature supports the association between negative affect and difficulties in regulating eating behaviour, such as binge eating. According to theoretical models, binge eating may be conceptualized as a strategy to escape or reduce some unwanted or aversive states. In fact, some individuals may engage in binge eating when they experience negative affect and distressing situations and are unable to embrace adaptive emotion regulation strategies to cope with them. This study tests the moderator effect of body image psychological flexibility on the relationships between negative affect and binge eating severity. Method: Participants were 403 adults (119 males and 284 females) from the general population, aged between 18 and 55 years old, who completed self-report measures. Results: Negative affect was positively correlated to binge eating severity. Results indicated that the moderation model explained 38.5% of binge eating behaviours and demonstrated that body image-related psychological flexibility had a moderator effect on the association between negative affect and binge eating. Conclusion: The present study indicate that body image flexibility may buffers the tendency to engage in binge eating in the context of aversive and unwanted emotional experiences and may promote self-regulation of eating behaviour. These findings seem to have relevant clinical and research implications.

38. Understanding the mediational role of body appreciation on the relationship between awareness and acceptance competencies and disordered eating

Primary Topic: Clinical Interventions and Interests
Subtopic: body appreciation and disordered eating
Cláudia Ferreira, Ph.D., Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra
Maria Coimbra, Master Student, Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra
Sara Oliveira, Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra

Background: Cardaciotto and colleagues (2008) conceptualized mindfulness as the present-moment awareness of one’s internal and external experiences (rather than preoccupation with past or future events) in an acceptive, open and nonjudgmental mindset. Previous literature corroborates that higher mindfulness abilities are associated with lower levels of psychopathological outcomes. Nevertheless, information about how present-moment awareness and acceptance operate in eating psychopathology is still scarce. Body appreciation, defined as a posture of respect and acceptance toward one's body despite the recognition of its flaws and imperfections, is negatively associated with several indicators of body image and eating-related difficulties. The present study analysed the impact of awareness and acceptance skills on body appreciation, and on the engagement in disordered eating. Method: A path model was tested in which body appreciation was hypothesized as a mediator on the relationship between awareness and acceptance competencies and disordered eating, controlling BMI’s effect, in a sample comprised of 308 women from the general population, aged between 18 and 35 years old. Results: The tested model accounted for 47% of the variance of disordered eating and revealed a very good fit. Results showed that acceptance and awareness skills presented significant indirect impact on eating psychopathology carried through body appreciation. Discussion: These findings suggest that mindfulness abilities may potentiate the promotion of positive body image which have a protective effect on the engagement in disordered eating. Present findings emphasise the importance of promoting mindful competencies in preventive programmes focused on body image and eating behaviours.

39. Caregivers of Alzheimer’s Patients: A 12-Session ACT Protocol

Primary Topic: Clinical Interventions and Interests
Subtopic: Alzheimer, Caregivers
Claudia Perdighe, Psy.D., Scuola di Psicoterapia Cognitiva, SPC
Antonella D’Innocenzo, Psy.D., Scuola di Psicoterapia Cognitiva, SPC
Paolo Rosamilla, Psy.D, Scuola di Psicoterapia Cognitiva, SPC
Emanuele Cassetta, M.D., Ospedale Fatebenefratelli di Roma
Bruno De Sanctis, Psy.D., Scuola di Psicoterapia Cognitiva, SPC
Emanuele Rossi, Psy.D., Scuola di Psicoterapia Cognitiva, SPC
Andrea Gragnani, Psy.D., Scuola di Psicoterapia Cognitiva, SPC

The study evaluated a 12-session protocol based on Acceptance and Commitment Therapy (ACT) aimed at reducing the emotional distress of relatives acting as caregivers of Alzheimer's patients. The work is the result of a collaboration between Scuola di Psicoterapia Cognitiva (SPC) and Fatebenefratelli Hospital in Rome. The protocol had two goals: to increase the acceptance of the disease and the negative outcomes it generates; to increase the commitment to plan and live the daily life in line with goals and values still achievable. Managing an Alzheimer's patient is a highly stressful event for carers, especially when the caregiver is a family member: the progression of the disease represents new and continuous emergencies to be managed for the caregivers, increasing the risk of developing emotional and physical disorders, and compromising the quality of life. The intervention included 10 individual therapy sessions and 2 follow-up sessions. Of the first 10 clients treated, only 8 have completed treatment. Clients completed a battery of tests before and after treatment and follow-up. Results indicate a good response to treatment, lower scores in depression and anxiety measures and an increase in the scores of scales that measure willingness of internal experience and commitment to their values.

40. A mindfulness, acceptance and self-compassion based intervention for eating disorders: Presentation of a clinical trial

Primary Topic: Clinical Interventions and Interests
Subtopic: Eating disorders, contextual-behavioral approaches
Cristiana Marques, M.Sc., CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra
Ana Telma Pereira, Ph.D., Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra
Miguel Castelo-Branco, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, University of Coimbra
Paula Castilho, CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra

Background: Individuals with eating disorder (ED) present difficulties in emotion regulation, engaging in maladaptive strategies (e.g.self-criticism, rumination, avoidance, suppression), to deal with negative internal experiences that arises from body image disturbance, feelings of incompetence, and/or weight concerns. Contextual-behavioral approaches, such as mindfulness, acceptance, and compassion, seem to demonstrate promising results on cognitive processes and eating psychopathology. Despite based on different theoretical models, we hypothesize that particular components of these approaches will address specific difficulties presented by individuals with ED. Therefore, the aim of this project is to develop, implement and assess efficacy of a mindfulness, acceptance- and self-compassion-based intervention for ED. Method: Participants will be selected in hospital centres considering inclusion criteria (female aged 16-30, and ED diagnose) and exclusion criteria (cognitive impairment, and serious medical condition). After the assessment, participants will be randomly assigned to intervention (12-session weekly group intervention) or control groups (which may enroll the intervention after their participation as controls). The content of the sessions will comprise psychoeducation, mindfulness, acceptance and self-compassion skills, with several formal and informal practices within and between sessions and homework assignments. Results: Participants will be assessed with psychological measures (before and after the intervention, and after 3 and 6 months), and fMRI, heart rate variability, and galvanic skin response (before and after the intervention). Discussion: This study may represent an important advance in research because it will test the efficacy of a psychological intervention for ED, based on integration of mindfulness, acceptance and compassion-based approaches, validated through psychological assessment and neuroimaging.

41. Validation of the Greek version of the Commitment Action Questionnaire (CAQ)

Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain
Dafne Morroni, University of Cyprus
Vasilis S. Vasiliou, Ph.D., University of Cyprus
Maria Karekla, Ph.D., University of Cyprus

Background: The Committed Action Questionnaire (CAQ) is a 24-item measure of one of the components encompassed in the psychological flexibility model. Committed action can be defined as goal-directed, flexible perseverance. The present study aims to validate this instrument in Greek and evaluate its psychometric properties and factor structure. Method: The total sample consisted of 102 (Mage = 53.79, 80.40% female) Greek-speaking chronic pain patients. Reliability-related analyses were conducted, including item correlation and corrected item-total correlation analyses and followed by Exploratory Factor Analysis. Results: The internal consistency reliability of the scale was considered good, Cronbach’s alpha=.79. Three items appeared poorly correlated with the rest of the scale and eliminating them improved the internal consistency to α=.80. Items excluded were not the same as in the original study indicating differences between the English and Greek measures. Principal Component Analysis conducted on the 24 items with oblique rotation suggested 4-factors explaining 51.1% of the variance. This finding also differed from the original study where a 2-factor scale was presented. Discussion: The validity of the Greek-CAQ, and especially its correspondence to the original version will be discussed.

42. Beyond Symptom Reduction: Changes in Mindfulness, Meaning, Acceptance, and Positive Emotions in Treatment at Higher Levels of Care
Rocky Mountain Chapter Sponsored
Primary Topic: Clinical Interventions and Interests
Subtopic: Higher Levels of Care
Dan V. Blalock, Ph.D., Duke University School of Medicine
Bonnie Brennan, M.A., LPC, CEDS, Eating Recovery Center
Angela Derrick, Ph.D., CEDS, Eating Recovery Center
Susan McClanahan, Ph.D., CEDS, Eating Recovery Center

Background: Historically, treatment planning in higher level of care settings targeted symptom reduction and skill acquisition. Mental health is now defined more broadly and includes the ability to skillfully recognize and manage a broader range of emotions – both accepting and regulating negative emotions, as well as cultivating positive emotions. This study examined which specific traditional and positive psychology constructs significantly improve over the typical course of higher level of care treatment. Method: N=30 adult patients enrolled in a mood and anxiety partial hospitalization program in a major American city. Participants completed a series of self-report measures at intake and discharge. including the Beck Depression Inventory-II (BDI-II), the Anxiety Reactivity and Perseveration Scale (ARPS), the DBT Ways of Coping Checklist (DBT-WCCL), the Five Facet Mindfulness Questionnaire (FFMQ) and Seligman’s PERMA Model (PERMA). Results: Traditional symptom reduction was achieved (BDI-II change =-13.49, p<.001; ARPS Probability change =-11.42, p<.001; ARPS Perseveration change =-13.00, p<.001). Coping skills improved (DBT-WCCL Dysfunctional Coping Skills change =-4.11, p<.01; DBT-WCCL Skills Use change =14.89, p<.001). Mindfulness and Acceptance-based changes were mixed (Nonreactivity to Inner Experience change= -2.38, p<.001; all other subscales p>.25). PERMA-based changes were mixed (Accomplishment change =2.76, p<.001; Meaning change =1.65, p<.01; Positive Emotion change =1.94, p<.001; all other subscales p>.10). Discussion: While higher levels of care are geared toward symptom reduction and skill acquisition, mindfulness and acceptance-based constructs may not be fully cultivated within the limited time frame of intensive treatment. Future studies should examine post-treatment changes in mindfulness and acceptance-based processes.

43. The Epidemiology of Fears in Cyprus and the Potential Role of Psychological Flexibility in Improving Quality of Life
Greek-Cyprus ACBS Chapter Sponsored
Primary Topic: Clinical Interventions and Interests
Subtopic: Fear
Danae Papageorgiou, M.Sc., University of Cyprus
Maria Karekla, Ph.D., University of Cyprus
Maria Orphanidou, M.Sc., University of Cyprus

Background: Research indicates that 14.6% of individuals suffer from fear and anxiety disorders affecting quality of life (Rogier et al.,1988). Such data enables targeted mental health initiatives that have real impact; yet in many countries epidemiological data remains non-existent. The current study aimed to provide epidemiological data regarding different types of fears (e.g., social phobia, specific phobias) within the Cypriot population and investigate the role of individual difference factors. Specifically, it explored whether psychological flexibility moderated the impact of fears on quality of life. Method: A representative sample of 412 participants (Mage=42.14, SD=.64) completed measures including: Fear Survey Schedule–III (FSS-III), Acceptance and Action Questionnaire and World Health Organization Quality of Life Instrument. Results: Mean fear score was 118.56 out of 320 (higher scores indicating more fears), with females reporting significantly higher fear levels than males (t(317)=-6.409, p<.001). Some fears were more common than reported in other countries (e.g., 10.2% endorsed plane phobia). Moderation analysis indicated no significant interaction (b<.001, t=-.4016, p=.69), suggesting that psychological flexibility does not buffer the impact of fears on quality of life. Subsequent hierarchical regression showed that fear levels significantly predicted quality of life (R=.15, F(1,280)=24.476, p<.001). Psychological flexibility had a large, positive, direct effect on quality of life over and above fear levels (ΔR² = .42, F(1,279)=67.071, p<.001). Discussion: Findings discuss the importance of cultural contexts on fear and highlight the impact of psychological flexibility on quality of life. Mental health initiatives targeting fears need to take it into account when planning prevention/intervention programs.

44. Conceptual analysis of cognitive defusion and the process of clinical change in ACT

Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy
Daniel Afonso Assaz, University of São Paulo
Claudia Kami Bastos Oshiro, University of São Paulo

Cognitive defusion is a central concept within Acceptance and Commitment Therapy (ACT). As a middle-level term, cognitive defusion can be useful in improving ACT’s dissemination and practice. However, its pragmatic value can be lost in the absence of conceptual clarity and a strong link with basic behavioral processes. In order to contribute to such efforts, this presentation offers a literature review on how cognitive defusion is usually conceptualized, distinguishing between the procedures, outcomes and processes involved while emphasizing the latter aspect. Then, this conceptualization is critically examined regarding logical consistency and empirical evidence, culminating in a theoretical proposal in which cognitive defusion is understood as an outcome, that can be achieved through different behavioral processes, underlying the different procedures used by ACT therapists to promote cognitive defusion: changes in stimulus control, differential reinforcement and contextual discrimination. After reading the poster, the audience is expected to be able to critically evaluate the pragmatic value of the term "cognitive defusion" and create functional hypotheses regarding the behavioral processes responsible for clinical change in the promotion of cognitive defusion.

45. Efficacy of a brief RNT-focused ACT protocol in panic disorder

Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy; Repetitive negative thinking
Derly J. Toquica-Orjuela, Fundación Universitaria Konrad Lorenz
Ángela M. Henao, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

Panic disorder, characterized by a persistent concern about the presentation of frequent panic attacks and their possible consequences, contributes to the development and implementation of avoidance strategies that cause a clinically significant limitation in people's lives. Clinical investigations show different treatment alternatives, with exposure therapy being the one with the greatest evidence of efficacy in this disorder. However, as this is a therapy with low acceptance by consultants and professionals, the need for new therapies arises. The purpose of the present study is to investigate the efficacy of Acceptance and Commitment Therapy (ACT) without Exposure in people who meet the diagnostic criteria for Panic Disorder (N = 5). This study uses a multiple randomized non-concurrent baseline design among participants. An ACT protocol of five sessions will be implemented, which aims to promote the acceptance of internal experiences and participation in values-based activities. The emotional symptomatology, worry and rumination and activities related to values will be evaluated, through different evaluation instruments. From the information gathered and analyzed, it is expected to be able to argue the existing evidence for ACT and, in more detail, its efficacy in panic disorder.

46. Randomised Controlled Trial Comparing ACT and MBSR-informed group interventions for anxiety in a London University setting: exploring outcomes and processes of change

Primary Topic: Clinical Interventions and Interests
Subtopic: Anxiety, Mindfulness
Dr Fran Smith, City, University of London
Jessica Jones-Nielsen, City, University of London
Julianna Challenor, City, University of London
Trudi Edginton, City, University of London
Martina Gerada, City, University of London
Kornillia Gvissi, City and Hackney Mind

Background- Given the need for brief group interventions to help university students cope with mental health problems, the main aim of the study is to test the effectiveness of a brief ACT intervention in comparison with an MBSR- informed group intervention. Comparison studies have illustrated that ACT treatment produces outcomes comparable to CBT interventions but possibly through alternative processes of change. However less research has focussed on the comparisons of change processes within mindfulness-based third wave therapies. Method- A randomised wait-list-controlled trial is being run in a psychology department research clinic at a London University providing two, four-week group interventions (one ACT and one MBSR-informed) to students presenting with mild to moderate anxiety. Pre and post measures of anxiety, depression, psychological flexibility, mindfulness, self-compassion, letter-number sequencing and trail making will be collected. Groups will be audio-recorded for qualitative analysis and long-term follow up outcomes will be collected. Practice logs will be analysed to examine the relationship between formal and informal practice and how these relate to outcomes. Both the AAQ-II (Bond et al., 2011) and CompACT (Francis et al., 2016) are employed to measure psychological flexibility in order to deepen understanding of the reliability and validity of these measures in relation to the core ACT processes. Results- Data is currently being collected and preliminary results will be presented in the poster in June 2019. It is hypothesized that participants in both intervention groups will demonstrate increases in acceptance and mindfulness from pre- to post-intervention. Discussion-

47. How Meditation is Used Matters!: Evaluating Purpose Behind Meditation and Its Impact on a Range of Psychosocial Outcomes

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness and Meditation
Eric Tifft, B.A., University at Albany, SUNY
Emily J. Padula, University at Albany, SUNY
Shannon B. Underwood, B.A., University at Albany, SUNY
Glenn A. Phillips, B.A., University at Albany, SUNY
John P. Forsyth, Ph.D., University at Albany, SUNY

Background: Practices that foster present-moment awareness, including mindfulness meditation, are simple, relatively easy to disseminate (e.g., via social media and smartphone apps), and associated with numerous positive psychosocial outcomes (Bamber & Schneider, 2016; Eberth & Sedlemeier, 2012). Traditionally, mindfulness meditations emphasize non-judgmental awareness and an openness to experience just as it is. Yet, mindfulness could potentially be misused as a means to control unpleasant psychological events and emotional experiences. To date, no studies have evaluated whether how one uses mindfulness meditation (i.e., traditionally as intended vs. as a means to control) matters in terms of its impact on a range of psychosocial outcomes. The central aim of the present study is to do just that. Methods: Undergraduates (N =395) completed a large psychosocial assessment battery. Of these, 19% (n = 75; 65% female; Mage = 19.63, SDage = 4.02) reported regularly practicing some form of meditation. Of the meditators, 59% reported using meditation as a strategy to control their emotional experience and 41% reported practicing meditation consistent with its original intended purpose. Results and Discussion: Results suggest that those who practice meditation as a control strategy rate anger, anxiety, unpleasant thoughts, and stress as more problematic in their lives than those who practice meditation consistent with its original intended purpose. Implications of these findings will be discussed in the context of psychotherapy practice (including ACT) and broadly in terms of dissemination to the general public.

48. How You Meditate Impacts Psychological Flexibility: Evaluating the Rationale of Meditation and its Relation to ACT Processes and Worry

Primary Topic: Clinical Interventions and Interests
Subtopic: Meditation, ACT
Eric Tifft, B.A., University at Albany, SUNY
Shannon B. Underwood, B.A., University at Albany, SUNY
Emily J. Padula, University at Albany, SUNY
Glenn A. Phillips, B.A., University at Albany, SUNY
John P. Forsyth, Ph.D., University at Albany, SUNY

Mindfulness and other meditative practices have become increasingly incorporated into psychotherapy. Western society appears to be amidst a mindfulness zeitgeist; numerous publications, podcasts, and smartphone apps promote mindfulness meditation and its benefits. By approaching mindfulness meditation to relieve stress and anxiety, one may deviate from the traditional approach of meditation to cultivate a nonjudgmental, open acceptance of experience. Using meditation to control one’s emotions could have paradoxical effects, leading to psychological inflexibility. To date, no such study has examined the rationale behind meditation use and its relation to ACT processes and psychosocial outcomes. In this study, participants (n=75) reported the rationale underlying their meditation practice. Fifty-nine percent reported meditating to control their emotional experience; 41% reported using meditation with its traditional intentions of nonjudgmental acceptance. In a series of linear regression models, meditation rationale predicted scores on cognitive fusion, mindfulness, self-compassion, negative emotions, and worry. Results suggest that those who utilize meditation as a control strategy reported higher cognitive fusion, negative emotions, and worry, and lower mindfulness and self-compassion. Frequency of meditation was found to moderate the relation between meditation rationale and experiential avoidance. Those who reported meditation as a control strategy indicated lower levels of EA the less frequently they meditate, and higher levels of EA the more frequently they meditate. The opposite pattern was found in those who reported using meditation with traditional intentions. Implications of these findings will be discussed in the context of psychotherapy practice and broadly in terms of dissemination to the general public.

49. Efficacy of a brief, RNT-focused ACT protocol in Fibromyalgia

Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy; Repetitive negative thinking
Estefany López-Palomo, Fundación Universitaria Konrad Lorenz
Juan C. Vargas, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

Fibromyalgia (FM) is a medical condition characterized by chronic musculoskeletal pain, fatigue, sleep disturbances and psychological difficulties. Repetitive negative thinking (RNT), such as worry and rumination, can significantly affect the quality of life and symptomatology of FM patients because they increase muscle tension. The present study proposes the application of Acceptance and Commitment Therapy (ACT) focused on RNT as a treatment for FM. To analyze the effect of this intervention approach, a protocol of four individual sessions was applied to 5 women between the ages of 35 and 60 who have a medical condition of FM. The experimental design was a randomized multiple-baseline design across participants. There will be a follow-up of 3 months. The dependent variables are emotional symptomatology, worry, health perception, subjective measures of pain, quality of sleep, pain intensity and interference, drug consumption, valued actions and cognitive fusion.

50. The Effectiveness of the Student Compass - Program Among International Students at the University of Jyväskylä

Primary Topic: Clinical Interventions and Interests
Subtopic: Wellbeing University Students
Francesca Brandolin, University of Jyväskylä
Simone Gorinelli, University of Jyväskylä
Panajiota Räsänen, University of Jyväskylä
Päivi Lappalainen, University of Jyväskylä
Raimo Lappalainen, University of Jyväskylä

Background: Approximately 20-30% of students report depression symptomsand a large numberof those suffering from mental health problems do not seek professional help (Cooke et al., 2006; Eisenberg et al., 2007). In particular, international students do not often have access to support services during their master and doctoral studies or an exchange year abroad. Therefore, the Department of Psychology, University of Jyväskylä, has provided a wellbeing program, Student Compass, to the international students in need for psychological support. The aim of the program is to enhance psychological wellbeing and decrease stress and anxiety symptoms. Method: International students (n= 46) were involved in 5-week group-format program based on Acceptance and Commitment Therapy (ACT) approach, with discussions and experiential exercises related to the processes of ACT: Values, Commitment, Mindfulness, Defusion, Acceptance. Outcome measures pre and post intervention included: AFQY, FFMQ, Perceived stress scale, GAD-7, PH9, scales for Wellbeing (Warwick Wellbeing Scale) and Values (VLQ and ELS). Results: Preliminary results show enhanced psychological flexibility and wellbeing, as well as a decrease in anxiety and perceived stress. Discussion: The results suggest that a 5-week ACT-basedprogramin groupformat can be an effective in enhancing the well-being of internationalstudents.The implications and limitations of the findings are discussed.

51. New perspectives in applied clinical research: moving from protocols to processes in the approach to eating disorders and obesity treatment

Primary Topic: Clinical Interventions and Interests
Subtopic: Eating Disorder, Process-Based Intervention
Giorgia Varallo, M.D., Istituto Auxologico Italiano; Catholic University of the Sacred Heart
Rob Cattivelli, Psy.D., Ph.D., Istituto Auxologico Italiano; Catholic University of the Sacred Heart
Anna Guerrini Usubini, M.D., Catholic University of the Sacred Heart
Nicola Maffini, M.D., Casa Gioia Research Centre
Gianluca Castelnuovo, Istituto Auxologico Italiano; Catholic University of the Sacred Heart
Enrico Molinari, Istituto Auxologico Italiano; Catholic University of the Sacred Heart

Traditional, "orthodox" CBT is actually the most widespread form of psychotherapy with reference both to clinical and research area. However, something begins to move in the context of the applied clinical research. World leading experts in the field are currently focusing their attention on the underlying processes of psychological intervention protocols included under the Cognitive Behavioral Therapy treatment umbrella. A new approach seems to emerge, which finds his roots in transdiagnostic psychological processes, and highlights common factors instead of disorder specific ones and focuses the attention on different dimensions, processes and results than reduction in symptoms. The interest in process-based intervention is rapidly rising, converging both from studies aimed to change transdiagnostic factors with a Unified Protocol applied to different disorders, and, to the other hand with the behavioral tradition, more focused on individualize treatment for underlying psychological processes. The actual challenge for both researchers and clinicians is now working with process based intervention to identify the core processes, moderators and mediators of change, and to develop modular interventions that promote functionally important pathways of changing. Modular treatment should represent a massive improvement in particular in the field of Eating Disorders, with overlapping factors but also specific processes converge. Historical foundation, present preliminary results and future directions are assessed.

52. Growing a garden in the middle of the sea: Applying the ACT matrix to behavioral parent training

Primary Topic: Clinical Interventions and Interests
Subtopic: Parent Training, Matrix
Giulia Mazzei, IESCUM
Elena Malaspina, IESCUM, Milan
Pietro De Martin, IESCUM, Milan
Marta Schweiger, IESCUM, Milan
Giovambattista Presti, Università Kore, Enna

The poster presents an ACT-oriented behavioral parent training for parents of children with externalizing disorders. In 2017 and 2018, IESCUM in partnership with Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico designed and delivered parent training and child training interventions in an outpatient child and adolescent mental health service, in Milan, Italy. 56 parents of children with externalizing problems (ODD, ADHD and other disorders) took part in 12 different groups conducted by 3 ACT psychotherapists. The intervention aims to improve awareness, psychological flexibility and the use of effective behavior change strategies in parenting. The program is made of 12 sessions and is based on Parent Management Training (Kadzin, 2005) and the six steps of ACT Matrix (Polk et al., 2016). Most of the participants completed a set of questionnaires pre and post intervention: Parenting Scale, 6-PAQ, a child social skill checklist and a satisfaction survey. Results show some significant changes in psychological flexibility and in parenting behaviors. Qualitative data suggested that applying the ACT Matrix to parent training has a positive effect on participants’ compliance and satisfaction.

53. Acceptance-ICD Study: Effects of psychological flexibility in patients undergoing Implantable Cardiac Defibrillator

Primary Topic: Clinical Interventions and Interests
Subtopic: ICD implantation, cardiac dieseas acceptance, cardiac health
Giuseppe Deledda, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar (VR), Italy
Sara Poli, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Giovanna Fantoni, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Matteo Giansante, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Eleonora Geccherle, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Giulio Molon, Department of Cardiology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Enrico Barbieri, Department of Cardiology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy

AIM: The proven efficacy of the implantable cardiac defibrillator (ICD) in the long-term treatment of ventricular arrhythmias, represents a surprising result for clinical research. A considerable part of patients report poor acceptance of the device, a low perceived quality of life, stress and anxiety and depressive symptoms in the pre- and post-intervention (incidence of anxious symptoms between 24% and 87%, of depressive symptoms between the 24% and 33%, ). This study is proposed to all patients suffering from ventricular arrhythmias awaiting implantation of the cardiac defibrillator afferent to the Cardiology Unit of IRCCS Sacro Cuore Don Calabria Hospital, Negrar Italy, in the period of one year, to evaluate the effect of psychological flexibility in the adaptation process. METHODS: PARTICIPANTS 33 patients (mean age = 63.36; sd=15.48), 23 male, 10 female. 75.8% is married, 57.6% retired and 42.4% have an high school degree. 57.6% have from 0 to 3 age of disease. MATERIALS: Hamilton Rating Scale (HAM-A) Survey of patient health-short form (SF-36) The Cardiovascular Disease Acceptance and Action Questionnaire (CVD-AAQ) The Chronic Pain Acceptance Questionnaire (CPAQ) RESULTS: Prelinary Data show a significant correlation between flexibility (CVD-AAQ) and vitality (SF36) (f(1,20) = 6,39, p=0.02) and level of health (f(1,20) = 5,43, p=0.03). CVD-AAQ (M=16; SD=7.08); Vitality (M=15.03; SD= 4.22); Health (M=16.45; SD= 4.7) CONCLUSIONS: This study shows as bigger levels of flexibility correlate with more vitality and more Health at SF36. Psychological flexibility can be a new construct to explain adaptation to cardiac deseas .

54. VR-DEM Pilot study: A protocol of a cognitive defusion Virtual Reality procedure, applied to neurological patients with migraine

Primary Topic: Clinical Interventions and Interests
Subtopic: Virtual Reality, defusion, Migraine, Acceptance and Commitment Therapy
Giuseppe Deledda, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar (VR), Italy
Sara Poli, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Matteo Giansante, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Eleonora Geccherle, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Fabio Marchioretto, Department of Neurology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Daniele Lombardo, Behavior Labs start up of Catania
Giovambattista (Nanni) Presti, University Kore, Enna, Italy

AIM: The migraine disorder affected the state of health, the condition of well-being and the level of quality of life perceived by the patient. This study explore feasibility of the protocol of a programmed VR-based cognitive defusion exercises, in line with the Acceptance and Commitment Therapy (ACT), able to generate effects in the process of altering the function of discomfort and credibility associated with some thoughts in patients with migraine. METHODS: They will be included in the study ten consecutive patients belonging to the Neurology Unit of the IRCCS "Sacro Cuore-Don Calabria" Hospital of Negrar (VR), Italy. According to the Masuda protocol, the conditions of defusion and distraction have been alternated. The software reproduced the words on a three-dimensional object suspended in virtual space and offering the subject the possibility of changing shape, size, color and gravity. The procedure was accompanied by a 5-minute guided meditation. The measure used was: Visual Analog Scale (VAS), assessing the discomfort and the credit given to one's own thoughts, Acceptance and Action Questionnaire (AAQ2), Mindfulness Attention and Awareness Scale (MAAS). For the analysis of the secondary objects, a descriptive statistical analysis will be carried out; correlations / associations will also be performed on these data. For statistical analysis, the STATA program (v12.o) and SPSS 20.0 will be used. CONCLUSIONS: The purpose of this study is to verifying the feasibility and the effect of a VR-based cognitive defusion exercises, in order to included in a wider protocol ACT model consistent.

55. VR-DRT Pilot study: A protocol of a cognitive defusion Virtual Reality procedure, applied to cancer patients with anxious and/or claustrophobic symptomatology subjected to radiotherapy

Primary Topic: Clinical Interventions and Interests
Subtopic: Virtual Reality, defusion, Cancer, Acceptance and Commitment Therapy, Radiotherapy
Giuseppe Deledda, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar (VR), Italy
Matteo Giansante, Psy.D., Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Eleonora Geccherle, Psy D, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Sara Poli, Psy.D., Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Filippo Alongi, Department of Radiation Oncology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Daniele Lombardo, Behavior Labs of Catania, Italy
Giovambattista (Nanni) Presti, University Kore, Enna, Italy

AIM: Radiotherapy can be perceived an highly adverse context, especially by patients with anxiety and claustrophobia, who can in some cases avoid treatment with heavy clinical repercussions. This study explore feasibility of a programmed VR-based cognitive defusion exercises protocol, in line with the Acceptance and Commitment Therapy (ACT), able to generate effects in the process of altering the function of discomfort and credibility associated with some thoughts in patients with cancer subjected to radiotherapy. METHODS: They will be included in the study ten consecutive cancer patients belonging to the Department of Radiation Oncology of IRCCS Sacro Cuore-Don Calabria Hospital, Negrar, Italy. According to the Masuda protocol, the conditions of defusion and distraction have been alternated. The software reproduced the words on a three-dimensional object suspended in virtual space and offering the subject the possibility of changing shape, size, color and gravity. The procedure was accompanied by a 5-minute guided meditation. The measure used was: Visual Analog Scale (VAS), assessing the discomfort and the credit given to one's own thoughts, Acceptance and Action Questionnaire (AAQ2), Mindfulness Attention and Awareness Scale (MAAS). For the analysis of the secondary objects, a descriptive statistical analysis will be carried out; correlations / associations will also be performed on these data. For statistical analysis, the STATA program (v12.o) and SPSS 20.0 will be used. CONCLUSIONS: The purpose of this study is to verifying the feasibility and the effect of a VR-based cognitive defusion exercises, in order to included in a wider protocol ACT model consistent.

56. Observational study on relationship between the type of breast surgery and body image flexibility

Primary Topic: Clinical Interventions and Interests
Subtopic: body image flexibility, breast cancer, Acceptance and Commitment Therapy
Giuseppe Deledda, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar (VR), Italy
Sara Poli, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Matteo Giansante, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Martina Righetti, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Eleonora Geccherle, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Giovanna Fantoni, Service Clinical Psychology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy
Stefania Gori, Department of Oncology, IRCCS Sacro Cuore - Don Calabria Hospital - Negrar (VR), Italy

AIM: Recent evidence emphasized the role of body image inflexibility: “the lack of the capacity to experience the ongoing perceptions, sensations, feelings, thoughts, and beliefs associated with one's body fully and intentionally while pursuing chosen values”. The aim of the study is to investigate the relationship between the type of breast surgery and body image acceptance, in a sample of breast cancer patients undergoing surgery of mastectomy or quadrantectomy. METHODS: Observational study. All patients coming to the hospital from August 2013 to August 2015, were invited to complete questionnaires on psychological flexibility (AAQ-2, BIAAQ) and distress perceived (Stress Termometer). RESULTS: 72 breast cancer patients completed the study (age: M=53,85; SD±9.39). The data showed an insignificant difference between the type of breast surgery performed by the patients in the sample and the BIAAQ questionnaire score (z = -0.348 p≥0.727). In particular, in the group of patients undergoing conservative surgery, an average score on the BIAAQ questionnaire emerged of 58.75 (SD ± 14.74), while in the group of patients undergoing mastectomy surgery, an average BIAAQ questionnaire score of 60.09 (SD ± 15.92). CONCLUSIONS: The results of this study suggest that in cancer patients treated for breast cancer, they report similar values of acceptance of the body image regardless of the type of surgery to which they were subjected. The fact that they have undergone a conservative surgical intervention (quadrantectomy) rather than a mastectomy-type surgery seems to have no influence on their capacity and degree of acceptance of the body image.

57. Mindful Parenting is Associated with Adolescents’ Emotion (Dys)regulation Through Adolescents’ Psychological Inflexibility and Self-Compassion

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindful parenting and Adolescence
Helena Moreira, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, University of Coimbra
Berta Rodrigues Maia, Faculty of Philosophy and Social Sciences, Braga Regional Centre, The Catholic University of Portugal

Background: The main aim of the present study is to investigate the mediating role of adolescents’ self-compassion and psychological (in)flexibility in the association between mothers’ mindful parenting and adolescents’ emotion regulation difficulties. We also aim to examine the moderating role of adolescents’ gender in the mediation model. Method: A total of 375 adolescents (aged between 12 and 19 years) and their mothers participated in the study. Mothers completed a measure of mindful parenting, and adolescents completed measures of self-compassion, psychological inflexibility and emotion regulation. Mediation and moderated mediation models were tested to explore the indirect effect of mindful parenting on adolescents’ emotion regulation through self-compassion and psychological (in)flexibility as well as the moderating role of adolescents’ gender. Results: The mindful parenting dimensions of compassion for the child and nonjudgmental acceptance of parental functioning were indirectly associated with adolescents’ emotion regulation through adolescents’ self-compassion, whereas the mindful parenting dimension of listening with full attention was indirectly associated with adolescents’ emotion regulation through adolescents’ psychological inflexibility. Some of the associations in the mediation model were only significant for adolescent girls and their mothers. Discussion: Mothers’ ability to adopt a mindful approach in parenting seems to play an important role in the adaptive emotion regulation of their children, specifically through its effect on adolescents’ self-compassion and psychological flexibility. Mothers' mindful parental practices have a different effect on boys and girls and appear to play a more prominent role in promoting girls’ self-compassion and emotional regulation.

58. Psychological Inflexibility in Adolescence: Exploring its Role on Adolescents’ Well-Being and the Mediating Role of Attachment to Peers and Parents

Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescence
Helena Moreira, Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra
Maria João Gouveia, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, University of Coimbra
Maria Cristina Canavarro, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, University of Coimbra

Background: Psychological inflexibility has been considered to be at the core of most human suffering. Enhancing psychological flexibility (PF) and promoting value-based living are important pathways to emotional wellbeing in different stages of life. There is preliminary evidence that one possible mechanism through which PF exerts its positive effect on mental health is through attachment security. However, this hypothesis has only been explored among adults. In fact, research on the role of PF in the wellbeing of adolescents is scarce. Therefore, the goal of this study is to investigate whether adolescents’ psychological (in)flexibility is associated with their psychological well-being and whether this association is mediated by their perception of security in the relationship with their parents and peers. Method: A total of 931 Portuguese adolescents (10-19 years) completed measures of psychological inflexibility, attachment to peers and parents, and psychological well-being. A mediation model was tested to investigate the indirect effect of psychological inflexibility on well-being through attachment to parents and attachment to peers. Results: Higher levels of psychological inflexibility were associated with lower levels of psychological well-being and this association was mediated by attachment to peers and attachment to parents. Discussion: Experiencing higher levels of psychological inflexibility seems to undermine the perceived security that adolescents experience in their close relationships, which, in turn, seems to lead to a lower level of psychological well-being. These results suggest that promoting PF in adolescence may have beneficial effects not only on the mental health of adolescents but also on their interpersonal relationships.

59. The Mediating Role of Maternal Psychological Flexibility in the Association Between Psychopathology Symptoms and Mindful Parenting

Primary Topic: Clinical Interventions and Interests
Subtopic: Parenting
Helena Moreira, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, University of Coimbra
Maria Cristina Canavarro, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, University of Coimbra

Background: there is ample evidence that maternal psychopathology has a strong negative impact on parenting behaviours, including the ability to adopt a mindful approach in parenting. However, the psychological mechanisms that may explain this association have been little investigated. In this study we explore the mediating role of psychological flexibility (PF) in this association in a sample of mothers of children and adolescents from the general community. Although high PF has been associated with several indicators of psychological adjustment, its role on mindful parenting has never been investigated. Method: a total of 383 mothers of children/adolescents (8-19 years) were recruited in two Portuguese school units and completed measures of PF (AAQ2), anxiety/depression symptoms (HADS) and mindful parenting (IMP). A mediation model was tested to explore the mediating role of PF on the association between psychopathology and mindful parenting. Results: higher levels of anxiety and depression were both indirectly associated with lower levels of mindful parenting through PF. This association was independent of the child’s age. Discussion: being able to contact the present moment more fully and to change/persist in values-based behaviours seems to play a key role in mothers’ ability to bring mindful awareness to parenting. In addition, PF seem to be influenced by mothers’ levels of anxiety/depression symptoms and to explain why these symptoms can lead to lower mindful parenting. These results suggest that mindful parenting interventions could benefit from including ACT-based techniques to increase the levels of mothers’ PF and, consequently, promote mindful parenting.

60. Expanding the scope and effectiveness of care for people with persistent pain: Research into process and outcomes from integrated ACT and physical therapy

Primary Topic: Clinical Interventions and Interests
Subtopic: Persistent pain management
Hilary Abbey, D.Prof.(Ost.), University College of Osteopathy
Lorraine Nanke, Ph.D., Surrey and Borders Partnership NHS Trust

Background: Persistent pain is a complex problem. Guidelines recommend manual therapy combined with psychological care. Few osteopaths have psychological training or access to multidisciplinary pain management programs. Three studies explored ways of expanding osteopaths’ scope of care using ACT principles. Study 1: Mixed methods observation study of pain groups for patients receiving osteopathic treatment (n=15), led by an ACT psychologist and osteopath. 3 month outcomes showed positive changes in responses to pain. Course format limited ability to work directly with bodily experience (e.g. experiential avoidance) as it arose for individuals in group activities. Study 2: Qualitative study of process in a 6 week course integrating ACT and osteopathy for individuals (n=4). Audio-recordings analysed using Linguistic Ethnography, showed positive changes in body/self awareness and willingness to stay active. Key factors that influenced one osteopath’s ability to use ACT and shift between acceptance and change-based interventions guided further research. Study 3: A 3 year cohort study of the Osteopathy, Mindfulness and Acceptance Program for persistent pain (OsteoMAP). Questionnaire outcomes at 6 months (n=79) demonstrated improvements in acceptance (AAQ-IIR), quality of life (EQ-5D), mindfulness (FMI) and pain coping (BQ). OsteoMAP courses were acceptable to patients (n~250) and feasible for delivery by osteopaths with limited ACT training (n~100). Future plans: Develop research to assess outcomes from individual OsteoMAP courses compared to pain management groups. Explore how integrating ACT and touch-based therapies affect interoceptive awareness and responses to pain. Develop training courses to help physical therapists integrate ACT interventions into their day-to-day clinical practices.

61. Treating multiple comorbidities simultaneously using multiple third-wave cognitive behavioral treatments: A preliminary analysis of an individualized comprehensive outpatient program for complex patients

Primary Topic: Clinical Interventions and Interests
Subtopic: Treatment of Complex Patients
Huda Abu-Suwa, M.S., Nova Southeastern University
Lori Eickleberry, Ph.D., ABPP, Institute for Life Renovation, LLC

Background: A new individualized outpatient treatment program was created for complex patients who present with multiple comorbidities. Preliminary outcomes were evaluated. The outpatient program consisted of integrated care with different individual third-wave CBT therapies among multiple providers, treating multiple diagnoses simultaneously. Patients were also placed into other services as deemed appropriate, which may have included a variety of groups, family therapy, individual yoga, art therapy, medication, and work with a dietitian. Method: Participants consisted of 16 individuals who successfully completed the program (mean age= 31.56, SD=11.21; female=15; Caucasian=9). Participants were administered the STAI, BDI, QOLI, and FFMQ on a weekly basis. Paired-samples t-tests were used to compare scores at initial assessment and after completing one month of treatment. Results: Results indicated significant decreases in Beck depression Inventory (BDI) scores (t=4.96, p<.001), and State-Trait Anxiety Inventory (STAI) state (t=4.90, p<.001) and trait scores (t=5.70, p<.001). Significant increases were found in quality of life measured by the Quality of Life Inventory (QOLI) overall t-scores (t=-6.10, p<.001) and skills measured by the Five Factor Mindfulness Questionnaire (FFMQ) observe (t=-3.22, p=.006), describe (t=-3.01, p=.009), act with awareness (t=-3.05, p=.008), nonjudge (t=-3.39, p=.004), and nonreact (t=-2.69, p=.02) scores were also found. Discussion: The outpatient program demonstrated an ability to decrease anxiety and depressive symptomatology, as well as increase mindfulness skills and quality of life in complex cases. These preliminary results provide a promising outlook for this individualized and integrated outpatient program. Future research is needed to validate results and determine long-term outcomes of the program.

62. Mind & Life project: A group intervention program on the physical and emotional well-being of overweight and obese individuals

Primary Topic: Clinical Interventions and Interests
Subtopic: Obesity
Idoia Iturbe, University of the Basque Country (UPV/EHU)
Iratxe Urkia, University of the Basque Country (UPV/EHU)
Enrique Echeburúa, University of the Basque Country (UPV/EHU)
Eva Pereda, University of the Basque Country (UPV/EHU)
Edurne Maiz, University of the Basque Country (UPV/EHU)

Background: The prevalence of overweight and obesity nearly tripled since 1975 and nowadays, excess weight is considered a worldwide public health problem. Usual treatments for weight control include dietetic restriction and physical activity instructions which even if they produce a significant weight loss in the short term, they are ineffective in the long term. Several psychological factors related to weight-gain reflect weight-related experiential avoidance patterns, which are associated with not to be willing to contact with weight and food related difficult inner experiences and attempts to control those experiences. Objectives: This study aims to assess the effectiveness of Acceptance and Commitment Therapy (ACT) and mindfulness based Mind&Life program in the physical and psychological wellbeing of adults with overweight or obesity. Method: A randomized clinical trial of 5 months of duration controlled by a control group. Participants will be 110 adults with overweight and obesity and will be randomly assigned to either of two conditions: (a) Control group will receive the treatment as usual (TAU) consisting on dietetic and physical activity recommendations, and (b) Experimental group will receive the same TAU plus Mind&Life psychological group-intervention. Measurements will be evaluated at baseline prior to randomization, at post-intervention, at seven-month post-intervention follow-up and at two-year post-intervention follow-up. Discussion: Findings are expected to support the implementation of this intervention program in the treatment of obesity together with usual treatments, so as to provide an integrated treatment that will help improving the quality of life of individuals and maintaining the results in the long term.

63. Adolescents with type 1 diabetes:Psychological flexibility is associated with glycemic control and wellbeing of the adolescents

Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescence, type 1 diabetes
Iina Alho, Lic.A, Central Finland Health Care District
Raimo Lappalainen, Ph.D., University of Jyväskylä

Background: Psychological flexibility has been assumed to be a factor leading to increased wellbeing in several studies in different populations, and we were interested in examining the role of psychological flexibility in wellbeing and glycemic control among adolescents with type 1 diabetes whose glycemic control is above the recommendations. Method: Adolescents (n=56, aged 12-16 years) completed Children and Adolescents Mindfulness Measure (CAMM), Diabetes Acceptance and Action Scale for Children and Adolescents (DAAS), Depression Scale (RBDI) and Health-Related Quality of life Scale (KINDL-R). HbA1c-values were collected from the medical records. The correlations between the variables were calculated and regression analysis was used to get more detailed information. Results: Higher level of psychological flexibility was connected to better glycemic control (CAMM: r=-0.31*, p<0.05, DAAS: r=-0.41**, p<0.01), better quality of life (CAMM: r= 0.61**, p<0.01, DAAS: r= 0.66**, p<0.01) and lower level of depressive (CAMM: r=-0.54**, p<0.01, DAAS: r=-0.62**, p<0.01) and anxiety symptoms (CAMM: r=-0.40**, p<0.01, DAAS: r=-0.34**, p<0.01). The higher the psychological flexibility skills, the better the glycemic control, quality of life and mood of the adolescent. Regression analysis showed that general mindfulness and acceptance skills (CAMM) explained 10% and diabetes-related acceptance (DAAS) explained 19% of variation of HbA1c. Discussion: Psychological flexibility seems to have a significant role in the wellbeing of adolescents with type 1 diabetes. It is reasonable to consider that interventions aiming at enhancing psychological flexibility would be useful for wellbeing of the adolescents as well as for increasing their adaptation and motivation for the treatment of diabetes.

64. The role of psychological flexibility in the relationship between post traumatic stress disorder symptom severity and health functioning

Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD, Mindfulness, health functioning
Im Fong Chan, Murray State University
Michael Bordieri, Murray State University

A large body of research has shown that post-traumatic stress disorder following traumatic events often leads to decreased health functioning and increased functional impairment (Bonanno, Brewin, Kaniasty, & Greca, 2010; Norris, Friedman, Watson, Byrne, Diaz, & Kaniasty, 2002). Emerging findings suggest that psychological flexibility, a willingness to be in contact with distressing feelings and thoughts in the service of valued livings appears to play a significant role in mitigating core symptoms of post-traumatic stress disorder, such as avoidance and negative cognition (Bonanno, Brewin, Kaniasty, & Greca, 2010; Moser, Hajcak, Simons, & Foa, 2007; Thompson & Waltz, 2010). However, previous research has not fully examined the role of psychological flexibility plays in the relationship between the severity of post-traumatic stress disorder and functional impairment. The aim of the current study was to explore how psychological flexibility affects the strength of the relationship between symptoms of post-traumatic stress disorders and functional impairment. It was hypothesized that psychological flexibility would moderate the relationship between severity of post-traumatic stress disorder and health functioning, such that the strength of the relationship between PTSD symptoms and health functioning was reduced among individuals with higher psychological flexibility. Results from 103 college students partially support this hypothesis, with psychology inflexibility conditionally predicting greater global disability as measured by the World Health Organization Disability Assessment Schedule 2.0. However, support for a moderated relationship was not found. These findings emphasize the importance of psychological flexibility as a protective factor to psychological well-being and health functioning following exposure to traumatic events.

65. Predicting vulnerability to posttraumatic stress disorder using hierarchical linear modeling

Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD, Mindfulness, self-compassion
Im Fong Chan, Murray State University
Michael Bordieri, Murray State University

Considerable evidence has established risk factors which increase vulnerability to post-traumatic stress disorder (Bonanno, Brewin, Kaniasty, & Greca, 2010; Foa, Ehlers, Clark, Tolin, & Orsillo, 1999; Irish, Fischer, Fallon, Spoonster, Sledjeski, & Delahanty, 2011). Females are at higher risk than males of developing post-traumatic stress disorder following exposure to traumatic events, despite the number of traumatic events experienced by females are higher than males. Also, psychological flexibility has been linked to reduced PTSD symptoms (Bonanno, Brewin, Kaniasty, & Greca, 2010; Moser,Vujanovic, Niles, Pietrefesa, Schmertz, & Potter, 2013). Additionally, reductions in negative cognition about oneself (self-criticism) was associated with reductions in PTSD symptoms (Foa, Ehlers, Clark, Tolin, & Orsillo, 1999; Foa & Rauch, 2004). Empirical research has shown lower self-criticism has been linked to greater self-compassion (Moser, Hajcak, Simons, & Foa, 2007). However, the hierarchical relationship of PTSD on gender, number of traumatic events, psychological flexibility, and self-compassion has not been fully examined in previous research. The aim of the current study was to examine the predictive effect of these variables on PTSD and evaluate if self-compassion improves prediction of PTSD beyond that provided by gender, the number of traumatic events, and psychological flexibility. Results from 103 college students did not support the incremental validity of self-compassion in predicting PTSD symptom severity. Obtained findings did support the incremental validity of psychological flexibility, suggesting that this process may be a key protective factor for PTSD symptom expression. Theoretical implications of the current findings to self-compassion and acceptance-based therapies are discussed.

66. Assessing progress in Acceptance and Commitment Therapy (ACT) with older adults: A literature review of existing measures

Primary Topic: Clinical Interventions and Interests
Subtopic: Older adults
Jacqui Gurevitch, Psy.D., VA Boston Healthcare System
M. Lindsey Jacobs, Ph.D., VA Boston Healthcare System
Patricia Bamonti, Ph.D., VA Boston Healthcare System

Background: Late adulthood is often characterized by significant changes in health status and social/occupational roles (e.g., caregiving, retirement), and those who struggle to adapt may develop problems such as anxiety, depression, and loneliness. As an intervention aimed at increasing flexibility and connection to values, ACT is well-suited to help older adults (OAs) face the challenges of aging. Empirical support for ACT with OAs is growing, but it is unclear whether measures of ACT concepts and processes have been validated with OAs. We conducted a literature review to identify existing ACT measures and determine which have been validated with OAs. Method: PubMed, MEDLINE, and PsychINFO were searched for combinations of ACT-related terms (e.g., “cognitive fusion”) and terms denoting measurement (e.g., “questionnaire”). Mindfulness measures have been reviewed elsewhere and were excluded from this search. Irrelevant and duplicate results were excluded, and adaptations and short-form versions of the same measure were consolidated to create a final list of measures. Results: 127 articles were included describing 37 unique ACT-relevant measures. Constructs measured included psychological flexibility (n=14), acceptance (n=6), cognitive fusion (n=5), values/committed action (n=8), self-as-context (n=2), and other (n=2). While four measures were developed for children or youth, no measures were created specifically for OAs. Only two studies included a sample of participants (in both cases, caregivers) whose mean age was greater than 60. Discussion: Validated outcome measures are needed for OAs engaged in ACT so that we can accurately study the effects of this treatment in this rapidly growing segment of the population.

67. Personal distress and empathic concern in relation to perspective taking in individuals with grandiose or vulnerable narcissism

Primary Topic: Clinical Interventions and Interests
Subtopic: Narcissism, Narcissistic personality disorder, Empathy, Perspective taking
Jan Topczewski, Institute of Cognitive and Behavioural Neuroscience, SWPS University of Social Sciences and Humanities
Aleksandra Skonieczna, Institute of Cognitive and Behavioural Neuroscience, SWPS University of Social Sciences and Humanities
Anna Duszyk, University of Warsaw
Kamila Jankowiak-Siuda, Institute of Cognitive and Behavioural Neuroscience, SWPS University of Social Sciences and Humanities

Background: Different types of affective empathy are triggered when imagining what others may feel (other-perspective) vs. imagining what we would feel in their situation (self-perspective). Self-perspective increases personal distress (PD) as well as empathic concern (EC) towards oneself, while other-perspective triggers EC towards others. The study was aimed at verifying whether perspective-taking (self- vs. other-) changes the level of EC and PD in individuals with grandiose or vulnerable narcissism. Method: Three groups participated in the study: (1) individuals with high level of grandiose narcissism (N = 21), (2) individuals with high level of vulnerable narcissism (N = 21) and (3) individuals with low levels of both types of narcissism (N = 18). Study 1 measured self-reported empathy level of EC and PD (IRI) as well as self-compassion (SCS). In study 2, participants watched short videos depicting pain reactions, either from self- or other-perspective. After each of the scenes, participants assessed the level of PD and the level of EC on the GRS scale. Results: Individuals with vulnerable narcissism experienced higher level of PD than other groups. In study 2, in other-perspective condition, individuals with vulnerable narcissism reported the highest EC for pain in comparison to other groups. In addition, individuals with vulnerable narcissism reported higher EC in other-perspective condition vs. self-perspective condition. Discussion: Taking the other’s perspective increases the level of EC in individuals with vulnerable narcissism. Because EC leads to prosocial behavior, training in perspective taking could increase prosocial behavior in individuals with vulnerable narcissism.

68. Willingness to suffer with others: Relationship between experiential avoidance, perspective taking and empathy of pain

Primary Topic: Clinical Interventions and Interests
Subtopic: empathy, empathic concern, perspective taking, pain
Jan Topczewski, Institute of Cognitive and Behavioural Neuroscience, SWPS University of Social Sciences and Humanities
Anna Duszyk, University of Warsaw
Kamila Jankowiak-Siuda, Institute of Cognitive and Behavioural Neuroscience, SWPS University of Social Sciences and Humanities

Background: Empathy can be conceptualized either as a trait (dispositional empathy) or as a response in particular situation (situational empathy). According to The Flexible Connectedness Model, experiential avoidance plays crucial role in healthy social functioning, allowing people to develop interpersonal closeness in spite of difficult experiences that accompany empathizing with others. No research, however, investigated the relationship between experiential avoidance (EA), perspective taking and empathy in the context of pain. Our aim was to fill this gap. Method: 42 individuals with high experiential avoidance (H-EA) and 42 individuals with low experiential avoidance (L-EA) (as measured by AAQ-II) had their dispositional cognitive and affective empathy assessed with IRI. Situational empathy was measured using movies evoking empathic reactions to physical pain and three scales measuring perceived pain intensity (cognitive empathy), personal distress (self-focused affective empathy) and empathic concern (other-focused affective empathy). We used specific instruction to elicit perspective taking (self/other). MANOVA and repeated measures ANOVA were performed. Perspective taking was a within-subjects factor and experiential avoidance was a between-subjects factor. Results: L-EA group reported lower level of personal distress (dispositional and situational) than H-EA group. Moreover, results showed that taking perspective of other evokes greater empathic concern than taking perspective of self. No interaction between EA and perspective taking was found. Discussion: Capitalizing on previous research showing that empathic concern, personal distress, EA and perspective taking are related to prosocial behavior, this study further highlights usefulness of ACT and perspective taking training in clinical and social contexts.

69. Tracking Changes in Mindful-Flexibility across ACT Treatment to Understand Treatment Gains: Three Mixed-Method Case Studies Using the MindFlex Assessment System

Primary Topic: Clinical Interventions and Interests
Subtopic: ACT Process Mechanisms
Jenna Macri, University of Rochester
Ronald D. Rogge, University of Rochester

OBJECTIVES: The study piloted the MindFlex Assessment System (MindFlex.org), an online assessment tool that facilitates the administration, scoring, norming, and interpretation of cutting-edge assessment tools in the ACT and Mindfulness literatures. MindFlex assessments are conceptually based on the Unified Model of Mindful Flexibility: a new model that organizes the 5 main dimensions of mindfulness and 12 main dimensions of psychological flexibility into a multistage, process-oriented framework. METHODS: Therapists completed a short (5-10min) online survey enrolling themselves into the project and then enrolled their clients. Clients then completed 15-20min MindFlex assessments at baseline and after 2 months of treatment. The therapists were provided with normed profiles for each client assessment completed, providing quantitative insights into baseline functioning and clinically meaningful change. Three clients will be presented in this poster to represent the experiences of clients and therapists using this system. RESULTS: The poster will then draw parallels between the clinicians’ experiences of the clients in treatment (case conceptualizations, qualitative impressions of change) and the quantitative findings from the MindFlex profiles. Specifically, changes in mindful/mindless lenses (e.g., describing thoughts/feelings, attentive awareness, inattention) will be linked to corresponding changes in flexible/inflexible responses (acceptance, defusion, self-as-context vs. experiential avoidance, fusion, self-as-content), which will be linked to changes in life-enriching/diminishing behaviors (contact-with-values, committed action vs. losing touch with values, inaction), and to corresponding changes in outcomes (depressive symptoms, anxiety, wellbeing). CONCLUSIONS: The findings support a conceptual framework for understanding the processes of change in ACT as assessed with the MindFlex Assessment System.

70. Evaluation of an ACT-based Mobile App for Problematic Pornography Viewing

Primary Topic: Clinical Interventions and Interests
Subtopic: Problematic Pornography Viewing
Jennifer L. Barney, M.S., Utah State University
Andria Soderquist, Utah State University
Tanner Ashcraft, Utah State University
Eric Lee, M.A., Utah State University
Michael P. Twohig, Ph.D., Utah State University
Michael E. Levin, Utah State University

Pornography viewing (PV) is a common behavior, with some studies indicating that approximately 75% of men and 41% of women have intentionally viewed erotic images online in their lifetime. In some instances, PV can become problematic in terms of difficulty controlling the behavior resulting negative consequences, which has been likened to pathological concepts including addiction, compulsions, and hypersexual behavior. PV has been associated with negative psychosocial outcomes including psychological distress, isolation, decreased quality of life, poorer sexual functioning, occupational concerns, spiritual/religious concerns, and impaired intimate relationships. One promising treatment for problematic PV to date has been acceptance and commitment therapy. To increase the accessibility to such treatment, the current study examined the efficacy of an ACT mobile app adapted for PV - “ACT-Daily for PV”, designed to intermittently check in with users about their current psychological functioning and ACT skills practice. 68 participants self-identifying as struggling with and seeking help for problematic PV were randomly assigned to either use the ACT-Daily app for 6-weeks, or to a 6-week waitlist condition. All participants completed weekly self-monitoring assessments in addition to more intensive assessment batteries at baseline, post-treatment, and 1-month follow-up. Data collection is expected to be completed in May 2019 and results on the app’s efficacy increasing psychological flexibility as well as changes in PV, hypersexual behavior, and pornography craving, will be reported.

71. Applications of Mindfulness in an Urban Elementary After-School Program

Primary Topic: Educational settings
Subtopic: Children, Mindfulness
Adrienne Garro, Ph.D., Kean University
Dominique Reminick, M.A., Kean University
Yael Osman, Kean University
Bracha Katz, Kean University
Cristin Pontillo, Kean University
Danielle Fishbein, Kean University
Vanessa Vega, Kean University

Background: The application of mindfulness practices in US schools has steadily increased over the past 15 years (Semple, Droutman, & Reid, 2017). Studies have found positive effects of mindfulness on students' social-emotional functioning, including social competence and emotional well-being (Schonert-Reichl & Lawlor, 2010; Viafora, Mathiesen and Unsworth, 2015). Despite the widespread use of mindfulness in schools, there is little information regarding its implementation in after-school programs. The purpose of this poster is to provide information from a pilot study examining the effectiveness and feasibility of a mindfulness-based intervention in an after-school program that aims to increase students’ emotion awareness and emotion management. Method: Participants include eighteen fourth-grade students in an urban after-school program. The majority of the students are bilingual and Latinx. The intervention includes breathing exercises, yoga, present moment awareness activities, and activities to identify emotions. Students are completing the Emotion Awareness Questionnaire (EAQ) (Rieffe, Oosterveld, Miers, Meerum Terwogt, & Ly, 2008) and the Children’s Emotion Management Scales (CEMS) (Zeman, Shipman, and Penza-Clyve, 2001). To examine potential intervention effects, these measures were completed at baseline in January, at mid-point in April, and will be completed at the end of June. Results: We will be using a mixed measures pre-post design to examine potential changes in emotion awareness and management based upon EAQ and CEMS scores. Discussion: This pilot study provides preliminary data regarding the effects of an after-school-based mindfulness intervention. We will also describe the strengths and challenges of our project and implications for future research and practice.

72. Exploring Acceptance and Commitment Processes as Predictors of Subjective Wellbeing in Student Practitioners

Primary Topic: Educational settings
Subtopic: Acceptance and Commitment Therapy
Alexandra Stenhoff, University of Liverpool
Ross White, University of Liverpool
Linda Steadman, University of Liverpool
James Reilly, University of Liverpool

Background: Medical, other healthcare and veterinary students collectively referred to here as student practitioners (SPs) represent a sub-group of students who frequently report high levels of psychological distress,as well as decreased levels of wellbeing during training. The current study aimed to explore factors, and mediating processes (i.e. psychological inflexibility) that may predict subjective wellbeing (SWB) in SPs. Method: A total of 274 SPs studying the following degree courses at a UK University took part in the study: medicine, physiotherapy, nursing, veterinary sciences, occupational therapy, physiotherapy, orthoptics, radiotherapy, radiography, dentistry and clinical psychology. A cross-sectional design was utilised. Participants completed a series of online, self-report questionnaires (measuring psychological inflexibility, values-based action, self-criticism, maladaptive perfectionism, SWB and distress). Results: Four out of every ten SPs who participated in the study met clinical caseness for psychological distress, and less than half the sample reported experiencing the highest level of SWB (‘flourishing’). Psychological inflexibility (AAQ-II) was found to be the strongest predictor of levels of subjective wellbeing, followed by values-based action. Psychological flexibility was found to mediate the relationship between maladaptive perfectionism and SWB. Conclusions: The findings of this study lend support for further exploration of contextual behavioural science approaches (e.g. Acceptance and Commitment Therapy) as a potential framework for helping to improve SWB and reduce distress in SPs. Further research is merited in order to explore the utility of these approaches, and how they might be best integrated into university curricula.

73. Correlation between experiential avoidance related to perfectionism, anxiety, depression and suicidal ideation in Mexican university students

Primary Topic: Educational settings
Subtopic: Experiential avoidance, emocional distress, perfectionism
Angélica Aragón Rodríguez, Masters Candidate, Mexico's National University (UNAM)
Angélica Riveros Rosas, Ph.D., Mexico's National University (UNAM)

University students experience heavy academic demands from their scholar environment and fear of failing frequently leads to increased efforts seeking high achievement but may also lead to rigid and perfectionist strategies or goals. In terms of perfectionism, minimal failures can be experienced with high anxiety and depressive symptoms compounded by negative self-evaluation. This evaluation can even relate to thoughts of dying, which may in turn, reflect attempts to escape or avoid discomfort. Under these conditions university students may neglect other key areas of their life, such as health, family, friends, and even abandoning their academic goals. The present study aimed at exploring correlations between experiential avoidance related to perfectionism, anxiety, depression and suicidal ideation in Mexican university students. Participants were 558 professional-career students from Mexico's National University (UNAM), 313 women and 245 men aged 17 to 29 years (M=20.28; DE=1.93). This cross-correlational study started with a non-probabilistic by convenience sampling procedure. Measurement included the AAQ-II-Yuc (experiential avoidance), APS-R-MX (perfectionism), and IMADIS (anxiety, depression and suicidal ideation) scales, and data were analyzed through Pearson correlation. Results revealed positive and moderate correlations between experiential avoidance with perfectionism (r=0.441, p=0.001); with anxiety (r=0.628, p=0.001); with depression (r=0.723, p=0.001), and with suicidal ideation (r=0.647, p=0.001). Results also showed that emotional distress affecting university students can be more important than overall perfectionism. Key words: experiential avoidance, perfectionism, anxiety, depression, university students.

74. The Use of Acceptance and Commitment Therapy Techniques to Augment Traditional Behavioral Skills Training for Educators Implementing Behavior Specivic Praise Statements in the Classroom Setting

Primary Topic: Educational settings
Subtopic: Staff training
Clelia Sigaud, M.S., BCBA, University of Southern Maine
Jamie Pratt, Psy.D., BCBA-D, University of Southern Maine

Research indicates that multi-tiered systems of student support, such as Positive Behavioral Interventions and Supports (PBIS), contribute to increases in adaptive behavior and improved outcomes for students and school communities. The use of behavior specific praise statements at the universal level is an example of an accessible, high impact practice. However, many schools are unable to provide the level of training and support necessary for teachers to experience ongoing performance feedback and accountability regarding their use of behavior specific praise. In this study, the author aims to expand the research on strategies to promote implementation fidelity of high rates of behavior specific praise statements in the public elementary classroom setting. The use of values-clarification work within an Acceptance and Commitment Therapy (ACT) framework as an augment to traditional behavioral skills training (BST) modalities will be explored to increase rates of behavior specific praise statements by educators in the classroom context. It is hypothesized that the ACT intervention will increase the efficacy of traditional BST by increasing the use of behavior specific praise statements in the absence of ongoing performance feedback. Multiple-baseline design across participants, along with individually-administered BST and ACT sessions, will be used to assist in answering the research question. This project is a dissertation study and is currently in the final stages of the IRB process. Results are therefore unavailable as yet. The study will be completed by the end of the academic year (early June).

75. Symbotypes as Cultural Memes: Cultural Resilience and Survival as Latent and Expressed Individual History

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Cultural Analysis
Christopher Hebein, University of Nevada
David Sloan Wilson Binghamton University/p>

The individual organism is selected by the interaction between several inheritance systems. Jablonka and Lamb (2005) outline these systems as genetic, epigenetic, behavioral and symbolic. While the time-span of dynamic influence varies between each system, their effects on the behavior of the individual is comprehensive. This presentation introduces the concept of symbotype in detail as it relates to the symbolic system of selection. Individual human behaviors are controlled either by direct behavior contingencies or indirect contingencies through verbal behavior. Cultural systems, as a larger unit of analysis in a multi-tier hierarchy of selection, select individual behavior within groups in context. Symbotypes are an important connecting and parsimonious concept between Relational Frame Theory, Behavior Systems Analysis and Evolutionary Science. Symbotypes represent the expression of cultural symbolic content, in context, or latent possession of cultural symbolic content, out of context, by individuals. This presentation describes the symbotypic framework using examples for analyzing aspects of diversity, resilience, and the selection and survival of cultural practices by individuals within groups.

76. How do athletes experience shame? The validation of a new measure of external and internal shame

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Clinical Psychology in Sport
Sara Oliveira, M.S., Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra
Maria Coimbra, Master Student, Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra
Cláudia Ferreira, Ph.D., Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra

Background: Shame is central to the understanding of human functioning. A novel measure of External and Internal Shame was developed by Ferreira and colleagues (2019) to assess the specific dimensions of external and internal shame, as well as a global sense of shame experience. The context of sport seems to be a conductive environment to the experience of shame, due to its competitive and public nature of demonstrating successes and failures. Given the lack of validated instruments of shame in sport, EISS_athletes was developed to assess the experience of the self as seen and judged negatively, by teammates (external shame) and by the self (internal shame) in the context of sport. Method: This study aimed to test EISS_athletes’ factor structure through Confirmatory Factor Analysis (CFA), and examining its psychometric properties in a sample of 247 Portuguese adult athletes (111 males and 136 females), who practice different team sports. Results: CFA’s results revealed good local and global adjustments, and indicated that EISS_athletes replicates the two-factor structure identified in the original EISS. EISS_athletes presented adequate internal reliability, good convergent validity and was associated with related constructs (self-criticism, self-reassurance, stress, anxiety, depression, and psychological quality of life). Discussion: EISS_athletes is a valid and reliable measure that allows for a comprehensive assessment of external and internal shame in athletes. This measure may significantly contribute for a greater understanding of how athletes experience shame and for the understanding of the role that this negative emotion has on athletes’ well-being and quality of life.

77. Does the psychological flexibility model provide a framework for potentially increasing acceptance in parents whose children identify as transgender and gender diverse?

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Transgender and Gender Diversity
Tim Cartwright, M.Sc., University of Chester
Lee Hulbert-Williams, Ph.D., University of Chester
Gemma Evans, Ph.D., D.Clin.Psy., University of Chester
Nick Hulbert-Williams, Ph.D., University of Chester

Background: Studies have found that transgender people tend to report high levels of psychological distress, with some suggesting that a lack of parental support may be a risk factor. Qualitative studies have explored parents’ difficulties experienced when their child comes out as gender diverse, which may impact their ability to accept their child’s gender identity. Although numerous interventions have been developed to support parents in accepting their gender diverse children, none have been robustly empirically tested. We therefore examined the plausibility of using Acceptance and Commitment Therapy/Training (ACT) as an intervention, by measuring the relationship between ACT processes and parents’ acceptance of their gender diverse children. Method: Through an online cross-sectional survey, we recruited 98 parents of gender diverse children from across the United States, Europe, and Australia. A novel psychometric was developed to measure Parental Acceptance of Gender Diversity In Children (PAGICS). Parents completed the PAGICS as well as measures of general parental acceptance, transphobia, psychological flexibility, and psychological wellbeing. Results: The PAGICS demonstrated excellent internal consistency (α = .97) and reasonable concurrent validity with general parental acceptance, transphobia, and psychological wellbeing. Spearman’s correlation analysis showed a weak relationship between PAGICS and psychological flexibility (AAQII, r=.159, p=ns; CompACT, r=.324, p<.01). Discussion: We found mixed support for using the psychological flexibility framework to increase parental acceptance, although effect sizes are still modest. A larger sample size and a more sensitive psychometric that measures parental acceptance would be needed for future studies to ascertain the appropriateness of ACT within this population.

78. An Exploratory Study on Strategies Used by Managers Who have Dyslexia in the Expression of Leadership

Primary Topic: Leadership
Subtopic: ACT
Erika Lefebvre, M.Ed. CPsych, University of Sherbrooke
Sophie Menard, Ph.D., Ottawa University

This qualitative exploratory study aims to deepen the understanding of the strategies used by managers who have dyslexia in the expression of their leadership and to determine the types of accommodations required to enable them to progress as leaders at the same pace as their peers who do not have dyslexia. The word stigma is often associated with mental health and, according to the Mental Health Commission of Canada has a greater impact on the lives of people with mental illness than the illness itself. Dyslexia is an invisible disability and recent research in Canada has shown that compared to those who do not have dyslexia, twice as many adults who have dyslexia report experiencing episodes of distress, depression, anxiety disorders, suicidal thoughts, or need to consult with mental health professionals. Among adults diagnosed with dyslexia in childhood, 85% choose not to disclose their condition to their employer because of stigma. While much research has been done on the impact of dyslexia in the workplace, very little has focused on the link between dyslexia and leadership. The results of this research may assist those working with managers who have dyslexia in creating supportive environments that will optimise their leadership development. Semi-structured interviews were conducted with five managers in Canadian Public Service who have dyslexia. Qualitative content analysis was used to identify the strategies used in the expression of leadership. Links will be made to Acceptance and Commitment Therapy as a potential facilitator of leadership development for this group.

79. Is parental psychological flexibility a (uni)dimensional construct? A bifactor analysis of the Portuguese version of the Parental Acceptance Questionnaire (6-PAQ)

Primary Topic: Measurement and assessment
Subtopic: Parental Psychological Flexibility
Ana Fonseca, Ph.D., University of Coimbra
Helena Moreira, Ph.D., University of Coimbra
Maria Cristina Canavarro, Ph.D., University of Coimbra

Background:The Parental Acceptance Questionnaire (6-PAQ) is a self-report questionnaire developed to measure the six core processes of psychological (in)flexibility applied to the parenting context. This study aimed to examine the (uni)dimensionality of the 6-PAQ in a sample of Portuguese parents of children within the community using a bifactor model that can test the separate contribution of the dimensions and of the general score. The reliability and convergent validity of the 6-PAQ were also examined. Methods: A sample of 334 mothers of children (1-11 years) recruited online and in person completed the assessment protocol, including the 6-PAQ and related measures (general psychological flexibility, mindful parenting, parenting stress and parenting styles). Results: The bifactor model showed a better fit to the data compared with the correlated model. The index of the degree of unidimensionality (.595) and the OmegaH index supported the strength of the general factor of parental psychological inflexibility, which accounted for 85.7% of the reliable variance in the total score. Reliability indices showed high reliability for the general factor (.89), and the 6-PAQ total score was significantly correlated with related measures. Discussion: Although the 6-PAQ contains items assessing the six core-processes defined within the ACT model, the results of this study were globally supportive of the unidimensionality of the Portuguese version of the 6-PAQ scale, and thus of computing its total score. The 6-PAQ scale showed adequate reliability and convergent validity, supporting its use in both clinical and research contexts.

80. Measuring psychological flexibility regarding smoking cessation: Psychometric testing in people with schizophrenia who smoke

Primary Topic: Measurement and assessment
Subtopic: Smoker
Doris YP Leung, Ph.D., Hong Kong Polytechnic University
Winnie FT Lau, B.A., Hong Kong Polytechnic University
Alice Y Loke, Ph.D., Hong Kong Polytechnic University
Yim-wah Mak, Ph.D., Hong Kong Polytechnic University

Background: The high rates of tobacco use in the schizophrenia population are widely recognized; and it was reported that they have greater difficulties in smoking cessation. Acceptance and commitment therapy has been applied to help them to quit. Measuring psychological flexibility regarding smoking cessation is important for process evaluation. Method: The AAQII-SC was developed by making the experience and feeling with reference to smoking and cessation. Interviewer-administered surveys were carried out with a convenience sample of 272 people with schizophrenia who smoke from 49 mental health rehabilitation setting in the community. Confirmatory factor analysis (CFA) was conducted to examine the factorial structure and Cronbach alpha values were calculated for the AAQII-SC. Results: The mean age of the respondents was 48.7 years (SD=11.3), 88.2% were male, their mean daily cigarette consumption is 12.3 (SD=8.4), and mean year of smoking was 27.7 (SD=12.9). Confirmatory factor analysis revealed that the original one-factor model with an addition of a correlation between Items 5 and 7 provides a good fit to the data (SRMR = 0.062; CFI = 0.956, RMSEA=0.065). Cronbach’s alpha of the scale was 0.763. Discussion: The findings provide support for the psychometric properties of AAQ-II with an adaption to smoking and cessation in a sample of people with schizophrenia who smoke. The scale provides a useful tool to assess psychological flexibility regarding smoking cessation in this particular population.

81. A New Behavioural Measure of Present Moment Awareness: A multi-study examination

Primary Topic: Measurement and assessment
Subtopic: mindfulness; assessment; present moment
Ivan Nyklíček, Tilburg University

Background: Contact with the present moment is one of the hexaflex factors and a central facet of mindfulness. Self-report instruments of momentary awareness have been criticised. Therefore, the aim was to examine a new behavioural measure of present moment awareness based on free verbal expression. Methods: In Study 1, 35 experienced meditators and 47 matched control participants performed the task and completed self-report instruments; in Study 2, 53 students performed the task two times, and in Study 3, 62 participants of a 8-week MBSR intervention performed the task before and after the intervention. Indices of Interoceptive, Exteroceptive, and Affective Awareness were obtained. Results: Inter-rater and test-retest correlations were satisfactory. Scores correlated with emotional self-awareness and introspective interest, but not with self-reported mindfulness or mood. Compared to controls, meditators scored higher on all awareness variables. The awareness scores did not change with MBSR participation. Discussion: The test seems to assess momentary awareness, which is not captured by self-report questionnaires. It seems to correlate with psychological traits and intensive longer term practice rather than with participation in a standard mindfulness intervention.

82. Psychometric Properties of a Short Form of the Five Facet of Midfulness Questionnaire (FFMQ-SF) Among a Sample of French-Canadian Adolescents

Primary Topic: Measurement and assessment
Subtopic: Mindfulness, Adolescents
José Angel Mendoza Herrera, Ph.D. Student, Université de Sherbrooke
Marie Claire Lepage, Université de Sherbrooke
Patrick Gosselin, Université de Sherbrooke

Background. The Five Facet Mindfulness Questionnaire (FFMQ) assesses different aspects of mindfulness: observing, describing, acting with awareness, and stances of non-judgment and of non-reactivity towards experience (Baer & al., 2006). The FFMQ has demonstrated excellent psychometric qualities with adult samples, and has been validated in French (Heeren & al., 2011) and in a short form (Bohlmeijer & al., 2011). Although several studies have observed negative relationships between mindfulness levels and psychological difficulties among adolescents (Royuela-Colomer et Calvete, 2016; Taylor et Millear, 2016), few attention has been paid to cross-cultural validation with this population. Objectives. This study aimed to examine the psychometric properties of the FFMQ-SF among a sample of French-Canadian adolescents. This instrument could reduce administrative burden, therefore improving assessment feasibility. Methods. French versions of the FFMQ-SF (24 items) and the Avoidance and Fusion Questionnaire – Youth (AFQ-Y) (Greco, Lambert et Baer, 2008) were administered in a high school setting in the province of Québec (N = 152; 55,9% men, mean age=13,74). Results. Exploratory factorial analyses support the FFMQ-SF five factor structure, explaining 48% of the variance. Also, correlations between the FFMQ-SF (and subscales) and the AFQ-Y support its convergent validity. Internal consistency estimates were good for the entire scale (Cronbach’s alpha=0.82) and acceptable for all the subscales (Cronbach’s alpha>0.70). Finally, item-total correlations showed good quality for each item (> .40). Conclusions. The French version of the FFMQ-SF showed good psychometric properties, corroborating its value to assess mindfulness processes among adolescents. Further research may evaluate its test-retest reliability.

83. Evaluating a Brief ACT intervention to Improve Direct Care Staff Performance During Crisis Intervention Encounters

Primary Topic: Performance-enhancing interventions
Subtopic: Residential Facilities
Ashley Shayter, M.S., BCBA, CBIS, Northern Michigan University
Jacob Daar, Ph.D., BCBA-D, Northern Michigan University
Mark Dixon, Ph.D., BCBA-D, Southern Illinois University

Direct care staff (DSPs) are often tasked with responding to difficult and oftentimes dangerous problem behaviors. While efforts to identify safe and effective procedures for addressing these has produced a number of proactive and function-based strategies, default technologies such as restraint may often be required to reduce risk of harm. However, staff who use these types of technologies tend to suffer from greater levels of anxiety, desensitization, and negatively interact with consumers. Additionally, staff are less likely to engage in recommended protocols, or accurately respond to incidents. Although clear correlations between burnout, poor interactions, and job stressors exist, there are currently few empirically-based programs designed to train appropriate coping responses. The present study examined the efficacy of a brief Acceptance and Commitment Training intervention combined with realistic role-play scenarios in improving DSP performance during crisis intervention encounters. Results indicated that four of six participants improved their performance following training, with a booster session further increasing performance. Implications of this study suggest that ACT may be a beneficial intervention to increase staff performance during crises.

84. Culturally adapting ACT for Latinos with co-occurring DUD/HIV in Puerto Rico

Primary Topic: Performance-enhancing interventions
Subtopic: Drug Use Disorders and HIV
Coralee Pérez-Pedrogo, Ph.D., University of Puerto Rico Medical Sciences Campus
Sugeily Rivera-Suazo, M.S.W., University of Puerto Rico, Medical Sciences Campus
Carmen E. Albizu-García, M.D., University of Puerto Rico, Medical Sciences Campus

Engaging people with co-occurring drug use disorders (DUD) and HIV in evidenced-based treatment (EBT) for drug addiction is of high public health significance. By 2016, injectable drugs were the cause of transmission for 43% of accumulated cases of HIV among adults and adolescents in Puerto Rico (PR). Self-stigma has been identified as a barrier to treatment access and adherence for both conditions with increased risk of morbidity and mortality. Evidence supports the efficacy of Acceptance and Commitment Therapy (ACT) for the treatment of self-stigma. However, the cultural adaptation and dissemination of EBTs among Latinos with DUD/HIV is scarce despite extensive research that demonstrates the positive effects of these interventions. The purpose of this study is threefold: (a) justify the importance of cultural adaptation research as a key strategy to develop efficacious interventions, (b) describe the initial steps of a study aimed to culturally adapt an EBT informed by ACT principles, and (c) discuss implications for advancing cultural adaptation treatment practice and research, based on the initial feasibility and acceptability findings of an intervention delivered to reduce self-stigma among Latinos with DUD/HIV living in PR. Research findings will illustrate the initial feasibility and acceptability associated with the dissemination of an EBT informed by ACT principles. The study is relevant because limited attention has been granted to interventions delivered to reduce self-stigma among populations with co-occuring DUD/HIV, specifically Spanish-speaking Latinos that are not included in efficacy studies.

85. ACT PAVES the Way - Preparation, Activation of Values, and Examination of Strengths: A Proposed Protocol for Treatment of Combat Stress Reactions

Primary Topic: Performance-enhancing interventions
Subtopic: Stress
Jourdin Navarro, M.A., Midwestern University, Glendale
Angela Breitmeyer, Psy.D., Midwestern University, Glendale
Jessica Powell, Psy.D., Midwestern University, Glendale

Background: Since September 2001, over 2.77 million United States service members (SMs) have served on 5.4 million deployments to various combat operation zones (Wenger, O’Connell, & Cottrell, 2018). There have been nearly 60,000 casualties since 2001, and countless others have experienced invisible wounds of war (Defense Casualty Analysis System, 2018). SMs deployed to a theater of operations are at greater risk of exposure to combat-related stressors. There is emerging evidence to support the use of Acceptance and Commitment Therapy (ACT) in the treatment of combat-related stress reactions (Seligman & Fowler, 2011; Vujanovic, Niles, Pietrefesa, Schmertz, & Potter, 2011; Wood, Britt, Wright, Thomas, & Bliese, 2012); however, an applicable treatment protocol for use in theater does not currently exist. Method: A review of the literature was conducted to assess the need for developing an ACT-based program for SMs experiencing combat-related stress. The proposed protocol utilizes ACT-based principles and interventions in a three-phase approach to accommodate the operational tempo in theater. Results: The number of treatment-focused DoD programs available to SMs deployed in support of combat operations are limited in availability and scope. The implementation of the proposed protocol will potentially result in a within-subject decrease in combat stress-related symptomology while increasing psychological flexibility and posttraumatic growth. Conclusion: The proposed protocol is designed to reduce rates of operational stress and provide SMs with psychological skills to promote psychological flexibility following exposure to combat-related stressors. This protocol is the first to utilize the integration of values-based interventions within the context of military culture.

86. More than words: The experiential versus didactic delivery of ACT metaphors

Primary Topic: Performance-enhancing interventions
Subtopic: Metaphors
Juwayriyah Nayyar, B. A., University College Dublin
Emily Lewis, B. A., University College Dublin
Martin O'Connor, M.Sc., University College Dublin
Louise McHugh, Ph.D., University College Dublin

Background: A number of studies have systematically assessed the clinical impact of metaphors in psychotherapy, and have shown them to increase memorability of therapeutic information and psychological flexibility. The present study aims to compare the effects of delivering acceptance and commitment therapy (ACT) metaphors physically versus didactically. Method: 82 participants will randomly receive either physically or didactically delivered ACT metaphors and will complete a delayed recall task and self-report measures to assess efficacy in communicating ACT concepts. Participants will receive three functionally distinct metaphors, each targeting a different psychological flexibility process: acceptance (Chinese Handcuffs Metaphor), self-as-context (Chessboard Metaphor), and values (Compass Metaphor). Results: Two-way ANOVA tests will be used to assess differences and interactions between groups. Based on previous research, it is hypothesised that participants in the physical metaphor condition will demonstrate greater recall and comprehension of the therapeutic content as well as higher scores on the measures of helpfulness and ACT processes than those in the didactic metaphor condition. Discussion: These findings will have several implications for the use of metaphor in clinical practice.

87. Testing the efficacy of parent training on the delivery of a perspective taking intervention for children diagnosed with autism spectrum conditions

Primary Topic: Performance-enhancing interventions
Subtopic: ASD, Perspective-taking
Luke Mather, University College Dublin
Zahra Moradi Shahrbabak, Ph.D, University College Dublin
Louise McHugh, Ph.D., University College Dublin

Central to effective social interacting is the capacity to take the perspective of another. Relational Frame Theory (RFT) posits that this skill emerges due to a history of reinforcement for relating the deictic relations of I-you, here-there, and now-then. While there is a voluminous body of research supporting the efficacy of this account in training perspective taking skills in typically developing children, the literature concerning its efficaciousness with children with autism spectrum disorder (ASD) remains sparse. The current study aims to use a multiple-baseline design to assess the effectiveness of a parent-led perspective taking intervention for children diagnosed with ASD. Training will consist of parents using the natural environment to train competency in each of the deictic frames. Participants will be three children diagnosed with ASD. Improvements in perspective taking ability will be measured through performance on theory of mind tasks, deictic relating tasks, and the results of the Vineland Adaptive Behaviour Scale at baseline, post-intervention and 3 week follow-up. It is hypothesised that the intervention will improve perspective taking skills in each participant.

88. The effect of value work and visual feedback to academic performances

Primary Topic: Performance-enhancing interventions
Subtopic: academic performance
Tomu Ohtsuki, Ph.D., Waseda University
Kana Yoshida, Waseda University
Kenichiro Ishizu, Ph.D., University of Toyama
Yoshiyuki Shimoda, Ph.D., Saga University

The present study explored the effect of value work and visual feedback to increase academic performance by single-case multiple baseline design. 3 university students (P1, P2, and P3) who would take the Test of English for International Communication (TOEIC) participated in this study. In intervention 1, they engaged in value work which aimed to clarify their values related to English learning and to plan committed actions. During intervention 2, they were provided visual feedbacks of their learning performances, such as learning time, number of words, learning efficiency, and scores of English words tests. Results showed that P1 and P2 increased number of words significantly which were measured during intervention and follow up phases as compared to baseline. P1 showed better learning efficacy during intervention and follow up phases as compared to baseline. P2 showed better scores of English words tests during intervention and follow up phases as compared to baseline. Other behavioral measures were not changed significantly. These results indicate that interventions of value work based on ACT and visual feedback based on behavior analytic approach are partially effective in increasing academic performance.

89. The Relationship Between Health Values Directed Behavior and Health Related Behavior

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Health
Alison Stapleton, University College Dublin
Martin O'Connor, University College Dublin
Emmet Feerick, University College Dublin
John Kerr, University College Dublin
Louise McHugh, Ph.D., University College Dublin

Research suggests having a sense of meaning in life is related to better physical health. The present study examined the relationship between health values directed behavior and engagement in specific health behaviors, namely physical activity, dietary quality, sleep quality, alcohol consumption, and cigarette smoking. Participants were 111 members of the general population aged 18 to 49 (M = 21.41, SD = 3.721) who attended a single assessment session to complete a values clarification task, the Values Wheel measure of values directedness, and questionnaire measures of engagement in health behaviors. Findings indicated that neither dietary quality nor alcohol consumption were related to values directedness, suggesting these behaviors were not functionally congruent with participants’ health values. Greater levels of physical activity were associated with greater commitment to valued action. Lower sleep disturbance was associated with greater commitment to valued action and greater health values directedness. The present findings highlight a need to emphasize the importance of health behaviors and suggest that interventions aiming to improve physical activity and sleep quality may benefit from a focus on values.

90. The practice of mindfulness: An intervention with high school students in the period of university entrance exams

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness. High School. Mental Health.
Ana Vera Niquerito-Bozza, Ph.D., Faculdades Integradas de Jahu (FIJ) and privacy practice
Paulo Cesar Bozza Junior, Private Practice
REGINA CÉLIA APARECIDA SANCHES, Private Practice
Gustavo José Martinho, Private Practice
Luciana Soares, Private Practice

Background: The mindfulness practice in high school students during the university entrance exams, a period in which adolescents have to deal with challenging situations, changes and uncertainties. Objective: verify the effectiveness of mindfulness practices in pre-college students. Method: the sample consisted of 22 students in high school. The following qualitative method were used for verification of the results from pre and post mindfulness intervention: Inventory of stress symptoms for adults of Lipp; Beck's inventory of anxiety; Acceptance and Action Questionnaire-II and Brazilian version of the Cognitive Fusion Questionnaire. Results: The results obtained after the intervention showed that the intervention reached the expected goal, for each analyzed variable. An improvement was noted in the routine of the adolescents: Stress symptoms decreased by 14%; the most acute phase of anxiety was extinguished and facilitated a cognitive flexibility to the public by the fact that the practice generated a process of awareness and action. Discussion: The result obtained was positive for the initial expectations of the research, which proved that the practice of mindfulness brings benefits to the mental health of the individual, because the technique facilitates to bring the person’s mind to the present moment, changing their approach to events, thoughts and feelings in a more non-judgmental way. The practice brings a perspective of not only emotional stability, but it develops the possibility of observing the present moment motivating the individual to be directed to valued actions and having greater mental health.

91. Acceptance and commitment therapy (ACT) for promoting mental well-being among new graduate nurses: study protocol for a pilot randomized controlled trial (RCT)

Primary Topic: Prevention and Community-Based Interventions
Subtopic: mental wellbeing, nurses
Ching Yee Lam, MPhil, MN, Ph.D. Candidate, Hong Kong Polytechnic University, The Open University of Hong Kong
Yim Wah Mak, Ph.D., Hong Kong Polytechnic University
Sau Fong Leung, Ph.D., Hong Kong Polytechnic University

Background: Stressful working life in clinical setting is a challenge experience for new graduate nurses (NGN), in particular, during transitional period. Transition program have been adopted for supporting NGN from novice to competent, yet, few studies have evaluated programs of promoting mental well-being in NGN. Because ACT advocates value-based living, it has been proposed to be an appropriate mental health promotion intervention. This study reports a protocol for a pilot RCT of a group-based face-to-face ACT intervention for promoting mental well-being in NGN. Methods: A randomized, two-group design to examine the feasibility, acceptability and potential efficacy of a four face-to-face ACT intervention sessions vs. control, with assessment on baseline, 6 weeks and 3 months follow-up for enhancement of mental well-being and perceived stress as primary outcomes. Data analysis will be descriptive and include an evaluation of eligibility, recruitment, and retention rates. A process evaluation will be conducted to identify potential resources needed to undertake a definitive study. Discussion: The findings would be useful for estimating effect size for a full powered trial for promoting mental well-being among Chinese NGN. \\

92. Mindful Eating – Conscious Living™: An acceptability study of an 8-week mindfulness programme focused on food and eating

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness
Christine Ramsey-Wade, Centre for Appearance Research, University of the West of England
Emma Halliwell, Centre for Appearance Research, University of the West of England
Heidi Willaimson, Centre for Appearance Research, University of the West of England
Melissa Atkinson, University of Bath

Mindful Eating – Conscious Living™ (ME-CL) is a mindfulness-based intervention originating in the US which aims to reduce anxiety around food and eating. While the programme is being delivered widely, it has never been tested under research conditions. This study represents the first stage of a larger trial, testing the acceptability or descriptive feasibility of the programme with a UK sample. Following ethical approval, three focus groups (n = 12) were held with adult women in the UK with an interest in mindfulness and/or (un)healthy eating. Participants were asked to read an overview of the ME-CL programme and session plans from two classes before the group. During the groups, they were asked for their views on the appropriateness and clarity of the language used, the novelty and relevance of the programme, and whether any changes were needed. The focus groups were audio-recorded and transcribed, to be analysed thematically in light of the research aims. Analysis is ongoing, and will be reported in more detail in the conference poster. Initial results indicate that, while some minor changes may be needed to accommodate differences in language, no major changes were felt to be required. However, the data does suggest some useful points of consideration for mindful eating teachers in the UK. Subclinical disordered eating, or dis-ease around food and eating, is widespread. ME-CL shows initial promise to address this, but further research is needed to test its efficacy and feasibility.

93. Enjoy translating TED talks from the ACBS world!

Primary Topic: Prevention and Community-Based Interventions
Subtopic: TED talks, ACBS
Emanuele Rossi, Psy.D., APC - SPC, AISCC

TED talks are powerful talks of brief duration which have the function of spreading ideas. In the last few years they increased their efficacy and today we can hear talks about almost all topics translated in more than 100 languages. At the same time the international community of TEDx organizes events at a local level elevating them to a global level. AMARA is the official award winning system that TED uses for translation and transcription. Amara is a subtitle editor designed to be easy to use and understand in order to transcript and translate video and make it more globally accessible. Recently the ACBS community is making extensive use of TED Talks and AMARA system, sharing around the world its mission to alleviate human suffering and advance in human well-being. This poster illustrates how to enjoy TED and AMARA communities. You will learn how to sign up and start the translation process and then move forward with the subtitling and the sharing. There are few clear rules to follow in order to accomplish the mission and spread the ideas in an effective way. By enjoying the community of volunteers and translators you will contribute to spread word of ACBS TED talks worldwide.

94. Nonpathologizing the effects of serious injuries among Filipino combatants: An intervention program using Acceptance and Commitment Therapy

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Trauma
Gabriel Sebastian Lizada, Ateneo de Davao University

Military personnel who are continuously deployed in the field are more prone to develop potentially traumatic events which may lead to certain mental health conditions such as significant distress, violence and PTSD. The most common way of treating PTSD using the medical model – a model that assumes that events and symptoms have a causal relationship. Following the medical model in treating PTSD and trauma will more likely focus on symptom reduction.(McLean & Follette, 2016), As a result, they are often quick to pathologize combat-related trauma and treat it as a mental illness. However, military personnel who survive potentially traumatic event report high levels of distress, but not meet the criteria for PTSD. Military personnel under chronic stress tend to develop complex posttraumatic stress disorder (C-PTSD) - a diagnosis for survivors of prolonged trauma, capturing the symptoms that do not meet the criteria for PTSD (Resick et al., 2012). In the Philippines setting, once a combatant (soldier) is seriously injured (physical or psychological) they must undergo a psychiatric assessment (PA) before being fit deemed fit for duty. In their PA, they are assessed physically, emotionally and psychologically before returning to active duty. If they are deemed unfit for the job because of their mental health, then they will be discharged from duty. This study aims to use the ACT model as a form of therapy to soldiers who have been seriously injured in the line of duty who are showing significant distress but not meet the criteria for PTSD.

95. Mind your Food Challenge: Reducing emotional eating in college students through components of Acceptance and Commitment therapy (ACT)

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Emotional eating
Gabriela Chia, IE University and IEU Wellbeing Center
Leticia Martinez

Background and objectives: Treatments for emotional eating have been based on the dietary restraint model of binge eating, such as cognitive behavioural therapy (CBT). Although this therapy is the most common treatment used for emotional eating, its effectiveness is questionable. Therefore, the interest in improving treatment for binging is growing. This paper aims to evaluate the impact of Acceptance and Commitment therapy (ACT) on emotional eating in college students. Method: 30 undergraduate students took part of a 1-day workshop on reducing emotional eating, based on three main components of ACT (cognitive defusion, experiential avoidance and awareness). Before the workshop cognitive fusion from the students was measured with the Cognitive Fusion Questionnaire (CFQ), experiential avoidance was measured with Acceptance and Action Questionnaire (AAQII) and their eating habits were measured with both, the Emotional Eating Scale (EES) and Dutch Eating Behaviour Questionnaire (DEBQ). One week after the workshop students were assessed again for a follow up. Results: A reduction in emotional eating was shown one week after the participants took part in the workshop. More specifically, participants showed an improvement in diffusion from thoughts and reduced experiential avoidance, which consequently lowered their engagement in emotional eating. Conclusions and discussion: One of the limitations of this exploratory study is that no control group was used. Hence, a randomised control trial could be carried out in the future for comparison and consequently obtain more specific results. This study, however can contribute for an improvement in clinical practice with people who suffer from emotional eating.

96. “#KindGirlsInACTion”: A School-based Group Programme for Adolescents

Primary Topic: Prevention and Community-Based Interventions
Subtopic: School-based Intervention
Joana Marta-Simões, Ph.D Student, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra
Ana Laura Mendes, Ph.D. Student, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra
Cláudia Ferreira, Ph.D., Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), University of Coimbra

Background: #KindGirlsInACTion is a school-based quality of life promotion and eating disorders prevention Programme for adolescent girls, which includes Compassion Focused Therapy (CFT) and Acceptance and Commitment Therapy (ACT) components. This programme aims at promoting girls’ compassion, acceptance and values-based committed action, with intended impact in the exhibition of self-care behaviors, positive body image attitudes and affiliative peer relationships and, consequently, in body and eating-related behaviors and overall levels of health-related quality of life. ACT and CFT have been separately applied in adolescents, in the form of school-based interventions, with success. Moreover, the combination of both therapies has been proved as successful in interventions with different aims. Methods: #KindGirlsInACTion is a school-based group programme designed for girls between 12 and 18, attending middle or secondary schools. It comprises 12-14 weekly sessions of 45 minutes each. Results: It is expected that, comparing to a control group, adolescents who attended the programme will present, and maintain over time, higher acceptance, values-driven behaviors, and mindfulness skills, which are hypothesized to impact positively in body image attitudes, self-care behaviors, affiliative skills and peer relationships, and in eating behaviors and quality of life levels. Discussion: We believe that the innovative combination of two empirically validated therapies, in a programme which is mostly experiential and cultivates compassion, acceptance, valued action and mindfulness skills, will contribute for the prevention of body and eating-related psychopathology and for the promotion of female adolescents’ well-being.

97. A mobile game for improving psychological flexibility skills in elementary school children

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Children
Katariina Keinonen, Ph.D. Student, University of Jyväskylä
Anna-Lotta Lappalainen, M.S., Solent NHS Trust
Päivi Lappalainen, Ph.D., University of Jyväskylä
Raimo Lappalainen, University of Jyväskylä

Background: Children with aggressive behavioural patterns have been found to have deficiencies in problem solving strategies and empathy skills while interacting with others. Classroom-level interventions are needed for prevention of psychological problems among children. To our knowledge there are few studies investigating the impact of mobile games as a tool in delivering ACT/RFT -based interventions at schools. The project was set to develop a mobile game for anti-bullying. Method: The game was based on principles of Relational Frame Theory (RFT). The game was designed for 10-13 years-old children. The gameplay aims to increase children’s psychological flexibility skills using dialogues and problem-solving approach. It teaches skills related to perspective taking, values, emotion and thought management through gamification. Results: The user-experiences and acceptability of the game have been positive. The paper will report preliminary acceptability and effectiveness results in classroom settings using an RCT design. Discussion: Using a mobile game to deliver psychological interventions for children in the school context can be an interesting alternative for increasing psychological well-being among children.

98. Acceptance-based or mindfulness-based interventions for parents: A systematic review of the effects on psychological or mental well-being

Primary Topic: Prevention and Community-Based Interventions
Subtopic: parents
Kyle, Ka Leung Lam, M.Sc., Hong Kong Polytechnic University
Yim Wah MAK, Ph.D., Hong Kong Polytechnic University

AIM: To review the effectiveness of acceptance-based or mindfulness-based interventions for improving psychological well-being and promoting mental well-being among parents of children METHODS: Studies were identified by searching five electronic databases to 1 March 2019 for randomized controlled trials (RCTs) RESULTS: Ten RCTs were included. Parents of the identified studies were healthy except one study included parents with history of depression, while studies included with broad range of clinical problems among their children such as autism spectrum disorder, developmental delays, and attention deficit and hyperactivity disorder (n=8). 3 studies used acceptance and commitment therapy (ACT) and the others used various types of mindfulness-based interventions such as mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MSBR). There is no clear definition on “psychological well-being” and “mental well-being” from all studies as they included different outcome measures. Both types of intervention showed improved psychological well-being. Participants who received ACT reported significant improvement in psychological flexibility CONCLUSIONS: ACT and mindfulness-based interventions can improve psychological well-being of participants. It was also found that the selected articles mainly focus on healthy parents with sick children, only one article reported the effects of interventions on healthy parent-child dyads. In addition, no study included healthy parent-child dyads with children aged 2-6 as their participants

99. Grazing behaviours: Exploring the impact of body image-related shame and self-compassion

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Eating behaviours
Lara Palmeira, Oporto Global University, Portugal
Diana Sousa, Oporto Global University, Portugal
Cristiana Marques, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra

Grazing - a pattern of repeated episodes of consumption of small amounts of food throughout the day in an unplanned manner - remains unexplored. In addition, growing evidence emphasizes the central role of body image shame in the adoption of maladaptive eating behaviours, particularly in binge eating. On the other hand, self-compassion, defined as the ability to have an attitude of acceptance and tolerance toward oneself, has been consistently associated with well-being and lower levels of eating psychopathology. This study aims to evaluate the impact of body image shame (both internal and external) and self-compassion in grazing behaviours. This is still an ongoing study. Currently, the sample encloses 25 women and 9 men from the community, with a mean age of 26.50 years (SD = 10.38), 11.72 years of schooling (SD = 2.76) and a mean BMI of 24.5 (SD = 5.08), mostly singles (73.5%). Results showed that BMI was positively related to body-image shame. In turn, body-image shame was positively associated with grazing. Conversely, grazing was negatively associated with self-compassion. Moreover, results from multiple regression analysis revealed that the model accounted for 34.8% of grazing behaviours. Self-compassion abilities was the best predictor (β = -.442, t = -2.892, p < .01), followed by internal body-image shame (β = .376, t = 2.461, p < .05). Overall, although still preliminary, results unveil the importance of developing a warmer and more compassionate attitude towards one’s body image and eating behaviours, promoting people’s health.

100. Turkish Version of Generalized Pliance Questionnaire: Preliminary Analysis of Psychometric Properties

Primary Topic: Relational Frame Theory
Subtopic: Rule Governed Behavior
Ahmet Nalbant, M.D., Adiyaman University Research and Training Hospital Department of Psychiatry
Zulal Celik, M.D., Bakirkoy Research and Training Hospital for Mental Health and Neurological Diseases, Istanbul, Turkey
K. Fatih Yavuz, M.D., Istanbul Medipol University

BACKGROUND: The ability of humans to generate and apply rules has both advantages and disadvantages. People can learn without any direct experience, respond abstract consequences and follow goals by benefiting from advantages of rules. Rules also have some disadvantages such as it is shown that rule governed behavior is associated with decreased awareness to contextual changes. Pliance, as a kind of rule following, means that consequences that reinforce this rule following is generated by the rule giver. Recently, Ruiz et al. developed Generalized Pliance Questionnaire (GPQ) to evaluate generalized pliance. More recently, Connor et al. translated GPQ to English and showed that it has good psychometric properties. In this study, we evaluated Turkish version of GPQ and discussed its psychometric properties. METHOD: The study sample consisted of 165 healthy volunteers. For the assessment, A socio-demographic data form, The Social Functioning Scale (SFS), Personality Belief Questionnaire (PBQ) and Turkish Version of Generalized Pliance Questionnaire (TGPQ) were used. Internal consistency and split-half analyses were performed to evaluate the reliability. Also, a principal component analysis was conducted to assess the validity. RESULTS: According to the results, TGPQ has a Cronbach’s alpha value of .93 and it showed good internal consistency. Results showed that TPQ has one component and it also showed significant correlation with PBQ and SFS. DISCUSSION: Turkish form of the GPQ is a reliable and valid tool for assessment of generalized pliance .

101. An Analysis of Empathy from a Functional Contextual Approach

Primary Topic: Relational Frame Theory
Subtopic: Empathy
Beatriz Harana, Ph.D. Student, Universidad de Almeria
Carmen Luciano, Ph.D., University of Almeria
Matheus Bebber, Ph.D. Student, University of Almeria
Beatriz Sebastián, Ph.D. Student, University of Almeria
Mari Luz Vallejo, Ph.D. Student, University of Almeria

Background: The most traditional mainstream of psychology has provided a multitude of explanations, theories and definitions about empathy. However, there has not been an agreement on what the empathic repertoire is and how it develops (Davis, 1996). From a functional contextual perspective, there have been some studies that have tried to address empathy. Nevertheless, no study has been conducted in order to isolate what an empathic interaction consists of. Conversely, one of the things that has also not been analysed is whether psychological flexibility is somehow related to empathy. In this line, the main objective of this study is to measure and analyse what an empathic interaction consists of and how this correlates with psychological flexibility and traditional empathy measures. Method: To this end, this study included the participation of undergraduate students (N=30). The participant carried out the Empathic Interaction Task (EIT), specifically designed for this study. Then, they completed two traditional empathy tests and two psychological flexibility questionnaires. Results: These results is discussed in terms of the confluence of responding between the different measures.

102. Implicit and explicit attitudes towards type 2 diabetes versus typical health

Primary Topic: Relational Frame Theory
Subtopic: IRAP
Charlotte Dack, University of Bath
Samantha Garay, Cardiff University

Background: Type-2 diabetes mellitus (T2DM) affects 3.3 million people in the UK alone. Effective self-management is essential to avoid diabetes-related complications. However, negative attitudes surrounding T2DM may be a barrier to this. This study aimed to investigate explicit and implicit attitudes towards T2DM versus typical health. Method: In total, 30 participants, all of whom had no diagnosis of T2DM completed an Implicit Relational Assessment Procedure (IRAP) designed to assess implicit relational responding towards T2DM versus typical health. Participants also completed a range of explicit measures including a feeling thermometer for both T2DM and typical health. Results: Explicit measures indicated a negative T2DM bias, with T2DM rated significantly more negatively and less warmly than typical health. The IRAP measure demonstrated a significant positive bias on all trial types (T2DM-positive-True; typical health-negative-False; typical health-positive-True) except for T2DM-negative-False. The differences found between implicit and explicit responses will be discussed.

103. ABA training for an ASD child and Behavioral Parent Training (BPT)+ACT Matrix parenting for his parent

Primary Topic: Relational Frame Theory
Subtopic: ABA, ASD, children, BPT, ACT
Chisako Ukita, Ritsumeikan University
Chisato Tani, Ritsumeikan University
Shinji Tani, Ritsumeikan University

An ASD child has a variety of difficulties, such as compulsive behaviors, narrow thinking and hypersensitivity. Therefore, parents of him often feel difficulty to raise a child. It leads to the aversive parenting and increases the risk of abuse.This study showed that the case reseach which were provided ABA training for an ASD child (5 years old) and Behavioral Parenting Training (BPT) +ACT Matrix parenting for his parents. The parents often used the aversive control to their child (ex. hit him, scolded him emotionally and threaten him, etc.). Total eight sessions (about 1. 5h each) were provided for the child and parents. The child and parents were received training session separately. ABA training which targeted to the basic academic skills ( learning basic concepts) and relational framings were introduced to him. BPT +ACT Matrix parenting were implemented to his parents. The results showed that he learned the basic concepts (right-left discrimination and mathematics) and combinatorial frame. The mental health condition measured by GHQ60 got better than before the session (Pretest 19, Posttest 7 for Father; Pretest 36, Posttest 9 for Mother). Psychological Inflexibility (by AAQ-II) increased a little after the BPT session (Pretest 21, Posttest 28 for Father; Pretest 26, Posttest 25 for Mother) but decreased after introducing Matrix. The decrease of aversive control also observed. We conclude BPT+ACT Matrix parenting is useful and helpful methods for parents having children of ASD.

104. Teaching a Child with Autism Spectrum Disorder to Pay: Applying Relational Frame Theory

Primary Topic: Relational Frame Theory
Subtopic: Derived relational responding
Daiki Furuya, M.A., Meisei University
Shinobu Ogasawara, M.A., Meisei University
Koji Takeuchi, Meisei University

Background: In RFT, reactions that occur without direct learning are called a derived relational responding. The current study was conducted with one child diagnosed with Autism Spectrum Disorder. When presented with a one-digit number, this child choose the same number objects; however, in case of three-digit numbers, the child could not pay the corresponding coin value. This study aimed to verify if a child could pay a corresponding three-digit coin value without being taught the number system directly. Method: The participant was a 5-year-old with an IQ of 85. This study used the Teaching-Implicit Relational Assessment Procedure (T-IRAP) to learn the relationship between the 3-digit numbers and Japanese coins. T-IRAP is a computer task. A 3-digit number that comprised 1 or 0 was presented on the top of the monitor screen. At the center, a picture of 3 types of Japanese coins (100 yen, 10 yen, 1 yen) was presented. The bottom left and right showed the options “same” and “different.” If the 3-digit number corresponded with the coin value, “same” was the correct answer; if they did not correspond, “different” is the correct answer. To investigate if the correct number of coins had been provided to correspond with the number, payment tests were conducted before and after T-IRAP. Result: The result of payment test was 0% before T-IRAP, 100% after it, and 100% two weeks later. Discussion: It is considered that a derived relational responding occurred without directly learning by matching between position of 3-digit numbers and corresponding coins.

105. Psychological flexibility, emotional regulation, and well-being in various life situations
ACBS Polska
Primary Topic: Theoretical and philosophical foundations
Subtopic: Psychological flexibility
Lidia Baran, Ph.D., University of Silesia in Katowice
Magdalena Hyla, Ph.D., University of Silesia in Katowice
Irena Pilch, Ph.D., University of Silesia in Katowice
Magdalena Bolek-Kochanowska, Ph.D., University of Silesia in Katowice
Maciej Bożek, Ph.D., University of Silesia in Katowice
Wiola Friedrich, Ph.D., University of Silesia in Katowice
Jagoda Sikora, M.A., University of Silesia in Katowice

Ability to act in a flexible manner is an important indicator of health (Kashdan, 2010). Research shows that high psychological flexibility is associated with lower emotional exhaustion (Biron, Veldhoven, 2012) due to applying emotional regulation techniques related to high emotional well-being (Brockman et al., 2016). However, it seems that this relation may be influenced by the character of the situations in which regulation occurs (Haines et al., 2016). The aim of the project was to analyze relations between psychological flexibility and suppression, reappraisal, situational self-esteem and positivity in various contexts. Participants completed AAQ-II, then assessed other variables six times a day for a week. Using experience sampling method we collected 20,708 surveys from 688 participants. We expected psychological flexibility to be positively related to well-being, negatively to emotional regulation and to moderate relation between emotional regulation and well-being. We address the role of context by comparing those relations in situations when participants were alone and with others. We analyzed the data using multilevel models and conducted hierarchical modeling. The results of our research can be used to plan therapeutic interventions and client psychoeducation.

106. Temperamental basis for psychological flexibility, committed action and life satisfaction level

Primary Topic: Theoretical and philosophical foundations
Subtopic: temperament, psychological flexibility, life satisfaction
Maria Cyniak-Cieciura, Ph.D., SWPS University of Social Sciences and Humanities
Joanna Dudek, Ph.D., SWPS University of Social Sciences and Humanities

Initial research on the role of temperament traits in the development of psychopathology and work efficiency proved their moderating role in functioning in different stimulation conditions. The next research may focus on the relation of temperament to factors leading to better mental and somatic health. These kind of approach is limited, therefore the aim of this research was to verify the relations of temperament to psychological flexibility and its processes and life satisfaction level. The research was conducted in February 2019 on 107 students (87 F and 20 M) in the age of 17-50 (M=33.12, SD=8.71), who filled out a battery of questionnaires: a revised version of Formal Characteristic of Behaviour – Temperament Inventory FCB-TI(R), Acceptance and Action Questionnaire AAQ, Cognitive Fusion Questionnaire CFQ, Committed Action Questionnaire CAQ, Freiburg Mindfulness Inventory FMI, Multidimensional Experiential Avoidance Questionnaire MEAQ and Satisfaction With Life Scale SWLS. The results show that temperamental traits defining ones’ possibilities of stimulation processing: emotional reactivity, endurance and perseverance are significantly correlated with psychological flexibility, its processes and life satisfaction. Life satisfaction was also significantly related to psychological flexibility and all its processes. Regression analyses results revealed that the relation between temperament traits and both life satisfaction and committed action is at least partly mediated by psychological flexibility. The final structural models will be presented. The results suggest that people who developed psychiatric or somatic disorders which were proved to be related to lower possibilities of stimulation processing may lack skills responsible for more flexible reaction to stressful events.

107. Distress Aversion Moderates the Relationship between State Emotion Regulation Difficulties and Negative Affect Intensity

Primary Topic: Theoretical and philosophical foundations
Subtopic: Experiential avoidance
Meaghan Lewis, Western Michigan University
Amy Naugle, Western Michigan University
Kyra Bebus, Western Michigan University
Tabitha DiBacco, Western Michigan University
Allie Mann, B.S., Western Michigan University
Audrey Conrad, Western Michigan University
Callum Smith, Western Michigan University

Emotional or experiential avoidance appears to play a key role in the pathway between psychological distress and comorbid sequelae. However, less is understood regarding the form and function of strategies that increase the likelihood of emotion regulation difficulties. Distress aversion, conceptualized as a form of experiential avoidance, appears to explain the link between psychological distress and the propensity to engage in non-suicidal self-injurious behavior (Nielsen, Sayal, & Townsend, 2017). Similarly, avoidance strategies (i.e., behavioral avoidance, distraction and suppression) are associated with problematic behaviors (Kingston, Clarke, & Remington, 2010). Still, the relationship between trait experiential avoidance strategies and specific state emotion regulation/affective states is less understood. Thus, the goal of the present study was to further elucidate this relationship in a convenience sample (N = 160) who completed several analogue tasks of emotional and physiological discomfort. Distress aversion interacted with specific emotion regulation difficulties to predict the intensity of negative affect in the moment post tasks that evoked physiological and emotional discomfort. State experiential avoidance post analogue tasks explained the direct effect of baseline experiential avoidance and emotion regulation on negative affect intensity. State emotion regulation was more strongly linked with tasks of emotional discomfort. Suggestions for refining conceptualizations of experiential avoidance as state and trait to improve contemporary behavior therapies methods and outcomes will be discussed.

108. Mindfulness Facets Mediate the Relation of Anxiety and Non-Suicidal Self-Injury: A Conditional Process Analysis Across Levels of Borderline Personality Disorder Symptomology

Primary Topic: Theoretical and philosophical foundations
Subtopic: NSSI
Rachel C. Bock, B.S., University of South Dakota
Emily K. Kalantar, B.A., University of South Dakota
Christopher R. Berghoff, Ph.D., University of South Dakota
Kim L. Gratz, Ph.D., University of Toledo
Matthew T. Tull, Ph.D., University of Toledo

Non-suicidal self-injury (NSSI) is associated with high borderline personality disorder (BPD) and anxiety symptomology, yet research suggests BPD does not moderate the relation of anxiety and NSSI (Bentley et al., 2015). This finding is surprising given the centrality of NSSI to BPD. To date, no research has evaluated the variance mindfulness may account for in these relations, though several revealing correlations have been identified. For example, NSSI and anxiety symptoms are related to low non-judging, nonreacting, and acting with awareness. BPD features are inversely related to present-moment awareness. Furthermore, acting with awareness mediates the relation of stress and NSSI, which is similar in nature to that of anxiety and NSSI. Collectively, this research suggests mindfulness may be an informative process to explore in the anxiety-BPD-NSSI relation. The present study evaluated these relations using conditional process analysis. College students (N=396; Female=74.7%, White=62.4%, Mage=20.24, Range=17-42) completed measures of anxiety and BPD symptoms, mindfulness, and NSSI. Results indicated non-judging and nonreactivity significantly mediated the relation of anxiety symptomology and NSSI history (ps < .05). Moreover, these relations depended on level of BPD symptomology (ps <.05). Probability of NSSI was especially high in the context of high BPD symptoms and low nonreactivity, whereas high non-judging was related to lower NSSI probability in the context of low to moderate BPD symptoms only. Mindfulness will be discussed as a process that may enhance understanding of NSSI behavior and support therapeutic change for those struggling with NSSI in the context of anxiety and BPD.

109. Different values of smokers and non-smokers

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Smoking Cessation
Lena Nugent, Neuropsychiatric Center Hamburg
Nina Schulze, Neuropsychiatric Center Hamburg
Peter Tonn, Neuropsychiatric Center Hamburg

Background: Smoking leads to a significant health burden for both the smoking individual and passive smokers, in addition to the massive economic burden on the health care system. While previous approaches in smoking cessation are effective, there is still a high percentage of smokers in the german population. Therefore, further steps to aid smoking cessation are necessary. Method: We have developed a new form of smoking cessation based on personal values, attitudes and goals. Before we begin this program, we want to investigate if there are differences in values between smokers and non-smokers. Therefor we investigate the values of smokers and non-smokers, using an adapted version of the personal values questionnaire and the fagerstroem test for nicotine abuse. Results: In this presentation we show the results of the study, which is currently ongoing.