Image denotes ACBS Junior Investigator Poster Award Recipients

A meta-analysis of Acceptance and Commitment Therapy on anxiety, depression and stress for parents of children with chronic illnesses

Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, psychological flexibility, anxiety, depression, stress, chronic illness, children, parents
Xiaohuan Jin, M.N., The Chinese University of Hong Kong
cho Lee Wong, The Chinese University of Hong Kong
Huiyuan Li, The Chinese University of Hong Kong
Jieling Chen, The Chinese University of Hong Kong
Yang Bai, The Chinese University of Hong Kong

Background: Parents of children with chronic illnesses experience significant anxiety, depression and stress. Acceptance and Commitment Therapy (ACT) appears to be a promising approach for these parents, but there is a lack of systematic evidence.

Method: Seven databases (MEDLINE, PubMed, Embase, Cochrane Library, CINAHL, PsychINFO and Web of Science) were systematically searched from inception to October 2019. Results were obtained using meta-analysis.

Results: Six studies of trials involving 428 participants were included in this review.The meta-analysis showed that at postintervention, parents who received ACT presented with less depressive (SMD = −0.25, 95% CI: [−0.50, −0.001], p = 0.05) and stress (SMD = −0.36, 95% CI: [−0.57, −0.15], p = 0.0007) symptoms compared with those in the control groups. No significant effect on anxiety symptoms was found (p =0 .16). At 4–6 months follow-up, the reductions in the symptoms of depression (SMD = −0.40, 95% CI: [−0.76, −0.03], p = 0.03), anxiety (SMD = −0.41, 95% CI: [−0.66, −0.15], p = 0.002) and stress (SMD = −0.42, 95% CI: [−0.68, −0.17], p = 0.001) in the ACT group were all significant compared with those in the control group.

Discussion: Thus far, this work is the first to systematically appraise the effectiveness on anxiety, depression and stress for parents of children with chronic illnesses based on available RCTs.Meta-analysis shows that ACT is effective in reducing parental depression and stress at postintervention and 4–6 months follow-up. A significantly better improvement in parental anxiety symptoms is not found immediately after intervention but observed at 4–6 months follow-up.

A Preliminary Investigation of the Psychometric Properties of the Engaged Living Scale and Acceptance and Action Questionnaire-II among Ethnically Diverse College Students in Hawai'i

Hawai'i Chapter Sponsored
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychometrics
Samuel Spencer, M.A., University of Hawaii at Manoa
Mapuana Antonio, University of Hawaii at Manoa
Earl Hishinuma, University of Hawaii at Manoa John Burns School of Medicine
Fumiaki Hamagami, University of Hawaii at Manoa John Burns School of Medicine
Akihiko Masuda, University of Hawaii at Manoa

Background: Psychological inflexibility and engaged living are two major constructs that are used to understand and target optimal health and well-being in contextual cognitive behavior therapy. The Acceptance and Action Questionnaire-II (AAQ-II) and Engaged Living Scale (ELS) are among the most commonly used measures of psychological inflexibility and engaged living, respectively. Previous research on assessment of psychological inflexibility with the AAQ-II suggests that one-factor solution is the best fit, and that engaged living measured by the ELS includes two facets: valued living and life fulfillment.

Method: Because of their conceptual relevance, the present study examined the factor structure of both the AAQ-II and ELS as well as several aspects of the reliability and construct validity of these measures in ethnically diverse college students.

Results: Findings from confirmatory factor analyses, exploratory factor analyses, and exploratory structural equation modeling indicated that three-factor and four-factor models represented the best fit of the data for the AAQ-II and ELS, respectively. The three factors identified for the AAQ-II were: (a) Fear of Feelings, (b) Life Interrupted, and (c) Entanglement with Worries. The four factors identified for the ELS were hypothesized to be: (a) Recognizing Values, (b) Clarity Regarding Life Direction, (c) Value-Action Congruence, and (d) Life Fulfillment.

Discussion: While these findings diverge from previous research, the results provide support for the overall construct validity of the latent traits the AAQ-II and ELS intend to measure. Findings are also considered in light of the conditional nature of the psychometric properties of self-report measures. Limitations and future directions are also discussed.

A qualitative study of the preliminary impact of Mindful Action for Pain

Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain
Lynn Nguyen, UCSD
Autumn Backhaus, VA San Diego Healthcare System
Angela Camodeca, VA San Diego Healthcare System
Matthew Herbert, Ph.D., VA San Diego Healthcare System

Background: Mindful Action for Pain (MAP) is a group-based behavioral treatment for chronic pain developed to systematically apply formal mindfulness meditation within the psychological flexibility model (PF) to maximize functional outcomes. In order to optimize the effectiveness of MAP prior to conducting a future randomized controlled trial, it is important to ensure participants understand and are adhering to mindfulness meditation practice and are applying PF processes to daily living.

Method: Veterans with chronic pain (N = 8) participated in the 8-week MAP intervention. Qualitative interviews were conducted at mid-treatment and 1-month follow-up. Structural coding was employed to identify conceptual and content-based phrases relevant to meditation practice and behavior change.

Results: A total of 15 interviews were coded by three investigators to determine frequency and characteristics of the following themes: mindfulness, relationship with pain, and change speak. Most participants reported adherence to and understanding of formal mindfulness meditation practice, communicated less impact of pain on thoughts and actions, and provided examples of taking actions toward values-based living. Some participants demonstrated confusion with some in-session exercises and diminished formal mindfulness meditation practice at 1-month follow-up.

Discussion: Overall, MAP is useful for influencing Veterans with chronic pain in terms of formal mindfulness meditation practice, relationship with pain, and behavior change. However, not all in-session exercises were clear to participants and some participants decreased or stopped formal mindfulness meditation practice after group ended. Additional development of MAP is warranted to maximize impact.

A Review of Contextual Factors of Interpersonal Regulation in Emotional Disorders

Primary Topic: Clinical Interventions and Interests
Subtopic: Depression, Anxiety, Interpersonal Processes
Kelsey Pritchard, M.A., The University of Toledo
Peter Mezo, Ph.D., The University of Toledo

Background: Emotional disorders, such as depression and anxiety, continue to be a major public health burden as they are among the leading causes of disability and morbidity worldwide and characterized by their persistence and recurrence (Alonso et al., 2018; Hoertel et al., 2017; Spinhoven et al., 2017; World Health Organization [WHO], 2017; Yonkers et al., 2003). Given the economic and societal costs of emotional disorders, more research is needed to identify their predictors and maintaining mechanisms. Interpersonal models of disorders are particularly well-supported and posit that dysphoric persons’ maladaptive social behaviors are both a causal and prolonging factor in emotional disorders (Coyne, 1976; Gillet & Mazza, 2018; Joiner & Metalsky 2001; Starr & Davila 2008; Stewart & Harkness, 2015; Zaki & Williams, 2018).

Method: While there is preliminary support for interpersonal models, studies often rely on self-report, lack naturalistic observation, and fail to consider dyadic processes. Further, the literature remains limited by conceptual and theoretical inconsistencies.

Results: To clarify this research, the present integrative review synthesizes models and prominent contextual mechanisms in interpersonal emotion regulation.

Discussion: In doing so, this review presents a potential theoretical framework that integrates interpersonal emotion regulation models and discusses the model’s implications and future directions for research.

A systematic review and meta-analysis of brief Acceptance and Commitment Therapy

Primary Topic: Clinical Interventions and Interests
Subtopic: Short term, Intensive
Masataka Ito, Doshisha University
Kohei Hashimoto, Ph.D., Nakama Clinic
Takashi Muto, Ph.D., Doshisha University
Kohei Hashimoto, Nakama Clinic
Takashi MUTO, Ph.D., Doshisha University

Background: Acceptance and Commitment Therapy (ACT) is a form of psychological intervention with trans-diagnostic effects. Traditionally, in face-to-face and multiple sessions, ACT is implemented in various formats. The implementation of ACT in the short term has the advantages of high possibility of participation and low cost. The purpose of this study was to examine the published studies on ACT implemented in the short term and show its efficacy.

Method: A systematic search was conducted to examine the evidence for brief ACT in mental or physical problems. PubMed, PsychoINFO, PsychArticles, and CENTRAL databases were searched. Two independent reviewers analyzed the abstract and text, determined study eligibility, and assessed the methodological quality of each study. Finally, thirty-seven studies were found to conform to the inclusion criteria for systematic review, and seven studies were identified for meta-analysis.

Results: The systematic review showed that most studies have been conducted after 2010, and the study targets range very widely from mental diseases to physical problems. This indicates that this area is currently expanding. Meta-analysis showed significantly large effect sizes favoring ACT (SMD = 1.12). The heterogeneity was very high and the funnel plot was biased to one side.

Discussion: A small number of randomized controlled trials have shown that ACT is not yet a well-established intervention in the short term. However, these results provide preliminary support for brief ACT intervention for various problems.

A Trauma-Focused Intensive Outpatient Program Integrating Elements of Exposure Therapy with Acceptance and Commitment Therapy

Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD
MELISSA RAMIREZ, LCSW-S, Defense Health Agency
Gerard Grace, Defense Health Agency
Richard Schobitz, Public Health Service
Craig Woodworth, Defense Health Agency
Roy Gissendanner, Defense Health Agency
Sara Villarreal, Defense Health Agency
Christopher Howells, Defense Health Agency
Kelli Jones, Defense Health Agency
Nicholas Katko, Defense Health Agency

Background: A Performance Improvement Project, conducted at Brooke Army Medical Center, assessed the effectiveness of treating PTSD with Acceptance and Commitment Therapy and elements of exposure therapy in an Intensive Outpatient Program.

Method: All 311 participants were included the Performance Improvement Project. The majority (68%) were men. Mean age was 37.6. Participants were ethnically diverse. Most (69.1%) were married. Average education level was high school. The Army was widely represented at 80.7%. The mean time in service was 15 years with 86.2% having been deployed. Traumas experienced include combat trauma, sexual assault, military sexual trauma, childhood abuse, and other. Ninety seven percent experienced more than one trauma.

Results: A series of two-tailed, repeated-measures, Student’s t-tests were used to test for potential changes in symptoms between the pre- and post-treatment measurements. Bonferroni corrections were used to counter the increased risk of type I error associated with multiple analyses. Ten tests were attempted, requiring that probability of .005 be required to reach statistical significance. Large effect sizes (d > 0.8) were found for the PDS-5 and the PCL-5. Medium effect sizes (0.8 > d > 0.5) were found for the AAQ-II, CFQ, and BASIS-24. Small effect sizes (0.5 > d > 0.2) were found for the PHQ-9, GAD-7, VLQ-Do, and VLQ-Imp. The effect size found for the ISI was not clinically significant.

Discussion: This Trauma-Focused IOP experienced a 90.7% completion rate. In addition, PDS-5 scores decreased by 18.97 and PCL-5 scores decreased by 16.75. Program designers attribute this success to the inclusion of ACT.

Acceptance and Commitment Therapy (ACT) /Cognitive Behavior Therapy for Insomnia (CBT-I) Group Treatment Model for insomnia and chronic pain

Primary Topic: Behavioral medicine
Subtopic: Chronic Pain and Insomnia
Skye Ochsner Margolies, Ph.D., UNC School of Medicine

Background: Clinical insomnia among chronic pain patients is well established. CBT-I as an intervention for these patients shows strong improvement in sleep but not consistently in pain outcomes. Current treatment approaches for chronic pain focus increasingly on acceptance-based interventions. Integrating ACT into a CBT-I group protocol has the potential to optimize both sleep and pain outcomes.

Method: An ACT/CBT-I 6-session weekly group protocol for insomnia was developed and piloted. ACT components included cognitive defusion, self-as-context, mindfulness, and values-guided behavioral activation. CBT-I components included sleep education, stimulus control, and sleep restriction. Pre-post measures assessing insomnia, sleep parameters, sleep and pain catastrophizing, pain acceptance, beliefs about pain, depression, and anxiety were analyzed using frequency analyses and paired sample t-tests.

Results: Participants recruited from outpatient pain management were on average 57 years old, 100% female and 75% White. Post-treatment, patients reported significantly improved insomnia symptoms (ISI Mdiff=5.8, SDdiff=3.9, p < .05, ES=1.5), sleep efficiency (SE , Mdiff=16%, SDdiff= 10%, p = .05, ES=1.5), pain catastrophizing (PCS Mdiff=9, SDdiff=4.7, p < .05, ES=2), pain acceptance (CPAQ Mdiff=11.5, SDdiff=7.5, p = .05, ES=1.5), beliefs about the relationship between pain and sleep (PBAS Mdiff=2.3, SDdiff=1.3, p < .05, ES=1.8) and anxiety (GAD-7 Mdiff=3.3, SDdiff=2.1, p < .05, ES = 1.6).

Discussion: ACT/CBT-I group protocol for insomnia showed significant improvements in sleep and pain outcomes. This pilot study demonstrates the benefits of incorporating an ACT approach to optimize pain as well as sleep outcomes. Future efforts will continue to refine an ACT/CBT-I protocol in the setting of chronic pain management

Acceptance and Commitment Therapy (ACT) for the treatment of an Obsessive-Compulsive disorder case: A Chilean experience

Primary Topic: Clinical Interventions and Interests
Subtopic: obsessive compulsive disorder
Camilo Sepúlveda Queipul, Hospital de La Serena / Universidad Católica del Norte
Fernando Parada, Ph.D. (c), Universidad de Chile, Millenium Institute for Research on Depression and Personality (MIDAP)
Sebastián Ortiz, Universidad Católica de Chile, Centro integral de Psicología Contextual (CIPSYC)

Background: Following are the results of a single clinical case study. Subject was a 50 year old woman diagnosed with severe Obsessive Compulsive Disorder (OCD) with 20 years of evolution. The therapy process was conducted in a Public Day Hospital located in La Serena, Chile. The main research objective was to explore the effect of an Acceptance and Commitment Therapy intervention on the evolution of severity and Experiential Avoidance measures.

Method: The intervention consisted of 12 sessions distributed within 6 weeks of treatment.The Yale-Brown Obsession and Compulsion Scale (Y-BOCS) was used to evaluate OCD severity and the Acceptance and Action Questionnaire, second version (AAQ-II), was used to assess levels of Experiential Avoidance. 8 measurements were taken during the study to assess pre and post intervention scores

Results: Progressive and beneficial changes were observed from the first to the eighth measurement, and severity of symptomatology changed from severe to moderate.

Discussion: Experiential Avoidance scores also indicated a decrease of the subject's psychological inflexibility, showing a potential benefit from the use of ACT in an OCD diagnosed sample. Limitations and future research suggestions are also discussed.

Acceptance and Commitment Therapy and Physical Activity: A Systematic Review

Sweden Chapter Sponsored
Primary Topic: Behavioral medicine
Subtopic: Physical Activity and Physical Function in ACT research: effectiveness and how it is measured
Kirsi Nurmi, M.D., Gothenburg University
Bright Nwaru, Epidemiologist, Gothenburg University
Graciela Rovner, Ph.D. in Rehabilitation Medicine, MSc. PT, MSc. Psychology and MSc. Clinical Medical Sciences, ACT Institutet Sweden & Karolinska Institutet

Background: Physical inactivity accounts for a massive health burden globally, and the maintenance of good physical function (PF) determines the quality of life among those suffering from chronic conditions. ACT shows effectiveness in various life-style interventions (i.e.smoke-cessation & weight-loss); however, it is not known if ACT can promote physical activity (PA) among them. Purpose: Is ACT effective to promote PA & PF? How are these measured?

Method: A systematic review including - original English ACT articles or theses - on adults - pre- and postintervention PA/PF measures

Results: Twenty-six articles: overall moderate quality and ES: medium to large Increased PA -sedentary oversized women, 6-articles -diabetes and colorectal cancer survivors -but not among chronic pain patients, those with bariatric surgery, or at risk for cardiac diseases. Increased PF: -in young athletes, 3articles -chronic pain, 2 articles PA/PF Measurement methods: too varied to perform a meta-analysis. Self -reported instead of objectively measured.

Discussion: ACT promotes PA and PF, both aspects essential to prevent and treat chronic conditions such as obesity, cancer, diabetes, pain, etc. However, ACT research does not consider them as primary outcomes nor uses objective measures, which are the only way to gather realistic PA and PF. Self-rating only measures the capacity to recall one's physical activity!

Acceptance and Commitment Therapy Delivered via a Mobile Phone Messaging Robot Decreases Postoperative Opioid Utilization

Primary Topic: Clinical Interventions and Interests
Subtopic: Pain and opioid utilization
Chris Anthony, M.D., University of Pennsylvania
Edward Rojas, B.S., University of Iowa
Valerie Keffala, Ph.D., University of Iowa
Natalie Glass, Ph.D., MHCDS, University of Iowa
Apurva Shah, M.D., MBA, Children's Hospital of Philadelphia
Benjamin Miller, M.D., M.S., University of Iowa
Matthew Hogue, M.D., University of Iowa
Michael Willey, M.D., University of Iowa
Matthew Karam, M.D., University of Iowa
John Marsh, M.D., University of Iowa

Background: Acceptance and Commitment Therapy (ACT) is a pragmatic behavior therapy approach to help individuals decrease avoidable suffering and pain. This study evaluated the effects of ACT delivered via an automated mobile messaging robot on postoperative opioid utilization and patient reported outcomes (PROs) in orthopaedic trauma patients who underwent operative intervention for their injuries.

Method: Adult patients presenting to a Level 1 trauma center who underwent operative fixation of a traumatic upper or lower extremity fracture, and who utilized mobile phone messaging were eligible for the study. Patients were randomized to either the control group, who received no messages, or the intervention group, who received twice-daily mobile phone messages communicating an ACT-based intervention for the first two weeks after surgery. Baseline PROs were completed at enrollment. Two weeks after surgery, follow-up was obtained in the form of an opioid medication pill count and postoperative PROs. Mean number of opioid tablets utilized by patients and mean PRO scores were calculated and compared between groups.

Results: Eighty-two patients were enrolled, while 76 (38 ACT, 38 controls) completed the study. No differences in demographic factors were identified between groups. Control group subjects utilized an average of 41.1±22.0 tablets while the intervention group utilized 26.1±21.4 tablets, a 36.5% reduction (P=0.004). Control group subjects reported higher mean postoperative PROMIS Pain Intensity score of 49.7±8.8 compared to the intervention group’s 45.9±7.2 (P=.04).

Discussion: Delivery of the ACT-based intervention via an automated mobile messaging robot decreased opioid utilization and resulted in lower reported pain intensity scores in selected orthopaedic trauma patients.

Acceptance and Commitment Therapy for Sexual Minorities Experiencing Work Stress: A Pilot Study

Primary Topic: Clinical Interventions and Interests
Subtopic: LGBTQAI+
Riley Cotterman, B.A., Western Kentucky University
Rajinder (Sonia) Singh, Ph.D., Central Arkanas Veterans Healthcare System
Tanya Watford, M.A., Bowling Green State University
Rachel Wasson, M.A., Bowling Green State University
Lynnel Goodman, M.A., Bowling Green State University/Tulane University Medical School
William O'Brien, Ph.D., Bowling Green State University

Background: In the work place, people who identify as a sexual minority (e.g., lesbian, gay, bisexual, pansexual) experience incivility, discrimination, and a lack of protection from unfair workplace practices. These difficulties can then lead to physical, psychological, social, and intrapersonal deficits. Acceptance and Commitment Therapy (ACT) is a contextual-behavioral therapy that is associated with improving psychological and health outcomes across various difficulties. Further, ACT has been used with people who identify as sexual minorities, and as a treatment for work stress. Previous literature cites that psychological flexibility may be an important target for intervention for people who identify as a sexual minority and endorse experiencing work stress (Singh & O’Brien, 2019).

Method: The current study is an acceptability and feasibility study for an ACT intervention for sexual minorities experiencing work stress. The current study included self-referred adults who endorsed identifying as a sexual minority and experiencing work stress (n = 8).

Results: All measures of feasibility and acceptability indicated that participants found the intervention to be helpful and effective. Further, outcome measures that were considered targets of the ACT intervention were administered to assess if change happened at a statistically significant level. There was a significant decrease in the scores for burnout in participant reports from pre-treatment (M = 3.53, SD = 0.78) to post-treatment (M = 2.97, SD = 0.78); t (7) = 2.18, p < 0.05; d = 0.72.

Discussion: Taken together, the results suggest that the participants found the study to be helpful and more research would be beneficial.

Acceptance and Commitment Therapy Processes Differentially Predict Psychological Distress and Satisfaction with Life

Primary Topic: Clinical Interventions and Interests
Subtopic: General population.
Jenna Flowers, M.S., Pacific University
Ashley Eddy, Pacific University
Andi Schmidt, Pacific University
Michael Christopher, Pacific University

Background: The Comprehensive Assessment of Acceptance and Commitment Therapy processes (CompACT; Francis, Dawson, & Golijani-Moghaddam, 2016) was developed to address limitations of existing ACT process measures and to provide a fuller assessment of psychological flexibility. Preliminary evidence suggests CompACT factors – Behavioral Awareness (BA), Openness to Experience (OE), and Valued Action (VA) – differentially predict depression and satisfaction with life (Rogee, Daks, Dubler, & Saint, 2019). The goal of the present study was to further examine CompACT factors in the prediction of depressive, anxiety, and stress symptoms, as well as satisfaction with life among a nonclinical sample of adults.

Method: Study participants (N = 601) completed a battery of self-report assessments using Qualtrics, including the CompACT, the Depression, Anxiety, Stress Scale - Short Form (Antony, 1997), and the Satisfaction With Life Scale (Diener et al., 1985). Separate hierarchical regression analyses were used to evaluate whether the factors BA, OE, and VA uniquely predicted symptoms of depression, anxiety, and stress, and satisfaction with life.

Results: BA, OE, and VA uniquely and significantly predicted depression, and BA and OE uniquely and significantly predicted anxiety and stress. OE and VA uniquely and significantly predicted satisfaction with life (all p’s < .01).

Discussion: Results suggest different ACT processes may target specific mental health outcomes. Results differ from Rogee et al. (2019) in that BA was not found to be a significant predictor of satisfaction with life. Thus, further research is warranted in this area.

ACT for Building a Life: Examining psychological flexibility in a stage 2 DBT group

Primary Topic: Clinical Interventions and Interests
Subtopic: acceptance and commitment therapy, dialectical behavior therapy, borderline personality disorder
Julie Matsen, Ph.D., Medical College of Georgia at Augusta University
Amy House, Ph.D., Augusta University

Background: Dialectical behavior therapy (DBT) is a multi-stage approach that reduces severe emotion dysregulation and its consequences (e.g., suicidal and self-injurious behavior; Linehan et al., 2006). DBT research has focused primarily on treatment in Stage 1 and less on Stage 2 of DBT. Continued suffering of individuals after Stage 1 DBT may be due to limited psychological flexibility. Acceptance and Commitment Therapy (ACT) has been shown to increase psychological flexibility and is effective with a wide variety of concerns (A-tjak, 2015). Consequently, using an ACT-based intervention in Stage 2 DBT is likely effective but has yet to be researched.

Method: Stage 2 DBT clients participated in a 24-week group, "ACT for Building a Life," consisting of three 8-week modules (defusion and acceptance, self-as-context and self-compassion, values and committed action). Data was collected at baseline, and at the end of every module. Measures included the Acceptance and Action Questionnaire-2, Self-Compassion Scale-SF, Cognitive Fusion Questionnaire, Difficulties in Emotion Regulation Scale-SF, the Borderline Symptom List, and the Valuing Questionnaire.

Results: Preliminary results from the first 6 participants indicate, at baseline, psychological flexibility is correlated with self-compassion and inversely correlated with cognitive fusion, nonacceptance of emotion, and symptoms of Borderline Personality Disorder. Examinations of individual data plots indicate most participants showed improvements in psychological flexibility and values-consistent action over the first 8 weeks of group.

Discussion: Preliminary results provide support for continuing to explore ACT as a promising treatment for individuals who need continued therapy after Stage 1 DBT. Future analyses will explore mediators of change over time.

ACT-Enhanced Behavior Therapy in the Treatment of Trichotillomania: A Case Study

Primary Topic: Clinical Interventions and Interests
Subtopic: Body-Focused Repetitive Behaviors, OCD, ACT
Shilpa Boppana, M.A., University of Mississippi
Alan Gross, Ph.D., University of Mississippi

Background: Trichotillomania, a disorder that involves repetitive pulling of one’s hair to the point of hair loss and clinically significant distress or functional impairment, has a 12-month prevalence of 1% to 2%. Behavior therapy conceptualizes hair-pulling using operant learning theory, explaining hair-pulling behavior as caused and maintained by environmental antecedents and consequences interacting with an individual’s biological makeup. This case study describes the treatment of a 20-year old woman using an Acceptance and Commitment Therapy Enhanced Behavior Therapy for Trichotillomania (AEBT-T) protocol. After 14 months of treatment and 32 therapy sessions, the patient reported significantly reduced hair-pulling and anxiety, as well as increased engagement in valued life domains.

Method: The patient was assessed throughout treatment, using self-report measures administered weekly. Measures included DASS-21, OQ-45.2, and the Massachusetts General Hospital Hair-Pulling Scale.

Results: By the end of treatment, the amount of time the patient spent pulling her hair decreased by 75%. Scores on outcome measures showed improvement and the patient reported a number of behavioral changes in valued life domains.

Discussion: This case adds additional evidence to the data demonstrating that behavioral interventions are effective treatments for TTM, and that ACT may provide additional benefits in decreasing experiential avoidance and increasing psychological flexibility in clients with TTM.

ACTIVE: Teaching Values as a Bridge to Patient-centered Care in Consultation-Liaison Psychiatry

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Inpatient Consultation Liaison Psychiatry in Academic Medical Setting
Brandon Goodman, M.D., UNC Hospitals
Jonny Gerkin, M.D., University of North Carolina School of Medicine

Background: On an inpatient Consultation-Liaison (CL) psychiatry service, the psychiatric learner is asked to simultaneously operate as psychopharmacologist, psychotherapist, and patient-advocate [1]. ACTIVE CLP (ACT Integration for Values Engagement in CL Psychiatry) is a tool for case conceptualization in the inpatient CL psychiatry setting using a modified “ACT Matrix” [2]. ACTIVE can be utilized starting with the consulting team as well as utilized within the standard psychiatric interview. The learner can ultimately collaborate with the patient to develop values-based treatment goals that can be integrated into a cohesive, patient-centered plan of care based in a functional contextual approach.

Method: ACTIVE was integrated starting August 2019 for interested third-year psychiatric residents. At the conclusion of the clinical rotation, a focus group was performed to assess if ACTIVE promotes: effective consultation requests, barriers to care, patient preferences/values, and ability to propose a patient-centered plan of care.

Results: A one hour focus group was performed with three of four participants. Responses were transcribed and summarized. In sum, all participants found the ACTIVE method clear, helpful and applicable to CL. Some noted limitations to its implementation into standard practice. Particularly, service time-constraints impacted ability to trial novel approach.

Discussion: Integration of values can allow for a balanced understanding of preferences and limitations of the patient and consulting team, particularly in cases that are unclear diagnostically. Ultimately, ACTIVE operates as an educational tool that realizes major tenants of a patient-centered care approach [3], as well as promotes psychiatric learner engagement with ACT in a structured and novel way [1].

ACT's Effect on Cooperative and Altruistic Choices Among College Students

Primary Topic: Educational settings
Subtopic: ACT and Cooperation
Neal Falletta-Cowden, B.A., University of Nevada, Reno
Natalie Buddiga, B.A., University of Nevada, Reno
Thomas Szabo, Florida Institute of Technology

Background: Cooperation is important in high-stress environments such as college campuses. ACT may help college students faced with a task work together and cooperate to better their outcomes. Social discounting is a relatively new and understudied basic human research line that serves as a behavior-analytic demonstration of altruism. This experiment examined an ACT workshop's effect on college students' cooperative choices as well as their likelihood to behave altruistically.

Method: Participants were 34 students in a UNR course on Behavior Analysis in Fall 2019. It was a Pre-Post Group Design with 3 conditions. Group 1 was exposed to a Lecture on ACT given by the PI, Group 2 was exposed to ACT Cooperation Workshop run by Dr. Szabo, and Group 3 was exposed to neither. This study's dependent variables were Pre/Post Social Discounting Questionnaire answers and their choices towards cooperation or independent completion of quizzes on class reading material.

Results: Participants' cooperative choices did not vary greatly across conditions. The social discounting curves for participants similarly did not seem to vary significantly between groups.

Discussion: This study is the first to bring social discounting into the ACT and CBS world. This linkage could stimulate research in the domain of altruism. The lack of significant results could be due to the brief length of the ACT workshop or other contingencies in place which "stacked the deck" against cooperation. Future research could explore the question of ACT dosage or whether a more controlled environment may have produced different results.

An exploratory analysis of mobile phone sensor-derived mobility patters and psychological flexibility using digital phenotyping

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Technology
Russell DuBois, Ph.D., Blueprint Health
Macon Paine, B.A., Blueprint Health
Sarah-Nicole Bostan, Alliant International University

Background: Digital phenotyping refers to the moment-by-moment in-situ capturing of social and behavioral experiences in naturalistic settings as lived by the individual. Using mobile phone sensor data, digital phenotyping has traditionally been applied to the medical model of mental health, whereby passively-collected behavioral phenotypes are mapped onto diagnostic constructs. While this approach can revolutionize proactive technology-driven care, current pathology-oriented research in this domain is not well aligned with contextual behavioral initiates that emphasize process-based approaches to understanding health and wellness. Thus, we aimed to apply digital phenotyping principles to investigate the relationship between weekly mobility patterns and psychological flexibility.

Method: Weekly mobility patterns - number of steps, distance traveled, and time spent at home (“homestay”) - were extracted from 58 individuals’ pedometer and GPS sensors via the Blueprint mobile application. Psychological flexibility was measured across time using the Acceptance and Action Questionnaire II. A multilevel time series model was used to explore the contemporaneous relationships between mobility patterns and experiential avoidance.

Results: Psychological flexbility was significantly predicted by distance traveled, b = -0.61, t(204.3) = -2.4, p = 0.03, and homestay, b = 0.55, t(213) = 2.1, p = 0.04, but not steps taken, b = -0.1, t(210.1) = -0.9, p = 0.09.

Discussion: Our study provides preliminary evidence supporting the feasibility of using real-time mobile phone sensor data as a continuous passive indicator of psychological flexibility. Digital phenotyping may thus represent a scalable and context-sensitive solution for improving population-wide contextual behavioral prevention and intervention efforts.

Anxiety as a Moderator of Perinatal Distress Trajectories Following a Condensed Mindfulness-Based Program

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Marissa Sbrilli, University of Illinois at Urbana Champaign
Heidemarie Laurent, Ph.D., University of Illinois at Urbana-Champaign

Background: Mind in Labor (MIL) is a condensed mindfulness-based childbirth preparation program that has shown to reduce depressive symptoms through six-weeks postpartum (Duncan et al., 2017). Further research is needed to identify the durability and moderators of mindfulness training effects on mental health. We examined whether MIL compared to treatment as usual (TAU) resulted in lower distress across the perinatal period (pregnancy to one-year postpartum) and whether women’s baseline anxiety symptoms moderated degree of benefit in a pilot RCT.

Method: Participating mothers (n=30) in their third trimester were randomized to MIL or TAU and reported distress (perceived stress, anxiety and depressive symptoms) at four times: pre- and post-intervention, 6-weeks and 12-months postpartum. Distress measures included the Perceived Stress Scale (PSS; Cohen et al., 1983), Spielberger State-Trait Anxiety Inventory–Trait (STAIT; Spielberger, 1983), and CES-D (Radloff, 1977).

Results: Multilevel modeling of distress trajectories showed MIL participation resulted in decreased distress trajectories, especially among women higher in baseline anxiety symptoms. Significant intervention*time 1 STAIT anxiety interaction effects on both distress intercepts (p<.01) and slopes (p<.01) were observed. Region of significance testing showed MIL participation resulted in lower (decreasing) distress slopes and lower ending distress levels for women with moderate to high levels of prenatal anxiety.

Discussion: This study offers preliminary evidence for sustained benefits of a brief mindfulness intervention on perinatal mental health. Further investigation of these effects in larger samples is warranted. Potential processes driving these findings and implications will be discussed.

Applying the Social Determinants of Health to ACT for Anxious or Traumatized African Americans

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Anxiety, ACT, African Americans
Jennifer Payne, Ph.D., LCSW, Azusa Pacific University

Background: In a national epidemiological NIMH funded study (the Collaborative Psychiatric Epidemiology Study), it was found that African Americans more frequently met criteria for anxiety and PTSD than white Americans, Hispanic Americans, and Asian Americans (Asnaani, Richey, Dimaite, Hinton, & Hofmann, 2010). While African Americans can often have fewer mental disorders than Whites, anxiety and PTSD rates are higher in Blacks than any other race or ethnicity in the U.S. (Alegría et al., 2013; Roberts, Gilman, Breslau, Breslau, & Koenen, 2011). ACT is a non-pathologizing approach to dealing with anxiety and trauma (McLean & Follette, 2016). However, it is well documented that African Americans under-utilize mental health treatment; only 8.6% of blacks utilize mental health services (SAMHSA, 2015). Thus, there are limitations produced by generalizing EBPs such as ACT to all populations (Kirmayer, 2012).

Method: There is little to no research available examining barriers to receiving ACT for African Americans suffering from anxiety and/or trauma. This poster presentation will apply the social determinants of health model (SDOH) to ACT to address barriers to treatment for this population.

Results: The integration of factors of SDOH and ACT led to a preliminary conceptual model of how ACT might be culturally tailored for African Americans experiencing anxiety or trauma. A pictorial model of this conceptual framework will be presented in the poster.

Discussion: Based on the conceptual model presented, recommendations for practice with this population will be discussed.

Appraising Anxiety as Problematic Increases Odds of Misusing Meditation Strategies Above and Beyond Transdiagnostic Processes and Symptomatic Distress

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Max Roberts, M.A., University at Albany, State University of New York
Eric Tifft, M.A., University at Albany, State University of New York
Shannon Underwood, B.S., University at Albany, State University of New York
John Forsyth, Ph.D., University at Albany, State University of New York

Background: The intended function of meditation is to cultivate openness to, and acceptance of, private experiences. Yet, meditation can be used in ways that paradoxically increase psychological distress (e.g., to avoid or suppress thoughts) which perhaps contributes to poor outcomes. Understanding how people use meditation in and outside of psychotherapy is needed. We anticipated individuals who appraised anxiety as more of “a problem” for them, and reported greater levels of experiential avoidance (EA), would be more likely to use meditation as a control strategy beyond the extent of anxiety symptoms.

Method: Undergraduate meditators (N = 103) were surveyed about their use of meditation and given a battery of measures. Participants (n = 43, 41.7%) endorsed using meditation to increase acceptance, and n = 60 (58.3%) endorsed using meditation to control/regulate unpleasant private events.

Results: Results showed that significantly more participants in the incentives condition passed all attention check items compared to the control condition. However, there was not a significant difference between conditions on self-reported attention and effort put forth on the study.

Discussion: A single item rating of how problematic individuals view anxiety to be, predicts how meditation is used above and beyond transdiagnostic and symptom-based variables. Results suggest that therapists ought to ask clients their views of anxiety and regularly evaluate how clients are using the contemplative practices that are becoming increasingly popular in psychotherapies.

BEWARE: Surfing the waves of Parkinson’s disease

Primary Topic: Clinical Interventions and Interests
Subtopic: Parkinson, Chronic disease, Anxiety, Multidisciplinary
Ires Ghielen, AmsterdamUMC
Tanja Kuut, AmsterdamUMC, location VUmc
Cees de Goede, AmsterdamUMC, location VUmc
Ingrid Burgers-Bots, AmsterdamUMC, location VUmc
Jorrit Hoff, St. Antonius hospital
Gerrit Tissingh, Zuyderland hospital
Debby van Rhijn, Zorgspectrum
Martine Wilbers, Zuyderland hospital
Erwin van wegen, AmsterdamUMC, location VUmc
Odile van den Heuvel, AmsterdamUMC, location VUmc

Background: In patients with Parkinson’s disease (PD), fluctuations in physical and psychological symptoms commonly occur within five years of commencing dopamine replacement therapy. Current treatment options for this so-called wearing-off phenomenon are limited and a multidisciplinary approach is needed to address the complex interactions between physical and psychological symptoms. Since wearing-off is eventually inevitable, treatment should focus on coping, acceptance, and valued living despite of the debilitating symptoms. We developed a body awareness training, named BEWARE, combining physical therapy with acceptance and commitment therapy to teach PD patients how to better deal with wearing-off related distress (WRD).

Method: The BEWARE training is being investigated in a multicentre randomized controlled trial (RCT). Ninety-two PD patients with WRD will be randomly assigned to the BEWARE or to the treatment as usual (physical therapy only) condition. The 90-minute group sessions are given once a week for ten consecutive weeks, including homework assignments. Assessments of outcome measures are performed prior to and immediately after the treatment period, and at three- and six-months follow up.

Results: In the previously conducted pilot RCT (Ghielen et al. 2017), patients in the BEWARE group showed significant improvements in standing balance and emotional wellbeing, and a (non-significant) decrease in feelings of stigmatization. The participants proposed improvements, which we integrated into the current treatment protocol.

Discussion: The BEWARE training showed to be a promising therapeutic approach to address WRD. When this multicenter RCT shows positive results, the BEWARE intervention will be made available for implementation in daily clinical practice.

Bisexual Therapy Clients: Are Therapists Perpetuating Monosexism And Biphobia In The Therapy Room?

Primary Topic: Clinical Interventions and Interests
Subtopic: LGBTQ+ Mental Health
Jennifer DiBartolomeo, M.A., Widener University, The Institute for Graduate Clinical Psychology
Courtney Slater, Ph.D., Widener University

Background: Research shows that bisexual individuals are discriminated against by both heterosexual and homosexual communities. This frequently leads to poor mental health outcomes as evidenced by the research that shows bisexual individuals as having significantly more mental health challenges than their straight, lesbian, and gay peers. While LGBT individuals tend to use therapy services more than heterosexual individuals, Bisexuality has not been studied independently from Lesbian/Gay orientations despite the fact that they suffer from more psychological distress. This research seeks to assess whether mental health providers are perpetuating bi-erasure or monosexism in therapeutic spaces, what percentage of bisexual individuals utilize mental health services, and outcomes of therapy in relation to monosexism and biphobic ideas being portrayed in mental health settings.

Method: The populations assessed will be bisexual individuals with mental-health difficulties and practicing therapists. Participants will complete online measures assessing monosexism, mental health, outcomes of treatment, and demographic information.

Results: Preliminary data from this research shows that a significant number of bisexual individuals who have been in therapy before have experienced some type of monosexism or biphobic microaggressions from their providers. This was also referenced as a reason for not continuing in therapy and not seeking out mental health services.

Discussion: This suggests that therapists are perpetuating bi-erasure and monosexism and that this is deterring bisexual individuals from accessing mental health services. Statistical analysis, including quantitative and qualitative analysis, still need to be conducted in order to better understand the relationship between monosexism in therapy and treatment outcomes

Changes in Psychological Flexibility as Related to Increased Resilience: Preliminary Analyses in Brief ACT Groups

Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological flexibility, Resilience, Brief ACT
Manny Stegall, B.S., University of Iowa
Anne Roche, M.A., University of Iowa
Michael O'Hara, Ph.D., University of Iowa
Emily Kroska, Ph.D., University of Iowa

Background: Resilience facilitates faster recovery after adversity or a traumatic experience (Fredrickson & Losada, 2005). Development of psychological flexibility has been identified as a fundamental component of health (Kashdan & Rottenberg, 2010). This study aims to examine the relation between psychological inflexibility and resilience in the context of brief group ACT interventions for individuals with depressive symptoms.

Method: Data were collected as part of a larger study that examined comparative effectiveness of three single-session, time-variant brief ACT interventions (Kroska, Roche, & O’Hara, 2020). Self-report measures in this analysis include psychological inflexibility (Acceptance and Action Questionnaire-II) and resilience (RS-14). Analyses across groups examined whether change in psychological flexibility from baseline to 3-month follow-up was associated with 1) resilience at 3-month follow-up and 2) change in resilience from baseline to 3-month follow-up.

Results: Linear regression analyses were used, with age included as a covariate. Standardized coefficients are reported. Improvements in psychological inflexibility from baseline to 3-month follow-up predicted increased resilience at 3-month follow-up (β= .44, t= 5.65, p< .001, R^2= .23) and increased change in resilience from baseline to 3-month follow-up (β= .49, t= 6.26, p< .001, R^2= .24). Age was not a significant covariate (p > .05).

Discussion: Findings indicate that an increase in resilience was associated with an increase in psychological flexibility in a sample of individuals with depressive symptoms. This suggests that building psychological flexibility may bolster resilience. Future research should examine the specific mechanisms that explain this association. Further, with larger samples, formal mediation analyses should be conducted.

Childhood Physical and Emotional Abuse, Vulnerability to Harm, and Post-traumatic Stress: The Moderating Effects of Experiential Avoidance

Primary Topic: Clinical Interventions and Interests
Subtopic: Trauma
Keryn Kleiman, M.A., Kean University
Brian Schopfer, Psy.D., Kean University
Donald Marks, Psy.D., Kean University
Jennifer Block-Lerner, Ph.D., Kean University

Background: Exposure to physical and emotional abuse in childhood may predispose individuals to hypervigilance, heightened autonomic arousal, loss of self-worth, and other symptoms of PTSD (Yehuda et al., 2001). Early trauma may intensify protective interpersonal styles, and rule-governed behavioral responses could heighten perceived vulnerability to maltreatment (Lim & Barlas, 2019). Young (1999) and others (Roediger et al., 2018) have described these patterns of behavior as cognitive-affective schemas. Schema formation may vary according to how individuals relate to perceived threats, with avoidance strategies (i.e., experiential avoidance; Hayes et al., 1994) potentially increasing likelihood of adopting a vulnerability-to-harm schema and contributing to the development of PTSD symptoms.

Method: We examined the relationship between childhood trauma (Childhood Trauma Questionnaire; Bernstein & Fink, 1998), a vulnerability-to-harm schema (Young Schema Questionnaire – Short Form; Young, 1999), and experiential avoidance (Brief Experiential Avoidance Questionnaire; Gamez et al., 2014) in an undergraduate sample (N = 70). The relationship between vulnerability to harm and posttraumatic stress (PTSD Checklist for DSM-5; Weathers et al., 2013) was also analyzed.

Results: Experiential avoidance moderated the relationship between combined emotional and physical abuse and vulnerability to harm (β = .459, t = 2.91, p = .005; ΔR2 =.10), with predicted relationships emerging as experiential avoidance increases. Additionally, vulnerability to harm significantly predicted posttraumatic stress, R2 =.27, F(1,64)=23.38, p<.001.

Discussion: Findings point to the role increased experiential avoidance plays in potentiating the impact of childhood trauma on development of perceived vulnerability to harm, which is linked to PTSD symptom severity. Implications and future directions are discussed.

Comparing adolescents’ generalized pliance and psychological inflexibility across cultural contexts

Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescent rule-following
Alison Stapleton, B.A., University College Dublin
Francisco Ruiz, PhD, Fundación Universitaria Konrad Lorenz
Louise McHugh, PhD, Associate Professor, University College Dublin

Background: In accordance with the Relational Frame Theory account of rule-governed behavior, generalized pliance refers to rule-following under the control of socially mediated consequences. Generalized pliance precipitates insensitivity to direct contingencies and is positively correlated with psychological inflexibility. Given that repertoires for generalized pliance and psychological inflexibility are shaped by social environments, there are likely differences in these behaviors across cultures.

Method: The present study examined adolescents’ generalized pliance and psychological inflexibility with respect to cultural context and gender in a sample of adolescents (n = 350) aged 15 to 16 years in the Irish and Colombian contexts.

Results: Results showed that generalized pliance was higher in the Irish context than in the Colombian context. Females reported greater generalized pliance than males in the Irish context and females reported greater psychological inflexibility than males in the Colombian context.

Discussion: Findings are discussed with reference to the need for larger longitudinal studies across cultural contexts to analyze developmental trajectories of generalized pliance and psychological inflexibility.

Comparison of Metacognitive and Psychological Inflexibility Models of Emotional Distress

Primary Topic: Theoretical and philosophical foundations
Subtopic: depression, generalized anxiety disorder
Huan Quan, M.Ed, Wichita State University
Robert Zettle, Ph.D., Wichita State University

Background: The models on which metacognitive therapy (MCT; Wells, 2009) and acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 2012) are based posit different processes in the initiation and maintenance of emotional distress. In a pair of related studies, the relative degree to which each model accounted for variability in self-reported symptoms of generalized anxiety and depression was evaluated.

Method: In Study 1, college students (N = 227) completed an online survey that included a self-report of generalized anxiety, questionnaires assessing six processes of psychological inflexibility (PI), and the Metacognitive Questionnaire (MCQ) that assesses positive and negative beliefs about worrying. In Study 2, another sample (N = 197) completed a self-report of depression, the same battery of PI measures, and a modified version of the MCQ that included positive and negative beliefs about rumination.

Results: Hierarchical regression analyses indicated that the PI model explained a significantly higher proportion of symptom variability in both generalized anxiety (Z ̅* = 2.45, p < .01) and depression (Z ̅* = 2.63, p < .01). Across both studies, cognitive fusion and valued living within the PI model and beliefs about the negative consequences of worrying and rumination within the metacognitive model were found to be most predictive.

Discussion: The findings of this project may hopefully provide a better understanding of the processes contributing to emotional distress and help inform potentially therapeutically integrative ways of alleviating it.

Compassion, social connectedness and trauma resilience during the COVID-19 pandemic: A multi-national study

Primary Topic: Other
Subtopic: COVID-19 Pandemic
Marcela Matos, PhD, University of Coimbra, Portugal
Daniel Rijo, University of Coimbra
Paul Gilbert, Compassionate Mind Foundation; University of Derby
Kirsten McEwan, Compassionate mInd Foundation; University of Derby
Stan Steindl, University of Queensland
Simone Cheli, University of Florence
Mariana Linharelhos, University of Coimbra
Vibeke Lunding-Gregersen, Mindwork
Sónia Gregório, Universidad Europea de Madrid
Kenichi Asano, Mejiro University
Catherine Bortolon, Université Grenoble Alpes
Júlia Halamová, Comenius University
Russell Kolts, Eastern Washington University
Gonzalo Brito, Pontificia Universidad Católica de Chile
Natali Gumiy, Motivacion Compasiva
Allison Kelly, University of Waterloo
Paola Lucena Santos, Pontifícia Universidade Católica do Rio Grande do Sul
Nuno Ferreira, University Of Nicosia
Elli Tholouli, Harokopeio University
Julia E. Wahl, SWPS University of Social Sciences and Humanities
Nicola Pettrocchi, John Cabot University
Lorena Llobenes, Motivacion Compasiva
Maria Costa, Motivacion Compasiva
Pascal Delamillieure, Université De Caen Normandie
Ask Elklit, University Of Southern Denmark
Sara Paloma Vilas Sanz, Universidad Europea de Madrid
Margarita Gomez Marquez, Universidad Europea de Madrid
Erika Leonardo De Souza, Universidade de São Paulo
Margareth Oliveira, Pontifícia Universidade Católica do Rio Grande do Sul
Philia Issari, National And Kapodistrian University Of Athens
James Kirby, University of Queensland
Gregoris Simos, University Of Macedonia
Martin Kanovský, Comenius University
Joanna Skrzelinska, University of Coimbra

Background: The world is facing an unprecedented crisis due to the COVID-19 pandemic, with detrimental effects on physical and mental wellbeing. In fact, the WHO has issued advice on the importance of protecting mental wellbeing during this pandemic. There are reports about increased stress, anxiety and isolation for the entire population, but especially for health professionals and vulnerable groups. There is evidence from numerous studies that self-compassion and compassion for others can act as a buffer against mental distress and promote feelings of social safeness and connectedness.

Method: This study aims to investigate the impact of the COVID-19 pandemic, across time, on compassion, coping mechanisms, feelings of social safeness, isolation, traumatic stress, psychopathological symptoms and posttraumatic growth, in 21 different countries/cultures. Importantly, this study aims to test the buffering effect of compassion against the detrimental impact of the COVID-19 pandemic on wellbeing.

Results: The design of the multinational study will be presented. The study is conducted in a sample of general population participants, recruited in 21 different countries from Europe, North and South America and Asia, using a longitudinal correlational design. Participants complete a set of self-report measures at three different assessment moments.

Discussion: Implications of the study to advance the scientific knowledge of the impact of the COVID-19 pandemic on mental wellbeing across time and countries/cultures will be presented, as well as the significance of the findings to the understanding of the protective role of compassion against the detrimental effects of the pandemic on mental health and social isolation.

Creative hopelessness Exercises and Metaphors: A Review of ACT English Language Books

Primary Topic: Clinical Interventions and Interests
Subtopic: Creative hopelessness, Metaphors, Exercises, Worksheets, Books
Emanuele Rossi, Scuola di Psicoterapia Cognitiva, APC-SPC, Italy; AISCC
Sara Di Biase, Psy.D., Scuola di Psicoterapia Cognitiva S.r.l.
Elena Martorella, Scuola di Psicoterapia Cognitiva S.r.l.
Paola Lioce, Psy.D., Scuola di Psicoterapia Cognitiva S.r.l.
Francesco Mancini, M.D., Scuola di Psicoterapia Cognitiva S.r.l.; Università degli Studi Guglielmo Marconi

Background: The present study wants to offer a overall outline of creative hopelessness on ACT books (1999-2018) with the purpose of creating an understandable and user-friendly profile of the use of creative hopelessness metaphors, exercises and worksheets within them.

Method: In order to realize this profile, books were divided into two main groups: (1) ACT Books for professionals and (2) ACT Books for clients. We have realized an easy-to-read summary table which provides a basic overview of creative hopelessness metaphors, exercises and worksheets.

Results: This review was carried out with the aim of furnishing a universally user-friendly, clear and intuitive cataloging tool of practical and experiential resources for ACT learners and practitioners. The summary table briefly describes the way each metaphor, exercise or worksheet is presented, and it indicates a reference to external resources as well.

Discussion: This poster related to creative hopelessness is part of a broader pilot project which also entailed the processes of psychological flexibility and that could be updated in the future.

Cultivating compassion in schools: The impact of a compassion focused intervention on teachers’ mental health and wellbeing

Primary Topic: Educational settings
Subtopic: Compassion Focused Interventions
Marcela Matos, PhD, University of Coimbra, Portugal
Isabel Albuquerque, University of Coimbra
Marina Cunha, University of Coimbra; Instituto Superior Miguel Torga
Margarida Pedroso De Lima, University of Coimbra
Ana Galhardo, University of Coimbra; Instituto Superior Miguel Torga
Lara Palmeira, Universidade Portucalense
Frances Maratos, University of Derby
kirsten McEwan, Compassionate Mind Foudation; University of Derby
Paul Gilbert, Compassionate Mind Foundation; University of Derby

Background: Compassion-based interventions have been found effective in developing adaptive emotional regulation skills and promoting mental health. Teachers present a high risk of professional stress, which negatively impacts their wellbeing and professional performance. Mental health problems are highly prevalent in the school context, affecting both teachers and students. Therefore it is crucial to support teachers in coping with the challenges of the school context and promote their mental wellbeing. This study explores the impact of the Compassionate Schools Program (CSP),a six-module compassionate mind training group intervention for teachers, on mental wellbeing indicators.

Method: A randomized controlled study was conducted in a sample of 153 public school Portuguese teachers (CSP N=80; WLControl N=73). Participants completed self-report measures of burnout, depression, anxiety and stress at pre (T1) and post intervention (T2). A subsample of teachers from the WLC group (N=37) underwent the CSP after T2 and completed the same questionnaires after the intervention (T3).

Results: Group comparisons revealed significant main effects, with teachers in the CSP group showing reductions in burnout and depressive, anxiety and stress symptoms after the CSP. Stepped wedge analysis found significant within-subject effects, with teachers revealing no significant changes before the CSP (T1-T2) but showing significant reductions in burnout, and psychopathological symptoms after the CSP (T2-T3).

Discussion: These findings suggest that the Compassionate Schools Program may be an effective psychological group intervention to promote wellbeing in educators. The cost-effectiveness and usefulness of this program seems promising, and future work should continue to assess its efficacy and promote its dissemination in other settings/countries.

Development and Psychometric Properties of the Unique Stress of Chinese International Students Questionnaire (USCIS)

Primary Topic: Other
Subtopic: Diversity, Acculturative Stress
Huanzhen Xu, M.A., Bowling Green State University
William O'Brien, Ph.D., Bowling Green State University

Background: As the Chinese international student (CIS) body in western countries expands, its needs for mental health assessment should be addressed. Research has indicated that these students face unique acculturative stressors and have higher levels of psychological distress compared to their domestic counterparts. Yet, there is a lack of research on the measurement of their stressors.

Method: Participants: 274 cases analyzed. Eligibility criteria included an age at 18 and above, a F1 student visa, and Chinese nationality. Procedures: the project was IRB approved. Various recruitment methods were used, including sending letters to CSSAs, CIS email lists, and online forums. Measures: Demographics, 89-item USCIS, and Kessler-10.

Results: Exploratory factor analyses (EFA) established a nine-factor USCIS with 40 items. All items have loading values of 0.5 or better. Internal Consistencies of the USCIS total (Cronbach’ alpha = 0.939) and subscales (0.766 - 0.898) were good. The combination of demographic variables accounted for 13.1% of variance in Kessler’s, while the USCIS total scores added a significant amount of variance (R2 = 36.7%, B = 0.339, β = 0.649, t = 13.847, p < .001).

Discussion: The USCIS is one of the first measures devoted to assessing acculturative stress experienced by CISs. The total USCIS and its nine subscales demonstrated excellent internal consistencies and good criterion-related validity. The USCIS could be used to measure CISs' levels of acculturative stress and serve as an outcome measure for interventions targeting acculturation stress. The USCIS could also be used to measure the effectiveness of universities’ international outreach and student welcoming programs.

Do these violent delights have violent ends?: Social Norms, Alcohol, & Sexual Cyberbullying

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Interpersonal Aggression, Technology, Sexual Assault
Anandi Ehman, M.A., The University of Mississippi
Alan Gross, Ph.D., University of Mississippi

Background: Sexually aggressive behavior is well-documented among college students. However, little is known about the role technology may play in facilitating this behavior. Given that social norms have been established as a useful framework for understanding problematic and risky behavior in college students, the current authors sought to determine whether this theory might also provide insight into the use of technology to facilitate sexually aggressive behavior.

Method: Participants were college students (N=641) at a midsized university in the south-eastern United States. Participants completed the following measures in order: perceived social norms of sexually aggressive strategies (SSS- Social Norms), sexual strategies scale for personal behavior (SSS- Self), Alcohol use Disorders Identification Test (AUDIT), the Cyberbullying Experiences Scale (CES), Sexual Experiences Scale (SES), the Depression Anxiety and Stress Scale (DASS-21), the UCLA Loneliness scale (UCLAL-8), and the Marlowe-Crowne Social Desirability scale.

Results: Conditional process modelling revealed a significant indirect effect of perceived social norms of sexually aggressive behavior on face to face sexual aggression via sexual cyberbullying (b=.0015, p<.001, 95% CI [.0030, .0110]), indicating mediation.

Discussion: Sexual cyberbullying is a relatively novel behavior little examined in scholarly research. However, the current study found that at least 15.6% of college students had engaged in sexual cyberbullying behavior recently, with 100% of participants believing their peers engaged in some form of sexually aggressive behavior either online or offline. This disturbing finding highlights students’ awareness of the pervasive nature of sexual aggression and coercion. Implications for both victims and perpetrators will be discussed.

Does the improvement of the unworkable change agendas measured by IRAP predict the change in acceptance behavior after the acceptance intervention?

Primary Topic: Relational Frame Theory
Subtopic: IRAP, change agenda, Acceptance intervention, Speech anxiety
Kazuya Inoue, Graduate school of human sciences, Waseda University
Nozomi Tomita, Ph.D., Faculty of Human Sciences, Waseda University
Hiroaki Kumano, Ph.D., Faculty of Human Sciences, Waseda University

Background: For the success of an acceptance intervention, it is important to let go of the unworkable change agenda in Acceptance and Commitment Therapy. We have developed an Implicit Relational Assessment Procedure to measure unworkable change agenda (CA-IRAP). In the current study, we examined whether the CA-IRAP can predict the change in acceptance behavior after the acceptance intervention.

Method: The final analytic sample were an acceptance group (N=25, mean age=20.80±3.65 years) and a control group (N=25, mean age=19.96±1.46 years) of undergraduate students. The participants completed the CA-IRAP (Inoue et al. 2018), change agenda questionnaire-believability (CAQ-b) (Shima et al. 2018), and the two-minute speech task before and after the acceptance intervention. The time to keep watching the audience’s eyes during speech task was used as an index of acceptance behavior. Regarding the intervention, the acceptance group engaged in the acceptance exercise, while the control group were instructed to continue with the participant’ strategy regarding speech.

Results: Contrary to our hypothesis, there was no significant correlation between the amount of change in the acceptance behavior from pre- to post-intervention and amount of change in the CA-IRAP D score and CAQ-b from pre to post-intervention (change agenda-positive trial-type: ρ = −0.04, p= 0.84, change agenda-negative trial-type: ρ = −0.09, p= 0.68, acceptance-positive trial: ρ = 0.10, p= 0.63, acceptance-negative trial-type: ρ = −0.02, p= 0.94, CAQ-b: ρ = −0.03, p= 0.91).

Discussion: CA-IRAP was not found to predict change in acceptance behavior during speech after the acceptance intervention.

Effectiveness of Acceptance and Commitment Therapy on facilitating self-management in patients with cardiovascular diseases: A Systematic Review

Primary Topic: Clinical Interventions and Interests
Subtopic: cardiovascular disease
xuelin zhang, RN, MAN, School of Nursing, Hong Kong Polytechnic University
Yim Wah Mak, School of Nursing,The Hong Kong Polytechnic University
Vico Chiang, School of Nursing,The Hong Kong Polytechnic University
Dan Bressington, School of Nursing,The Hong Kong Polytechnic University

Background: The prevalence of cardiovascular diseases (CVDs) is increasing. Patients with CVDs often feel difficult to comply self-management regimen due to the increasing needs of self-monitoring symptom, complexity of medication and requirement for lifestyle changing. Previous studies found that ACT might be effective for improving outcomes in chronic diseases. However, it is less clear if ACT is effective on facilitating self-management in patients with CVDs. Thus, this systematic review was performed to evaluate the effectiveness of ACT on this issues.

Method: Seven English databases and three Chinese databases were searched up to November 2019. Experimental and quasi-experimental studies including people with CVDs such as hypertension, heart failure, coronary heart disease, stroke, which reported self-management behaviors and mental health following ACT intervention were identified. The assessment tool of Effective Public Health Practice Project (EPHPP) and Psychotherapy Outcome Study Methodology Rating Form (POMRF) were utilized, narrative synthesis rather than meta-analysis was used to analyze the extracted data.

Results: A total of three publications consisting two randomized controlled trials and one single-group pretest-posttest with 99 participants were included in this study. The preliminary results showed improvement in dietary pattern, weight and depression, the effect on physical activity, anxiety among CVDs patients remains unclear. Among them, only one study was rated as moderate quality by using the EPHPP assessment tool. The average score of included studies based on POMRF was 16 (range: 10-22).

Discussion: Further studies with a rigorous design is are needed to establish the evidence of using ACT on facilitating self-management in patients with CVDs.

Effectiveness of Brief Focused Acceptance and Commitment Therapy Group in Primary Care

Primary Topic: Clinical Interventions and Interests
Subtopic: Primary Care
Marcia Sasano, Psychologist, New Zealand Psychologist Board
Anel Kieser, M.Sc., New Zealand Psychologist Board

Background: This study examines the effectiveness of brief Focused Acceptance and Commitment Therapy (fACT) group provided to primary care patients presenting with psychological distress.

Method: Participants were invited to engage in 4, 2-hour open fACT group. Assessment tools consisted of the Depression, Anxiety, and Stress Scale (DASS-21), Outcome Rating Scale (ORS), Session Rating Scale (SRS), and Partners for Change Outcome Management System (PCOMS).

Results: Of the 37 participant attending the group (77% female, mean age 38.3), 22 (60%) completed all for sessions between May and November 2017. The statistical analysis demonstrated significant reduction in psychological distress for depression; t(17)=4.44, p=.001, d=0.52, anxiety t(17)=5.00, p<.001, d=0.78, and stress t(17)=4.22, p=.001, d=1.10. There was no significant difference in SRS score between the first and final sessions; t(21)=1.91, p=.07, d=0.42. However, there was a significant improvement in ORS scores t(18)=5.14, p<.001, d=1.32 and overall therapeutic alliance t(18)=5.59, p<.001, d=1.52.

Discussion: This study demonstrated that brief fACT based group in primary care can be effective in reducing psychological distress and improve therapeutic outcomes while fostering a high level of clinical alliance between patients and facilitators.

Effects of Acceptance and Commitment Therapy on quality of life, fatigue, and psychological distress for patients with advanced cancer: A systematic review and meta-analysis

Primary Topic: Clinical Interventions and Interests
Subtopic: advanced cancer; fatigue; psychological distress; quality of life; systematic review; meta-analysis
Huiyuan Li, Master of Nursing, RN, The Nethesole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Che Lee Wong, Ph.D, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Xiaohuan Jin, Ph.D student, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Jieling Chen, Ph.D, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Yang Bai, Ph.D, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong

Background: Advanced cancer is an incurable and life-threatening disease that poses a major challenge to patient's psychological and physical well-being. This review aimed to systematically summarize the current studies and explore the immediate effect of Acceptance and Commitment Therapy (ACT) on quality of life (QOL), fatigue and psychological distress.

Method: Nine electronic databases were searched by key words. Two independent reviewers assessed the eligible studies by The Joanna Briggs Institute critical appraisal checklist. Meta-analysis was conducted when at least three studies reported the same outcome, with subgroup analysis for modality of ACT and presence of dyadic involvement, otherwise, narrative synthesis was used. Sensitivity analysis was performed to test the influence of study quality and control type.

Results: Six studies involved 261 participants were identified. Meta-analysis found face-to-face individual ACT significantly improved psychological distress (standardized mean difference [SMD]: -0.50; 95% confidence interval [CI]: -0.93 to -0.08; p = 0.02; I2 = 0%) post-intervention. However, a favourable but non-significant improvement in fatigue was found post-intervention (SMD: -0.08; 95%CI: -0.44 to 0.27; p = 0.64; I2 = 0%). Narrative synthesis revealed ACT could significantly improve their QOL. Sensitivity analysis revealed that type of control group influenced the outcomes.

Discussion: These findings support ACT is an effective approach for advanced cancer patients to promote health condition.

Effects of After-School Mindfulness on Urban, Elementary Students

Primary Topic: Educational settings
Subtopic: Children, Mindfulness
Dominique Reminick, M.A., Kean University
Adrienne Garro, PhD, Kean University

Background: Use of mindfulness practices in US school settings has steadily increased over the past 15 years (Semple et al., 2017). Many studies found positive effects of mindfulness on students' social-emotional functioning (Schonert-Reichl & Lawlor, 2010; Viafora et al, 2015). There's a need to examine the effects of school-based mindfulness on the psychosocial functioning of students of color, who are often at higher risk for poor mental health outcomes (Black & Fernando, 2014). Interestingly, there's little information regarding implementation of mindfulness in after-school programs. The present investigates the impact of mindfulness-based activities on children’s emotional functioning in an urban, elementary after-school program.

Method: Participants --4th grade students enrolled in an after-school program in an urban school district in Northeastern US --Majority bilingual, Latinx Procedures --Interventions 1x/week, 2 hours, Jan-June 2019 --Activities: physical, breathing, sensory, emotion awareness, art --14 students completed baseline, mid-and at end-point surveys Measures --Emotion Awareness Questionnaire (EAQ) and Children’s Emotion Management Scales for Anger and Sadness (CEMS) Data Analyses --Using SPSS, paired sample t-tests were conducted --Analyzed all subscales of EAQ, CEMS Sadness/Anger, item analysis

Results: Quantitative --EAQ Item Analysis: "When I have a problem, it helps me when I know how I feel about it.” -----Scores increased from 1.86 at baseline to 2.29 at endpoint, t= -2.48 p= .028 Qualitative: Students able to mindfully color for less than 2 minutes at baseline, 20+ minutes at endpoint

Discussion: Our study suggests that mindfulness practices incorporated as part of after-school programs can have positive effects on some aspects of students’ emotional functioning.

Efficacy of an Acceptance and Commitment Therapy protocol for provider burnout and stigma

Primary Topic: Supervision, Training and Dissemination
Subtopic: Burnout, Stigma, Substance Use Disorders
Neilou Heidari, M.A., Denver Health Medical Center
Lucia Walsh, Ph.D., Denver Health Medical Center
Katherine Washington, Ph.D., Denver Health Medical Center
Jonathan Hawkins, LPC, Denver Health Medical Center
Christian Thurstone, M.D., Denver Health Medical Center

Background: Significant research demonstrates the efficacy of Acceptance and Commitment Therapy (ACT) in addressing provider burnout and decreasing provider stigma towards substance using patients. However, only one training protocol to date is designed to decrease provider’s stigma and burnout simultaneously and this protocol was unable to effectively decrease provider burnout and stigma.

Method: A pilot training was recently completed with twenty-four behavioral health hospital employees working in various settings within a large urban hospital. Participants were, on average, 36.57 year of age, had completed a Bachelor’s degree, and had worked at the hospital for 5.27 years. Participants completed pre- and post-training measures in order to assess provider burnout, stigma, and ACT process measures (i.e., psychological flexibility, cognitive fusion, and valued living) were also administered. Four more trainings with approximately 25 participants each will be completed by July 2020. Participants also took part in qualitative interviews in order to examine the effectiveness of this protocol and identify necessary adaptations in the training structure.

Results: We are analyzing the qualitative interviews from 16 participants using grounded theory to inform subsequent trainings. Quantitative data from all trainings will be analyzed using regression analyses to examine the relationship between participant demographics and change in burnout and stigma over time. We will also examine potential mediating effects of ACT process measures with changes in burnout or stigma.

Discussion: This study will provide preliminary evidence for a joint stigma-provider burnout intervention to improve substance use provider quality of life and improve patient care for often disenfranchised substance using individuals

Enjoy translating TED talks from the ACBS world!

Primary Topic: Prevention and Community-Based Interventions
Subtopic: TED talks, ACBS
Emanuele Rossi, Scuola di Psicoterapia Cognitiva, APC-SPC, Italy; AISCC

Background: 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.

Evaluating the Impact of Cognitive Fusion on Forms of Repetitive Thinking and Depression

Primary Topic: Clinical Interventions and Interests
Subtopic: Depression
Shannon Underwood, B.S., University at Albany, State University of New York
Eric Tifft, M.A., University at Albany, State University of New York
Max Roberts, M.A., University at Albany, State University of New York
John Forsyth, Ph.D., University at Albany, State University of New York

Background: Forms of repetitive thinking, such as rumination and worry, are regarded as important intervention targets in traditional cognitive-behavior therapies for depressive disorders. Recent work, however, suggests that entanglement with such thoughts (i.e., cognitive fusion) may be more critical than the form of such thoughts in accounting for suffering seen in depressive disorders.

Method: Undergraduates (N = 394; Mage = 18.99, SD = 2.36; 69% female) completed a battery of measures assessing cognitive fusion, worry, rumination, and depression. Several mediational models were evaluated (Preacher & Hayes, 2008) to clarify relations between forms of repetitive thinking, cognitive fusion, and depressed mood.

Results: The impact of both rumination and worry on depression were partially mediated by cognitive fusion. Overall, greater cognitive fusion was related to more depressive symptomatology in both analyses.

Discussion: These findings support the importance of cognitive fusion in clarifying relations between forms of repetitive thinking and depressive symptoms. Clinical and research implications will be discussed.

Evaluating the Relation of Psychological Flexibility, Self-Compassion, and Anxiety Symptoms Prior to and Following a Mindfulness Intervention

Primary Topic: Theoretical and philosophical foundations
Subtopic: Psychological Flexibility, Self-Compassion, Anxiety
Emily Kalantar, University of South Dakota
Ashmita Ghosh, University of South Dakota
Lucas Baker, University of South Dakota
Rachel Bock, B.S., University of South Dakota
Christopher Berghoff, Ph.D., University of South Dakota

Background: Psychological flexibility, which entails being able to remain in contact with the present moment while engaging in value congruent and contextually sensitive behaviors despite unwanted internal experiences (Hayes et al., 2006), is related to high self-compassion and reductions in anxiety symptoms over time (Davey, 2019; Tirch et al., 2017; Webb et al., 2017). Yet, the nature of these relations has not been delineated. Self-compassion, which entails extending care to oneself during times of suffering or personal failure (Neff, 2003), is related to decreases in anxiety symptoms (Arch et al., 2018; Mahali et al., 2020). Thus, self-compassion may serve as a mediator of the relation of psychological inflexibility and anxiety symptoms.

Method: The present study aimed to identify the mediating effect of self-compassion on the relation of psychological flexibility and anxiety symptoms pre- and post-establishment of a 2-week, 10-min daily mindfulness practice in a sample of undergraduate college students and community members (N = 120; Mage = 22.25; SDage = 8.33; Range: 18–56 years). Mediation analyses, conducted using the PROCESS macro (Hayes, 2018) and 10,000 bootstrapped samples, were used to evaluate relations before and after the intervention.

Results: Results indicated psychological flexibility was related to self-compassion in both models (a = 2.44 and 1.97, respectively). Contrary to hypotheses, results suggested self-compassion did not mediate the relation of psychological inflexibility and anxiety symptoms before the intervention. However, self-compassion was a significant mediator of this relation following the intervention, ab = .07, p < .05.

Discussion: Implications of results and future directions will be discussed.

Even with pain, I can still do many things I like to do: Examining body and illness mindsets in a pediatric pain sample

Primary Topic: Behavioral medicine
Subtopic: Pediatric Pain, Mindsets
Gillian Rush, B.A., Stanford University
Marissa Heirich, Stanford University

Background: Mindsets surrounding stress and chronic illness have increasingly been linked to health outcomes. The current study introduces the Illness Mindset Inventory for chronic pain (IMI-CP), consisting of six mindset scales: The body is an adversary, the body is responsive, the body is capable, illness is a catastrophe, illness is manageable, and illness is an opportunity.

Method: During pain clinic evaluations at Stanford, 73 children with mixed etiology chronic pain (65.8% female, Mage 13.7 years, SD = 2.53) completed the Functional Disability Index, Fear of Pain Questionnaire, Pain Catastrophizing Scale, Chronic Pain Acceptance Questionnaire, and IMI-CP. Parents (93.2% mothers) also completed the IMI-CP. Initial correlations were run between child and parent scores, and between child scores pain-related distress and functioning.

Results: Scores on all scales of both the child and parent IMI-CP were normally distributed. Children’s “illness is a catastrophe” scores correlated with their Fear of Pain scores (r = .468, p < .001) as did “the body is an adversary” (r = .387, p = .003) Child and parent scores were distinct, with only “illness is an opportunity” modestly aligning (r = .287, p = .016).

Discussion: Illness and body mindsets may reflect unique pain-related cognitions and are not necessarily shared between parent and child. A larger sample is needed. “Catastrophe” and “adversary” mindsets may be linked to more fear and avoidance of activities and may indirectly hinder functioning. Future studies can investigate the effects of fostering positive mindsets in clinical or educational contexts to shift negative pain-related cognitions and ultimately improve functioning.

Examination of the effect of label stimulus used for self-concept IRAP in Japanese

Primary Topic: Relational Frame Theory
Subtopic: IRAP, Self, RFT, AAQ
Pin ZHANG, Ritsumeikan University

Background: Verbal self is an important topic for clinical and basic research, and a measurement method called Implicit Relational Assessment Procedure (IRAP) has been used as basic research of Verbal-self. In the IRAP Verbal self-study (Self-IRAP), the word “I”, ”You” or participant's name, have been used as label for IRAP setting. However, no research has been conducted to accurately distinguish whether the usage of these different words would influence IRAP results. Especially in the Japanese community where the language highly dependent on context. Therefore, the present study verifies the effectiveness of the term “WATASHI” that means I in Japanese or participant's name in IRAP and determines its associations with the AAQ-II and self-esteem.

Method: Participants were Japanese native college students. This study used two different label(label_1 WATASHI or participant's name, label_2 “Others”), and the same targets(target_1 positive words, target_2 negative words) of IRAP. Each participant was required to complete the AAQ-II and the self-esteem surveys first and completed two different IRAPs later.

Results: Data of three participants were collected for now. The results evinced that IRAP using participant's name as label_1(Name-IRAP) showed a bias against “I’m positive”. However, IRAP using WATASHI as label_ 1(WATASHI-IRAP) do not. The result of “Others”, WATASHI-IRAP showed a bias against “Others are positive”, but Name-IRAP do not.

Discussion: The current study also plans to accomplish additional analyses when the data meet the evaluation conditions. This study suggests that choosing different self-representing words such as WATASHI or participant's name would affect the IRAP results in Japanese.

Examining acceptance as a protective factor against negative influences of social media exposure on mood and self-evaluation using ecological momentary assessment

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Acceptance, Technology
Russell DuBois, Ph.D., Blueprint Health
Macon Paine, B.A., Blueprint Health

Background: Research suggests that excessive social media (SM) exposure may have negative consequences under certain contexts, including leading to disturbances in body image and self-esteem. Studies utilizing EMA methodology identify a relationship between momentary SM exposure and mood and self-evaluation, but there is little research on potential protective factors that could limit the negative effects of otherwise maladaptive SM exposure. The current study aims to investigate the relationship between SM exposure and mood constructs using EMA methodology and identify ACT-consistent processes to moderate this relationship.

Method: Participants (N = 58) were prompted via their mobile phone eight times a day for 10 days and asked to answer questions related to social media exposure and momentary experiences of acceptance, negative affect, self-esteem, and body dissatisfaction. Hierarchical linear regression was used to examine acceptance as a moderator of the relationship between social media exposure and negative consequences.

Results: Moment-by-moment acceptance significantly moderated the relationship between social media exposure and negative affect, b = -2.77, t(403) = -3.40, p = 0.01, and body dissatisfaction, b = -0.02, t(401) = -2.46, p = 0.01, but not self-esteem, b = 0.01, t(401) = 1.67, p = 0.09. More specifically, social media exposure positively predicted negative affect and body dissatisfaction only during moments when acceptance was low.

Discussion: Social media exposure can be harmful to mood and self-image, but abstention is not a realistic goal for most young people. Results of the current study indicate that acceptance may be a protective factor.

Examining the effect of Attention Training Technique on task performance in situations where others have noticed

Primary Topic: Performance-enhancing interventions
Subtopic: Attention training technique,scribble task,flexibility of attention
shinichirou Ibe, Clinical psychologist, Start Line Co., Ltd.

Background: By using Attention Training Technique (ATT), the flexibility of attention is improved, and the effect of promoting "awareness at this moment" is expected. On the other hand, few previous studies have experimentally verified how ATT affects behavioral aspects. Therefore, the purpose of this study was to examine the effects of experiencing ATT on behavioral performance.

Method: In the first study, we conducted research on university students without disabilities. After performing the scribble task for all participants, the participants listened to the ATT or the environmental sound, and then performed the same scribble task again. In addition, he pointed out where the lines protruded during the first scribble assignment. In the second study, the same task was performed for mentally disorder persons. In addition, we maintained the effect of ATT by performing multiple ABA design.

Results: The first study compared the average time spent scribbling. As a result, the ATT group took less time to scribble the second time than the first time, but the group with only environmental sounds increased. The second study had the same results as the first study. However, there were individual differences in maintaining the effect.

Discussion: It was confirmed that excessive attention to the protruding line would increase the time required for the scribble. However, performing ATT had the opposite effect, which may have eliminated inflexibility of attention. This result suggests that the effect of ATT can be seen regardless of the presence or absence of mental disorders.

Expanding Intensive Programs to Meet the Needs of Patients: Doing What Works

Primary Topic: Clinical Interventions and Interests
Subtopic: Intensive outpatient programs, complex patients, third-wave CBT
Lori Eickleberry, Ph.D., Nova Southeastern University and Renovation of Life, LLC
Huda Abu-Suwa, M.S.; PhD candidate, Nova Southeastern University; Institute for Life Renovation

Background: Comorbidity of psychological disorders is common, and accompany higher symptom severity and suicidal behavior, as well as reduced prognosis, quality of life, and social support. While IOPs typically recognize that patients may present with multiple comorbidities, treatment often focuses on immediate problems and do not address comorbid issues. Further, some models are overgeneralized, utilizing standardized treatment plans and do not meet the individualized needs of patients. The current model for treating complex patients is therefore inept, either overgeneralizing or hyper-focusing treatment. Treatment models should instead be both specific and broad, focusing broadly on multiple cormobidities while incorporating specific goals and treatment strategies.

Method: An innovative, individualized IOP was created to test this model. The IOP incorporates a variety of third-wave CBTs, as well as groups, family therapy, individual yoga, art therapy, medication management, and work with a dietitian. 56 participants who completed the program and were administered relevant measures, including the BDI-II, FFMQ, STAI, MPFI and QOLI were utilized. Paired samples t-tests were used to compare measure scores at intake and after completing the program.

Results: Clinically and statistically significant changes were found across each of the measures (p<.001).

Discussion: The current IOP model demonstrates an ability to decrease symptomatology while simultaneously increasing mindfulness skills and quality of life. It supports the current model on providing individualized treatment programs that are both broad and specific. These results provide a promising outlook for this individualized and integrated outpatient program. Further research is needed to validate these results and determine long-term outcomes of the program

Experience Sampling Method Protocol: Feasibility, Acceptability and Examination of the Dynamics of Repetitive Negative Thinking, Valued Actions and Emotional Health during the Perinatal Period

ACTing with Technology SIG Sponsored
Primary Topic: Other
Subtopic: ESM/EMA, Perinatal, RNT, Valued action, Emotional health
José Mendoza Herrera, Université de Sherbrooke
Patrick Gosselin, Ph.D., Université de Sherbrooke

Background: Repetitive negative thinking (RNT) is a transdiagnostic process referring to iterative, relatively uncontrollable and intrusive negative-laden thoughts about oneself and one’s difficulties, viewed as a momentary experiential avoidance (EA) strategy perturbing values-consistent actions (VA). During the perinatal period, RNT fluctuates considerably , suggesting that its effects vary within and between individuals across time. These findings thus encourage the use of the Experience Sampling Method (ESM) – multiple and context-sensitive assessments of day-to-day life experience – to investigate the daily dynamics of RNT, VA and emotional health. Nevertheless, its applicability and the use of communication technology (i.e. smartphones and mobile applications) during the perinatal period requires further validation and adjustment. Thus, this study has two aims: 1) validate the feasibility, acceptability and reactivity effects of ESM during the perinatal period and 2) assess RNT, VA and emotional concurrent and lagged relationships.

Method: Participants (N = 100; 50 pregnant) will complete an ESM time-contingent protocol with a semi-random schedule (4 times per day, 7 days, between 07:00 – 23:00). Dispositional questionnaires (PTQ, BEAQ, DASS-21, VQ) will establish a baseline level through a web-platform approach and a mobile app will mirror these processes through momentary questions. A self-reported questionnaire will evaluate the applicability of the methods. Descriptive and multi-level mixed effects analyzes will be performed.

Results: Preliminary results of a pilot study will be provided.

Discussion: Assessing and adjusting ESM applicability during the perinatal period could improve compliance and data quality, strengthening our confidence in new methods to study RNT and its influence over valued-behavioural patterns.

Experiential Avoidance and Emotion Regulation in Interpersonal Stress Generation

Primary Topic: Clinical Interventions and Interests
Subtopic: Experiential Avoidance, Emotion Regulation
Kelsey Pritchard, M.A., The University of Toledo
Peter Mezo, The University of Toledo

Background: Experiential avoidance and maladaptive emotion regulation (ER) are implicated as risk factors for the generation of interpersonal stress and affective symptoms (Gerhart et al., 2014; Moriya & Takahashi, 2013). Though research has focused on intrapersonal ER, recent work has linked interpersonal ER (IER), which is the regulation of emotion in social contexts (Dixon-Gordon et al., 2018). However, little is known about the association between experiential avoidance and ER (Chapman et al., 2011). Thus, the current study examined the roles of experiential avoidance and IER in interpersonal stress.

Method: Data were collected from 391 undergraduate students (68% female; Mage = 19.71, SD = 3.32). Participants completed measures of experiential avoidance (BEAQ; Gamez et al., 2014), inter- and intrapersonal ER (DIRI-RS and DIRE; Joiner et al., 1992; Dixon-Gordon et al., 2018), and interpersonal stress (NLEQ; Saxe & Abramson, 1987). Mediation analyses with PROCESS (Hayes, 2018) estimated the indirect effects of inter- and intrapersonal ER on the relationships between experiential avoidance and interpersonal stress.

Results: Mediation analyses revealed that facets of IER (i.e., venting and reassurance-seeking) partially mediated the relationship between experiential avoidance and the generation of interpersonal stress. Moreover, intrapersonal ER (i.e., avoidance) were linked to elevated interpersonal stress in the context of experiential avoidance.

Discussion: Results of this study provide preliminary evidence that integrates the research on experiential avoidance, IER, and interpersonal stress generation. However, clearer distinctions between ER the broader construct of experiential avoidance are needed. Clinical and research implications will also be discussed.

Exploratory study of common changes in client behaviors following routine psychotherapy: Does psychological flexibility change and predict outcomes?

Primary Topic: Clinical Interventions and Interests
Subtopic: Therapeutic Processes
Shamell Brandon, Psy.D., ABPP, Lehigh University
Christina Pallotti, B.A., Lehigh University

Background: Researchers have argued that psychological flexibility processes might be activated by diverse therapy approaches included in routine psychotherapy, even if those approaches do not purport to target those processes. This study explored the degree to which clients’ psychological flexibility changed after episodes of routine psychotherapy (n=196) in a naturalistic treatment setting. Additionally, this study investigated if changes in psychological flexibility predicted changes in treatment outcomes.

Method: The first and last administration of process and outcome measures within a semester were coded as baseline and post scores of a treatment episode, respectively. Ten therapists reported using integrative theories, including psychoanalytic/psychodynamic, cognitive-behavioral, interpersonal, feminist, and multicultural. One therapist exclusively used Acceptance and Commitment Therapy. We conducted paired sample t-tests and effects sizes for the complete and treatment responders sub-samples. Lastly, we ran hierarchical regression analyses for the complete sample.

Results: Statistically significant improvements in acceptance-and-mindfulness (p<.001; d=.22) and commitment-and-behavioral activation (p<.001; d=.24) occurred after routine therapy. For sub-samples with reliable clinical change in general distress or flourishing, greater changes in acceptance-and-mindfulness (d=.44 or d=.99, respectively) and commitment-and-behavioral activation (d=.54 or d=1.37, respectively) occurred. Furthermore, changes in psychological flexibility predicted changes in flourishing and distress after therapy, explaining 42% and 23% of the variance in those respective treatment outcomes.

Discussion: Findings suggest that psychological flexibility’s relevance might extend to the treatment outcomes of other diverse theories within routine psychotherapy. Given this relevance, explicit therapeutic attention to strengthening psychological flexibility may benefit the work of therapists across therapeutic schools.

Exploring Acceptance and Commitment Therapy metaphors: A systematic scoping review

Primary Topic: Clinical Interventions and Interests
Subtopic: Metaphor
Alison Stapleton, B.A., University College Dublin
Juwayriyah Nayyar, M.Psych.Sc, University College Dublin
Louise McHugh, PhD, Associate Professor, University College Dublin

Background: In Acceptance and Commitment Therapy (ACT), therapeutic metaphors are used to help clients derive key aspects of the psychological flexibility model. However, at present, it is unclear what metaphors are used in ACT interventions, the method in which these metaphors are delivered, the efficacy of each metaphor, and how helpful each metaphor is in conveying its therapeutic message (both individually and relatively).

Method: This systematic scoping review mapped the research conducted on ACT-metaphors using a methodological framework in line with the PRISMA-ScR checklist. Two researchers searched Pubmed, Web of Science, Embase, and PsycINFO databases, and performed title and abstract screening, the removal of duplicates, and a parallel abstract and full-text screening according to eligibility criteria.

Results: Data extraction was completed by two researchers independently with key pieces of information sorted using a data-charting form created for this purpose by the researchers.

Discussion: Findings are discussed with reference to inconsistencies in what constitutes a metaphor and the overall lack of detail on metaphor usage observed across articles.

Feasibility of a Mindfulness-Based Group within a Spinal Cord Injury Center

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness; Spinal Cord Injuries
Channing Cochran, Psy.D., South Texas Veterans Health Care System
Melissa Talamantes, Psy.D., South Texas Veterans Healthcare System

Background: Prior research on individuals with spinal cord injuries (SCI) have demonstrated that this population often faces psychological challenges, such as depression, anxiety, and chronic pain, in addition to obstacles in accessing appropriate, evidence-based care (Hearn & Finlay, 2017). Recent research has highlighted the benefits of mindfulness-based interventions to manage psychological distress and chronic pain, with some research demonstrating improved mood and decreased experiential avoidance specifically in SCI populations (Skinner et al., 2010).

Method: The purpose of this project was to evaluate the feasibility and effectiveness of a mindfulness-based group within the Spinal Cord Injury (SCI) unit at the South Texas Veterans Affairs Healthcare System with the aim of improving delivery of patient health care treatments. The mindfulness-based group consisted of 6 weekly, one-hour long sessions. Participating Veterans were asked to complete pre- and post-measures of depression and self-awareness, as well as qualitative self-report measures of knowledge and expectations of mindfulness interventions on reduction of psychological symptoms. Another aim of this project was to identify barriers to accessing care within the SCI population.

Results: Results of this project demonstrate that factors, such as transportation, timing of group, and co-morbid medical conditions, negatively impacted Veterans ability to participate consistently in the group. Yet, Veterans who attended majority of group sessions self- reported an increase in quality of life, awareness of present moment, and decreased depression symptoms.

Discussion: Further adaptations to current group schedule and content will be discussed in order to further maximize mindfulness-based interventions within the SCI population.

Getting better data in online surveys: Offering an incentive for responding behavior lowers careless responding

Primary Topic: Other
Subtopic: careless responding
Elizabeth Malagisi, Metropolitan State University of Denver
Janna Burnam, Metropolitan State University of Denver
Liddy Tryon, Metropolitan State University of Denver
Sierra Held, Metropolitan State University of Denver
Maureen Flynn, Metropolitan State University of Denver

Background: Careless responding by participants can be detrimental to data quality (Maniaci & Rogge, 2014; Meade & Craig, 2012). Therefore, it is essential to find effective ways to reduce careless responding in order to mitigate this problem. The current study examined whether offering an incentive (i.e., rule-based antecedent manipulation) for careful responding reduced careless responding behavior.

Method: Participants were randomly assigned to either the incentive (n = 291) or control condition (n = 294). In the incentive condition, participants were told in the informed consent document that they would be entered into a drawing for gift cards if statistical methods showed that they answered survey items honestly and accurately. In the control condition, participants were not informed of the drawing or of any statistical analysis of their responding behavior. All participants received course credit for their participation and were entered into the drawing, regardless of condition.

Results: Results showed that significantly more participants in the incentives condition passed all attention check items compared to the control condition. However, there was not a significant difference between conditions on self-reported attention and effort put forth on the study.

Discussion: Future research could continue to investigate the use of incentives and compare different types of incentives or varied monetary amounts among a variety of populations.

Growth and Goals: Building psychological flexibility toward self-regulated learning

Primary Topic: Performance-enhancing interventions
Subtopic: Psychological flexibility
Fergal O'Hagan, Ph.D., Trent University
Alison Flynn, University of Ottawa
Robyne Hanley-Dafoe, Trent University

Background: We report on the development and evaluation of an open-source online learning module designed to promote self-regulated learning skills in students. Growth and Goals is based on psychological flexibility principles including self-as-context, present-time awareness, acceptance, values, and committed action. The module integrates into courses, aligning with course learning objectives and has been used in over 10 courses at multiple institutions, with over 2,000 students participating.

Method: Practical participatory evaluation including student responses to the module, measures related to self-regulated learning and course performance data.

Results: 80% of students find the module beneficial and 80% of students complete the module when incentivized to do so. Students demonstrate improved confidence towards learning objectives and accuracy in predicting performance. Students identified that module components helped them set up better antecedents for academic behaviours, implement more effective study skills and encouraged learning engagement by reducing anxiety towards course performance.

Discussion: Growth and Goals is a promising tool for improving access for resources to support self-regulated learning in post-secondary education.

How facial make-up effect on the implicit or explicit relational responses?

Primary Topic: Relational Frame Theory
Subtopic: IRAP
Shinji TANI, Ritsumeikan University
Megumi Yoshioka, Ritsumeikan University

Background: Facial make-up is a usual and daily behavior in modern society. Many studies showed it effected on person’s interpersonal behaviors and emotions. The purpose of the current study is to investigate how facial make-up effects on a person’s BIRRs or EERRs.

Method: 23 undergraduate students (all are female) attended the experiment. They were divided into two groups randomly. One is a “Make-up first group” in which participants with facial make-up conducted IRAP and answered questionnaires (STAI and AAQ-II). After finishing IRAP and questionnaire they removed make-up and tried IRAP and questionnaires again. Another is a “No make-up first group” which carried out IRAP and questionnaires with no make-up at first. So, all participants tried IRAP and questionnaires two times (make-up condition/no make-up condition).

Results: The data got from 17 of 22 participants were analyzed. The score of STAI of no make-up condition was larger than make-up condition significantly (t=-3.29, p<.01). No significant difference was found in a score of AAQ-II (t=.28, n.s.). About IRAP effect, the significant biases were found in “I-Positive-Yes” response (t=.48, p<.01) and “Other-Positive Yes” (t=-.26, p<.05) in make-up condition. On the other hand, “I-Positive-Yes” (t=.43, p<.01) and “ I-Negative-No” response showed the significant bias in no make-up condition. Total D-score in no make-up condition also showed the significant bias (t=.14, p<.05).

Discussion: These results showed facial make-up influenced on participants’ BIRRs and EERRs. In no make-up condition, anxiety became stronger, and “I-Negative-No” response showed larger bias. Facial make-up might have a function of avoiding anxiety.

Identity, Relationship, and Behavioral Values in Relation to Resilience and Stress

Primary Topic: Clinical Interventions and Interests
Subtopic: ACT
Shilpa Hampole, San Jose State University
Elizabeth Flores Medina, San Jose State University
Olexandra Kanivets, San Jose State University
Jennifer LaHood, Student
Crystal Zoghi, San Jose State University
Jennifer Gregg, Ph.D., San Jose State University

Background: Values clearly influence many psychological processes in ACT, but the exact mechanism for this influence remains unclear. Previous research has shown that values-related behavior may have a relationship with resilience in college students (Ceary et al., 2019). Additionally, this relationship may be influenced by factors related to stress (Ceary et al., 2019). The present study sought to examine subcategories of values, such as values related to relationships, identity, and behavior.

Method: The present study (N = 190) examined these subcategories via linear regression of each subcategory (relationship, identity, and behavior) of values as measured by the VLQ (Wilson et al., 2010) in order to determine the predictive validity, compared to the VLQ overall, on resilience (CD-RISC; Connor & Davidson, 2003) and stress (PSS; Cohen et al., 1983).

Results: Results showed no predictive advantage to the creation of subcategories.

Discussion: To our knowledge, this analysis is the first to look at the effects of three values domains independently. While results for resilience and stress were inconclusive, this may have been due to floor effects for stress, which may change in the face of the current pandemic. Further analyses are needed and future directions discussed.

Improvements in Heart Rate Variability following ACT for Chronic Pain

Primary Topic: Behavioral medicine
Subtopic: ACT and Psychophysiology
Taryn Allen, Ph.D., Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Leidos Biomedical, Inc.
Stephanie Reda, National Cancer Institute, National Institutes of Health
Mary Anne Toledo-Tamula, M.A., Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Leidos Biomedical, Inc.
Kari Struemph, Ph.D., Behavioral Psychology, Department of Pediatrics, University of Kansas Medical Center
Staci Martin, Ph.D., National Cancer Institute

Background: There is increasing interest in evaluating biomarkers of pain alongside patient reported outcomes following contextual and behavioral therapies for chronic pain. Heart rate variability (HRV) is one potential biomarker of pain, which reflects the variability in time elapsed between consecutive heart beats. Research suggests that greater HRV is associated with more psychological flexibility and better overall health. The current analysis examined HRV before and after an 8-week multimodal (in person and online) trial of Acceptance and Commitment Therapy for individuals with chronic pain and neurofibromatosis type 1 (NF1). It was hypothesized that participants would have increased levels of HRV post-intervention.

Method: Individuals with NF1 and chronic pain (n=66; Mage=30.7 years; 61% female) enrolled in a waitlist-controlled trial of ACT. Questionnaires regarding pain intensity, pain interference, pain acceptance, and pain-related inflexibility were completed pre- and post-intervention. In addition, at each time point, participants underwent a 5-minute resting electrocardiogram from which a measure of high-frequency HRV (HF-HRV) was obtained.

Results: Results suggest that, when controlling for gender (a variable known to impact HRV), there were significant improvements in HF-HRV for the intervention group compared to the waitlist control condition (F(1, 50)=4.48; p<0.05). Further, baseline HF-HRV significantly predicted improvements in pain inflexibility post-intervention (F(1, 55)=5.29; p<0.05), and has a significant indirect effect on pain interference at follow-up (T(53)=2.36; p<0.05).

Discussion: Altogether, these results suggest that ACT beneficially impacts HRV, and that HRV indirectly influences pain interference via psychological flexibility. This speaks to the wide-reaching mind-body health benefits of ACT for individuals with chronic pain.

Improvements in Mindfulness and Psychological Flexibility in Adults Living with Serious Mental Illness in a Multimodal Residential Program

Primary Topic: Clinical Interventions and Interests
Subtopic: Serious Mental Illness, Residential Treatment
Dagoberto Heredia, Ph.D., Mayo Clinic
Sharon Rohde, LPCC, Mayo Clinic
Brian Strauss, LPCC, Mayo Clinic
Mark Frye, M.D., Mayo Clinic
Brandon Coombes, Ph.D., Mayo Clinic
Justin Breaker, B.A., Mayo Clinic
Eleshia Morrison, Ph.D., Mayo Clinic
Matthew Clark, Ph.D., Mayo Clinic
Ajeng Puspitasari, Ph.D., Mayo Clinic

Background: Meta-analytic reviews of mindfulness-based interventions in adults with serious mental illness (SMI) have demonstrated promising treatment effects (Goldberg et al., 2018; Chu et al., 2018). However, few studies have examined how mindfulness-based interventions might enhance broad cognitive functions such as psychological flexibility in adults with SMI (Wielgosz et al., 2019). This study involved patients admitted to Mayo Clinic’s John E. Herman Home and Treatment Facility, a residential treatment program for adults living with SMI that delivers Acceptance and Commitment Therapy (ACT) as one of its primary interventions. This study evaluated changes in self-reported levels of mindfulness and psychological flexibility from admission to discharge.

Method: Patients included 23 adults (M=30.57, SD=10.05) who were primarily Caucasian (95.7%) and male (65.2%) with an average length of stay of 12 weeks. Patients completed the Five Facet Mindfulness Questionnaire (Baer et al., 2006) and the Acceptance and Action Questionnaire-II (Bond et al., 2011).

Results: Paired sample t-test indicated that patients reported significant increases in levels of mindfulness (p < .001) and psychological flexibility (p<.001) from pre-treatment to post-treatment.

Discussion: These preliminary findings suggest that ACT may facilitate improvements in mindfulness and psychological flexibility skills among adults living with SMI receiving multimodal care in a residential treatment setting.

Improving Academic Performance in Adolescents: Effect of an ACT Protocol Focused on the Most Problematic Self-Beliefs or the “BIG ONES”

Primary Topic: Performance-enhancing interventions
Subtopic: Adolescentes, Psychological Flexibility, BIG ONES, Relational Frame Theory, ACT
Katia Aranzabal, M.A., Private Practice
Barbara Gil-Luciano, Ph.D., Nebrija University and Madrid Institute of Contextual Psychology (MICPSY)
Beatriz Sebastian, M.A., MSc, Madrid Institute of Contextual Psychology

Background: Although there has been an increase in studies regarding the efficacy of Acceptance and Commitment Therapy (ACT; Hayes, Strosahl & Wilson, 1999, 2014; Wilson & Luciano, 2001) with young clinical population, studies in school settings are rare. In addition, recent research shows the importance of addressing the Big Ones (most problematic self-beliefs, or self-concepts) (Gil-Luciano et al., 2019; Ruiz et al., 2016, 2018; Luciano, 2017), in that they unleash an inflexible class of behaviors that produce multiple limitations. To our knowledge, no prior studies have addressed psychological inflexibility with teenagers this way. The aim of this pioneer study was to develop an ACT-based protocol focused on the Big Ones and assess its impact on academic performance.

Method: : a single case design with a sample of 7 adolescents with poor academic performance, 75 % male, aged 14-17 years old. Firstly, participants filled in several questionnaires and a functional assessment was performed. Secondly, the protocol was tailored to each participant. Finally, all measures were taken again. The ACT-based protocol consisted on a multiple exemplar training on discriminating private events as they emerged in several academic tasks, learning to frame them in hierarchy with the deictic I, so that flexible reactions could take place.

Results: Results show clinically relevant improvements in psychological flexibility.

Discussion: Results are discussed in terms of psychological flexibility improvement from the impact of directly addressing the Big Ones.

Increasing the Efficacy of Student Learning Groups

Primary Topic: Educational settings
Subtopic: Core Design Principles
Juliet Buddiga, Binghamton University
Melvin Philip, Binghamton Univeristy
David Wilson, Ph.D., Binghamton Univeristy

Background: Nobel laureate Elinor Ostrom previously identified 8 “core design principles” [“CDPs”] initially for the purpose of managing common pool resources. It has since been suggested that the CDPs can be generalized in order to increase the efficacy of all groups. This study analyzes the effect of CDP intervention in a real classroom setting, utilizing a group poster project integrated into a university course.

Method: Students enrolled in an introductory evolution course formed groups of 2-4, and were asked to apply evolutionary theory to ask a novel research question to ultimately be compiled into an academic research poster. 3 out of 6 discussion sections received a minor CDP intervention in the form of a worksheet explaining principles in the context of groups. All groups were asked to write a "group contract", and individually complete weekly satisfaction surveys.

Results: Our results show that groups that received intervention showed a significant increase in word count for both the written contracts and weekly surveys, and well as significantly more cited sources on their final poster.

Discussion: These results suggest that the small intervention does affect group function in a real-world classroom setting. Further analysis is currently being conducted to observe differences in final poster grades between intervention and control groups. A final, extended survey is also currently being analyzed for further outcome variables amongst groups (trust, commitment, satisfaction, cooperation). Although this was an extremely minor intervention, further research can look at the effects of increased intervention levels, as well as variations in group sizes and assignment types.

Intervention Effect of Mindfulness Based Stress Reduction training on China National Skeleton Team Athletes

China Chapter Sponsored
Primary Topic: Performance-enhancing interventions
Subtopic: Mindfulness
shousen xu, Capital University of Physical Education and Sports
jingcheng li, Capital University of Physical Education and Sports
jiaxin li, Graduate Schoool, Capital University of Physical Education and Sports

Background: Objective：to explore the effect of Mindfulness Based Stress Reduction (MBSR) on anxiety , depression, sleep quality and mindfulness level of Chinese skeleton athletes.

Method: Methods: Total 21 athletes from Chinese skeleton team were trained once a week for 8 weeks. State trait anxiety inventory (TSAI), depression self rating scale (SDS), Pittsburgh sleep quality index (PSQI), the five mindfulness scale (FFMQ) at baseline (T1), 4 weeks after the intervention (T2), 8 weeks after the intervention (T3), and a month after the end of the intervention tracking (T4) for measuring, evaluating MBSR for athletes level of anxiety, depression, sleep quality and level of mindfulness.

Results: Results: The results of repeated measures analysis of variance were shown, Trait anxiety, depression and sleep quality all improved, and were statistically significant. There was a significant improvement in the five factors of mindfulness about acting with awareness, and no significant improvement in the remaining four factors: non-reactivity, observing, describing and non-judging.

Discussion: Conclusion: MBSR training had positive effects on anxiety and depression, sleep quality and acting with awareness in athletes.

Measuring Behavior Change In Clinical Behavior Analysis: A Pilot Study

Primary Topic: Clinical Interventions and Interests
Subtopic: Clinical Behavior Analysis
Andrew Carr, Ph.D., Momentum Center for Clinical Excellence
Emily Sandoz, Ph.D., University of Louisiana at Lafayette

Background: Process-based therapies are increasingly popular in clinical and research settings. Process-based therapies target mediators and moderators based on testable theories of client behavior. Accordingly, therapists then must begin to measure these processes in order to test these theories. However, the measurement of these processes remains opaque for many therapists. One approach rooted in clinical behavior analysis measures the consistency of flexible behaviors in a client’s response to aversive stimuli as rated by the therapist across one individual therapy session.

Method: In this pilot study, we present a case series with single-case design elements which demonstrates this approach.

Results: Preliminary analyses after multiple therapy sessions the therapist rated client behavior as more consistently flexible and clients reported higher level of valued-behaviors irrespective of their subjective distress.

Discussion: In conclusion, the findings study suggests that this method a useful tool for assessing behavior change in therapy

Military-Related Moral Injury: The Role of Experiential Avoidance and Event Centrality in Increasing Suicide Risk Among U.S. Military Veterans

Primary Topic: Clinical Interventions and Interests
Subtopic: Moral Injury, Military, Veterans, ACT, Suicide, Trauma
Lauren Johnson, M.Ed., M.S., Drexel University

Background: The rise in suicide risk among military veterans is increasingly recognized as a significant public health concern. Recently, there has been increased attention on the emerging construct of moral injury (MI), which has been demonstrated to increase suicidal thoughts and behaviors. Both experiential avoidance (EA) and event centrality (EC) have been shown to increase trauma pathology and psychological distress. As such, it appears that EA and EC could be salient underlying factors that better clarify the linear relationship between MI and suicidal thoughts and behaviors.

Method: The present study explored the moderating effects of EA and EC on the relationship between MI and suicide ideation. Three hundred veterans completed an online survey with validated self-report measures.

Results: The results support the moderating effects of both EA and EC, even when controlling for posttraumatic stress symptoms. It was demonstrated that when veterans endorsed higher MI symptoms and greater experiential avoidance, they experienced significantly elevated suicide ideation. This finding was identical with greater event centrality.

Discussion: These results suggest the significance of evaluating EA and EC among veterans reporting higher MI symptoms to more comprehensively assess for suicide risk. Additionally, these outcomes imply the value of interventions that specifically target these constructs. There is evidence to suggest the utility of ACT as the extant literature has established its effectiveness in reducing both experiential avoidance and event centrality. This reinforces the salience of testing the efficacy of ACT among veterans with moral injury and further indicates the potential significance of this treatment in reducing suicide risk.

Mindfulness and Technology: An Evaluation of an Online Mindfulness Program for Symptoms Related to Sexual Assault

Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD, Mindfulness
Erica Johnson, M.A., Western Michigan University
Amy Naugle, Ph.D., Western Michigan University

Background: Sexual violence, including sexual assault and victimization is a frequent occurrence that results in varying adverse effects. Sexual assault has been found to increase the risk of distressing psychological symptoms including PTSD, drug and substance use, and experiential avoidance. As such, interventions for reducing the distress and negative impacts of sexual assault are of importance.

Method: The current study used a within subjects repeated measures open clinical trial design to investigate the effectiveness of an online mindfulness based intervention on trauma symptoms among college students. A sample of 8 students currently enrolled at a Midwestern university participated. Participants completed an eight-week online mindfulness based intervention. It is hypothesized that the engagement in the mindfulness program will be associated with a reduction in PTSD symptoms and experiential avoidance. In addition, it is hypothesized that there will be an increase in mindfulness skills.

Results: Participants who completed the mindfulness program had a significant reduction in PTSD symptoms as well as experiential avoidance and an increase in mindfulness skills.

Discussion: This study contributes to the limited literature evaluating online mindfulness based interventions, and is the first to the authors knowledge to evaluate this intervention specifically for individuals with symptoms related to sexual assault. The findings of the current study are promising. Individuals who completed the mindfulness based intervention illustrated a reduction in PTSD symptoms and experiential avoidance, indicating a promising impact an online mindfulness based intervention can have.

Mindfulness, Culture, and Clinical Practice: Clinician Experiences Utilizing Mindfulness and Acceptance with Hispanics/Latinos

Primary Topic: Clinical Interventions and Interests
Subtopic: Diversity
Rebeca Castellanos, M.A., Medical University of South Carolina
Kate Flory, Ph.D., University of South Carolina
Rosaura Orengo-Aguayo, Ph.D., Medical University of South Carolina

Background: Research suggests there is a significant need to address health inequities among Hispanics/Latinos given that they comprise the fastest growing ethnically diverse population in the United States (U.S. Census Bureau, 2015). A recent comprehensive review of the literature on cultural adaptations of Mindfulness-Based Interventions (MBIs) for Hispanics/Latinos indicated several critical gaps in the study of culturally adapted MBIs which included a need to systematically assess cultural adaptations in clinical settings (Castellanos et al., 2019). The present study investigated the intersection of culture and psychotherapy by understanding and contributing to the improvement of mindfulness-based interventions (MBIs) for Hispanic/Latino populations.

Method: Qualitative methodology was utilized to investigate how mindfulness-based interventions were culturally adapted by clinicians working with Hispanic/Latino populations in the U.S. Eighteen clinicians who reported utilizing MBIs with Hispanic/Latino clients completed interviews.

Results: Results demonstrated that clinicians utilize several strategies and theories to implement MBIs with Hispanic/Latino clients. Clinicians also reported on several challenges that they experience when implementing MBIs with Hispanic/Latino clients and ideas for resources that would aid in implementation.

Discussion: Findings suggest that when implementing MBIs with Hispanic/Latino clients, it is important to consider contextual functionalism, intersectionality and cultural humility.

Mindfulness, Self-Compassion, and Psychological Flexibility as Predictors of Reduced Alcohol Use and Burnout Among Law Enforcement Officers

Primary Topic: Clinical Interventions and Interests
Subtopic: MINDFULNESS
Aaron Bergman, Ph.D., University of Massachusetts Medical School
Kaylie Green, M.S., Pacific University
Josh Kaplan, M.S., Pacific University
Michael Christopher, Ph.D., Pacific University

Background: Burnout and alcohol misuse are among the many negative health outcomes that law enforcement officers (LEO) experience at a disproportionally high rate, relative to the general population. Mindfulness-based intervention (MBI) mechanisms such as mindfulness, self-compassion, and psychological flexibility have been negatively associated with both burnout and alcohol use, and show promise in mitigating these negative health outcomes among LEOs.

Method: In the current study, we investigated the relative impact of improvements in mindfulness, self-compassion, and psychological flexibility in predicting decreased burnout and alcohol use in a sample of LEOs participating in an MBI as part of a larger randomized controlled trial. We completed two, four-step regression models with baseline PROMIS AU-SF or OLBI entered into first step, and residualized change in FFMQ-SF, SCS-SF, and AAQ-II entered in the second, third, and fourth steps respectively.

Results: In the first regression, only increases in mindfulness significantly predicted decreased post-intervention problematic alcohol use. In the second regression, only increases in self-compassion significantly predicted decreased post-intervention burnout.

Discussion: This study adds to a growing body of literature on the impact of mindfulness, self-compassion, and psychological flexibility in predicting outcomes among high-stress cohorts. Results suggest that depending on the targeted outcome (reduced alcohol use or burnout), different mechanisms of change may be more impactful.

Music performance anxiety in community music: The role of psychological flexibility and flow

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Community music, flow, music performance anxiety
Diana Singh, SWPS University of Social Sciences and Humanities
Joanna Dudek, Ph.D., SWPS University of Social Sciences and Humanities

Background: Music performance anxiety is very common among musicians (Studer, Gomez, Hildebrandt, Arial i Danuser, 2011) and can negatively influence the performer’s personal and professional life (Steptoe, 2001). Environmental interaction is an important part of community music (Veblen and Olsson, 2002), signifying the role of performances in the community musician’s life. As previous studies involving music students suggest (Juncos et al., 2017) ACT could be and effective method of supporting community musicians in sharing their music. The aim of this study was to examine the relationship between psychological flexibility, flow and music performance anxiety in community musicians.

Method: A sample of 63 polish batucada (samba percussion orchestra) players completed self report questionnaires measuring psychological flexibility, mindfulness, flow and music performance anxiety levels.

Results: Results suggest that there is a significant relationship between music performance anxiety and psychological flexibility (r=0.706, p<0.01), flow (r= -0.409, p<0.01) and mindfulness (r=-0.300, p<0.05) in community musicians. Multiple regression analysis suggests that psychological flexibility and flow explain 57% of variance of music performance anxiety.

Discussion: The higher the psychological flexibility and the higher the experience of flow, the lower the level of musical performance anxiety among participants. Implications of the current findings to acceptance and commitment therapy use in the community music environment will be further discussed.

Pain acceptance patterns identify reticulated Behavioral Flexibility profiles that predict needs and responsiveness to pain rehabilitation

Sweden Chapter Sponsored
Primary Topic: Behavioral medicine
Subtopic: Profiling behavioral plasticity and psychological flexibility patterns predicts rehabilitation neeeds and responsiveness to interventions
Jens Nislby, M.D., Sahlgrenska Academy
Graciela Rovner, Ph.D. in Rehabilitation Medicine, MSc. PT, MSc. Psychology and MSc. Clinical Medical Sciences, ACT Institutet Sweden & Karolinska Institutet
Jens Nilsby, Gothenburg University- SWEDEN

Background: Chronic Pain is highly prevalent and still an unresolved condition to be treated in a conservative manner. Behavioral medicine and rehabilitation are implementing Acceptance and Commitment Therapy (ACT). ACT demonstrated strong evidence and effectiveness in increasing functional level and quality of life among patients with medically explained pain conditions

Method: Hundred seventy-six (N=176) patients underwent the ACTiveRehab 5-sessions group program at a specialty pain rehabilitation clinic in Sweden. ACTiveRehab aims to increase the individual’s Behavioral Flexibility in order to improve their physical, mental and social function so that they can regain the sense of living a meaningful and vital life, even in the presence of pain.

Results: Pain Acceptance creates reticulated psychological flexibility patterns that clearly indicate different Behavioral Plasticity(BP) profiles. In this study, the profiles were distinctly different before intervention regarding Awareness and Activity Engagement. When offering the same intervention to all of them, the profiles with low behavioral plasticity improved their capacity to be open to experience, while the profiles with higher Activity engagement improved their capacity to be present and aware.

Discussion: Each BP profile’s differential responsiveness to rehabilitation points to the need for tailored and modularized rehabilitation programs. Activity engagement is more indicative than Pain Willingness for quality of life and flexibility, which confirms that it is not enough to ‘think’ that we can accept pain, we need to ACT, be ACTive and be engaged in our life to really accept pain and discomfort!

Participant interest in the research topic as a predictor of careless responding behavior in a long online survey

Primary Topic: Other
Subtopic: careless responding
Janna Burnam, Metropolitan State University of Denver
Elizabeth Malagisi, Metropolitan State University of Denver
Sierra Held, Metropolitan State University of Denver
Liddy Tryon, Metropolitan State University of Denver
Maureen Flynn, Metropolitan State University of Denver

Background: Careless responding effects the quality of data (Maniaci & Rogge, 2014; Meade & Craig, 2012). It is important to examine variables that predict careless responding behavior to help inform possible ways to reduce it. The purpose of this study was to examine whether interest in the research topic predicts lower levels of careless responding in a long, online survey.

Method: Two hundred and ninety-four undergraduate students participated in the study. Participants rated their interest level in the research topic (i.e., attitudes towards homosexuality) and completed a battery of questionnaires online. They also rated how much attention and effort they put forth on the study.

Results: Regarding the results, two binary regressions showed no significant association between interest in the research topic and passing attention check items. Additionally, results from two linear regressions showed that higher levels of interest predicted higher levels of self-reported effort and attention levels while participating in the study.

Discussion: This study’s findings are similar to other studies that have shown that self-report data does not always match actual behavior (e.g., Boase & Ling, 2013; Tenkorang, Sedziafa, Sano, Kuuire, & Banchani, 2015; Wilcox, Bogenschutz, Nakazawa, & Woody, 2013).

Predicting Help-Seeking: Internalized Stigma and Psychological Flexibility in an Anxious Sample

Primary Topic: Theoretical and philosophical foundations
Subtopic: Anxiety
Rachel Bock, B.S., University of South Dakota
Emily Larson, B.S., University of South Dakota
Jasmine Schneider, University of South Dakota
Jacey Anderberg, University of South Dakota
Christopher Berghoff, Ph.D., University of South Dakota

Background: Help-seeking attitudes (tendency to seek or resist psychological treatment; Fischer & Turner, 1970) are not consistently associated with favorable help-seeking attitudes among college students mental health concerns (Czyz et al., 2013; Ryan et al., 2010). Research also suggests low help-seeking behavior is related to both high internalized stigma (Corrigan, 1998; Schomerus & Angermeyer, 2008) and low psychological flexibility (Pakenham & Viskovich, 2018). Identifying the relation of internalized stigma and psychological flexibility with help-seeking attitudes may clarify factors associated with low help-seeking behavior by college students with mental health concerns, which may inform intervention development efforts. The current study evaluated the relation of internalized stigma, psychological flexibility, and help-seeking attitudes within a high anxiety sample.

Method: Participants were college students (N=173; Mage=20.07, SDage=2.94; Range: 18-38) who screened positive for anxiety and completed an online survey battery in exchange for course credit.

Results: A stepwise multiple regression was used to evaluate outcomes, with help-seeking attitudes entered as the consequent. Internalized stigma entered the model at step one and accounted for a significant amount of variance in help-seeking attitudes, ΔR2=.04, F(1, 172)=7.42, p<.01. Psychological flexibility entered at step two and accounted for significant variance in help-seeking attitudes above that accounted for by internalized stigma, ΔR2=.07, F(2, 170)=10.35, p<.001.

Discussion: Results indicate internalized stigma and psychological flexibility are related to help-seeking attitudes and suggest increasing anxious individuals’ psychological flexibility may be one path by which help-seeking attitudes and, in turn, help-seeking behavior, may be enhanced. Future directions and limitations of the present research will be discussed.

Preliminary results from an Acceptance and Commitment Therapy and Motivational Interviewing intervention for new mothers of infants exposed to perinatal substance use

Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use Disorder
Angela Stotts, Ph.D., McGovern Medical School at UTHealth
Yolanda Villarrreal, Ph.D., McGovern Medical School at UTHealth
Thomas Northrup, Ph.D., McGovern Medical School at UTHealth
Mackenzie Spellman, M.S., McGovern Medical School at UTHealth
Michelle Klawans, MPH, McGovern Medical School at UTHealth

Background: Infants exposed to perinatal substance use often require NICU hospitalization. Mothers of NICU infants are motivated to engage in health-seeking behaviors; however, postpartum interventions designed for this population to prevent future substance-exposed pregnancies have not been tested.

Method: A randomized, controlled, pilot trial tested the efficacy of a newly developed, adaptive, brief, hospital-delivered intervention comprising a novel combination of evidence-based treatments (motivational interviewing [MI] and acceptance and commitment therapy [ACT]) targeting substance use treatment and contraception initiation. NICU mothers who reported or tested positive for any illicit substance at their infants’ birth (N = 64) were randomized to either: MI-ACT or Conventional Care. MI-ACT treatment intensity (1, 2, or 3 sessions) varied based upon participant response (i.e., treatment/contraception initiation), per the adaptive intervention strategy.

Results: Results indicated that during the 8-week treatment window, MI-ACT participants reported initiating in-person treatment intake assessments more often than mothers in conventional care (19.4% vs. 9.1%), although the analysis failed to reach statistical significance (X2 = 1.4, p=0.24). However, mothers who received MI-ACT were significantly more likely to receive contraception during an OB/GYN postpartum visit (41.9% vs. 9.1% [X2=9.2, p<0.01]). A majority of MI-ACT participants (58.3%) chose longer-acting (3 years) Progesterone implants (e.g., Nexplanon); whereas a majority of conventional care participants chose shorter-acting (3 months) Depo Provera injections (66.7%).

Discussion: Effective, brief, hospital-based interventions targeting mothers of substance-exposed infants at high medical risk could result in substantial decreases in adverse health and social effects, and the large associated costs.

Present moment and Self-as-context (Awareness) Exercises and Metaphors: A Review of ACT English Language Books

Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, Present moment, Self-as-context, Awareness, Exercises, Metaphors
Emanuele Rossi, Scuola di Psicoterapia Cognitiva, APC-SPC, Italy; AISCC
Paola Lioce, Psy.D., Scuola di Psicoterapia Cognitiva S.r.l.
Elena Martorella, Scuola di Psicoterapia Cognitiva S.r.l.
Sara Di Biase, Psy.D., Scuola di Psicoterapia Cognitiva S.r.l.
Francesco Mancini, M.D., Scuola di Psicoterapia Cognitiva S.r.l.; Università degli Studi Guglielmo Marconi

Background: This study is designed to offer a global overview of present moment and self-as-context processes on ACT books (1999-2018) with the aim of outlining a comprehensible and easy-to-use profile of the use of present moment and self-as-context metaphors, exercises and worksheets within them. Present moment and self-as-context processes form one of the three pillars of psychological flexibility: awareness.

Method: 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 two easy-to-read summary tables which furnish a basic overview of present moment and self-as-context metaphors, exercises and worksheets.

Results: This review was carried out with the purpose of providing a universally user-friendly, clear and intuitive cataloging tool of practical and experiential resources for ACT learners and practitioners. The summary tables briefly describe the way every metaphor, exercise or worksheet is presented and a reference to external resources as well.

Discussion: This poster related to present moment and self-as-context is part of a broader pilot project which also entailed other processes of psychological flexibility and that could be updated in the future.

Profiles of psychological flexibility: A conceptual replication of Tyndall et al. (2018)

Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological Flexibility
Taiki Shima, Doshisha University

Background: This study performed a conceptual replication of Tyndall et al. (2018), investigating profiles of psychological flexibility (PF) using latent class analysis (LCA). This investigation was conducted in Japan, where the culture is different from the original study.

Method: Participants The sample (N = 673, 347 women; mean age 43.42 ± 9.96) was recruited using an online survey. Measures Following Tyndall et al. (2018), the instruments AAQ-II (testing PF), CFQ (testing cognitive fusion), BEAQ (testing experiential avoidance), PANAS (testing positive and negative affectivity), and DASS (testing psychological distress) were employed. The Values Clarification Questionnaire (testing commitment; published in Japan), the Three Senses of Selves Questionnaire (testing perspective taking; published in Japan), MAAS (testing mindfulness), VQ (testing values), and the Satisfaction with Life Scale (testing life satisfaction) were also used. Analysis Following Tyndall et al. (2018), LCA was performed. Once the best LCA solution was determined, psychological and sociodemographic variables were compared among the identified profiles.

Results: LCA indicated a four-class solution, which determined high, moderate 1 and 2, and low PF, while, a three-class solution of high, moderate, and low PF was found in the previous study. ANOVA and a chi-square test revealed that high QOL appeared in the high-PF class, and low QOL was found in the low-PF class, which is consistent with previous research. However, more unpartnered individuals were found in the low-PF class, unlike the findings of Tyndall et al. (2018).

Discussion: The previous and current research showed a similar profile but with cultural differences.

Psychological Control and Child Routines as Mediators of Negative Parenting Practices and Child Externalizing Behaviors

Primary Topic: Clinical Interventions and Interests
Subtopic: Children
Lauren Short, University of Southern Mississippi
Kristy Larsen, M.A., University of Southern Mississippi
Kristen Coln, Ph.D., University of Southern Mississippi
Sara Jordan, Ph.D., University of Southern Mississippi

Background: Harsh/inconsistent discipline and poor supervision (i.e., facets of negative parenting practices [NPP]) are linked with child externalizing behaviors. Moreover, research shows that daily child routines partially mediate the relation between NPP and externalizing behaviors. Psychological control (i.e., parents manipulating their child’s behaviors by invalidating the child’s feelings) is another facet of negative parenting linked with child disruptive behaviors. Yet, no past studies have explored psychological control and child routines simultaneously; therefore, the current study examined psychological control and routines as serial mediators linking NPP to child externalizing behaviors.

Method: Mothers (N=111) of children between the ages of 6-12 completed questionnaires assessing parenting practices, psychological control, child routines, and child externalizing behaviors. A serial mediation analysis was conducted (PROCESS, model 6).

Results: Each specific indirect effect was significant (i.e., NPP on externalizing behaviors through psychological control [independent of routines], and NPP on externalizing behaviors through routines [independent of psychological control]). However, the indirect effect of NPP on externalizing behaviors through first psychological control and then routines was not significant. The total effect of NPP on externalizing behaviors was significant, and the direct effect was not significant when both mediators were taken into account.

Discussion: Results suggest that parents with more negative parenting practices display more psychological control and less frequent routines, which separately relate to more child externalizing behaviors. Clinically, this suggests that establishing consistent child routines and training parents to flexibly respond to their child’s emotions may be important components of interventions for parents of children with disruptive behaviors.

Psychological Flexibility and Wellbeing Among Police Officers: The Mediating Role of Burnout

Primary Topic: Organizational behavior management
Subtopic: Psychological Flexibility, Police Officers, Burnout, Mental Wellbeing
Mahsa Mojallal, M.A., University of South Dakota
Lucas Baker, B.S., University of South Dakota
Randal Quevillon, Ph.D., University of South Dakota
Mason Hatwan, B.A., University of South Dakota

Background: Policing is an inherently stressful occupation, which exposes officers to variety of traumatic events (Chopko, 2010). This unique level of work-related stress exposes officers to heightened risk of burnout comparing to other professions (Dowler, 2005), and negatively impact their well-being (Machell et al., 2015). Due to the sensitive nature of policing, officers’ psychological well-being has grave implications for law enforcement and society (El Sayed et al., 2019;); thus, understanding the factors contributing to officers’ burnout and well-being is of high importance. Research suggest lack of psychological flexibility can increase the risk of burnout in occupations such as social working (Vilardaga et al., 2011). However, no study has investigated the role of psychological flexibility in police population. Present study aimed to investigate the relation of psychological flexibility and well-being through the mediating role of burnout after controlling for age and service years.

Method: Sample consisted of 181 officers (age range 21–64; 84% Male; 94% White) from eight departments in Midwest, West-coast, and East-coast of the U.S., who completed online cross-sectional surveys.

Results: Results suggest lack of psychological flexibility is positively related to burnout (a = 0.04, p < .01), which, in turn, is inversely related to well-being (b = -2.88, p > .0001) after controlling for age and service years. Bootstrapped 95% CIs (10000 samples) indicate burnout mediated the relation of psychological flexibility and well-being, ab = -0.11, 95% CIs [-0.23, -0.002].

Discussion: In conclusion, lack of psychological flexibility can expose officers in heightened risk of burnout, which can negatively impact their well-being.

Psychological Flexibility in Participants in an ACT for Substance Abuse Recovery Group

Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use Disorder, Acceptance and Commitment Therapy
Amy House, Ph.D., Augusta University
Julie Matsen, Ph.D., Medical College of Georgia at Augusta University
James Griffin, Ph.D., Chase Brexton Health Care

Background: Psychological flexibility processes are thought to moderate clinically relevant changes in psychotherapy. ACT interventions have been shown to increase psychological flexibility (Ciarocchi, Bilich, & Godsel, 2010) and changes in psychological flexibility are related to substance abuse treatment outcomes (Luoma et al., 2008). The purpose of this study was to understand how psychological flexibility, self-compassion, and substance use behavior are related and change over time among participants in an Acceptance and Commitment Therapy (ACT) group for clients with substance use disorders.

Method: Individuals with substance use disorders participated in a 12-week group, "ACT for Recovery." This intervention consists of three 4-week modules (Open Up, Be Present, Take Action). Data was collected at baseline, and at the end of every module. Measures included the Acceptance and Action Questionnaire – Substance Abuse, Self-Compassion Scale-Short Form, and the Brief Addiction Monitor.

Results: Preliminary results from the first 8 participants indicate that, at baseline, substance use related psychological flexibility is correlated with self-compassion. In addition, substance use related psychological flexibility tends to improve over the course of the group. Visual inspection of data plots for each participant indicate that participants whose AAQ-SA scores improve are also more likely to report maintaining abstinence over time.

Discussion: These preliminary results provide support for continuing to explore psychological flexibility processes in an ACT group for individuals with substance use disorders. Future analyses will explore mediators of change over time.

Psychometric Properties of the Greek version of the Valued Living Questionnaire (VLQ-G)

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

Background: The Valued Living Questionnaire (VLQ) is a 20-item measure of one of the components encompassed in the psychological flexibility model. Values give meaning to our everyday lives and we set goals based on these. The study aims to validate this instrument in Greek and evaluate its psychometric properties and factor structure.

Method: The total sample consisted of 214 (Mage = 54.37, 80.3% female) Greek-speaking chronic pain patients. Reliability-related analyses were conducted, including item correlation and corrected item-total correlation analyses followed by Exploratory Factor Analysis. Confirmatory Factor Analysis was then conducted to confirm the factorial latent structure. Criterion and construct validity were investigated by calculating Pearson correlation coefficients. Finally, the VLQ was compared to the Valuing Questionnaire (VQ).

Results: The internal consistency reliability of the scale was considered good, Cronbach’s alpha=.88. Principal Axis Factoring conducted on the 20 items with oblique rotation suggested 1 factor explaining 34.8% of the variance. Scree plot and Parallel Analysis favoured a one-factor solution. This finding is similar to the original study where a one-factor scale was also presented.

Discussion: The validity of the Greek VLQ, and its correspondence to the original version will be examined. Clinical implications of the differences between VLQ and VQ will be discussed.

Reaching Across the Aisle: Tackling Real World Problems with Interdisciplinary Collaboration

Primary Topic: Educational settings
Subtopic: Trauma, Clinical Behavior Analysis
Darren Aitchison, M.Ed., BCBA, National Louis University

Background: This study was conducted to see if using the ACT model to teach children psychological flexibility would lead to greater participation in, as well as more efficient, Restorative Justice victim-offender mediations.

Method: We used ACT as outlined in Hayes, 2019, and Harris. 2008. We used single-subject designs: a range-bound changing criterion design for the Restorative Justice mediations and ABAB reversal designs for the ACT sessions.

Results: The results were a demonstration of experimental control for the ACT sessions, and a functional relationship for the mediation sessions. This was true for both participants. Interobserver agreement was within established parameters.

Discussion: This data is very promising, but the sample size is small. There is much more work to be done. One interesting paradigm is how these factors come to bear and in what temporal sequence. We assert that teaching these children psychological flexibility led to positive outcomes of their mediations, but the reciprocal could also be true. Teaching conflict resolution skills in mediation might cause a child to be more psychologically flexible.

Research Mentorship and Publishing Bias in the ACBS Community

Primary Topic: Supervision, Training and Dissemination
Subtopic: Bias, Research Mentors, Publishing, JCBS
Amanda Rhodes, Psy.D., National Institutes of Health/ National Cancer Institute
Emily Sandoz, Ph.D., University of Louisiana at Lafayette
Staci Martin, Ph.D., National Cancer Institute

Background: Minimizing gender and ethnic disparities in academic publishing has become a goal in research communities in recent years. While some claim that the gap is closing, researchers still notice inequity in research and related activities. This study examines the presence of gender and ethnic patterns in publishing within the ACBS community and investigates patterns in research mentorship related to publishing barriers.

Method: Adults (N=282) were recruited from the ACT for Professionals Listserv of ACBS to participate in an anonymous survey about research mentorship, publishing, and perceptions of bias. Chi-square tests were conducted in SPSS to determine frequency relationships among nominal and ordinal data.

Results: Men reported publishing significantly more than women, while women more frequently reported experiencing publishing barriers related to lack of adequate research mentorship and collaboration (ps<.05). Regardless of gender, respondents reported the top barriers to publishing as lack of time (41.5%), lack of institutional support (29.4%), and lack of funding (18.9%). Having the same gender as one’s primary research mentor did not relate to any areas of training (e.g., grant preparation, study design, statistical analysis, career advice, encouragement, goal-setting, and work/life balance). Interestingly, being the same ethnicity as one’s mentor related to lack of training in running a study and receiving less positive feedback compared to those with non-matched ethnicity (ps<.05). Finally, having matched gender or ethnicity with one’s mentor did not relate to publishing variables.

Discussion: Barriers to publishing are both gender-related and non gender-related, while some mentorship factors relate to ethnicity variables.

Social anxiety and depressive symptoms: An examination of the moderating role of cognitive fusion

Primary Topic: Clinical Interventions and Interests
Subtopic: social anxiety, depression, fusion
Sierra Held, Metropolitan State University of Denver
Liddy Tryon, Metropolitan State University of Denver
Janna Burnam, Metropolitan State University of Denver
Elizabeth Malagisi, Metropolitan State University of Denver
Maureen Flynn, Metropolitan State University of Denver

Background: Social anxiety is positively associated with depressive symptoms (Carnes & Winer, 2017; Dell’Osso et al., 2014; Flynn, Bordieri, & Berkout, 2019; Ledley et al., 2005). The relationship between social anxiety and depressive symptoms may be due to behavioral avoidance of situations that promote distress, which can lead to isolation and loneliness, thereby exacerbating both anxious and depressive symptoms (Moitra, Herbert & Forman, 2008). Not everyone with social anxiety experiences depressive symptoms, so moderators must be involved. One such moderator may be cognitive fusion. The current study examined whether cognitive fusion moderates the relationship between social anxiety and depressive symptoms in a sample of undergraduate college students.

Method: Approximately 961 participants completed self-report questionnaires measuring cognitive fusion, fears of being scrutinized, social interaction anxiety, and depressive symptoms in an online format.

Results: Results showed that cognitive fusion was positively correlated with social anxiety and depressive symptoms. Furthermore, cognitive fusion moderated the relationship between fears of being scrutinized and depressive symptoms, such that the relationship strengthened with increasing cognitive fusion. Lastly, cognitive fusion moderated the relationship between social interaction anxiety and depressive symptoms, such that the relationship strengthened with increasing cognitive fusion.

Discussion: Future studies could examine the efficacy and effectiveness of interventions that target cognitive fusion on social anxiety and depressive symptoms.

Stoking the Flames for Stress-Is-Enhancing Mindset Interventions within the Military

ACT for Military SIG Sponsored
Primary Topic: Behavioral medicine
Subtopic: Cardiac and Pulmonary Rehabilitation
John Blue Star, Ph.D., United States Air Force
Robert Vanecek, Ph.D., Clinical Psychology; Board Certified in Behavioral and Cognitive Psychology and Clinical Psychology, United States Air Force
Megan Gaschk, Ph.D., Clinical Psychology, United States Air Force
Megan Davis, Ph.D., Clinical Psychology, United States Air Force

Background: Messages about the negative impacts of stress are pervasive in Western military culture and health systems. Evidence suggests that stressors are more deleterious to physical and psychological health when individuals view stress as debilitating and harmful. Conversely, a Stress-Is-Enhancing (SIE) Mindset obtained by past experience or intervention promotes adaptive cardiovascular and hormonal responses, better occupational performance under pressure, and decreased struggle with anxiety and mood.

Method: We developed SIE presentations to address burnout among medics and a distinct module for cardiopulmonary rehabilitation patients. Images intended to resonate with military personnel were included in videos summarizing the positive impacts of stress (shared by QR code). A one hour module was also crafted for a cardiopulmonary rehabilitation class and initial anonymous surveys were collected to evaluate patient opinion of novel SIE information (n = 7) on a 5-pt Likert scale.

Results: Post intervention feedback from cardiopulmonary class attendees indicated overall positive experience. All participants agreed or strongly agreed that content was understandable, 6/7 patients strongly agreed the class was satisfying and relevant to their condition and all patients agreed or strongly agreed they would recommend the class to others.

Discussion: Developing SIE interventions tailored to the military may aid in combating a number of stress-based concerns common to service members and their families. Next steps will include more robust testing of developed interventions measuring change in domains of stress, emotional, and physical functioning, stress mindset, and psychological flexibility.

STUCK on Medicine: ACT Matrix Intervention for Medical Inpatients Awaiting Psychiatric Admission

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: ACT in Consultation Liaison Psychiatry
Thatcher Coleman, MS candidate, UNC Clinical Rehabilitation and Mental Health Counseling
Nikki Steinsiek, MD, MPH, University of North Carolina Hospitals
Typ Whinnery, M.D., University of North Carolina Hospitals
Brandon Goodman, M.D., UNC Hospitals
Jonny Gerkin, M.D., University of North Carolina School of Medicine

Background: Consultation-Liaison (CL) psychiatry services require providers to operate in a variety of time-limited pharmacological and therapeutic capacities for individuals with comorbid medical and psychiatric illnesses [1]. As a result, the utilization of evidenced based, brief, transdiagnostic psychotherapeutic interventions is needed in this setting. Research of ACT-based interventions within the inpatient CL psychiatry setting is sparse. ACT Matrix Cards could function as a feasible psychotherapeutic intervention focused on facilitating rapid growth in psychological flexibility and value-oriented engagement [2, 3].

Method: Multiple levels of consulting providers (counseling trainee, resident psychiatrist, attending psychiatrist) integrated ACT Matrix into standard care after an initial inpatient psychiatric consultation evaluation in the following scenarios: medical readmission due to psychiatric comorbidities, self-injurious behavior, suicidal ideation, and lack of access to psychiatric hospitalization. Psychological flexibility, including improvement in present-moment awareness, acceptance of circumstances, identification of values, and engagement in committed action, was assessed by authors during admission and at time of discharge through chart review.

Results: ACT Matrix Cards were reviewed with patients in ten to thirty minute sessions on multiple days per week. Duration ranged from one to three weeks. Each patient engaged in brief ACT intervention via Matrix Cards, promoting psychological flexibility in varied ways between individuals.

Discussion: Brief ACT-based interventions such as Matrix Cards can serve as a trans-diagnostic approach to treatment that is feasible for implementation within CL psychiatry [4]. Psychological flexibility can serve as a driving mechanism to facilitate adaptive, value-oriented change among patients with comorbid psychiatric and medical conditions [2].

The effect of one-word repetition and compound word repetition on negative thoughts related to the self: A preliminary study

Primary Topic: Clinical Interventions and Interests
Subtopic: Defusion, self-related negative thoughts
Natsumi Tsuda, M.A., Clinical Psychologist, Doshisha University
Takashi Muto, Doshisha University

Background: The purpose of this study was to examine the effectiveness of word repetition (WR) to reduce negativity and believability using compound words (CW). Most WR exercises use simple words (e. g., stupid). However, there are some words that combine two words (CW, e.g., communication disorder), and the effect of WR using CW has not been studied yet.

Method: Participants were undergraduate students (N=34). Participants chose their own negative words and took part in the 10 minutes intervention. The design was 2times (Pre, Post)×4groups. The groups were 1) control1 : only repeating “o-cha (tea in Japanese, 20sec)”; 2) control2 : repeating o-cha and negative simple word (30sec); 3) CW30sec : repeating o-cha and negative CW (30sec); and 4) CW60sec : repeating o-cha and negative CW (60sec). Outcomes were negativity and believability for their own negative words (VAS, 0-100).

Results: Negativity…The analysis showed a main effect for time and interaction between time and group (time: F (1, 30) = 64.99, p<.01; time×groups: F (3, 30) = 3.46, p<.05). Multiple comparisons revealed a significant reduction in negativity of control2, CW30sec, and CW60sec groups compared with control1 group at post-treatment. Believability…The analysis showed only a main effect for time (time: F (1, 30) = 37.85, p<.01).

Discussion: The results indicated that WR reduces negativity toward negative words regardless of word type. However, the effectiveness for believability was not enough. It is possible that this was caused by the limited number of participants, but there is also the possibility that believability is difficult to change only using WR.

The effectiveness of Acceptance and Commitment Therapy on depression, anxiety and acceptance among advanced cancer patients: a systematic review and meta-analysis

Primary Topic: Clinical Interventions and Interests
Subtopic: advanced cancer; depression; anxiety; acceptance; systematic review; meta-analysis
Huiyuan Li, Master of Nursing, RN, The Nethesole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Che Lee Wong, Ph.D, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Xiaohuan Jin, Ph.D student, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Jieling Chen, Ph.D, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Yang Bai, Ph.D, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong

Background: Advanced cancer is an incurable and life-threatening disease that places a heavy burden on patients’ psychological well-being. This study systematically summarized the current studies and aimed to explore the immediate effect of Acceptance and Commitment Therapy (ACT).

Method: Nine electronic databases were searched by key words. Two independent reviewers assessed the quality of eligible studies by The Joanna Briggs Institute critical appraisal checklist. Meta-analysis was conducted when at least three studies reported the same outcome, with subgroup analysis for modality of ACT and presence of dyadic involvement, otherwise, narrative synthesis was used. Sensitivity analysis was performed to test the influence of study quality and control type.

Results: Six studies involved 261 participants were identified. The results found face-to-face individual ACT significantly improved depression (face-to-face: standard mean difference, SMD: −0.79; 95% confidence interval, 95%CI: −1.32 to −0.27; p = 0.003; I2 = 15%; individual: SMD: 0.58; 95%CI: −1.08 to −0.08; p = 0.02; I2 = 43%) post-intervention. However, a favourable but non-significant effect by face-to-face individual ACT on decreasing anxiety post-intervention was found (SMD: −0.27; 95%CI: −0.87 to 0.33; p = 0.38; I2 = 38%). Non-significant change in acceptance was found (SMD: 2.29; 95%CI: -0.65 to 5.22; p =0.13) with high heterogeneity. Sensitivity analysis revealed that type of control group influenced the outcomes.

Discussion: In conclusion, ACT can be beneficial for patients with advanced cancer to promote psychological well-being. These findings suggest implications for intervention options on modes for advanced cancer patients.

The Effects of Mindfulness on Perceived Stress and Meaning in Life

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Shilpa Hampole, San Jose State University
Jennifer Gregg, Ph.D, San Jose State University

Background: Researchers have suggested that mindfulness buffers the effects of stress on reduced life satisfaction (Bergin & Pakenhma, 2016) and moderates the relationship between stress and subjective well-being (Lu et al., 2019). Meaning in life has also been correlated with well-being (Chu & Mak, 2020), but the mechanism linking stress to meaning in life remains unclear. This study analyzed the moderating effects of mindfulness on the relationship between perceived stress and meaning in life.

Method: In the present study (N = 101), a hierarchical multiple regression analysis was conducted with presence of meaning in life (MLQ; Steger et al., 2006) entered as the criterion variable. Demographic variables (age and sex) were entered first as controls, perceived stress (PSS; Cohen, 1994), a known predictor was entered second, mindfulness (FFMQ; Baer et al., 2006) was entered third to assess its unique variance after stress is accounted for, and the two-way interaction between perceived stress and mindfulness was entered fourth to test for moderation effects.

Results: Perceived stress was significantly negatively related to meaning in life. Once perceived stress was taken into account, mindfulness accounted for a significant amount of remaining variance. However, there was no significant effect from the perceived stress and meaning in life interaction.

Discussion: Higher levels of mindfulness may improve people’s ability to have meaning in life while coping with stress but the moderating role of mindfulness may not be as strong as proposed in previous studies. Implications and guidance for future studies will be discussed.

The Interconnected Node of Wellness: A Network Approach to Understand Police Officer Well-being

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Well-being
Lucas Baker, University of South Dakota
Rachel Bock, B.S., University of South Dakota
Emily Kalantar, University of South Dakota
Jennifer Kuo, M.A., University of South Dakota
Christopher Berghoff, Ph.D., University of South Dakota

Background: Approximately 808,700 sworn police officers work in the United States, functioning as gatekeepers to the legal system. Research has established associations of police work-related stressors (e.g., traumatic events, department pressure, etc.) and physical and psychological concerns (Violanti et al., 2017). Indeed, police officers experience one of the highest rates of injury and illness among all professionals (U.S. Department of Labor, 2019) and on the job stressors appear to have a negative impact on officer well-being (Juniper et al., 2010; Wolter et al., 2019). These outcomes have a negative impact on society broadly, in that low well-being is associated with improper policing behavior (e.g., inappropriate use of force, high cynicism, poor decision-making) relative to officers who report high well-being (Harman et al., 2019; Rajaratnam et al., 2011; Trinkner et al., 2016).

Method: Thus, the present study aimed to clarify wellness-related factors associated with high well-being among a sample of police officers (N=459; Mage=41.98, 84% Male, 64% White) recruited from three geographically representative law enforcement agencies. Network analysis using Markov Random Fields from nodes representing physical, psychological, and environmental factors was conducted.

Results: Bootstrapped modeling indicated a stable network wherein well-being was the most highly connected and well explained (R2=.51) node, demonstrating unique bi-directional associations with psychological flexibility, sleep, social support, and depression (|r| = .18–.24). Weaker associations with well-being were identified for occupational burnout, anxiety, posttraumatic stress symptoms, and chronic pain (|r| = .01–.12).

Discussion: Equifinality of well-being and implications for the development of programs that enhance officer well-being will be discussed.

The moderating effects of Fear of Intimacy on Loneliness and Grief

Primary Topic: Clinical Interventions and Interests
Subtopic: Functional Analytic Psychotherapy
Abby LeMaster, Morehead State University
Daniel Maitland, Ph.D., Morehead State University

Background: Loneliness is a meaningful predictor of detrimental physical and mental health status. Past research has indicated that the death of a loved one frequently results in loneliness. It is possible that an unwillingness to share after the death of a loved one helps us understand the relationship between loneliness and grief vis-à-vis the interpersonal model of intimacy, a key target in FAP.

Method: 90 participants from a medium-sized Hispanic Serving Institution completed a cross-sectional survey administered online. The student’s average GPA was 3.21 (SD = .44). Participants were 22.61 (SD = 5.99) years old on average. 76.7% of the participants were under the age of 22. 85.6% of the sample identified as female. 60% of participants self-identified as Latinx, while in the domain of race 71.1% identified as white, 20.0% multiracial, 5.6% black, 1.1% American Indialaskan Native.

Results: Analyses suggested that the relationship between loneliness and grief is moderated by a willingness to share experiences. Visualization through the marginal effects plot suggests that the magnitude of the moderating effects of fear of self-disclosure change as a function of scores with higher scores indicating a stronger moderating effect.

Discussion: These findings suggest that individuals with high levels of fear of intimacy may be particularly vulnerable to loneliness, whereas at low levels other factors may account for more variance. These findings may have implications for individuals seeking psychotherapeutic treatment for coping with grief and may indicate FAP as an intervention.

The moderating role of fear of intimacy in the relationship between sexual compulsivity and sexual satisfaction

Primary Topic: Clinical Interventions and Interests
Subtopic: Functional Analytic Psychotherapy
Kayla Daulton, Morehead State University
Daniel Maitland, Ph.D., Morehead State University

Background: Sexual compulsivity is a behavior that can significantly impact individual’s quality of life. Not all individuals who engage in compulsive sexual behavior are unsatisfied with their sex lives, but many are. Past research has indicated that fear of intimacy frequently impacts sexual satisfaction. Fear of intimacy is an intuitive and regularly utilized target of Functional Analytic Psychotherapy suggesting a potentially effective intervention if there’s a meaningful relationship between sexual compulsivity and sexual satisfaction.

Method: Using an online cross-sectional survey, participants (n=253) completed questionnaires relating to sexual compulsivity, sexual satisfaction, and fear of intimacy. The sample collected from a mid-sized Hispanic Serving Institute in the southern United States was made up of participants ranging from 18 years old to 52 (M = 22.63, SD = 5.86). The majority of participants identified as Women (N = 214), Latinx (N =143), and White (N = 177). Data analysis was conducted using the PROCESS Maro (Hayes, 2017) in SPSS.

Results: Results supported our hypothesis that fear of intimacy moderates the relationship between sexual compulsivity and sexual satisfaction. The magnitude of moderation differed as a function of level of fear of intimacy.

Discussion: These findings may help clinicians better understand the function of sexual compulsivity and develop interventions when sexual compulsivity becomes problematic and affects client wellbeing. In particular, these findings may have particular relevance to guide the effectiveness of interventions targetting fear of intimacy such as Functional Analytic Psychotherapy.

The predictive power of self-compassion, mindfulness and stress on quality of life in undergraduates

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, Self Compassion
Paul Guay, B.A., University at Albany, State University of New York
Eric Tifft, MA, University at Albany, State University of New York
Max Roberts, MA, University at Albany, State University of New York
Shannon Underwood, BS, University at Albany, State University of New York
John Forsyth, PhD, University at Albany, State University of New York

Background: Mindfulness, an attentional practice involving a conscious attempt to perceive the present moment openly and without judgment, predicts quality of life (QOL; Grossman et al., 2003) However, the processes underlying mindfulness which effect change in QOL remain unclear. Stress can be a robust factor regarding the health and wellbeing of college students (Roberti et al., 2006). It has been proposed that mindfulness may affect QOL by facilitating a change in the perception rather than the degree of stress (Valikhani et al., 2020). One psychological process that may be important to consider is self-compassion, as it has been shown to be a strong predictor of QOL in help-seeking adults (Van Dam et al., 2011). The present study aimed to examine the predictive utility of mindfulness, self-compassion, and stress in relation to QOL in undergraduates

Method: Undergraduates completed a battery of assessments including measures of perceived stress, quality of life (QOLI), self-compassion (SCS), and mindfulness (FMI).

Results: As expected, univariate linear regression analyses show that mindfulness and perceived stress predicted the QOL (R2 = .190, F(1, 543) = 38.2, p<.001). Self-compassion was found to predict variance in QOL above and beyond perceived stress and mindfulness (R2 = .043, F(1, 554) = 127.3, p<.001).

Discussion: These findings suggest that among university students, self-compassion may be an important target of intervention for students reporting low QOL.

The Questionnaire on Self-Transcendence: A New, Validated Measure of Self-Transcendence Informed by Relational Frame Theory

Primary Topic: Other
Subtopic: Questionnaire development
Joel Fishbein, M.A., University of Colorado Boulder
Ruth Baer, University of Oxford
Joshua Correll, University of Colorado Boulder
Joanna Arch, University of Colorado Boulder

Background: RFT provides a framework for how we may overcome rigid boundaries in perspective-taking and experience ‘self-transcendence.’ We propose an RFT-informed model of self-transcendence consisting of three processes: distancing from mental content ('distancing'); distinguishing an observer separate from the content of experience ('observing self'); and sensing connection with the observer-self of other beings ('inter-transcendence'). Though used in ACT, these processes have not been comprehensively measured. We will describe our analytic strategy and findings in testing the RFT-informed model and developing a novel questionnaire over four studies (total N = 1,706).

Method: [See Results section for combined Method and Results across 4 studies]

Results: We compiled items from related questionnaires and novel items refined with ACT/RFT expert feedback (Study 1) to test our model. Exploratory factor analyses (Study 2) and exploratory structural equation modeling (Study 3) of item responses from undergraduates, community adults, and meditators supported the model and identified items for the questionnaire. Subscales evidenced convergent validity with related constructs and incremental validity in predicting psychological well-being over-and-above decentering and defusion (Study 4).

Discussion: These findings support an RFT-derived model of self-transcendence and introduce a comprehensive scale, the Questionnaire on Self-transcendence (QUEST), to measure it. Further research is needed to validate the QUEST in additional populations, and to examine its sensitivity to change in experiments and interventions designed to promote self-transcendence. The QUEST is available for use in research programs wherein measurement of self-transcendence processes is warranted.

The role of ACT in improving the quality of life in an adult with Adverse Childhood Experiences

Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD, ACE, ANXIETY, DEPRESSION, CHILDHOOD TRAUMA, INDIA
Gita Srikanth, BCBA, ACBS
Swati Narayan, BCBA, ACBS

Background: The participant was a 28 year old Indian woman with a history of adverse childhood experiences in the form of emotional abuse and neglect, physical abuse and rejection from the mother. She presented with a history of feeding disorders, extreme social anxiety, generalized anxiety, guilt, self-blame, suicidal thoughts and chronic pain. She had previously seen a counsellor and a psychiatrist before approaching the ACT model.

Method: The participant attended weekly sessions with the therapist who used the ACT Hexaflex and the choice point to help her accept and navigate the impact of Adverse Childhood Experience (ACE) on her emotional and physical health. Assessment measures -B-SA-AAQ, ACE-IQ, MPFI and the Childhood trauma questionnaire were administered before and at the end of 15 weeks of intervention.

Results: The participant expressed a healthy concept of self, constructing values and taking actions that were more in tune with her values. She developed psychological flexibility that enabled her to accept her past experiences while leading a meaningful life, there was also a significant reduction in the test scores at the end of the 15 week period. Additionally, she developed a positive relationship with food and people.

Discussion: The link between ACE and poor physical and mental health outcomes in adulthood is well known, culturally Indian women are not encouraged to speak about their mental health, their physical needs and seek help for them. This study demonstrated the benefits and the effectiveness of ACT as a treatment protocol to improve the quality of life for the young woman.

The role of fear of intimacy in negative world views following traumatic experiences

Primary Topic: Clinical Interventions and Interests
Subtopic: Functional Analytic Psychotherapy
Emma Gundler, Morehead State University
Daniel Maitland, Ph.D., Morehead State University

Background: PTSD is characterized by intense avoidance of stimuli associated with a traumatic experience. Frequently that avoidance results in a diminished level of intimacy with individuals in one’s social network and a pessimistic world view. The current study seeks to elucidate a pathway linking traumatic experiences to pessimistic world views through a pathway including PTSD symptoms and fear of intimacy, a common target in Functional Analytic Psychotherapy.

Method: In this study, an online cross-sectional survey was administered to college students at a mid-sized Hispanic Serving Institute. The questionnaires in the survey assessed exposure to trauma, trauma symptoms, and social functioning. 264 students completed the survey. Participants were 21.47 (SD = 5.46) years old on average. 54 of the 264 were male, the remaining 210 were female. The sample was 71.2% white and 62.1% Latinx. 155 of the participants in the sample reported that they had been exposed to trauma as indexed by criteria A of PTSD. Data analysis was conducted using the SPSS Process Macro (Hayes, 2017) model number 6.

Results: The results suggest serial indirect effects of trauma symptoms and fear of intimacy on the relationship between experiencing trauma and viewing the world as hostile or having negative views of the self as a result of trauma.

Discussion: Understanding how these two factors can influence maladjustment may help to better understand PTSD and influence our understanding of best practice in treating trauma, especially in Functional Analytic Psychotherapy.

The role of psychological flexibility variables in shape and weight concerns

Primary Topic: Behavioral medicine
Subtopic: Eating disorders
Aniko Viktoria Varga, M.A., Bowling Green State University
Elizabeth Emley, M.A., Bowling Green State University
LaNaya Anderson, M.A., Bowling Green State University
Abby Braden, Ph.D., Bowling Green State University

Background: Shape and weight concerns are important etiological factors in emotional eating and eating disorders. Some approaches posit that the problem with such cognitions lies in efforts to control them. The current study examines whether psychological flexibility processes are correlates of shape and weight concerns in people who engage in emotional eating.

Method: The sample consisted of adults (Mage = 47.86) with overweight/obesity (n=64) who self-identified as emotional eaters. Participants were recruited to participate in a weight loss program that included emotion regulation skills. Baseline data from self-report questionnaires were used (i.e., Five Facet Mindfulness Questionnaire; Cognitive Fusion Questionnaire; Difficulties in Emotion Regulation scale–Nonacceptance subscale; Eating Disorder Examination Questionnaire–Shape and Weight Concerns subscales). Bivariate correlations were calculated between primary study variables. Then, multiple regression analysis was conducted to test the relationship between psychological flexibility variables and shape and weight concerns.

Results: Mindfulness was significantly correlated with cognitive fusion (r = -.63, p < .001) and emotional nonacceptance (r = -.49, p < .001), while cognitive fusion was significantly correlated with emotional nonacceptance (r = .38, p = .002). The Shape and Weight subscales were combined due to their high correlation (r = .86, p < .001). Multiple regression revealed that mindfulness, defusion, and acceptance predicted 18% of the variance in body concerns (i.e. Shape and Weight concerns) (R2 = .183, F = 4.49, p < .01). None of the predictors were significant individually.

Discussion: Psychological flexibility processes are important, interrelated factors in shape and weight concerns in individuals with emotional eating.

Treatment Maintenance and Beyond with Substance Use Disorders: A Sleeper Effect

Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use Disorder
Brian Berman, Psy.D., Retreat Behavioral Health
Kris Kurlancheek, M.A., Retreat Behavioral Health
Tom Longenecker, MDiv, Retreat Behavioral Health
Bill Hartranft, M.A., Retreat Behavioral Health

Background: Approximately 21.5 million people in the U.S. have a substance use disorder (SUD). Only 30%-50% remain abstinent for short periods following treatment (Lee, An, Leven & Twohig, 2015; SAMHSA, 2014). Research suggests that Acceptance and Commitment Therapy (ACT) produces a unique “sleeper effect” contributing to longer-term abstinence beyond established protocols (Lee, et. al, 2015).

Method: This study was part of a larger investigation (N=47) into Choice Point Model ACT for residential SUD treatment. Paired sample t-tests were performed comparing baseline functioning with 3-month follow-up (n = 30) and post-treatment with 3-month follow-up (n = 20). It was hypothesized that improved psychological inflexibility, valued-living, and self-compassion would be maintained at follow-up when compared to pre-treatment. Additional gains were expected when comparing post-treatment to follow-up for each variable.

Results: Therapeutic gains were maintained in psychological inflexibility, t(29) = 10.25, p < .001, valued-living, t(29) = -5.12, p < .001, and self-compassion, t(29) = -6.40, p < .001, when comparing baseline functioning with follow-up. Improved psychological inflexibility and mindfulness (self-compassion subscale) occurred when follow-up was compared to post-treatment, t(19) = 3.29, p = .004, t(19) = -2.25, p = .036, respectively.

Discussion: Participants sustained treatment gains in psychological flexibility, valued-living, and self-compassion at follow-up. Continued improvements in psychological flexibility and mindfulness following treatment indicate that benefits kept increasing. This has important implications as therapeutic rewards typically deteriorate with time. Instead, findings revealed a sleeper effect, suggesting more robust outcomes than traditional approaches. Interventions capable of yielding a sleeper effect may be critical for longer-term SUD abstinence.

 

Understanding Attitudes about Climate Change Threat and Dread through Perspective Taking and Acceptance

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Climate change mitigation
Carter Davis, B.F.A., Utah State University
Jennifer Krafft, M.S., Utah State University
Michael Twohig, Ph.D., Utah State University
Michael Levin, Ph.D., Utah State University

Background: Climate change is posed to cause increasingly catastrophic damage to global ecosystems as well as human societies (Intergovernmental Panel on Climate Change, 2019). Thus, urgent and sustained actions required to mitigate these effects. Psychological processes are influential and manipulable variables, and may have important effects on climate-relevant actions (Gifford, Kormos, and McIntyre, 2011). A better understanding of the relationship between processes that contribute to psychological flexibility and climate change attitudes may therefore help to reveal opportunities for intervening on these processes at both an individual and societal level.

Method: A large undergraduate sample (N= 395) was recruited to complete an online survey consisting of measures of cognitive fusion, awareness and acceptance, valued living, stigma-related psychological flexibility, and general distress. A validated measure (Bostrom et al., 2012) was administered to assess general knowledge and attitudes concerning global climate change, as well as perceived individual responsibility of climate change mitigation.

Results: Correlational analyses will be used to assess potential relationships between psychological flexibility processes and climate change attitudes. Additionally, exploratory mediation analyses will be used as appropriate to determine any possible psychological mediators of attitudes or perceived individual responsibility towards climate change mitigation.

Discussion: Interventions based on contextual behavioral science (CBS), through their targeting of core psychological processes, allow for the possibility of meaningful behavior change at the scale of communities and societies as well as individuals. Thus, a better understanding of the relationship between CBS-relevant processes and attitudes towards climate change may reveal meaningful points of intervention to mitigate an increasingly dire global situation.

Using an ACT-based protocol in a sample of Italian diabetic patients

Primary Topic: Clinical Interventions and Interests
Subtopic: Diabetes, Self-care, Coping Strategies
Sara Di Biase, Associazione Culturale Studi Cognitivi Pandora
Emanuele Rossi, Scuola di Psicoterapia Cognitiva, APC-SPC, Italy; AISCC
Alessandra Benedetti, Psy.D., Villamare-Neomesia, Comunità di Riabilitazione e Cura per Disturbi Alimentari, Lido di Camaiore
Marco Saettoni, M.D., Scuola Psicoterapia Cognitiva APC-SPC, Grosseto, Italy

Background: Diabetes is the most frequent human metabolic disease caused by a low or inappropriate function of insulin. Hyperglycemia is the major sign of diabetes. Diabetes needs a constant self-care in order to lower the risks of health complications: careful monitoring of hyperglycemia, regular pharmacologic therapy and a proper diet. Data from literature show that psycho-education helps to develop healthy behaviors and well-being, however, cannot guarantee a persistent improvement in self-care (Gregg et al., 2007). Studies highlighted the efficacy of ACT (Hayes et al., 1999, 2012) in diabetes increasing psychological flexibility by using acceptance and mindfulness strategies with commitment and coping strategies (Gregg et al., 2007; Massey et al., 2018; Noordali et al., 2017). ACT interventions seem to improve both medical and psychological conditions (Zeinab et al., 2016; Norris et al., 2002).

Method: In this study we used an ACT-based protocol elaborated by Gregg et al. (2007) for diabetic patients, presented in Acceptance and Commitment Therapy for Diabetes Self-Management - Therapist Manual. The protocol provides a 24hrs intervention which comprises both psycho-education and ACT modules. Patients who underwent the ACT protocol showed better coping strategies, diabetes self-care, and hemoglobin glycosylated; this last was mediated by ACT skills.

Results: This study is aimed at testing the ACT approach according to Gregg et al. (2007) in a sample of Italian type 2 diabetic patients. The hypothesis tested is that learning ACT skills mediates the improvement of hemoglobin glycosylated.

Discussion: Data collection is still ongoing. Results and clinical implications will be presented and discussed at the conference.

Using an undergraduate research pool: Feedback from introduction to psychology students

Primary Topic: Educational settings
Subtopic: participants, ethics
Liddy Tryon, Metropolitan State University of Denver
Sierra Held, Metropolitan State University of Denver
Elizabeth Malagisi, Metropolitan State University of Denver
Janna Burnam, Metropolitan State University of Denver
Maureen Flynn, Ph.D., Metropolitan State University of Denver

Background: Psychology departments in the United States commonly have an applied research requirement for students enrolled in their Introduction to Psychology courses. One way students can fulfill this requirement is to participate in research. Ethical considerations have suggested that in the absence of educational benefit, student participation in research should be voluntary (Leentjens & Levenson, 2013). The aim of the current study was to get feedback from students regarding participating in research for their course requirement.

Method: Undergraduates (n = 195) responded to items related their experience participating in research.

Results: Approximately 94.2% of the participants stated research participation opportunities should be offered for Introduction to Psychology students and 65.8% of the participants agreed that their understanding of research increased as a result of participating in studies. Thematic analysis was conducted on an open-ended item that asked students what they learned from participating in research. Multiple themes emerged (e.g., learned about the research process, themselves, and the importance of item wording).

Discussion: Although the majority of students reported educational benefits, findings also suggest that these benefits could be enhanced.

Utilizing Acceptance and Commitment Therapy to Treat Suicidality: Addressing the Needs of Both the Client and the Clinician

Primary Topic: Clinical Interventions and Interests
Subtopic: Suicide
Erin Wolff, Widener University's Institute for Graduate Clinical Psychology

Background: Suicide is the 10th leading cause of death in the U.S. and is responsible for roughly one death every forty seconds worldwide. Despite efforts to destigmatize mental health conversations and treatment in our communities, suicide remains a pervasive problem.

Method: This poster presents a review of the field’s current understanding of how suicidality develops and best practices for treatment and then makes the case for creating an Acceptance and Commitment Therapy-based model for treatment of suicide. This new model addresses both the needs of the suicidal client and those of the treating clinician. The primary goal of this dual-pronged approach is to improve treatment and organizational outcomes (burn out and retention rates).

Results: This will be achieved by increasing the clinician’s self-awareness and confidence in their ability to work with this population.

Discussion: The model includes a breakdown of each component of the hexaflex and how it applies to both the client and the clinician during the course of treatment and ends with suggestions for how healthcare organizations can build these ideas into their recruitment, training, and retention efforts.

Validation of the Tacting of Function (TOF) Scale in healthy older adults

Primary Topic: Other
Subtopic: Behavioral function
Jenna Adamowicz, M.A., University of Iowa
Emily Kroska, University of Iowa
Natalie Denburg, University of Iowa
Anne Roche, University of Iowa

Background: Acceptance and Commitment Therapy (ACT) focuses on the function of behavior in context. The ability to tact, or label, behavioral function (avoidance- or values-based) may facilitate psychological flexibility - the overarching goal of ACT. The Tacting of Function (TOF) Scale (Pierce & Levin, 2019) was developed and validated in a college student population. The current study's purpose is to validate the TOF Scale in a healthy older adult sample.

Method: Eighty community-dwelling older adults (M age = 78, 56.3% female, 97.5% white) completed the TOF Scale, the Comprehensive Assessment of Acceptance and Commitment Therapy (CompACT), the PROMIS Satisfaction with Social Roles and Activities assessment, and psychological symptom measures as baseline measures prior to an intervention. Confirmatory factor analysis (CFA) will investigate construct validity and factor structure in this sample, and correlation and regression analyses were conducted to explore concurrent, discriminant, and incremental validity.

Results: Results of the CFA are forthcoming. TOF scores correlated significantly with the ACT processes of behavioral awareness (r = .41) and valued action (r = .58) but did not significantly correlate with openness to experience (r = .16). TOF scores were significantly negatively correlated with stress (r = -.36) and depressive symptoms (r = -.38) and positively correlated with satisfaction with social roles and activities (r = .40).

Discussion: Tacting of function may be an important process in improving psychological flexibility. The validation of the TOF Scale in a sample of older adults contributes both to the field’s understanding of the construct and to the measure’s clinical utility.

Where the Diverse Mind Grows: Demographic Variables as Predictors of Response to Mindfulness Practice and Spiritual Diversity Films

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness
Jonah McManus, M.S., Kean University
Nnamdi Uzoaru, Kean University
Neil Patel, Kean University
Paola Ricardo, Kean University
Donald Marks, Psy.D., Kean University
Jennifer Block-Lerner, Kean University

Background: Mindfulness practice highlights the value of living in the moment and bringing kind awareness to thoughts, emotions, and bodily sensations. Even one brief practice has been shown to improve a person’s reported emotional state and psychological well-being (Zeidan, Johnson, Gordon, & Goolkasian, 2010). These practices are utilized less in under-served populations, and an exploration of reasons for limited access and/or receptivity is warranted (Waldron, Hong, Moskowitz, & Burnett-Zeigler, 2018). The present study entailed provision of a brief mindfulness practice and films related to spiritual diversity to a diverse group of undergraduate students.

Method: We aimed to examine whether demographic variables – including gender, ethnic origin/race, and religious affiliation – predict response to the intervention. As part of a larger study, undergraduate participants (N = 77) completed measures (Satisfaction with Life Scale [Diener, Emmons, Larsen, & Griffin, 1985] and Self-Compassion Scale [Neff, 2003]) before and after engaging in a brief mindfulness practice aimed at fostering an experientially accepting stance and then watched one of two films (the documentary One Track Heart or a conference on spiritual pathways).

Results: Hierarchical multiple regression analyses will determine whether any of the demographics predict post-scores over and above pre-scores on the same measures. Film condition will also be explored as a potential moderator.

Discussion: Results and implications for making practices accessible and appealing to those from diverse backgrounds will be discussed.

Why Do Clinical Psychology Graduate Students Choose ACT?

Primary Topic: Clinical Interventions and Interests
Subtopic: Therapeutic Approach
Jolie Pepperman, B.S., Widener University
Frank Masterpasqua, Ph.D., Widener University
Erin Wolff, B.A., Widener University
Gareth Harrison, M.A., Widener University
Sloane Ferenchak, B.A., Widener University
Lisa Edwards, B.A., Widener University
Rebecca Glass, B.A., Widener University
Jordan Barnada, M.A., Widener University
Sara Hertzel, B.A., Widener University
Karishma Lalchandani, M.A., Widener University
Marisa Motisi, B.A., Widnener University
Kat Kovacs, B.A., Widener University

Background: Throughout their education and training, graduate students in clinical psychology are tasked with finding their therapeutic voices. In doing so, they are exposed to a wide variety of therapeutic approaches to psychotherapy, rooted in varying empirically supported theories and perspectives to practice from. Such approaches include Cognitive Behavioral Therapy, Psychodynamic Therapy, Person-Centered Therapy, and many more. The focus of this study was on the identification of reasons why Acceptance and Commitment Therapy (ACT) has become the preferential approach for graduate students in clinical psychology who identified ACT as their preferred approach. No research has been done on graduate students in clinical psychology who prefer to implement ACT as their preferred approach.

Method: This study involved ten clinical psychology students in a graduate program who identified ACT as their preferred approach.

Results: They completed a brief survey and their responses were subsequently coded to determine common themes and connections. These findings suggest 15 themes that draw these students to ACT, and even overlap with one another.

Discussion: These findings suggest 15 themes that draw these students to ACT, and even overlap with one another. Keywords: acceptance and commitment therapy (ACT), graduate students in clinical psychology, therapeutic approach

Workshops on ACT Matrix Card Japanese version and case formulation using HDML framework, and the effect of practice based on them

Primary Topic: Professional Development
Subtopic: ACT Matrix, Case formulation
Fumiki Haneda, Certified psychologist, Start Line Co., Ltd.

Background: Research Center at Start Line Co., Ltd., has practiced ACT for many peaple. On the other hand, we also find it difficult to introduce ACT as talk therapy in the practice of developmental disorders and mental disorders.

Method: Matrix Card developed by Mr. Benjamin Schoendorff, and started selling it in Japan in September 2019. The ACT Matrix Card is a tool designed to provide visual cues to perform the 52 most common ACT exercises. I also planned and conducted a workshop style training to help my company staff implement ACT Matrix Card support. In this training, I classified and organized the ACT Matrix Card on the ACT Matrix to promote understanding of the overall structure, and introduced examples of use of each cards. Based on this knowledge, the group role-play was performed using tasks classified according to 3 clinical strategies (Torneke, Luciano, Barnes-Holmes & Bond, 2016). Workshop-style training was also conducted on case formulation concepts and methods based on the HDML framework (Barnes-Holmes,Y.,McEnteggart,C.,& Barnes-Holmes,D.2020. in press)for various psychological issues.

Results: As a result, our company introduced the ACT Matrix Card into several cases by February 2020, and reported the implementation of the ACT Matrix Card in 6 cases.

Discussion: In this poster presentation, I will report the contents of the workshop and training for the ACT Matrix Card practice, and the outline of the cases that have been practiced since then.