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

Location: Estrel Saal B, Foyer Estrel Saal, and Large Gallery

Wednesday, 15 July, 19:30-20:30 - Poster Session #1 

Thursday, 16 July, 12:30-13:00 - Poster Session #2

Friday, 17 July, 12:30-13:00 - Poster Session #3

Saturday, 18 July, 12:30-13:00 - Poster Session #4

(Posters will be on display from 19:30-21:00 (Wed. only) and 9:00-16:30 on their respective days)

Image denotes ACBS Junior Investigator Poster Award Recipients

Wednesday, 15 July - Poster Session #1

1. Emotion regulation processes in couples with infertility, fertile couples and couples applying for adoption
Primary Topic: Behavioral medicine
Subtopic: Infertility
Ana Galhardo, Instituto Superior Miguel Torga; CINEICC - Faculty of Psychology and Educational Sciences of the University of Coimbra
Marina Cunha, ISMT; CINEICC
José Pinto-Gouveia, CINEICC - Faculty of Psychology and Educational Sciences of the University of Coimbra

Background: Facing infertility is often seen as a physically and psychologically demanding experience and feelings of defectiveness, inadequacy, inferiority, worthlessness, shame and guilt are frequently experienced by men and women with infertility. In turn, emotion regulation can be defined as a set of processes by which we monitor, assess, and change emotions according to the context of their occurrence. Until recently, coping styles were the emotion regulation mechanisms that interested researchers the most in the area of infertility. The current study addresses emotion regulation processes such as psychological inflexibility/experiential avoidance, self-judgment and self-compassion along with emotional/detached, rational and avoidant coping styles. Considering that infertility has been described as an experience that induces stress, in the individual as well as in the couple, the aim was to explore differences in emotion regulation processes between infertile couples pursuing medical treatment, fertile couples, and couples who were applying for adoption. Method: Our sample included 120 fertile couples (FG), 147 couples with an infertility diagnosis who were pursuing medical treatment for their fertility problem(s) (IG), and 59 couples with infertility applying for adoption (AG). Participants filled in paper-pencil questionnaires assessing coping styles, psychological inflexibility/experiential avoidance, self-judgment and self-compassion. This was a cross-sectional study, using the couple as unit of analysis. Results: IG couples, and particularly women, tend to use more experiential avoidance and self-judgment mechanisms and less emotional/detached coping style. When compared to FG couples, IG and AG couples tend to apply more avoidant coping strategies. AG couples showed higher self-compassion. Discussion: From a clinical perspective, when working on psychological difficulties in infertile patients it is important to bear in mind the role of emotion regulation processes, particularly in women, that may contribute to the increasing of psychological suffering. These findings suggest that the Mindfulness Based Program for Infertility, Acceptance and Commitment Therapy and Compassion-Focused Therapy may be adequate approaches for patients dealing with infertility. These contextual cognitive-behavioral therapies explicitly address emotion regulation skills and may expand the effectiveness of psychotherapeutic interventions.

2. An examination of psychological flexibility in the context of parental well-being and infant cognitive and social-emotional functioning
Primary Topic: Behavioral medicine
Subtopic: children, development
Anne Brassell, University of Vermont
Jordan Weith, University of Vermont
Karen Fondacaro, University of Vermont

Increasing occurrences of war and political conflict have led to a worldwide growth in the number of refugees. Currently, there is global need to identify and address the psychosocial needs of this at-risk population using culturally relevant and accepted methods. Acceptance and Commitment Therapy (ACT) principles allow for the adaptable and idiographic evaluation and treatment of multi-cultural populations. The current presentation focuses on ACT-based principles in relation to infant development in the refugee population. Preliminary case studies demonstrate greater likelihood of poorer attachment and developmental concerns in refugee infants. However, little is known regarding the mechanisms leading to such outcomes. We empirically evaluate the association between parental psychological flexibility, parental well being, and infant cognitive and social-emotional functioning.

3. The role of psychological flexibility in predicting treatment response for a behavioral parenting program
Primary Topic: Clinical Interventions and Interests
Subtopic: Culture
Anne Brassell, University of Vermont
Justin Parent, University of Vermont
Jessica Clifton, M.A., University of Vermont
Karen Fondacaro, Ph.D., University of Vermont

Refugee parents face unique challenges raising adolescents that are assimilating into Westernized culture given their past experiences, cultural differences (e.g., views on adolescent autonomy), and unfamiliarity of parenting practices in their new environment. These factors may lead to an increase in negative adolescent behavior, psychopathology, and familial stress. Behavioral parenting programs targeting common adolescent behavior may be one method of reducing these effects. However, given the unique experiences of refugee parents, it is important to incorporate culturally-adapted methods to previously established parenting programs. Psychological flexibility may enhance the effects of parenting training, as the parent is able to engage with the material and their adolescent despite the challenges they experience. The current study will present a modified adolescent parenting program designed for refugee parents rooted in ACT principles. We will examine the association between parental psychological flexibility in predicting treatment change in parenting style and adolescent behavior. We predict greater psychological flexibility will be associated with greater gains in parenting skills and a reduction in adolescent psychopathology.

4. Beyond a physical symptom: The importance of psychosocial factors in Multiple Sclerosis pain
Primary Topic: Behavioral medicine
Subtopic: Chronic pain, Neurological Conditions
Anthony Harrison M.Sc., Institute of Psychiatry, Kings College London
Rona Moss-Morris Ph.D., Institute of Psychiatry, Kings College London

Background: Pain is a common and unpredictable symptom affecting around 63% of people with Multiple Sclerosis (pwMS). Current biomedical treatments demonstrate limited efficacy and many pwMS experience uncontrollable pain. While a recent systematic review and qualitative study indicate several psychosocial factors may be associated with outcome, there is no coherent understanding of how they fit together in MS pain, how they interact with relevant disease variables and whether relationships differ according to pain subtype. The aim of this study was to determine whether potentially modifiable psychosocial factors, drawn from a theory of Multiple Sclerosis (MS) pain, explain significant amounts of the variance in pain severity and interference above and beyond measures of disease severity and pain subtype. Methods: 612 people with MS (pwMS) experiencing pain completed a UK wide cross-sectional survey including brief pain inventory short-form (BPI), hospital anxiety and depression scale (HADS), chronic pain acceptance questionnaire (CPAQ-8), cognitive fusion questionnaire (CFQ), pain catastrophizing questionnaire (PCS) Illness perceptions questionnaire (IPQ-R) and avoidance endurance questionnaire (AEQ). Participants were recruited from national health service MS clinics, and online through the MS UK Register and MS Society. Hierarchical regressions determined the relative contribution of disease severity and psychosocial factors in predicting pain severity and pain interference. Subgroup analyses explored potential differences between pwMS with neuropathic and non-neuropathic pain. Results: All psychosocial factors from the MS pain model, including distress, negative illness perceptions about pain and its consequences, avoidance of social and physical activity, pain acceptance and cognitive fusion were related to pain outcomes, explaining a further 24% and 30% of the variance in pain severity and pain interference after controlling for demographic and disease variables. Findings were similar for neuropathic and non-neuropathic pain subgroups. However, disease factors explained more of the variance in neuropathic pain. Conclusion: All people in this study reported significant pain and associated disability even though over 90% were taking pain medication. The psychosocial factors identified as important in predicting pain severity and, to a greater extent, pain interference are potentially modifiable and thus may be important treatment targets for both neuropathic and non-neuropathic pain. How these data were used to guide the development of a self-management intervention for MS pain will be briefly discussed.

5. Effects of an ACT consistent intervention for insomnia in adults with longstanding pain
Primary Topic: Behavioral medicine
Subtopic: chronic pain, insomnia
Rebecca Andersson, lic psychologist, Behavioral Medicine Pain Treatment Service, Karolinska University Hospital
Jenny Rickardson, lic psychologist, Behavioral Medicine Pain Treatment Service, Karolinska University Hospital
Marie Kanstrup, Ph. D. student, psychologist
Lie Åslund, Ph. D. student, psychologist
Rikard K. Wicksell, Ph.D

Background Insomnia is common among patients attending health care due to longstanding pain and it is related to depression and functional disability (Menefee et al., 2000). However, insomnia is not necessarily improved in pain rehabilitation suggesting the need to specifically address sleep problems as part of treatment (Kemani et al., 2015). Few studies evaluating acceptance and behavioral interventions for insomnia among longstanding pain patients exist. Aim of the study To investigate the utility of an ACT consistent intervention for insomnia in adult patients with longstanding pain and insomnia attending tertiary care. Method This pilot study was conducted as an open trial with pre-post design (N=15). Patients that already have completed an ACT-based treatment for longstanding, debilitating pain at the Behavioral Medicine Pain Treatment Service, Karolinska University Hospital, are recruited in this study. The intervention consists of six group sessions based on CBT/ACT including psychoeducation on sleep, sleep restriction and stimulus control, valued driven behavior and acceptance towards unwanted experiences such as pain or daytime fatigue (Dalrymple, Fiorention, Politi & Posner, 2010). Outcome measures include the following self-report measurements compared to pre-study reports: Insomnia Severity Index (ISI), Pain Disability Index (PDI), Short Form 12 (SF-12), Actigraph (objective sleep measure), sleep diary assessments, values and goal assessment. Process measures include Psychological Inflexibiliy in Insomnia Scale (PIIS), Longstanding Pain Acceptance Questionnaire-8, modified for insomnia (CPAQ-8_I) Results Preliminary results for fifteen patients will most likely be available for presentation in July 2015 together with a discussion on clinical implications and future research plans. Discussion Implications of these results will be discussed. More research, including controlled clinical trials evaluating interventions for insomnia is much needed. Future studies should include investigating ACT processes of change in sleep treatment.

6. A confirmatory factor analysis of facets of psychological flexibility in a sample of people seeking treatment for chronic pain
Primary Topic: Behavioral medicine
Subtopic: Chronic Pain
Whitney Scott, PhD, King's College London
Lance M. McCracken, PhD, King's College London
Sam Norton, PhD, King's College London

Background: Evidence supports the validity of subprocesses of psychological flexibility in the context of chronic pain. However, only very limited research has comprehensively tested a model of psychological flexibility that simultaneously incorporates several of the proposed subprocesses. Although psychological flexibility is described as a single overarching process, research has not adequately tested higher-order or general factor models to explain the inter-relationships between subprocesses of psychological flexibility among individuals with chronic pain. Therefore, this study investigated the structure of measures assessing subprocesses of psychological flexibility among individuals with chronic pain. Method: Five hundred and seventy-three individuals with chronic pain attending an ACT-based interdisciplinary treatment completed measures of pain, depression, daily functioning, acceptance, and processes of psychological flexibility during their pre-treatment assessment. Confirmatory factor analyses tested competing lower-order, higher-order, and bifactor models to examine the structure of psychological flexibility process measures. Results: A bifactor model with a general underlying “psychological flexibility” factor appeared to be the most appropriate empirical representation of the relationships between individual item responses on questionnaires assessing acceptance, defusion, decentering, and committed action. As expected, the general factor was strongly correlated with measures of social functioning, mental health, and depression. Discussion: The results will be discussed in terms of their implications for future refinements to existing measures of psychological flexibility.

7. ACT & psychosis: Theoretical and practical discussion from psychosocial rehabilitation and recovery experience
Primary Topic: Clinical Interventions and Interests
Subtopic: PSYCHOSIS
Abraham Alvarez, CRPS Hermanas Hospitalarias
Jose Luis Arroyo, CRPS Hermanas Hospitalarias
Elena Soteras, CRPS Hermanas Hospitalarias
Sara De Rivas, Universidad Autonoma de Madrid

First of all an exhaustive review of ACT and psychosis will be presented. From manual and computerized search, 26 studies with empirical evidence of ACT and psychosis were selected. Results suggest that ACT decreases rehospitalization rates, hallucinations’ credibility and increases the frequency of valued actions, among other benefits. Although more research is required, ACT seems a promising treatment for psychosis. Secondly, we will present several testimonies from different ACT clinicians working within the model of psychosocial rehabilitation and recovery, and we will promote an open discussion around it.

8. Subjective Happiness Scale (SHS): Psychometric Properties on an Italian sample of adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: subjective happiness, life satisfaction, wellbeing, adolescents
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Valentina Carloni, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Martina Romitelli, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

Subjective Happiness Scale (SHS; Lyubomirsky, Lepper, 1997) is a measure of global subjective happiness developed on adult samples. Its 4 items have been translated into Italian and submitted on a sample of about 400 students aged 11-14. Data collected support its comprehensibility also for youths and its good convergent and discriminant validity and reliability. Adolescents with higher levels of subjective happiness reveal a better quality of life, more mindfulness abilities, less anxious, depressive, somatic and dissociative symptoms, less negative beliefs. The availability of an italian version of SHS could have important consequences both for clinical practice and research.

9. Preliminary analysis of motivational reasons in an aversive task
Primary Topic: Clinical Interventions and Interests
Subtopic: Defusion, values
Ángel Alonso, Universidad de Almería
Carmen Luciano, Universidad de Almería

The aim of this preliminary study is, first, to explore the impact of motivational reasons on tolerance in an aversive task. Secondly, we explored the effect of these motivational reasons together with a brief Defusion protocol. Twenty two participants were randomly assigned to three conditions. All of them went through the aversive task two times (pretest and posttest). In the Reasons Condition, the participants responded to a questionnaire inbetween the pretest and the posttest of an aversive task. They were asked to report a reason why they would continue in the aversive task again, so that the questionnaire included reasons that could establish a motivational context of values. In the Reasons and Defusion Condition, a brief protocol of Defusion skills was applied to the participants, in addition to the questionnaire of reasons. In the Control Condition, the tasks were presented without any protocol inbetween. Two measures were taken during the aversive task procedure: tolerance to the task and discomfort self-reports. Results showed a wide diversity in the tolerance to the task. That variability and the limitations are discussed.

10. Effectiveness of acceptance and commitment therapy on parental stress of mothers of children with nocturnal enuresis
Primary Topic: Clinical Interventions and Interests
Subtopic: acceptance and commitment therapy,nocturnal enuresis, parental stress
Arezu Kabiri, M.A., Islamic Azad University, Najaf Abad branch, Isfahan, Iran
Leili Nourian, M.A., Islamic Azad University, Najaf Abad branch, Isfahan, Iran

The purpose of present study was to investigate the effectiveness of acceptance and commitment therapy on parental stress of mothers of children, aged 5 to 12, with nocturnal enuresis in 2014 in Iran. This semi-experimental study was conducted as pre-test and post-test with control group. Statistical population included all mothers of children with enuresis in city of Isfahan(Iran). From among these mothers, 30 mothers were randomly selected and put into the experimental and control groups of 15 persons each. The parenting stress index(PSI) questionnaire(Abidin, 1990) was the instrument of this study. The intervention involved 8 sessions, each lasting for 90 min of acceptance and commitment therapy which was provided merely for experiment group. At the end, the post-test was applied on both groups. The result of covariance analysis indicate that the experimental group has significantly decreased parenting stress in the realm of parent(p<0.05) and the realms of child(p<0.05) and there is a significant difference between the experimental and control groups in terms of the parenting stress of children with enuresis(P<0.05). thus, the effectiveness of acceptance and commitment therapy on decreasing the level of parental stress of mothers of children with nocturnal enuresis was confirmed.

11. My Body and You: The impact of Body Image on Interpersonal Relationships
Primary Topic: Clinical Interventions and Interests
Subtopic: Body Image Disturbance
Benjamin Ramos, University of Louisiana at Lafayette
Glenn Callaghan, San Jose State University
Emily Squyres, Louisiana Tech University
Emily Sandoz, University of Louisiana at Lafayette

Many experience dissatisfaction with the way their bodies look. Sometimes this dissatisfaction comes to interfere with their lives across many domains. Body image disturbance involves inaccurate perceptions about one’s body that prompt distress. People struggling with body image disturbance tend to place high importance on their perceptions about their body and the accompanying thoughts and feelings while actively attempting to avoid them. This sometimes involves restricting social interactions in an attempt to manage painful body experience. This study focused on the development and validation of The Body Image and Relational Distress Scale (BIRDS) with samples with and without body image disturbance. Preliminary evidence suggests that the BIRDS allows for reliable and valid assessment of the impact of body image on interpersonal relationships. Data also suggest positive relationships amongst body image disturbance, psychological distress and interpersonal difficulties. Implications for family- and group-based treatments of body image disturbance will be discussed.

12. The relation between executive function and psychological flexibility in adolescents with longstanding pain
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological flexibility, Executive function
Camilla Wiwe Lipsker, MSc, PhD cand., Behavioral Medicine Pain Treatment Service, Karolinska; Department of Clinical Neuroscience, Karolinska Institutet
Malin Bygård, MSc student, Behavioral Medicine Pain Treatment Service, Karolinska University Hospital
Marie Bjoernstjerna, MSc student, Behavioral Medicine Pain Treatment Service, Karolinska University Hospital
Rikard K. Wicksell, PhD, Karolinska Institute, Stockholm, Sweden

Background Executive function refers to a set of cognitive processes used in the management of goal-directed behaviors and includes intentional skills, such as the ability to initiate, sustain, inhibit, and shift attention. Chronic pain conditions are complicated and psychologically challenging to live with. Current research proposes a relationship between pain, self-regulatory capacity, executive functions and attention control, suggesting that executive functions and self-regulatory deficits are part of the etiology and maintenance of chronic pain conditions. In ACT a central treatment target is psychological flexibility, defined as the ability to take action in line with personally held values even in the presence of interfering thoughts, emotions and sensations. Psychological flexibility has been described as much depending on and related to executive functioning. To our knowledge however, there is to date no study that examines the relation between executive function and psychological flexibility. Aim To examine the relationship between executive function and psychological flexibility in a sample of adolescents with longstanding pain Method Patients at the Behavioral Medicine Pain Treatment Service, Karolinska University Hospital, between the ages 13 – 17 are recruited to the study. At present, data from 24 subjects have been obtained. A correlational study design is employed to evaluate the degree of association between executive function, psychological flexibility and functional impairment due to pain. The influence of pain level, depression and insomnia is also investigated. Participants are administered four tests from the Delis-Kaplan Executive Function System (D-KEFS) as a direct measure of executive function: the Trail Making Test, The Sorting test, the Color-Word Interference Test, and the Tower Test. Self-report assessments are administered for measurement of psychological flexibility (PIPS and AFQ-Y), impairment due to pain (PII), degree of pain (VAS), sleep disturbance (ISI), and depression (CES-DC). Results & Conclusion Correlation and mediation analyses will be performed in order to clarify the relationships between the investigated variables. Preliminary results for a minimum of 24 subjects will be available for presentation in July 2015 along with a discussion on possible clinical implications and directions for future research.

13. The effect of body image inflexibility on adolescent restrained eating
Primary Topic: Clinical Interventions and Interests
Subtopic: eating psychopathology
Cláudia Ferreira, PhD, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra
Inês A. Trindade, MSc, PhD student, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra
Cristiana Duarte, MSc, PhD student, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra

Background: Body dissatisfaction has been considered a major problem for women of today’s Western societies. Besides, it was found to be strongly associated with poorer mental health and to be a predictor of a variety of negative health outcomes, such as depressive mood and eating psychopathology. Beyond that, research has shown that suffering associated with negative body image may be mostly due to the way a person deals with unwanted internal experiences (e.g., perceptions, sensations, thoughts) related to one’s own physical appearance. The impact of these body-related negative experiences may be amplified when associated with maladaptive emotional regulation processes. In that line, body image-related experiential avoidance (i.e., the inability to openly contact and accept experiences related to one’s body) may play a central role in the development and maintenance of restrained eating. The present study thus aimed to explore whether BMI, weight dissatisfaction (WD), and body dissatisfaction (BD) impact on restrained eating through the effect of increased body image-related experiential avoidance (BI-AAQ). Methods: In this study participated 751 female adolescents with ages comprised between 15 and 19 years old (M = 17.37; SD = 1.46) who completed the following self-report instruments: the Figure Rating Scale, the Body Image – Acceptance and Action Questionnaire (BI-AAQ), and the Eating Disorder Examination – Questionnaire (EDE-Q). Path analyses were performed to analyse the mediational effect of BI-AAQ on the relationships of BMI, WD and BD towards restrained eating. Results: The final model explained 22% of BI-AAQ and 34% of restrained eating, revealing an excellent model fit to the empirical data: CFI = .99; TLI = .99; RMSEA = .03, p = .708. WD (β = .09) and BD (β = .11) presented direct effects on restrained eating, while controlling for BMI. Nevertheless, the impact of BD on restrained eating was revealed to partially act through the mechanisms of BI-AAQ with a significant indirect effect of .22. Discussion: This study suggests that the known impact of body dissatisfaction on restrained eating may be partially mediated by the inability to accept associated negative body image experiences (i.e., body image-related experiential avoidance). This emotional regulation process should therefore be targeted in clinical interventions aiming to treat disordered eating symptomatology, which should promote a more accepting stance towards inner events.

14. Entanglement with body image and women’s psychological well-being
Primary Topic: Clinical Interventions and Interests
Subtopic: Quality of Life
Cláudia Ferreira, PhD, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra
Inês A. Trindade, MSc, PhD student, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra
Cristiana Duarte, MSc, PhD student, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra

Background: Literature has considered negative perceptions of body image as important predictors of lower well-being, especially in women from Western societies for whom physical appearance is a central self-evaluation dimension. Specifically, body dissatisfaction in women has been strongly associated with decreased psycho-social functioning and psychological QoL. These relationships however do not seem to be linear and may involve maladaptive emotional regulation processes, which are considered crucial to understand the impact of negative experiences on human’s well-being. Cognitive fusion (defined as the entanglement with one’s internal events considering them facts rather than interpretations of reality) is one maladaptive process that has been vastly associated with QoL impairments and psychopathology. Still, the role of cognitive fusion regarding body image-related internal experiences in psychological QoL is little explored. This study thus examines whether the effects of experiences associated with body weight and shape on decreased psychological QoL are mediated by higher levels of body image-related cognitive fusion (CFQ-BI). Method: This study’s sample was composed of 679 female college students aged between 18 and 23 years old (M = 20.17; SD = 1.56) and with a mean BMI of 21.83 (SD = 2.88). The test battery comprised several self-report measures: Figure Rating Scale, Cognitive Fusion Questionnaire – Body Image (CFQ-BI), and World Health Organization Brief Quality of Life Assessment Scale (WHOQOL-BREF). With basis on the postulated hypothesis, a theoretical model was designed and tested through path analyses. These analyses examined the mediational effects of body image-related cognitive fusion on the associations of BMI, WD, and BD towards psychological QoL. Results: The tested model explained 31% of psychological QoL and revealed an excellent model fit to the empirical data: CFI = .999; TLI = .998; RMSEA = .020, p = .785. Data also indicated that the effects of BMI, WD, and BD did not directly predict psychological QoL, being totally mediated by the mechanisms of body image-related cognitive fusion. Discussion: These findings show that the impact of body-related unwanted experiences on women’s psychological QoL seems to be dependent upon the level of cognitive fusion with those internal events. Therefore, programs aiming to promote young women’s well-being in the context of body image difficulties may benefit from developing the ability to observe body image-related internal events as transitory and subjective experiences (i.e., body image-related cognitive defusion).

15. Virtual defusion is real defusion? An exploration of a VR-supported defusion exercise
Primary Topic: Clinical Interventions and Interests
Subtopic: Defusion, Virtual Reality
Concetta Messina, University Kore, Enna (Italy)
Martina Leuzzi, University Kore, Enna (Italy)
Daniele Lombardo, Behaviour Labs, Catania (Italy)
Marco Lombardo, Behaviour Labs, Catania (Italy)
Giovambattista Presti, MD, PhD, Kore University, Enna (Italy)
Paolo Moderato, PhD, IULM Unversity (Milan, Italy)

Cognitive defusion is one of the six processes of an ACT protocol. Experiential exercises are designed to undermine the functions of thoughts by altering the literal meaning of words putting the in contexts that are different from those in which they usually occur. This can be done in different ways that have been described in many research protocols. We aimed to test one particular new way of working on cognitive defusion using Virtual Reality, who has been demonstrated and effective technology in exposure based protocols. Ten participants were asked, with a mindfulness exercise, to focus on particular negative thoughts that were lately troubling them. A thought was typed in a specifically designed software and a physicalizing exercise in which the thoughts of the participant took any of 6 shapes and any of 9 colours was presented. While listening to a mindfulness exercise the participant could play with the thought-object in a 3D environment which reproduced also their hands in a full immersion experience. In a series of single-case alternating treatment designs, the VR-supported defusion exercise was compared to a distraction task, and to a thought control task. Discomfort and believability of negative thoughts were measured with a visual analog scale. In addition AAQ was repeatedly administered before and after the exercise. Both discomfort and believability were reduced by the VR-supported defusion exercise, more than the distraction and thought control task. Virtual teality could be a promising technique to be used in ACT protocols.

16. Turning towards adaptive eating behaviours: Examination of the Portuguese version of the Intuitive Eating Scale-2 and its association with decentering and body image flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: Eating Behaviours
Cristiana Duarte, MSc, PhD Student, Cognitive and Behavioural Centre for Research and Intervention (CINEICC), University of Coimbra
José Pinto-Gouveia, MD, PhD, Cognitive and Behavioural Centre for Research and Intervention (CINEICC), University of Coimbra
Ana Mendes, MSc., Faculty of Psychology and Educational Sciences, University of Coimbra

Background: Intuitive eating is defined as an adaptive form of eating characterized by the ability of connecting with and understanding one’s internal hunger and satiety signals, rather than engaging in reactive eating behaviours in response to emotional or external cues. The current study aimed at examining the psychometric properties of the Intuitive Eating Scale-2 (IES-2) in the Portuguese population and the association between IES-2 and important protective mechanisms for body image and eating-related difficulties, namely decentering and body image flexibility. Method: A sample of 545 women from the general population was used to examine the factorial structure of the IES-2 through a second-order Confirmatory Factor Analysis, and to examine the scale’s psychometric properties. Results: A four-factorial structure was corroborated which included the factors: Unconditional permission to eat; Eating for physical reasons rather than emotional reasons; Reliance on hunger and satiety cues; and Body-food choice congruence. The scale revealed adequate internal consistency, construct and discriminant validity, and good temporal stability. IES-2 was inversely associated with body mass index, eating psychopathology, namely binge eating, and anxiety, depressive and stress symptoms. On the contrary, positive associations were found between the IES-2 and decentering, and especially body image flexibility. Discussion: Findings confirmed that the IES-2 seems to be a valid and useful tool for assessing adaptive eating behaviours and their association with mecanisms relevant for healthy eating and weight regulation, and carry therefore important implications for the treatment and prevention of body image and eating-related problems in the community.

17. Should eastern meditation be used in drug treatment facilities?: An examination of psychological and spiritual symptoms of substance use disorder
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Debesh Mallik, University of Louisiana at Lafayette

Despite the availability of various substance abuse treatments, substance misuse and the negative consequences associated with it remain a serious problem in our society. Various types of meditation have been evaluated for treatment of substance use disorders, but the research has not drawn any specific conclusions. This may be due to the lack of a structurally equivalent control group, and lack of spiritual emphasis. Therefore, the current study included a spiritual emphasis (12-steps) and inner eye concentration, a relaxation control group (progressive relaxation), and a treatment-as-usual control (TAU) group. The meditation technique was a simple raja yoga meditation technique where the attention of focus remains on the point between the eyebrows. The current study examines changes in substance use, spirituality, depression, anxiety, stress, emotional regulation, and health-related quality of life among three groups (meditation, progressive relaxation, and TAU) over a 6 week period. Implications for integration of meditation with behavioral treatments and how Hindu philosophies of meditation relate to contextual science will be discussed.

18. Self-reference Alters Positive Evaluations in Borderline Personality Disorder
Primary Topic: Clinical Interventions and Interests
Subtopic: Borderline Personality Disorder
Dorina Winter, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
Cornelia Herbert, PhD, Institute of Psychology and Education, Ulm University, Ulm, Germany
Katrin Koplin, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
Martin Bohus, MD, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
Christian Schmahl, MD, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
Stefanie Lis, PhD, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany

Background: Borderline personality disorder (BPD) is characterized by emotional dysregulation, impulsivity and interpersonal difficulties (Leichsenring et al., 2011). It has been suggested, that self-related processes may contribute to BPD patients’ psychopathology (Bender & Skodol, 2007; Jorgensen, 2009, 2010; Moritz et al., 2011; Schilling et al., 2015). Indeed, the extent to which people tend to refer (emotional) information to themselves influences their emotional reactions and social interactions (Heider, 1958; Weiner, 1986). Thus, we present original data aimed to investigate self-referential processing in BPD and its modulation by the valence of information content. Methods: 30 BPD patients and 30 healthy control participants rated negative, positive and neutral words paired with self-, other- or no reference. Afterwards, depth of mental processing was measured using a recall and a recognition task. Results: BPD patients rated self-referential, positive words as less positive than healthy controls. This was not the case for negative or neutral words nor for words with other-reference. This devaluation of self-referential, positive words was related to psychometric measures of attributional style. Groups did not differ regarding the effect of reference or the interaction of valence and reference in the memory tasks. Conclusions: Our findings suggest a devaluation of self-related, positive information in BPD. Associations with self-esteem and implications for emotion dysregulation and problems in social interactions will be discussed.

19. Development and Validation of the Flexibility of Responses to Self-Critical Thoughts Scale (FoReST)
Primary Topic: Clinical Interventions and Interests
Subtopic: Assessment measure
Dr Peter Larkin, University of Glasgow
Dr Ross White, University of Glasgow
Judith McCluskey, University of Glasgow

Background: Acceptance and Commitment Therapy (ACT) aims to help individuals live a life congruent to their values by cultivating psychological flexibility (PF); the ability to respond to experiences with acceptance and creativity. Concurrently, Compassion Focused Therapy (CFT) addresses the role of self-attacking cognitions on psychological difficulties. Recent work suggests that integrating aspects of CFT into an ACT approach (i.e. developing a person’s PF to self-attacking thoughts through self-compassion) may offer additional therapeutic value. There remains no assessment of this specific therapeutic process. Aims: The project aimed to develop and validate a new scale to assess flexibility of responses to self-critical thoughts (FoReST). A further study is ongoing to validate the FoResT within a clinical population. Methods: Factor Analysis was used to explore factor structure of the FoReST in a convenience sample of 253 adults. Construct validity was explored by comparing FoReST with measures of similar constructs (PF, self-compassion, self-criticism) and potentially related outcomes (anxiety, depression, quality of life). Results: Alternative 2-factor (‘unworkable action’ and ‘avoidance’) and 1-factor (‘unworkable action’) versions of the FoReST showed high concurrent validity with similar measures, good predictive validity for mental health and wellbeing outcomes and good internal consistency. The relative strengths and weaknesses of both versions are discussed. 100 participants are now being recruited from Primary care and Community Mental Health Teams in order to complete Confirmatory Factor Analysis on a clinical sample. Recommendations: Findings indicate that the FoReST may offer a useful clinical and research tool for emerging forms of ACT for people high in self-criticism. Future research is ongoing to confirm the factor structure of the FoReST, confirm concurrent, predictive validity, test-retest reliability, and validate the scale in relevant clinical populations.

20. ACT-Cardbook / ACT-Kartenbuch
Primary Topic: Clinical Interventions and Interests
Subtopic: Transfer of ACT in to daily living
Dr. Hagen Boeser, Private Practice

I created 13 cards for ACT therapy. 5 ideas, 4 metaphors and 4 exercises. Each card has a topic that is explained on one side of the card and on the other side of the card there is a picture that illustrates the topic. So you can talk about the topic in the session and can give the patient the card to take home. At home he/she can put it at the refrigerator to remind him/her self about the topic. Also in ACT-training I use the cards to enhance the learning on ACT topics. The card book is written in german.

21. Work in progress: The Role of Psychological Flexibility in Expecting and Reaching a Behavioral Change
Primary Topic: Clinical Interventions and Interests
Subtopic: Common factors perspective
Dragan Zuljevic, University of Novi Sad, Serbia

The role of psychological flexibility in provoking, reaching and maintaining a behavioral change is well documented (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). On the other hand, the expectations of treatment outcome have been identified as one of the crucial common factors of successful psychotherapy (Wampold & Imel, 2015). The main goal of this evolving longitudinal research is to determine the relations between change expectations and psychological flexibility and their potential power in predicting the psychotherapy outcome. So far, the research consists of cca. 100 participants suffering from some kind of psychological problem of nonclinical intensity, receiving psychotherapy as usual within the counseling centers across Serbia. Each of them are subjected to multiple assessments: during the contact interview, before the first therapy session, after third and sixth session, on the treatment end, as well as three months after the end of treatment. During these assessments, the following instruments are administered: Acceptance and Action Questionnaire II (AAQ II; Bond et al., 2011, Depression, Anxiety and Stress Scale 21 (DASS21; Lovibond & Lovibond, 1995), Anxiety Change Expectation Scale (ACES; Dozios & Westra, 2005) and Satisfaction With Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985). The theoretical and practical implications of possible relations between these variables and their change slopes across various treatment phases will be presented and discussed.

22. Profiles of Avoidance, Acceptance, Tolerance, and Mindfulness Predict Psychosocial Health
Primary Topic: Clinical Interventions and Interests
Subtopic: Avoidance
Emily R. Pichler, B.A., University of Vermont
Justin Parent, B.A., University of Vermont
Martin Seehuus, M.A., University of Vermont
Jessica Clifton, M.A., University of Vermont

Background Emotional responding involves the different manners in which individuals might react to their internal experiences, and is of primary interest in the development of psychological and behavioral health. Accepting, non-avoidant responses have reliably been associated with increased well-being and decreased symptomology. However, despite increasing interest in various forms of emotional responding, few efforts have been made to capture typical patterns of emotional responding using person-centered approaches. The present study aims to uncover unique profiles of emotional responding that relate to differential risk for psychosocial problems and mental health. Method Participants were 307 men and women ages 18-64 recruited via Mechanical Turk. Information gathered included experiential avoidance (Acceptance and Action Questionnaire II), emotional non-acceptance (Non-acceptance of Emotional Responses subscale of the Difficulties in Emotion Regulation Scale), mindfulness (Mindful Attention Awareness Scale), tolerance of negative emotions (Tolerance of Negative Affective States scale), current psychological symptoms and well-being (Inventory of Depression and Anxiety Scale), and recent drug and alcohol use. Results Model-based cluster analysis was conducted with experiential avoidance, nonacceptance of emotions, emotional tolerance, and mindfulness as input variables. The best-fitting solution identified distinct profiles of responding, including (1) highly mindful, accepting, and nonavoidant, (2) highly mindful, accepting, nonavoidant, and tolerant, (3) average, (4) average but experientially avoidant, and (5) avoidant, nonaccepting, and nonmindful responding. Associations between emotional profile and outcomes of interest were computed using ANOVA; results indicated differential risk for psychological problems and propensity for well-being and satisfaction based on emotional response profile. Discussion Findings offer support for unique profiles of responses to emotions; further, individual differences in emotional responding may be associated with increased risk for particular psychological, social, or behavioral problems. Recommendations for assessment and treatment include increased attention to particular profiles of acceptance, mindfulness, avoidance, and tolerance. Future research should examine the impact of emotional response profiles in clinical samples and culturally diverse populations.

23. Act for Kids and Teens in Italy: Experience and directions of a working group
Primary Topic: Clinical Interventions and Interests
Subtopic: Children, adolescents and parents
Francesco Dell'Orco, Università IULM,Milan & IESCUM, Italy
Arianna Ristallo, Università IULM,Milan & IESCUM, Italy
Marta Schweiger, Università IULM,Milan & IESCUM, Italy
Giovambattista Presti, Università Kore,Enna(Italy) & IESCUM, Italy
Francesca Pergolizzi, IESCUM, Italy

Act for kids and teens is a special interest group of ACT-Italia, founded in 2013. The group aims to exchange ideas and share experiences, to promote communication among clinicians, to support empirical studies and application of ACT-based work to children, adolescents and their families. Participants. Clinicians, researchers and students from different parts of Italy, interested and specialized in the application of ACT with children, adolescents and parents. Organization. Eight meetings and a 2-days intensive workshop have been organized since October 2013. Each meeting had a specific topic (i.e. assessment procedures, basic processes, valued actions) shared by the group. Participants submitted their contributions (clinical reports, assessment tools, experiential exercises, paper reviews or data) through an online form. Each contribution was presented and discussed by the group during the meeting. Goals. Publication of a handbook that collects different resources for practicing ACT with children and adolescents in the Italian context: assessment measures, practical tools (exercises, cards, games…) developed by the group and clinical cases with young clients. The group also is working to explore and validate creative ACT-oriented procedures and protocols to manage interventions with parents and caregivers. The structure of the group and a preview of its work will be presented.

24. ACT, selective mutism, and sociale phobia (I): Case Conceptualization and integration of contingent reinforcement of conversation patterns
Primary Topic: Clinical Interventions and Interests
Subtopic: Selective mutism, social phobia, children
Giovanna Nardin, Humanitas Clinical School, Milan (Italy) and Iescum (Italy)
Margherita Gurrieri, IESCUM (Italy)
Simone Napolitano, ASCoC Clinical School, Lamezia Terme (Italy) and IESCUM (Italy)
Giovambattista Presti, MD, Phd, Kore University, Enna (Italy)
Paolo Moderato, IULM University, Mialn (Italy)

The purpose of this poster is to show how it is possible to integrate more traditional behavioral strategies with the ACT model when working with children. As an example we will discuss the case of a 8 year old child with Selective Mutism, who started speaking at 3 but only with his parents and sister. Treatment was delivered at child’s home in individual sessions in the context of children games that required the use of language. At the beginning his mother was present with the function of prompting child’s verbal responses and her presence was later gradually faded. Initially the ACT protocol was focused of the child avoidant behavior as a consequence of his fusion with the thoughts of being unable to speak in public. Defusion exercises such as asking the child to note his thoughts and write them on rubber balls that he had to keep in his pocket also after the end of the therapy session, were used to undermine his verbal rules related to speaking in public. Parents were also fused with the idea of the child’s difficulties. After working on defusion the therapist focused on increasing child’s verbal skills by shaping his verbal behavior pattern with contingent reinforcement. Generalization of his verbal interaction with peers and the significant adults, such as teachers, was carefully planned to extend to his many social contexts the trained interactios. The ACT hexaflex was particularly helpful to the therapist to help conceptualize her fusion and avoidant behavior and to better work with the child in the present moment.

25. ACT, selective mutism, and sociale phobia (II): Case Conceptualization and intervention in the mother-child interaction

Primary Topic: Clinical Interventions and Interests
Subtopic: Selective mutism, social phobia, children
Simone Napolitano, ASCoC Clinical School, Lamezia Terme (Italy) and IESCUM (Italy)
Margherita Gurrieri, IESCUM (Italy)
Giovanna Nardin, Humanitas Clinical School, Milan (Italy) and IESCUM (Italy)
Giovambattista Presti, Kore University, Enna (Italy)
Paolo Moderato, IULM University, Mialn (Italy)

Selective mutism is a complex disorder characterized by persistent inability to speak in specific social contexts, such as schools or other public situations, or even at home or with peers. Both spontaneous speaking and responding to requests can be reduced sometimes to zero levels. The onset of SM usually occurs before age 5 and it affects 1% of the clinical population. It is frequently associated and overlaps with social phobia. Both disorders are characterized by strong experiential avoidance. In SM, experiential avoidance is focused on communicative performance. This makes the differential diagnosis very complicated and often SM is confused with other developmental disorders, such as mental retardation. The purpose of this poster is to offer a rationale for using ACT with those children and their families, being experiential avoidance crucial to this disorder. A clinical case of a 6 year old child with SM treated with ACT is presented. The treatment is focused on child’s and mother’s experiential avoidance, conceptualized as a set of behaviors governed by verbal rules, non in line line with own svalues. The first part of the treatment was designed to promote mother’s values-oriented behavior towards her child after defusing her from unpleasant thoughts and emotions related to her son’s difficulties. The second part of the protocol was addressed to increase child’s awareness of his verbal rules using the matrix built on Mickey Mouse metaphor. It will be ahown how it was possible to to increase his discrimination of his own behavior, and through defusion and acceptance promote many changes by shaping his behavior with contingent reinforcement. It was also possible to generalize these changes to the other contexts, such as school and interactions with the strangers. Treatment adaptations that need to be considered when using ACT with such young subjects suffering from this disorder, will be described and relevant areas for future research will be discussed.

26. ACT, selective mutism, and social phobia (III): Case Conceptualization and FAP enhanced intervention
Primary Topic: Clinical Interventions and Interests
Subtopic: Selctive mutism, social phobia, adolescent
Margherita Gurrieri, IESCUM, Italy
Paola Stracquadanio, Kore University, Enna (Italy)
Simone Napolitano, ASCoC Clinical School, Lamezia Terme (Italy) and IESCUM (Italy)
Giovanna Nardin, Humanitas Clinical School, Milan (Italy) and IESCUM (Italy)
Giovambattista Presti, MD, PhD, Kore University, Enna (Italy)
Paolo Moderato, PhD, IULM Unversity (Milan, Italy)

Acceptance and Commitment Therapy (ACT) and Functional Analytic Therapy (FAP), are effective in the treatment of different anxiety disorders. DSM-5 defines Selective Mutism as the consistent inability to speak in specific social situations (in which there is an expectation for speaking, e.g., at school) despite speaking is possible in other situations (e.g. at home). The treatment of a 18 years old young man, diagnosed with Selective Mutism and Social Phobia will be presented, in order to introduce the ACT conceptualization model and to show how to map the processes on the Hexaflex to guide intervention. ACT experiential exercises were enhanced with FAP in order to promote significant changes by shaping client responses with contingent reinforcement. The general aim of the therapy was to reduce relevant clinical symptoms and decrease the number of avoided contexts. The first phase of the treatment aimed to increase the ability to recognize emotions and thoughts and identify values and goals. During the second phase the matrix model was introduced as a “videogame” in order to develop discriminations of avoidant behavior and develop psychological flexibility. The third phase of the therapy was oriented to help the client to apply the developed social and interpersonal skills in a range of new situations, by being present in the moment an be open to make room to discomfort. The effect of the treatment was measured with AAQ2, VLQ, CFQ, YSR, BAI. Changes in the frequencies of some CRB1 and CRB2 during sessions will be shown. Presentation will underline the changes made by the client’s behavior and how they correlate to the six processes of the Hexaflex and particular attention will be given to exposure experiences

27. Psychological flexibility in Middle Earth: metaphors and experiential exercises for an Hobbit lover kid refusing school
Primary Topic: Clinical Interventions and Interests
Subtopic: School refusal, social anxiety, children
Giulia Mazzei, IESCUM (Italy)
Giovambattista Presti, MD, PhD, Kore University, Enna (Italy)
Paolo Moderato, PhD, Iulm University, Milan (Italy)

Acceptance and Commitment therapy (ACT) uses metaphors and experiential exercises to disentangle verbally governed behavior that is functionally related to inflexibile human behavioral patters. Though originally not designed for kids, it is possible to use standard ACT metaphors and experiential exercises to help verbally competent children. However, it is necessary to tweak those metaphors and exercises to make them meaningful and close to the child’s world. We explored the possibility of creating an homogeneous therapeutic environment for a 9 year old child, passionate about “The Lord of the Rings”, to help him facing school avoidance, decrease cognitive fusion with self-judgment and ideas about himself and others, and increase his emotional and empathic skills. The designed protocol was based on “The Lord of the Rings” trilogy so that every metaphor and experiential exercise working on every ACT process was linked to the fantasy novel. A functional analysis had previously identified a restricted repertoire in taking the perspective of others, So every session started with the vision of a scene of one of the three movies of Tolkien’s trilogy relevant to the process the therapist would work on and a perspective taking exercise on the characters in the scene. Focus of the exercise was the perspective of the characters and the child and the feelings and emotions involved in the scene and in the moment in the office. By the end of the protocol the child increased his psychological flexibility in every area of his life and perspective taking skills. The value of a metaphorical environment, based on children’s preference, as a useful tool to face verbal rules and promote significant changes will be discussed.

28. Changes of valued behaviors and functioning during an Acceptance and Commitment Therapy Intervention
Primary Topic: Clinical Interventions and Interests
Subtopic: Values; value-directed behaviors; valued-behaviors
Hanna Wersebe, University of Basel
Roselind Lieb, PhD., University of Basel
Andrea Meyer, PhD, University of Basel
Andrew Gloster, PhD, University of Basel

Background: The purpose of the study was to examine changes in value-directed behaviors and their association with patient functioning. Further we aimed to investigate whether initial higher levels of psychological flexibility are associated with subsequent increases in valued action and if initial lower levels of panic symptomatology are associated with a subsequent increases in valued action. Methods: Participants were 43 adult patients with treatment-resistant panic disorder, who received Acceptance and Commitment Therapy (ACT) and completed measurements at pre-treatment, post-treatment, as well as 6-months later at Follow-Up (FU). Results: Results of mixed models analyses showed that valued behaviors increased from pretreatment to FU, suggesting that participants lived more in accord with their values. Functioning increased significantly over the course of the study. Increased functioning was not associated with increased valued action. Initial higher levels of psychological flexibility were not associated with subsequent increase in valued action. Also, patients with lower initial levels of panic symptoms did not exhibit subsequent increases in valued action. Discussion: Our study extends prior findings about valued behaviors and showed that valued behaviors increase over the course of the study. Further studies investigating changes in value-directed behaviors across various diagnoses samples are clearly necessary.

29. Simple Living, Valued Living: An international study of Voluntary Simplicity and Psychological Flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: Values-Based Living
Hein Zegers, UvH University Utrecht

Background Voluntary Simplicity or Simple Living is a low-consumption lifestyle that does not attract much empirical scientific attention, partly because its practitioners are considered a “hard-to-reach” population. In this international study, more than 500 “Simplifiers” have been interviewed in four different languages. The data are then analysed thematically according to the Psychological Flexibility Model. Method People living a Voluntary Simplicity lifestyle were recruited over the Internet. After selection by objective criteria, 489 “Simplifiers” world-wide were withheld. These people were interviewed in resp. English, French, German and Dutch. This makes this the first multilingual study of its kind. Then the international Simplifier data are analysed. After a grounded theory analysis allowing themes to emerge, a thematic analysis is performed according to the six components of the Psychological Flexibility Model (the so-called ACT Hexaflex Model). Results The Hexaflex / Psychological Flexibility Model offers a surprisingly close match to how Simplifiers explain how they came to live and currently live their Voluntary Simplicity lifestyle. With “more time/resources for what really matters” as the most frequently occuring global theme, Simplifiers seem to be especially skilled in Values / Committed Action. Discussion Many “Simplifiers” from all over the world turn out to unknowingly “walk the talk” of ACT. Therefore, more ACT-specific research into the Simplifier Community may yield a boiler plate for clinical and community interventions leading towards more global psychological flexibility.

30. The Use of Mindful Focusing as Chronic Pain Management Skills
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain, Mindfulness
Lee Sook Huey, Hospital Kuala Lumpur

This poster aims to describe the use of mindful focusing technique to reduce impact and interference of pain on chronic pain patient in Kuala Lumpur General Hospital, Malaysia. Fear avoidance towards pain is found to predict patient's distress towards their pain. Patients were taught to intentionally pay attention and stay with the pain, describe and label the pain with acceptance and non-reactivity. Patient's feedback on their experience of using focusing will be discussed.

31. MatheMatrix: an advance contextual behavioral tool for in-vivo modeling of clinical relevant behaviors
Primary Topic: Clinical Interventions and Interests
Subtopic: The Matrix, clinical tools
Nicola Maffini, Private Practice: Leaves, Applied Psychology - Parma, Italy
Roberto Cattivelli, Istituto Auxologico Italiano

Focused Acceptance and Commitment Therapy (FACT) is developed to help individuals to unstuck from unhealthy thought patterns by encouraging them align their values with their actions. MM is a way to simplify, deliver and adapt FACT intervention for even more essential therapy and consulting setting, both individual and group. MatheMatrix (MM) is a discriminative training procedure that allow to implement and strengthen the effect of core therapeutic processes as: maieutic persuasion, ongoing shaping, creative hoplessness and problem solving. Further application regarding promotion of generalization and extension to novel context such as disfunctional pliance and reason giving reduction. Developed from Kevin Polk’s “The Matrix”, MatheMatrix is based three pillars of Hexaflex, and in particular on the framework of FACT, Focused Acceptance and Commitment Therapy, focusing on a narrowing set of basic processes and aimed to promote radical change in a brief treatment context. MatheMatrix should be consider as a variant of the Matrix, used in alternative or in combination with it, and is founded on principles of Acceptance and Commitment Therapy, Relational Frame Theory and, more in general, on behavior analysis by a functional contextualist point of view. Two multicentric pilot study based on the application of MM are currently running.

32. AWAY from talk, TOWARD action: Using the Matrix to engage challenging youth
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescence
Susie McAfee, Ph.D., IWK Health Centre

There is increasing recognition that the ACT model is suitable to adaptations addressing the developmental needs of adolescence and evidence is accumulating for its efficacy with youth. Successful work with adolescents requires quickly generating a high level of engagement, a task for which the matrix is well suited. Using case examples, the author will discuss the matrix as a youth-friendly framework for jump starting ACT work with teens. The matrix’s interactive and visual format allows clinicians to easily avoid the common traps of over-reliance on verbal discussion and intellectualization. The “workability” of the matrix in individual therapy, school-based intervention, and as a waitlist management strategy will be discussed. In addition, the author will discuss how the matrix has functioned as an excellent entry point for increasing awareness of ACT as an evidence-based alternative and providing education about basic ACT principles to colleagues and trainees within the outpatient Mental Health and Addictions Program at the IWK Children’s Hospital in Halifax, Nova Scotia, Canada. The matrix’s value as an professional education tool is particularly important given that the application of ACT in publicly funded pediatric mental health centres across Canada is at its earliest stages.

33. Engagement in Mindfulness Practices and the Impact on Trait Mindfulness Ability in a College Sample
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Sarah A. Potts, Utah State University
Scott DeBerard, PhD, Utah State University

Background: Mindfulness interventions have become an increasingly popular psychological intervention for mental health providers, especially in Westernized countries (Shapiro, Brown, Thoresen, & Plante, 2011). While a number of studies suggest that mindfulness interventions increase mindfulness ability, as demonstrated by an increase in awareness, attention to the present moment, or other component of mindfulness (Piet, Hougaard, Hecksher, & Rosenberg, 2010; Shapiro et al., 2011), this assertion has not been validated since many researchers utilizing a mindfulness intervention fail to include measures assessing change in trait mindfulness ability. Methods: The survey study examined mindfulness engagement and trait mindfulness, as well as physical and mental health correlates of trait mindfulness. Participants included 275 students enrolled at Utah State University (74% female). Trait mindfulness ability was measured with the Mindful Attention and Awareness Scale (MAAS; Brown & Ryan, 2003) and the Five Facet Mindfulness Scale (FFMQ; Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006). Psychological factors were assessed via the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) and the Perceived Stress Scale (PSS; Cohen, Kamarck, & Mermelstein, 1983). The Short Form Health Survey (SF-36v2; Ware, Kosinski, Dewey, & Gandek, 2000) measured mental and physical health-related quality of life. Results: Previous time spent in mindfulness was positively correlated with two FFMQ subscales [Observe r(218)=0.26, p<.01) and Describing r(218)=0.19, p<.05)] and negatively related to FFMQ subscale Nonjudging of Inner Experience r(218)=-0.16, p<.05). Individuals with previous mindfulness engagement reported similar trait mindfulness to those who had not reported previous engagement, with the exception of the MMFQ subscale Observe, which was higher for individuals with previous engagement (d=0.41). (Additional results will be reported.) Discussion: Overall, these data suggest a weak relationship between general mindfulness engagement impact and trait mindfulness ability. They also suggest that more efforts are needed toward understanding this relationship (e.g., intervention, measurement, identifying mediators), especially since a significantl amount of therapeutic interventions incorporate mindfulness engagement.

34. Weight Self-Stigma and Problem Eating Behaviors: Multiple Predictors, Unique Associations, and the Centrality of Psychological Flexibility in a College Sample
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Weight Self-Stigma and Eating Problems
Sarah A. Potts, Utah State University
Jack Haeger, Utah State University
Benjamin Pierce, Utah State University
Michael M. Levin, Utah State University

Background: Research has found that weight self-stigma contributes to psychological distress and is a greater predictor of health-related quality of life than body mass index (BMI). Similarly, emotional eating behavior has been associated with low distress tolerance, greater psychological distress, and unhealthy food choices. The ability to manage weight self-stigma and urges to eat emotionally may be linked to the ability to behave flexibly in the context of these and other difficult inner experiences. Therefore, it was hypothesized that psychological flexibility would predict later self-stigma associated with weight, emotional eating tendencies, and binge eating episodes in a sample of undergraduate students. These relationships were anticipated to persist after controlling for participant gender, BMI, and prior psychological distress. Methods: Participants (N = 354; 64% female) completed measures of BMI, psychological distress, and psychological flexibility during the first wave of the study. One month later, participants reported on weight self-stigma, emotional eating, and the count of binge eating episodes within the past month. Weight self-stigma and emotional eating were regressed separately upon participant age, gender, BMI, psychological distress, and psychological flexibility as predictors. Poisson regression analysis was used to model the count of binge eating episodes as a function of these predictors. Results: Psychological flexibility emerged as a statistically significant predictor of all outcomes after controlling for psychological distress, BMI, and participant gender. Psychological distress statistically significantly predicted emotional eating and the count of binge eating episodes, but was not related to weight self-stigma. BMI statistically significantly predicted weight self-stigma, while gender was a significant predictor of emotional eating and the count of binge eating episodes. Discussion: The results of this study suggest that psychological flexibility may reduce the impact of perceived weight stigma and increase the ability to cope with urges to eat emotionally. Further, the findings indicate that psychological flexibility a better predictor of weight self-stigma than psychological distress. Implications of these findings for preventing and intervening with body image concerns and problem eating behaviors are discussed.

35. Individual trajectories of online students' academic emotions, effort regulation, and well-being following a brief academic values exercise: A replicated, case-based time series evaluation.
Primary Topic: Educational settings
Subtopic: Value
Kelli Howard, M.Ed, University of Minnesota, Twin Cities
Patricia Frazier, Ph.D, University of Minnesota, Twin Cities
Viann Nguyen, MPH, University of Minnesota, Twin Cities
Julia Urban, B.A., University of Minnesota, Twin Cities

Online learning is attractive for the potential to connect global learners and reach traditionally underserved populations. However, attrition rates are demonstrably higher in online learning environments, a difference some have attributed to the lack of contextual sources of self-regulation (Allen & Seaman, 2013; Hart, 2012; Lehman & Conceicao, 2014), as well as higher amounts of negative academic emotions in online vs. traditional classroom settings. Additionally, online students typically lack access to on-campus resources for emotional well-being and prevention of mental health problems. Thus, there is a need for the development and testing of interventions that help online students respond adaptively, and persist, alongside negative emotional experiences. Research suggests that brief values-based interventions can be helpful in improving students' academic performance and well-being (Chase et al., 2013; Cohen, Garcia, Apfel, & Master, 2006); however, such interventions have not been tested in the online learning environment. Researchers in the current study investigated the effectiveness of a brief online values exercise that had been embedded into the curriculum of two online psychology courses at a large university. Ninety university students completed weekly measures of academic emotions, self-regulation, and well-being for twelve weeks. Results of data analyses, using a replicated, case-based time series design, indicated salutary effects of the intervention on several outcomes, with small to medium effect sizes. Additionally, individual and group-level trajectories on outcome measures will be shown in comparison to a group (n = 380) of students who did not complete the academic intervention, suggesting a preventative effect. Implications for embedding similar interventions into a range of online learning contexts will be discussed.

36. Integrating ACT Training into Post-graduate Psychology programs at Makerere University, Uganda
Primary Topic: Educational Settings
Subtopic: Professional Development
Rosco Kasujja, Makerere University School of Psychology, Department of Mental Health & Community Psychology

My name is Rosco Kasujja, and I am from Kampala, Uganda. I am a clinical Psychologist currently employed by Makerere University School of Psychology with the Department of Mental Health & Community Psychology. The school of Psychology has four post-graduate programs including the post-graduate diploma in counseling and guidance, M. A. Counseling Psychology Master of Science in Clinical Psychology , and a Masters in Organizational Psychology. Makerere University is the oldest and biggest training institution in East Africa, and has been a source of education to so many African scholars. In fact, Makerere continues to attract many scholars from East Africa and beyond. It currently ranks amongst the top ten universities in Africa.
I have been involved with the department since 2009. I worked as a lecturer while I also coordinate activities for the masters programs, especially internship and practicum placement. I am also involved in curriculum development within the department. In my position at the university I have noticed that most of the text-books and resources utilized are typically from either North America, specifically U.S.A, or Europe, which limits students from having context specific references while learning.
While I am fully employed by Makerere University, I also get involved in a lot of psychosocial work in Northern Uganda (formerly war-affected areas) where the LRA rebels disrupted life. I am actively involved in training and supervising local counselors there. This training offers me a great honor of introducing ACT to wide range of practitioners within and around the country.
Training opportunities for students in Uganda
Post-graduate students at Makerere University (both M.A counseling & Msc. Clinical Psychology) are expected to learn and practice psychotherapy. However, most of the approaches passed onto them strictly follow text from Europe and North America. Last year’s introduction to ACT workshop which was offered by an ACT expert from the University of Glasgow offered was an intrigue and excited us. The students want to learn more because the approach was something they related to. It’s indeed an approach that is very much contextual and has room for local resources. This is something, with proper training, can become a very useful tool for students and other local experts they get in contact with.

37. The role of experiential avoidance in a University setting: Associations between perceived occupational stress, social support, coping, and health problems
Primary Topic: Organizational behavior management
Subtopic: workplace stress
Eleni Karayianni, Psy.D., Department of Psychology, University of Cyprus
Georgia Panayiotou, Ph.D., Department of Psychology, University of Cyprus

Background: WHO has been reporting that the cost of stress, job strain, as well as related mental and physical health issues experienced in the workplace is increasing each year. While ACT has been applied to the workplace with great success, the exact role of experiential avoidance needed to be defined. Method: The present study investigated the relationship between experiential avoidance as measured by the AAQ-II, perceived stress as measured by the PSS-10, social support as measured by the SSQ, and coping as measured by the Brief COPE as related to physical and health problems measured by the PHQ-15 in a University sample (N = 112). Results: Analyses indicated significant correlations between perceived stress and overall health (r = .46), and experiential avoidance and perceived stress (r = -.65). Further analyses showed there are significant correlations between emotional avoidance and perceived social support received, reported recent health problems, coping factors (e.g., positive reframing, denial, behavioral disengagement, etc). Regression analyses, however, failed to result in significant interactions between these factors and other factors such as gender, marital status, and age. Discussion: Results are discussed in terms of previous research findings of applying ACT in this context, the role of psychological flexibility within the workplace and occupational intervention design.

38. The Impact of Acceptance vs Suppression During an ROTC Army Physical Fitness Test
Primary Topic: Performance-enhancing interventions
Subtopic: Performance and Sports Psychology
Stephen Sheets, MA, California School of Professional Psychology
Jill Stoddard, Ph.D, California School of Professional Psychology

Background: In performance and sports psychology, Psychological Skills Training (PST), which involves suppression and control strategies including arousal control, goal setting, self-talk, and imagery/visualization, has dominated the focus of research and practice for the last 30 years (Singer et al., 1991). Despite its use as the primary methodology for performance and sports psychologists, the efficacy of PST has been found to be at best experimental (Gardner & Moore, 2009). Growing research is investigating the application of Mindfulness and Acceptance-based Therapies to sports performance on the field of play (Gardner & Moore, 2006). However, little is understood about the underlying mechanisms of performance. Furthermore, despite the emphasis the military places on performance, little research has been conducted with military populations and the role of performance enhancement techniques. Method: 95 ROTC cadets from three San Diego Universities participated in an experimental study to determine the effects of emotion regulation on physical performance. Utilizing a 2 X 2 factor design, participants were randomized to either an acceptance or suppression emotion regulation condition. Dependent variables included scores on the Army Physical Fitness Test (APFT), the Activity Flow State Scale (AFSS; Payne, et. al. 2011), and participants’ subjective self-ratings of performance. It was hypothesized that participants in the acceptance group would demonstrate greater improvements in performance over time following the intervention. Analyses included a Repeated-measures Multivariate Analysis of Variance (MANOVA) to assess for main effects and interactions. Results: Results indicated three significant interactions. First, the participants’ APFT scores has a significant interaction of F(1, 93)=4.278, p=.041. Second, the participants’ subjective rate of performance has a significant interaction of F(1, 93)=4.138, p=.045. Finally, the participants’ push-up scores has a significant interaction of F(1,93)=6.073, p=.061. Further detail can be provided as to the specifics of these interactions through post-hoc tests. Discussion: The results are consistent with previous research suggesting acceptance based emotion regulation strategies may provide advantages over suppression techniques across a number of domains (e.g., pain tolerance, distress about pain, mobility, emotional recovery). Results from this study may have implications for improved sport and military performance.

39. Using Implicit Measures to predict known groups: An IRAP v IAT comparison
Primary Topic: Other
Subtopic: IRAP
Aidan Hart, D.Clinpsy, University of Lincoln, UK
Ross Bartels, Ph.D, University of Lincoln, UK

Recent years have seen an increase in the use of implicit measures to assess hard to access beliefs/covert behaviour processes. In the field of Forensic Clinical Psychology there has been a growing interest in the use of such measures to assess group differences in offence supportive attitudes between offenders and non-offenders. Such uses can be problematic due to potential overlaps in the groups, such as shared pro-offending attitudes or undetected delinquency in the control group. The current authors believe that more work is needed to demonstrate that such measures can actually differentiate between groups where we would expect minimal overlap before their use is extended to such applied settings. In order to carry out such a test 183 self-identifying heterosexuals (m=91, f= 92) completed both an IRAP and an IAT that broadly measured their attitudes to the opposite and same sex in terms of sexual attractiveness and unattractiveness. The ability of each measure to differentiate the groups (male v female) was analysed using logistic regression and discriminative function analysis. The differences between the two measures and their relative strengths and weaknesses are discussed.

40. Mindful Practice for Air Traffic Controllers: Application of Mindfulness and Contextual Behavioral Science to promote safety in Aviation.
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness practice, Aviation, Safety
Arianna Gatti, Private Practice
Roberto Cattivelli, Istituto Auxologico Italiano
Valentina Villa
Annalisa Caretti
Alessandro Musetti
Gianluca Castelnuovo
Gian Mauro Manzoni
Emanuele Cappella
Silvia Ruggiero
Chiara Spatola

Background: Aviation statistics, both in the military and civil field, indicates that approximately 85% of incident reports include a mention of loss of Situational Awareness that lead to an inadequate decision making and inappropriate actions. Method: In the present exploratory study we test the feasibility of a mindfulness-based intervention in a sample of Military Air Traffic Controllers, to promote through mindfulness practice an improvement in Situational Awareness, considered the core requirement for an effective performance of both pilots and Air Traffic Controllers. Recent literature suggests that it may be identified a strong link between the enhancement of the situational awareness of an individual and mindfulness practice. Results and Discussion: The aim of this preliminary study was to test the efficacy of the intervention in the development of a flexible expertise that lead to a more effective decision-making and the enrichment of the behavioral repertoire.

41. Solutions for the (near) Future: Improve Safety in Aviation with contextual Behavioral Science Technological Application
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Safety, Aviation, Multiple exemplar Training
Arianna Gatti, Private Practice
Roberto Cattivelli, Istituto Auxologico Italiano
Alessandro Musetti
Valentina Villa
Nicola Maffini
Gianluca Castelnuovo
Giada Pietrabissa
Martina Ceccarini
Chiara Spatola
Annalisa Caretti
Gian Mauro Manzoni

Background: Recent literatures in the field of Aviation Safety indicate that the focus of future research programs should move from technological development to the interaction with increasingly complex systems that will be likely the future of both military and civil aviation. The safety question no longer concerns aircraft industries that have reached levels of security still unthinkable in other fields. Therefore Behavior-Based Safety interventions are to be considered among the most effective strategies, focused on the behavior of the pilot and all the people involved at different levels in managing efficiently these systems. Contextual Behavioral Science and behavioral interventions more in general are focused on directly changing behaviors with social impact. The opportunity to translate contextual behavioral interventions to the field of aviation safety is directly aimed at widen the effect of traditional intervention with the same efficacy but better efficiency and sustainability. The use of flight checklists is considered a core element to reduce workload of the pilots and increase the standardization of operating procedures. Interventions based on the application of Applied Behavior Analysis techniques are to be considered among the most effective in promoting an appropriate use of checklists, since focused on the behavior of the single pilot as well as all of the people involved at different levels in flight safety. Method: The aim of the present study was to examine the effectiveness of using contingent and specific feedbacks to promote the accuracy in checklist use in a sample of General Aviation pilots. Results and Discussion: In this preliminary study we tested the feasibility of a contextual behavioral approach to improve performance in checklist use both in directly trained and trained flying phases.

42. Disordered eating and body image flexibility in women with lipoedema
Primary Topic: Prevention and Community-Based Interventions
Subtopic: lipoedema, eating disorders, body image dissatisfaction, body image flexibility
Joanna E. Dudek, University of Social Sciences and Humanities
Pawel Ostaszewski, Ph.D., University of Social Sciences and Humanities
Wojciech Bialaszek, Ph.D., University of Social Sciences and Humanities

Lipoedema (lipedema) is a chronic disease which is very often misdiagnosed as obesity and therefore mistreated. In lipoedema fat accumulates in the lower parts of the body and cannot be lost through diet or intensive exercise and in obesity which leads to learned helplessness, depression, body dissatisfaction, anxiety and feelings of shame and guilt as well as development of disordered eating. Lipoedema is a disease affecting all women irrespective of their body size (also observed in patients with anorexia nervosa). In our study we wanted to investigate what psychological factors are connected to disordered eating of women with lipoedema. Our aim was to find out whether contextual behavioral approach might propose any useful interventions for preventing development of eating disorders in the population suffering from lipoedema. We conducted an internet-based cross-sectional study. Participants were 120 women suffering from lipoedema, mostly from the USA, the UK and Australia. Statistical analyses showed that irrespective of symptom severity and BMI, body image flexibility is an important factor related to disordered eating in women with lipoedema.

43. The Impact of Age, Gender, and BMI on Thought Control, Food Acceptance, and Eating Behavior
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Obesity; Emotion Regulation
Kristin D. Whelan, M.A., Alliant International University, San Diego
Kimberly A. Corp, MFT., Alliant International University, San Diego
Shawnee L. Brew, B.A., Alliant International University, San Diego
Taryn L. Gammon, M.A., Alliant International University, San Diego
Jill A. Stoddard, Ph.D., Alliant International University, San Diego

Background: Contemporary research indicates a relationship between cognition, emotion regulation and eating. Research also commonly supports gender and age discrepancies in emotion regulation. For example, studies postulate that women report more negative affect and an increased tendency to ruminate, catastrophize, and reappraise negative emotion than men (Thomsen, D.K., Mehlsen, M.Y., Viidik, A., Sommerlund, B., & Zachariae, R., 2005; Nolen-Hoeksma, A., 2011). Women’s use of emotional acceptance appears to remain stable with age, whereas emotional suppression increases with age for women but not men. Older adults report less negative affect than youth. Finally, studies suggest a higher prevalence of food craving, cognitive dietary restraint, and disinhibition of eating among women compared to men (Alexander, J & Tepper, B., 1995; Lafay, T. et al., 2001). The extent to which these age and gender related findings extend to maladaptive cognitive processes and unhealthy food related behaviors remain unclear. Method: The current study uses the Thought Control Questionnaire (TCQ), The Food Acceptance and Action Questionnaire (FAAQ) and the Three-factor Eating Questionnaire (TFEQ) to examine how various thought control strategies, experiential acceptance of food-related internal experience, and relationships between cognitive restraint of eating, disinhibition, and hunger differ based on age, gender, and BMI. Recruitment of 180 normal weight and overweight/obese males and females of varying ages is proceeding (current N=132). Results: It is expected that younger age will be associated with higher levels of worry and social thought control, and older age will be associated with higher levels of food acceptance. It is also hypothesized that women and overweight/obese will have higher mean levels of cognitive restraint, disinhibition, perceived hunger, rumination, and punishment thought control strategies than men or normal weights, whereas women and normal weights will have higher levels of food-related acceptance and reappraisal thought control strategies than men or overweight/obese. Correlations and t-tests will be used to investigate the relationships between age, gender and weight on the TCQ, FAAQ and TFEQ. Discussion: Results from this study will help to increase understanding of the impact that gender, age, and weight have on emotion regulation, preoccupation with body, food, and weight as well as unhealthy eating patterns. Findings may illuminate important considerations for the development of prevention and treatment programs that target the global obesity epidemic.

44. The acceptance and commitment therapy for smoking cessation: A review of the literature
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Smoking cessation
Lam Ching Yee, MPhil, MN, BN, RN, The Open University of Hong Kong
MAK YIM WAH, PhD, RN, RM, The Hong Kong Polytechnic University

Background: A common strategy that clients use for quitting smoking is to avoid physical cravings and urges. However, evidence indicated that higher experiential avoidance is associated with higher levels of substance use. Acceptance and commitment therapy (ACT) is an emerging contextual-focused intervention in managing psychological or behavioral health problems. It helps to increase an individual’s psychological flexibility, and encourages an individual to accept and experience internal events non-judgmentally. However, the efficacy of ACT for smoking cessation is less documented. In this review, we assess deliverables, feasibility and the effectiveness of ACT for smoking cessation. Method: A systematic search of relevant English language literature was conducted in computerized databases, including Pubmed, Medline, PsycINFO, CINAHL, and ProQuest, using keywords smoking cessation, tobacco cessation, smoking reduction, quit smok*, acceptance and commitment therapy and ACT, with date restriction from 1900 to March 2015. With reference to the PRISMA statement, abstracts meeting inclusion criteria were reviewed and full papers for selected abstracts were then retrieved and assessed. Result: A total of 17 studies were included in this review. The use of ACT in smoking cessation program has increased gradually in adult populations. It could be delivered in different formats, for example, telephone-delivered, web-based, smartphone applications, group therapy or individual therapy. Majority of the studies were conducted in Western countries with only one exception from Hong Kong, though it was a study protocol. The efficacy of ACT was examined independently and was compared with medication treatment or other behavioral therapy. ACT appeared to be a feasible and applicable therapy for smokers in tobacco cessation and promising quit rate were reported. Discussion: This review revealed the updated information about ACT and smoking cessation. This presentation will inform attendees about the feasibility of different formats of ACT for smoking cessation and its efficacy, and hopefully help to identify implications for practice and to suggest directions for future research relating to ACT and smoking cessation.

45. Psychological inflexibility and anxiety in greek-cypriot adolescents
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents
Marios Theodorou, Ph.D. Student, University of Cyprus
Georgia Panayiotou, Ph.D., University of Cyprus, Center of Applied Neuroscience
Klavdia Neophytou, University of Cyprus, Center of Applied Neurosience

Background: Previous research supports the association between psychological difficulties and psychological inflexibility (e.g. Hayes et al. 2006). One of the fundamental principles of Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) is to help people disentangle from inflexible and rigid rules that are not helpful. A considerable body of research focuses on the role of psychological flexibility as a basic aspect of health (e.g. Kashdan, & Rottenberg, 2010). The aim of this study was to examine the relation between anxiety, and related constructs (e.g. Behavioral Inhibition/ BIS) with psychological inflexibility in adolescents. Method: Seven hundred twenty one adolescent students, (Mean Age: 15.5, 64% female) completed a series of questionnaires (Acceptance and Fusion Questionnaire for Youth/AFQ-Y8, Social Phobia Anxiety Inventory-23/SPAI-23, Βehavioral Ιnhibition System & Behavioral Activation System scales/ BIS/BAS for children, Social Phobia Screening Questionnaire for Children and adolescents/SPSQ-C and the the revised version of the Screen for Child Anxiety Related Emotional Disorders/SCARED-R. Results: Psychological Inflexibility (AFQ-Y8) was positively related with all anxiety measures (SPAI-23 different score, BIS, and SCARED-R subscales). An independent t-test analysis showed that high socially anxious participants (based on SPAI-23 and SPSQ-C cut-off criteria) scored significantly higher than low socially anxious participants in Psychological Inflexibility. Additionally, female students scored higher than male students in Psychological Inflexibility. Discussion: These results replicate previous findings on the relation between anxiety and psychological inflexibility, and indicate that this association is already established in adolescence. The potential role of inflexibility in the etiology and maintenance of anxiety is discussed.

46. Training "barefoot counselors" in Afghan displaced persons camps
Primary Topic: Prevention and Community-Based Interventions
Subtopic: traumatic stress, domestic violence
Norman Gustavson, Ph.D., PARSA a US based International NGO
Sabour Mansouri, M.D., APMO, an National Afghan NGO

During the thirty years of armed conflict affecting Afghanistan, from the war between the Russian backed government ("Russian Invasion, 1978), to the Mujaheddin civil war that followed and the Taliban takeover of the government that lasted until 2001, and the ongoing war against insurgents and Taliban groups over six million Afghans fled to Pakistan, some two million to Iran and to many other countries. Since 2001 these refugees have returned in their millions and there is a continuing flow of "internally displaced persons" coming into the major urban areas from the conflict zones around the country. Some of these camps house over 25,000 people and many have become permanent settlements existing for over a decade. The residents of these Internally Displaced Persons Camps "IDPs" are marginalized people who seldom find homes and jobs outside these camps. they live in marginal conditions in mud and canvas huts with as many as a dozen people in a one room "dwelling". Chronic poverty, preasure to participate in illegal and marginal ways to support families, infiltration by Talib and other insurgents lead to chronic threats and vilolent behavior within and between families and groups in these camps. Resources are extremely marginal while physical, social and psychological needs are significant.

War Child Canada is working in camps in Kabul, Jalalabad and Kandahar to provide "child safe spaces", human rights education and legal aid to residents and has innaguarated this program to train community members in basic counseling skills and to develop referral resources. Our program provides training to WC staff and then to selected men and women in the camps who are supported in becoming a first line of mental health/ counseling intervention in the camps.

Our program design includes a very basic orientation to rft and uses the ACT Matrix as a model for exploring personal and family problems, sorting out maladaptive avoidance behaviors and developing a values based program of behavior change to support clients and their families.

This training is in its first iteration at the three named sites and is currently working to support the first cohorts of counselors in providing direct services and making appropriate referrals.

47. Predicting dishonest behaviors in the academic context
Primary Topic: Relational Frame Theory
Subtopic: IRAP, academic dishonesty, Theory of Planned Behavior
Lidia Baran M.A., University of Silesia in Katowice

The problem of dishonest behaviors has become an increasingly significant issue in the area of the social psychology not only because of alarming numbers of dishonesty in academic, politic and interpersonal context but also because of its complex nature. Therefore, ability to successfully identify factors which influence individual decision to cheat is crucial to the process of creating effective dishonesty prevention and educational programs. The aim of the present study is to answer question about possible predictors of intention to commit an academic fraud. By combining elements of Theory of Planned Behavior (TPB) and implicit attitude measured from Relational Frame Theory perspective in the research plan author intended to maximized the level of explained variation in intention to and actual cheating behavior and investigate possible relation between those constructs. Student participants were invited to the laboratory in order to test new computer based methods measuring cognitive abilities. The first task gave participants a chance to solve a given exercises either in honest or dishonest way and the second one introduce them to the Implicit Relational Assessment Procedure (IRAP) concerning academic dishonesty. Finally participants were given a questionnaire measuring moral obligation, perceived behavioral control, subjective norms, attitude and intention toward cheating. Incorporating results obtain in the recent study into direct interventions in the academic context may increase their effectiveness and allows practitioners to better understand the phenomenon of the academic dishonesty.

48. Exploring attitudes towards gender and science using the IRAP & the IAT
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Lynn Farrell, B.A., University College Dublin
Andy Cochrane, Ph.D., Maynooth University
Louise McHugh, Ph.D., University College Dublin

Gendered beliefs and stereotypes can have a pervasive influence on the lives of males and females, influencing both behaviour and attitudes. There is a stereotypically masculine image related to the fields of science, technology, engineering and maths (STEM), with men often more strongly associated with these areas than women. Even when individuals claim to hold gender-neutral beliefs about STEM, research has found they may still hold gender-biased implicit beliefs. The issue of women’s under-representation in STEM, in combination with gendered STEM stereotypes, is a global concern having been found in many countries across the world. Two implicit measures, the Implicit Relational Assessment Procedure (IRAP) and the Implicit Association Test (IAT), were compared to assess attitudes towards women and science-based versus liberal arts college subjects. The IAT indicated the hypothesised significant men-science, women-arts bias for both males and females, with a stronger effect for females. The IRAP, however, produced a more complex pattern of results, with females showing a tendency to pair men with science and with liberal arts, whereas the males showed a more neutral effect. A follow up study aimed to investigate whether manipulation of the IRAP’s stimuli (i.e. using a more subtle label phrase) influenced any resultant bias particularly among females. The findings demonstrate the IRAP’s ability to provide more specific detail, such as the directionality of bias. These findings also have implications for those concerned with addressing the worldwide gender imbalance in STEM.

49. Comparing emotional regulation difficulties in women with premenstrual syndrome and normal women in Tehran city.
Primary Topic: Theoretical and philosophical foundations
Subtopic: mindfulness
Mahboube Ahmadi, M.S. in clinical psychology, Islamic Azad University, Khorasgan branch
Fatemeh Zargar, assistant professor in clinical psychology, Kashan University in Medical Sciences

This study aimed to compare the skills of mindfulness and emotion regulation ability in women with symptoms of premenstrual syndrome (PMS) and normal women in Tehran city. This is a case- control study. Women who referred to psychiatric clinics and offices of Obstetricians and Gynecologists at the second half of 2014 were selected by PMS screening questionnaire. Fifty women with PMS symptoms and 50 women without PMS symptoms filled out difficulties in emotion regulation scale (DERS) that had 6 subscales (no acceptance of Emotional Responses, difficulties engaging in goal-directed, impulse control difficulties, lack of emotional awareness, limited access to emotion regulation strategies and lack of emotional clarity). Data analysis using multivariate analysis of variance (MONOVA) showed significant differences in all subscales of DERS except in lack of emotional awareness and lack of emotional clarity. It can be concluded that women with PMS have weaker emotional acceptance, goal-directed behavior, impulse control and emotional regulation strategies than non-infected women.

Thursday, 16 July - Poster Session #2

1. A Systematic review of ACT for Chronic Pain: Outcome measures and delivery from a physical function perspective
Primary Topic: Behavioral medicine
Subtopic: Physiotherapy; ACT; Interprofessional Pain Rehabilitation; Chronic Pain; Interdisciplinary
Cleo Barrable, M.A., MSc., University of Brighton
Guy Canby, University of Brighton

BACKGROUND: Acceptance and Commitment Therapy (ACT) for chronic pain management (CPM) focuses on increasing function and engagement in valued life rather than pain reduction. Physiotherapists clearly have an invaluable role in helping to achieve this aim. Furthermore, since the mid-90’s, research and evidence-based guidelines have stated that pain management programmes (PMPs) should be delivered by an interdisciplinary team, with the physiotherapist as an integral member. An increasing number of studies are evaluating the efficacy of ACT in CPM, but their outcome measures and delivery methods have not been analysed from a physical function perspective. Therefore this systematic review will identify randomized controlled trials (RCTs), and RCT-protocols, that investigate ACT-based-interventions within an adult non-oncological chronic pain population, with the primary objective being to determine: (1) how physical function is measured and establish if it is (a) consistently selected as a primary outcome and/or (b) comprehensively measured (e.g. self report, performance-based, both); (2) how ACT is being delivered and establish if physiotherapists are involved. A secondary objective is to consider whether planned research (i.e. RCT-protocols) differ within these areas as this may affect the recommendations made for future research. METHODS: An extensive systematic search across 12 databases, 2 clinical trial registries and 2 websites identified 2208 trials, 20 (16 RCTs; 4 Protocols) were found eligible for inclusion. A pre-specified data extraction tool was used across all studies and protocols were analysed as a separate subgroup for comparison. RCTs were assessed for Quality and Risk-of-Bias (RoB). RESULTS: Half the RCTs suffered from high RoB. Overall 9 different physical function outcome measures were identified, 8 were self-report format. Half of the trials included one of these measures as a primary outcome. All of the RCTs used psychologist(s) to administer the ACT-intervention, with 3/16 trials additionally using a pain physician to administer 2 sessions, but no trials included physiotherapist(s). Protocols proposed only self-report measures, but 3/4 planned physiotherapist involvement in their treatment and/or control. DISCUSSION: The research evaluating the efficacy of ACT in CPM does not comprehensively and effectively measure physical function. Furthermore, against what is recommended, the interventions delivered were mostly unidisciplinary and did not involve physiotherapists. The lack of an interdisciplinary approach may challenge the generalisability of findings to those PMPs that follow recommendations. Planned research is focusing on physiotherapy-delivered treatments, but continues to restrict outcome measurement to self-report. It is recommended that future RCTs include performance-based measures alongside self-report modalities, for a more comprehensive assessment of the important domain of physical functioning.

2. Investigating the Relationship Between Psychological Flexibility and Health Behaviors Among Dieters
Primary Topic: Behavioral medicine
Subtopic: Dieting, Psychological Flexibility
Jessica Borushok, M.A., Bowling Green State University
Robert Carels, Ph.D., East Carolina University

Background: Obesity is a prominent health concern that affects nearly two-thirds of U.S. adults. Health professionals are especially alarmed by the prevalence of obesity because of the associated preventable chronic health risks, including cardiovascular disease, Type II diabetes, and cancer (Pi-Sunyer, 2009). Thus, researchers have focused on identifying specific factors related to successful weight loss and health behavior change. One growing area of research examines the relationship between psychological flexibility and health behaviors in an effort to identify factors that impact health behavior change and healthy lifestyles. Method: Data were collected through an online survey from self-reported dieting (i.e. engaging in active attempt to lose weight) adults (N= 196; 74% Female; 78.4% Caucasian; mean age: 37.85, SD: 12.23, range = 19-74) in a community, non-treatment seeking (i.e. not using surgical, bariatric, and/or formal behavioral interventions to lose weight) sample. All participants resided in the United States. They completed measures of weight-related psychological flexibility, eating and physical activity habits and beliefs, as well as dieting and self-monitoring practices. Results: Preliminary tests were conducted to examine relationships among demographic characteristics. Significant relationships were included as covariates in subsequent analyses. Hypotheses examining the relationship between weight-related psychological flexibility and various health-related behaviors among dieters were analyzed using hierarchical regression analyses where covariates were added in Step 1 and weight-related psychological flexibility was added in Step 2. Discussion: Findings highlight relationship between weight-related psychological flexibility and dieting variables, and suggest psychological flexibility may be an important factor that influences an individual’s success in creating and maintaining positive health behavior habits when dieting. Further research aimed at interventions that increase psychological flexibility and can be disseminated to large communities is important. Keywords: Diet, Psychological Flexibility, Health

3. Study protocol: Group based Acceptance and Commitment Therapy for adolescents with functional somatic syndromes – randomized trial.
Primary Topic: Behavioral medicine
Subtopic: Adolescents, functional disorders
Karen Hansen Kallesøe, MD, Ph.D. student, Aarhus University Hospital, Denmark, The Research Clinic for Functional Disorders and Psychosomatics
Charlotte Ulrikka Rask, MD, associate professor, Ph.D., Aarhus University Hospital, Denmark, The Research Clinic for Functional Disorders and Psychosomatics
Andreas Schröder, MD, PhD, Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
Rikard Wicksell, Ph.D., Karolinska Institute, Stockholm, Sweden
Per Fink, professor, Ph.D., Dr.med.sc., Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark

Background Over the last 3 decades, an increasing number of adolescents report recurrent functional somatic symptoms, i.e. somatic symptoms not attributable to any known conventionally defined physical disease. Epidemiological studies illustrate that five to ten percent experience persistent symptoms and reduced functioning and may receive diagnoses for functional somatic syndromes (FSS) such as chronic fatigue syndrome (CFS), fibromyalgia (FM), recurrent abdominal pain/irritable bowel syndrome (IBS) or idiopathic pain syndrome, characterized by severe disability and reduced quality of life. Unfortunately, despite the high need for care, there is yet a lack of empirically supported treatments for these adolescents. Aim The aim of this study is to examine the efficacy of group based Acceptance and Commitment Therapy (ACT) for adolescents with severe FSS. Method and design A total of 120 adolescents aged 15-19 years and diagnosed with severe FSS will be assessed and randomized to either: 1. Standard treatment: a single consultation with a psychiatrist and treatment as usual or 2. Standard treatment plus manualized ACT based group therapy. The ACT program is specifically developed for adolescents with severe FSS and consists of 9 modules (i.e. 27 hours in total) and one follow up meeting (3 hours). Self-report questionnaires will be administered at baseline and 2, 4, 5½, 8 and 12 months after baseline with 5½ months as end of treatment and 12 months as primary endpoint. The primary outcome variable is physical health, as assessed by SF36. Secondary outcome variables include symptom interference, stress, quality of life and global improvement. Process measures are illness perception, illness related behavior and psychological flexibility. In addition, physiological stress response will be measured by heart rate variability (HRV), hair-cortisol and inflammatory response (e.g. IL6, TNF-α, high-sensitive CRP, IL1, neopterin, CD163, HO1, MCP1 but also newer proteo-based markers) at baseline and primary endpoint. Discussion This is one of the first larger studies which aims to develop effective, evidence based treatment for adolescents with severe, disabling chronic FSS. Objective markers for physiological stress response will increase our knowledge of FSS and the potential process of change. If the treatment is effective this may result in significant improvement in the well-being and overall quality of life of these young patients as well as substantial reductions in health-related costs

4. The role of psychological inflexibility in the relationship between life hassles and depressive symptoms in adolescence
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescence
Ana Xavier, Ph.D. Student, Cognitive and Behavioral Center for Research and Intervention, University of Coimbra, Portugal
José Pinto Gouveia, Ph.D., Cognitive and Behavioral Center for Research and Intervention, University of Coimbra, Portugal
Marina Cunha, Ph.D., Instituto Superior Miguel Torga, Coimbra, Portugal; Cognitive and Behavioral Center for Research and Intervention

Background: Empirical evidence demonstrates that psychological inflexibility is a major issue of social and emotional functioning in several mental disorders. It is also well-established that everyday life hassles are associated with psychological maladjustment and depression. However, there are still unanswered questions about the role of psychological inflexibility in the relationship between recent life hassles and depression among adolescents. Method: This study aims to test whether psychological inflexibility mediates the relationship between life hassles and depressive symptoms. The sample consists of 787 adolescents (53% female adolescents) aged between 12 and 18 years old (M = 14.99, SD = 1.76), collected from middle and secondary schools from centre region of Portugal. Participants answered the following self-report questionnaires: Daily Hassles Microsystems Scale (DHMS), Avoidance and Fusion Questionnaire for Youth (AFQ-Y) and Depression Anxiety and Stress Scale (DASS-21). Results: Descriptive analysis showed that girls presented higher levels of everyday school and peer hassles, psychological inflexibility and depressive symptoms than boys. Age and years of education were positively correlated with daily school hassles and with depressive symptoms. There were significant correlations between life hassles and psychological inflexibility. Daily school and peer hassles were moderately associated with depressive symptoms. There was a significant correlation between psychological inflexibility and depressive symptoms. Results from path analysis showed that the model explained 39% of depressive symptoms variance. A bootstrap analysis revealed a significant indirect effect of psychological inflexibility in the relationship between life hassles and depressive symptoms, even when socio-demographic variables were controlled for. Discussion: These results indicate that daily school and peer hassles indirectly predicted depressive symptoms, through their effect in psychological inflexibility. It seems that adolescents who perceived more daily school and peer hassles tend to deal with it in an inflexible and avoidant way, which in turn impacts upon increased levels of depressive symptoms.

5. ACT for OCD: a single case study of a 13 years old child with compulsive hoarding
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, OCD, Children
Angela Valli, IESCUM (Italy)
Giovambattista Presti, M.D., Ph.D., Università Kore, Enna (Italy)

Compulsive Hoarding is characterised by “excessively save items that others may view as worthless and have persistent difficulty getting rid of or parting with possessions” (APA, 2014). Cognitive-Behavioral Therapy (CBT) is a commonly implemented therapeutic intervention for Obsessive-Compulsive Disorder (OCD), and also for compulsive hoarding. However, third wave therapies such as Acceptance and Commitment Therapy (ACT) are increasingly recognized as treatments of choice for OCD (Bluett E.J. et al., 2014). The aim of this work is to present the rationale for using ACT and the application to a 13 years old child showing compulsive hoarding. Rather than aiming to restructure problematic beliefs related to hoarding, we tried with the help of an ACT protocol to promote psychological flexibility, the ability to take distance from problematic thoughts (cognitive defusion) and to accept internal experiences (feelings, thoughts, urges, bodily sensations) in the service of decreasing the aversive control of anxiety and obsessions and increasing personal values-oriented committed actions. To investigate the effectiveness of therapy, direct measures of hoarding behaviors and the following psychometric tools DAWBA (Goodman et al., 2000), CBCL (Achenbach and Rescorla 2001), AFQ-Y (Greco and Baer, 2008), CAMM (Greco, Smith and Baer, 2008) were used at pre and post-treatment intervals.

6. Does contextualizing AAQ make it more sensible to clinical changes? An exploratory analysis of two ways of using it
Primary Topic: Clinical Interventions and Interests
Subtopic: AAQ, Experiential avoidance
Annalisa Oppo, Sigmund Freud University, IULM University (Milan, Italy)
Giovambattista Presti, MD, PhD, Kore University, Enna (Italy)
Cristina Rizzo, Kore University, Enna (Italy)
Concetta Messina, Kore University, Enna (Italy)
Martina Leuzzi, Kore University, Enna (Italy)
Paolo Moderato, PhD, IULM Unversity (Milan, Italy)

AAQ is a measure of experiential avoidance which is extensively used in clinical studies. The interest on this measure comes from the fact that experiential avoidance/ psychological inflexibility is of significant importance in relation to the development, maintenance, and treatment of psychopathology. Thus testing its sensitivity to changes in the measured dimension is important to understand some aspects of its psychometric properties. Two hundred undergraduate students attending a class on personality were randomly assigned to one of two groups: AAQ and in-context-AAQ. Eight mindfulness exercises were delivered at the end of 8 different lessons at the same time to all the subjects. Before each mindfulness exercise subjects were asked to complete the AAQs. Instructions on the in-context-AAQ sheet required the participant to write down on top of the page the thought that was particularly worrying him/her in the last period and to complete the AAQ in the light of the worries expressed. He/she could tear the thought reported on top of the sheet, once the responses were marked. A significant statistical difference emerged from the fourth evaluation on for the in-context-AAQ group with respect to baseline while the AAQ group remained stable. In the in-context-AAQ group the score differed showing more flexibility. While other variables could account for this statistical difference, it is nevertheless interesting to note such a difference on the same instrument under the same conditions, except for the way it was administered. Implication for future research to deepen into this difference will be discussed

7. Evaluating the effect of a 3-days Acceptance and Commitment Therapy workshop on therapists' psychological flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological Flexibility
Arianna Ristallo, Università IULM, Milan and IESCUM, Italy
Massimo Cesareo, Università IULM, Milan and IESCUM, Italy
Francesco Dell'Orco, Università IULM, Milan and IESCUM, Italy

Psychological flexibility and acceptance are relevant in promoting psychological health. Few studies provide data on therapist skill development and personal benefit for therapists related to receiving ACT training. The present study investigates the effects of a 3-days intensive ACT workshop on clinical psychologists in training. Six self report measures - Cognitive Fusion Questionnaire (Gillanders et al., 2014), Acceptance and Action Questionnaire II – Italian Version (Pennato et al. , 2013), Experience Questionnaire (Fresco et al. , 2007), Depression Anxiety and Stress Scale - Italian Version (Severino & Haynes, 2010) and Symptom Checklist-90 (Derogatis, 2011) - were administered to 170 Italian psychologists from different part of Italy (age 24-56, mean=30.98 sd=4.33, 88.2% female, 11.8% male). Participants completed the questionnaires (paper pencil form) before and after the workshop. A 3-months follow up was administered online. Among the therapists 128 (75%) completed the first two evaluations and among them 69 (54%) completed the online follow up. An increase in the indices of psychological flexibility is expected among the therapists after completing workshop. Results will be discussed.

8. Is less effective? A preliminary evaluation of the effects of a comprised ACT-treatment for longstanding pain
Primary Topic: Clinical Interventions and Interests
Subtopic: Longstanding pain
Björn Liliequist, Lic Psych, M.Sc, Karolinska University Hospital
Martin Jonsjö, Ph.D.-Student, Karolinska Institutet
Mike Kemani, Ph.D., Karolinska Institutet
Camilla Wiwe-Lipsker, Ph.D-Student, Karolinska Institutet
Rikard Wicksell, Ph.D., Karolinska Institutet

Introduction and objectives Since 2001, an ACT-based behavioral medicine treatment model for longstanding debilitating pain has been developed at the Karolinska University Hospital. A number of RCT's have shown the efficacy of the treatment model in increasing functioning and quality of life. However, a subgroup of patients choose not to participate in treatment. In our clinical experience, a number of these patients decline treatment due to the extensiveness of the intervention, i.e. these patients prioritize engagement in valued activities such as work, school etc before treatment. A less extensive version of the treatment program may be of benefit for these patients who, though already engaged in some valued areas of life, are still affected by pain and pain-related problems in other areas. There is a lack of studies evaluating the effect of comprised ACT interventions for longstanding, debilitating pain. The main aim of this ongoing study is to evaluate whether a short format treatment program is effective in increasing functioning in patients who otherwise would not receive treatment for their pain-related problems. Method Treatment consists of 5-7 weekly individual ACT sessions, delivered by a psychologist (4-6) and by a physician (1) respectively. In addition, parents to children and adolescents in treatment receive 2 ACT sessions delivered by a psychologist and 1 session with a physician. An open case trial design is used, with assessments at pre- and post-treatment as well as at 3, 6 and 12 months follow-up. The primary outcome measures are pain disability (PDI), pain interference (PII). Secondary outcome measures include psychological flexibility (Psychological Inflexibility in Pain Scale, PIPS). Results and conclusion Data collection is ongoing. Treatment evaluations of outcome will be presented, and clinical implications of these findings will be discussed.

9. Examining the Relations Between Anxiety, Depression, Chronic Traumatic Stress, and Psychological Flexibility in Male Bhutanese Refugees
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological Flexibility
Carly Baetz, J.D., M.Phil., The Graduate Center, CUNY
Jessica Clifton, M.A., University of Vermont
Victoria Baptiste, B.A., University of Vermont
Jeff Winer, M.S., University of Massachusetts Amherst
Sheau-Yan Ho, B.A., University of Vermont
Emily Pichler, B.A., University of Vermont
Valerie Harder, M.H.S., Ph.D., University of Vermont
Karen Fondacaro, Ph.D., University of Vermont

Prior research has shown that psychological flexibility is an important predictor of general psychological health and well-being. In refugee populations, psychological flexibility may also constitute an important factor in overcoming trauma (including a history of torture), resettlement, and acculturative stressors. However, to date there is little research on how psychological flexibility is related to mental health symptoms in refugee populations. The current study will begin to fill this gap in the literature by examining the relationship between psychological flexibility and symptoms of anxiety, depression, and chronic traumatic stress among Bhutanese refugee men referred to a community health clinic. Participants included 9 male Bhutanese refugees enrolled in an open-format psychotherapy group for adjustment disorder. Treatment was rooted in an acceptance and commitment therapy (ACT) framework, with the goal of enhancing overall psychological well-being. Baseline measurements included the Hopkins Symptom Checklist-25 (HSCL-25) and the Harvard Trauma Questionnaire (HTQ) to assess for depressive, anxiety, and posttraumatic stress symptom severity. Psychological flexibility was also assessed at baseline using the Acceptance and Action Questionnaire-II (AAQ-II). Results will include descriptive data and correlation analyses to assess the relationship between acceptance, willingness to pursue valued experiences, and symptom severity. These findings will provide critical, and otherwise unknown, information about the role of psychological flexibility in relation to mental health symptoms in Bhutanese male refugees. These findings will also highlight the implications of using ACT in a group psychotherapy setting to address these symptoms in male refugee populations. More broadly, the results may be used to inform and improve the treatment of mental health problems in refugees and survivors of trauma and torture.

10. ACT for Depression and Anxiety: Group Therapy with College Students and Community Members
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression and Anxiety
Cassandra Pentzien, B.A., Bowling Green State University
Jessica Borushok, M.A., Bowling Green State University
Jennifer Lackey, M.A., Bowling Green State University
Kelly E. Amrhein, M.A., Bowling Green State University
Dryw Dworsky, Ph.D., Bowling Green State University 

A 10-week therapy group using Acceptance and Commitment Therapy for depression and anxiety was modified and implemented at the Bowling Green State University (BGSU) Psychological Services Center. Based originally on an intervention created for Cornell University’s Counseling and Psychological Services by Matthew Boone and Cory Myler, the group served undergraduate and graduate students from BGSU as well as nonstudent members of the community. The intervention combined didactic elements, mindfulness exercises, experiential activities, group discussion, and homework. Most worksheets and handouts were adapted from ACT Made Simple and The Happiness Trap. The first six sessions focused on the processes of psychological flexibility, while the remaining sessions encouraged group members to integrate these processes into their own lives in the service of mobilizing toward values-driven committed action. Group members were administered survey measures before participating in the intervention and after their completion to assess psychological flexibility and life satisfaction. This poster will examine treatment outcomes and discuss potential differences in outcomes between community versus college student groups. Additionally, the practical challenges and barriers that are associated with the implementation of an ACT group protocol with college students and community members will be discussed, including the unique barriers that arise with recruiting and integrating community members into groups with traditional college students.

11. Parent counseling based on Acceptance and Commitment therapy: A pilot study
Primary Topic: Clinical Interventions and Interests
Subtopic: Parents of children with developmental and/or psychological problems
Denise Bodden, Ph.d., Radboud University Nijmegen, Behavioural Science Institute
Denise Matthijssen, Altrecht, Division of Youth

Research on the effectiveness of ACT as a parent counseling therapy is scarce. In a study by Blackledge and Hayes (2006), it was demonstrated that after a 2-day group ACT workshop for parents with children diagnosed with autism that parents improved. Additionally, Coyne, McHugh and Martinez (2011) have described how ACT can be employed in families. Both concluded that additional research is necessary to investigate effectiveness of ACT parent programs. In this pilot study, ACT was delivered as a parent counseling therapy in order to provide the parents new skills in dealing with their children’s interaction problems by increasing psychological flexibility. The ACT parent counseling consisted of eight group-therapy sessions with six to eight parents. The goal of this quasi experimental research was to investigate whether this ACT parent program led to an increase in psychological flexibility, parental competence, positive parenting skills and the quality of the parent-child interaction. In this presentation, the content of the ACT parent program will be presented, as well as the effects of this program based on 50 parents’ self-reports. Results suggest that ACT parent counseling is a promising intervention.

12. A Pilot Study of an Acceptance and Commitment Therapy-Based Intervention addressing emotion regulation in individuals with Substance Use Disorder and Borderline Personality Disorder
Primary Topic: Clinical Interventions and Interests
Subtopic: Emotion regulation, Substance use disorder, Borderline Personality Disorder
Dr Kate Hall, DPsych, Deakin University
Dr Angela Simpson, DPsych, Deakin University
Ms Romy Briner, Deakin University
Associate Professor Petra Staiger, Deakin University
Ms Jane Morton, Spectrum Personality Disorder Service
Professor Dan Lubman, Turning Point Eastern Health & Monash University

Background: While around 1-2% of the general population meet criteria for Borderline Personality Disorder (BPD), up to 65% of substance users in treatment meet criteria for BPD. It is common for these individuals to engage in impulsive, maladaptive behaviours (e.g. risk taking, self-harm). The severity of emotional and behavioural symptoms in these treatment seeking individuals present considerable challenges for addiction treatment services. Treatment studies highlight that clients with co-occurring SUD and BPD have higher rates of relapse, treatment noncompliance and poorer outcomes than those with either diagnosis alone. These clients pose considerable challenges to treatment services and the currently available treatments are not feasible in real-life alcohol and other drug (AOD) settings. There is a clear need for effective treatment options which can occur within the context of alcohol and other drug (AOD) treatment services. Method: A pilot evaluation of an individually administered acceptance and commitment therapy (ACT)-based intervention for treatment-seekers with co-occurring substance use disorder (SUD) and borderline personality disorder (BPD) traits was conducted. The study investigated whether 12 sessions of the ACT-based intervention improved AOD and BPD outcomes, and emotion regulation skills. It also examined the post-treatment associations between these outcomes. The sample consisted of 23 adult treatment-seekers (17 women and 6 men) attending psychological counselling at an outpatient AOD service in Melbourne, Australia. Results: Following the ACT-based treatment, participants demonstrated a significant reduction in the severity of BPD symptoms, as well as significant improvements in both ACT-related and emotion regulation skills. There was a significant reduction in drug use, but not alcohol use. Negligible relationships were demonstrated between levels of AOD use with both ACT-related and emotion regulation skills. There were significant inverse post-treatment relationships between the severity of BPD symptoms and level of ACT-related skills, as well as between the severity of BPD symptoms and emotion regulation skills. Discussion: The outcomes of the present study suggested that the ACT-based intervention could be an effective and practical treatment option for co-occurring SUD and BPD when delivered in outpatient treatment services.

13. ACT versus CBT for children with OCD. A preliminary naturalistic investigation
Primary Topic: Clinical Interventions and Interests
Subtopic: OCD
Elena Campanini, Psy-D, IESCUM Italy, ASCCO Parma
Francesca Pergolizzi, Psy-D, IESCUM Italy, ASCCO Parma
Annalisa Oppo, Psy-D, IESCUM Italy, Sigmund Freud University Milano

Obsessive Compulsive Disorder (OCD) is a disorder that affects between 0.5% and 3% of children and adolescents (Heyman et al., 2003; Leonard et al., 1993). Children and adolescents with OCD are typically characterized by symptoms that involve (a) intrusive unwanted thoughts, ideas, or images that evoke anxiety (obsessions), and (b) behavioral or mental rituals performed to neutralize this distress (compulsions). OCD frequently causes a high degree of distress and impaired functioning, with an high risk of chronic outcomes (Piacentini, Bergman, Keller, & McCracken, 2003; Thomsen, 2000). OCD interferes with child's daily functioning, and may have an adverse impact on child's psychosocial development (Peris et al., 2008; Piacentini et al., 2003; Storch et al., 2007). Controlled clinical trials with young people diagnosed with OCD support the efficacy of CBT as well as medication with serotonin reuptake inhibitors (SRI) (Abramowitz, Whiteside, & Deacon, 2005; Geller, Biederman, Stewart, Mullin, Martin, et al., 2003; Watson & Rees, 2008). International expert guidelines recommend the use of exposure-based CBT as a first-line of treatment for children and adolescents with OCD (NICE, 2005) and SRI or combined treatment (CBT plus SRI) for moderate to severe OCD (Geller et al., 2012). Corrent evidence suggests that cognitive behavioural treatments are the first choice treatments for children and adolescents with OCD (March, et al.,1997). Bolton and Perrin (2008) demonstrated that exposure with response prevention (E/RP) alone is sufficient to achieve significant benefits. Treatment with Acceptance and Commitment therapy in adult OCD produced clinically significant reductions in compulsions increasing willingness to experience obsessions (Twohig, Hayes & Masuda, 2006), but there is no evidence for treating youth with OCD. The aim of this study is to assess the effectiveness of an 8 sessions ACT Protocol for OCD children and to analyze differences between ACT and CBT in terms of different outcome measures. Between Jannuary 2004 and November 2014, 20 children aged between 11 and 15 (Males=45%) were recruited in a private practice setting. Children were allocate to CBT (N=10) or ACT (N=10) treatment on the basis of convenience. Participants were assessed pre-intervention, at the end of intervention, 3 months after intervention, one year after intervention and two years after intervention with self-report measures of children’s compulsion (compulsion’s daily frequency and length in time) and with Children Yale Brown Obessive Compulsive Scale (CY-BOCS). Results swow that both CBT and ACT are effective treatment. All children responded to treatment both in terms of obsessions (Wilcoxon U=-3.93; p<.001) and compulsions (Wilcoxon U=-3.94; p<.001). ACT was effective as CBT in terms of severity of hilness reduction (Wilcoxon U=-3.86; p<.001). Results were maintained at 3 month, 1-year and 2-years follow-ups Although both treatment are equally effective for children who soffer from OCD, Acceptnance and Commitment (median number of session=22) therapy was better than CBT (median number of session=34) in terms of length of treatment (Mann-Whitney U =3,79; p<.001; ES=6.98) and in terms of hilness insight.

14. Diabetes acceptance and personal characteristics: Impact on health and behaviour outcomes in emerging adults with type 1 diabetes (T1D)
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance
Emma Nieminen, MA (Hons), University of Edinburgh
Nuno Ferreira, Ph.D., University of Edinburgh

Objectives: Emerging adulthood is an important transition point for youths with Type 1 diabetes. Personal characteristics such as self-efficacy, fear of hypoglycaemia, depressive symptoms, emotional distress, and impulse control have been hypothesized to be key predictors of health and behavioural outcomes (Hanna,2012). This study aims to test the utility of incorporating diabetes acceptance (Schmitt, Reimer, & Kulzer, 2014) in this model of transition. Methods: Participants included 175 young adults aged 16-25 with a diagnosis of type 1 diabetes recruited from online diabetes support forums and groups. An online survey was used to collect data on the key variables of personal characteristics, acceptance and health and behavioural outcomes. Linear multiple regression analysis was used to test the predictive value of personal characteristics and acceptance in health (glycaemic control, quality of life) and behavioural (self-management) outcomes. Results: Diabetes acceptance (31.5%) and diabetes distress (10.3%) predicted 41.7% of variance in self-management (R2 = .417, F(2,142) = 50.83, p < .001). Diabetes acceptance (25.9%), diabetes distress (4.1%), and age of diagnosis (3.7%) predicted 33.7% of variance in glycaemic control (R2 = .337, F(3,134) = 22.69, p < .001). Diabetes distress (50.2%) was the only predictor of quality of life (R2 = .502, F(1,143), p < .001). Conclusions: Diabetes acceptance is an important predictor of both health and behavioural outcomes in emerging adults with type 1 diabetes. There is also further support for other personal characteristics such as diabetes distress affecting these outcomes. These should be considered for ideal diabetes management. Keywords: type 1 diabetes, acceptance, emerging adults, personal characteristics, health outcomes, behaviour outcomes

15. Validation of the Dysfunctional Attitude Scale (DAS) in the Italian Youth Population
Primary Topic: Clinical Interventions and Interests
Subtopic: dysfunctional attitudes, negative beliefs, depression, adolescent
Erika Melchiorri Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Valentina Carloni, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Martina Romitelli, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Gilda Picchio, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

Dysfunctional Attitude Scale (DAS; Weissman & Beck; 1978) was developed to investigate cognitive attitudes towards the self, the future and the others in adult depressed people, according to Beck’s cognitive triad. This study aims to present an Italian version of DAS and to investigate its validity, reliability and comprehensibility in a sample of non clinical adolescents. It has been translated into Italian and administered to about 400 students aged 11-14. This DAS version is useful both in clinical practice and in psychological research to recognize adolescents negative beliefs and to observe their link with mindfulness abilities defusion on one hand and with psychopathological symptoms on the other. The DAS italian version shows good psychometric characteristics supporting its use on adolescents.

16. Reliability and Validity of an Italian version of the Perceived Stress Scale (PSS) for Youth
Primary Topic: Clinical Interventions and Interests
Subtopic: Perceived Stress, quality of life, wellbeing, happiness
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Nicoletta Ristè, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Valentina Carloni, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

This poster presents the Italian validation of Perceived Stress Scale (PSS; Cohen, Kamarck, Mermelstein, 1983) on a sample of about 400 adolescents (aged 11-14). PSS is a 14 items instrument originally developed for adults, measuring the degree to which life events are cognitively appraised as stressful. The utility of PSS administration to adolescents’ population is linked to its suggested capacity in examining nonspecific appraised stress function in the etiology of psychological disease and behavioural disorders. Collected data support PSS use on Italian adolescents, revealing good understandability and psychometric properties. Moreover, this study shows a negative correlation between perceived stress degree and good quality of life or mindfulness abilities and a positive correlation between perceived stress and dysfunctional attitudes or psychopathological symptoms.

17. Post Traumatic Stress Disorder, Experiential Avoidance and ACT: A single case study
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD
Francesca Ferretti, Ascco e Iescum
Campanini Elena, Ascco e Iescum

Background: Orsillo & Batten (2005) argued that Post Traumatic Stress Disorder (PTSD) can be considered as a disorder of experiential avoidance. Experiential avoidance has been defined as a process by which individuals engage in strategies designed to alter the frequency or experience of private events, such as thoughts, feelings, memories, or bodily sensations (Hayes et al., 1996). Similarly experiential avoidance can be seen as a contributory factor in the development and maintenance of PTSD, in fact symptoms experienced by PTSD clients can be explained within a model that proposes that chronic, pervasive efforts to avoid thoughts, feelings, and memories related to the traumatic event produce long-term exacerbation of these private events and ensuing functional impairment. ACT is a contextual behavioral therapy based on the assumption that many of the symptoms seen across the range of psychopathology represent efforts to avoid or escape emotions, thoughts, memories, and other private experiences (Hayes et al., 1996). Recently a practitioner's guide (Walser & Westrup, 2007) and self-help version (Follette & Pistorello, 2007) of ACT as a treatment for PTSD have been published: an ACT treatment could overstep several limitations of traditional CBT treatments. This script is a single case study in which ACT treatment has been applied to a young woman with PTSD symptoms. Christina was the victim of an aggression and after that episode she wasn’t able to go on with her daily life and she had a high level of experiential avoidance. Method: Avoidances and behavioral restrictions were monitored as an independent measure of the behavior. Measurements of PTSD symptoms were taken using the Impact of Event Scale - Revised (IES – R, Weiss & Marmar, 1996). The Acceptance and Action Questionnaire II ( AAQII - Bond et al., submitted; Italian version by Miselli G., Presti G., Rabitti E. and Moderato P., 2008) was used to assess experiential avoidance and psychological flexibility. There were two measurement times: - T0 ( April 2013 ) initial assessment, pre-treatment - T1 ( November 2013 ) follow-up after 6 months, post-treatment The treatment consisted of 10 sessions. Results: Results showed a reduction on avoidances and behavioral restrictions, a reduction in PTSD symptoms (IES-R) and an increased of psychological flexibility (AAQ-II). Discussion: The third-generation cognitive behavioral therapies such as ACT, can contribute to help people who experienced trauma: it can allow to make room for their suffering and to see the pain as part of the totality of human experience. This case study shows that ACT effectively treated a case of PTSD. We hope that these findings will stimulate additional research on the effectiveness of ACT and about mechanisms of action in all varieties of CBT.

18. Psychological flexibility in chronic pain: an exploratory analysis in an Italian population
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic pain
Giovambattista Presti, M.D., Ph.D., Kore University, Enna (Italy)
Chiara Vona, Kore University, Enna (Italy)
Paolo Moderato, Ph.D., Iulm University, Milan (Italy)

Psychological flexibility, is the ability to act effectively pursuing personal values, even in the presence of interfering thoughts, emotions and body sensations. Research show that it is related to better functioning and quality of life in patients with chronic pain. Parodoxically, the attempt to improve an individual's condition by fighting, controlling and trying to avoid pain, seems to have the effect of reducing interests, diminishing quality of life, and altering relations. To test the relation between pain and quality of life over a long period, we designed a trial conducted in collaboration with hospital “Umberto I” of Enna (Italy). Two groups of subjects, hospitalized patients suffering from chronic pain and a control group were assessed with the Acceptance and Action Questionnaire-II (AAQ-II), the Chronic Pain Acceptance Questionnaire-Revised (CPAQ-R), the Valued Living Questionnaire (VLQ), the Hospital Anxiety and Scale (HADS), the Survey on the State of Health (SF-36), the Illness Perception Questionnaire (IPQ), the McGill Pain Questionnaire (MPQ), and the Visual Analogue Scale (VAS) to refer the pain intensity in the moment of the interview, in the last 24hrs and in the last week. Measures reflect the aim to investigate the possible relation between psychological flexibility and levels of anxiety and depression, cognitive representations of illness identity, psychological impact of the disease (in terms of disability in the life of the subject), intensity of perceived pain. We present the very first baseline data of this longitudinal study referred to 109 patients homogeneously distributed in the three groups. First assessment shows that level of depression and anxiety on HADS are at the same and not statistically different in both groups (total HADS score is 22.32 for chronic pain group and 22.67 for control group). A difference emerges between AAQ scores (surprisingly there is no statistical difference between the two groups) and the CPAQ score (p < 0.01). Results will be discussed in terms of possible correlation between measures of psychological flexibility and variables related to it, in our case anxiety, depression and pain. In addition, to test if the results could related to pain per se or to the chronic condition of painful suffering the possible difference between patients with chronic pain and patients with acute pain will be investigated too by adding a hospitalized group with acute pain. A 6-months follow-up is planned to further investigate the effect of disease fluctuation over the constructs assessed.

19. Evaluating psychological flexibility in self-harmers: an exploratory study of Internet bloggers
Primary Topic: Clinical Interventions and Interests
Subtopic: Self-harming
Giovambattista Presti, MD, PhD, Kore University, Enna (Italy)
Martina Algozino, Kore University, Enna (Italy)
Paolo Moderato, PhD, Iulm University, Milan (Italy)

Self-harming has many functions and forms (cutting, head banging, hair pulling, skin picking and self-burning). Researchers have focused on its relationship with psychiatric and personality disorders. We investigated self-harming analyzing online behavior of self-harmers in various contexts such as social websites or blogs, assessing shared contents (photos, links, posts and videos) and investigating constructs that could be related in self-injurious behavior (such as depressive states and dissociative and tendency to action and avoidance). One-hundred-eleven 13 to 23 years old subjects were contacted and recruited through online services (Twitter, Facebook, Google +, Youtube). They were asked to fill the following questionnaires posted in a private webpage: Inventory of Statement About Self-injury (ISAS), Beck Depression Inventory (BDI), Adolescent Dissociative Experiences Scale (A-DES), Acceptance and Action Questionnaire (AAQ-2). Self-harm behaviors most frequently referred by the subjects were cutting (98.52%), interfering with wound healing (73.53%), pinching (66.18%), banging or hitting self (64.71%), severe scratching (58.82%), burning (54.41%), and bitting (51.47%). The group showed also high level of dissociation measured with A-DES (mean 4.7 (2.01)) and low level of psychological flexibility as measured by AAQ-II (21.13 (8.79)), and 90% of the sample were in the higher range (score between 30 and 63) of the BDI. When invited to comment the ISAS score subjects reported the cause of self-harming as follows: “To feel less Worthless”, “I am giving myself a distraction from my emotional pain”, “I self harm if I feel happy as I don’t deserve to be happy”, “Letting out all the pressure and stress”, “To feel I'm in control”, “I can't stop. I do it cause I need to, I'm addicted”, “It is the only thing that can make the static go away”, “I have a kind of sick obsession with scars, so if the ones I have fade too much I have to make more”. Fusion and avoidance thus seems emerging both from psychometric instruments and from qualitative analysis of verbal patterns. Any ACT based intervention in self-harming should take into consideration also data related to dissociation and pain avoidance.

20. Teach your children well: creating homogeneous environment to do ACT with kids
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT for kids, Hexaflex, Metaphor and exercises
Giovambattista Presti, M.D., Ph.D., Kore University, Enna (Italy)
Antonella Beneficio, Kore University, Enna (Italy)
Simona Mosca, Kore University, Enna (Italy)
Francesca Pergolizzi, IESCUM (Italy)
Paolo Moderato, IULM University, Mialn (Italy)

Acceptance and Commitment Therapy (ACT) was originally developed mainly for and with verbally competent adults. However there is nothing in the clinical model and in Relational Frame Theory (RFT), the underline theory of language and cognition, that suggests it might not be effective with verbally competent children or younger adults. ACT therapy with kids does not depart from the traditional hexaflex based protocols and ACT can be applicable to help children develop psychological flexibility and get unstuck from the functionally same language traps that catch adults. However some tweaks are necessary to metaphors and experiential exercises. To create clinically meaningful context of changes it is necessary to (re)create overarching verbal environments familiar to children. The tweaks used in the clinical examples that will be illustrated and discussed are inspired to Harry Potter, Courage the Cowardly dog, or Kung-Fu Panda or other tales. Tales (verbal contexts) can also be purposefully built from scratch to vehicle metaphors and experiential exercises that may promote change. We will show the main logic behind each “tale-hexaflex” and data derived from clinical cases will also be discussed and reviewed.

21. Disseminating “ACT for pain” on a national basis: a preliminary overview of “Beyond pain” Italian project
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT for pain, Web app, ACT dissemination
Giovambattista Presti, M.D., Ph.D., Kore University, Enna (Italy)
Francesco Dell'Orco, IULM University, Milan (Italy)
Francesco Pozzi, IULM University, Milan (Italy)
Michele Pozzi, Ibis Informatica (Milan, Italy)
Paolo Moderato, Ph.D., IULM Unversity (Milan, Italy)

ACT based pain management protocols were recognized as having strong empirical support by Division 12 of APA. Several randomized and controlled trials show that ACT improves outcomes in heterogeneous chronic pain samples, particularly functioning and mood, although pain severity may be less affected. These results overlaps with the concept of psychological flexibility which is related to functioning and moving in the direction of one’s values in the presence of pain. ACT is a relatively new treatment within the Italian clinical community, which is still mainly dominated by psychodynamic oriented clinicians, and moreover is unknown to the medical doctors, which almost neglect the support that other CBT psychotherapies have demonstrated in the literature. Based on an unrestricted grant a project to disseminate ACT for pain in the medical community and to raise awareness and offer support to patients is being implemented in Italy. The project is based on three main pillars: 1. Brief medical traing on the ACT model and effectiveness of the ACT treatment 2. Raising awareness among population over the availability of the treatment 3. Availability of a web-app that delivers an ACT protocol for patients with chronic pain The poster will show the details of the plan to roll-out ACT for pain in Italy and the data that will be collected to measure the effectiveness of the plan. Some critical points from the learned lesson will be underlined for future planners.

22. Effects of learning new symbolic relations over stereotyped responses: An exploratory analysis of sexual prejudice
Primary Topic: Relational Frame Theory
Subtopic: Sexual prejudice
Giovambattista Presti, M.D., Ph.D., Kore University, Enna (Italy)
M.G. Adalgisa Guagenti, M.A., Kore University, Enna (Italy)
Paolo Moderato, PhD, Iulm University, Milan (Italy)

Categorization and stereotypes help us to make sense of the world and face unknown situations, anticipating aspects of our everyday life. Prejudice is a special case of categorization and a derived learned response about a person or a group that arises in the absence of direct exposure or contact, with that specific person or group. Prejudice shows that humans can get caught in categories, irrespective of whether they are valid or not. Relational Frame Theory conceptualizes prejudice or stereotype as a network of verbally derived stimuli whose establishment/development, maintenance and termination can be empirically investigated within the paradigm of symbolic relational responding (Hayes, et al. 2002). Watts et al. (1991) investigated religious prejudice with an equivalence based learning paradigm and found that the response over the derived relations were idiosyncratic and sometimes related to the learning history of the subjects, sometimes related to the learned task. We used a similar model to test, in a conditional matching-to-sample task, the relation between an individual history of learning related to sexual prejudice and new learned relations. Twenty-two homosexual and heterosexual subjects were enrolled for this research. In the presence of gay or lesbian stereotyped images (A) subjects learnt to associate one of three nonsense syllables (B) and in the presence of nonsense syllables (B) they learnt to associate one of three images depicting issues which are not prevalently associated with homosexual individuals (C), such as marriage, family and having children. After learning these new relations in a frame of coordination, subjects were tested in three tasks: 1. relating A to C (learned) vs C (stereotyped) [an similar-IRAP task]; 2. relating A to C (learned) vs C (stereotyped) vs C (unrelated); and 3. the standard combinatorial A-C/C-A task. Patterns of responding in pre-post tasks were analyzed. Subjects who constantly responded at baseline with a “prejudice” pattern, maintained that pattern in the post-training tests notwithstanding the emergence of the derived combinatorial relations. Subjects who responded at chance level at baseline, responded according to the new learned relations in all three post-training testing tasks. Some implications for understanding the relations between learning new symbolic responses and derived responding is discussed. Data support the idea that learning new relations is not enough to disrupt or undermine strong symbolic networks. Implications for therapy and educational programs are discussed in light of RFT and ACT principles.

23. Treating Eating Disorders: Post-Hoc Reflections about past, present and future cognitive-behavioral intervention approaches
Primary Topic: Clinical Interventions and Interests
Subtopic: Eating Disorders
Giovanna Cristina Campione, Eating Disorder Service of Scientific Institute 'Eugenio Medea' (Child Psycopathology Unit), Bosisio Parini, Italy
Katia Manduchi, Fap trainer and supervisor, Iescum trainer and supervisor, Private practice
Gianluigi Mansi, Eating Disorder Service of Scientific Institute 'Eugenio Medea' (Child Psycopathology Unit), Bosisio Parini, Italy
Alessandra Fumagalli, Eating Disorder Service of Scientific Institute 'Eugenio Medea' (Child Psycopathology Unit), Bosisio Parini, Italy
Robert Allegri, Private Practice, Iescum alumni

Authors (the first one as therapist, the second one as supervisor) describe the treatment of the case of Irma, a 33 year-old patient diagnosed with Other Specified Feeding or Eating Disorder (OSFED) according to DSM-5 criteria. At the beginning, case conceptualization and treatment were performed as stated in Fairburn’s CBT-E (Cognitive Behavioral Therapy - Enhanced) model for treatment of Eating Disorders. However, as assessed by EDI-3 and clinical reports, although scores related to Eating Disorder symptoms improved, patient’s distress did not decrease and scores related to hyper-control got worse. Authors re-conceptualized Irma’s case according to Functional Contextualism, and treated it using a combined FAP-ACT intervention, which was effective as assessed by EDI-3, ACT-consistent measures, and clinical reports. Treating Irma’s case was an opportunity for thinking about and comparing second and third generations of cognitive behavioral therapies, especially in case of an Eating Disorder.

24. Acceptance and Commitment therapy for the multidisciplinary rehabilitation of fatigue
Primary Topic: Clinical Interventions and Interests
Subtopic: Fatigue
Henrik Børsting Jacobsen, Ph.D., St Olavs University Hospital; Oslo University Hospital

Background: Targeting maladaptive cognitions through cognitive-behavioral therapy (CBT) have previously been shown to reduce fatigue. The current study aimed to see whether less fatigue symptoms and improved quality of life (QoL) was associated with improving psychological flexibility as defined by Acceptance and Commitment Therapy (ACT). It was also an aim to see if psychological flexibility explained variance above and beyond maladaptive cognitions targeted in CBT and/or reduction of comorbid symptoms. Methods: 188 patients on long-term sick leave reporting disabling fatigue were included. Participants’ filled out a survey asking about socio-demographics, somatic and psychological complaints and maladaptive cognitions. They were also examined and diagnosed for mental disorders according to DSM-IV criteria at a designated outpatient clinic. Results: At post-treatment, participants reported an improvement in fatigue (p<.001; g=1.08). Hierarchical regression analyses showed that when controlling for other significant cognitions and co-morbid symptoms, only changes in fear-avoidance cognitions pre- to post-treatment were associated with reduced fatigue at treatment termination. No post-treatment changes in average psychological flexibility were reported. Physical function, insomnia, pain, and depressive symptoms were all significantly associated with reduced fatigue at treatment termination. Conclusion: The ACT-based RTW-program was effective in reducing fatigue from pre- to post-treatment. As predicted by more traditional CBT, reduction in fear-avoidance cognitions during treatment was significantly associated with reduction in self-reported fatigue. Psychological flexibility, the key theoretical concept in ACT, was not associated with a reduction in self-reported fatigue or improved QoL.

25. The Relationship of Self-Compassion, Experiential Avoidance, and Depression among Young Adult Women in Korea
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression
Hyeeun Kim, Ph.D., Seoul Women's University Graduate School of Professional Therapeutic Technology
Kyung Park, Ph.D., Seoul Women's University Graduate School of Professional Therapeutic Technology

Background: The present study examines how self-compassion, experiential avoidance, and depression are related from research conducted among young adult women in Korea. Especially, based on theoretical framework of acceptance and commitment therapy, our study assumes that experiential avoidance mediates the effect of previous depression which leads to persistence of depression. Also, this study examines whether self-compassion moderates the relationship between previous depression and experiential avoidance. Method: For this study, 269 Korean young adult women (age range 18-30 years) participated and completed a self report questionnaire which is comprised of self-compassion scale, acceptance action questionnaire, and Beck’s depression inventory. Our study assessed all variables twice at an interval of two months. Results: The level of previous depression, self-compassion, experiential avoidance are significantly correlated with depression in present. Also, experiential avoidance partially mediated the effect of depression at time 1 impacted to depression at time 2, because depression at time 1 still influenced on depression at time 2 after the controlled effect of experiential avoidance. In hierarchical multiple regression analysis, it is worthy of notice that, depression at time 1 which interacted with self-compassion influenced on experiential avoidance. Therefore, the moderating effect of self-compassion is significant in the relationship between previous depression and experiential avoidance. Discussion: Thus, depression can be reduced through improving acceptance of one’s experiences. Especially, it is verified, self-compassion has a role of buffer which can decrease experiential avoidance is important in development and persistence of depression. Furthermore, acceptance of experiences and self-compassion can act as a protective factor for treatment and prevention of depression. Finally, the present study was discussed in limitation of our research, and recommendation for future researches.

26. A Preliminary Investigation of the Use of Acceptance and Commitment Therapeutic Principles in Group Treatment with a Community Sample of Bhutanese Refugee Women
Primary Topic: Clinical Interventions and Interests
Subtopic: Refugee, Group Therapy
Jessica Clifton, M.A., University of Vermont
Sheau-Yan Ho, B.A., University of Vermont
Carly Baetz, J.D., University of Vermont
Emily Pichler, B.A., University of Vermont
Maggie Evans, B.A., University of Vermont
Diane Gottlieb, Ph.D.; Valerie Harder, Ph.D., University of Vermont
Karen Fondacaro, Ph.D., University of Vermont

Psychological inflexibility and experiential avoidance have been associated with negative outcomes, including depression, anxiety, and mental health problems in general. Furthermore, these psychological processes have shown to mediate the impact of Acceptance and Commitment Therapy (ACT) on mental health problems. Research has also demonstrated the importance of treatment engagement in psychotherapy outcomes. However, very little is known about the relationship between these variables in non-Western cultures. The present feasibility study examined changes in psychological inflexibility and experiential avoidance in a group of 13 female Bhutanese refugees seeking services at a community clinic. These women were assessed and invited to join an open-ended group with ongoing enrollment. Weekly group psychotherapy sessions were oriented in ACT principles and aimed to enhance psychological wellbeing. We utilized the Acceptance and Action Questionnaire (AAQ-II) to assess for psychological inflexibility and experiential avoidance at two mid-treatment time points (approximately 25 weeks and 50 weeks). Group psychotherapy treatment and assessment were performed with the assistance of a Nepali interpreter(s). Descriptive statistics indicated a decrease in mean scores on the AAQ-II (25 weeks: M = 44.2, SD = 26.05; 50 weeks: M = 37.4, SD = 8.74). Although not statistically significant (t(4) = .787, p = .47), this difference speaks to the clinical utility of using an ACT framework with this population. Additionally, a moderation analysis revealed that the number of treatment sessions attended may play a role in changes in psychological inflexibility and experiential avoidance, thus suggesting a dose-response relationship (F(3)=74.29, p = 0.08). Despite the exploratory nature and statistical limitations due to small sample size, this study provides support for (1) addressing psychological inflexibility and experiential avoidance in group therapy with non-English speaking refugees using ACT principles; (2) continuing to examine the use of ACT constructs with validated measurements in this population; and (3) understanding the impact of group attendance on changes in psychological flexibility. Overall, these results add new and relevant information to the extant literature by demonstrating the feasibility and utility of doing group therapy and research with non-English speaking refugees using an ACT framework. Future research should assess for barriers involved with attending therapy (e.g., avoidance, transportation, pain) and explore how psychological inflexibility and experiential avoidance are involved.

27. A Case Series on the Effects of Yoga for Generalized Anxiety Disorder
Primary Topic: Clinical Interventions and Interests
Subtopic: GAD, Yoga, Mindfulness
Jessica Morgan, M.A., Georgia State University
Page Anderson, Ph.D., Georgia State University

Background Generalized anxiety disorder (GAD) is a prevalent psychiatric disorder associated with substantial impairment and poor treatment response. Yoga is found to influences processes that are linked to GAD, including mindfulness, anxiety, and heart rate variability, but has yet to be evaluated among people with the disorder. The present study is a first step and evaluates the efficacy of yoga for reducing worry among people with GAD. Method Three participants diagnosed with primary GAD using received eight twice-weekly Kripalu yoga sessions following a baseline data collection period. Using a single-subject AB design case series, daily ratings of worry were collected and compared across baseline and intervention phases. For secondary analysis, standardized self-report measures of worry, trait anxiety, experiential avoidance, and mindfulness, as well as heart rate variability are assessed at pre- and post-treatment. Results Two of three participants showed evidence of change in daily worry ratings coinciding with the introduction of yoga. The participant who did not reduce in worry showed increases in mindfulness and HRV. Effect sizes indicate overall trends in therapeutically desirable directions for standardized measures of worry, trait anxiety, experiential avoidance, and mindfulness as well as high-frequency heart rate variability. Discussion Yoga has the potential to reduce worry in individuals with GAD; in this sample, two of three participants showed evidence of reductions in worry. The increase in mindfulness and HRV in the participant who showed non-response on the worry variable is discussed.

28. Acceptance and Commitment Therapy for Public Speaking Anxiety – a Case Series Study of Effects on Self-reported, Implicit, Imaginal, and In-vivo Performance Outcomes
Primary Topic: Clinical Interventions and Interests
Subtopic: Public Speaking Anxiety / IRAP
Joe Priestley, University of Lincoln, UK
Dr. David Dawson & Dr. Nima Moghaddam, University of Lincoln

Abstract Public speaking anxiety affects a large percentage of the general population. In some cases, public speaking anxiety can lead to a number of interrelated social difficulties such as interference or distress related to work, reduced likelihood of continued education, and higher levels of unemployment. Although Cognitive Behavioural Therapy has been shown to be effective in treating this difficulty, around 25% of patients fail to respond. Acceptance and Commitment therapy (ACT) may offer an alternative for patients who find traditional models of exposure distressing. Although limited, extant research in this area is promising. The present study investigated the effects of a self-help ACT intervention in the domains of willingness, distress, and avoidance related to public speaking. The single case experimental design allowed for changes in participant responding to be tracked in line with the chapters being read in the self-help workbook (Get out of your mind, and into your life) allowing for inferences to be made about which ACT process may beneficial in treating this difficulty. Change was also tracked using ACT process measures and the Implicit Relational Assessment Procedure (IRAP), to investigate whether self-rated and implicit change occurred concordantly. Finally, participants were given the option to take part in a public speaking task, and their performance rated. The study is still underway, however, initial findings will be available for the ACBS conference. It is hoped that the findings from this study will support the use of ACT, delivered in a self-help format, to treat public speaking anxiety for patient’s wishing to address their difficulty independently or for patients with wider social anxiety who do not seek treatment.

29. Vitalis – A randomized intervention study aiming at Return To Work for women with long-term sick leave.
Primary Topic: Clinical Interventions and Interests
Subtopic: Return To Work
Linnea Molin, Psychologist, ArbetsRehab, Department of Occupational and Environmental Medicine, Uppsala University Hospital
Ingrid Anderzén, Ph.D. Head of Arbetsrehab, Deptarment of Public Health and Caring Sciences, university of Uppsala
Åsa Andersen, Doctoral Student, Deptarment of Public Health and Caring Sciences, university of Uppsala
Anna Finnes, Karolinska Institutet, Stockholm
Per Lytsy M.D, Ph.D., Deptarment of Public Health and Caring Sciences, university of Uppsala

Background: Sweden has been challenged by a high number of people on long-term sick leave due to health reasons. In addition there is a gender difference with a higher proportion of women than men on long-term sick leave. The main purpose of the study was to facilitate return to work and to improve participants' health during the period of one year.
Method: Vitalis was a randomized controlled intervention study that addressed women on long-term sick leave due to mental illness and/or pain in Uppsala County, Sweden. The participants were expected to reach the time limit within the health insurance. In total 308 persons were randomly assigned to one of the following groups: 1) psychotherapy with Acceptance and Commitment Therapy (ACT), 2) multimodal team treatment (TEAM), or 3) Treatment as usual (TAU). The ACT intervention was an individualized psychotherapy according to ACT. In the TEAM intervention the participants met a physician, a psychologist, an occupational therapist and a social worker. The TEAM condition could but did not have to include ACT psychotherapy. All three groups received the standard program offered by the public employment office. Returning to the health insurance, number of reimbursed days during first year and self-reported health assessments were used as outcomes measures at 12 months. Results: At one year follow-up no significant differences were found between the groups concerning the percentage of individuals returning to the health insurance system. Neither was there any significant difference in the number of reimbursed days between the interventions and TAU. There were significant interaction effects were ACT and TEAM show  improvement with less anxiety and depression assessed by HADS compared to TAU. Health, assessed by GHQ (General Health Questionnaire) and quality of life, assessed by SWLS (Satisfaction with life scale) had improved significantly in the TEAM-intervention compared to TAU. Participants in the ACT-intervention reported significantly less pain during the follow-up year compared to TAU. Conclusions: In this study the interventions seem to have improved different aspects of health in the participants, although there are no clear effects concerning RTW. RTW after a long absence can be viewed as a process-oriented activity with a number of coordinating actors – it is a complex multidimensional topic in need of further research.

30. Acceptance and Commitment Therapy for ME/CFS (Chronic Fatigue Syndrome) – does it work, and for whom?
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Fatigue Syndrome (ME/CFS)
Martin Jonsjö, M.Sc., Ph.D-student, Karolinska Institutet
Rikard Wicksell, Ph.D., Karolinska Institutet
Linda Holmström, Ph.D., Karolinska Instiutet
Mike Kemani, Ph.D., Karolinska Institutet
Anna Andreasson, Ph.D., Karolinska Institutet
Gunnar Olsson, M.D., Ph.D., Karolinska Institutet

Background For many patients with ME/CFS, medical strategies alone appear insufficient to increase functioning and quality of life. Cognitive behavioral therapy (CBT) is the only treatment approach with preliminary evidence of efficacy. However, effect sizes are generally modest. Recently, Acceptance and Commitment Therapy (ACT) has gained increasing attention and research support within clinical trials in similar disorders (e.g. chronic pain). Results from these areas illustrate the utility of this approach for individuals with somatic symptomatology. Also, mediation analyses indicate that psychological flexibility is central to functioning and quality of life. In contrast to a traditional CBT-approach which focuses on symptom reduction, the treatment objective in ACT - to increase functioning and quality of life by promoting psychological flexibility, i.e. the ability to behave in accordance with important long-term goals/values in the presence of interfering experiences (fatigue, pain, anxiety, negative thoughts) – seems of utmost importance to evaluate for this chronic debilitating illness. To date, the efficacy of ACT has not been evaluated for ME/CFS. Therefore, this pilot study will explore the utility of ACT for adults with ME/CFS as well as identify factors of importance to predict treatment outcome. Method Treatment consists of 13 weekly individual ACT sessions, delivered by a psychologist (10) and by a physician (3) respectively. An open trial design is used, with assessments at pre- and post-treatment as well as at 3, 6 and 12 months follow-up. Assessments of process (Psychological Inflexibility in Fatigue Scale, PIFS) and outcome measures are also carried out during treatment. The primary outcome measures are mental and physical functioning (SF-36, ME/CFS Disability Index) and quality of life (EQ-5D). Secondary outcome measures include psychological flexibility (Psychological Inflexibility in Fatigue Scale, PIFS) and activity data assessed by an accelerometer. Data will be analyzed using hierarchical regression analyses and linear multilevel modeling. Results and discussion Data collection is ongoing. Although tentative, preliminary findings and clinical experiences are promising. Treatment evaluations and predictors of outcome will be presented, and clinical implications of these findings will be discussed.

31. The relation between symptoms, psychological flexibility and disability in Chronic Fatigue Syndrome (ME/CFS)
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Fatigue Syndrome (ME/CFS)
Martin Jonsjö, M.Sc., Ph.D-student, Karolinska Institutet
Rikard Wicksell, Ph.D., Karolinska Institutet
Linda Holmström, Ph.D., Karolinska Instiutet
Anna Andreasson, Ph.D., Karolinska Institutet
Mike Kemani, Ph.D., Karolinska Institutet
Gunnar Olsson, M.D., Ph.D., Karolinska Institutet

Background Even though it is plausible that the often very debilitating symptoms in ME/CFS are caused and maintained by multiple factors (e.g. immunological, CNS, endocrine, psychological), previous research suggests that psychological factors are of significant importance for the relation between symptoms and functioning and quality of life in this condition. However, there is a need for further research that examines which psychological factors that are of most importance for the relation between symptoms and functioning and quality of .life. For the last 14 years, a behavioral medicine treatment approach based on Acceptance and Commitment Therapy (ACT) has been developed for the treatment of chronic pain in children and adults at the Karolinska University Hospital. In chronic pain, as well as in other longstanding somatic problems (e.g. tinnitus), psychological flexibility has been shown to be of central relevance in explaining disability, more so than e.g. symptom intensity. To date, there is a lack of studies evaluating the importance of psychological flexibility for the relation between symptoms and disability in patients with ME/CFS.In an ongoing study, we will explore the relationships between symptoms, psychological factors, functioning and quality of life in adult patients with ME/CFS. Furthermore, analyses of the relevance of psychological flexibility in explaining functioning and quality of life will be carried out. Method The current study uses a cross-sectional design, with measurements carried out as part of a pre-treatment assessment. Measures include history data (e.g. presence of symptoms according to the Canadian case definition of ME/CFS and grading of symptom severity, type of onset), psychological factors (e.g. psychological flexibility, kinesophobia), physical activity and sleep (Åstrand test of fitness test and VO2, accelerometer, pedometer), functioning and quality of life (SF-36, EQ-5D). Data will be analyzed using hierarchical regression analyses. Results and discussion Data collection is ongoing. The poster will present preliminary findings regarding the relationships between symptoms, psychological factors and disability. Specifically results pertaining to the potential importance of psychological flexibility for functioning and quality of life in ME/CFS will be presented and discussed, as well as clinical implications of these preliminary findings.

32. A pilot study of psychological support group for GAP patients with ACT
Primary Topic: Clinical Interventions and Interests
Subtopic: GAP
Pamela Garofani, ASCCO Academy of Behavioral and Cognitive Sciences Parma Italy; Ser.T DAI-SMDP AUSL PARMA Italy
Giovanni Miselli, IESCUM Italy; ACT-Italia Italy
Lucia Maria Giustina, Ser.T DAI-SMDP AUSL PARMA Italy
Annalisa Pelosi, UNIVERSITA' DEGLI STUDI DI PARMA Italy

Background: this work is a pilot study in patients with GAP in the context of a national health service. The study was carried out within the Service of Pathological Addictions (SER.T DAI-SMDP). The Service aim was to accompany patients in a psychological support group, which was oriented on the analysis of the function of the behavior. The ACT approach allowed to shift the focus of the intervention and to direct this on training of psychological flexibility and experiencing processes ATC model. Objects: The pilot study purpose was to promote the identification of values, to identify commitment actions with the purpose of improving the quality of life, training the psychological flexibility as a tool in situations of life, foster acceptance and evaluate the well-being perceived before and after the intervention. Method: The study involved a small heterogeneous group of patients (participants were 10 clients) in a psychological support group through the approach ACT. The activity consists of two phases of somministration questionnaires: before and after the intervention to measure the values, behavioral effectiveness, the mood and the experience gambling (VLQ, AAQ-2, Core- om, SOGS). The treatment phase consist of eight sessions that were structured into a active listening of self report of behaviors (in the subsequent sessions: checking of homework), training to use ACT processes (contact with the present moment, acceptance, defusion, self-as-context, committed action, values), training to improve flexibility psychological and ACT homework. Results and Discussion: Data from the pilot study and first phase intervention will be presented at the conference.

33. Disordered eating cognitions, pyschological flexibility, and help-seeking attitudes towards professional psychological help in Asian American women
Primary Topic: Clinical Interventions and Interests
Subtopic: Eating Disorders
Stacey Ng, Georgia State University
Akihiko Masuda, Ph.D., Georgia State University
Lee Ward Schaefer, Georgia State University

Background: Investigating attitudes towards seeking professional psychological help may be important for understanding treatment utilization for female Asian American college students. Within that population, disordered eating cognitions are common psychological concerns, which are found to be a potential barrier for seeking psychological services.. Using an ACT conceptual framework, the present study examined whether disordered-eating cognitions and psychological flexibility were uniquely associated with stigma tolerance and interpersonal openness, facets within help-seeking attitudes towards professional psychological services in a sample of Asian American college women. Methods: A subsample of college undergraduates, consisting of Asian American females, from a larger cross-sectional study was examined using a multiple regression analysis of self-report measures of general psychological health, psychological flexibility, and disordered eating cognitions on help-seeking attitudes. Study 1 (N = 119) examined whether disordered eating cognitions and psychological flexibility, measured by the Acceptance and Action Questionnaire-Revised (AAQ-R), were uniquely associated with these help-seeking attitudes while controlling for age and psychological distress. Study 2 (N = 257) replicated the results of Study 1 by using a more psychometrically sound measure of psychological inflexibility (i.e., Acceptance and Action Questionnaire-II). Results: In both studies, psychological flexibility/inflexibility was found to be uniquely and significantly related to stigma tolerance and interpersonal openness in expected direction. Disordered eating cognitions were found to be a significant predictor of these help-seeking attitudes in Study 2, but not in Study 1. Discussion: Our findings suggest that both psychological flexibility and disordered eating cognitions may be useful concepts to explore help-seeking attitudes on stigma tolerance and interpersonal openness in a sample of Asian American college women.

34. A Preliminary Exploration of Values-based Practice to Protect Police and Emergency Responders from Lasting Negative Consequences of Trauma
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD
Wanda L. Smith, Private Practice & McMaster University
Stephanie Swayne, Private Practice

Police and other emergency responders such as firefighters and paramedics are at risk for the development of Posttraumatic Stress Disorder (PTSD) and Operational Stress Injuries (OSI's) by nature of their professions, i.e., the preponderance of traumatic events in their work environments. The prevalence of PTSD in the normal population is approximately 3-5%; the prevalence of PTSD in police and emergency responders is significantly higher with rates reported as high as 18%. Further, this population often presents with symptoms which may not be detected or may not meet full criteria for a diagnosis of PTSD, i.e., “subthreshold”. Co-morbid disorders such as depression are also common. Suicide rates have been steadily increasing and reached alarming levels, e.g., during a 10 week period in the summer of 2014 13 Toronto EMS personnel suicided as a result of PTSD. Interventions targeting the oft negative sequelae of trauma exposure are urgently needed. Brief interventions such as debriefing exercises have not proven successful in addressing the aftermath of trauma exposure and may, in fact, be detrimental to long term mental health. Evidence based treatments for PTSD and trauma related disorders have been developed however, the police culture and general mental health stigma often precludes treatment from a registered health care provider, as well, introduction of formal trauma therapy may not be feasible or realistic for a working force. This context opens discussion for interventions which can be readily introduced as needed including during such contexts as the aftermath of a traumatic incident as well as during police and emergency responders training and education. Values based interventions as conceptualised in Acceptance and Commitment Therapy may be promising. RCT’s supporting ACT interventions have been cumulating including ACT interventions for PTSD and depression. Values work has been studied in isolation including development of a values questionnaire. The proposed presentation will describe an ACT intervention model for police and emergency responders designed to be protective for the long term negative consequences of trauma exposure through ongoing monitoring and engagement with vocational and personal values. The proposed intervention includes a series of brief values-clarification and values-connection experiential exercises that can be conducted with individuals or groups and will be described in further detail as part of the presentation.

35. Effects of experiential avoidance and cognitive fusion on psychological stress responses among Japanese adolescents
Primary Topic: Educational settings
Subtopic: adolescents, experiential avoidance and fusion,psychological stress
Kenichro Ishizu, Ph.D., University of Toyama
Yoshiyuki Shimoda, Ph.D., Saga university
Tomu Ohtsuki, Ph.D., Waeda university

This study aimed to investigate the effects of avoidance and fusion on psychological well-being among Japanese early adolescents. A short-time three-wave prospective design was used with intervals of 1 week; we examined the relationship among experiential avoidance and fusion, psychological stress responses, and school stressors. We used 1-week intervals because we aimed to understand how psychological distress(stress response) in school was maintained and how avoidance and fusion would affect it over a short period. Japanese junior high school students (N = 689, age range = 12~15, mean age = 13.29) were requested to complete the questionnaire about experiential avoidance and fusion, psychological stress responses, and school stressors (waves 1~3). We used a cross-lagged panel model to reveal the longitudinal relationship among those variables and found that not only does avoidance and fusion affect psychological stress responses but also that psychological stress affects avoidance and fusion. The results also showed that avoidance and fusion at waves 1 and 2 affected school stressors at waves 2 and 3. These results suggest that once psychological stress response is provoked by avoidance and fusion, it also affects following avoidance and fusion, which would maintain the psychological distress in school.

36. A Comparison between Islamic Spiritual Therapy (IPS) and Acceptance Commitment Therapy (ACT)
Primary Topic: Organizational behavior management
Subtopic: Psychotherapy
Dr. Tahereh Seghatoleslam, University of Malaya , Centre of Addiction Sciences UMCAS) Malaysia Shahid Beheshti University of Medical Sciences ,Tehran Iran
Hussain Habil, University of Malaya , Centre of Addiction Sciences UMCAS) Malaysia

This study has been clarified the differences and similarities between ISP and ACT from an Islamic point of view. It showed that there are a lot of similarities and a few difference in ISP and ACT principals that are following. However , in Islam everything is related to Allah, and has been everybody must be targeted to Allalh, therefore in the Holy Quran emphasis on some actions that mentioned Vajeb, means it is compulsory to do and avoid the behaviour that are not acceptable in Islam as a cardinal sin in the Holy Quran. Whereas in ACT cognitive avoiding is not encouraging. In Islam there are five times pray that are Vajeb (Compulsory) for all Muslim. It is similar to mindfulness in ACT that is the cause of consciousness. In the Holy Quran ordered that you have to conscious and be responsible for all of your behaviour to yourself and to other people, if not you are doing Haram. Haram is a religious word that is opposite of Vajeb , means compulsory to avoid. In Islamic Point of view also recommended that the Values play an important role in the personal and social life. These values developed the framework of cognitive life. Regarding the time as mentioned by ACT in the theory the moment is one of principals that proposed by Steven Hays, Moreover , in Islam has been mentioned, be careful about future, because you have to think about another world it is promised in the Holy Quran if you are caring about your life in another world and your future you will be blessed by Allah.in the original paper these dimensions are considered completely.

37. Developing a new repeatable measure of ACT processes
Primary Topic: Other
Subtopic: Psychometric development
Ashley Francis, Universities of Nottingham and Lincoln
David Dawson, Universities of Nottingham and Lincoln
Nima Moghaddam, Universities of Nottingham and Lincoln

Background Acceptance and Commitment Therapy (ACT) is an evidenced based psychological therapy which seeks to increase ‘psychological flexibility’ through mindfulness and behavioural change strategies. Valid and reliable measures of the six core processes underpinning psychological flexibility are central to contributing to ACT's continuing growing evidence base. However, the most widely used measure of psychological flexibility, the Acceptance and Action Questionnaire (AAQ-II), has been criticised by several authors on a number of grounds including: poor item face and content validity; poor discriminant validity; theoretical overlap and therefore redundancy of several of the underpinning ACT processes; and poor suitability for repeatable administration. The aims of this research were therefore to generate and validate a new measure of ACT processes that: 1) addressed the shortcomings of the AAQ-II; 2) is underpinned by three versus six dyadic core ACT processes; and 3) is suitable for repeatable administration. This measure is referred as the Repeatable measure of ACT Processes (ReACT). Method Phase 1. Measurement development 106 items were initially pooled from existing ACT process measures based on their high factor loadings. ACT experts (n=13) were recruited from the Association for Contextual Behavioural Science's (ACBS) website and were asked to rate items hosted on an online survey on a five-point Likert scale in terms of their face and content validity. Items which failed to reach pre-defined ratings thresholds were removed and remaining items were re-rated until a pre-defined consensus threshold was reached. Each item's wording was adapted to be better suited for repeated administration. Trainee clinical psychologists (n=15) were then asked for feedback regarding the comprehensibility of items and the adapted items were then sent to ACT experts for final comments. Phase 2. Measurement validation The validity, reliability and structure of the ReACT was investigated in phase two. The measure was hosted on an online survey and disseminated to a non-clinical sample of participants (n= 300?). The research was advertised through various social media platforms, as well as through the Universities of Nottingham and Lincoln's research boards. Several small sub-samples of participants were asked to: a) complete the AAQ-II in order to assess the ReACT's convergent validity (n=?); b) complete a distress measure in order to assess the ReACT's discriminant validity (n=?); and c) complete the ReACT again a week later in order to assess the ReACT's test-retest reliability (n= ?). A factor analysis was performed in order to assess the ReACT's individual items and overall factor structure. Results Some preliminary results from phase 1 of the study will be available by the time of the poster presentation at the ACBS conference. Discussion Some preliminary discussion points from phase 1 of the study will be available by the time of the poster presentation at the ACBS conference.

38. Validation of the short version of the Committed Action Questionnaire (CAQ-8) in a French-Speaking Population
Primary Topic: Other
Subtopic: Committed Action
Joel Gagon, Ph.D. (c), Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières
Marie-Eve Martel, D.Psy. (c), Université du Québec à Trois-Rivières
Whitney Scott, Ph.D., King’s College London
Lance M. McCracken, Ph.D., King’s College London

Background: Committed action is defined as flexible persistence with actions linked to chosen values and goals even in the presence of psychological barriers, such as difficult feelings, thoughts, and urges. Emerging evidence supports the empirical and clinical relevance of this construct. However, no questionnaire is available yet in French. This study aimed to validate a French translation of the short form of the Committed Action Questionnaire (CAQ-8; McCracken & Norton, 2014), which has already been validated in English in a chronic pain sample. Method: Two different samples were used in this study. The first sample was comprised of 704 participants who suffer from chronic pain, with a mean age of 51.93 (SD = 11.55); the majority of this sample (77.6%) was female. The second sample was comprised of 398 college students with a mean age of 25.08 (SD = 6.32); the majority of this sample (82.7%) was likewise female. Results: To evaluate the factor structure of the CAQ-8, an Exploratory Factor Analysis (EFA) was conducted with the data of half of the participants from the first sample. Similar to the original version, the EFA revealed a two-factor structure with coefficients ranging from .44 to .93, and explaining 53.54% of the total variance. Cronbach’s alpha from the first sample was .80 and .83 for the second sample. Furthermore, two Confirmatory Factor Analyses (CFA) were conducted using AMOS 20 to confirm the bifactor structure of the CAQ-8 on the other half of the first sample and on the second sample. Both CFAs confirmed the bifactor structure of the CAQ-8 and showed overall good model fit evaluated by different indicators based on Kline’s (2005) recommendations and cut-off values. Discussion: Overall, these data support the construct validity and reliability of the French CAQ-8 for use in clinical and non-clinical samples. Keywords: Acceptance and Commitment Therapy (ACT), Committed Action, Validation, Psychological Flexibility.

39. 3rd Wave Sport Psychology Strategies in Optimizing the Performance of Elite Athletes: Effectiveness of a Mindfulness Based Program (MBSR-SP)
Primary Topic: Performance-enhancing interventions
Subtopic: Mindfulness based interventions/ACT and Elite Sports
Bruno Carraça, MD, PhD candidate, FMH-Lisbon University
Catia Magalhães, PhD, ESEV- Polytechcnic Institute of Viseu-Portugal
Sidónio Serpa, PhD, FMH-Lisbon University
Joan Palmi, Phd, INEFC-Lleida University

Introdution: The difference between success and failure has become increasingly smaller in sport. A “third wave” approach in sport psychology, is been recently used for the first time to increase the performance level of the elite athletes with very well defined programs (Birrer et al, 2012). Study findings yielded that high-level athlete’s meta-awareness and effective refocusing training by MBSR were identified as important factors on performance training and competition (Solé, Carraça, Palmi, & Serpa, 2014). Objectives: To adapt and determine the effectiveness of the implementation of the mindfulness-based stress reduction program (MBSR) to optimize the performance of a sample of elite-performance athletes. Secondary aims are: understand the relationship between attributes mindfulness, acceptance, commitment, and compassion - and the impact on the state of sports performance and dispositional flow; relation between salivary stress response (cortisol), reduced psychological symptoms and consequent effect on the level of sports performance. Methods: 60 elite-athletes from different sports will be assigned or 30 per the two groups sports (n=30 experimental group and n=30 control group). Standardized instruments will be used. Data analysis included descriptive (mean, standard deviation) and 2 x 3 ANOVAs (pre- post- and 3-month follow-up) with t-tests and Cohen´s d effect size after Cronbach´s alpha reliabilities. Pearson correlations between the mindfulness, compassion, acceptance and commitment, reducing suppression of thought measures and physiological response and the MBRS outcomes will be performed. Also a standard concentration of salivary cortisol (pg.ml deviations -1, SalimetricsTM) will be measured. Results and discussion: It is expected that athletes participating in the MBSR program significantly increase the attributes related to mindfulness, higher levels of self-compassion , acceptance flow state, sport performance, a lower overall index of psychopathological symptoms and physiological response to stress, less suppression of thought compared with the control group (Moghadam et al, 2013).

40. The use and feasibility of an ACT-based course for increasing well-being in high school students: Pilot study
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents
Charlotte Ulrikka Rask, Ph.D., Research Clinic for Functional Disorders, Denmark
Louise M Lykke Kronstrand, MSc., research clinic for functional disorders
Lisbeth Frostholm, Research Clinic for Functional Disorders

Background Young people in high school face many pressures and challenges, including growing academic expectations, changing social relationships with family and peers and the physical and emotional changes associated with maturation. These years mark a period of increased autonomy in which independent decision-making that may influence their health and health related behaviour develops. A recent survey among Danish adolescents has shown that 8 % experience ‘high stress’ and 46 % ‘medium stress’ that may negatively affect many aspects of their lives. School-based preventive interventions could represent a possible solution. Aim The aim is to pilot test the use and feasibility of an ACT-based course developed with the intention to increase well-being and prevent stress in high school students. Method and design Six high school student counsellors were trained on a three day course by ACT specialists in the delivery of a 3 x 1.5 hour sessions introducing ACT principles and related exercises for the students. A total of 278 first grade high school (US: senior high school) students were enrolled for this pilot study. They received one weekly session during a 3 week period. Self-report questionnaires on self-perceived stress, general wellbeing and ACT specific measures were completed prior and approximately one month after course participation. Furthermore the counsellors provided a qualitative evaluation on course feasibility. Discussion The data collection is still ongoing. Preliminary results indicate that the sessions were well received by students and student counsellors: the ACT-based content was successfully delivered in a larger class setting with students actively participating in exercises and discussions. More detailed results will be presented at the conference.

41. The value of health in prisons: giving voice to the detainees
Primary Topic: Prevention and Community-Based Interventions
Subtopic: improvement of the health of detainees
Evelyn Uhunmwangho, psychologist, AUSL of Piacenza; ASCCO of Parma

BACKGROUND: The recent reform in the field of prison health in Italy is stimulating the renovation and reorganization of the services offered pursuing a principle of “equality in differences” with regards to access to care in prison. In this context, the Health Service in Emilia Romagna has initiated various types of experimentation and awareness for the improvement of the health of detainees. As a member of a regional multidisciplinary team dedicated to this subject, I gave my contribution through this qualitative survey that has a descriptive and exploratory purpose. Several studies prove the effectiveness of interventions that focus on acceptance and mindfulness in order to help people identify their valued directions and follow them to improve their quality of life and resilience. OBJECTIVES: This study proposes an assessment tool than can guide interventions for health improvement in prison via identifying motivational levers for the implementation of healthy behaviour, and the environmental and relational resources and obstacles that the detainees can perceive in this regard. The investigation into the subjective point of view of the detainees aims also to stimulate a reflection on the matter that can help build a healthier prison environment. METHOD: The survey involved a small group of people detained in five different prisons in the region. They were subjected to purpose made, semi-structured interviews which explored the importance they give to different domains of living and in habit of health, the types of healthy behavior they adopt and the environmental and relational resources and obstacles they percieve in this regard. MAIN RESULTS AND DISCUSSION: For majority of the people interviewed, engaging in healthy behaviour is a way of pursuing their own values in relation to parenting, careers and passions, which suggests that for these people the interventions promoting the adoption of healthy behaviors should focus on these aspects. The type of the environmental resources and obstacles encountered and their motives, shows that in order to make their life healthier they should have the possibility of an active role in changing their life context. As for the relational resources and obstacles, it emerged that it is the operators' willingness to listen to the detainees that makes the difference. The interviewees strongly insisted on becoming actively involved in both the interactions with the operators and with their environment. These are the directions to take and experiment in order to make the prison community an environment that can promote a healthier life.

42. Implicit Attitudes, Explicit Attitudes or Subliminal Effect: What does actually guide food choice?
Primary Topic: Prevention and Community-Based Interventions
Subtopic: IRAP
Francesco Pozzi, Ph.D., Iescum, Parma
Francesco Dell'Orco, Iescum, Parma
Massimo Cesareo, IESCUM, Parma; IULM University, Milan
Paolo Moderato, Ph.D, IESCUM, Parma; IULM University, Milan

Subliminal Messages (SM) are traditionally thought to affect consumer's choices. The effectiveness of SM will be evaluated on a sample of students in a 4-phases daily experiment; Phase1)Semantic differential tests will be administered to evaluate the subjects'explicit preferences toward 2 brands, ie Parmigiano-Reggiano and Grana-Padano; Phase2) An Implicit Relational Assessment Procedure(IRAP)will be administered to evaluate the subjects'implicit attitudes toward the brands; Phase3) Based on the explicit preferences will be created a "pro-Grana", "pro-Parmigiano" and a control group. Pro-Grana subjects will be exposed to a video including Parmigiano SM, and viceversa. The control group will not receive SM; Phase4) the subjects will be asked to choose a product related with Grana-Padano or Parmigiano-Reggiano. Expected results:1)SM should not affect subjects'choices; 2)Subjects'choices should be coherent with their implicit attitudes; 3)If explicit and implicit measures are incoherent,the latter should be more predictive of the subjects'choices. Data will be shown.

43. Live Balance – A mindfulness based universal mental health promotion program: Conceptualization, implementation, participants' appraisal
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Primary prevention
Lisa Lyssenko, Central Institute of Mental Health, Mannheim, Heidelberg University, Germany
Martin Bohus, Central Institute of Mental Health, Mannheim, Heidelberg University, Germany

Background: We developed a 7 week prevention health promotion program, which is based on resilience research and uses strategies from acceptance and commitment therapy. The program was implemented in cooperation with a German insurance company. The data is part of an ongoing effectiveness evaluation. Methods: Data was collected via self-administered psychological questionnaires. Findings: Between 11/2013 and 6/2014 participants (n=4.898) enrolled on their own initiative. 37.0% of all participants (n = 1.813) agreed to take part in the study: average age was 49.5 years, 83% were female. At admission, the self-selected participants differ significantly from the general German population regarding initial symptoms of depression and anxiety, life satisfaction and resilience. Overall participant’s appraisal of the course was good, 83% of participants attended at least at 6 of the 7 sessions. Discussion: Although provided as a nonselective primary prevention program, the data point to an indicative utilization of people with mental load. Nevertheless, as satisfaction and compliance ratings show only slight correlations with socio-demographic characteristics such as age, gender and education, the concept of Live Balance seems suitable and feasible for universal prevention.

44. The relationship between early adverse experiences and social anxiety in adolescence: the mediator role of fears of compassion
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescence
Marina Cunha, PhD, Instituto Superior Miguel Torga; CINEICC - Faculty of Psychology and Educational Sciences of the University of Coimbra
Ana Xavier, MSc, CINEICC - Faculty of Psychology and Educational Sciences of the University of Coimbra
Ana Galhardo, Instituto Superior Miguel Torga; CINEICC - Faculty of Psychology and Educational Sciences of the University of Coimbra
Cátia Pereira, Instituto Superior Miguel Torga

Background: Several studies show that recalling of early adverse experiences with parents contribute to higher levels of psychopathology. Furthermore, negative emotional experiences during childhood may lead individuals to resist or be fearful of experiencing compassion for themselves, from others and of having compassionate feelings for others. These difficulties in experiencing affiliative emotions have been related to mental health problems. In this context the current study sought out to explore whether difficulties in receiving affiliative soothing emotions from self and from others (fears of compassion) mediate the impact of adverse memories (early experiences of threat, submissiveness, unvalued) on social anxiety symptoms in adolescents. Method: The sample included 309 adolescents (58.3% males; 41.7% females) aged between 12 and 19 years old (M = 14.91, SD = 2.12). These adolescents showed a mean of 9 years of education (SD = 1.73). Participants completed a set of self-report questionnaires, namely the Early Life Experiences Scale (ELES), the Fears of Compassion Scales (FCS) and the Social Anxiety Scale for Adolescents (SAS- A). Results: Descriptive analysis showed that girls report higher levels of unvalued feelings in early interactions with parents as well as higher levels of social anxiety. Younger adolescents (12-13 years-old) presented higher scores in social anxiety when compared to older adolescents (ages between 14 and 19 years old). Path analysis results showed that the model explained 35% of social anxiety variance. The recall of unvalued feelings in early interactions directly predicted increased levels of social anxiety. Bootstrap analysis indicated that threatening experiences indirectly predicted increased levels of social anxiety through fears of compassion from others and for the self, even when socio-demographic variables were controlled for. Additionally, there were significant indirect effects of fears of compassion from others and for the self in the relationship between submissiveness experiences and social anxiety. Discussion: Current results indicate that adolescents who recall unvalued feelings in early interactions with parents tend to report higher levels of social anxiety. Moreover, adolescents who come from threatening and submissiveness early environments tend to report more fears of receiving compassionate feelings from others and more fears of self-compassion which in turn impact on social anxiety. These findings emphasize the role of fears of compassion from others and for the self on how early threatening and submissiveness experiences impact on social anxiety. Therefore, in terms of clinical implications, these data suggest that compassion abilities are particularly relevant to develop among adolescents with increased social anxiety as a way of reducing the damaging impact of early negative experiences.

45. Increasing Racially Diverse Social Connections through Contextual Behavioral Science.
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Intergroup Anxiety
Michael J. Thurston-Rattue, M.A. (Hons), University of Washington
Jonathan W. Kanter, Ph.D., University of Washington
Forogh Hakki, University of Washington
Adam Kuczynski, B.S., University of Washington
Maria M. Santos, M.A., University of Washington
Keith Bailey, Milwaukee Matters
Mavis Tsai, Ph.D., University of Washington
Robert J. Kohlenberg, Ph.D., University of Washington

We suggest that the next great battlefront in the war on modern racism is psychological, and it is here that contextual behavioral science may have great potential in the development of effective interventions. Using principles from Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP), we developed a 6-hour, workshop-style intervention to first increase psychological flexibility with respect to aversive private experiences around race-based interactions and then develop intimacy and closeness in a workshop-style, group setting involving previously unacquainted black and white college students. We report on results from qualitative interviews of participants (n = 10 black participants and 10 white participants) after our first pilot of the workshop. Participants reported various positive outcomes from the workshop, including decreased prejudicial responses, increased intimacy and social connection with other participants as well as significant others in their lives, increased empowerment to be more authentic in relationships, and increased desire from white participants to confront other white students when they make racist or insensitive remarks. One student reported feeling somewhat overwhelmed and inhibited by the experience, but reported that this effect was temporary. Overall, this work establishes the feasibility of a brief, workshop style intervention to increase social connection in racially diverse groups at a crucial time in which this issue is a national priority. We are primarily interested in developing a solid scientific foundation for our efforts and future research directions are discussed.

46. Explicit and implicit naïve concept of talent - relations with self-esteem Machiavellianism and self-determined motivation
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Maria Chełkowska, M.A., University of Silesia
Magdalena Hyla, M.A., University of Silesia
Lidia Baran, M.A., University of Silesia

In the present study we made an attempt to answer questions concerning the explicit and implicit naïve concept of talent. On previous research we have found that people perceive talent in two main ways – as a result of hard work or as an innate trait. This study was conducted to determine if explicit and implicit concepts of talent are different among people high and low in self-esteem, Machiavellianism and self-determined motivation. Furthermore, we wanted to determine if students of different fields - social sciences, arts and natural sciences - differ in explicit and implicit concepts of talent. In reported study we used the Implicit Relational Assesment Procedure (IRAP) as a measure of implicit concept of talent (hard work vs innate trait), Rosenberg Self Esteem Scale (RSES) as a measure of self-esteem, MACH-IV as a measure of Machiavellianism, and Global Motivation Scale (GMS) as a measure of self-determined motivation. Our sample consisted of 40 students from University of Silesia in Katowice and Academy of Music in Katowice. Results are discussed in terms of potential utility of Relational Frame Theory and IRAP in assesing implicit concept of talent. Furthermore, potential utility of the naïve concept of talent as a predictor of career choices and a motivating factor is discussed.

47. Modifications/widening of the concept of value in RFT (and ACT) / Titel: Modifikationen/Erweiterungen zum Werte-Begriff in RFT (und ACT)
Primary Topic: Theoretical and philosophical foundations
Subtopic: RFT
Gerhard Kugler, Private praxis

ACT and RFT are based on a problematical concept of "values". An alternative suggestion: Values develop out of cooperation of works which disseminate as culture over the centuries. The individual finds his outstanding place in these branches of works and working, but that place is meaningful only as a part of the whole grounded on many works. In working an individual influences the lives of others, even if he follows his own aims and emphasis more or less consciously. Verbal depictions, symbols (in RFT: augmentals) of his working may broach the issues of his direction or parts of his avenues of approach, but are not the base. Psychotherapy should therefore attach to the common base of values, especially as it is cooperation and consequently needs common values. The individual characteristics of valueing, arranging, creating are not questioned thereby, but obtain another context.ACT und RFT fußen auf einem problematischen "Werte"-Begriff. Ein alternativer Vorschlag: Werte entstehen aus der Kooperation an Werken, die sich über die Jahrtausende als Kultur verbreiten. Der einzelne Mensch findet in diesem Geäst von Werken und Wirken zwar einen besonderen Platz, dieser ist aber nur als Teil des Gesamten, verankert an vielen Werken, bedeutungsvoll. Im Wirken gestaltet ein Mensch das Leben anderer mit, auch wenn er eigene Zieleund Schwerpunkte mehr oder weniger bewusst verfolgt. Verbale Repräsentationen bzw. Symbole (in RFT: augmentals) seines Wirkens können seine Gestaltungs-Richtung oder Teile der Verfahrensweisen des Einwirkens thematisieren, sind aber nicht ihre Grundlage. Auch Psychotherapie setzt sinnvollerweise an der gemeinsamen Grundlage von Werten an, zumal sie eine Kooperation sein soll und schon von daher gemeinsame Werte braucht. Die individuellen Eigenarten des Wertens, Gestaltens sollen damit nicht in Frage gestellt werden, erhalten aber einen anderen Kontext.

48. The Impact of Age, Gender, and BMI on Thought Control, Food Acceptance, and Eating Behavior
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Obesity; Emotion Regulation
Kristin D. Whelan, M.A., Alliant International University, San Diego
Kimberly A. Corp, MFT., Alliant International University, San Diego
Shawnee L. Brew, B.A., Alliant International University, San Diego
Taryn L. Gammon, M.A., Alliant International University, San Diego
Jill A. Stoddard, Ph.D., Alliant International University, San Diego

Background: Contemporary research indicates a relationship between cognition, emotion regulation and eating. Research also commonly supports gender and age discrepancies in emotion regulation. For example, studies postulate that women report more negative affect and an increased tendency to ruminate, catastrophize, and reappraise negative emotion than men (Thomsen, D.K., Mehlsen, M.Y., Viidik, A., Sommerlund, B., & Zachariae, R., 2005; Nolen-Hoeksma, A., 2011). Women’s use of emotional acceptance appears to remain stable with age, whereas emotional suppression increases with age for women but not men. Older adults report less negative affect than youth. Finally, studies suggest a higher prevalence of food craving, cognitive dietary restraint, and disinhibition of eating among women compared to men (Alexander, J & Tepper, B., 1995; Lafay, T. et al., 2001). The extent to which these age and gender related findings extend to maladaptive cognitive processes and unhealthy food related behaviors remain unclear. Method: The current study uses the Thought Control Questionnaire (TCQ), The Food Acceptance and Action Questionnaire (FAAQ) and the Three-factor Eating Questionnaire (TFEQ) to examine how various thought control strategies, experiential acceptance of food-related internal experience, and relationships between cognitive restraint of eating, disinhibition, and hunger differ based on age, gender, and BMI. Recruitment of 180 normal weight and overweight/obese males and females of varying ages is proceeding (current N=132). Results: It is expected that younger age will be associated with higher levels of worry and social thought control, and older age will be associated with higher levels of food acceptance. It is also hypothesized that women and overweight/obese will have higher mean levels of cognitive restraint, disinhibition, perceived hunger, rumination, and punishment thought control strategies than men or normal weights, whereas women and normal weights will have higher levels of food-related acceptance and reappraisal thought control strategies than men or overweight/obese. Correlations and t-tests will be used to investigate the relationships between age, gender and weight on the TCQ, FAAQ and TFEQ. Discussion: Results from this study will help to increase understanding of the impact that gender, age, and weight have on emotion regulation, preoccupation with body, food, and weight as well as unhealthy eating patterns. Findings may illuminate important considerations for the development of prevention and treatment programs that target the global obesity epidemic.

49. The Relationship Between Control of Unwanted Thoughts and Perceived Success Implementing Emotion Regulation Strategies
Primary Topic: Clinical Interventions and Interests
Subtopic: Emotion Regulation
Shawnee L. Brew, B.A., Alliant International University, San Diego
Kimberly A. Corp, MFT, Alliant International University, San Diego
Taryn L. Gammon, M.A., Alliant International University, San Diego
Kristin D. Whelan, M.A., Alliant International University, San Diego
Jill A. Stoddard, Ph.D., Alliant International University, San Diego

Background: Experimental research on emotion regulation often includes emotion induction procedures followed by the introduction of varying emotion regulation strategies. To accurately assert that the emotion regulation intervention has an impact on the dependent variables being measured, it is important to perform integrity checks ensuring that (1) the emotion induction was successful, and (2) the appropriate emotion regulation strategy was understood and successfully employed. To date, little research has investigated characteristics of participants who report an inability to effectively implement an emotion regulation practice. A greater understanding of these characteristics may have applied value in clinical settings where understanding and effectively implementing of therapy techniques is paramount to successful treatment outcomes. Method: The current study (data collection ongoing; current N=132) is part of a larger investigation examining the impact of acceptance, suppression and cognitive reappraisal of emotions on hunger, desire for food, craving, distress, and eating behavior in normal weight and overweight/obese participants. Following an emotion induction procedure, participants were randomly assigned to one of four emotion regulation (ER) conditions: Acceptance, Suppression, Cognitive Reappraisal, or No Instruction Control. An integrity check was conducted to determine the extent to which participants (1) understood ER instructions and (2) believed they successfully employed the ER strategy taught. The Thought Control Questionnaire (TCQ; Wells & Davies, 2004), a measure of habitual strategies to control one’s unwanted thoughts, was administered at baseline to assess participants’ typical responses when experiencing an unwanted or unpleasant thought (e.g., “I call to mind positive images instead”). The TCQ is scored by summing the totals from the 5 categories it assesses: distraction, social control, worry, punishment and re-appraisal. It was hypothesized that participants who scored higher on negative control strategies at baseline would report lower success with acceptance ER and higher success with suppression ER. Participants who scored higher on the reappraisal subscale would report higher success with reappraisal ER. Results: Correlational analyses revealed that there was a significant negative correlation between worry (as measured by the TCQ) and perceived mastery of the acceptance strategy. In other words, participants who tend to respond to negative thoughts by worrying were less likely to believe in their ability to successfully utilize an acceptance based ER strategy. Discussion: These findings may suggest a need to assess a worrier’s sense of mastery when learning acceptance based treatment strategies. This is particularly important given the literature on the impact of patients’ expectations on successful treatment outcome (Linne, Hemmingsson, Adolfsson, Ramsten & Rosser, 2002).

50. The Impact of Acceptance, Suppression, and Cognitive Reappraisal of Emotion on Subjective Distress, Food Craving, and Eating Behavior in a Mixed-Weight Sample
Primary Topic: Behavioral medicine
Subtopic: Obesity
Taryn L. Gammon, M.A., Alliant International University, San Diego
Kimberly A. Corp, MFT., Alliant International University, San Diego
Kristin D. Whelan, M.A., Alliant International University, San Diego
Shawnee L. Brew, B.A., Alliant International University, San Diego
Jill A. Stoddard, Ph.D., Alliant International University, San Diego

Background: The global obesity epidemic represents a major challenge for healthcare professionals and organizations worldwide. Numerous programs have been developed to target weight loss in overweight or obese individuals, yet results from these initiatives are often short-lived. The application of psychological interventions to this epidemic has received increasing attention, with cognitive behavioral and acceptance-based interventions demonstrating promising outcomes. However, there remains a lack of clarity regarding the mechanisms that contribute to overeating. In order to maximize the effectiveness of these interventions, more information is needed to determine what factors contribute to unhealthy eating behavior. Method: The present study evaluates the role of emotion regulation on subjective distress, food craving, and eating behavior in 180 normal weight, overweight, and obese adults (current N= 127). Participants are randomly assigned to one of four emotion regulation conditions: Acceptance, Suppression, Cognitive Reappraisal, or Control. After an emotion induction procedure, participants are taught to practice the appropriate emotion regulation strategy. Pre and post assessment of food craving and distress are determined by administering the Food Craving Questionnaire-State (FCQ-S) and Subjective Units of Distress Scale (SUDS). Eating behavior is also recorded and quantified during the session. The data will be analyzed for main effects and interaction of time, group, BMI, and emotion regulation condition by using repeated measures ANOVA. Results: Preliminary results suggest that eating behavior varies as a function of emotion regulation condition, with individuals in the suppression condition consuming the most food after the emotion induction. It is hypothesized that there will be significant differences in subjective distress between emotion regulation conditions and that distress will impact eating behavior. Discussion: Findings from this study will enhance understanding in the field about the role of different styles of regulating emotional distress on eating behavior. These findings may prove valuable for healthcare professionals and organizations designing targeted treatments for obesity.

Friday, 17 July - Poster Session #3

1. The Self Experiences Questionnaire (SEQ): Preliminary analyses of an item pool for a measure of self in people with chronic pain
Primary Topic: Behavioral medicine
Subtopic: Chronic pain
Lin Yu, King's College London
Lance M McCracken, Ph.D., King’s College London INPUT Pain Unit, Guy’s & St Thomas’ NHS Foundation Trust, London
Sam Norton, King's College London

Background: Accumulating evidence supports the efficacy and effectiveness of Acceptance and Commitment Therapy (ACT) for chronic pain. ACT is based on what is called the Psychological Flexibility model. Included in the evidence for ACT for chronic pain is support for the important role of acceptance, present-focused attention, and value-based action as potential key therapeutic processes from this model. Another potentially important process from this same model, “self-as-context”, has not yet been studied in relation to ACT as there has been no instrument available to assess this variable. Self-as-context can be defined briefly as the capacity to adopt a perspective where we are experienced as separate from our thoughts and feelings. A measure of self-as-context could improve our understanding of treatment mechanisms and lead to further treatment development. Methods: 205 consecutive referrals to a pain management center participated in this study. All participants completed 29 items that represent the item pool for a planned measure called the Self Experiences Questionnaire (SEQ). Based on analyses of item response frequencies, item inter-correlations, and exploratory factor analyses, fifteen items were selected that formed an internally consistent scale. Results: The selected items formed an overall scale with good internal consistency, α = .85. The mean item rating M=3.14, SD=.24 (rated on a scale of 0 to 6). Three subscales, of six, four, and six items, with adequate internal consistency emerged from Principle Factor Analysis with Oblique Rotation: (1) Self As Distinct From Content, α = .86 (2) Non-Attached Self, α = .75 (3) Self-As-Observer, α = .78. Adequate construct validity of the overall scale was supported through correlations with other measures of psychological flexibility including: Pain Acceptance, r= .48*, General Acceptance, r=.57*, Decentering, r=.65*, Cognitive defusion, r=.55*, and Committed Action, r=.45*. Adequate predictive validity was supported through correlations with measures of outcomes: Depression, r=-.38*, Work and Social Adjustment, r=.22*, and Interference, r=-.19*. All subscales significantly correlated with all other measures of psychological flexibility and measures of outcomes, except for Self As Observer subscale, which did not correlated with General Acceptance and any outcomes to a significant level. (*p<.001) Discussion: SEQ overall represents a reasonably reliable and valid measure for Self-As-Context. Sense of Self-As-Observer, however, does not appear to easily emerge in natural language environment. Perhaps training is required for accurate reporting on this aspect. Further investigation in the context of treatment is warranted.

2. Social relationships and chronic pain - Findings from a Swedish clinical sample
Primary Topic: Behavioral medicine
Subtopic: Chronic pain, social connection, self-report measure, adults
Marie Blom, MSc, PhD candidate, Linköping University, Sweden
Björn Gerdle, PhD, MD, Linköping University, Sweden

Chronic debilitating pain is a global health concern. Multimodal rehabilitation programmes are considered treatment of choice, many of which are ACT influenced. Contents vary greatly, as do degree of involvement of significant others. Earlier studier using West-Haven Yale Multidimensional Pain Inventory (MPI) have pinpointed a cluster of interpersonally distressed chronic pain sufferers, characterized by reporting high degrees of punishing pain responses from significant others. This poster will present descriptive data from the Swedish version of MPI on a large sample of outpatients with chronic pain, identifying prevalence of interpersonal distress and considering needs of alternate measures. Presented will also be the outlining of a PhD thesis aiming to predict and influence satisfaction with social relationships among chronic pain sufferers.

3. The role of pain acceptance on functioning in individuals with disabilities: A longitudinal study
Primary Topic: Behavioral medicine
Subtopic: Chronic pain
Mark P. Jensen, Ph.D., University of Washington
Amanda E. Smith, B.A., University of Washington
Kevin N. Alschuler, University of Washington
Dagmar Amtmann, Ph.D., University of Washington
David T. Gillanders, Ph.D., University of Edinburgh
Ivan R. Molton, Ph.D., University of Washington

Background: Pain acceptance is hypothesized to (a) have direct beneficial effects on functioning and (b) buffer the effects of pain on functioning. This study sought to test these hypotheses using a longitudinal design in a sample of individuals with physical disabilities and chronic pain. Methods: A sample of 392 individuals with physical disabilities (muscular dystrophy = 58, post-polio syndrome = 111, multiple sclerosis = 103, spinal cord injury = 120) and chronic pain were administered measures assessing two domains of pain acceptance (Pain Willingness and Activity Engagement; CPAQ), pain intensity (0-10 NRS), and four functioning domains measured by PROMIS instruments (pain interference, physical functioning, depression, and sleep disturbance). The pain and functioning measures were administered again about 3.5 years later. Results: Significant (p < .05) or non-significant trends (p < .10) for direct effects emerged for the prediction of subsequent changes in all five of the criterion variables. In each case, higher levels of acceptance predicted either more improvement or less worsening in pain and functioning. Moderation analyses indicated that among individuals endorsing more willingness to engage in activities despite pain, a subsequent increase in pain was not associated with an increase in depression (r = .00), while among those with lower activity engagement there was a significant and positive association (r = .15) between change in pain and depression. Discussion: The findings provide further support for the role that pain acceptance plays in adjustment to chronic pain in individuals with physical disabilities. In particular, the findings indicate that direct effects (consistent with the possibility that more pain acceptance may contribute to better outcomes) are stronger than moderation effects (consistent with acceptance is a protective factor on the association between pain and functioning), although at least some moderating effects may exist. Research examining the causal impact of changes in pain acceptance on functioning is warranted.

4. Nonverbal change mechanisms underlying Acceptance and Commitment Therapy
Primary Topic: Clinical Interventions and Interests
Subtopic: Panic disorder and agoraphobia
Catharina Zazoff, Master Student, University of Basel
Marie-Noëlle Cottens, Master Student, University of Basel

Objective: Research indicates the effectiveness of Acceptance and commitment Therapy (ACT) in treatment resistant patients (Clark et al., 2014 & Gloster et al., 2015). The underlying nonverbal mechanism of change haven`t been examined yet in detail. This study aimed to examine how three indications of nonverbal behavior [(a) complementarity (the correspondence of an interaction between individuals); (b) nonverbal synchrony; and (c) eye contact between patient and therapist] interacted with the six core processes of ACT and treatment outcome. Method: Videotapes collected within a randomized controlled study of ACT for treatment resistant patients diagnosed with primary panic disorder and / or agoraphobia (PD / A) (Gloster et al., 2015). These videotapes showing therapy sessions of 41 patients (two per patient), were rated and analyzed for psychological flexibility and the three indicies of nonverbal behavior: synchrony, complementarity, eye contact. Each videotape was rated by two master students. These variables were associated with various outcome measures (Psychological flexibility rated by the client (AAQ-II), Clinical Global Impression (CGI), Panic disorder and Agoraphobia (PAS) and Cognitive Fusion (CFQ)). Results: Results indicated a negative association between psychological flexibility and complementarity in the end of therapy. A negative association between psychological flexibility and severity of panic disorder and agoraphobia at follow-up assessment was found, whereby the change of psychological flexibility from beginning to end of therapy predicted outcome (CGI and PAS). A trend was found for the association between nonverbal synchrony and the improvement of psychological flexibility during therapy. Although the significance level was not reached, there was a positive correlation of a medium effect size between nonverbal synchrony and the improvement of psychological flexibility. No association was found between nonverbal synchrony and the outcome variables. The variable of eye contact will be analyzed next. It is expected to find a negative association between psychological flexibility and gaze-aversion. Conclusion: ACT increases psychological flexibility, whereby decreasing complementarity tend to improve psychological health. However, the results suggest that there is not a strong link between nonverbal synchrony and psychological flexibility. The study offer new findings regarding nonverbal processes involved in ACT treatment of patients with panic disorder and / or agoraphobia which provides additional information for clinicians.

5. A Preliminary Study on Validating the Self-Compassion Scale (SCS) in Italian Adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: self-compassion, mindfulness, wellbeing, adolescents
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Erika Mlechiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Martina Romitelli, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

Self-Compassion Scale (SCS) is a 26 items measure originally developed on adult samples. Self-compassion construct has been defined as the awareness that “suffering, failure, and inadequacies are part of the human condition, and that all people are worthy of compassion” (Neff, 2003). This measure allows to reveal how people behave towards themselves in life hard times. Considering adolescence as a period rich in psychological, social and biological changes, the availability of an SCS version for this population could have important conceptual, clinical and social implications. This study purpose is to present an Italian version of SCS that has been translated into Italian and administered to a sample of about 400 students aged 11-14. Subsequently its validity and reliability were investigated, obtaining satisfactory results. Moreover adolescents with greater self-compassion levels show more psychological wellbeing, such as less anxious, depressive, somatic, dissociative symptoms, less dysfunctional attitudes and better quality of life.

6. Validation study of the Italian Version of the Mindful Attention Awareness Scale for Adolescents (MAAS-A)
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents, Mindfulness, Psychological Flexibility, Acceptance
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Nicoletta Ristè, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Valentina Carloni, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Martina Romitelli, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

The measurement of mindfulness on adolescents has important conceptual, clinical and social implications. This study aims to present an Italian version of the Mindful Attention Awareness Scale for Adolescents (MAAS-A; Brown, West, Loverich & Biegel, 2011), and to analyze its psychometric properties. MAAS-A is a 14 items scale assessing mindfulness as a one-dimensional construct, considered “a receptive state of attention that, informed by an awareness of present experience, simply observes what is taking place”(Brown & Cordon 2009; Brown & Ryan 2003; Brown et al. 2007). MAAS-A has been translated into Italian and administered to a sample of about 400 students aged 11-14. Supporting literature data, adolescents with better quality of life, higher subjective happiness, lower levels of perceived stress, anxiety, depression and dissociation show higher scores in mindfulness competences. The study explores factor structure, validity and reliability and the findings suggest that MAAS-A presents good psychometric characteristics for its use on Italian adolescents.

7. The body image psychological inflexibility scale (BIPIS): Toward a functional contextual approach to assessment and treatment planning
Primary Topic: Clinical Interventions and Interests
Subtopic: Assessment
Glenn M. Callaghan, Department of Psychology, San Jose State University, San Jose, CA
Emily K. Sandoz, Department of Psychology, University of Louisiana at Lafayette, Lafayette, LA
Sabrina M. Darrow, Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Timothy K. Feeney, Department of Psychology, University of Nevada, Reno, Reno, NV

There are a variety of theoretical and empirical approaches to understanding body image disturbance and body dysmorphic disorder (BDD), problems experienced by human across the globe. While these differing conceptualizations have created little in the way of clarity, a functional contextual approach may offer a unique way to assess and treat issues related to body image. Using a model focused on psychological inflexibility (avoidance of one’s own cognitive and affective states) can be useful to understand these problems and attempt to integrate the values that different people have from unique and international cultures. The Body Image Psychological Inflexibility Scale was developed based on the principles of Acceptance and Commitment Therapy (ACT). The scale was created by generating new items to represent the construct and revising items from the Body Image Acceptance Action Questionnaire, which focuses primarily on weight. A validation study of this measure was conducted using an ethnically diverse undergraduate population of over 700 participants and multiple assessment devices. The 16-item final scale has good internal consistency, a single factor solution, convergent validity, and good test re-test reliability. Data are presented that demonstrate a relationship between psychological inflexibility and body image disturbance indicating empirical support for an ACT conceptualization of body image problems and the use of this measure to assess body image disturbance and BDD. Treatment implications using contextual behavioral interventions are highlighted.

8. Results from a group-based stress management ACT-intervention for workers with long-term work-related stress: A pilot-study
Primary Topic: Clinical Interventions and Interests
Subtopic: Work-related stress
Greta Lassen Lund, MSc.psych, Aarhus University Hospital, Denmark
Hanne Knudsen, MSc.psych, Aarhus University Hospital, Denmark
Morten Vejs Willert, MSc.psych.PhD, Aarhus University Hospital, Denmark

Results from a group-based stress management ACT-intervention for workers with long-term work-related stress. A pilot-study. Greta Lassen Lund (MSc. psych.), Hanne Knudsen (MSc. psych.) and Morten Vejs Willert (MSc.psych, PhD) Background: Relatively little is known about using ACT as a group-based stress management intervention targeting persons with long-term work-related stress. At the Department of Occupational Medicine, Aarhus University Hospital, Denmark, we have previously investigated the effects of a group-based, cognitive behavioural stress management intervention directed at workers with elevated symptoms of work-related stress. The study showed a large effect size in terms of reducing perceived stress when comparing the intervention to a wait-list control condition and the gains achieved were maintained at three months follow-up. Aim: The aim was to test ACT as an alternative intervention to CBT intervention targeting persons with long-term work-related stress. We wanted to develop and test a group-based ACT intervention manual, using the Acceptance and Action Questionnaire-II (AAQ-II) as a measure of change in psychological flexibility. We also wanted to assess the reliability of a Danish translation of the AAQ-II. The Perceived Stress Scale (PSS-10) was the main outcome in the CBT project, therefore in this project we also wanted to look at the comparability of effect related to PSS-10. Method: 89 persons from the working population in the municipality of Aarhus and its surrounding communities were included in the intervention program after referral from local general practitioners (GP), union social workers and the employee-counselling program in Region Central Jutland. Inclusion criteria were persistent symptoms of work-related stress, defined as physiological and psychological symptoms of reduced level of functioning lasting more than four weeks and elevated reactivity of symptoms when confronted with demands at work. Exclusion criteria were sick-leave for more than 26 consecutive weeks, concurrent major life-events and interpersonal workplace conflicts as the major problem, a severe psychiatric disorder requiring treatment and active substance abuse. A total of 89 persons were included in the 9 consecutive pilot groups. Between 7-12 participants per group met for a total of 9 sessions over a 3 month period followed by a booster session after an additional 3 months. The intervention followed a manual developed by two ACT trained psychologists who also led the groups. Key elements in the ACT intervention were psychoeducation on stress, mindfulness exercises, identifying avoidance behavior, defusion techniques, acceptance, defining values and comitted action. The Acceptance and Action Questionnaire (AAQ-II), (range 10-70) was administered at the beginning of all sessions, excluding the booster session. Our comparison measure, the Perceived Stress Scale (PSS-10), (range 0-40) was administered at sessions 1 and 8. For both measures the pre-post within-group changes from session 1 to 8 were analyzed using the student’s t-test. Results: The study sample consisted of 93% women who were all in active employment. The average labor market attachment was 17.6 years with an average of 8.5 years in current/latest employment. At baseline we found a Crohnbach’s alpha of 0.87 for the Danish translation of the AAQ-II. This is comparable to the mean alpha coefficient of 0.84 reported for the original English version of the AAQ-II by Bond et al. (2011). Participants baseline AAQ-II mean score was 37.9 points (SD=8.9), which declined to 31.8 points (SD=8.3) at session 8, demonstrating a pre-post difference of 6.2 (3.3 – 9.0 95% CI) that reached statistical significance (p<0.001). Participants baseline PSS-10 mean score was 22.8 points (SD=5.8), which declined to 15.1 points (SD=5.2) at session 8, demonstrating a pre-post difference of 7.7 points (4.9 – 6.3 95% CI) that reached statistical significance (p<0.001). Discussion: From this pilot-study of a 3-month group-based stress management ACT-intervention we have found that it was possible to develop a stress management intervention program based on the ACT framework. The Danish translation of the AAQ-II demonstrated good reliability. Participants improved their psychological flexibility and perceived stress scores declined from pre- to post-intervention. Comparison of PSS-10 scores with the previously conducted group-based, cognitive behavioural stress management intervention showed similar changes over time.

9. Psychological processes in obese or overweight women with and without binge eating: An exploration of their differences
Primary Topic: Clinical Interventions and Interests
Subtopic: Obesity, Binge eating
Lara Palmeira, MSc., CINEICC - University of Coimbra
Sérgio Carvalho, MSc., CINEICC - University of Coimbra
José Pinto-Gouveia, M.D., Ph.D., CINEICC - University of Coimbra

Several studies have showed the negative impact of experiential avoidance, cognitive fusion, shame and self-criticism on quality of life and well-being. Obesity has been consistently linked to individual suffering, especially when associated with binge eating. However, differences between obese people with and without binge eating regarding these psychological processes are scant. The current study explored the differences in several psychological processes in overweight or obese women: with binge eating disorder (BED) (n= 32) and without binge eating disorder (n=46). A t-test analysis showed that, although there were no differences regarding BMI, the two groups were significantly different in overall experiential avoidance (t=3.106, p=.003), body-image cognitive fusion (t=2.246, p=.028), external shame (t=4.015, p≤.001), weight self-devaluation (t=2.632, p=.010) and weight discrimination (t=4.461, p≤.001), disordered eating behaviors and attitudes (t=4.778, p≤.001) and diminished quality of life (t=4.305, p≤.001), with binge eating group revealing higher scores. Interestingly, both groups did not differ on measures of self-criticism, self-compassion, mindfulness and restricting food intake. Clinical implication: the importance of delivering differentiated interventions for obese patients with or without BED, with binge eaters requiring special focus on developing acceptance and body-image cognitive defusion.

10. Acceptance and Commitment Therapy for Chronic Fatigue Syndrome: A case series approach
Primary Topic: Clinical Interventions and Interests
Subtopic: IRAP
Lauren Roche, Universities of Lincoln and Nottingham
David Dawson, DClinPsyc, University of Lincoln
Nima Moghaddam, DClinPsyc, University of Lincoln

Background Acceptance is understood to be an important element in coping and living with chronic illnesses such as diabetes and chronic pain - increasing acceptance has been related to a number of positive outcomes such as reduced symptoms as well as greater reported quality of life. Acceptance and Commitment Therapy (ACT) is a psychotherapeutic model aimed at increasing psychological flexibility, and sees increasing acceptance as a key process underlying change. Chronic Fatigue Syndrome (CFS), a disabling and not uncommon disorder, is associated with a poor reported quality of life even in comparison to other chronic conditions therefore an intervention such as ACT could increase acceptance, there are promising implications for coping and living with CFS. This would furthermore have interesting implications for future service provision and client care. Method This study used a multiple single case series approach. Six participants were recruited from a specialist NHS service, and after completing a baseline period of measures, took part in a six week guided self help intervention, based on the text ‘Get out of your life and into your mind’ by Steven Hayes. The lead researcher telephoned each participant once a week. Frequent and mixed method data collection throughout the intervention was used to gather detailed information – participants completed thrice weekly questionnaires assessing ACT and CFS variables; there was a behavioural measure in the form of a Fitbit activity monitor; this data was complimented by qualitative data from a change interview at the end of the study. Finally an implicit measure in the form of the Implicit Relational Assessment Procedure (IRAP) was taken at the beginning, middle and end of the study as an interesting addition to the self-report data. Results This study is currently on-going – the data is due to be completed by May, and so preliminary results will be available for discussion at the conference in July. Data will be analysed in each case with visual analysis and testing for statistically significant change. Discussion I will look to discuss any change in the participants across all of the measures. I will be able to explore whether change occurs in line with ACT theory, and the implicit measure will further allow interesting theoretical exploration of the nature of any change. These initial results can also be used to discuss implications for ACT in this format as an adjunct to current treatment for individuals with Chronic Fatigue Syndrome.

11. Stop Thinking, Start ACTing – The Effectiveness of Acceptance and Commitment Therapy in an Inpatient Sample of a Psychiatric Department
Primary Topic: Clinical Interventions and Interests
Subtopic: Effectiveness of ACT in a naturalistic setting
Mareike Pleger, M.Sc. Psych., Evangelisches Krankenhaus Königin Elisabeth Herzberge (KEH), Berlin
Karolin Treppner, M.Sc. Psych., Humboldt University Berlin

Objective. Acceptance and Commitment therapy (ACT) is a young approach, which evolved from the so called third wave of behavior therapy. ACT is a contextual approach, which expands traditional cognitive behavioral therapy (CBT) by, inter alia, mindfulness and valued living. It has not been unequivocally clarified yet, if ACT is superior to CBT. However, previous research findings indicate ACT to be generally efficacious. Even though ACT is increasingly applied in clinical practice, only little research has been conducted in this field. Hence, to examine the effectiveness of ACT compared to CBT, further investigations are needed. The present study aims to explore the therapeutic effect of ACT and CBT groups within a naturalistic setting, taking possible influencing factors into account. Method. Sixty-seven inpatients of a German psychiatric department were assessed with respect to different symptom measures as well as ACT-specific outcomes. Results. Regarding to symptom reduction, both ACT and CBT proved to be equally effective treatments. ACT-specific variables turned out to have an influence on therapeutic success. Conclusion. Results suggest ACT to be an equivalent alternative to CBT. Findings are discussed in terms of to what extend outcomes of ACT and CBT are distinct and which variables may be influential.

12. Perceived Injustice and its Impact on Physical and Emotional Functioning: The Mediating Role of Chronic Pain Acceptance
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance, Chronic Pain, Perceived Injustice
Marie-Eve Martel, M.A., D. Ps. (c), Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières
Joel Gagnon, Université du Québec à Trois-Rivières

Background: Perceived injustice can be defined as a negative appraisal regarding irreparability and severity of loss associated to pain, and feelings of blame and injustice (Sullivan, 2008). Recent findings suggest that perceived injustice is an important risk factor associated to chronic pain disability. However, few research studies have examined its role within a clear theoretical framework, and the mechanisms by which this perception leads to disability are unknown. Acceptance and Commitment Therapy (“ACT”, Hayes et al., 2012) is considered as a highly validated approach by the American Psychological Association. Acceptance of chronic pain, a central variable in this model, has been associated to better physical and emotional functioning in individuals who live with chronic pain. Acceptance of pain implies staying active on a daily basis and cultivating an open attitude towards pain symptoms (McCracken et al., 2014). Acceptance could prove to be an explanative variable in the relation between perceived injustice and pain disability (Scott et al., 2013). Method: The current study aims to examine the mediating role of pain acceptance on the relation between perceived injustice and physical and emotional functioning, within a sample of 801 individuals who suffer from chronic pain. Results: Results of mediation analysis revealed significant direct and indirect links between perceived injustice, acceptance of pain, pain disability, and anxiety and depressive symptoms, thus confirming the proposed mediation models. Discussion: Clinical and theoretical implications will be discussed along with future research directions. Keywords: Acceptance and Commitment Therapy (ACT), Chronic Pain, Acceptance, Perceived Injustice, Pain Disability

13. Psychological Inflexibility for Pain: Translation and Validation for a French-Speaking Population
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy (ACT), Chronic Pain, Psychological Inflexibility, Translation
Marie-Eve Martel, M.A., D. Ps. (c), Université du Québec à Trois-Rivières (Canada)
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières (Canada)
Aurélie Gauchet, Université de Grenoble (France)
Yamina Zouikri-Roland, Unité-Douleur. Clinique Clémentville, Montpellier (France)
Emmanuelle Decker, Université de Montpellier
Raphaël Trouillet, Laboratory Epsylon EA4556 (Montpellier)
Rikard Wicksell, Karolinsca Institutet (Sweden)
Jean-Louis Monestès, Université de Grenoble (France)

Background: A growing number of studies have provided empirical support for the use of Acceptance and commitment Therapy (ACT) in the treatment of chronic pain. The psychological flexibility model can be seen as a basis for integration and progress in psychological approaches to pain (McCracken & Morley, 2014). Further research is needed to clarify the role of the ACT processes in their relationship to physical and emotional functioning. Several measures have been developed specifically to assess ACT processes related to chronic pain, like acceptance and values. Recently, the Psychological Inflexibility in Pain Scale (PIPS; Wicksell et al., 2010, 2008) has been developed to measure avoidance and fusion, and its relationship to disability has been demonstrated. More research is needed to support its role in chronic pain, related to other variables. Furthermore, the PIPS is not yet available in French for clinicians or researchers. Method: This study aims to translate and validate a French version of the Psychological Inflexibility in Pain Scale (PIPS; Wicksell et al., 2010), a brief 12-item questionnaire, among a large sample of French-speaking individuals. Our sample was comprised of 1,077 individuals from both Quebec (Canada) and France who suffer from chronic pain. Results: An exploratory factor analysis was conducted using unweighed least square as the extraction method and Promax as the rotation method, thus allowing the factors to correlate. As expected, results revealed a two-factor structure (cognitive fusion and avoidance) with coefficients ranging from .36 to .85, and explaining 51% of the total variance. Furthermore, a Confirmatory Factor Analysis (CFA) was conducted using AMOS 20 to confirm the bifactor structure of the PIPS and results were very similar to the original version (Wicksell et al., 2010). The PIPS questionnaire demonstrates very good internal consistency (Cronbach’s alpha = .89). Convergent validity for the Quebec part of the sample was established with other measures, such as the Pain Catastrophizing Scale (r = .66, p < .01), the Chronic Pain Acceptance Questionnaire (r = -.73, p < .01), the Cognitive Fusion Questionnaire (r = .52, p < .01), and the Acceptance and Action Questionnaire (r = -.49, p < .01). Predictive validity was also established with multiple regression analysis and the French version of the PIPS predicted pain disability (∆R = .04, p < .05) as well as symptoms of anxiety and depression (∆R = .04, p < .05) independently of chronic pain acceptance. Discussion: Implications and future research directions will be put forward as these results provide support for the use of the French version of the PIPS, as much in clinical practice as in research.

14. Processess of change in ACT and AR for longstanding pain – analyses of weekly assessments
Primary Topic: Clinical Interventions and Interests
Subtopic: Pain
Mike Kemani, Behavioural Medicine Pain Treatment Services, Karolinska University Hospital
Hugo Hesser, Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden

Background Thus far, a number of studies indicate the clinical utility of acceptance and commitment therapy (ACT) for longstanding pain (Wicksell et al., 2008; Wicksell et al., 2012). A few studies have explored the mediating role of psychological (in)flexibility in comparison with other potential mediators e.g. catastrophizing, on pain interference and disability (Wicksell, Olsson, & Hayes, 2010). However, the temporal precedence of changes in the mediator in relation to the outcome has not been assessed in studies evaluating mediation in ACT for chronic pain. In a previous study we evaluated the efficacy of ACT and applied relaxation (AR) for longstanding pain (Kemani et al., under review). The aims of the present studies was to evaluate if psychological inflexibility would mediate reductions in pain interference in the ACT-condition and if catastrophizing would mediate reductions in pain interference in the AR-condition. Method Participants (n = 60), adults with longstanding pain (> 6 months) received 12 weekly group-sessions of ACT or AR. Data was collected weekly, post-treatment, and at 3- and 6-month follow-up. Data was analyzed using hierarchical linear modeling. Results and discussion Results showed that psychological mediated changes in pain interference in ACT, but not in AR. Limitations and strengths of the study will be discussed. Also, results will be discussed in relation to previous research in the field, and as well to potential future research.

15. Low-grade inflammation moderates the effect of behavioral treatment for chronic pain in adults
Primary Topic: Clinical Interventions and Interests
Subtopic: Inflammation in longstanding pain in adults
Mike Kemani, Behavioural Medicine Pain Treatment Service, Karolinska University Hospital
Julie Lasselin, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

Introduction: A low-grade activation of inflammatory processes has been hypothesized as a contributor of non-specific longstanding pain. The utility of behavioral interventions for chronic pain is fairly well established. However, the influence of behavioral treatment on low-grade inflammation is uncertain. In addition, the moderating role of inflammatory markers in behavioral interventions for chronic pain has not yet been addressed. Method: In the present study, forty-eight patients suffering from chronic pain were randomized to two different types of cognitive behavioral therapy (CBT): acceptance and commitment therapy (ACT) or applied relaxation (AR). Interventions consisted of twelve weekly group sessions. Pain intensity, pain disability, psychological inflexibility, acceptance of pain, health-related quality of life were evaluated by self-assessment questionnaires at pre- and post-treatment, as well as medication intake and circulating concentrations of the inflammatory markers, IL-6, TNF-α and IL-8. Results: Improvements in the self-report questionnaires were seen following CBT, in particular after ACT. Reduction in medication intake and TNF-α levels were also observed. Importantly, concentrations of inflammatory markers prior to CBT significantly moderated the treatment effect, i.e. higher pre-treatment levels of IL-6 and TNF-α were related to less improvement in pain intensity, psychological inflexibility and mental health-related quality of life across conditions. Discussion: Altogether, results indicated that behavioral interventions for pain may reduce inflammation and suggest that pre-existing low-grade inflammatory state can reduce the beneficial effect of treatment.

16. Acceptance and Commitment Therapy and Pain: A Comprehensive Theory-based Systematic Review
Primary Topic: Clinical Interventions and Interests
Subtopic: Pain
Mike Kemani, Behavioural Medicine Pain Treatment Services, Karolinska University Hospital
Marie Kanstrup, Behavioural Medicine Pain Treatment Services, Karolinska University Hospital

Background: Recent developments within cognitive-behavioral therapy include Acceptance and Commitment Therapy (ACT). A growing number of clinical trials suggest the utility of this approach, and ACT was recently listed as an empirically supported treatment for chronic unspecific methodological perspective. The aim of the present study was to provide a broad theory-based systematic overview of studies on ACT and pain. Method and Results: In accordance with PRISMA guidelines, systematic searches were conducted to identify original and peer-reviewed articles published between 1997 and 2014 evaluating ACT in relation to pain. A total of 153 articles were included based on study criteria, and classified as cross-sectional (n = 89), treatment evaluation (n = 40), laboratory based (n = 18), or qualitative (n = 6). The results illuminate several patterns, for example results illustrate the scarcity of studies with subgroups of patients (e.g. children) or studies assessing for example cost-effectiveness and long-term effects. Discussion: Clinical and research implications are discussed, and future directions for research on ACT and pain are suggested.

17. The Prosociality of Compassion: Relating to self and other
Primary Topic: Clinical Interventions and Interests
Subtopic: Compassion
Owen Rachal, University of Louisiana at Lafayette
Jessica Auzenne, University of Louisiana at Lafayette
Grayson Butcher, University of Louisiana at Lafayette
Emily Sandoz, Ph.D., University of Louisiana at Lafayette

Research on self-compassion has linked the concept to psychological health and well-being, decreases in negative affect and stress responses, increases in social connection and kindness toward the self and others, as well as other-focused concern (Jazaieri et al., 2013; Neff & Pommier, 2013). Altruistic behavior is a possible mediator of the relationship between increases in social connection and other-focused concern and associated increases in self-compassion (Jazaieri et al., 2013; Neff & Pommier, 2013; Smeets et al., 2014). This presentation will discuss a study on the ways in which people relate to themselves and others. Self-compassion and psychological flexibility were examined, using questionnaires as well as ecological momentary assessments (EMA), in order to investigate the relationships between indicators of psychological well-being, valuing, empathy, and altruistic behavior. Preliminary findings indicate relationships among compassion and these other variables, which we argue warrants additional and increasingly precise inquiry into the contexts which foster these prosocial behaviors.

18. Increasing pro-sociality through a Deictic Frame Training to Decrease Challenge Behaviors for individuals with Intellectual Disabilities
Primary Topic: Clinical Interventions and Interests
Subtopic: Deictic Framing, Perspective Taking, Challenge Behavior, Intellectual Disabilities
Roberto Cattivelli, Istituto Auxologico Italiano
Giada Pietrabissa, Istituto Auxologico Italiano
Martina Ceccarini
Chiara Spatola
Valentina Villa
Annalisa Caretti
Alessandro Musetti
Gian Mauro Manzoni
Silvia Ruggiero
Gianluca Castelnuovo

 

Background: The approaches to treat intellectual disabilities and, more in general, adults with chronic psychiatric issues or Intellectual Disabilities (ID) are often more psychiatry-based than multidisciplinary and, in many situations, long-term hospitalization is the preferred choice. In Italy special residential facilities are available for long-time or even life-time hospitalization aimed at promoting a better quality of life and at fostering rehabilitation. Behavioral sciences had been proven effective to promote autonomies and foster quality of Life for individuals with Intellectual Disabilities or chronic psychiatric conditions. In particular, Contextual Behavioral Science could help the implementation of generally broaden interventions aimed at increasing Quality of Life, social inclusion, prosociality, decreasing stigma, etc. Challenge Behaviors are among the main problems for individuals with ID resident in Assisted Living Facilities and the strategies to reduce them could dramatically improve their QoL. Behavioral strategies aimed directly at decreasing problem behaviors are effective but sometimes this is not enough. In many cases, challenge behaviors are driven and susteneid by inadequate social and relational skills. Method: We implemented Deictic Relational protocol for subjects with moderate intellectual disability. Results: In this exploratory study we tested the effect of a deictic relations protocol to promote the acquisition of deictic frames, a core component for perspective taking, social skills, and also empathy skills and a consequent decrease of challenge behaviors. Discussion: Although results seems promising, due to methodological limitations, the link to through the implementation of the protocol and the reduction of problem behaviors needs to be further deepened.

20. ACTraining for the Taiwanese Parents of Children with Disabilities
Primary Topic: Clinical Interventions and Interests
Subtopic: Parents, mental health, ACTraining, Group
Shinji TANI, Ph.D., Ritsumeikan University
Yuanhong JI, Ph.D., Ritsumeikan University
Nien-Hwa LAI, Ph.D., National Taipei University of Education

Background We developed the ACTraining program for the parents of children with disabilities, and conducted the research to show the effectiveness of the program in Japanese parents. TANI & KITAMURA (2014) showed that psychological flexibility was the predictive factor of depression and psychological QOL of the parents. One of the aims of this research is to investigate the studying effects under different conditions. Another aim is to examine the cultural differences between Japanese parents and Taiwanese parents when the ACTraining is provided. Methods Participants; 26 Taiwanese parents of children having disabilities attended the program (M=1, W=25, mean age=50.2y, range 28-62y ). Mean child age was 17.4y (range 9-32). Methods; The program was implemented by group format. The textbook and PP slides used in Japan were translated into Chinese. Participants were divided two classes, and attended the program for two days (about six hours). Measures; BDI-II (Chinese ver.) was used as the outcome measure. AAQ-II (Chinese ver.) was used as the process measure. Pre-test/ Post-test design was used to investigate the effectiveness of the program. Results The score of BDI-II and AAQ-II was decreased significantly after finishing the program (BDI-II;p<.01 ES; d=1.31, AAQ-II; p<.01, ES; d=1.89). The significant correlation was found between the score of pre-test AAQ-II and the change score of BDI-II (r=.49, p<.05). Discussion These results showed that the program was effective under the different condition. It was probable that the psychological flexibility of the participants was related to depressive symptoms of the parents. It was difficult to translate some ACT words, such as experimental avoidance, defusion, psychological flexibility, and so on, into Chinese. Because these words were necessary to express with Kanji. Some exercises and metaphors were needed to modify to fit Chinese culture.

21. Transdiagnostic Occupational Rehabilitation: Patients’ Experiences with Acceptance and Commitment Therapy (ACT) in Mixed Groups of Musculoskeletal and Common Mental Disorders
Primary Topic: Clinical Interventions and Interests
Subtopic: Occupational Rehabilitation
Sigmund Gismervik, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim
Egil Fors, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim
Marius Fimland, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim
Roar Johnsen, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim
Marit B. Rise, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim

Background: Several randomized trials are currently assessing the efficacy of ACT in occupational rehabilitation. In one of these an ACT based occupational rehabilitation program was developed for musculoskeletal, common mental and unspecific symptom disorders. Participants with different diagnoses were mixed in a 3 ½ week inpatient and mainly group based intervention. The aim of this study was to explore patient experiences with transdiagnostic occupational rehabilitation and how their experiences reflected the intended ACT core processes. Method: Twenty-three participants were included in five focus group interviews at the end of their stay. Findings from phenomenological and thematic analysis were reflected upon the six core processes in the ACT model. Results: Participants described changes in perspectives that reflected varying degrees of comprehension, integration and implementation of the intended processes in the ACT model. Participants talked about an increasing awareness and mindful presence but there were few statements indicating awareness of ‘self’ as a process. A mix of diagnoses within treatment groups was perceived by participants as strengthening the program. Participants talked about behaviour changes in direction of values. Committed actions indicating immediate return to work were not mentioned. Conclusions: A transdiagnostic group based approach in occupational rehabilitation has a potential to reach larger proportion of people on sick-leave compared to diagnosis-specific and more individualised programs. In this study we found mainly positive participant experiences with the transdiagnostic program and that the approach of mixing musculoskeletal and common mental disorders may have facilitated openness. However, few statements made by participants regarding immediate return to work raise the question of return to work efficacy.

22. Why don't I do what I want to do?: An Acceptance and Commitment Therapy based psychotherapeutic intervention to overcome procrastination
Primary Topic: Clinical Interventions and Interests
Subtopic: Procrastination
Sol Casassus Montero, Pontifical University Catholic of Chile & University of Chile
Domingo Salvo Rivera, Pontifical University Catholic of Chile & University of Chile
Lydia Gómez Pérez, Pontifical University Catholic of Chile

Results from empirical studies have supported the hypothesis that procrastination can be understood as a way of experiential avoidance. Acceptance and Commitment Therapy (ACT) provides a coherent and comprehensive model for understanding and intervening on experiential avoidance. Even though in ACT there are some group interventions for this problem, there is a lack of studies on individual psychotherapeutic settings. We present in this study a systematic review of interventions for procrastination treatment. A also, we propose a individual psychotherapy design aim to reduce procrastination. This intervention is based on ACT and integrates strategies that have proven effective for the procrastination treatment (e.g., time management and self-management). We specified some aspects that clinicians should identify in order to assess what is influencing the person to procrastinate and specific interventions for better outcomes. This is an in course research, in which subsequently we will implement and evaluate the effect of the proposed intervention.

23. The Effects of Reason for living in Depression and Suicidal Ideation
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression, Reason for living , Suicidal Ideation
So-young Park, Ph.D. student, Seoul Women's University Graduate School of Professional Therapeutic Technology in Korea
Kyung Park, Ph.D., professor, Seoul Women's University Graduate School of Professional Therapeutic Technology in Korea
Sehee Park, Master's student, Seoul Women's University Graduate School of Professional Therapeutic Technology in Korea
Yeongmi Yang, Master student, Seoul Women's University Graduate School of Professional Therapeutic Technology in Korea
Jeongah Lee, Master student, Seoul Women's University Graduate School of Professional Therapeutic Technology in Korea

The present study examined the effectiveness of Reason for Living in depressed university students and suicidal ideation in hope of clarifying the reason why they did not commit suicide even though they had suicidal thoughts. This study examined self-reported versions of the scale for reason for living, depression, suicidal ideation in 394 Korean university students (female 297, male 97). The Reason for Living inventory is a scale developed by Linehan (1983) and validated in a Korean version of the study by Lee et al (2010). This scale consists of 4 sub-scales (Survival and Coping Beliefs, Fear of Death and Social Disapproval, Family Responsibility and Child-related concerns, Future Expectation). The findings of this study show that Reasons for Living as well as all its sub-scales were negatively correlated with depression and suicidal ideation to depression and suicidal ideation. Furthermore, Reason for Living influenced depression and suicidal ideation as a partial mediator. Additionally, Reason for Living’s sub-scale of Survival and Coping Beliefs also affected depression and suicidal ideation as partial mediator. The result of this study suggests Reason for Living is an important factor for suicide prevention via psychological intervention. Finally, The relationship between ACT (Awareness and Commitment Therapy) value (Bahraini et al, 2013) and Reason for Living requires further research.

24. Acceptance and Commitment therapy – do we know enough? A sequential meta analysis of randomized treatment trials.
Primary Topic: Clinical Interventions and Interests
Subtopic: Anxiety, Depression, Adults
Thomas Hacker, DClinPsy, Universitätsmedizin Rostock
Angus MacBeth, Ph.D., DClinPsy, Edinburgh University
Paul Stone, BSs, NHS Fife, Edinburgh University

Acceptance and Commitment Therapy (ACT) has emerged as an alternative to established models of Cognitive Therapy, emphasising context and experiential facets of psychological experience. Existing evidence from systematic reviews and meta analyses (Powers et al., 2009) provides qualified support to the effectiveness of ACT as a psychological intervention when compared with no intervention. However, data with regards to ACT in comparison to other psychological therapies are more equivocal. Therefore, clinicians, health service commissioners and policy makers at present must judge whether the evidence base for ACT is sufficient to make a confident recommendation regarding it’s efficacy. Sequential meta analysis (SMA; Pogue & Yusuf, 1997) uses group sequential boundaries based on the alpha spending function to measure the accumulation of knowledge across studies, enabling decisions on the sufficiency of knowledge to recommend treatment to be made based on statistical properties. This approach, commonly used in the evaluation of medical interventions, is under-utilised in the evaluation of psychological therapies. We report outcomes for well-designed, randomized controlled trials of ACT against control conditions indicating that ACT is an effective treatment for depression, with a moderate post treatment effect size. SMA suggested that there was significant evidence to make this assertion. However, the data are more equivocal regarding ACT compared to existing psychological therapies. Similarly, the data for ACT as a treatment for anxiety are indicative of a more modest degree of effectiveness. SMA indicated insufficient evidence for ACT as an effective treatment for anxiety. Our aim was to evaluate the evidence base for ACT as a psychological intervention for depression and anxiety compared with treatment as usual (TAU), waiting list control and other evidence-based psychological therapies. We sought to establish: 1) What is the effect size for ACT compared to control conditions (waiting list/ treatment as usual/active control) in the treatment of depression and anxiety? 2) Is the evidence base sufficient to recommend ACT as a psychological intervention for depression and/or anxiety? We applied a systematic search strategy, using PRISMA guidelines. We selected randomized controlled trials (RCTs) of acceptance-based treatments for mental and physical health disorders using a comprehensive search strategy. We searched the following databases: PsycINFO, MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trials. Primary outcomes were based on validated measures of depression and anxiety. Reliability of search strategy and data extraction was assessed by independent verification by the third author. Effect sizes for treatment were expressed as standardized mean difference (Cohen’s d) for independent groups. We conducted fixed and random effects meta analyses of randomized controlled trials (incorporating SMA), with measurement of heterogeneity (Q, Tau2 and I2). Publication bias was examined by linear regression analysis of the funnel plot for included studies. For the SMA we constructed an Optimal Information Size (OIS) function to determine a threshold for significant magnitude of association. To control for between-study variance the OIS was adjusted by degree of heterogeneity, (heterogeneity-adjusted optimal information size; HOIS). We performed a sequential meta analysis in chronological sequence according to publication year, using an a-priori random effects model. The OIS was used to construct group sequential boundaries at each interim analysis using the Lan–DeMets alpha spending function. This generates a fixed significant threshold and power for establishing the OIS criterion has been met. At each interim analysis the sufficiency of the cumulative knowledge can be calculated. When sufficiency criteria have not been met, additional studies are required to statistically establish that there is sufficient evidence to recommend the intervention. When criteria are met at a given analysis we can statistically establish significant evidence of the efficacy of the intervention in question. If the HOIS is reached at the final analysis Q and boundaries have not been crossed, the evidence suggests that the cumulative knowledge base is sufficient to refute the efficacy of the specified intervention, as the SMA is unable to detect the anticipated effect despite an appropriately specified level of power. We identified k=15 studies representing n=685 participants receiving ACT, and n=569 participants in the control condition. Measurement of depression was predominantly via the BDI (1st and 2nd edition), DASS or the CES-D. Anxiety was predominantly measured using the Beck Anxiety Inventory, State-Trait Anxiety Inventory or DASS. For studies of depression (k=15; Fig 1), using a random effects model for depression, when ACT was compared with a control condition the post treatment effect size was d= -0.62 (95% CI = -0.90 to -0.33), indicating a moderate treatment effect for ACT compared with a control condition (TAU/other therapy or W/L). Study heterogeneity was significant (I2=78.8%; tau2 = 0.21, p<.0001). When ACT was compared with another psychological treatment (k=10) effect size dropped to d= -0.10 (95% CI = -0.35; to 0.15), indicating a negligible effect for the effectiveness of ACT compared with other psychological treatments. Heterogeneity was low to medium (I2=40.3%; tau2 = 0.06, p<.09). Sensitivity analyses suggested effects were not affected by depression measure. The effect size on anxiety for ACT compared with a treatment control (k=12 studies) was d= -0.39 (95% CI = -0.71; to -0.077), indicating a small to medium effect size for the effectiveness of ACT compared with control group. Between study heterogeneity was significant (I2=84.5%; Tau2=0.24, p<.0001). There was no evidence of publication bias for anxiety or depression samples. For depression, removal of Roemer et al (2008) reduced heterogeneity but did not significantly alter the group comparison effect size estimates. SMA provided convincing evidence that there is at least a medium group difference favouring ACT for Depression against control, for a post treatment effect, as the boundary was crossed before the HOIS was reached (Fig3a). This was significant with power=.9 and α=.01. In contrast, the cumulative Z-value for ACT and anxiety did not cross the boundary before reaching the HOIS (Fig. 3b), indicating evidence in favour of at least a medium post treatment effect was not obtained despite a power of 90% The current set of analyses are limited to the efficacy of ACT in the immediate post treatment phase, thus we cannot comment upon longer term treatment effects. Nor can we comment on the efficacy of ACT for other conditions such as psychosis or physical health difficulties. The meta analysis suggests that although ACT may not be a ‘one size fits all’ psychological therapy, it is an effective treatment for depression. Further research is required to ascertain specific presentations for which ACT may be of benefit as a targeted therapy.

25. Investigating the Effects of a Brief Mindfulness Intervention on the Encoding of Positively and Negatively Valenced Novel Verbal Stimuli Under an Induced Negative Affect
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Varsha Eswara Murthy, B.A., University College Dublin
Louise McHugh; MA, Ph.D., University College Dublin

Background: Major components of mindfulness are the non-judgmental observation and acceptance of both internal and external stimuli. This study aimed to investigate the effect a brief mindfulness intervention would have on the encoding of novel positively and negatively valenced verbal stimuli post induction of a negative affect. Method: Participants were exposed to either the mindfulness condition or the unfocused attention (active control) condition and subsequently took part in a learned helplessness task, in order to induce a negative affect. Following this, participants were presented with and asked to learn 10 positively valenced (.e.g. rafiki=friend), 10 negatively valenced (.e.g. maiti=corpse) and 10 neutrally valenced (.e.g. ndoo=bucket) Swahili-English word pairs, after participation in an arithmetic filler task for a period of one-minute, participants were then presented with the Swahili words and asked to recall the English equivalents. Results: Analysis showed that those in the mindfulness condition remembered significantly more positive words than those in the unfocused attention group and those in the unfocused attention group remembered significantly more negative words than those in the mindfulness condition. Results also revealed that those in the mindfulness condition remembered significantly more words in total in comparison to the unfocused attention group. Discussion: These findings suggest that memory processes as well as the ability to create a sense of self that is distinguishable from one’s thoughts, emotions and feelings may be potential mechanisms underlying the link between mindfulness and subjective well-being. Results also suggest that mindfulness may emancipate cognitive resources being used to regulate one’s own emotional state and the emotional content of what is being learned, which result in better learning outcomes.

26. Which comes first?: Emergence of temporal frame responding in an autistic kid
Primary Topic: Relational Frame Theory
Subtopic: RFT
Giovambattista Presti, MD, PhD, Università Kore, Enna (Italy) & IESCUM, Italy
Davide Carnevali, Università IULM, Milan & IESCUM, Italy
Arianna Ristallo, Università IULM, Milan & IESCUM, Italy
Paolo Moderato, Università IULM, Milan & IESCUM, Italy

Background. Orientation in time is a fundamental ability. Often developmentally typical or developmentally delayed children show difficulties in learning this skill. They cannot, for example, order a simple sequence of events or understand how to properly use yesterday, today and tomorrow. Learning orientation in time allows the child a better autonomy (i.e. organize everyday activities) and strengthens the acquisition of cause-effect relation. Method. The present study tested the efficacy of a computerized RFT training (Hayes, Barnes-Holmes, Roche, 2001) with a 9-years old autistic child. The aim of this training was to teach temporal relational responses and then to test the maintenance of relational learning with new stimuli (not presented during the training sessions). During the training phase three familiar sequences, with three elements each (before, now and after), were used. The task consisted of 27 subsequent matching to sample responses under the control of three verbal contextual cues (before, now and after). The stimuli (samples, comparisons and contextual cues) were alternated in instruction blocks, with a specific organization in a matrix model. Results and discussion. Results showed the acquisition of target temporal responses and the emergence of mutual and combinatorial entailments. Three new temporal sequences (three steps each) were tested: results showed the ability to derive correct temporal responses in presence of non-trained stimuli.

27. Skinner’s Verbal Behavior heritage: What are behavior analyst really studying?
Primary Topic: Educational settings
Subtopic: Verbal behavior, Relation Frame Theory, Applied Behavior Analysis
Giovambattista Presti, M.D., Ph.D., Kore University, Enna (Italy)
Siana Saddemi, Kore University, Enna (Italy)
Maria Josè Sireci, Kore University, Enna (Italy)
Paolo Moderato, PhD, IULM university, Milan (Italy)

Much experimental work has been done after the publication of Skinner’s Verbal Behavior (1957), though it took almost 25 years to behavior analysts to generate experimental models drawn from its theoretical approach. A steady, though, slow increase in experimental work was observed since the ‘70s, with an acceleration in the mid ‘80s, mostly due to the publication of a dedicated journal, The Analysis of Verbal Behavior. Skinner’s conceptual analysis has also given rise to a wide range of applied programs in the educational setting, mostly with autistic children. Skinner sensed that his book Verbal Behavior (1957) was his most important work (Sunberg, 1998). But is it true? And what is the real impact of Skinner’s analysis in the basic and applied field? A thorough analysis of the papers published on TAVB was conducted to understand which parts of Skinner’s taxonomy of verbal operants generated experimental data and how this influences the way the field progresses. Strong trends in research with elementary verbal operants emerged, posing some questions on the ease of experimental models and the biases that this work can generate in the field, especially when research neglects the multiple causation analysis of the most complex operants that address cognitive human functioning. Much of the most challenging aspect of human cognitive behaviors, mainly under-the-skin behaviors, remain almost untouched and unsatisfied by the few researches and experimental model that VB has generated. At the same time RFT offers an alternative and compatible model at the operant level to address some of these issues. A comparative analysis of papers inspired to the theoretical models of VB and to RFT will be offered to have a sense of what areas are lacking sounded experimental research to be addressed in future

28. It sounds like Han! Testing the feasibility of a social robot delivered conditional discrimination training.
Primary Topic: Educational settings
Subtopic: RFT, Conditional discrimination task, autism, social robots
Giovambattista Presti, M.D., Ph.D., University Kore, Enna (Italy)
Maria Josè Sireci, University Kore, Enna (Italy)
Daniele Lombardo, Behaviour Labs, Catania (Italy)
Marco Lombardo, Behaviour Labs, Catania (Italy)
Paolo Moderato, IULM University, Mialn (Italy)

Relational Frame Theory (RFT) is a relatively new account of human language and cognition. According to RFT, such complex human behaviors can be conceptualized as a through an examination of derived relational responding, tha ability of respond to relations between stimuli (Hayes, Barnes-Holmes e Roche, 2001). In recent years research has implemente more and more RFT based training to teach language and other abilities to children with autism in order to make learning faster and more efficient and increase novel behavior. Most RFT training included conditional discrimination tasks, that is a discrimination task that depend on the stimulus context: for example a matching to sample task where the subject has been trained to select a stimulus in presence of another stimulus (select a triangle when the red light is on.In this framework, the use of humanoid robots in ABA training serves two main purposes: 1. The robot, with its characteristics, acts as a motivating element to children and can make learning more fun. The structural characteristics, together with the ability to produce words, spontaneously catalyze the child's attention and create a Motivating Operation to the training 2. The robot can perform some functions today made by operator who works with the child: we refer in particular to the continuous process of data collection which, although necessary to ensure the scientific rigor proper of behavior analysy, causes a considerable expenditure of time and is still subject to human error as well 3. The robot can be used by less skilled people, like parents or relatives to enhance the occasions of learning in the child, while maintaing a rigorous procedure We present an interactive solution based on Robots4autism that is currently under testing for efficacy and effectiveness with autistic kids and other kids with special needs.

29. The invisible trainer: testing the feasibility of motion tracking technology in conditional discrimination training
Primary Topic: Educational settings
Subtopic: Autism, Relational Frame Theory, Motion tracking, Computer mediated learning
Giovambattista Presti, MD, PhD, University Kore, Enna (Italy)
Maria Josè Sireci, University Kore, Enna (Italy)
Olga Beltramello, CERN (Geneva, Switzerland)
Matteo Vignoli, University of Modena and Reggio Emilia (Italy)
Lakshmiprabha Nattamai Sekar, CERN (Geneva, Switzerland)
Clio Dosi, University of Modena and Reggio Emilia (Italy)
Paolo Moderato, IULM University (Milan, Italy)

The operant is the central unit of behavior analysis useful to understand the interaction between an organism and its environment and analyze the functional relationship between independent variables, antecendent and consequences, and the dependent variable, the behavior (Skinner, 1953). The operant can be better understood like a costant process in which the interaction between variables (dependent and indipendent) makes learning processes possible. In this framework operant can be easily implemented by a machine thanks to his characteristics of repetitiveness and independence from topography. Moreover peculiar characteristics of ABA analysis (such as the task analysis), match with the analysis necessary for software and hardware programing (Hoyert, 1992). We tested the feasibility of a conditional discrimination training delivered with “augmented reality” platform in which children were trained to select a stimulus in a range of three other stimuli. A computer with tracking technology was programmed to recognize and record both correct and wrong responces, and latency of response over an invisible grid projected on a surface. A procedure to correct and prompt the response was also implemented and reinforcement was delivered following an FR1 schedule for testing purposes. The use of such a platform can serve training process in many ways: 1. The platform, with its characteristics, acts as a motivating element to children and can make learning funnier. 2. The platform can perform some skills today made by operator who works with the child: we refer in particular to the continuous process of data collection which and contingent deliver of reinforcement especially with random schedule or time-dependent schedule, which are delivered by humans with difficulties 3. The motion tracking and invisible grid allows to use motivating stimuli in the child environment and favors generalization of responses.

30. Come together!: An exploratory analysis of the complexity of categorization
Primary Topic: Educational settings
Subtopic: RFT, Category, language disorders, autism
Giovambattista Presti, M.D., Ph.D., Kore University, Enna (Italy)
Melissa Scagnelli, IULM University, Milan (Italy)
Margherita Gurrieri, IESCUM (Italy)
Claudio Premarini, Department of Child Neuropsychiatry and Neurorehabilitation; "Eugenio Medea" Scientific Institute, Bosisio Parini, Lecco
Catia Rigoletto, Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
Massimo Molteni, Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
Paolo Moderato, IULM University (Milan, Italy)

Categorization is a fundamental ability for the development of complex skills, such as thinking, perception and language. (Lakoff 1987). Relational Frame Theory (RFT) con offer a sound and simple account of arbitrary categorization offering opportunities to enhance cognitive performance in new and potentially powerful ways. Three group of children with different degree of disabilities with autism, specific language disorder and borderline intellectual functioning were exposed to a conditional discrimination procedure with arbitrary matching to sample to promote the development of arbitrary categorization. Categorization was operationalize as symbolic arbitrary equivalence of items (grouping pictures), picture controlled labeling of items (tacting), picture controlled labeling of categories (tacting), verbal responses under the control of the category-item verbal response (intraverbal) and item-category (intraverbal) verbal responses in a frame of coordination. After testing for Subjects were trained to select the “printed picture of grouped items_1” upon a vocal label of the category (A-B training), and to select “printed picture of grouped items_2” in the presence of “printed picture of grouped items_1” (B-Ct training). After testing for mutual and combinatorial entailment a four-member class emerged. The results seems to confirm the importance of a training based on frame of coordination for the acquisition of basic categorization and challenge the analysis of intraverbals made by Skinner. Pre-post treatment changes in standardized tests will be presented to show the generalized effect of the training over language skilles. A number of advantages of this training along with the limits of the study will be discussed.

31. Use Your Words: An Examination of Student Writing in Response to Experiential Learning Exercises Targeting Psychological Flexibility
Primary Topic: Educational settings
Subtopic: Academics
Tracy Protti, University of Louisiana at Lafayette
Emily Allen, University of Louisiana at Lafayette
Emmy LeBleu, University of Louisiana at Lafayette
Ryan Albarado, University of Louisiana at Lafayette
Bronwyn Frederick, University of Louisiana at Lafayette
Jada Horton, University of Louisiana at Lafayette
Alaina Kiefner, University of Louisiana at Lafayette
Lauren Griffin, University of Louisiana at Lafayette
Emily Kennison Sandoz, University of Louisiana at Lafayette

College students are often faced with a number of transitions across important domains of life. For many students, academic demands, living conditions, financial status, primary relationships and social activities undergo repeated changes during the course of their college education. Psychology of Adjustment is a course designed to teach non-majors fundamental concepts of psychological health. As currently taught, the course includes primarily experiential interventions in which students learn the concepts of psychological adjustment by practicing psychological flexibility in and out of class. Informal student evaluations suggest that these methods not only ensure intellectual grasp of the concepts but also improve student's psychological adjustment more broadly. The current qualitative study examines the content of students' journal assignments in order to identify ways in which the class impacts psychological flexibility and college adjustment. Preliminary thematic analysis of 157 students' journal assignments has revealed the following themes: the identification and clarification of values, observable changes in valued domains of life, the realization that everybody struggles, the awareness of psychological inflexibility and its consequences, willingness to experience painful thoughts and feelings, and gratitude for newfound presence in everyday experience. Implications for future research and course development will be discussed.

32. The Mediating Effect of Experiential Avoidance between Psychological Capital and Work Performance in Chinese Employees
Primary Topic: Organizational behavior management
Subtopic: Positive Organizational Behavior(POB)
Jing Cao, 1. Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences. 2. University of Chinese Academy of Sci
Sheng Huang, Roechling Automotive Parts (Kunshan),Ltd
Zhuohong Zhu, 1. Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences. 2. University of Chinese Academy of Sci

Background: Luthans defined psychological capital as an individual’s positive psychological state of development, which is characterized by: (1) having confidence (self-efficacy) to take on and put in the necessary effort to succeed at challenging tasks; (2) making a positive attribution (optimism) about succeeding now and in the future; (3) persevering toward goals and, when necessary, redirecting paths to goals (hope) in order to succeed; and (4) when beset by problems and adversity, sustaining and bouncing back and even beyond (resiliency) to attain success. A meta-analysis which included 51 independent samples indicated the expected significant positive relationships between psychological capital and work performance. Experiential avoidance is the attempt to change the form, frequency, or situational sensitivity of experiences even when doing so causes life harm. Several studies showed that acceptance as an alternative to experiential avoidance can explain and predict employees’ job satisfaction and work performance. Acceptance and Commitment Therapy (ACT) aims at decreasing experiential avoidance and improving psychological flexibility. With the combination of eastern culture, such as Buddhism and Zen, the theories and practices in ACT are suitable for studying and applying in China. With regard to the vacancy of studies in experiential avoidance related to positive organizational behavior (POB) in China, we maintained that the present research would have theorital and practical significance. The aim of the study was to explore the relationship among experiential avoidance, psychological capital and work performance. Futhermore, the mediating effect of experiential avoidance between psychological capital and work performance was tested. Method: A total of 285 validated questionnaires were collected by cluster sampling in four enterprises. The employees were assessed by Acceptance and Action Questionnaire-2nd Edition(AAQ-Ⅱ), Psychological Capital Questionnaire(PCQ) and Work Performance Questionnaire(WPQ). Statistical analysis was conducted by SPSS version 20.0. We computed Pearson’s correlations and the mediating effects testing procedure which was proposed by Wen Zhonglin. Results: After controlling sex, age, job, the level of education and length of service, experiential avoidance is negatively correlated with the total score and four subscales of psychological capital (r=-0.258~-0.337, ps<0.001), and experiential avoidance is negatively correlated with five subscales of work performance(r=-0.123~-0.276, ps<0.05). Experiential avoidance partially mediates the total score of psychological capital and the four subscales of work performance separately. The standard regression equations are: y1=0.280x-0.122m(tx=4.498,p<0.001; tm=-1.990,p<0.05); y3=0.170x-0.209m(tx=2.712,p<0.01;tm=-3.396,p<0.01); y4=0.234x-0.124m(tx=3.787,p<0.001;tm=-2.045,p<0.05); y5=0.169x-0.146m(tx=2.554,p<0.05;tm=-2.249,p<0.05)( y1=Work Performance-Energy, y3=Work Performance-Happy, y4= Work Performance-Focus, y5= Work Performance-Enjoy). While the mediating effect of experiential avoidance in psychological capital and Work Performance-Engage is not significant: y2=0.264x-0.031m(tx=4.132,p<0.001;tm=-0.494,p>0.05)( y2= Work Performance-Engage). Discussion: Experiential avoidance is negatively correlated with psychological capital and work performance. The preliminary analyse indicated that these three concepts are related but not identical constructs. Psychological capital can partially decrease energy, happy, focus and enjoy through experiential avoidance, but it doesn’t influence engage by experiential avoidance. In the applied area, this may enlighten us one more path to promote employees’ work performance. That is, we can not only improve their psychological capital directly, but also decrease their experiential avoidance or increase acceptance indirectly.

33. Effectiveness of Acceptance and Commitment Therapy on Weight self-efficacy lifestyle and Body Mass Index (BMI) in women afflicted with obesity
Primary Topic: Organizational behavior management
Subtopic: obesity, adult, acceptance and commitment therapy
Leili Nourian, M.A., Islamic Azad University, Najaf Abad branch, Isfahan, Iran
Asghar Aghaei, Ph.D., Islamic azad university, isfahan(khorasgan) branch, Isfahan, Iran

background: The purpose of this research was to determine the effectiveness of acceptance and commitment therapy on weight self-efficacy and body mass index among women afflicted with obesity in Isfahan(Iran). method: Through a quasi-experimental research with pre-test, post-test design and three month follow up as well as using convenience sampling method, a number of 30 women with an obesity diagnosis (BMI≥30) were chosen according to the criteria of entering this research project. Then, they were randomly incorporated into experiment and control groups. The measurement tool was Weight Efficacy of Lifestyle Questionnaire(Clark, Abrams, Niaura, Eaton & Rossi, 1991). Also BMI was calculated by dividing weight (Kg) by squared height (m^2). results: The result of covariance analysis indicated that there were significant increases in weigh self-efficacy lifestyle in all sub scales (including food availability, social pressure, physical discomfort, negative emotions and fun activity), between experimental and control groups in pre-test, post-test and follow-up stages. also Results showed that there were no significant differences in body mass index between the experimental and control groups at post-test stage. But results showed a significant decrease in body mass index at follow up(p˂ 0.05). discussion: According to the findings of this research about the effect of Acceptance and Commitment Therapy on weight self-efficacy and body mass index, the proposed treatment can be used to improve these variables in women with obesity.

34. A Positive Framing Bias Flaw in the Implicit Relational Assessment Procedure (IRAP)
Primary Topic: Other
Subtopic: IRAP
Brian O'Shea, University of Warwick
Derrick G. Watson, University of Warwick
Gordon D. A. Brown, University of Warwick

How can implicit attitudes best be measured? The Implicit Relational Assessment Procedure (IRAP), unlike the Implicit Association Test (IAT), claims to measure absolute, not just relative, implicit attitudes. In the IRAP, participants make congruent (Fat Person-Active: False; Fat Person-Unhealthy: True) or incongruent (Fat Person-Active: True; Fat Person-Unhealthy: False) responses in different blocks of trials. IRAP experiments have reported positive or neutral implicit attitudes (e.g., neutral attitudes towards fat people) for prior associations that normally show negative attitudes on explicit or other implicit measures. It was hypothesized that these results might reflect a Positive Framing Bias (PFB) that occurs when participants complete the IRAP. Implicit attitudes towards categories with varying prior associations (nonwords, social systems, flowers and insects, thin and fat people) were measured. Three conditions (standard, positive framing, and negative framing) were used to measure whether framing influenced estimates of implicit attitudes. It was found that IRAP scores were influenced by how the task was framed to the participants, that the framing effect was modulated by the strength of prior stimulus associations and that a default PFB led to an overestimation of positive implicit attitudes when measured by the IRAP. Overall, the findings question the validity of the IRAP as a tool for the measurement of absolute implicit attitudes. A new tool (Simple Implicit Procedure: SIP) for measuring absolute, not just relative, implicit attitudes is proposed.

35. Stigmatisation Attitudes and Psychological Flexibility of Mental Health Professionals
Primary Topic: Other
Subtopic: psychological flexibility in mental health professionals,stigma
Fatma Betul Esen, MD, Bakirkoy Research and Training Hospital for Psychiatry and Neurology
KAASIM FATİH YAVUZ, Bakirkoy Research and Training Hospital for Psychiatry and Neurology
SEVINC ULUSOY, ELAZIG STATE HOSPITAL FOR MENTAL HEALTH AND DISORDERS
TUGBA KARA, NIGDE BOR STATE HOSPITAL

BACKGROUND:Stigmatization is a mark of disgrace that sets a person aside from others and attributes that reduces an individual “from a whole and usual person to a tainted, discounted one”. It influence psychiatric clients largely. They need to challenge with their symptoms and the stigma from the society. It diminishes the use of mental health services and medicine. It causes decrease in functioning. Not only society but also mental health professional stigmatize the patients. AIM:The purpose of this study was to assess the attitudes of mental health professionals to mental disorders and find out whether it is related to psychological flexibility, burnout and occupational properties. METHOD: The study was carried out with 50 psychiatrists, 50 psychologists and 50 nurses from all over the country (Turkey). Mental Health: Clinicians’ Attitudes Scale(MICA), Acceptance and Action Questionaire(AAQ) and Maslach Burnout Inventory(MBI) were given to attendants. RESULT:There was no significant difference between groups’ age, gender and AAQ scores. There was significant difference between groups’ training, % 82 of psychologists % 48 of psychiatrists and % 16 of nurses said that they attended to a therapy training. The ones who don’t have therapy training had lower score on Personal Accomplishment scale of MBI. MICA(stigmatising attitudes) scores were higher for nurses compared to psychiatrist and psychologists. Nurses and psychologists think that the etiology of mental disorders is best explained by psychoanalytic theory; but psychiatrists think that is biological theory. Pharmacology is preferred by psychiatrists and nurses in the first line treatment of mental disorders, and psychologists prefer cognitive therapy. The ones who prefer pharmacology in the first line have higher MBI scores. MICA scores were negative correlated with age and ‘the years in the mental health services’. The years in the mental health services is negative correlated with AAQ and positive correlated with ‘Personal Accomplishment’ scale of MBI. DISCUSSION: We found that score of Personal Accomplishment scale was higher in the group who have therapy training and %16 of nurses had a therapy training; it was the lowerest percentage among the groups. It may show that therapy training lowers the stigmatising attitude and make the person feel more competent. The ones who prefer pharmacology in the first line have higher MBI scores; so applying therapy skills in the clinical practice may lower burnout. Negative correlation between ‘the years in the mental health services’ and AAQ – MICA scores can be result from experience, experience can enhance the empathy. The nurses spend more time with clients and they expose to their negative attitudes more. Their higher MICA scores may be result of it.

36. Stigmatisation Attitudes and Psychological Flexibility of Mental Health Nurses
Primary Topic: Other
Subtopic: Stigma
Merve Terzioglu, Bakirkoy Research and Training Hospital for Psychiatry and Neurology
K.Fatih Yavuz, Bakirkoy Research and Training Hospital for Psychiatry and Neurology
Sevinc Ulusoy, Elazig State Hospital for Mental Health Disorders
Huseyin Sehid Burhan, Bakirkoy Research and Training Hospital for Psychiatry and Neurology

Background: Stigmatisation is described as the prejudiced behaviour accompanying the feeling toward the person who was considered to be different. Stigmatising attitudes are more common toward to individuals with mental disorders than those who suffer from physical diseases. Loss of functionality has been found to be correlated with the level of stigmatisation of individuals with mental disorders. Stigmatising attitudes may also be seen among mental health professionals and these attitudes may prevent patients to apply mental health services. In this study we aimed to assess nurses’ attitudes toward mental disorders and investigate its relation with sociodemographic and occupational properties, psychological flexibility and level of burnout. Method: The study was carried out with 143 nurses working in mental health area from all over the country. Mental Health: Clinicians’ Attitudes (MICA), Acceptance and Action Questionnaire-II (AAQ-II) and Maslach Burnout Inventory (MBI) scales and Sociodemographic Data Form were administered to participants. MBI had 3 subscales; Emotional Exhaustion(EE), Depersonalisation(DP) and Personal Accomplishment(PA). Results: 108 of the participants were female, 35 were male. There was no significant difference between scales among gender groups. Approximately %35 of nurses think biological theory as the best explanation for the etiology of mental disorders and they commonly prefer pharmacotherapy as the first line treatment. Participants who prefers pharmacotherapy as first line treatment had higher burnout scores. Therapy training was rare among nurses; only 30 of them(%21) had a therapy training. Individuals who had therapy training had higher scores on MBI scale and also on EE and DP subscales of MBI. There was no significant difference on AAQ-II and MICA according to therapy training. The ones who had relatives with mental illnesses(%27.3) had higher scores on AAQ-II. MBI and PA scores were negatively correlated with age. MICA scores were positively correlated with AAQ-II and MBI. Also there was a positive correlation between AAQ-II and MBI. Discussion: Burnout scores were higher in nurses who had therapy training. This finding may be due to limitations related to their working conditions and not having opportunity to apply their professional skills. Psychological inflexibility was associated with both stigmatisation attitudes and burnout scores. Stigmatisation attitude may be learned verbally, or it may be due to unwilligness to experience negative thoughts and emotions about patients that ends up with avoidance behaviour related to psychological inflexibility. Increase in vocational burnout could also be the result of escape and avoidance behaviour from negative thoughts and emotions. ACT approach that based on psychological flexibility may be useful to alter stigmatising attitudes of nurses.

37. Flow in Context: Approaching Positive Psychology's Optimal Experiences
Primary Topic: Performance-enhancing interventions
Subtopic: Positive Psychology
Grayson Butcher, University of Louisiana at Lafayette
Emily Sandoz, Ph.D., University of Louisiana at Lafayette

Research into the “optimal experience” of flow began with Mihalyi Chiksentmihalyi, who was drawn to the single-minded focus with which artists became absorbed in their craft (Chiksentmihalyi, 1990). Flow is now considered as one of three optimal experiences by positive psychologists, the other two being spirituality and mindfulness (Lopez, Pedrotti, & Snyder, 2014). Together these experiences are said to be indicative of a deeper and more purpose-filled quality of living that is invigorated with novelty, absorption, and the sacred. Processes of the psychological flexibility model, as well as deictic framing, have been utilized to functionally approach these topics. However, little research has been done on flow specifically. This conceptual paper will examine the research done on flow thus far. The purpose of this analysis is threefold: 1) to discuss, in a preliminary and conceptual manner, the necessary and sufficient conditions (behavior-environment relations) which may account for the experience of flow, 2) to identify explanatory gaps worthy of further inquiry, and 3) to situate the analysis of flow within CBS’s reticulated, progressive scientific enterprise.

38. Parental Experiential Avoidance on the Parental Acceptance and Action Questionnaire (PAAQ) Relates to Higher Parental Stress and Higher Child Defiance: Evidence from a community sample of Greek-speaking parents
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Parental Experiential Avoidance
Anthi Loutsiou, PsyD, University of Cyprus
Anastasios Matsopoulos, PhD, University of Crete
Andri Anastasiou, M.A., University of Cyprus

Background The Parental Acceptance and Action Questionnaire (PAAQ) (Cheron, Ehrenreich & Pincus, 2009) is a 15-item measure for parent’s acceptance of their child’s emotions and commitment to acting in a valued way. In the norming sample, the original scale yields a total score, an inaction subscale and an unwillingness subscale in the parenting role. Method The PAAQ was translated in Greek using the front and back translation method and the original scoring instructions were maintained. Its psychometric properties and ecological validity were tested in a community sample of Greek speaking parents (N=162 Greek speaking parents (136 mothers, 26 fathers) of 3-8 year old children who participated in clinical trials of the 6-week Parenting the Strong Willed Child (PSWC) training program. Results The 15-item adaptation of the PAAQ internal consistency was below the recommended cut-off and inter item correlations were lower than expected. Problematic items were removed resulting in an 8-item scale with borderline acceptable alpha coefficient. Paired samples t-tests showed no significant results for the PAAQ Total Score . The factorial structure of the scale will be further tested using exploratory factor analyses. Correlational analysis of the PAAQ and parent-report measures suggest adequate concurrent validity with the Strengths and Difficulty Questionnaire-Conduct Problems ( p < .05). As expected, parents with children higher on the Defiance Scale of the Eyberg Child Behavior Inventory also scored higher on the PAAQ (p < .05). Further, parents with higher experiential avoidance also reported statistically significantly higher Parental Distress on the Parenting Stress Inventory- Short Form (PSI-SF) (p < .05). Discussion The PAAQ does not appear to have the same factor structure across samples but it may be a useful instrument in clinical trials of parent training programs for disruptive behaviors given the importance of parental avoidance in taking action in the context of the parenting role.

39. Application and effectiveness of ACT in the satellite office with the support for the employment of persons with disabilities
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Workplace, Ssatellite office with the support, Schizophrenia, Neurodevelopmental disorder
Fumiki Haned, Senior vocational counselor, Startline.Co.Ltd

In order to realize the employment of persons with disabilities by companies, Startline.Co.Ltd offers a supported satellite office services. Working people with various disabilities in satellite office with the support．Recently, there has been increasing employment of people with mental disorders, difficulty of support towards stability of employment has become a problem. We solve this problem by implementing the ACT in individual or group format. ACT in the workplace, and work hours, we observed the effect of preventing anxiety and drowsiness. These effects have also appeared on indicators such as improvement and stability of attendance rate. In this poster, I will report some of these case studies, and discuss implementation methods and effects of ACT in the workplace of people with disabilities. Also, I would like to consider the impact of these effects have on corporate managemen

40. Successful smoking self-quitting and psychological flexibility
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Smoking behavior
Jesus Gil Roales-Nieto, Ph.D., University of Almeria, Spain
Emilio Moreno San Pedro, Ph.D., University of Huelva
Rodrigo Córdoba García, M.D., University of Zaragoza, Spain
Bartolomé Marín Romero, M.A., University of Almeria, Spain
Rosa Jiménez López, Ph.D., iversidad de Almería (University of Almeria in Spain)
Agustina Silvano Arranz, M.A., Servicio Andaluz de Salud, Spain
Isabel R. Fernández Lao, Servicio Andaluz de Salud, Spain
Genoveva Granados Gámez, Ph. D., University of Almeria, Spain
Mónica Hernández López, Ph.D., from the University of Jaén, Spain

Background The health consequences of smoking and the benefits of cessation are extensive and perfectly documented. Nevertheless, the majority of smokers continue smoking in spite of the legislative, preventive and care efforts to reduce smoking, even after the diagnosis of diseases directly related to smoking. The treatment of smoking behavior presents a small rate of success, independently of the specific treatment, with better results for pharmacological and / or psychological interventions. Data indicates that a smokers’ minority chooses to abandon with professional treatments, whereas unassisted cessation (self-quitting) remains the preferred method for most smokers. The professional assisted option has been widely evaluated and we have relatively precise information that indicates the efficiency of some treatments and the superiority of pharmacological treatments in combination with psychological treatments. Nevertheless, most smokers choose the self-quitting option which has not been studied with detail that provides information, for example, about the variables related to the success and the failure in this practice. Also, it has not been studied in depth the relationship between Psychological Flexibility (PF) and smoking cessation. Research has shown that PF is inversely associated with a wide range of negative psychological outcomes, including depressive symptoms, anxiety, general psychological ill-health, and emotional distress in stressful interpersonal contexts. The main objective of the present study is to analyze the relationship between psychological flexibility measured by the Acceptance and Action Questionnaire-II (AAQ-II) and the success or failure in the smoking cessation in self-quitter smokers. Method 288 people that tried to quit on their own (37% women) participated in the study. They were categorized in two groups: smokers (n= 71, people that failure in self-quitting) and ex-smokers (n= 217, people with successful self-quitting) using self-report of continuous abstinence (report of no smoking since a specific cessation attempt) supported by analyses of carbon monoxide using measures obtained by a CO-oximeter. We used the Spanish version of AAQ-II (7 items) to assess PF. Results We found no significant differences in the success or failure to stop smoking, nor in the PF score based on gender, or variables related to smoking (i.e., years of consumption, number of cigarettes smoked daily, etc.). Smokers that failure in self-quitting showed an average score of 26.45 in PF. Ex-smokers (people with successful self-quitting) showed an average score of 32.13 in PF. Analysis by t-test for independent samples showed statistically significant differences between the means of the two groups (t = 6,194; p < 0,01). 100% of participants that showed a low level of PF failed in their attempt to quit. However, 89% of participants that showed a high level of PF succeeded in self-quitting smoking. Discussion Participants who were successful in quitting smoking on their own showed PF scores significantly higher than participants who failed. The results show that psychological flexibility can facilitate success in the attempt to stop smoking without professional help. Implications and limitations of this study will be discussed.

41. ACT Resilience Building in Schools: A Pilot
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents
Julia Kostiuk Warren, DClinPsy, ProCARE Psychological Services
Casey Mendiola, DClinPsy, ProCARE Psychological Services

Background We work as part of the Enhanced School Based Health Services (ESBHS) programme, in which four primary health organisations, in conjunction with the Auckland District Health Board, are working together to provide primary physical and mental health services in low decile secondary schools. This is the first time in New Zealand that clinical psychologists have been employed to work specifically in secondary schools. We are the two psychologists who currently work in this programme, and between us cover seven secondary schools in the Auckland area. All of these schools have decile ratings of between 1 and 3 (a decile rating indicates the extent to which schools draw their students from low socio-economic communities; the lower the decile the higher proportion of students from these communities), and have high populations of Maori and Pacific island students, who are over-represented in the negative statistics of physical health, crime, and mental health in New Zealand. After working in the schools for six months, mainly providing individual support to students, we wanted to work more widely within our schools, focusing on early intervention and prevention, as well as continuing to be able to provide therapy for students who were struggling to cope. We decided to use our ACT training and experience to develop a school-based ACT resilience-building group. We hoped to be able to fit our group within the school timetable (where most schools have five one-hour periods per day), to make it relevant and helpful to our student populations, with an ultimate aim of having our group accepted into the school curriculum. Method We discussed our concept with school staff, and there was significant support. We researched the current literature around adolescent ACT groups and found that the majority were structured into approximately 10 sessions of at least two hours' duration. This was considered to be too long for our purpose, so we distilled our group content into six one-hour sessions, each covering a separate topic – Mindfulness, Defusion, Open Up and Make Room, Values, Committed Action, and Putting it All Together. We brainstormed and researched relevant activities, developed participant workbooks and facilitator guides for consistency of delivery, and gathered resources. Outcome measures were selected based on use in previous adolescent ACT studies, ease of use and brevity. Because participants were drawn from the general student population we did not measure symptoms of mental ill-health. Limited time could be spent completing measures due to time constraints. We wanted to assess psychological flexibility, mindfulness, personal well-being, and students' evaluations of the group. Measures: Acceptance and Fusion Questionnaire for Youth (AFQ-Y), Life Satisfaction - Teen Survey, Personal Wellbeing Index for School Children (PWI-SC), Mindful Attention Awareness Scale for Children (MAAS-C), and Group Session Rating Scale (GSRS). Results Five schools agreed to trial the group in term 1, 2015; four in classes and one in a small group. Because of the exploratory nature of our project we decided to be as flexible as we could and follow each school’s lead with regard to our group participants. Because of this, three of our class groups were low functioning Year 9 classes, while the fourth was a mainstream Year 9 Health class. Participants: 67 adolescents; age range 12-14. Female - 44%; Male - 56%. Ethnicity: NZ Maori - 12%; Pacific Island - 74%; Pakeha (European) - 10%; Asian - 4%. Issues identified were clustered into themes: time constraints, working with cognitively challenged adolescents, and adapting to cultural context, age and stage. Time constraints limited our capacity to comprehensively assess participants' understanding of the concepts, and limited our use of outcome measures. The students in three of our five groups were lower in cognitive ability than we expected when planning our project, meaning that we adapted some of the material as we went along, removing some of the more abstract and complex explanations and exercises that required reading/writing. All of our participants were also younger adolescents,which further affected their ability to understand concepts such as metacognition. One of us (CM) is Maori and the other (JKW) is Pakeha, so neither of us is from the same cultural background as the majority of our participants. Discussion As predicted schools supported our group programme, to an even greater extent than we had hoped. We were able to run our group in five schools, with plans for more groups through the rest of the year. Key selling points were the idea of resilience-building, that it could fit into the school timetable, that we could work with larger groups of students, and that we were flexible about who could participate. This enabled us to take our group into the classroom setting, where previously we had only been able to work with students who were referred to us via the school student support centres. We were able to teach helpful well-being enhancing skills that the majority of the students would otherwise have had no knowledge of, and it was gratifying to work with adolescents from impoverished and often deprived backgrounds and help them to comprehend and identify with such ideas as mindfulness and acceptance of emotions. Key challenges related to fitting the material into six one-hour sessions, the participants' level of cognitive functioning and understanding, and differing levels of motivation and interest of the participants. Our flexibility around our group participants resulted in one of the most challenging aspects of the project: working with some of the schools’ lowest functioning students. Some students had difficulty grasping some of the concepts, particularly defusion, meaning we have to adapt and simplify our material further to enable a greater ease of understanding. Interest and motivation were enhanced by the frequent use of activities and rewards (in the form of sweets) for participation, and participants became more engaged in discussions and activities as the group progressed. We are continuing our work on adapting and improving our group, including plans for eliciting the assistance of senior students to help us enhance the cultural acceptability of our group, including culturally appropriate metaphors and examples, and activities that use cultural concepts to illustrate the ACT content. We are encouraging teachers to use mindfulness regularly in the classes that have participated in our group, and hope to train school staff members in ACT concepts.

42. Can undergoing an internet – based ACT intervention change the impact of predictors thought to lead to substance use?
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Substance use predictors
Leonidou Georgia B.A., University of Cyprus
Stella Nicoleta Savvides Ph.D., University of Cyprus
Maria Karekla Ph.D., University of Cyprus

Research suggests that peer or parental smoking, rules enforced in the home and age of first cigarette use are significant predictors of substance use among youth. It is not clear whether undergoing treatment, such as Acceptance and Commitment Therapy (ACT), for smoking cessation can change the power of these factors to predict substance use post intervention. The aim of this paper was to examine substance use predictors in youth prior to and following an ACT smoking cessation internet-based intervention. Fifty-five university students aged 19-28 (M=22.84, SD=2.58) were randomly assigned to either the treatment or control group. The treatment group completed 6 sessions of internet – based ACT for smoking cessation. The assessment included demographic characteristics, smoking history, smoking cessation outcomes and ACT process variables pre and post treatment. Predictors of smoking differ pre and post intervention. Findings will be discussed in light of impact of the intervention on changing predictors of substance use and ultimate effect to the uptake of substance use among youth.

43. ACT Research for Kids: How to introduce the Hexaflex at School
Primary Topic: Prevention and Community-Based Interventions
Subtopic: children, mindfulness, hexaflex, school
Nicoletta Ristè, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

This study meets the need to bring Acceptance and Commitment Therapy in schools, particularly addressing to 8-10 years old children. It has been created a story in which the hexaflex cores were proposed in an understandable and adapted way. This story is called “The adventures of Mr. Shapey”, and it explains how Mr. Shapey, the main character (that is, basically, the shape of a man), learns to be human, and to act like a human being, acquiring, during his journey, six important parts of his body (each part is connected to one of the six ACT principles). The story was read to 120 children. Before and after the reading of the story, CAMM (Greco, Smith & Baer, 2011) was administered to the pupils, to assess their level of mindfulness. Also, after the reading of each paragraph, the kids had to answer some easy questions about the story to verify their ACT main cores comprehension. After the reading of the story, the children show higher scores at CAMM.

44. The Effectiveness of an ACT Self-help Intervention for Stress, Burnout and Depression: An Exclusively Online Randomized Controlled Trial
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Self-help, Bibliotherapy, Burnout, Job Stress, Depression
Patrizia Hofer, Ph.D. Candidate, University of Basel, Clinical Psychology and Epidemiology
Regula Aschwanden, B.Sc., University of Basel
Marina Milidou, B.Sc., University of Basel
Michael Waadt, insas Institut für Arbeit und seelische Gesundheit
Roselind Lieb, Ph.D., University of Basel, Clinical Psychology and Epidemiology
Andrew Gloster, Ph.D., University of Basel, Clinical Psychology and Epidemiology

Background: The aim of the present study was to examine the effectiveness of a self-help book using ACT to target stress, burnout and depression in a randomized controlled trial without therapist contact. Another aim was to investigate the effect of motivational assessment before and imposed structure during the intervention on outcomes. Method: 122 participants were randomly assigned to an immediate intervention (II) or 2 waitlist-groups (WL). WLs differed with respect to (a) motivational assessment before, and (b) imposed structure during the subsequent intervention. Stress, burnout, depression, psychological flexibility and other ACT-specific measures were assessed at baseline, post and follow-up. Results: The II reported lower stress, decreased burnout and depression and higher psychological flexibility at post than the WLs. Benefits were maintained at follow-up. Motivational assessment and imposed structure had no effect on outcomes. Additional results will examine potential moderators and differential outcome strength across variables. Discussion: Data suggests that an ACT self-help book without therapist contact is effective in reducing stress, burnout and depression and in increasing psychological flexibility. Thus, it may provide a cost-effective first-step intervention.

46. Investigating Delay of Gratification in Children from the Perspective of Relational Frame Theory
Primary Topic: Relational Frame Theory
Subtopic: children, Self-Control, Rule governed behavior
Midori Uemura, Waseda University；Research Fellow of Japan Society for the Promotion of Science
Tomu Ohtsuki, Waseda University
Hironori Shimada, Waseda University

The current study investigated the relationship between relational framing and the delay of gratification in children. From a relational framing theory perspective, we specify the delayed reward by temporal relational framing and identify the larger reward by comparative relational framing. Therefore, it is assumed that temporal and comparative relational framing is related to delay of gratification. Twenty-eight children (ages 6 to 9 years) were exposed to temporal and comparative relational tasks to measure relational ability, picture arrangement (WISC-III) to measure ability to specify the contingency, and a delay of gratification task and delay-discounting questionnaire to measure delayed choice. As a result, a significant correlation was found between the two relational tasks and the delay of gratification task, delay-discounting questionnaire, and picture arrangement. These findings suggest that two types of relational framing are related to delay of gratification. Further study is required to clarify the functional relationship between relational framing and delay of gratification.

47. Deictic Relational Framing of Spatial Perspective Taking and Theory of Mind
Primary Topic: Relational Frame Theory
Subtopic: Deictic relations, Theory of Mind, IRAP
Paul Guinther, Ph.D., Portland Psychotherapy

Relational Frame Theory is making headway in characterizing perspective taking and Theory of Mind in terms of functional contextualism and deictic relational framing (e.g., McHugh, Barnes-Holmes, Barnes-Holmes, & Stewart, 2006; Villatte, Monestès, McHugh, Freixa i Baqué, & Loas, 2010). However, whereas the pattern of function transformation characterizing non-deictic relations (e.g., coordination, opposition, comparison, etc.; see Guinther & Dougher, 2012) is fairly well understood, there is room in RFT to more fully specify the manner in which deictic framing alters stimulus functions, particularly with respect to taking the emotional and informational perspective of other people. In order to more fully specify how functions are transformed during informational perspective taking, I have developed and piloted in verbally competent adults a match-to-sample training paradigm that gives rise to contextual control of deictic relational responding and successful derived performances on a “Sally-Anne” false-belief test for Theory of Mind (Wimmer & Perner, 1989).

Saturday, 18 July - Poster Session #4

1. Acceptance of internal experiences in cardiovascular and gastrointestinal disease compared to healthy individuals in Isfahan city.
Primary Topic: Behavioral medicine
Subtopic: acceptance
Mina Kavoosi, M.S. in clinical psychology, Azad University, Khorasgan Branch
Fatemeh Zargar, assisstant profesor in clinical psychology, Kashan University in Medical Sciences

Background: Psychological factors affecting other medical condition (psychosomatic disorder) are a class of disorders that psychological factors play an important role in creating, sustaining and delayed recovery in medical conditions. The most important psychosomatic disorders are cardiovascular and gastrointestinal disease. The present study aimed compare acceptance of internal experiences in cardiovascular and gastrointestinal disease and healthy individuals in Isfahan city. Method: Based on purposive sampling, 50 patients with gastrointestinal disease (13 male and 37 female), 50 patients with cardiovascular diseases (29 male, 21 female) that referred to clinics in Isfahan compared to 50 healthy individuals (15male, 35 female). These three groups filled out Acceptance and Action Questionnaire. Results: Analysis by SPSS-21 and Multivariable Analysis of Variance (MANOVA) showed that acceptance of internal experience significant difference between the patient groups and healthy individuals. But there were no significant differences between patients with gastrointestinal disease and cardiovascular disease. Conclusion: It seems avoidance from internal experiences (thoughts, emotions and bodily sensations) plays an important role in gastrointestinal and cardiovascular disease.

2. Acceptance and daily occupational well-being in relation to negative work events
Kuba, K.
Scheibe, S.  

We examined the role of acceptance – the tendency to openly receive one’s emotions and associated cognitions, including negative ones, while maintaining a focus on current goal pursuit –for daily occupational well-being. We hypothesized that acceptance would be associated with better daily occupational well-being, operationalized as low end-of-day negative affect and fatigue, and high work engagement. Furthermore, we predicted that acceptance would buffer the adverse impact of negative work events on daily well-being. A micro-longitudinal study across 10 work days was carried out with 92 employees of the health care sector, yielding a total of 832 daily observations. As expected, acceptance was associated with lower end-of-day negative affect and fatigue across the 10-day period. Furthermore, acceptance moderated the effect of negative event occurrence on daily well-being: Highly accepting employees experienced less increase in negative affect and less reduction in work engagement (though comparable end-of-day fatigue) on days with negative work events, relative to days without negative work events, than less accepting employees. These findings highlight affective, resource-saving, and motivational benefits of acceptance for daily occupational well-being and demonstrate that acceptance is associated with enhanced resilience to daily negative work events.

3. Web-based ACT in chronic pain: For whom and how does it work?
Primary Topic: Behavioral medicine
Subtopic: chronic pain, web-based, online, mediators, moderators
Trompetter, H. R., PhD., University of Twente
Bohlmeijer, E. T., PhD., University of Twente
Schreurs, K. M. G., PhD., University of Twente

Introduction: In a recent, large three-armed randomized controlled trial we tested the efficacy of web-based ACT for chronic pain sufferers. The course Living with Pain was effective on several important outcomes compared to control groups. We will present outcomes of secondary examinations into the processes of change during the intervention, and also present for whom exactly web-based ACT worked or did not work. Method: Data from all 238 Dutch participants gathered during the RCT from all three study arms (ACT; Expressive Writing, Waiting List) was used. Data was collected at baseline, several time-points during the 9-12 week intervention, post intervention and at three month follow-up. Mediation and moderation analyses were performed using the PROCESS procedure in SPSS developed by Andrew Hayes. Results: Psychological flexibility was a significant working mechanism of changes in pain interference in daily life, pain intensity and depression over the course of the trial. In addition, also pain catastrophizing functioned as a mediator of change, although to a much smaller extent and also, significant changes occurred later during the trial than changes in psychological flexibility. Furthermore, psychological well-being served as a significant baseline moderator of effectiveness of the intervention, showing that only those have strong mental resources despite pain at baseline were able to draw effect from the intervention. Discussion: Outcomes support the psychological flexibility model of ACT, and specify interesting subgroups that do (not) profit from following web-based ACT. These outcomes can help to further understand treatment and successfully allocate treatment to clients in the future.

4. The Effect of Post Traumatic Growth on Post Traumatic Growth:Moderation effect of Cognitive Fushion
Primary Topic: Behavioral medicine
Subtopic: PTSD, PTG,fusion
Xiong Peng-Di, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences

There are debates about relationship between Posttraumatic stress disorder(PTSD) and posttraumatic growth (PTG). Researchers have suggested three possible modes,which indicate PTSD and PTG are opposite, positively related, or independent repectively, while the mechanism behind them is unclear. Cognitive fusion refers to the tendency that individuls’s cognition and behavior are over controlled by language and content of thoughts. This study aimed at investigating the the moderating role of cognitive fusion in the relationship between PTSD and PTG. 1808 freshmen from vocational high school, most of whom experienced Wenchuan earthquake in China, participated in the study. PTSD, PTG, cognitive fusion were assessed. Results supported the moderation model. Simple slope analysis found that for individuals with higher cognitive fusion, PTG was negatively predicted by PTSD, while for individuals with lower cognitive fusion, PTSD didn’t predict PTG significantly. This study supports that PTSD’s negative effect on PTG can be dissolved by reducing cognitive fushion.

5. Influence of Patient Expectations on Treatment Outcome
Primary Topic: Clinical Interventions and Interests
Subtopic: CBGT
Ainhoa Sánchez, Consorci Sanitari de Terrassa (CST)
Isabel Ramirez, Consorci Sanitari de Terrassa
Anna Soler-Roca, Consorci Sanitari de Terrassa
Irene Ramos-Grille, Consorci Sanitari de Terrassa
Marti Santacana, Consorci Sanitari de Terrassa
Ana Costas, Consorci Sanitari de Terrassa

OBJECTIVE: Recent research indicates that high levels of outcome expectancy are associated with better treatment outcome. The aim of the study was to investigate whether higher expectations for treatment outcome are related to better response rates in a Brief Cognitive-Behavioral Group Therapy (CBGT) in patients with Adjustment Disorder (AD). METHOD: Fifty-six patients (16 males and 40 females) diagnosed with AD (DM-IV-TR) agreed to take part in the study. All participants completed a self-report psychometric battery for pre-treatment assessment. Among others, the battery included the Spanish Treatment Expectancy Questionnaire by Echeburúa and Corral (CEC) and the Beck Depression Inventory-II (BDI-II). All the patients were included in a brief CBGT (6 sessions, 1 hour per week). In order to assess clinical improvement, the BDI was readministred at the end of the treatment. T-tests were used to compare treatment outcome (pre-post differences on the BDI-II) between patients with high and low expectations. Pearson correlations between treatment outcome and treatment expectations were also conducted. Statistical analyses were performed using the Statistical Package of Social Science (SPSS 18.0). RESULTS: Statistically significant differences (p<0.05) were observed in treatment outcome between high and low expectations subgroups. A significant correlation was found between expectations and treatment outcome. CONCLUSIONS: Despite methodological limitations, this study provides data to support the hypothesis that high levels of outcome expectancy are associated with better treatment response.

6. The role of uncommitted actions with life values in college students’ quality of life
Primary Topic: Clinical Interventions and Interests
Subtopic: quality of life
Inês A. Trindade, MSc, PhD student, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra
Cláudia Ferreira, PhD, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra

Background: Recent research has focused on the role of uncommitted action in well-being and quality of life (QoL). It has been found that the engagement in uncommitted or inconsistent actions with life values restrains one from following a meaningful life path, and is often linked with emotional and psychological difficulties. Furthermore, literature has found that psychological suffering is not only due to negative experiences themselves (e.g., anxiety) but mainly from the strategies one uses to deal with those experiences. The present study aimed to contribute to the clarification of the importance and impact of uncommitted action on one’s QoL. More specifically, the main aim of this study was to analyse uncommitted action (ELS-rev)’s mediational role in the known association between college students’ anxiety symptomatology and lower psychological QoL. Method: The sample was composed of 284 college students (43.3% males and 56.7% females), with ages comprised between 18 and 24 years old (M = 20.80; SD = 1.85). Participants completed a research protocol that included the Depression, Anxiety and Stress Scales (DASS-21), the Engaged Living Scale (which was reverted to assess uncommitted action), and World Health Organization Brief Quality of Life Assessment Scale (WHOQOL-BREF). Data analyses were performed using SPSS and additionally MedGraph was used to conduct the mediation analyses. Results: Psychological QoL presented negative associations with anxiety symptomatology and uncommitted action (with moderate to high correlation magnitudes). In turn, increased anxiety was correlated with the presence of more inconsistent actions with one’s values. The tested mediation model showed statistical significance and explained 39% of psychological QoL. Moreover, results also showed that 47% of anxiety’s impact on decreased psychological well-being was partially explained by the mediational effects of uncommitted action. Discussion: These findings thus seem to indicate that the negative effect of anxiety symptomatology on psychological QoL is in part explained by the presence of actions inconsistent with one’s personal life values, that is, by maladaptive responses to anxiety that amplify the impact of this emotion on one’s well-being. Thereby, this study suggests that interventions aiming to improve college students’ QoL should comprise the clarification and promotion of personal life values and actions committed with those values.

7. Cognitive fusion exacerbates the impact of IBD symptomatology on patients’ depression severity
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Diseases
Inês A. Trindade, MSc, PhD student, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra
Cláudia Ferreira, PhD, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra
José Pinto-Gouveia, MD, PhD, Cognitive Behavioural Centre for Research and Intervention, University of Coimbra

Background: Inflammatory Bowel Disease (IBD) encompasses two chronic conditions, Crohn’s Disease and Ulcerative Colitis, characterized by incurable and relapsing inflammation of the intestinal system that causes symptoms such as abdominal pain, persisting diarrhoea, and bloody stools. Patients with these illnesses seem to continuously present decreased levels of quality of life and significantly higher levels of psychopathology compared to the general population and even to patients with other chronic illnesses. At the same time, different studies have demonstrated that depression severity plays a pertinent role in the clinical recurrences of IBD in a self-perpetuating cycle of depressive mood and inflammation. Due to these reasons, it is considered that the study of factors that influence depressive symptomatology in IBD patients should be further investigated. The aim of the present study was thus to explore the role in these relationships of cognitive fusion, a maladaptive emotional regulation process linked to depression and characterized by the excessive entanglement with one’s private events. We hypothesize that cognitive fusion exacerbates the effects of IBD symptomatology on patients’ depression severity. Method: The sample of this study was composed of 176 IBD patients (96 diagnosed with Crohn’s Disease and 80 diagnosed with ulcerative colitis), aged from 18 to 65 years old (M = 35.70; SD = 10.32). Participants completed an internet-based survey that comprised demographic and medical information (e.g., frequency of IBD symptoms) and self-report instruments (Cognitive Fusion Questionnaire - CFQ-7; Depression, Anxiety and Stress Scales - DASS-21). Results: Results from regression analyses demonstrated that the interaction between IBD symptomatology and cognitive fusion is a significant predictor of depression severity (β = .43; p < .05). This interaction accounted for a total of 46% of depression’s variance, being the best predictor of the model. Results revealed that, for the same level of IBD symptomatology, patients who presented higher levels of cognitive fusion showed increased depressive symptoms. Discussion: The current study seems to indicate that cognitive fusion acts as a moderator in the association between increased IBD symptomatology and higher levels of depression. That is, it suggests that dealing with one’s internal events as if they were literally true with disregard to contextual cues may exacerbate the impact of IBD clinical symptoms on the severity of depressive symptomatology. These findings seem to present important clinical implications for the improvement of IBD patients’ physical and psychological functioning.

8. Brief Cognitive-Behavioral Therapy Group in Adjustment Disorder: Locus of control on treatment outcomes.
Primary Topic: Clinical Interventions and Interests
Subtopic: Adjustment disorder, Brief CBT Group
Isabel Ramirez-Gendrau, Consorci Sanitari de Terrassa
Ainhoa Sánchez, Consorci Sanitari de Terrassa
Anna Soler-Roca, Consorci Sanitari de Terrassa
Irene Ramos-Grille, Consorci Sanitari de Terrassa
Isabel de María, Consorci Sanitari de Terrassa
Mireia González, Consorci Sanitari de Terrassa
Anna Garcia-Caballero, Consorci Sanitari de Terrassa

Recent research has established that Locus of Control (LC) is a construct related to psychological treatment outcomes. The specific aim of our study was to investigate whether differences in health LC are related to a better response rates in a Brief Cognitive-Behavioral Therapy Group (BCBT-G) in patients with Adjustment Disorder (AD). Fifty-six patients (32% males and 68% females) diagnosed with mixed AD with anxiety and/or depressed mood (DSM-IV-TR) agreed to take part in the study. All patients were included in a BCBT-G (6 one hour sessions, weekly). The participants completed a self-report psychometric battery for pre-treatment assessment. Among others, the Spanish Health Locus of Control Scale (ELCS) and BDI-II were administrated. In order to assess clinical improvement, BDI-II was readministrated at the end of the treatment. Statistical analysis was performed using the Statistical Package SPSS Version 18.0. The differences observed between health LC and the better response rates in the treatment (lower BDI-II scores) were not statistically significant (p>0.05). We did not observe any correlation between lower BDI-II scores and scores on ELCS at the end of treatment. Despite methodological limitations, this study suggests that having an internal or external LC is not related with better treatment response. Maybe LC could not be involved on treatment outcomes.

9. The Impact of Parental Psychological Flexibility on Refugee Infant Development
Primary Topic: Clinical Interventions and Interests
Subtopic: Torture/trauma history, Infants, Secondary Survivors, Refugees
Jordan Weith, University of Vermont
Anne Brassell, B.A., University of Vermont
Karen Fondacaro, University of Vermont
Susan Crockenberg, University of Vermont

Psychological flexibility is a primary construct that warrants investigation in the mitigation of the effects of post-migration stress and past-trauma within the refugee population. The impact of trauma and post-migration stress can be widespread and often extend beyond the survivor to non-afflicted family members, known as secondary survivors. Case studies have suggested that infant secondary survivors are at a greater risk of demonstrating underdeveloped physical or cognitive growth. Psychological flexibility may ameliorate this relation, as the parent is able to engage with their infant and attend to the present moment despite the obstacles they encounter. The current study will present empirical data on 32 refugee parent/infant (3-12 months, Bhutan or Somalia country of origin) pairs. The relation between post-migration stress, torture/trauma history, and psychological flexibility will be examined. It is expected that the relation between post-migration stress, torture/trauma, and infant development (cognitive and social) will be moderated by psychological flexibility. These findings will be discussed as they relate to the importance of developing a dyadic intervention for refugee parents and infants.

10. ACT inpatient treatment concept for OCD patients
Primary Topic: Clinical Interventions and Interests
Subtopic: OCD
Karoline Albrecht, Ph.D., University Medical Center Freiburg
katharina Wetterkamp, University Medical Center Freiburg
Marlene Stecher-Sperlich, University Medical Center Freiburg
Lothar Bonk, University Medical Center Freiburg
Tobias Freyer, University Medical Center Freiburg

Cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP) as its key element is the psychotherapeutic method of choice in the treatment of obsessive-compulsive disorder (OCD). It is long established and recommended in the treatment guidelines (APA, 2007). However, an essential number of patients – between 20 – 60% - do not benefit from treatment, fail to engage in the strenuous ERP treatment or drop out prematurely (Franklin & Foa, 1998; Abramowitz, 2006). Several factors – such as poor patient adherence to the ERP procedures, poor insight into the irrationality of the obsessions, respectively obsessions held with delusional conviction or comorbid affective, anxiety or personality disorders - have been reported to negatively impact the outcome of ERP (APA, 2007). ACT as an experiential contextual approach of cognitive behavioral therapy, which aims at changing the function of cognitions and other inner experiences rather than changing the content, might be a viable option to address these factors (Twohig et al., 2010; Twohig, Hayes & Masuda, 2006; Tolin 2009). Its broad, not disorder-tailored nature might hold the chance to adequately deal with comorbidities. Furthermore ACT procedures show promise in increasing treatment engagement in exposure treatments (Bluett et al., 2014). ACT in OCD treatment focuses on helping the patient to pursue valued-based living while mindfully noticing inner experiences, thus disempowering irrational or delusional obsessions and compulsive urges by not giving them more significance than they merit. So far studies suggest that ACT as an outpatient treatment seems to be a promising treatment approach for OCD (Twohig et. al., 2010; Twohig et al., in press). However no evidence exists on ACT for OCD in the inpatient setting. Given the high degree of chronicity, comorbidity, and therapy resistance in OCD patients, however, many of these patients require inpatient treatment (Stengler-Wenzke et al., 2005; Voderholzer et al., 2011). Here, we report on a first specialized program of applying ACT to inpatient OCD treatment. This program is currently tested for feasibility and effectiveness in a pilot study with 10 patients in the University Medical Center Freiburg. The aim of this poster is to present the multidisciplinary structured treatment program, which incorporates ERP in ACT and combines individual and group therapies. Preliminary data on its feasibility and acceptance of patients will be presented.

11. The moderating effect of psychological flexibility on defeat and suicidality
Primary Topic: Clinical Interventions and Interests
Subtopic: Suicide
Kevin Hochard, Ph.D., University of Chester
Nadja Heym, Ph.D., Nottingham Trent University
Ellen Townsend, Ph.D., University of Nottingham

Background: Defeat, stress or humiliation following a loss of status (real or perceived), has been established as a risk factor for suicidality as described in the cry of pain model proposed by Williams (2001). Psychological flexibility, the ability to persist in behaviours serving a valued goal, provides a trait that could moderate the impact of defeat on suicidality through the shifting of perspective. Methods: A cross sectional online psychometric survey was conducted (n=843) assessing depressive symptoms, defeat, psychological flexibility, and suicidal ideation. Results: Moderation analyses (Hayes, 2013) were performed. Our findings indicate a clear significant moderating effect of psychological flexibility on the relationship between defeat and suicidal thinking whilst controlling for the effects of depressive symptoms. Discussion: We suggest that while increasing levels of psychological flexibility may not be possible during periods of high suicidal risk, receiving training to increase flexibility may be beneficial for individuals with cyclic bouts of suicidal ideation or those at low levels of risk. Thus, improving at risk individuals’ ability to cope with negative life events.

12. Psychological Inflexibility as a Transdiagnostic Prospective Mediator
Primary Topic: Clinical Interventions and Interests
Subtopic: psychological flexibility
Ljiljana Mihić, Ph.D., University of Novi Sad, Faculty of Philosophy, Department of Psychology, Serbia

Background: Both Negative Affectivity (NA) and Psychological Inflexibility (PIF) have been proposed as transdiagnostic variables, implicated in the emergence of various mental disorders, including anxiety symptoms. PIF has been suggested to act as a mechanism by which NA leads to psychopathology, via amplification of negative emotions. Hence, the aim of this study was to test the hypothesis that PIF would be a mediator in the relations between NA and the prospective symptoms of social phobia, panic, and generalized anxiety disorders, controlling for the contribution of the previous anxiety symptoms and anxiety sensitivity. Method: Participants were undergraduates (N = 165 (80% females), Mage=19.86 (.98)) at the University of Novi Sad, Serbia, who consented to participate in a three-wave longitudinal study. At Time 1, they completed the PANAS-trait form, the Anxiety Sensitivity Index-3, and the Depression, Anxiety and Stress Scale-21. A year later, participants filled out the Acceptance and Action Questionnaire-II. Six months later, they were screened for the diagnosis of social phobia (SP), generalized anxiety disorder (GAD), and panic disorder (PD) using the Psychiatric Diagnostic Screening Questionnaire. All measures were administered in Serbian. Results: Analyses were conducted using the PROCESS macro in which PIF was expected to mediate the relations between NA and the anxiety symptoms, controlling for the prior levels of anxiety symptoms and anxiety sensitivity. The results suggested that these relations were completely mediated by PIF (indirect effect for SP: 95% BC(.03-.09); indirect effect for GAD: 95% BC (.02-.11); indirect effect for PD: 95% BC (.01-.03)). Discussion: This study in a nonclinical sample showed that both PIF and NA were predictors of the prospective symptoms of panic, social phobia, and generalized anxiety disorders, in which PIF mediated completely the effects of NA on the symptoms. It seems that PIF contribute to the anxiety symptoms by amplifying the experience of negative emotions. It is noteworthy that this effect remained after controlling for anxiety sensitivity, a well-known risk factor for anxiety psychopathology. Future studies should test whether such a complete mediation would be obtained in a clinical sample. Our results have implications for prevention of anxiety psychopathology.

13. The relationship between mindfulness, psychological flexibility, perceived parental control and diabetes-related outcomes in adolescents with type 1 diabetes
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescent diabetes
Lorraine Lockhart, University of Edinburgh
Dr Nuno Ferreira, University of Edinburgh

Parental involvement in the daily treatment regime for adolescent diabetes can increase the likelihood of achieving optimum glycaemic control, and is therefore often necessary. However, adolescents with T1D who perceive their parents as controlling often report lower levels of treatment adherence and poorer health-related quality of life. To date, there has been little investigation of the factors that influence this relationship. The current study hypothesises that the relationship between perceived parental control and poor outcomes is mediated by the adolescent’s mindfulness and psychological flexibility. It further hypothesises that this relationship is moderated by parental mindfulness and psychological flexibility. A total of 131 parent-adolescent dyads will be recruited from adolescent diabetes clinics throughout Scotland over an 8 month period. Parents and adolescents will be asked to complete a range of self-report questionnaires measuring parent and adolescent mindfulness and psychological flexibility, treatment adherence, adolescent perception of parental control and diabetes-related quality of life. The data will be analysed using conditional process analysis to fully understand the mediating and moderating roles of mindfulness and psychological flexibility. Preliminary results will be presented where these are available.

14. Efficacy and clinical utility of individual and group treatment with Acceptance and Commitment Therapy for children and youths with longstanding pain
Primary Topic: Clinical Interventions and Interests
Subtopic: Pediatric longstanding pain
Marie Kanstrup, Behavioural Medicine Pain Treatment Services, Karolinska University Hospital
Mike Kemani, Behavioural Medicine Pain Treatment Services, Karolinska University Hospital

Background: Longstanding pain in children and adolescents may lead to reductions in daily functioning and disability. Acceptance and commitment therapy (ACT) aims at improving functioning and disability by increasing psychological flexibility, i.e. the ability to act in accordance with personal values and goals in the presence of interfering pain or distress (Hayes, 2006). Previous studies on the efficacy of ACT- to improve disability and quality of life in children and youths suffering from longstanding pain has indicated the clinical utility of this aproach (e.g. Wicksell, 2009). Research indicates that there is no difference in efficacy between individual therapy and group therapy. However, to our knowledge, there is a limited number of studies that have evaluated possible differences in efficacy for individual therapy in comparison with group therapy for children and youth with longstanding pain. The present study aimed to evaluate possible differences in treatment outcome and treatment responders, between individual and group treatment for children and youths suffering from longstanding pain. Method: Forty children and youths with longstanding debilitating pain referred to the Behavior Medicine Pain Treatment Services were randomized to ACT in a group format or to individual ACT. Psychological inflexibility was the primary process measure and pain disability and pain interference were the primary outcome measures. Secondary outcome measures consisted of e.g. emotional functioning. Analyses were performed using repeated measures ANOVA, and responder analyses will be based on e.g. criteria by Jacobson and Truax (1991). Results and discussion: Preliminary results showed that there were no differences between the two treatment modalities (individual format/group format) on the different measures. Furthermore, there were significant improvements in psychological inflexibility, pain disability, pain interference and emotional functioning across treatment modalities. Responder analyses are ongoing. Results will be discussed in relation to previous research, clinical implications and future studies.

15. Captains Courageous: An ACT-oriented group training for children with emotional disorders
Primary Topic: Clinical Interventions and Interests
Subtopic: Children
Marta Schweiger, Università IULM,Milan & IESCUM,Italy
Francesca Pergolizzi, IESCUM, Italy
Paolo Moderato, Università IULM,Milan & IESCUM,Italy

The poster illustrates an ACT - oriented group training for children with emotional problems. Population. Two groups of 5 children (10 subject; age 8-11 ; 7 male, 3 female), with different psychopathological diagnosis and significant internalizing problems were selected in a child mental health service near Milan (Italy). Procedures. Pre and post measures (CBCL, RCMAS-2, AFQ-Y) were administered to parents and children. Children received training (10 sessions, 90 minutes each) through exercises, games and creative activities within a metaphorical framework: every child plays as a captain and learns to appreciate his boat (self-awareness), observe the waves (recognizing antecedents), drop anchor (present moment), accept seasickness (sensations and emotions), signal with flags (getting help), use compass (valued directions) and steer (committed actions). Outcomes. Parents and children reported a decrease in internalizing problems, depression and anxiety symptoms and lower levels of fusion and avoidance. Children discovered that "everyone has difficult emotions when sailing the sea", and that "a good captain is patient, courageous, and creative".

16. Assessing quality of life in young people: the Italian version of the Youth Quality of Life (YQOL-R)
Primary Topic: Prevention and Community-Based Interventions
Subtopic: children and adolescents
Marta Schweiger, Università IULM,Milan & IESCUM,Italy
Arianna Ristallo, Università IULM,Milan & IESCUM,Italy

Improving the quality of life is the primary focus for many ACT-based interventions with children and adolescents. The aim of this study is to validate the Italian version of the Youth Quality of Life Instrument – Research Version (YQOL-R, Patrick & Edwards, 2002), a 57 items self-report measure that evaluates children’s and adolescents’ self perceptions about positive and negative aspects of their life. 433 Italian students were recruited from different part of Italy (age 11-18 mean= 13.79 sd=1.54, 39.1% male, 60.5% female). The YQOL-R was administered along with Avoidance and Fusion Questionnaire for Youth, Child and Adolescents Mindfulness Measure (Greco 2008, 2011) and Child Behavior Checklist Youth Self Report (Achenbach, 2001). Preliminary results show that the four scales (Self, Relationships, Environment and Genral QoL) of the YQOL-R have good internal consistency (Cronbach’s alpha=0.80 – 0.91). Other psychometric properties, correlations among instruments, and relations between contextual (1-15) and perceptual items (16-41) will be discussed.

17. Student’s Life Satisfaction Scale (SLSS): Psychometric Characteristics on an Italian Youth Sample
Primary Topic: Clinical Interventions and Interests
Subtopic: life satisfaction, quality of life, positive psychology, wellbeing, adolescents
Martina Romitelli, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Nicoletta Ristè, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Valentina Carloni, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

The emerging literature emphasizes the importance to assess adolescents' mental health also considering their life satisfaction. This poster reviews the psychometric properties of an Italian version of the Student’s Life Satisfaction Scale (SLSS; Huebner, 1971), a 7 domain-free item measure of general life satisfaction developed on children aged 8-18. SLSS has been translated into Italian and administered to a sample of about 400 students aged 11-14, being easily understood. This instrument was included in a wider questionnaire package assessing subjective happiness, mindfulness, defusion, dysfunctional attitudes and psychopathological symptoms. The findings suggest that SLSS presents good psychometric characteristics for its use on Italian adolescents.

18. Regulating Eating through Acceptance and Commitment Therapy (RE-ACT)
Primary Topic: Clinical Interventions and Interests
Subtopic: weight management
Mary Jinks, Trainee Clinical Psychologist, University of Lincoln
Nima Moghaddam, Clinical Psychologist, University of Lincoln
Dave Dawson, Clinical psychologist, University of Lincoln
Mike Rennoldson, University of Nottingham

Background Obesity is a growing global epidemic (Lillis, Hayes, Bunting, & Masuda, 2009; Weineland, Arvidsson, Kakoulidis & Dahl, 2012) and it is associated with significant health consequences (Kopelman, 2000; Rapp et al., 2005). However, weight loss, and its maintenance over time is difficult, leading to experts recognising the need to address the psychological challenges of obesity (Cooper & Fairburn, 2001; Tapper, Shaw, Ilsley & Moore, 2007). Obesity is linked in part with emotional eating (Torres & Nowson, 2007). Therefore, it has been highlighted that interventions which may tackle emotional eating may be an effective means of addressing obesity (Tapper et al., 2009). Acceptance and Commitment Therapy (ACT) is a psychotherapeutic approach which may help reduce emotional eating. Aim To evaluate the effectiveness of a guided ACT self-help intervention for weight management of emotional eaters. Method Six participants recruited from a university population consented to take part in a five week guided self-help ACT intervention. Utilising an AB single case series design, participants completed a range of implicit, explicit and behavioural assessments over the course of the study. Results and discussion Preliminary results indicate that the intervention resulted in weight loss. Participants reported positive experiences about the intervention. An overview of the analysis to date will be outlined, along with a discussion of the results in line with ACT processes.

19. Group acceptance and commitment therapy for persistent postural and perceptive dizziness: A clinical study
Primary Topic: Clinical Interventions and Interests
Subtopic: psychosomatic medicine
Masaki Kondo, Nagoya City University Graduate School of Medical Sciences
Keiko Ino, Nagoya City University Graduate School of Medical Sciences
Wakako Igarashi, Kikuchi mental clinic
Sei Ogawa, Nagoya City University Graduate School of Medical Sciences
Toshitaka Ii, Nagoya City University Graduate School of Medical Sciences
Meiho Nakayama, Nagoya City University Graduate School of Medical Sciences
Tatsuo Akechi, Nagoya City University Graduate School of Medical Sciences

Background: Persistent postural and perceptive dizziness (PPPD), which has been called chronic subjective dizziness or phobic postural vertigo, is assumed to be a chronic clinical condition arisen from interactions among multiple factors, such as vestibular function, visual sensation, somatic sensation, muscle tone, autonomic nervous system, and psychological elements. Cognitive behavioral therapy (CBT) is one of the promising treatments, however, some patients have resistance to CBT. They seem to fall into vicious circles by struggle to avoid “dizziness”, therefore, acceptance strategy may be effective in PPPD. The aim of this pilot clinical study is to examine effectiveness and feasibility of group acceptance and commitment therapy (ACT) for PPPD. Methods: We enrolled adult outpatients at a special dizziness clinic who had a chief complaint of dizziness or unsteadiness that lasted more than three months in most days and that were exacerbated by upright posture, head motion, or exposure to moving or complex visual patterns. We excluded dizziness and unsteadiness explained adequately by other diseases, such as central nervous diseases, vestibular diseases, and psychiatric disorders. Participants received six weekly sessions of group ACT. The primary outcome was Handicap due to dizziness, evaluated by Dizziness Handicap Inventory. Results: All three participants could undergo group ACT smoothly. Although they had severe handicap due to dizziness at pre-treatment, one of three showed complete remission and another one showed treatment response one month after treatment. Conclusion: The results suggest that group ACT for PPPD may be feasible. Further clinical study should be required.

20. Validity and Reliability of the Acceptance and Action Diabetes Questionnaire Turkish Version
Primary Topic: Clinical Interventions and Interests
Subtopic: acceptance and diabetes
Mehmet Emrah Karadere, Hitit University Corum Education and Research Hospital
Ece Yazla, Hitit University Corum Education and Research Hospital
Ferit Kerim Küçükler, Hitit University Corum Education and Research Hospital
Kasım Fatih Yavuz, Bakirkoy Mazhar Osman Research and Training Hospital for Psychiatry and Neurology
Emre Demir, Hitit University Medical Faculty

Objective: High degree of acceptance was found to be related with better metabolic control and higher coping capability in diabetic patients (1). Acceptance and Action Diabetes Questionnaire (AADQ) is a scale which was constructed for measuring acceptance of diabetes related thoughts and feelings and the degree to which they interfere with valued action (2). We investigated the reliability and validity analysis of Turkish version of AADQ. Method: 106 patients who applied to the endocrinology outpatient clinic of Hitit University Çorum Education and Research Hospital with the diagnosis of type II Diabetes Mellitus were included to our study. Their mean age was 52,74 years (SD = 9,43). 56,6% of them were female. Mean education duration was 7,65 years (SD=3,97). We used Beck depression inventory(BDI), State-Trait Anxiety Inventory (STAI-I and II), Problem Areas in Diabetes Scale(PAID), Audit of Diabetes-Dependent Quality-of-Life (ADDQoL) Questionnaire. The translation of the original AADQ to Turkish carried out by authors. Each of them translated AADQ independently from each other. Back-translation was provided by a bilingual translator, who have no interest on psychopathological issues. After back-translation, original version of AADQ and back-translated version compared and final version of Turkish AADQ completed. Results: Internal consistency: Cronbach’s alpha value of Turkish version of AAQ-II: 0.822. AADQ scale results were positively correlated with STAI-II (r=0,229, p=0,020), BDI (r=0,428, p<0,001), PAID (r=0,534, p<0,001), negatively correlated with ADDQoL (r=-0,274, p=0,005). STAI-I wasn’t found significantly correlated with AADQ (r=-0,07, p=0,483). Discussion: Our results showed that Turkish version of AADQ was applicable for the evaluation of the acceptance degree of Turkish diabetic patients.

21. ACT for a complex trauma
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD, depression, ACT, exposure therapy
Nathalia Vargas Psy. D, Contextual Science and Therapy Institute; National Institute of Psychiatry Ramón de la Fuente
Michel Reyes Psy. D., Institute of Contextual Science; National institute of Psychiatry Ramón de la Fuente
Edgar Miguel Miranda Terres M.S, Institute of Contextual Science; National institute of Psychiatry Ramón de la Fuente
Elsa Mediana, Private Practice

We present a longitudinal study where they showed the achievements and limitations of an intervention group ACT and Exposure therapy for complex trauma, to measure impact on symptoms of PTSD, Depression and Quality of life, using Check list of PTSD symptoms (PCL-C) Weathers, Litz, Herman, Huska & Keane (1993). Translate and suits for mexican population (Flores, Reyes & Riedl 2012), Beck Depression Inventory (BDI). Beck (1988) .Adaptación Robles, Varela, Jurado and Paez (2001) and Inventory of Quality of Life and Health (INCAVISA) Riveros, Sanchez Sosa and Groves (2003). Both groups showed decrease in PTSD symptoms, but the results differ on the impact on quality of life and depressive symptoms

22. Bringing support to family members with BPD with ACT and DBT Skills
Primary Topic: Clinical Interventions and Interests
Subtopic: family´s interventions, BPD
Nathalia Vargas Psy. D., Contextual Science and Therapy Institute; National Institute of Psychiatry Ramón de la Fuente
Michel Reyes Psy. D., Contextual Science and Therapy Institute; National Institute of Psychiatry Ramón de la Fuente
Edgar Miguel Miranda Terres, Contextual Science and Therapy Institute; National Institute of Psychiatry Ramón de la Fuente
Ivan Arango de Montis M.D, National Institute of Psychiatry Ramón de la Fuente
Elsa Mediana, Private Practive

The present study is an intervention program based on ACT and strengthened with DBT skills with 60 relatives of people diagnosed with BPD divided into two groups to assess changes in family relationships, emotional regulation of family members and psychological flexibility the measurements used are intrafamiliaes relationship scale (Rivera Hereida and Andrade Palos, 2001, intermediate version) Acceptance & Action Questionnaire (AAQ-II) (Patron, 2010) and the Scale of Emotional adjustment Difficulties (Marín was used Tejeda, García Robles, González Forteza, Andradre Palacios, 2012). Both groups showed improvement in domestic relations, as well as emotional regulation psychological flexibility

23. The adaptation of an ACT based intervention to a digital intervention as a means to increase adherence and lower attrition rates in chronic pain patients
Primary Topic: Clinical Interventions and Interests
Subtopic: Technology
Orestis Kasinopoulos, M.Sc, University of Cyprus
Vasilis Vasiliou, University of Cyprus
Evangelos C. Karademas, Ph.D, University of Crete
Maria Karekla, Ph.D, University of Cyprus

Acceptance - based psychological interventions for chronic pain have been receiving empirical support for pain management. Yet, financial barriers for the patients and the healthcare system as well as obstacles regarding physical access to treatment, highlight the need for innovative cost-reducing digital interventions. The adaptation of an ACT - group protocol to digitalized interventions (e.g. web-based and smartphone application) aim to improve the human-computer interaction with the use of a persuasive system design, Avatars and the bare minimum number of sessions aimed at improving adherence rates in both digital interventions. In the original study, sixty-nine patients were assessed and randomly assigned to an ACT or CBT group for eight, 90-minute, sessions. Attrition and adherence rates of ACT - group intervention in Greek-speaking chronic pain patients are presented. The process of converting a face-to-face ACT intervention to both a web-based and a mobile - application is described. Potential obstacles arising during the adaptation (such as creating a user - friendly and culturally sensitive platforms) and fruitful solutions to them shall be discussed.

24. Psychometric properties of the Brazilian version of the Cognitive Fusion Questionnaire (CFQ-7): A study with multigroup analysis of factorial invariance
Primary Topic: Clinical Interventions and Interests
Subtopic: cognitive fusion, psychometric properties
Paola Lucena-Santos, Ph.D. Student, University of Coimbra - Portugal
José Pinto-Gouveia, MSc., Ph.D., University of Coimbra - Portugal
Renata Klein Zancan, MSc., Pontifical Catholic University of Rio Grande do Sul - Brazil
Daniela Franceschi Souza, Pontifical Catholic University of Rio Grande do Sul - Brazil
Marina Camargo Barth, Pontifical Catholic University of Rio Grande do Sul - Brazil
Margareth Silva Oliveira, MSc., Ph.D., Pontifical Catholic University of Rio Grande do Sul - Brazil

Introduction: The CFQ-7 was developed with the purpose of becoming a useful tool in the assessment of the cognitive fusion, as it is believed that the type of relationship of the individuals with their own thoughts is potentially more important than the thoughts themselves, when it comes to predicting psychological pain. Meanwhile, there aren’t assessment studies of psychometric properties of this measure in Brazil. Method: This is a transversal study, with self-report measures. The sample was composed of three convenience groups of adult women (sample of general population, n=301; college students, n=171; and clinical sample of overweight or obese women undergoing treatment to lose weight, n= 205). The analytic strategies used Confirmatory Factorial Analysis (CFA), with Maximum Likelihood as the estimation method (to confirm scale structure), Multigroup Analysis (to investigate factorial invariance) and Cronbach’s alpha coefficient (to assess internal reliability). We used the SPSS (Statistical Package for the Social Sciences) and the software AMOS to perform all analysis involved in this study. Results: The average age of the 677 participants was 33.62 years (SD= 11.9) and the average years of education was 13.1 (SD= 3.9), most of them were single women (53.6%, n= 363), followed by married women (30.0%, n= 203), consensual unions (9.2%, n= 62), divorced (5.4%, n= 37) and widows (1.8%, n= 12). In the CFA of the total sample (n= 677), the modified model with covariances between the residual errors of two pairs of items (1/2 and 2/3 – given the similarity of these pairs of items, their content analysis supported this decision) showed a very good fit (χ2/df= 1.995; TLI= 0.994; CFI= 0.996; GFI= 0.990; RMSEA = 0.038; p= 0.784), with high factorial weights and individual reliability of the items (λ≥ 0.69 and R2≥ 0.48). This adjustment was significantly better than the original model (∆X2 (2) = 88.25; p<0.05). The multigroup analysis showed that the scale has strong measurement invariance in this three groups simultaneously, once no intergroup differences were observed in what concerns the factorial weights (∆X2 (12)= 4.208; p= 0.979) and the averages (intercepts) of the items (∆X2 (14)= 23.123; p= 0.058). Also, the general reliability (considering the total sample) was α= 0.93. Discussion: Considering our results, it is possible to affirm that the Brazilian version of the CFQ-7 shows unifactorial structure, has an excellent internal consistency and can be reliably used with this three different study groups to assess both the cognitive fusion scores, as the effects of other variables on these scores.

25. Psychological Flexibility as a Mediator of Depression, Anxiety, and PTSD in Group Therapy with Female Bhutanese Refugees
Primary Topic: Clinical Interventions and Interests
Subtopic: Refugee Mental Health
Sheau-Yan Ho, B.A., University of Vermont
Jessica Clifton, M.A., University of Vermont
Emily Pichler, B.A., University of Vermont
Maggie Evans, B.A., University of Vermont
Diane Gottlieb, Ph.D., University of Vermont
Valerie Harder, Ph.D., University of Vermont
Karen Fondacaro, Ph.D., University of Vermont

Psychological flexibility has been indicated in research as an important mediator of therapeutic change. Group therapy models for refugees and torture survivors point to the importance of multi-systemic and multi-component treatment; however, few studies have examined therapeutic processes in refugee populations. In the current study, adult female Bhutanese refugees seeking psychological services from a community clinic were treated in an open-ended group therapy context for adjustment disorder (N = 13). Group psychotherapy utilized an acceptance and commitment therapy (ACT) framework and covered a range of topics, including acculturative stressors, social isolation, and stress management. Participants were assessed for symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) at baseline and mid-treatment (approximately at 50 weeks) using the Hopkins Symptom Checklist and Harvard Trauma Questionnaire. Additional mid-treatment measurements (approximately at 25 weeks) included the Acceptance and Action Questionnaire – II. In this project, we will examine acceptance and willingness to pursue valued experience as a mediator of change in depression, anxiety, and PTSD symptoms across group treatment. The findings of this study will help to elucidate potential mechanisms that may explain therapeutic change over time in female Bhutanese refugees. Further, results will inform our understanding of using an ACT framework in a group psychotherapy setting with refugees to address a range of presenting mental health concerns.

26. An Acceptance and Committment Therapy approach to increase well-being in spinal cord injury survivors
Primary Topic: Clinical Interventions and Interests
Subtopic: Spinal Cord Injury, Well-being, ACT
Sophia Serpa, M.S., Nova Southeastern University
Alexia Holovatyk, B.S.
Barry Nierenberg, Ph.D., ABPP, Nova Southeastern University

Background It is not surprising that although about 5% of Americans become depressed every year, the rates of depression among those surviving spinal cord injury (SCI) are even higher ranging from 11% to 37%. Although it is necessary to study interventions that alleviate depressive symptoms in the short term, it is not sufficient. Previous studies have found that the challenge of treating depression lies in the prevention of relapse rather than in the alleviation of initial symptoms. A study by Fava & Ruini (2004) found that while 70% of patients remitted following a treatment for depression, 90% of people in a clinical management group relapsed at least once over a 6-year period compared to only 40% of people who completed a well-being based intervention. Ryff and Singer (1996) have suggested that the absence of well-being creates conditions of vulnerability to possible future adversities and that the route to enduring recovery lies not exclusively in alleviating the negative, but in also engendering the positive. In an effort to focus on moving past this state of depression to a state of well-being, we have utilized an intervention similar to Fava & Ruini’s Well Being Therapy (WBT) outlined in their 2003 article to explore the potential benefits such interventions can have with survivors of SCI. WBT is a cognitive-behavioral approach based on Carol Ryff’s multidimensional model of psychological well-being. We chose to add components of Acceptance and Commitment Therapy (ACT) to our group intervention in hopes to add the concept of living according to your values to this intervention. To our knowledge, no other study has attempted to replicate this finding in a group of people with chronic physical disabilities. This article seeks to further this line of study by proposing that a well-being based ACT intervention will be a significant predictor of lower depression scores at 0 and 6 months following the intervention in a group of people with spinal cord injury. In addition, we hope that by increasing well-being we can prevent hospitalizations associated with secondary complications in SCI survivors. Methods This pilot study consists of eight group sessions where the focus is on increasing well-being in the six dimensions proposed by Ryff (1989) and on aiding participants to live according their values in the six domains identified. Participants consist of the board members of the Spinal Cord Injury Support Group (SCISG) at Jackson Memorial Hospital in Miami, FL. The following assessments were administered directly before (Time point 1) and after the intervention (Time point 2) and again 6 months following the intervention (Time point 3): the Acceptance and Action Questionnaire II (AAQ-II); Patient Health Questionnaire-9 (PHQ-9); Post Traumatic Growth Inventory (PTGI); Psychological Well-Being Scale (PWB); Quality of Life after Spinal Cord Injury (QLI-SCI); State Trait Anxiety Inventory (STAI-Y6) and the Trait Hope Scale (HS). Results We will run a repeated measures one-way ANOVA to compare the means of the PHQ-9 to see if they significantly differ across the three time points. If the means do differ, we will conduct post-hoc analyses to see which time points are different. We expect the scores of the PHQ-9 at time points 2 & 3 to be significantly lower than Time point 1. We will conduct similar analyses to explore the other potential effects of this novel intervention (e.g. increased well-being). Discussion We expect that following this intervention, we can help lower depression and increase quality of life scores in this population. It is also expected that participants exprience increased levels of well-being in the six domains proposed by Ryff and have a better understanding about which behaviors participants can engage in to live according to their identified values. Finally, we expect that as a result of their increased level of well-being, participants will have less complications associated with a spinal cord injury and therefore less hospitalizations. It is our hope that we can tailor this group intervention to populations that are likely to experience decreased well-being in the future such as individuals with traumatic brain injury, cardiovascular problems, limb-loss, stroke and other disabilities.

27. Reducing Aggression One Value at a Time
Primary Topic: Clinical Interventions and Interests
Subtopic: Value-Consistent Living, Aggression
Teresa Hulsey, B.A., University of North Texas
Erin K. M. Hogan, B.A., B.S., University of North Texas
Amy R. Murrell, Ph.D., University of North Texas
Sarah E. Pepper, Ph.D., VA North Texas Healthcare System

Value-consistent living involves actively behaving in accordance with freely identified and chosen life pursuits, regardless of emotional states (e.g., anger). Values have no achievable endpoint (Murrell & Kapadia, 2011; Wilson & DuFrene, 2009). Valued living is significantly negatively associated with general pathology, treatment difficulty, relationship and other psychosocial environmental problems, and with a hostile attitude (Wilson, Sandoz, Kitchens & Roberts, 2010). Engaging in behaviors consistent with one’s values can act as a protective factor against internalizing and externalizing difficulties, such as aggression. Aggression is significantly associated with substance abuse (Bushman, 1993), situational stressors (Berkowitz, 1993), early traumatic experiences (Flemke, 2009), and impulsivity (Derefinko, DeWall, Metze, Walsh, & Lynam, 2011). Although the relationship between impulsivity and aggression has been supported in many studies, the relationship between value-consistent living and aggression was in need of investigation. A sample of 368 undergraduate students completed online self-report measures of impulsivity (Barratt Impulsiveness Scale, BIS-11; Barratt, 1959, 1994), valued living (Valued Living Questionnaire, VLQ; Wilson et al., 2010), and aggression (Aggression Questionnaire, AGQ; Buss & Perry, 1992). Results from a multiple regression analysis indicated that valued living negatively predicts aggression (β = -.12, t = -2.47, p = .014), after controlling for impulsivity (β = .42, t = 8.52, p < .001). The implications of identification of and living consistently with values on aggression will be discussed. Aggression correlates and potential interventions, along with ideas for future research, will be covered.

28. Acceptance and Commitment Therapy for Substance Use Disorder | Qualitative review
Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use Disorder
Toshitaka Ii, Dept of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences
Hirofumi Sato, Dept of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences
Norio Watanabe, Translational Medical Center, National Center of Neurology and Psychiatry
Tatsuo Akechi, Dept of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences

Back ground Substance Use Disorder is characterized by cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance related problems. Approximately five per cent of the world’s adult population are estimated to have used an illegal drug at least once in 2010. Problem drug users are 0.6 per cent of the world adult population. In 2010, substance use disorders accounted for 13.6 million disability-adjusted life years (DALYs) (95% CI 11.5~15.8 million). Clinical guidelines recommends psychosocial interventions, cognitive behavioral therapy in particular. On the other hand, acceptance and commitment therapy (ACT) is one of the so-called ‘third wave’ cognitive and behavioral therapies. In the ACT theory, people always try to avoid or control unwanted thoughts, feelings, sensations, impulses and other experiences. This experiential avoidance plays important role in variety of addiction problems. Focusing on acceptance of emotional difficulties related to day-to-day stress in order to reduce experiential avoidance that bring into difficulties for over the life, ACT may be effective for Substance Use Disorder. However there are no systematic reviews on the effects of ACT for Substance Use Disorder.The purpose of this study is to assess the effects of ACT approaches for Substance Use Disorders. Methods This study is a qualitative review that is conducted as one of Cochrane Reviews. All randomized controlled trials (RCTs) that compared ACT for Substance Use Disorders in adults and adolescent will be sought. Primary outcome is the number of patients who can abstinence from substance and the change in substance use. Secondary outcomes include the Severity Dependence Scale, the Hamilton Anxiety Scale, and the World Health Organization Quality of Life. The trial database in the Cochrane Drugs and Alcohol Group will be searched. We will conduct a qualitative review of RCTs by summarizing findings and discussing about the effects of ACT for Substance Use Disorder. Our study is in the middle of reviewing. Results and discussions are scheduled to be completed by the ACBS World Conference.

29. The Effect of Group Acceptance and Commitment Therapy for Patients with Severe Health Anxiety
Primary Topic: Clinical Interventions and Interests
Subtopic: Health anxiety
Trine Eilenberg, Ph.D., Research Clinic for Functional Disorders, Denmark
lisbeth frostholm, Ph.D., research clinic for functional disorders

Background Existing randomized controlled trials of psychological treatments of health anxiety have primarily tested individual cognitive behavioural treatments. The aim of this study was to test the effect of ACT group therapy for severe health anxiety. Method and Design A two-arm randomised, controlled trial including 126 of 173 consecutively referred patients during March 2010 to April 2012 (mean age 37 years) meeting research criteria for severe health anxiety. After diagnostic assessment patients were block-randomised into ACT-G (ten 3-h sessions) (n=63) or a ten-month wait list (n=63). Main outcome measure Primary outcome was self-rated improvement in illness worry on the Whiteley-7 Index (WI) ten months after randomisation. Results Intention-to-treat analysis showed a mean improvement of 22.1 score points (95% CI 15.3 to 28.7, p<0.001) in ACT-G on the WI from baseline to ten months after randomisation and a mean change of 1.5 score points in the wait list (95% CI -4.3 to 7.3, p=0.607). The unadjusted mean difference of 21.3 score points (95% CI 12.6 to 30.0, p<0.001) between the groups at ten months were statistically significant and controlled effect sizes were large (Cohen’s d=0.89, 95% CI 0.5 to 1.3). The number needed to treat was 2.4 (95% CI 1.4 to 3.4, p<0.001). Conclusions ACT delivered in a group format seems feasible, acceptable and effective in treating severe health anxiety.

30. Validation of The Brief Multidimensional Student’s Life Satisfaction Scale (BMSLSS) for the Italian youth population
Primary Topic: Clinical Interventions and Interests
Subtopic: adolescents, life satisfaction, wellbeing
Valentina Carloni, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)Martina Romitelli, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Martina Romitelli, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

Gilda Picchio, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

The Brief Multidimensional Student’s Life Satisfaction Scale (BMSLSS) is a 5 items self-report measure created to survey children and adolescents’ satisfaction towards five areas of life considered most significant during youth develop: family life, friendships, school experiences, self, and then living environment. BMSLSS has been translated into Italian and submitted to a non-clinical sample of about 450 students ages 11 – 14. Adolescents with higher BMSLSS scores show significantly higher scores at mindfulness, defusion and subjective happiness measures, while adolescents with lower BMSLSS scores reveal higher scores at measures assessing cognitive dysfunctions and psychopathological symptoms. The psychometric characteristics of this version has been successfully analyzed, taking the shape of an appropriate measure of positive subjective well-being of italian youth.

31. Iraping the Reality Slap: A pilot trial
Primary Topic: Clinical Interventions and Interests
Subtopic: defusion, IRAP
Valeria Squatrito, Kore University, Enna (Italy)
Giovambattista Presti, Kore University, Enna (Italy)
Paolo Moderato, Iulm University, Milan (Italy)

Experiential avoidance refers to the unwillingness to contact particular private experiences (e.g., bodily sensations, emotions, thoughts, memories, and behavioral predispositions) and to take steps to alter the form or frequency of these events. In specific context patterns of avoidance bring individuals away from a valued path of living. Acceptance and Commitment Therapy’s based protocols work to increase psychological flexibility and healthy functioning while decreasing experiential avoidance. When faced with a discrepancy between what they have and what they want, verbally competent human beings may prove negative feelings such as anger and sadness and show pattern of experiential avoidance. Harris (2012) used the expression reality slap to describe this gap. To test the effect of a component of an ACT protocol after verbally reproducing a personal reality slap 10 university studebts were tested with IRAP before and after a defusion mindfulness exercise delivered via audio file. In addition explicit measures of avoidance, believability and discomfort were used before and after the same exercise. After listening to a passage of the Reality Slap (Harris, 2012) students were asked to write down, to rate the intensity of psychological suffering after reading it and to close in an envelop Effects of defusion in explicit and implicit measures were demonstrated in students who underwent the meditation exercise, but not in students who were busy in a distraction task. The small number of subjects limits the generalization of these data, but strengthens this model as a way to test the interaction of verbal repertoires and one component, namely defusion, of ACT protocols.

32. Ultra-brief defusion and acceptance interventions for chocolate craving taught by an inexperienced facilitator
Primary Topic: Clinical Interventions and Interests
Subtopic: Eating behaviour, brief interventions
Wendy Nicholls, PhD, University of Wolverhampton
Nick Hulbert-Williams PhD, University of Chester
Sian Williamson BSc, University of Chester
Jivone Poonia BSc, University of Wolverhampton
Lee Hulbert-Williams PhD, University of Chester

Introduction Food cravings are associated with higher body mass and poor outcome in weight loss programmes. To date, there has been a dearth of effective strategies for ameliorating the effects of food cravings. We report a trial of ultra-brief (15-minute) contextual behavioural interventions, supported by self-help leaflets, in association with a chocolate challenge. Method Sixty-three student participants (mean Body Mass Index = 24.7, SD=5.1) ranging in age from 18 to 47 (M=22.6, SD=6.4) were pseudo-randomised to groups and then briefly taught either an acceptance, defusion, or relaxation (control) technique. Participants were asked to carry a bag of chocolates for the subsequent week without eating them. Measures included a self-report diary, and the number of chocolates consumed during a rebound period at the end of the experiment. Results Planned contrasts suggest that the two intervention strategies were effective by comparison with a relaxation control, though this was not reflected in a self-report diary measure. Discussion Ultra-brief contextual interventions may have utility in helping clients deal with food cravings and can be taught by inexperienced facilitators, given proper support materials.

33. Potential efficacy of acceptance and commitment therapy for smoking cessation in the primary health care setting: Preliminary findings
Primary Topic: Clinical Interventions and Interests
Subtopic: Smoking cessation
Yim-wah MAK, School of Nursing, The Hong Kong Polytechnic University
AY Loke, Ph.D, School of Nursing, The Hong Kong Polytechnic University

Objective: The objective of this study is to report preliminary findings for a randomized controlled trial examining the feasibility and potential efficiency of an individual, telephone-delivered acceptance and commitment therapy among Chinese population. Design: A randomized, two-group design was chosen, with assessment at baseline (before intervention) and via telephone follow-ups at three, six, and twelve months. Subjects were proactively recruited from six primary healthcare centers. Eligible and consented participants were randomly assigned to either the intervention (ACT) or control group following the baseline assessment. Both groups received self-help materials on smoking cessation. Those in the ACT group were undergone an initial face-to-face session and two telephone ACT sessions at one week and one month following the first session, to be delivered by a counselor based on the acceptance and commitment treatment protocol. Results: Up till December 2014, participants in the intervention (n=77) and control (n=79) groups were similar in baseline characteristics. Preliminarily findings on the primary outcome on 7-day point prevalence at the 12-month follow-up the cessation rate for participants assigned to the intervention group (n=7, 9.09%), while not statistically significant that of the control group (n=9, 11.39%). Effects on secondary outcomes such as average daily cigarette consumption, stages of readiness to quit smoking, quit attempts and psychological flexibility are to be conducted. Discussion: The study will provide evidence about a program which is preventive and corrective, and carries brief messages by approaching and influencing services attendees of primary health care settings, who may not think of smoking cessation. This study is registered at ClinicalTrials.gov on 26 July 2012. Identifier number: NCT01652508

34. An Initial Research on the Role of Acceptance and Commitment Therapy in the Explanation of Fear of Failure in a Sample of College Students
Primary Topic: Educational settings
Subtopic: Fear of failure
Catherine Ethier, Université du Québec à Trois-Rivières
Joel Gagnon, Université du Québec à Trois-Rivières
Frédérick Dionne, PhD, Université du Québec à Trois-Rivières

In the recent years, there has been a growing interest in the application of ACT in college and university settings (Pistorello, 2013). Indeed, there are at least two randomized trials exploring the efficacy of ACT for math anxiety (Zettle, 2005) and for test anxiety problems (Brown et al., 2011). Furthermore, the association between experiential avoidance and anxiety has been established in several correlational studies (see Ruiz, 2010 for a review). However, very few studies have addressed the contribution of ACT’s core processes in the explanation of fear of failure. Thus, the aim of this study was to assess the contribution of three ACT processes, namely experiential avoidance (AAQ-II), cognitive fusion (CFQ), and mindfulness (MAAS), on a measure of fear of failure taken from a subscale of the Academic Procrastination State Inventory (APSI; Schouwenburg, 1992). A sample consisting of 282 students from the University of Quebec at Trois-Rivières completed the AAQ-II, CFQ, MAAS, and the APSI. A two-step hierarchical multiple regression analysis was performed. Gender was entered in the first step as a control variable. In the second step, in line with ACT theory, experiential avoidance, cognitive fusion, and mindfulness were added in the model. Results showed a statistically significant overall model F(4, 277) = 30.22, p < .05, accounting for 30 % of the total variance of fear of failure. At the individual level, experiential avoidance (β= 0.17, p < .05), and mindfulness (β= -0.32, p < .05) were both significant predictors of fear of failure. Treatment implications and future directions will be discussed.

35. An Investigation of Peers, Delinquency, and Psychological Flexibility in Undergraduate Students
Primary Topic: Educational settings
Subtopic: College Students
Jennifer Lackey, M.A., Bowling Green State University
Sindhia Swaminathan, B.S., Bowling Green State University
Carolyn Joyce Tompsett, Ph.D., Bowling Green State University

General components of Acceptance and Commitment Therapy (ACT), such as experiential avoidance, acceptance, and values, have been shown to be related to several outcomes in college student populations (Levin, 2013; Scent, & Boes, 2014). This study seeks to examine the role of the broad ACT concept of psychological inflexibility in relation to several college undergraduate outcome measures including undergraduates’ self-reported delinquency, their perceptions of peers’ delinquency, substance use, depression, and anxiety. We expect to find that students scoring high on a measure of psychological inflexibility (cite for measure here) will report a number of associated negative outcomes, including greater rates of problem behaviors, association with more deviant peers, more substance use, and higher levels of depressive and anxious symptoms. Currently online surveys have been collected with N = XXX students at a large, Midwestern university, and data collection is ongoing. Additionally, exploratory analyses will be run on psychological inflexibility and demographic variables to determine if further noteworthy differences exist between groups. Results will be presented and discussed in the context of informing university level awareness and intervention programs regarding the utility of addressing psychological flexibility among incoming students.

36. Experiential Avoidance, Empathy and Anger Attitudes In Antisocial Personality Disorder
Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Antisocial Personality Disorder, psychological flexibility
K. Fatih Yavuz, M.D., Bakirkoy Research and Training Hospital for Psychiatry and Neurology, Istanbul, Turkey
Sevinc Ulusoy, M.D., Elazig State Hospital for Mental Health and Disorders, Elazig, Turkey
Oktay Sahin, M.D., Bakirkoy Research and Training Hospital for Psychiatry and Neurology, Istanbul, Turkey
Okan Ufuk Ipek, Bakirkoy Research and Training Hospital for Psychiatry and Neurology, Istanbul, Turkey

Background: Antisocial personality disorder (ASPD) is characterized by a long-standing pattern of a disregard for other people’s rights, often crossing the line and violating those rights. There are many theories about the psychopathologic background of dysfunctional behaviors that accompanies ASPD like anatomical differences, lack of empathy, temperament , difficulty in physiological arousal and schemas with themes of worthlessness and unlovability. ACT approach, based on functional contextualism, can be a useful model to explain ASPD by evaulating behavior comprehensively. The aim of this study is to research correlation of psychological flexibility and empathy levels with social functionality and anger patterns of individuals with ASPD and compare them with control group. Method: The study consists of 34 male literate voluntary individual with ASPD who received treatment in Bakirkoy Research and Training Hospital for Psychiatry and Neurology and 32 male literate voluntary individual without any psychiatric disorder. Socio-demographic data form, Interpersonal reactivity index (IRI), Acceptance and action questionnaire-II (AAQ-II), The State-Trait Anger Expression Scale(STAXI), Social functioning scale (SFS) were administered to participants. Results: Chi-square test was used to compare sociodemographic factors; suicidal behavior, domestic violence, immigration in childhood rates were higher than control group (p<0,001). With Mann Whitney U test the findings showed that ‘Trait anger’, ‘anger expression-out’, ‘anger expression-in’ total scores were significantly higher in ASPD group than the control group (P<0,01), while there was no significant difference at ‘anger control’ subscale total scores (p>0.05). Also AAQ-II total scores were found significantly higher in ASPD group,too. Independed T-test was used to compare IRI scores in empathy related analysis. ‘Perspective taking’ subscale total scores were significanty lower while ‘fantasy’ subscale total scores were higher in ASPD group and no significant statistical difference was found in ‘Empathic Concern’ and ‘Personal Distress’ subscale scores. In the analysis of SFS ‘Social withdrawal’ subscale total scores were found significantly higher and ‘prosocial activities’ were lower in ASPD group. Discussion: Individuals with ASPD meet physical and emotional stressors like immigration, violence that can be resource of disfunctional behaviors in the developmental period more than others. Higher scores at trait anger, ‘anger expression-out’, ‘anger expression-in’ may indicate experiential avoidance. Supression attempts or outpouring of anger can be related with not accepting anger as normal and rules about necessity to reduce it. Another finding of our study is lower scores of ‘Perspective taking(PT)’ in ASPD group. PT skill is one of the six core processes of psychological flexibility model of ACT that emphasizes awareness of both private events and external stimuluses and observing them as they are. This finding indicates that individuals with ASPD have weak perspektif taking attitudes for present situations by putting themselves in anothers’ place. We found that ‘fantasy’ subscale of IRI and AAQ-II total scores were higher in ASPD group. This shows that individuals with ASPD are unwilling to experience private events, so try to control or escape from them and they use daydreaming(fantasy) as a cognitive avoidance method. In conclusion lack of perspective taking and experiential avoidance can be evaluated as two important dimensions in the development of ASPD.

37. Coping with somatic symptom disorders: The impact on quality of life and the moderating role of psychological flexibility
Primary Topic: Other
Subtopic: Somatic Symptom Disorders
Chrysanthi Leonidou, M.Sc., University of Cyprus
Georgia Panayiotou, Ph.D., University of Cyprus
Maria Karekla, Ph.D., University of Cyprus
Aspa Bati, B.A., University of Cyprus

Background. Clinical levels of somatic symptom disorders influence individuals’ functioning in the psychological, social, professional and other domains, and account for frequent medical visits and excessive healthcare costs. The present study aims to investigate the impact of somatic symptom and illness anxiety disorders on quality of life, potential differences on coping strategies utilized by individuals who meet the criteria for the two diagnoses and the role of psychological flexibility. Method. 295 community volunteers (182 females; Mage=44.84, SD=1.17) were recruited through stratified random sampling for the purposes of a larger epidemiological study in Cyprus and completed a set of questionnaires, including Greek versions of Psychiatric Diagnostic Screening Questionnaire, Acceptance and Action Questionnaire, Brief COPE, and World Health Organization’s Quality of Life instrument. Results. Multivariate analyses of covariance indicate that controlling for the severity of medical conditions, groups meeting somatic symptom disorders screening criteria report reduced quality of life on the physical, psychological and environmental domains, compared to the typical group. In addition, groups meeting screening criteria report more avoidant coping strategies, and lower psychological flexibility, which also significantly moderates the impact of somatic symptom disorders on specific domains of quality of life. Discussion. These findings extend existing evidence on the role of psychological flexibility as a buffering factor between psychopathology and quality of life for another population, individuals with somatic symptom disorders, and provide guidance for the development of prevention and therapeutic interventions.

38. The Impact of Acceptance vs Suppression During an ROTC Army Physical Fitness Test
Primary Topic: Performance-enhancing interventions
Subtopic: Performance and Sports Psychology
Stephen Sheets, MA, California School of Professional Psychology
Jill Stoddard, Ph.D, California School of Professional Psychology

Background: In performance and sports psychology, Psychological Skills Training (PST), which involves suppression and control strategies including arousal control, goal setting, self-talk, and imagery/visualization, has dominated the focus of research and practice for the last 30 years (Singer et al., 1991). Despite its use as the primary methodology for performance and sports psychologists, the efficacy of PST has been found to be at best experimental (Gardner & Moore, 2009). Growing research is investigating the application of Mindfulness and Acceptance-based Therapies to sports performance on the field of play (Gardner & Moore, 2006). However, little is understood about the underlying mechanisms of performance. Furthermore, despite the emphasis the military places on performance, little research has been conducted with military populations and the role of performance enhancement techniques. Method: 95 ROTC cadets from three San Diego Universities participated in an experimental study to determine the effects of emotion regulation on physical performance. Utilizing a 2 X 2 factor design, participants were randomized to either an acceptance or suppression emotion regulation condition. Dependent variables included scores on the Army Physical Fitness Test (APFT), the Activity Flow State Scale (AFSS; Payne, et. al. 2011), and participants’ subjective self-ratings of performance. It was hypothesized that participants in the acceptance group would demonstrate greater improvements in performance over time following the intervention. Analyses included a Repeated-measures Multivariate Analysis of Variance (MANOVA) to assess for main effects and interactions. Results: Results indicated three significant interactions. First, the participants’ APFT scores has a significant interaction of F(1, 93)=4.278, p=.041. Second, the participants’ subjective rate of performance has a significant interaction of F(1, 93)=4.138, p=.045. Finally, the participants’ push-up scores has a significant interaction of F(1,93)=6.073, p=.061. Further detail can be provided as to the specifics of these interactions through post-hoc tests. Discussion: The results are consistent with previous research suggesting acceptance based emotion regulation strategies may provide advantages over suppression techniques across a number of domains (e.g., pain tolerance, distress about pain, mobility, emotional recovery). Results from this study may have implications for improved sport and military performance.

39. Combining mindfulness and ACT to learn how to manage emotions and to engage in valued activities: Assessment of the feasibility of a training group and its efficiency
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Acceptance and commitment therapy
Aurélie Wagener, M.A., University of Liège
Christophe Dierickx, M.A., University of Liege
Sylvie Blairy, Ph.D., University of Liege

BACKGROUND Managing painful emotions could be an issue for a lot of adults. Indeed, learning how to manage painful emotions is an often-requested demand in psychotherapy. Mindfulness-based programs and acceptance and commitment therapy (ACT) offer useful tools which aim to guide in this learning process. ACT also provide guidelines to engage in valued activities. In order to help community adults to manage their painful emotions and to engage themselves in valued activities, we offer training group cycles combining tools of mindfulness-based programs and ACT. This study aims to assess the feasibility of such training groups and their efficiency. METHODS A longitudinal design with three assessment-times (T0, T1 and T2) is employed. Participants to the training group attend to three three-hours training sessions on a six-weeks period. They are assessed before the training sessions (T0), directly after (T1) and at three-months follow-up (T2). Questionnaires assess these variables: sociodemographic data, mood, mindfulness, psychological flexibility, cognitive coping strategies and behavioural activation. Student t tests for paired samples are conducted. RESULTS Fifty-four adults participated to four training cycles (the cycles are all identical). Until now, 28 participants (21 women) completed the T0 and the T1 (mean age = 41.43, SD = 11.83). Student t test indicate a significant decrease of depression (t(25) = 4.53, p < 0,001), anxiety (t(25) = 6.23, p < 0.001) and non-adaptive cognitive coping strategies (t(24) = 3.76, p < 0.001). Student t test also indicate a significant increase in mindfulness (t(26) = -3.87, p < 0.001), psychological flexibility (t(26)) = -5.48, p < 0.001) and behavioural activation (t(26) = -4.86, p < 0.001). DISCUSSION Preliminary results indicate the feasibility of training groups combining tools of mindfulness-based programs and ACT. Results show a decrease in several variables (depression, anxiety and non-adaptive cognitive coping strategies) and an increase in other variables (mindfulness, psychological flexibility and behavioural activation). These results seem to indicate that participants benefit from the training groups. Data collection is still ongoing and a control group (waiting-list) is currently being composed. Results and clinical implications will be further discussed during the congress.

40. Promoting the effectiveness of teachers’ group work in Italian Secondary Schools: The assessment of psychological flexibility as preliminary phase for intervention
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Groups
Elena Catenacci, IESCUM
Giovanna Fungi, IESCUM
Francesca Pergolizzi, IESCUM

Effective teachers’ teamwork is considered to play a crucial role within school improvement strategies intended as prevention and community based interventions. In this poster we describe the assessment phase of a project aimed at exploring and enhancing psychological flexibility in teams of teachers (Consigli di Classe – CC) of Italian Secondary schools, referring to an ACT based approach which can help groups take the committed actions needed to achieve common goals (Hayes, Barnes-Holmes, Wilson, 2012). This phase is to be seen in the light of Nudge Theory (Hausman, Welch, 2010): positive reinforcement and indirect suggestions are used to achieve non-forced compliance and to influence the decision making process of groups. To assess the group’s awareness of its values and the committed actions implemented by the group itself, each teacher received via email a presentation of the project, an anagraphic questionnaire, the Perceived Stress Scale (Cohen, 1994), the Psychological Flexibility Survey and the Rating by group members of the core and auxiliary design principles (Biglan, Ciarrochi, Hayes, Miller, Polk, Wilson, 2014). Collected data will be presented and discussed in the poster. The following step will involve some CCs in an intervention to increment the level of the group’s psychological flexibility.

41. Mindfulness-based training and ACT in a palliative care setting
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Palliative Care, Mindfulness, Health Psychology, ACT
Elisa Rabitti, Ph.D, ACT-Italia, AUSL RE, IESCUM
Anna MAria Marzi, Hospice Madonna Uliveto (RE)

Background: The contact with difficult emotions is a main point in palliative care’s settings, and frequently the challenge of the staff is “how to stay with" the patient's experience. Remain for a long period in a context that requires the ability to interface with extremely heavy situations from emotional point of view could expose the nursing staff to the risk of burn-out. In order to increase the emotional resources of the professionals involved in the context of the Hospice, we proposed an experiential training based on the integration of ACT and experience of Mindfulness. Method: The training was structured into three sessions of three hours each and participants were doctors, nurses and medical social workers. In order to measure the effect of the intervention on participants we used the AAQ-II. Result: AAQ-II's scores reported by 26 participants showed an increasing in psychological flexibility and acceptance of difficult emotions.

42. Radio show: "The Voice of Madness Live on Air"
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Destigmatisation, social affirmation
Mario Maricic, BA of Psychology, NGO "Metanoia"

Radio show: "The Voice of Madness Live on Air" (originaly „Glas ludila u Eteru“) is genuine and sustainable project of the NGO „Metanoia“, Association for destigmatisation and social affirmation of persons with psycho – social difficulties. It aims to encourage social inclusion and equality of persons with psychosocial difficulties. The radio show was modeled from the similiar project created in Buenos Aires (Radio la Colifata) and Barcelona (Radio Nikosia). Project in Western Balkans first started in Zagreb in 2010. After that, in Sarajevo and Banjaluka (2013), and in Belgrade (2014). Project is decentralised, and is governed by the people in their own local comunities, so the four cities have different management and their unique dynamics. It is supported by local radio stations. The project is solely based on the voluntary work of the members of the "Metanoia" (Sarajevo), students of Psychology (Banjaluka) and it wasn`t funded not from foreign or from local donors. In Banjaluka it started from pure entusiasm. Radio show is completely created, managed and runned by persons who had experience as patients in the psychiatric system and whose experience is labeled by at least one of the psychiatric diagnosis. Radio as medium is selected because it can provide protection of the identity for the persons who are involved in running the show. One of the goals of the radio show is to create context in which ones with the experience from the psychiatric system can express themselves in their own unique way. Context in which they can share their unique stories, talents, hopes, fears and etc., without sanctions. Also, it provides context in which is supported conversation about problems in mental health comunity, psychiatric disorders, diagnosis and stigmatisation. Often, guests are publicly relevant and recognised persons, such as actors, musicians, poets, psychologists, psychiatrists, who share their own toughts about their own suffering, their own "madness" and etc. Experience so far (Banjaluka) showed that listeners and guests who are following the radio show, changing their views, when it`s about psychological difficulties. Public figures who were guests and are interviewed by someone with diagnosis, without exception talked about positive experience and about breaking their prejudices regarding people who were diagnosed as schizophrenics. Example (from Banjaluka), which describes impact of being involved in these kind of activities in real life is example of one of our participants who were diagnosed with schizophrenia, bipolar personality disorder, OCD and etc. in the period of working on the radio show, not once was returned into psychiatry hospital. Before that period, she was in psychiatry as inpatient at least 2 times a year. Today, she is 2nd year journalist student.

43. The Implicit Relational Assessment Procedure: a promising method to measure Implicit Attitudes toward Auditory Verbal Hallucinations
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Mirte Mellon, MSc., Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray
Annemieke Hendriks, MSc., Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray
Ciara McEnteggart, National University of Ireland, Maynooth
Linde van Dongen, MSc., Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray
Gwenny Janssen, Ph.D., Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray
Yvonne Barnes-Holmes, National University of Ireland, Maynooth
Prof. dr. Jos Egger, Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray

Background: The Implicit Relational Assessment Procedure (IRAP) is a relatively new method for measuring implicit attitudes. The current study examined the utility of the IRAP to point out differences in implicit attitudes toward Auditory Verbal Hallucinations (AVHs) between psychotic patients and non-clinical voice hearers. Method: Two IRAPs—one concerning emotional valence and one concerning perceived controllability of AVHs—were completed by psychotic patients and non-clinical voice hearers. The IRAPs required participants to sometimes respond to statements in a way that was consistent with their beliefs and sometimes in a way that was inconsistent with their beliefs. Results: The results showed no significant group differences in IRAP effects (i.e., response latency differentials between consistent and inconsistent trials). However, a trend was found for non-clinical voice hearers to be more accepting (as opposed to controlling) toward their voices than psychotic patients. No correlations were found between the IRAP and corresponding self-report measures. Discussion: These findings provide preliminary indications for the utility of the IRAP to point out differences in implicit attitudes between the groups. Additionally, the fact that no correlations were found between the IRAP and corresponding self-report measures suggests that the IRAP may have potential to usefully complement self-report measures. Further research on the IRAP regarding voice-related attitudes is recommended, as this may contribute to a more profound understanding and assessment of AVHs in the future.

44. Comparision between experimentally and pre-experimentally established attitudes measured with the Implicit Relational Assessment Procedure (IRAP)
Primary Topic: Relational Frame Theory
Subtopic: IRAP, Basic Research
Pablo J. L. Zaldivar, Universidad de Almeria
Magdalena Hyla, Uniwersytet Śląski w Katowicach (University of Silesia)
Lidia Budziszewska, Universidad de Almeria

In order to develop experimental analogs of concrete situations, behavioural researchers frequently generate experimentally the function of stimuli. This also applies to the IRAP research. Despite that, there is no experimental evidence analysing how to compare between experimentally or pre-experimentally induced attitudes, either within IRAP research or within behavioural research in general. Native Polish or Spanish speakers without previous IRAP training or any knowledge of the unknown language (Polish for Spanish participants and Spanish for Polish ones) were randomly assigned to one of two conditions: pre-experimental or experimental attitudes training. Participants who were assigned to the experimental attitude condition were trained to respond using the unknown language (Spanish or Polish) and then were tested with an IRAP about the relations they learned, whereas participants assigned to the pre-experimental attitudes condition were trained to respond in their native language and then tested with an IRAP about the relations they already knew. Results are discussed in accordance with hypotheses: because of a lower amount of received reinforcement, 1) experimentally induced attitudes will produce a lower IRAP effect than the pre-experimentally induced attitudes and 2) D-IRAP scores of the experimental attitudes induction condition will decrease sooner and more significantly than the pre-experimental ones.

45. Pragmatism, contextualism and the radical behaviorist perspective about science
Primary Topic: Theoretical and philosophical foundations
Subtopic: Radical behaviorism
Cesar Antonio Alves da Rocha, Federal University of Sao Carlos

Radical behaviorist philosophy, and the science of behavior analysis, are said to be inspired by the philosophy of pragmatism. Some authors have argued that the world view of such a science is contextualism, according to the work of Stephen Pepper, who asserted that contextualism is a theory about the world derived from classic pragmatism. Besides this, some have argued that contemporary pragmatism, such as the perspective developed by Richard Rorty, also shares common traits with behavior analysis. But the issue is far from being consensual: some have argued that mechanism is the more appropriate world view for characterizing behavior analysis, pointing out that contextualism would not be productive. Given this dissent, the proposal of this presentation is to compare and discuss the radical behaviorist perspective about science and pragmatist remarks about science, with the goal of clarifying relations established between pragmatism, contextualism and radical behaviorism.

46. Developing a new behavioral task for measuring defusion in depressed people: Comparing performance on the Kanji maze task and IRAP
Primary Topic: Theoretical and philosophical foundations
Subtopic: defusion rumination rigidity IRAP
Yuki Shigemoto, Graduate school of psychology Doshisha University
Muto Takashi, Faculty of psychology Doshisha University

Background: The purpose of this study is to develop a new behavior task to measure defusion in depressed people. While the IRAP (Implicit Relational Assessment Procedure) is a useful tool for measuring defusion, it is difficult to implement in clinical interview, as, it takes a long time to complete. Thus, this study developed a new behavioral task ―the Kanji-maze task to measure defusion and investigated its validity. An alphabet-maze was referred to when developing the Kanji-maze task. An alphabet-maze is a maze that consists of letters in the alphabet. The purpose of the task is to move from the upper right corner of the maze to the lower left corner, spelling out English words on the way. Participants were told to use the shortest solution to reach the end. Initial mazes were solvable by the same route, but in later mazes, it was possible to solve using an additional much shorter route without warning. In this study, a Japanese version of the task consisting of Chinese characters (Kanji) was developed and administered. Method : Participants completed the Ruminative Response Scale, Cognitive Fusion questionnaire, and Beck Depression Inventor—II and performed the IRAP and Kanji-maze task. Result and discussion: Correlation was found between the IRAP and Kanji-maze task and among the Kanji-maze task and questionnaires. These results indicated that the Kanji-maze task is a useful tool for measuring defusion.

47. Using Implicit Measures to predict known groups: An IRAP v IAT comparison
Primary Topic: Other
Subtopic: IRAP
Aidan Hart, D.Clinpsy, University of Lincoln, UK
Ross Bartels, Ph.D, University of Lincoln, UK

Recent years have seen an increase in the use of implicit measures to assess hard to access beliefs/covert behaviour processes. In the field of Forensic Clinical Psychology there has been a growing interest in the use of such measures to assess group differences in offence supportive attitudes between offenders and non-offenders. Such uses can be problematic due to potential overlaps in the groups, such as shared pro-offending attitudes or undetected delinquency in the control group. The current authors believe that more work is needed to demonstrate that such measures can actually differentiate between groups where we would expect minimal overlap before their use is extended to such applied settings. In order to carry out such a test 183 self-identifying heterosexuals (m=91, f= 92) completed both an IRAP and an IAT that broadly measured their attitudes to the opposite and same sex in terms of sexual attractiveness and unattractiveness. The ability of each measure to differentiate the groups (male v female) was analysed using logistic regression and discriminative function analysis. The differences between the two measures and their relative strengths and weaknesses are discussed.