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 Fred at acbsstaff@contextualscience.org.

Location: Grand Ballroom

Thursday, June 16, 2016, 7:00-8:00pm - Poster Session #1 

Thursday, June 16, 2016, 8:00-9:00pm - Poster Session #2

Image denotes ACBS Junior Investigator Poster Award Recipients

Thursday, June 16, 7:00-8:00pm - Poster Session #1

1. Weight-related psychological inflexibility among Hispanic college students: Initial validation of the Acceptance and Action Questionnaire for Weight-related Difficulties
Primary Topic: Behavioral medicine
Subtopic: Weight
Karley K. James, Metropolitan State University of Denver
Maureen K. Flynn, Ph.D., Metropolitan State University of Denver
Olga Berkout, Ph.D., Western Psychiatric Institute & Clinic
Solomon Kurz, M.A., University of Mississippi

There is a growing amount of evidence suggesting that psychological inflexibility influences a variety of psychological difficulties, including obesity, disordered eating, and life satisfaction. The Acceptance and Action Questionnaire for Weight-Related Difficulties (AAQ-W) is a measure psychological flexibility for weight-related issues specifically. Previous studies have shown that the AAQ-W is psychometrically sound and has mediated treatment outcomes. Weight-related flexibility has yet to be studied using in Hispanic populations. The purpose of the current study was to examine weight-related flexibility and the psychometrics of the AAQ-W in a Hispanic sample. Hispanic undergraduate students (n = 313) from a university on the Texas/Mexico border completed a battery of web-based assessments. Weight-related inflexibility was significantly associated with greater levels of disordered eating and general psychological inflexibility, and lower levels of mindfulness and obesity-related life satisfaction. Weight-related psychological inflexibility also added to the prediction of disordered eating and obesity-related wellbeing above and beyond BMI, general psychological inflexibility, and mindfulness. This study provides initial support for the validity of the AAQ-W in a Hispanic college student sample.

2. Is pain acceptance a good indicator for differential response to various rehabilitation packages?
Primary Topic: Behavioral medicine
Subtopic: Chronic pain, Interprofessional rehabilitation, Assessment & Prediction, comparison between ACT and CBT
Linn Wifstrand, MD, University of Gothenburg
Graciela Rovner, Ph.D., 3Division of Rehabilitation Medicine, Section for Highly Specialized Pain Rehabilitation, Department of Clinical Sciences, Dande
David Gillanders, Ph.D., University of Edinburgh, School of Health in Social Science, Edinburgh, United Kingdom

Introduction: Behavioral medicine and inter-professional rehabilitation is considered as the state of the art in the area of chronic pain. Rehabilitation programs based on Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) are known to have strong evidence. What is not known is which patient benefits of what kind of rehabilitation program. One way to explore differences in patients’ response to rehabilitation is to stratify and group them according to their behaviors in order to identify common rehabilitation needs. How patients relate to, and accept their pain can potentially be a useful and pragmatic indicator, according to prior studies. Aim: To investigate patients’ differential response to ACT respectively CBT-based pain rehabilitation programs and to explore the usefulness of clustering patients according to their pain acceptance. Method: This study includes 391 patients who underwent ACT or CBT based rehabilitation at Danderyd’s Rehabilitation Clinic in Sweden. Measures of physical, mental and social function were gathered. Patients were grouped into four clusters based on their pain acceptance scores measured through the Chronic Pain Acceptance Questionnaire- 8 items. Baseline differences between ACT and CBT groups were analyzed with independent t-tests and chi-square tests while the differences between the four clusters were explored with a one-way ANOVA. To compare patients’ response to rehabilitation t-tests and mixed between-within-subjects ANOVAs were performed. Results: Patients in the ACT group mainly suffered from widespread pain while the patients in the CBT group mainly had local pain (neck- and/or back). Both groups improved during rehabilitation, but only the ACT group improved regarding physical function. When clustering patients according to their pain acceptance, each cluster became homogenous regarding the patients’ status and distinct differences were found between clusters. Differential response to treatment could be identified: cluster including patients that had lower functional level and quality of life before rehabilitation, got best results from the ACT program. Overall, the group that underwent CBT decreased their kinesiophobia, but only the group that underwent ACT showed an increase of physical function. Conclusion: This study provides further support for the usefulness of clustering patients according to their pain acceptance. Results from this study suggest that patients with the lowest quality of life, highest pain and lowest function benefit more from rehabilitation with ACT than CBT. Results also suggest that ACT better targets and improves patients’ physical function compared to CBT, which in this study only induced cognitive changes regarding patients fear of movement and failed to improve their actual physical function. These preliminary results would need to be replicated with randomized controlled trials in order to be conclusive. Key word: Pain acceptance, Acceptance and Commitment Therapy, Cognitive Behavioral Therapy, rehabilitation, chronic pain The study was granted ethical clearance by the Regional Ethics Board in Gothenburg (approval number 815-12).

3. Using Acceptance and Commitment Therapy to Treat Chronic Pain
Primary Topic: Behavioral medicine
Subtopic: Cognitive defusion, self as context versus self as concept, acceptance
Ryan Tolman, MSW, LICASW, Northwest Nazarene University

Chronic pain persists for more than three months with no known way to resolve, often without physical explanation. This author sought a practical behavioral medicine tool to treat chronic pain which patients and practitioners can easily understand. Acceptance and Commitment Therapy (ACT) provides a theoretical framework of elegant simplicity which can be used with great depth by the medical or mental health practitioner yet is easy for non-professionals to understand. This author reviewed over 40 peer-reviewed journal articles related to ACT and psychological treatment of chronic pain. The literature indicates that ACT is a very hopeful treatment to alleviate suffering for chronic pain patients. Treatment as usual, including opioid painkillers and surgery, can include psychological treatment if doctors, psychologists, therapists, and other care providers have a framework (such as ACT) to guide treatment. The following themes emerged from the literature review: Using "acceptance" in therapy is indicated more effective than mindfulness to treat chronic pain; valued living (doing what matters) is an important facet to managing chronic pain; there was a wide variety of ACT consistent therapy used in research, from group therapy to workbooks to online training, and still be delivered in a manner consistent with ACT adherent theory. This author will present different ways ACT can be used for practitioners and patients towards the alleviation of suffering. Research seemed to indicate that cognitive defusion (seeing one's self in context, not as a rigid concept, such as "I'm always in pain, I can't move") combined with acceptance training is likely to be effective in treatment. The poster will have three themes. The first theme defines chronic pain and the biology/psychology of pain and how the initial signal of pain passes through neuro pathways to the brain. The second theme relates the ACT Triflex to the treatment of chronic pain. The third theme presents what this author discovered through a literature review of ACT treatment of chronic pain (i.e. results of research, ways to use ACT to treat chronic pain.) This author recognizes that the psychological treatment of chronic pain can evoke shame from the chronic pain sufferer, i.e. "You think this is all in my head!!!" This author and current researchers promote the patient following all treatment as usual and using psychological treatment as an adjunct therapy to reduce suffering and increase the patient's ability to "do what matters" to them. During this author's research, everyone who was part of the process either experienced or knew someone who experienced chronic pain. The subject matter written by this author was well received by those with chronic pain in their life, and the poster presentation will reflect empathy for chronic pain sufferers and the practitioners who may be frustrated by challenges in chronic pain treatment.

4. Coping Styles of Patients Hospitalized in an Intermediate Trauma Unit
Primary Topic: Behavioral medicine
Subtopic: Traumatic Injury
Ana C. Sala, PsyD, University of Puerto Rico, School of Health Professions and School of Medicine
Karen Martínez, MD, University of Puerto Rico, School of Medicine
Lydia Temoshok, PhD, University of Maryland
Milagros Figueroa, RN, PhD, University of Puerto Rico, School of Nursing
Omar Rodríguez, PhD, University of Puerto Rico, School of Medicine
Giselle Alicea, MA, University of Puerto Rico, School of Medicine
Lourdes Guerrios, MD, University of Puerto Rico, School of Medicine
Pablo Rodríguez, MD, FACS, FCCM, FACP, FCCP, University of Puerto Rico, School of Medicine

Background: Injury occurs in a social context. Therefore, both physical and environmental elements should be taken into account when predicting and improving patient outcomes post-injury. Patients who suffer from traumatic injuries may also experience psychological distress and there is abundant literature documenting the psychological sequelae of an unexpected injury. The physical and mental changes that a person experiences as a result of an external stressor such as a traumatic injury, may affect a patient’s coping repertoire. Effective coping, such as active and adaptive coping, involves selecting thoughts or behaviors that address the problem and decrease stress and have shown to promote healing. Ineffective coping, such as anxiety, depression, hostility and avoidant behavior, on the other hand, can negatively influence the course of injury. Although research suggests that when coping patterns and contexts are taken into account predictions of health outcomes are more accurate, there is very little research on coping styles of patients hospitalized in trauma units after unexpected injuries. This study aims to describe the coping styles of a group of patients hospitalized in our local trauma unit and their relation to patient personal and clinical characteristics in attempts to develop culturally adapted interventions that promote adaptive coping. Methods: Forty-three trauma patients (41.9% female, 58.1% male; mean age of 39.49) were recruited during their hospital stay to assess their coping styles by using vignettes that exemplify adaptive, active, avoidant, Type A & Type C coping. Median scores of each vignette were calculated to determine the most frequently used coping styles. A semi-structured socio-demographic interview and medical record review was completed to obtain patient personal and clinical characteristics (i.e., age, gender, SES, length of hospital stay, mechanism of injury, physical and psychiatric comorbidities). The association between coping style and personal and clinical characteristics and their impact on coping style were established by calculating Spearman’s correlations. Results: Patients reported higher use of adaptive coping style (median=9.0) in which they selected particular thoughts and behaviors to decrease stress, followed by active coping (median=7.0) in which they reported seeking information to take control of their situation. There were no significant correlations between patient personal characteristics and coping style. However, increased length of stay was associated with increased use of Type A coping (r=0.310; p=0.043) which is characterized by a tendency to react with a hostile edge, impatient or critical of others. Discussion: Although most of our subjects used adaptive coping skills to deal with the trauma, our findings highlight the need to develop novel, culturally appropriate interventions to sustain adaptive skills in patients with prolonged hospital stay. Acceptance and commitment therapy (ACT), which focuses on diminishing experiential avoidance, through acceptance and valued based living, has proven to be effective with multiple health-related problems including emergency care. Effective implementation of coping strategies in these more medically complicated cases may promote compliance with treatment, result in reduced recidivism and translate into lower costs for our healthcare system. “This presentation is supported by National Institute on Minority Health and Health Disparities of the National Institutes of Health Award No. R25MD007607. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.”

5. Attention bias in irritable bowel syndrome: Implications for acceptance and commitment therapy.
Primary Topic: Behavioral medicine
Subtopic: Irritable bowel syndrome, attention bias, modified stroop task, ACT
Masataka Ito, M.A., Graduate school of psychology, Doshisha University
Takashi Muto, Ph.D., Faculty of Psychology, Doshisha University

Study objective: The biopsychosocial model suggests that attention plays a role in the mechanism of irritable bowel syndrome (IBS). The present study examined selective attention to visceral stimuli in IBS and explores the relationship between Quality of Life, experiential avoidance, cognitive fusion, mindfulness, and indices of selective attention. Design: A between-subjects design was used to enable comparison between an IBS group and healthy controls in selective attention. Methods: Thirty-five undergraduates who scored above the clinical cutoff in the Irritable bowel syndrome severity index (IBS group) and 35 healthy undergraduates who scored below the clinical cutoff were recruited into the study. All participants attended a single testing session. They completed the Mixed-Modified Stroop task (using 4 word categories: neutral, IBS-related, negative, and positive). Both groups also filled out a set of psychological questionnaires (the SF-36, AAQ, CFQ, and FFMQ scales). Results: The results did not show selective attention in the IBS group (all p’s >.10). Selective attention in the IBS group showed no correlations with any measures (all p’s > .10). The IBS group showed higher scores in the AAQ and lower scores in the FFMQ factor than healthy controls. Conclusion: Contrary to the cognitive behavioral model of irritable bowel syndrome model, the IBS group showed no selective attention to IBS-related words and no correlations with any questionnaires. Although it is possible that IBS sufferers do not show selective attention to IBS-related words, we suggest using ACT for IBS.

6. Engage in ACTivity: Group therapy for chronic pain sufferers significantly improves engagement in life activities
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain
Lauren Baras, M.D., Medical University of South Carolina
Sharlene Wedin, PsyD, ABPP, Medical University of South Carolina

BACKGROUND: Individuals with chronic pain often find their lives narrowly defined by their illness and the pursuit of pain elimination. Frequently individuals neglect meaningful life activities, placing life “on hold” until total pain relief is achieved. Acceptance and commitment therapy focuses on accepting unpleasant experiences while increasing engagement in value-oriented life activities. METHODS: Seventeen female patients (mean age = 46 ± 13.52) experiencing nonmalignant chronic pain of more than 6 months duration participated in a six-week acceptance and commitment therapy (ACT) group. Participants were referred from surgical and medical subspecialties at the Medical University of South Carolina. Patients were assessed initially and upon completion of therapy using the Center for Epidemiologic Studies Short Depression Scale (CES-D 10), Chronic Pain Acceptance Questionnaire (CPAQ) and the Freiburg Mindfulness Inventory (FMI). RESULTS: Mean scores were calculated for each measure at session 1 and session 6. Subscales of Willingness and Engagement on the CPAQ were calculated separately. All scores showed changes in the expected direction as follows: CES-D (16.71±8.28; 15.76±7.40), FMI (34.88 ± 6.32; 36.76 ± 7.51), CPAQ-W (16.00 ±9.41; 19.24 ±8.77), and CPAQ-E (26.23 ±14.57; 31.06 ±12.90). Paired t-test analyses revealed a significant difference in the Engagement score from session 1 to session 6 (P = .037). CONCLUSION: These findings suggest that brief ACT group treatment is an effective means of increasing engagement in life activities as measured by the Chronic Pain Acceptance Questionnaire (CPAQ). Considering that attempts to eradicate chronic pain are often unsuccessful and that chronic pain sufferers frequently neglect day-to-day activities, ACT group therapy provides a means to transition from waiting for a life after chronic pain to engaging in a meaningful life with pain.

7. Does a Reduction of Distress Following Values Clarification Relate to EA?
Primary Topic: Clinical Interventions and Interests
Subtopic: Values and Experiential Avoidance
April R. Wentworth, B.S., San Jose State University
Jannet E. Lara, San Jose State University
Stephanie Lin, San Jose State University
Elain Yin, San Jose State University
Soultana Mboulkoura, San Jose State University
Polline Villalobo, San Jose State University
Kendra Fisher, San Jose State University
Jennifer Gregg, Ph.D, San Jose State University
Jessica Meyer, San Jose State University

ABSTRACT Background. It is unclear whether a reduction in distress in experimental preparations demonstrates an effective intervention or an increase in experiential avoidance during the experiment. While studies have demonstrated a reduction in distress and cortisol following a values intervention (Gregg, Namekata, Louie, & Chancellor-Freeland, 2014) the mechanism of distress reduction is unclear. Certainly behavioral outcome measures are a stronger demonstration of effective values interventions than a reduction in distress. The current study sought to elucidate this difference by examining both distress and a behavioral values measure in a laboratory preparation of social rejection. Method. Participants (N = 29) were given false negative, neutral, or positive social feedback following a social interaction with a fellow student, and then randomized to receive a brief values clarification intervention or not. Participants then gave subjective ratings of distress and also recorded a video message for the participant with whom they interacted as a behavioral measure. Results. Results demonstrate that participants who received the values clarification exercise actually reported increased distress, compared to control participants. Discussion. Values clarification in the middle of a complex social interaction may not proffer the same distress reduction seen in other laboratory stress paradigms.

8. How Does Experiential Avoidance Cloud Values Clarification Outcomes?
Primary Topic: Clinical Interventions and Interests
Subtopic: Experiential Avoidance, Values
Kendra Fisher, San Jose State University
Soultana Mboulkoura, San Jose State University
Amanda Stacy, San Jose State University
Polline Villalobo, San Jose State University
Jannet Lara, San Jose State University
Jessica Meyer, San Jose State University
Stephanie Lin, San Jose State University
April R. Wentworth, B.S., San Jose State University
Jennifer Gregg, Ph.D, San Jose State University

Background. The relationship between experiential avoidance (EA) and values is complex, with awareness of values eliciting more, rather than less, EA in some context. For example, when examining a values clarification task in a laboratory preparation, individuals high in EA may demonstrate lower emotional reactivity and distress due to avoidance, rather than lower experienced emotion. Methods. Participants (N = 29) were assessed on baseline levels of EA, and then put in an experimental preparation where they were given false negative, neutral, or positive social feedback following a social interaction with a fellow participant. Participants were then randomized to receive a brief values clarification exercise, and Profile of Mood States were administered throughout the experiment. Results. Results indicated an interesting interaction with EA and values clarification, with individuals reporting high EA demonstrating a significantly less distressed trajectory than individuals with low EA following the values clarification. Results are discussed in terms of intervention development. Discussion. While this study demonstrated a short-term relationship between distress and EA following values clarification, studies focusing on the long-term are needed to truly understand the role of clarifying values in experiential avoidant individuals.

9. Effect of values clarification on student’s academic procrastination
Primary Topic: Clinical Interventions and Interests
Subtopic: Procrastination
Oscar Alejandro Cordoba-Salgado, Fundacion Universitaria Konrad Lorenz
Marcela Porras-Melo, Fundacion Universitaria Konrad Lorenz
Diana Riaño-Hernández, Fundacion Universitaria Konrad Lorenz

The aim of this study was to identify the effectiveness of two brief Acceptance and Commitment Therapy (ACT) based protocols. Participants were 20 university students from Bogota, ranging between 18- and 34-years-old, who reported on academic procrastination. They were assessed weekly using the Academic Procrastination Scale (APS), Cognitive Fusion Questionnaire (CFQ), Action Acceptance Questionnaire-II (AAQ-II), Values Questionnaire (VQ), and reported daily using self-record cards to assess valued actions. Ten participants were randomly assigned to each condition. The first condition was focused on values clarification exclusively and the second condition on creative hopelessness, cognitive defusion and values clarification. A multiple baseline design across participants was used. Baselines were obtained during at least two weeks and then interventions were applied. Overlap and trend analysis were performed with each case along with size effect caculations for each intervention. Results showed no difference between the interventions' effect size although a reduction on applied measures was found. Implications regarding the effect of the condition isolating the values component are discussed

10. Gamified Web-based Acceptance and Commitment Therapy program for Benzodiazepine discontinuation: A Pilot Study for Randomised Controlled trial
Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use Disorders, ACT-Technology
Toshitaka Ii, Departmant of Psychiatry, Nagoya City Univrsity Graduate School of Medical Sciences
Sei Ogawa, Departmant of Psychiatry, Nagoya City Univrsity Graduate School of Medical Sciences
Masaki Kondo, Departmant of Psychiatry, Nagoya City Univrsity Graduate School of Medical Sciences
Keiko Ino, Departmant of Psychiatry, Nagoya City Univrsity Graduate School of Medical Sciences

【Back ground】 Benzodiazepine(BZ) has been used for many anxiety disorders. However, Long term BZ using causes dependence. Tapering and Cognitive Behavioral Therapy (CBT) have been widely used for BZ dependence but, providing tapering and CBT take a high cost. One of the solution to this problem is self-help interventions, but the effectiveness of self-help interventions is not enough compared with the wait list (odds rate 2.3 95% Cl 1.3 to 4.2) and more than 50% of participants dropped out of the study. For these reasons, highly effective and motivated self-help intervention is necessary for BZ dependence. Acceptance and Commitment Therapy (ACT) is one of the promising intervention for substance use disorder. Gamified web-based ACT program may be highly effective and motivated self-help intervention for BZ discontinuation. The aim of this study is to provide a preliminary examination for randomised controlled trial. 【Methods】 In this pilot study, we targeted a sample size of five patients ages 20 to 60 years who had been taking BZ for more than two months. Participants received six weeks gamified web-based program. This program was provided free on the internet. When participants type given URL, they can access the program with their personal computer or smart phone. The primary outcome is BZ discontinuation at two months. Depression and anxiety symptoms was measured with K6 and State-Treat Anxiety Inventory. Severity of dependence was measured with Severity of Dependence Scale. Process measurement for ACT such as Cognitive Fusion Questionnaire or Acceptance and Action Questionnaire-Ⅱ was measured. 【Result】 We have already finished developing gamified web-based ACT program for BZ discontinuation. We have also recruited participants for this study. However, the follow-up assessment has not been completed yet. Results and discussions will be presented by the ACBS World Conference.

11. Self as Context Intervention Versus Focused Breathing Intervention to Cope with Negative Thoughts
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Varsha Eswara Murthy, University College Dublin
Louise McHugh, Ph.D, University College Dublin

Intrusive negative thoughts are experienced by a large majority of the non-clinical population. These thoughts if intensified can lead to the precipitation of various psychopathologies. Avoidance or control strategies have been empirically proven to be an ineffective method of dealing with such thoughts, leading to the development and popularity of acceptance and mindfulness based interventions. Acceptance and Commitment Therapy’s main objective is to increase psychological flexibility, which can be facilitated through enhancing a sense of self that is decentred from one’s psychological content, known as self as context. A gap in the literature exists in highlighting how self-based mindfulness techniques can specifically enhance therapeutic outcomes, as they are normally combined with other processes such as cultivating present moment awareness. The present study aims to compare whether a self as context intervention, a verbal, self-based intervention is more effective than a somatic based mindfulness intervention for coping with a personally relevant negative thought. Participants were asked to identify a personally relevant negative thought and given either a self as context, focused breathing or control strategy to manage the negative thought over a five-day period. The self as context intervention involved the completion of the ‘observer you’ exercise daily, as well as utilising hierarchal metaphors in order to cope with the negative thought. The somatic based intervention group completed a focused breathing exercise daily, as well as being instructed to focus on their breath and bodily sensations when the negative thought occurs as a coping strategy. Daily questionnaires assessed the total frequency and level of willingness to have the thought. Also, 10 positive and negative self-statements were rated on the same scales, and self-report measures of mood, mindfulness and psychological flexibility were completed. Findings indicated that the self as context intervention lowered believability, increased comfort, increased willingness and decreased negative affect significantly more than than the focused breathing or control strategy. The focused breathing strategy also made significant gains in the same direction as the self as context strategy in comfort, willingness, believability and affect of the target negative thought, however, the control group did not. Similar trends were observed in the reduction of the frequency of negative thought occurrence and also in the effects the strategies had on the positive and negative self-statements. Levels of mindfulness increased in both intervention strategies with no group differences observed pre and post intervention, however, levels of mindfulness were maintained for the no instruction control group. Findings provide evidence for the efficacy of self-based mindfulness intervention as a superior strategy for managing negative intrusive thoughts over strategies that employ present moment awareness alone.

12. A Comparison between Cognitive Therapy and Acceptance and Commitment Therapy for dysmorphic concern in Iranian women seeking cosmetic rhinoplasty
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy
Milad khajepoor, Young Researcher and Elite Club, Roudehen Branch, Islamic Azad University, Roudehen, Iran
Zahra-sadat khoshcheshm, Young Researcher and Elite Club, Roudehen Branch, Islamic Azad University, Roudehen, Iran
Sajad bahrami, Young Researcher and Elite Club, Roudehen Branch, Islamic Azad University, Roudehen, Iran
Peyman Rezaiemaram, Department of Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
Sirous Momenzadeh, Queensland Health, Psychosis Academic Clinical Unit (Metro South Addiction &Mental Health Service), AUSTRALIA ، QLD
Parichehr Sharifi, Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Leipzig, Germany

Background: Iran has high rates of cosmetic rhinoplasty in the world. According to research findings, one of the most common complaints reported by rhioplasty applicants is dysmorphic concern—an intensive and/or irrational preoccupation with slight (or imagined) flaws in physical appearance. Dysmorphic concern can lead to the tendency to take various maladaptive control strategies, such as excessive and inflexible checking/camouflaging of perceived body defects, social avoidance, reassurance-seeking about appearance, and demanding cosmetic surgeries. Cognitive Therapy (CT) focuses on individuals adopting learned strategies to alter unhelpful thought patterns about their own body appearance. However, from an Acceptance and Commitment Therapy (ACT) perspective, the focus is on learning new skills to change the relations individuals have with their negative conceptualized self and to accept uncomfortable feelings involved. ACT views ‘psychological inflexibility’ as the root cause of people’s persisting behavior in seeking rhinoplasty. Functionally speaking, the primary goal of such behavior is to avoid unpleasant private experiences related to body appearance. These reactions may be reinforced by relatives and friends. In view of the different emphasis of CT and ACT, the aim of this study was to examine the effectiveness of CT and ACT in reducing dysmorphic concerns of Iranian women who were requesting rhinoplasty. Method: The research design included a randomized pretest-posttest control group. Forty-five women, aged 18-25 years who decided to undergo rhinoplasty, at three medical centers in Tehran participated in this study. They were assigned randomly into three groups (15 participants per group). The first group received eight-sessions of CT; the second group received eight-sessions of ACT; and the third group served as a waiting control. The participants of these three groups completed the Persian version of the Body Image Concern Inventory (BICI) before and after the completion of treatments. Finally, an analysis of covariance (ANCOVA) was undertaken to investigate the effectiveness of CBT and ACT on participants' dysmorphic concern. In the analysis, the pretreatment score entered as a covariate. Results: A post-hoc analysis indicated that although the BICI score was significantly reduced in both treatment groups compared with the control group, the ACT group showed more a significant reduction than the CT group. It should also be noted that one participant of the CT group and three participants of the ACT group withdrew from the study as they refrained from cosmetic surgery. discussion: In this study, The Iranian women undergoing rhinoplasty who attended an ACT based treatment reported less dimensions of dysmorphic concerns (i.e., excessive preoccupation of one's appearance, and avoidant and safety behaviors against one's perceived flaws ) than their counterparts who attended CT based treatments. It remains unknown the underlying reasons for the ACT group in this study showing more improvement in expressing their dysmorphic concerns than the CT group. It is also not clear if their expressed concerns will be translated into a long term and more accepting behavior, where people are able to live their life without seeking further medical advice on their physical appearance. In other terms, to compare long-term therapeutic effects of these two treatments, a follow-up assessment would be beneficial. It is worth inquiring about the mediating factors contributing to such outcome and comparing the processes mediating the effect of ACT and CT on Iranian women seeking cosmetic rhinoplasty.

13. Predictors of Depression and PTSD Treatment Response Among Veterans Participating in Mindfulness-Based Stress Reduction
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, PTSD, Depression
Benjamin Felleman, Ph.D., UC San Diego & VA San Diego Health Care System
David Kearney, M.D., University of Washington & VA Puget Sound Health Care System

Background: Posttraumatic stress disorder (PTSD) and depression are prevalent and often co-occur among veterans. There has been a growing interest in the effects of mindfulness-based interventions among veterans. This study examined PTSD and depression outcomes, and baseline predictors of response, among veterans who participated in Mindfulness-Based Stress Reduction (MBSR). Method: A retrospective analysis of 116 veterans with PTSD before and after MBSR. Multilevel modelling assessed baseline predictors of change in PTSD and depressive symptoms. Results: There were clinically significant reductions in PTSD and depression symptoms post-treatment and at 4-months follow-up. For PTSD, effect sizes were in the medium range post-treatment (d = -.63) and at follow-up (d = -.69), and for depression post-treatment (d = -.58) and at follow-up (d = -.70). Baseline PTSD was a significant predictor of slope (β = .03, p = .04) on PCL outcomes; higher baseline PTSD predicted greater rate of reduction in symptoms. For depression (β = .04, p < .01,), those with severe or moderately severe depression exhibited the greatest rate of improvement. However, veterans with high symptom severity did remain symptomatic post MBSR. Discussion: These findings show preliminary support for MBSR in facilitating symptom reduction for veterans with severe PTSD and co-occurring depression.

14. A comparison of brief cognitive intervention methods - cognitive defusion, cognitive restructuring and perspective taking - in coping with angry thoughts
Primary Topic: Clinical Interventions and Interests
Subtopic: Anger
Tracey McDonagh, M,Sc, University College Dublin
Louise McHugh, Ph.D.

Background: Anger has many adaptive functions but can also become dysfunctional; it can be disruptive to people’s lives and the pursuit of valued living. Despite this, anger has been under researched in comparison with other emotional disorders and there is no clear consensus on how it should be defined or treated. The current study aims to assess the relative effectiveness of cognitive restructuring, cognitive defusion and perspective taking techniques for coping with angry thoughts. Method: 80 participants from student and community populations will undergo mood induction in order to bring to mind autobiographical memories of a recent anger inducing inter-personal encounter. They will report on the state anger they experienced by completing the relevant questions from a STAXI inventory. Pre- and post-intervention participants will report (a) anger associated with the thought (measured by the state items of the STAXI inventory) (b) believability of the thoughts, (c) discomfort associated with the thoughts, and (d) willingness to experience the thoughts. The experiment will involve a mixed design with group (defusion, restructuring, perspective taking, control) as the between-subject factors and Time 1 (T1) and Time 2 (T2) measures as the within-subject factor. Results: This study is exploratory, aiming to assess the potential effectiveness of the aforementioned techniques for managing angry thoughts. However, it is expected, given findings suggesting that cognitive defusion was more effective in managing negative thoughts than cognitive restructuring (Larsson , Hooper, Osborne, Bennett and McHugh, 2015) that cognitive defusion may also be more effective for managing angry thoughts. It is postulated that all three of the techniques will be more effective than a no intervention control. Discussion: While cognitive restructuring is an established technique in the treatment of anger, recent research on negative thoughts has suggested that cognitive defusion lowers believability, increases comfort and willingness to have the target thought, and increases positive affect significantly more than a control and cognitive restructuring (Larsson et al, 2015). The current study hypothesises that these findings may generalise to negative thoughts generated by affective processes. Perspective taking is also hypothesised to also be an effective brief anger reduction technique. This study may have implications for anger management treatments, which could be useful in the reduction of aggression and criminal activity, with potentially important social implications.

15. Proposing a factor structure for the Diabetes Acceptance and Action Scale and examining relations with diabetes-related outcomes
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents with Diabetes
Tiffany M. Rybak, M.S., The University of Memphis
Kristoffer S. Berlin, Ph.D., The University of Memphis; The University of Tennessee Health Science Center
Gabrielle G. Banks, M.S., The University of Memphis
Kimberly L. Klages, B.S., The University of Memphis
Jeanelle S. Ali, M.S., The University of Memphis
Riply Wood, B.A., The University of Memphis
Ramin Alemzadeh, M.D., Le Bonheur Children's Hospital; The University of Tennessee Health Science Center
Robert J. Ferry, M.D., The University of Tennessee Health Science Center
Alicia Diaz-Thomas, M.D., Le Bonheur Children's Hospital; The University of Tennessee Health Science Center

BACKGROUND: Type-1 diabetes (T1D) is a burdensome and complex illness to manage during adolescence. Researchers have posited that psychological processes such as cognitive fusion and experiential avoidance lead to some of the difficulties with managing T1D. The Diabetes Acceptance and Action Scale is an unpublished measure developed by Greco and Hart (2005) that was developed to assess youth’s psychological flexibility with regard to having T1D. However the factor structure and validation of the DAAS has yet to been tested. The purpose of this study is to test a proposed factor structure and examine how it relates to diabetes-related outcomes, such as glycemic control, diabetes-related quality of life (QoL), adherence to medical regimen, and diabetes-specific conflict with caregivers. METHODS: Youth (N = 174) aged 12-18 (Mage = 14.63, SD = 1.68) with T1D and their caregivers completed the PedsQL 3.2 Diabetes Module, Self-care Inventory, and Diabetes Family Conflict Scale. Youth also completed the Diabetes Acceptance and Action Scale. Youth’s HbA1c was obtained from their medical record. RESULTS: Confirmatory factor analyses of a hypothesized five-factor model of the DAAS (acceptance, action, values impairment, experiential avoidance, and cognitive fusion factors) in relation to diabetes-related outcomes yielded an acceptable model fit (X2/df=1.65, CFI=0.936, RMSEA=0.061, 90% C.I. [0.054, 0.068]). Values impairment was inversely related to pediatric QoL reported by youth and caregiver (β = -0.757, p = 0.006; β = -0.979, p = 0.02, respectively). Values impairment is also positively associated with HbA1c (β = 0.844, p = 0.027). Lastly, experiential avoidance is associated with greater diabetes-specific conflict with caregiver per youth report (β = 0.704, p = 0.012). No factors were associated with reports of adherence. DISCUSSION: A five-factor model is supported for the DAAS and can help delineate elements of psychological flexibility or inflexibility that can be targeted for future ACT-based interventions for youth with T1D. One such area of focus may be on values impairment, given that it was related to poorer quality of life and higher HbA1c. Thus, it may be important to examine how strategies to manage difficult thoughts and feelings about living with T1D interfere with adolescents’ ability to live consistently with their values. Targeting experiential avoidance may lead to less diabetes-specific conflict among youth and caregivers. Overall, this study suggests that these core processes representing psychological flexibility measured by the DAAS may be influential in improving the physical and psychological wellbeing of youth with T1D.

16. Psychological flexibility and dyadic adjustment: the mediating role of communication.
Primary Topic: Clinical Interventions and Interests
Subtopic: couple, relationship satisfaction, communication, dyadic adjustment, ACT,
Alexandre Marseille, Psy.D.(c), Université du Québec à Trois-Rivières
Yvan lussier, Ph.D., Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières

Acceptance and commitment therapy (ACT) is becoming increasingly popular among behavioral therapists, having been supported empirically in the treatment of various disorders including anxiety, depression, chronic pain, substance abuse, and psychotic disorders (A-Tjak, 2015). Despite the recent emergence of ACT in all areas of psychopathology, few studies have explored the relationship between psychological flexibility and couple satisfaction (Harris, 2009; Peterson, Eifert, Feingold, & Davidson, 2009). In an attempt to better document this reality, our study attempts to assess the contribution of psychological flexibility’s major constructs (acceptance, mindfulness, and engaged action) to explain dyadic adjustment, taking into account the mediating role of communication. The sample is composed of 411 participants (87% women, M age = 28.3 years) who responded to a series of questionnaires measuring each of these variables. Results of a path analysis demonstrate that experiential avoidance associated with non-acceptance of unwanted thoughts or feelings is directly linked to weak dyadic adjustment, and indirectly linked through the demand-withdrawal communication pattern. Mindfulness and engaged action are associated to dyadic adjustment through the mediating role of positive communication. Our model explains 37% of the dyadic adjustment variance. Clinical implications as well as future research will be discussed.

17. Getting Our ACT Together: A Pilot Study with Adolescents in Outpatient Mental Health
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescence, Group Therapy
Susie McAfee, Ph.D., IWK Health Centre
Amber Johnston, Ph.D., IWK Health Centre
Melanie Khu, M.Sc., University of Calgary

The current pilot study was proposed to address a perceived gap in service within a large pediatric, hospital-based, outpatient mental health program. Current treatment options consist of traditional CBT groups for primary anxiety disorders and individual therapy (of various modalities) for depression or other presenting problems. Given that these CBT for Anxiety groups have shown low retention rates and individual therapy may not be the most cost-effective, we developed a transdiagnostic ACT group for youth 15-18 years old. Three groups are planned with results of the first two presented here (N=13). It was hypothesized that this group would have lower rates of attrition, would show increases in psychological flexibility and valued living, as well as decreases in mood symptoms, anxiety, and believability of negative automatic thoughts. Pre-post results from the first two groups demonstrated a high rate of retention, statistically significant increases in psychological flexibility (AFQ-Y) and valued living (VQ), as well as statistically significant decreases in depression (CDI2), anxiety (MASC), frequency and believability of negative automatic thoughts (ATQ). Participants will be followed for at least 3-months post-treatment to assess whether treatment results were maintained over time and explore possible reductions in costly mental health service utilization.

18. Italian validation on the AAQ-S scale: a preliminary investigation of its psychometric properties
Primary Topic: Clinical Interventions and Interests
Subtopic: Stigma assessment
Cristina Rizzo, Kore University, Enna (Italy)
Palmira Faraci, Kore University, Enna (Italy)
Michael Levin, Utah State University
Giovambattista Presti, Kore University, Enna (Italy)

Stigma can be conceptualized as a general tendency to evaluate and discriminate others based on identification with a social group. Following this conceptualization it is possible to investigate and identify the processes that contribute to the development of stigma and its generalization as well as work on it from the point of view of psychological flexibility. The Acceptance and Action Questionnaire – Stigma (AAQ-S) was specifically developed to assess psychological flexibility with stigmatizing thoughts, to have a more sensitive scale focused on a specific and unique area (Levin, Luoma, Lillis, Hayes & Villagarda, 2014). In the context of providing Italian researchers and clinicians with tools related to the psychological flexibility construct we translated and validated the AAQ-S (Levin, Luoma, Lillis, Hayes & Villagarda, 2014). The scale was translated, the translation was evaluated by experts and then back-translated by two English mother-tongue individuals, before being administered. AAQ-S was administered along with the Social Dominance Scale (SDO), the Right-wing Authoritarianism Scale. In addition the empathic attitude of the subject (Interpersonal Reactivity Index -IRI), mindfulness skills (Mindful Attention and Awareness Scale - MAAS) and Experience Questionnaire (EQ) to measure decentering were administered to correlate to the stigma construct. A heterogeneous sample of 220 individuals, 78 of whom responded online, while the others responded to a paper pencil version responded to all the questionnaires. Overall 80% of the sample is female and mean age is 22. AAQ-S in the Italian version has a bi-factorial structure with two subscales: Psychological Inflexibility Subscale and Psychological Flexibility Subscale. Preliminary analysis show a Cronbach’s alpha of .754, that the scale correlates with its two subscales AAQ-S inflexibility r=0.646 p<0.01, AAQ-S flexibility r= 0.731 p<0.01, and a positive correlation with the personal distress subscale of IRI, r=0.190 p<0.05.

19. Mindfulness as Relationship: Opportunities for Mothers and their Infants
Primary Topic: Clinical Interventions and Interests
Subtopic: Attachment
Lindsey R. Wallace, M.A., Hofstra University

Mindfulness is a way of relating to the self and others through acceptance, openness, and compassion. It is uniquely positioned to assist women in the transition to motherhood and strengthen the bond between mother and infant, as it helps to improve intrapersonal and interpersonal attunement. The purpose of this poster is threefold: (1) to address the psychological needs of women through pregnancy and childbirth (2) to emphasize the importance of prenatal and postnatal attachment, and (3) to highlight the ways in which mindfulness strategies can benefit mothers and their infants during the perinatal period. Current empirical research on mindfulness theory and mindfulness-based interventions for the prenatal and postnatal are described. Additional mindfulness strategies and directions for future research are suggested throughout.

20. Willing to Stutter? Stuttering Treatments Combined with Brief ACT Intervention Improves Speech, Quality of Life, and Employment Outcomes of Prospective Health Care Professional. A Case Report.
Primary Topic: Clinical Interventions and Interests
Subtopic: Stuttering
Anthony Garrett Hazelton, Ph.D., East Carolina University
Patricky M. Briley, M.S., East Carolina University

Background The current case study focuses on a 25 year old Caucasian female with a moderate to severe stuttering disorder. She was in her final year as a graduate student and preparing for a career in the medical field. Marked distress related to speaking led her to “white knuckle” her way in through school, particularly in situations in which speaking was involved. With years of speech therapy and ongoing disability in speech, she avoided class presentations, obtaining permission to engage in alternative projects or written activities. However, with internship and employment the next step of her professional journey, she decided to take control of her speech. She sought treatment and was offered a speech correcting device accompanied by speech therapy. Despite initial improvements in fluency, her speech therapist referred her to ACT due to ongoing and severe dysfunction on measures of speech related quality of life. Methods Patient was fitted with a SpeechEasy Device, initiated a course of Speech Therapy, and then was referred to and participated in 3 monthly sessions of ACT. Psychological treatment focused on concepts of experiential avoidance, dirty distress, mindfulness, willingness, and value based action in the context of stuttering disorder. Fluency was measured by clinical rating scales. The Overall Assessment of the Speaker’s Experience of Stuttering (OASES) was used to assess baseline and post-treatment quality of life. Results Qualitatively, at baseline she described how challenged she was socially with her speech impairment and how she continued to struggle with self-doubt and anxiety. Clinical rating scales indicated severe dysfluency in speech at the start of treatment that improved to mild dysfluency by the end of the 3 months treatment process. Her Overall Impact Rating on the OASES began in the severe range at 4.22 and by the end of treatment her score was in the mild to moderate rage at 1.97. She also obtained an internship and part-time employment in her field much easier than she had expected. Discussion The speech of a person who stutters (PWS) in a social context can result in reduced quality of life as experiential avoidance emerges from attempts to reduce social anxiety and the constant internal struggle with speech. The dirty distress that occurs when a PWS struggles with fluency can actually worsen fluency during speech. Experiential avoidance in PWS commonly occurs through disengaging socially and avoiding job opportunities that require talking. In the current case, a brief course of ACT combined with an evidence based speech protocol resulted not only in improved fluency but also in QOL and the patient finding employment. Education on experiential avoidance, defusing from the idea that dysfluency needs to be cured, enhancing mindfulness of when dirty distress arises, and value based goal setting were key ingredients to a brief and effective course of ACT in a PWS.

21. The impact of body image flexibility on dietary habits and weight gain in breast cancer adjuvant therapy
Primary Topic: Clinical Interventions and Interests
Subtopic: Eating behavior
Sara Poli, Psy, Clinical Psychology Service, Hospital “SacroCuore - Don Calabria” Negrar, Verona, Italy
Matteo Giansante, Clinical Psychology Service, Hospital “SacroCuore - Don Calabria” Negrar, Verona, Italy
Monica Turazza, Med, U.O. Oncology, Hospital Sacro Cuore-Don Calabria, Negrar, Verona, Italy
Stefania Gori, Med, U.O. Oncology, Hospital Sacro Cuore-Don Calabria, Negrar, Verona, Italy
Giuseppe Deledda, Psy, Clinical Psychology Service, Hospital “SacroCuore - Don Calabria” Negrar, Verona, Italy

Background: Weight gain is a demonstrate side effect in the adjuvant treatment (chemotherapy, endocrine therapy, radiotherapy after surgery) of breast cancer. Little is known concerning the impact of psychological variables. The aim of the study is to explore the impact of the psychological flexibility on eating behavior and weight gain in breast cancer patients during treatment. Method: Subjects enrolled in the study completed questionnaire concerning: psychological flexibility (AAQ-II; BIAAQ) and eating behavior (TFE.Q-51). The whole sample was divided on the basis of the weight changes (g1: increased; g2: loss / no change); T-tests and correlation analysis (Spearman's Rho) were finally performed. Results: 54 breast cancer patients were enrolled (age: M=53; SD=9.39]). T-test analysis showed significant difference between groups, g1 reported lower scores in BIAAQ [g1: M = 54.17 [DS = 16.69) , g2: M = 65.15 [DS = 13.85], p <.05) and higher scores in TFEQ total score (g1: M = 60.28 [SD = 5.08], g2: M = 43.08 [SD = 24.70, p <. 05]) and in TFEQ-disinhibition scale (TFEQ-Disinhibition g1: M = 8.62, SD = 2.53, g2: M = 6.02 [SD = 2.14], p <.05). Significant inverse correlation was found between BIAAQ score and TFEQ-Total score (rho = -.482 variables, <.01) and BIAAQ mean score and TFEQ- disinhibition score (rho = -. 480, p <.01). Discussion: Body image inflexibility seem to affect eating behavior and specifically disinhibition (the tendency to respond impulsively to the stimulus of hunger).

22. Measuring psychological flexibility and inflexibility in developmental age: A report on instruments available for Italian adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents, psychological flexibility, diagnosis
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC

Children and adolescents mental disorders occur very frequently, with adverse consequences from both clinical and societal point of view. An accurate and early diagnosis, made with measures characterized by strict psychometric properties and validated on particular samples of population, is necessary to take prompt action. This poster presents a review of the clinical instruments currently available in order to measure psychological flexibility and inflexibility in Italian youths. Three self-report instruments were found: (1) Child and Adolescents Mindfulness Measure (CAMM), measuring mindfulness and acceptance; (2) Avoidance and Fusion Questionnaire for Youth (AFQ-Y), assessing fusion and experiential avoidance; (3) Mindful Attention Awareness Scale for Adolescents (MAAS-A), measuring mindfulness as a "receptive state of attention and awareness of the present experience". Since in our clinical practice we use these three measures with very promising implications, we encourage other clinicians in their use. However, it is advisable to wide even more the range of the assessing instruments for psychological flexibility on Italian youth, and this represents a future achievement for our research.

23. Taking a picture of Italian adolescents: How psychological inflexibility can affect psychological well-being?
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents, psychological flexibility, psychological distress
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

This paper outcomes moved from two validation studies of seventeen measures on two different non clinical Italian adolescents samples (n. tot = 1315). The considered instruments assess psychological inflexibility and flexibility (with a particular focus on mindfulness facets, such as acceptance, presence, awareness), psychological distress (anxiety, depression, somatization, dissociation, perceived stress), well-being and quality of life. The scores obtained were submitted to a correlation analysis in order to explore the relationship between the ACT core processes and psychological well-being. As a result, it was supported the existence of a direct correlation between psychological flexibility and psychological well-being, so that at the increase of the first parameter corresponds the increase of the second one. Furthermore, it was highlighted an inverse correlation between psychological distress and mindfulness abilities. This study has important implications for both research and clinical practice.

24. "What about being an accepting and committed mum?" An ACT contribution on psychological well-being in pregnancy
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological flexibility, distress, mindfulness, pregnancy
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

This study explores the effects of incorporating childbirth preparation classes with a six-week Acceptance and Commitment Therapy intervention on a group of ten pregnant women enrolled between 15 and 35 weeks gestation. The samples was non-clinical (absence of psychological or medical diagnosis) but, as reported in literature, pregnancy is characterized by deep changes, in both body and mind, for the most of the women, The study starts from the assumption that, if these changes are accepted in a mindful way, a woman’s life, as mum and partner, will be more rich and meaningful. The main focuses of the intervention were on values and on the acceptance of their private events, in order to gain a greater flexibility towards life. To check the effect of this intervention women compiled twice (T0 and T1) a set of questionnaires on psychological wellbeing, anxiety, depression, mindfulness abilities and psychological flexibility. The study reveals an increase in mindfulness, self compassion and psychological flexibility scores over time and a decrease in stress and anxiety scores. These results seem to endorse the effect of an ACT contribution on women’s psychological wellbeing during pregnancy.

25. A Preliminary Psychometric Evaluation of the I-AAQ: A measure of Interpersonal Psychological Flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: FAP
Lindsey Knott, M.A., Western Michigan University
Chad Wetterneck, Ph.D., Roger's Memorial Hospital
Sonia Singh, M.A., Bowling Green State University

Psychological flexibility appears to be an important process related to overall functioning and quality of life. This flexibility is the balance of making contact with the present moment, accepting one’s thoughts and feelings as they arise, while pursuing values toward a more meaningful existence. The Acceptance and Action Questionnaire (AAQ-II) is a measure developed in an attempt to capture this process. Thirteen years ago, one of the founders of ACT presented at the first ACBS conference and called for more specific variations of experiential avoidance to be examined (Hayes, 2003). Since that time, several variations on the AAQ have been developed to address particular disorders or relevant transdiagnostic processes. To date, no variations have been looked at for psychological flexibility in the context of interpersonal relationships. This study examines a new measure, called the Interpersonal AAQ (I-AAQ), which may fill that void. Utilizing a clinical cPTSD sample (n > 64) and a non-referred clinical OCRD sample (n > 500) we collected data on the AAQ-II, I-AAQ, and other relevant measures of interpersonal relevance (i.e., Functional Idiographic Assessment Template Short form -- FIAT-SF; Awareness, Courage, Love – ACL; Experiences of Shame Scale – ESS; Self-Compassion Scale Short Form – SCS; Quality of life measures – WHOQOL, Fear of Intimacy Scale – FIS). We evaluated basic psychometrics the I-AAQ demonstrated excellent internal consistency and demonstrated a pattern of convergent validity to related measures and divergent validity with unrelated constructs. Although the I-AAQ and AAQ-II were highly correlated, there was a differential pattern of correlations with other measures, with the I-AAQ being more highly related to interpersonal avoidance and shame than the AAQ-II. Further results and implications will be discussed.

26. How does the Awareness Courage Love scale relate to treatment change? Results from a PTSD treatment program.
Primary Topic: Clinical Interventions and Interests
Subtopic: FAP
Chad Wetterneck, Ph.D., Roger's Memorial Hospital
Lindsey Knott, M.A., Western Michigan University
Jennifer Parra-Brownrigg, M.A., Rogers Memorial Hospital
Beth Ann Wuerl, M.A., Rogers Memorial Hospital

Post-traumatic stress often reduces one’s functioning in emotional intimacy and in engagement with interpersonally oriented values. An adjunct to prolonged exposure therapy, Functional Analytic Psychotherapy (FAP) may be a useful treatment to target disengagement in relationships in those with complex PTSD (cPTSD). Researchers recently developed a tool to that may capture important constructs in FAP (i.e., Awareness, Courage, and Love; ACL scale) and may also be beneficial for evaluating the efficacy of such enhanced treatment protocols. The ACL model and measurement tools (i.e., ACL scale) require further investigation in order to demonstrate that these constructs are relevant to functioning and engagement in interpersonal relationships. At a PTSD partial-hospitalization program, a sample of approximately 50 patients with cPTSD received prolonged exposure therapy enhanced with contextual behavior therapies, such as FAP and ACT, and completed the ACL scale at pre- and post-treatment. In order to assess engagement in interpersonal values domains, patients were given the Valued-Living Questionnaire (VLQ) each week during treatment. Preliminary results show that the interpersonally relevant domains on the VLQ (i.e., family and social) predict change in the ACL from pre- to post-treatment, indicating that the ACL may be a sensitive clinical tool to capture change over time. Likewise, this predictive relationship may indicate that intentional engagement in interpersonal relationships may be one of the mechanisms leading to change in these FAP relevant constructs. Further implications of these data will be discussed.

27. Comparison between MCBT-I and CBT-I among college student with Insomnia
Primary Topic: Clinical Interventions and Interests
Subtopic: insomnia
Yoon Jin Kim, Chung-Ang University
Haekyung Koo, M.A., Chung-Ang University
Xinyu Gu, M.A.,
Myoung Ho Hyun, Ph.D, Professor, Chung-Ang University

Background: People with insomnia have predisposing factor (i.e., rumination tendency, depression, emotional arousal, and neuroticism) precipitating factor (i.e., stressor), and perpetuation factor (i.e., frequently making up for short sleep time, doing activities in bed that are irrelevant to sleeping, having dysfunctional belief and attitude about sleeping, and worrying about daytime sleepiness and fatigue due to insomnia). Cognitive Behavior Therapy for Insomnia (CBT-I) is known as the effective therapy for insomnia. CBT-I usually includes sleep restriction, sleep hygiene, stimulus control, and correction of dysfunctional beliefs and attitudes about sleep. However, while CBT-I focuses on perpetuation factors, the therapy does not deal enough with predisposing factor and precipitating factor. In recent years, researchers have begun to apply mindfulness in diverse subjects. Mindfulness therapy is revealed to be effective on reduced depression, rumination, emotional arousal, and stress etc. Therefore we expected Mindfulness based Cognitive Behavior Therapy for insomnia (MCBT-I) to be more effective than traditional CBT-I. The aim of the present study was to compare CBT-I and MCBT-I on college students with insomnia. Method: There were total of 20 participants. 10 in CBT-I and 10 in MCBT-I. All participants individually met with a therapist six times: 1 orientation, once a week for 4-week treatment, and 1 wrap-up session. All participants recorded sleep diary, KIMS, PSAS, DBAS-16, ISI, WBSI, DHS-Revised 3 times (before treatment, end of treatment, and 2 month later after the therapy). Results: All participants showed decreased scores on PSAS, DBAS, ISI, and components of sleep diary after the treatment. However, KIMS score did not decrease after the treatment. When we compared CBT-I and MCBT-I with repeated measures ANOVA, only Wake After Sleep Onset (WASO) was significantly different: CBT-I showed greater decreased on WASO than MCBT-I. Treatment effects also maintained 2 months after the therapy. Discussion:. The Duration of treatment was too short to show significant effect of mindfulness on the participants. Also, the participants in MCBT-I showed low rate of adherence on meditation homework. All participants have primary insomnia, which means their insomnia was due to poor sleeping habits and dysfunctional belief about sleep. Therefore, mindfulness treatment was not effective to these participants. Further research should compare MCBT-I and CBT-I among people with secondary insomnia. Despite of the unexpected results, this study was first study using MCBT-I and CBT-I in individual short-term therapy.

28. Experiential Avoidance and Change in Self-Control in Response to ACTV
Primary Topic: Clinical Interventions and Interests
Subtopic: Intimate Partner Violence
Meg Berta, Iowa State University
Amie Zarling, Ph.D., Iowa State Univeristy

Experiential Avoidance and Change in Self-Control in Response to ACTV Background The current study investigates Achieving Change Through Values-Based Behavior (ACTV; Lawrence, Langer Zarling, & Orengo-Aguayo, 2014), a new treatment for male intimate partner violence (IPV) offenders in the Department of Corrections, which is modelled after Acceptance and Commitment Therapy, emphasizes experiential learning, developing adaptive responses to one’s thoughts and emotions, and recognizing and acting on one’s values. In the current study, ACTV is implemented in jail. In-jail ACTV lasts eight weeks and consists of three two-hour sessions per week. Methods ACTV targets experiential avoidance, the tendency to avoid aversive thoughts and feelings, by teaching offenders to move toward their values instead of away from aversive thoughts and feelings. One aim of this study is to examine the relationship between experiential avoidance and self-control, an important predictor of IPV, (Finkel, DeWall, Slotter, Oaten, & Foshee, 2009). In addition, changes in experiential avoidance and self-control in response to ACTV will be examined. Results Experiential avoidance was measured with the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; Greco, Lambert, & Baer, 2008) due to the reading level of participants. The 10-Item Self-Scoring Self-Control Scale (Tangney, Baumeister, & Boone, 2004) showed a significant negative correlation with experiential avoidance at the start of treatment (r= -.362, p=.098). The AFQ-Y did not show a significant change over the course of treatment (t= 1.31, df= 12, p = .213). Additionally, self-control improved over the course of treatment (t= -2.931, df= 11, p=.014). Discussion While these results are preliminary, they indicate a promising connection between a target of ACT, experiential avoidance, and a core deficit among IPV offenders. ACTV’s ability to change not only experiential avoidance but self-control makes it a good choice for incarcerated IPV offenders. References Finkel, E. J., DeWall, C. N., Slotter, E. B., Oaten, M., & Foshee, V. A. (2009). Self-regulatory failure and intimate partner violence perpetration. Journal of Personality and Social Psychology, 97(3), 483-499. Tangney, J. P., Baumeister, R. F., & Boone, A. L. (2004). High self‐control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of personality, 72(2), 271-324.

29. PTSD Symptom Severity and Functional Impairment: The Moderating Role of Valued Living
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD
John Donahue, Psy.D., University of Baltimore
Jefferson Huggins, University of Baltimore
Humama Khan, MS, University of Baltimore

Background and introduction. Posttraumatic Stress Disorder (PTSD) is a psychological disorder with a lifetime prevalence of 6.8% (Kessler, et al., 2008). The debilitating nature of PTSD is evident in its consistent associations with functional impairment in social (Sayers, et al., 2009), occupational (Stein, et al., 2000), and physical (Vasterling, et al., 2008) domains. However, while the positive association between PTSD symptomology and functional impairment is generally assumed to be strong, a recent meta-analysis by McKnight and colleagues (2016) only found a moderate mean correlation between PTSD symptom severity and global functioning (M = .33). These findings are concerning when considering that treatment trials for PTSD largely use measures of symptom severity as primary outcome measures (see Becker, et al., 2011; Watts, et al., 2013). Acceptance and Commitment Therapy (ACT; Hayes, et al., 1999) is a contextual behavioral treatment with the goal of fostering psychological flexibility, with symptom reduction viewed as secondary to valued living (Hayes, et al., 2013). As such, while ACT generally results in a reduction of symptoms across problem areas (Hayes, et al., 2006), its underlying theory suggests that valued living may increase (and functional impairment thereby decrease) even in circumstances in which symptoms remain present. Aim and hypothesis. The primary aim of this study is to investigate the moderating influence of valued living in the relationship between PTSD symptom severity and functional impairment in a sample of trauma-exposed adults. It is specifically predicted that the link between symptomology and impairment will be attenuated under conditions in which valued living is high. Method. Two hundred fifty online participants (Mean Age = 35.01) from across the country completed a battery of questionnaires including the Brief Trauma Questionnaire (BTQ; Schnurr, 1999), The PTSD Checklist-5 (PCL-5; Weathers, et al., 2013), the Valued Living Questionnaire (VLQ; Wilson, et al., 2010), the Overall Anxiety Severity and Impairment Scale (OASIS; Norman, et al., 2006), and the Patient Health Questionnaire - 3 (PHQ-3; Kroenke, et al., 2001). One hundred thirty-three participants identified a history of at least one DSM Criterion A trauma, and were selected for analysis. Results. A hierarchical regression analysis was computed to examine the hypothesis that valued living moderates the relationship between PTSD symptom severity and functional impairment after controlling for PHQ-3 measured depression. Supporting our hypothesis, preliminary results revealed that the PHQ-3 (β = .48), PCL-5 (β = .39), and VLQ (β = -.14) each emerged as significant predictors; the overall model explained substantial variance in impairment, R2 = .69, F(4, 128) = 72.99, p < .001; and, the addition of the VLQ-PCL interaction explained incremental variance in OASIS ratings, ΔR2 = .02, F(1, 128) = 7.23, p < .01. Therefore, valued living was a significant moderator of the relationship between PTSD symptom severity and functional impairment. Discussion. These results empirically demonstrate valued living as an important construct in understanding functional impairment among trauma-exposed individuals, even when PTSD symptomology is high. Our discussion will emphasize the clinical implications of these findings as they relate to contextual behavioral treatments for PTSD.

30. Measuring Activation in Depressed Adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression
Carmelita S. Foster, Western Michigan University
Alison DeLizza, Western Michigan University
Julissa Duenas, Western Michigan University
De'Lon Dixon, Western Michigan University
Andrew Register, Western Michigan University
Scott T. Gaynor, Ph.D., Western Michigan University

Behavioral Activation is a contemporary behavioral therapy designed to activate clients by scheduling activities that are functional and informed by the client’s life values (Kanter, Busch, & Rusch, 2009). Research evidence suggests that Behavioral Activation is a promising treatment for depression in adolescents; however, there is a paucity of research on whether or not Behavioral Activation actually increases activation levels. This study utilized a single-subject, A/B (stepped care) design, and measured the effectiveness of Behavioral Activation with 13 depressed adolescents between the ages of 14 and 18. All participants were offered up to 12 sessions, but they each received varying amounts of MIA (Phase A) or VBBA (Phase B) based on their scores on the Behavioral Activation for Depression – Short Form (BADS-SF) rating scale. Of the 13 participants who consented to treatment, three received varying amounts of Phase A and eight received varying amounts of both Phase A and Phase B. At the single case level, results suggest half of the participants, who only received MIA, showed baseline trend improvement on the Beck-Depression Inventory- Primary Care version (BDI-PC). Single case results also suggest that one participant, who received both MIA and BA, showed a significant improvement on the BDI-PC during VBBA. At the group level, all participants who received both MIA and VBBA showed significant symptom improvement on the BDI-PC and the CDRS-R. At the single case level, results suggest baseline improvement on the BADS-SF for only one of the participants who received only MIA. At the individual level, results show that four of the participants who received both MIA and VBBA showed significant trend in baseline improvement during MIA and no significant differences in scores during VBBA. There is evidence to include that activation scores increased and depression scores decreased after the exposure to the intervention, however, more rigorous methodology is needed to conclude that VBBA is responsible for the results found.

31. A comparison of four protocols for managing intrusive thoughts: A failure to replicate Marcks and Woods (2005)
Primary Topic: Clinical Interventions and Interests
Subtopic: Thought Suppression
Lucas Cylke, B.A., Wichita State University
Robert Zettle, Ph.D., Wichita State University

Wegner's seminal thought suppression research has shown that attempts to suppress thoughts can lead to a paradoxical increase in the frequency of that thought as well as distress towards that thought. This phenomenon has been a central component of cognitive- behavioral models of disorders such as obsessive-compulsive. The present study tried to replicate a Marcks and Wood (2005) study in which they compared three groups (thought suppression, acceptance, and monitor-only groups) on the frequency and distress associated with experiencing personally relevant intrusive thoughts over three five minute time periods (baseline, experimental condition, baseline). Their results revealed that those instructed to suppress their intrusive thoughts were unable to do so and experienced an increased level of distress after suppression, while the acceptance-based strategy experienced a decrease in discomfort level (but not thought frequency) after having used such a strategy. The current study used the same protocol but added 2 new conditions (total of four conditions), acceptance, acceptance using directions with a metaphor, suppression, and not suppress. It was expected, like the Marcks and Woods (2005) study, that the suppression group would have higher thought frequency and more distress towards their target thoughts. Despite our predictions, the results of the current study did not replicate, finding no difference between groups on distress and found opposite results on thought frequency, with the suppression group having significantly less frequency of intrusive thoughts than the other three groups. These results either suggest that the ironic effects of thought suppression may not be as robust as once thought or that their needs to be better methodology in studies dealing with intrusive thoughts and acceptance and suppression strategies.

32. Under One Roof: Evaluating and ACT based intensive outpatient program for military and first responders
Primary Topic: Clinical Interventions and Interests
Subtopic: Military and First Responders
Susan Faye Balaban Ph.D., Brattleboro Retreat Uniformed Service Program
Hannah Saltzman, Smith College
Nicholas Morrison M.S., Department of Psychology University of Massachusetts-Amherst
Nnamdi Pole Ph.D., Smith College Department of Psychology

This study examines the relation between individual differences in mental health difficulties and demographic variables and treatment outcomes (symptom reduction and changes in acceptance, awareness, and avoidance) in patients (primarily white, male, N = 650, M = 46) participating in an ACT-based intensive outpatient program for first responders and military personnel (current, separated, and retired). Most group based programs for uniformed service personnel partition treatment programs, focusing on "mental health" or "substance abuse," or triaging patients into separate treatment tracks based on these categories. This program, acknowledging hearty evidence that behavioral health problems in this population often involve complex combinations of chronic pain, sleep difficulties, trauma, mood disorders, neurocognitive challenges, and stress related medical problems. This study showed overall positive outcomes for patients. Our results also indicated that clinical presentation (e.g., severity of PTSD greater than severity of addiction) predicted greater benefits from ACT based treatment, as did specific demographic factors (service type & age). These results reflect the uniquely good fit of ACT based programs for culture specific therapy programs with highly diverse clinical presentations while highlighting the areas for growth and refinement in addressing the individual needs of patients struggling with diverse problems.

33. Under One Roof: Evaluating and ACT based intensive outpatient program for military and first responders
Primary Topic: Clinical Interventions and Interests
Subtopic: Military and First Responders
Susan Faye Balaban Ph.D., Brattleboro Retreat Uniformed Service Program
Hannah Saltzman, Smith College
Nicholas Morrison M.S., Department of Psychology University of Massachusetts-Amherst
Nnamdi Pole Ph.D., Smith College Department of Psychology

This study examines the relation between individual differences in mental health difficulties and demographic variables and treatment outcomes (symptom reduction and changes in acceptance, awareness, and avoidance) in patients (primarily white, male, N = 650, M = 46) participating in an ACT-based intensive outpatient program for first responders and military personnel (current, separated, and retired). Most group based programs for uniformed service personnel partition treatment programs, focusing on "mental health" or "substance abuse," or triaging patients into separate treatment tracks based on these categories. This program, acknowledging hearty evidence that behavioral health problems in this population often involve complex combinations of chronic pain, sleep difficulties, trauma, mood disorders, neurocognitive challenges, and stress related medical problems. This study showed overall positive outcomes for patients. Our results also indicated that clinical presentation (e.g., severity of PTSD greater than severity of addiction) predicted greater benefits from ACT based treatment, as did specific demographic factors (service type & age). These results reflect the uniquely good fit of ACT based programs for culture specific therapy programs with highly diverse clinical presentations while highlighting the areas for growth and refinement in addressing the individual needs of patients struggling with diverse problems.

34. The Effects of Creative Hopelessness on Wishing to Avoid Speech Situations
Primary Topic: Clinical Interventions and Interests
Subtopic: Social anxiety, Creative Hopelessness, willingness, Exposure
Kazuya Inoue, Waseda University

The present study examined effectiveness of Creative Hopelessness on avoidance feelings from speech situations. Undergraduate students with social anxiety tendency (n=29) were assigned to Creative Hopelessness groups (n=10), Control groups (n=10), Placebo groups (n=9). All participants completed measure before and after the intervention to assess Believability and Motivation of Change Agenda, SUD rating on Speech task. Results suggested reduction of Believability and Motivation of Change Agenda following the intervention were found only in the Creative Hopelessness groups as well as previous research. Moreover positive correlation was observed between the rate of change of believablitiy of Change Agenda and wishing to avoid speech Situations. But other indicators was't observed correlation for wishing to avoid speech Situations. It was considered decreasing the believablitiy of Change Agenda read to increase willingness in phobia situations.

35. The impact of a Mindfulness-Based Art Therapy Program on Body-image Dissatisfaction
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, Body-Image, Creative/Art Interventions
Kyle Horst, California State University, Chico
Jasmine Buck, California State University, Chico

In the context of negative body image, the use of mindfulness addresses appearance-related cognitions by encouraging self-acceptance (Stewart, 2004). Rather than attempting to control or combat one's negative thoughts and feelings, mindfulness teaches a more adaptive way of relating to one's thoughts and feelings, allowing for an increase in body image flexibility, acceptance, and non-judgmental awareness (Wendel, Masuda & Le, 2012). The following poster outlines results from a non-randomized control study of the efficacy of a Mindfulness-Based Art Therapy group program on negative body-image dissatisfaction. The poster will discuss the development of program, giving the audience samples from the program manual. The poster will also discuss the strengths and challenges of practicing mindfulness within a creative art therapy framework. Finally, pre-post, follow-up, and focus-group data from participants in three groups (Intervention Group, “Treatment as usual” group, and no treatment control) on multiple domains of body-image will be reviewed.

36. Students’ Understandings and Applications of Mindfulness Meditation
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, Misconceptions, Learning, Meditation
Ethan G. Lester, University of North Texas
Danielle Moyer, University of North Texas
Nina Laurenzo, Naropa University
Amy Murrell, University of North Texas

Mindfulness meditation is an increasing area of interest for both mental health professionals and the general public alike. Benefits of these practices are well documented in the literature, although the variety of measurement techniques makes interpreting research difficult. Construct definitions vary, and anecdotal accounts from practitioners suggest many people hold misconceptions about mindfulness meditation, even when taught otherwise. Still, no formal research has been introduced on misconceptions of mindfulness – or, if they exist, how such misinformation affects acquisition of related skills. The current analogue study was used to explore how the presentation of mindfulness meditations (i.e., inaccurate rationale/meditation and accurate rationale/meditation) affected university students’ acquisition of said skills. Specifically, self-reported mindfulness and meditation skills, mood questionnaires, a match-to-sample task, and qualitative measurements were used in an experimental design to assess acquisition. Results, limitations, and applications of this research for clinical scientists will be discussed.

37. Time allocation as a translational process in contextual behavioral science
Primary Topic: Clinical Interventions and Interests
Subtopic: Translational research
Cory E. Stanton, M.S., University of Nevada-Reno
Thomas J. Waltz, Ph.D., Eastern Michigan University

Background One of the goals of contextual behavioral science is to foster meaningful conversations between basic and applied scientists, and developing coordinated research programs. This poster presents empirical data from a measure development project examining the convergent and discriminant validity of self-reported time allocation, an attempted extension of the quantitative matching law from the experimental analysis of behavior. Previous basic research has shown that time allocation may be an acceptable proxy for response allocation, including work with human participants. The matching law has been linked to contextual analyses of depression. Method Undergraduate college students completed a battery of self-report measures, including measures of depression and physical / mental health. Participants also completed the Time Allocation Task (TAT), which asked participants to report time spent on meaningful activities, managing life’s negatives, and sleep. In addition, participants reported 1-10 subjective quality ratings of these three areas. Results Preliminary analyses (n = 204) suggest that the TAT predicted 22% of the variance in depression scores on the PHQ-9, and 26% of the variance on the BADS in regression analyses. Subjective quality ratings of time allocated were found to be as or more predictive of outcomes, a finding that was not expected. Final analyses for the conference will include an expanded sample, and correlation matrices of study variables. Discussion The relationship between time allocated toward life’s negatives, the perceived effectiveness of that time and the study's findings related to the AAQ-II will be reviewed.

38. Adjustment to problems of appearance in women with lipedema.
Primary Topic: Clinical Interventions and Interests
Subtopic: lipedema, body dissatisfaction
Joanna E. Dudek, University of Social Sciences and Humanities, Warsaw
Pawel Ostaszewski, Ph.D., University of Social Sciences and Humanities, Warsaw
Wojciech Bialaszek, Ph.D., University of Social Sciences and Humanities, Warsaw
Tilly Smidt

Background: Lipedema is a chronic, progressive condition that affects mainly women, is under-recognized and frequently misdiagnosed as obesity. Lipedema is characterized by accumulation of fat tissue on the extremities with accompanying swelling and pain that is not responsive to dieting or exercising. It may lead to severe disfigurement. Method: We conducted an online survey of 330 women with lipedema, mostly from North America and Europe. Results: Results showed how lipedema severity, psychological flexibility, social connection are related to adjustment to problems of appearance in women with lipedema. Further implications of these results will be discussed.

39. Softened Blows: Psychological Flexibility, Self-Compassion, and Coping Style and the Relationship between Daily Experiences of Discrimination and Distress among Gender and Sexual Minorities
Primary Topic: Clinical Interventions and Interests
Subtopic: Gender and Sexual Minorites
Lauren E Griffin, BS, University of Louisiana at Lafayette
Alyson Gieseman, BS, University of Louisiana at Lafayette
Emily K Sandoz, PhD, University of Louisiana at Lafayette

Gender and sexual minorities (GSM) are at increased risk of psychological distress, mental health difficulties, physical health problems, and high-risk behavior in several domains (Kirsch, Conley & Riley, 2015). This seems to be in part attributable to limited social resources, discrimination, and victimization experienced by many GSMs (Kirsch et al., 2015). It is unclear, however, what differentiates well-functioning GSMs from those struggling to thrive in similarly hostile social climates (Herek & Garnets, 2007). This may be related to a distinct ability of some GSMs to experience psychological distress without threat to psychological well-being. GSMs that respond to discrimination with self-compassion and psychological flexibility may be at decreased risk for the psychological suffering that contributes to mental and physical health problems and high-risk behaviors. The current study explores the distress associated with daily experiences of stigma and discrimination, along with the role of psychological flexibility, self-compassion, and coping.

40. The role of psychological flexibility in cancer patient with pain: an observational study
Primary Topic: Clinical Interventions and Interests
Subtopic: ncological patients, Pain, psychological flexibility
Dr. Giuseppe Deledda, Sacro Cuore Don Calabria Hospital Verona Italy
Dr. matteo giansante, Sacro Cuore Don Calabria Hospital Verona Italy
Dr. Sara Poli, Sacro Cuore Don Calabria Hospital Verona Italy

Background It has been extensively studied chronic pain in patients suffering from different non-cancer diseases. Aim of this study is to investigate the role of psychological flexibility in cancer patients with pain. Methods Patients with pain were asked to complete questionnaires designed to detect pain (NAS , BPI), the psychological flexibility (AAQ II), the anxiety-depressive symptoms (HADS) and distress (TS). Results 27 patients, completed questionnaires, (M= 62 years (SD 11.28)), 52% of which are female. Greater levels of psychological flexibility showed a higher correlation with lower levels of anxiety (r = - 0.73, P <0.000), depression (r = - 0.59, P <0.001), distress (r = - 0.45 P <0.019) and emotional interference (rs = 0.38, P <0:40). Discussion The results seem consistent with studies in patients with non-cancer pain. In the future study it could further investigate the role of psychological flexibility to adapting to pain in cancer disease.

41. Measuring Awareness, Courage, and Love as a Contextual Behavioral Interpersonal Process Model for the Development of Intimacy
Primary Topic: Clinical Interventions and Interests
Subtopic: Functional Analytic Psychotherapy, Social Functioning, Psychometrics
Adam M. Kuczynski, University of Washington
Jordan Epistola, University of Washington
Joanna E. Dudek, University of Social Sciences and Humanities
Jonathan W. Kanter, University of Washington

The present research describes the development and psychometric evaluation of a self-report measure of awareness, courage, and love. The items were designed to reflect a well-researched model of social connection that involves attention to interpersonal contextual cues (i.e., awareness), engagement in interpersonally vulnerable behavior in the service of one’s values (i.e., courage), and naturally reinforcing responses to those behaviors (i.e., love). With exploratory and confirmatory factor analyses we identified a subset of items that demonstrate strong reliability and validity. In total, over 1,800 participants were surveyed from five large universities. Results demonstrated a positive association with quality-of-life, self-compassion, and empathy, and a negative association with loneliness and fear of intimacy. The final measure has utility for researchers and clinicians alike.

42. KORSA: An ACT-based intervention developed to help university students live better with their stress.
Primary Topic: Educational settings
Subtopic: University students
Simon Grégoire, Université du Québec à Montréal
Lise Lachance, Université du Québec à Montréal
Thérèse Bouffard, Université du Québec à Montréal
Lysa-Marie Hontoy, Université du Québec à Montréal
Laurence DeMondehare, Université du Québec à Montréal

Stress-management workshops (www.korsa.uqam.ca) were offered to students enrolled in four universities in Canada. The workshops were based on the six core processes of ACT and included both didactic activities and experiential exercises. A pretest-posttest switching-replication design was used to assess changes in mental health (stress, anxiety, depression, psychological wellbeing) and school commitment among students (N = 179). The data were collected using self-report questionnaires at baseline (t1), week 5 (t2) and week 9 (t3) and examined using multivariate analysis of variance. The results showed that the workshops helped reduce stress, anxiety, and depression among students while they increase their level of wellbeing and school commitment. The results also showed that parts of the effects of the workshops on mental health were mediated by psychological flexibility. This study makes two important contributions: it introduces a novel ACT intervention specifically designed for university students and assesses its impact by using a research design rarely used in ACT studies.

43. Cross-Cultural Comparison of Values in Acceptance and Commitment Therapy with Expressive Writing Paradigm in the United States and South Korea
Primary Topic: Educational settings
Subtopic: cross-cultural comparison
Woolee, An, M.S., Missouri State University
Ann Rost, Ph.D., Missouri State University

The aim of the current study is threefold: (a) to explore similarities and differences in values between students in the United States and students in South Korea based on the ACT perspective; (b) to study the impact of expressive writing, which might be a tool for improving value concordant life, on value concordant living; and (c) to examine potential differences in writing across cultures. A total of 571 participants from the US and 547 participants from South Korea were recruited for part 1 of the study. Different rank orders in the Valued Living Questionnaire between these two countries were observed using mean differences. The top three important values in VLQ for the students in the United States were ‘Family Relations,’ ‘Education/Training,’ and ‘Friends/Social Life.’ However, the top three important values in VLQ for the students in South Korea were ‘Family Relation,’ Friends/Social Life,’ and ‘Marriage/Couples/Intimate Relations.’ While the top three consistent values in VLQ for the student in the United States were ‘Education/Training,’ ‘Family Relations,’ and ‘Friendships/Social life,’ the top three consistent values in South Korea were ‘Friendships/Social life,’ ‘Family Relations,’ and ‘Citizenship/Community Life.’ A total of 51 students from the US and 14 students from South Korea were recruited for part 2 of this study. A Friedman test was used, and several statistical differences were observed between these countries due to the impact of expressive writing. Participants were divided into three experimental groups: Values, Traumatic, and Control. The values in South Korea showed significant differences in anger from the POMS, and the control group showed significant difference in confusion and total scores from the POMS. However, the value groups from the United States showed several significant differences, such as the VLQ total difference score, the total AAQ score, BAI score, Anger score from POMS, and the total POMS score. The traumatic group in the United States showed significant differences in total score on the AAQ and BAI. The control group of the United States also showed several significant differences in the VLQ total difference score, the total score of AAQ, BAI score, the mental disengagement of COPE, tension score from POMS, anger score from POMS, and the total score of POMS. In the part 3 of this study, a brief content analysis was conducted on the actual writings from participants between the United States and South Korea. Different and similar values themes were confirmed from the writings between the two, consistent with the results of part 1.Most participants in the United States wrote about their family, friend, and personal values like education and recreation while participants in South Korea were mainly focused on their relationships with other people. These findings from the qualitative and quantitative analyses provide some degree of support for the concepts associated with ACT from a cross-cultural perspective. Due to the relative lack of research in this area, however, much more investigation in to these issues in warranted.

44. Improving cognitive performance in college students: The impact of a single mindfulness training session
Primary Topic: Educational settings
Subtopic: Mindfulness
Scott Williamson, Metropolitan State University of Denver
Maureen Flynn, Metropolitan State University of Denver

Past research has shown that extensive and repeated training in mindfulness techniques can help improve a variety of cognitive functions, including working memory, attentional focus, and decrease feelings of anxiety in order to improve performance on cognitive tasks (Fjorback, Arendt, Ørnbøl, Fink, & Walach, 2011: Brunye, Mahoney, Giles, et. al., 2012). This present study examines whether a single session of mindfulness training improves performance on a cognitive task, specifically questions derived from the Standardized Aptitude Test (SAT). The sample included 97 undergraduates. Study sessions were randomly assigned to the experimental condition (a brief mindfulness training session) or the control condition (an audio book recording). Results showed that participants in the single session mindfulness training reported higher levels of state mindfulness post-intervention than those in the control condition but there were no significant differences between groups on performance on the standardized test. Implications of this study will be presented.

45. The Impact of Mindfulness on Residential Treatment Direct Care Providers’ Job Satisfaction and System Participation
Primary Topic: Performance-enhancing interventions
Subtopic: Mindfulness
Drew Heckman, Ph.D., Boys Town Outpatient Mental Health Clinic
Wesley J. Sheeley, Ph.D., Complete Children’s Health Pediatric Clinic

The Boys Town Treatment Family Home Program (TFH) is part of a residential treatment approach for middle and high school aged males and females that are typically developing, but present with a wide variety of clinically significant emotional and behavioral concerns. The Boys Town model incorporates a continuum of care for these children, with TFH incorporating traditional family style living arrangements, with clinical supports and behavior modifications from a team of in-home service providers and clinical staff. Mindfulness has been shown to have positive performance impact for individuals, as well as for quality of care by mental health service providers. The study aimed to incorporate psychoeducation and regular mindfulness exercises over an eight week program to direct care providers. As the group itself is a pilot project, analysis only included pre-post testing on all data points. We assessed treatment related direct effects (i.e., self-reported job satisfaction, burn out) and indirect effects (i.e., ratios of positive to negative teaching interactions for residential youth, frequency of serious behaviors exhibited by youth in their care). A mixed methods design incorporating single case, within subject, and qualitative components was used, with data collection for burn out/job satisfaction, positive and negative point interactions with youths, and other behavioral incidences of the providers’ homes (school incident reports, consultation, etc.). Using the structured mindfulness-based cognitive behavioral therapy approach the intervention design incorporated small group discussion, mindfulness activities, and structured homework done on an individual basis. Five direct-care providers (Family Teachers) volunteered for the pilot program and participation was unrelated and in addition to their existing job duties. Data collection for Treatment B phase is currently ongoing, with baseline data visual inspection indicating high risk of burn out, issues with depersonalization from job expectations and programming, and low ratings of personal achievement. Discussion section for this study will focus on impact of mindfulness for both individual provider job satisfaction and burnout, and systemic change indicators for a residential treatment facility. The study hopes to show how mindfulness can be used as a support to improve results of a residential placement for high risk teens, relationships between providers and teen age clients, as well as reduce burn out and improve job satisfaction for a high risk mental health service position.

46. A Mindfulness-Acceptance-Commitment Based Leadership Training to Improve the Performance of Olympic Athletes
Primary Topic: Performance-enhancing interventions
Subtopic: sport psychology
Karoly Schlosser, Goldsmiths University of London
Frank Bond, Goldsmiths University of London

Applied sport psychology has become key interest field within professional sport to increase the performance and psychological well-being of athletes. Arousal regulation is one of the major approaches within the field and the interpretations of the ACT concept can be implemented well into this context. ACT works contrary to existing interventions, instead of attempting to control internal events it encourages the individual to pay attention to external stimuli resulting in better engagement in task and sense of psychological well-being and therefore in better performance (Bond, Hayes, & Barnes-Holmes, 2006). Gardner and Moore (2007) explored the ACT concept (Mindfulness-Acceptance-Commitment Approach) within the sport field and results show that it might benefit elite athletes better than typically used interventions. Combining the MAC approach with leadership development, this study aims to increase the competitiveness of the table tennis section of the British Olympic Team (N=29) for the upcoming games in Rio de Janeiro 2016. After the training, atheletes will be followed up throughout a year.

47. Examining the Effectiveness of Group Based Acceptance and Commitment Therapy for Adolescents in a Community Outpatient Mental Health Setting
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents, Group Treatment, Transdiagnostic intervention, Anxiety, Depression,
Tajinder Uppal Dhariwal, M.A., OISE/University of Toronto
Sheri Turrell, Ph.D., Trillium Health Partners
Mary Bell, M.S.W., R.S.W., Trillium Health Partners
Marci Gordeyko, M.A., OISE/University of Toronto

Background: Acceptance and commitment group therapy has been found to be effective for a transdiagnostic adult population within the hospital setting (Pinto et al., 2015). There is limited research of ACT group treatment with adolescents (Halliburton & Cooper, 2015). The effectiveness of ACT group treatment for adolescents diagnosed with heterogeneous psychiatric disorders in a community hospital has not yet been examined. Objective: The present study examined the effectiveness of 10 week group-based ACT treatment for adolescents presenting with primarily anxiety and depression-related psychiatric difficulties in a community outpatient mental health setting. Methods: Adolescents (n = 72) diagnosed with anxiety and depression-related psychiatric disorders took part in the present open trial. Data were collected prior to treatment, post-treatment and three months following the treatment. Participants completed outcome measures examining anxiety and depression symptoms and ACT process measures examining cognitive fusion/experiential avoidance, mindfulness and values-based direction. The present study consisted of data collected from fifteen groups run over four years. Results: Analyses revealed significant reductions in anxiety and depression symptoms from pre- to post-treatment. Significant reductions in anxiety and depression symptoms were also found from post-treatment to three months following the treatment. Changes in ACT processes were determined to predict changes in anxiety and depression symptoms. Discussion: The present research provides support for ACT group treatment as a transdiagnostic approach for adolescents presenting with primarily anxiety and depression-related heterogeneous psychiatric disorders in the community. Future research comparing ACT group treatment and existing treatments in the community setting with a similar population is warranted. References Halliburton, A. E., & Cooper, L. D. (2015). Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. Journal of Contextual Behavioral Science, 4(1), 1–11. doi:10.1016/j.jcbs.2015.01.002 Pinto, R. A., Kienhuis, M., Slevison, M., Chester, A., Sloss, A., & Yap, K. (2015). The effectiveness of an outpatient Acceptance and Commitment Therapy Group programme for a transdiagnostic population. Clinical Psychologist. doi:10.1111/cp.12057

48. Feasibility, Acceptability, and Preliminary Outcomes of Randomized Controlled Trial Comparing Loving Kindness Meditation to Referral to Treatment as Usual for College Students with PTSD Symptoms and Problem Drinking.
Primary Topic: Prevention and Community-Based Interventions
Subtopic: PTSD, problem drinking, loving-kindness meditation
Helen Valenstein-Mah, University of Washington
Matthew Enkema, University of Washington
Hye In Cho, University of Washington
Tracy Simpson, VA Puget Sound
Sarah Bowen, Pacific University
Mary Larimer, University of Washington

Background: College can be a period of personal growth and development for many students; however, many also struggle with mental health issues, including trauma exposure and PTSD symptoms. Two thirds of students have experienced a traumatic event in their lifetime, and students with PTSD symptoms are more likely to drop out of college (Duncan, 2000). In addition to reporting high rates of trauma exposure, college students also engage in high rates of problem drinking (Perkins, 2002). They do so for a number of different reasons; however, there is increasing evidence that those experiencing PTSD symptoms often drink heavily to cope and that students with PTSD have worse drinking outcomes than those that do not (Read et al., 2012). For young adults with PTSD symptoms and problem drinking, college may be a critical time for intervention, since effective early intervention could decrease chronicity and lessen future need for PTSD and alcohol treatments. No studies to date have evaluated mindfulness for students with both posttraumatic stress symptoms and problem drinking. This study aims to evaluate a group loving-kindness meditation for college students with PTSD symptoms and problem drinking compared to existing services to determine if this intervention a) is feasible and acceptable, b) reduces PTSD symptoms and problem drinking, and c) contributes to a deeper understanding of the relationship between PTSD symptoms, problem drinking, self-compassion, experiential avoidance, and negative cognitions. Method: Undergraduate students at a large public university in the Northwest United States were recruited from the psychology subject pool. Students were eligible for the study if they: a) had experienced at least one traumatic event in their lifetime, b) had PTSD symptoms in at least two symptoms clusters lasting more than one month; c) had engaged in heavy episodic drinking at least twice in the past month; and d) were not actively suicidal or having psychotic symptoms. Students were randomized to attend either a four-week loving-kindness meditation group (based on the protocol developed by Kearney et al., 2013) or receive referrals to low-cost or free existing mental health services for college students both on and off campus. Students will be assessed pre-treatment, on a weekly basis for 4-weeks during the study, post-treatment, and at a one-month follow-up. Results: Currently 20 undergraduates are enrolled in the study and an estimated 40 will have completed the study by the ACBS conference date. Pre-to-post changes in PTSD symptoms and drinking quantity and frequency will be examined for both groups. Self-compassion, as measured by the Self-Compassion Scale (Neff, 2003), and experiential avoidance, as measured by the Acceptance and Action Questionnaire (Bond et al., 2011), will be examined as potential mediators of changes in PTSD symptoms and problem drinking pre-to-post treatment and pre-treatment to the one-month follow-up. Group acceptability, as measured by a participant satisfaction, will also be discussed. Discussion: These preliminary findings will be discussed as well as potential implications for disseminating LKM interventions for student populations will also be discussed.

49. ACT with Mindfulness: Piloting a Curriculum for Reducing Intern/Resident Burnout
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Burnout
Amy House, Ph.D., Augusta University
Christopher F. Drescher, Ph.D., Augusta University

Background: Clinician burnout, defined as the emotional exhaustion, depersonalization, and a low sense of personal accomplishment experienced in practice (Epstein, 1999), is a prevalent phenomenon. Studies estimate up to 60% of practicing physicians report burnout (Shanafelt et al., 2002), which is correlated with poorer quality of care (Shanafelt et al., 2003), patient dissatisfaction (Haas et al., 2000), increased medical errors (Crane, 1998), decreased ability to express empathy (Shanafelt et al., 2005), increased rates of substance abuse (O’Connor & Spickard, 1997), stress-related health problems, and familial discord (Spickard et al., 2002). Burnout can be found among trainees, including up to 75% of clinicians in residency training (Shanafelt et al., 2002). As noted by Krasner et. al (2009) there remain very few programs that exist to prevent the symptoms of burnout and effectiveness data is scarce. To date, there are no studies that examine the efficacy of any such programs on the well-being of psychiatry residents and psychology interns specifically. One possible intervention to address clinician burnout, Acceptance and Commitment Training (ACT), has been used in a variety of workplace settings and been shown to improve employee well-being and reduce psychological distress (Flaxman et al., 2013). In an effort to expand the research on interventions promoting clinician resilience and preventing burnout, our project tested the impact and acceptability of an ACT intervention for reducing and preventing burnout in psychology and psychiatry trainees. Method: Psychiatry and psychology trainees at an academic medical center (n = 22) participated in a 6 session ACT intervention over 4 months, and completed pre- and post-intervention surveys. Measures included the Work-Related Acceptance and Action Questionnaire (WAAQ), the Maslach Burnout Inventory (MBI), the Professional Quality of Life Scale (ProQOL), and questions regarding how many of the ACT sessions they attended, and how satisfied they were with the intervention. Results: Analyses from the pre-intervention survey indicate that the psychology and psychiatry trainees (N = 22) were reporting high levels of professional efficacy, but also high levels of exhaustion and cynicism on the MBI. Those who completed measures at post-intervention (N = 12) reported moderate levels of satisfaction with the ACT intervention, and that it had been moderately helpful to them. Attending more sessions was correlated with perceiving the intervention to be more helpful and influential. Step-wise regression analyses examined the impact of the number of ACT sessions attended while controlling for scale scores at Time 1. The number of ACT sessions attended significantly predicted post-intervention scores on the WAAQ (β = .49, p < .01), the Burnout scale of the ProQOL (β = -.70, p < .01), the Compassion Satisfaction scale of the ProQOL (β = .65, p < .05). In contrast, the Secondary Traumatic Stress scale of the ProQOL, and the subscales of the MBI were not predicted by number of sessions attended. Discussion: The ACT intervention was successfully implemented with psychiatry and psychology trainees at an academic medical center. There was some evidence of a dose-response effect, indicating that participants attending more intervention sessions experienced greater psychological benefits. Results of this study are limited by the small sample size and attrition in data collection. ACT may be an acceptable and useful intervention to decrease clinician burnout among psychiatry and psychology trainees.

50. Extending ACT’s Reach: Building Leadership for Community Improvement
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Leadership Development
Larry Dumka, Ph.D., Arizona State University

To date, applications of ACT have focused on individual well-being and more recently, on couple and parent-child relationships.This poster presents how the ACT model is used to train university students to lead action research projects that improve community well-being. In the year long Community Action Research Experiences (CARE) program, students pitch and collaborate with a community human services organization, whose mission they are passionate about, to complete a project that increases that organization’s effectiveness. Students increase their psychological flexibility as they address the challenges of developing a proposal collaboratively, implementing their action research project, and impacting their community organization. Correspondingly, the community organizations increase their capacity to integrate evidence to improve their practices.This poster outlines how the CARE program works, how ACT is employed to transform students from consumers to citizens, and how results are evaluated.

51. Promoting emotional and cognitive health (PEACH) among African-Americans residing in Peoria, Arizona
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Emotional and cognitive health
Janina Krell-Roesch, Mayo Clinic, Scottsdale, Arizona
Yonas E. Geda, Mayo Clinic, Scottsdale, Arizona

Background: A growing body of literature indicates that in the absence of adaptive emotional self-regulation, the wear and tear of day-to-day stressors can make a person vulnerable to mental and neurocognitive disorders. We hypothesize that high levels of perceived daily stress coupled with a person’s implicit or explicit evaluation of an adverse event, can be modified by our PEACH (Promoting Emotional And Cognitive Health) intervention which is anchored upon ACT. Method: To test our hypothesis, we conducted a feasibility study involving 12 African-Americans from a church community in Peoria, Arizona that underwent 4 PEACH sessions and completed perceived stress scale (PSS), quality of life questionnaire (WHO-QOL), valued living questionnaire (VLQ-2) and cognitive measures before and after the intervention. Results and Discussion: Preliminary analyses show a significant difference between pre- and post-intervention for VLQ-2 and PSS indicating more favorable outcomes. The participants’ self-assessment revealed that post-intervention, the consistency of their actions directed towards personal values was higher and perceived stress levels were lower than at baseline.

52. Factor Analysis of the M-Tracker 5: Theoretical Significance for Mindfulness Research
Primary Topic: Theoretical and philosophical foundations
Subtopic: Mindfulness
Nicholas Borgogna M.A., RBT, Roosevelt University
Jonathan Smith Ph.D., Roosevelt University

Title: The Factor Structure of Relaxation and Mindfulness: Two States or One? Background: Mindfulness, (open monitoring meditation), is an increasingly popular form of self-regulation (Davidson, 2015). Many scholars and practitioners consider mindfulness as one of many relaxation tools (such as progressive muscle relaxation, autogenic training, tai-chi, yoga, and hypnosis). A debate has emerged as to whether such exercises evoke a single self-reported psychological state or several. Benson’s (1975) relaxation response model suggests that most approaches to relaxation and mindfulness evoke a single nonspecific state of low arousal, the “relaxation response.” If this is the case, different techniques should be interchangeable since they all reduce stress arousal. Smith (2001, 2005, 2011, 2016) has suggested that mindfulness is different from traditional relaxation exercises and that different approaches have different psychological effects. Little research has directly addressed this important question. Do mindfulness and relaxation exercises evoke a single self-reported psychological state or several? Corbeil (2015) conducted a factor analysis on the Smith Relaxation States Inventory 3 (SRSI-3), a comprehensive measure containing both items related to mindfulness and general relaxation. She found three factors: Basic Relaxation, Positive Energy, and Spirituality. Consistent with Benson’s model, she found a single relaxation factor, Basic Relaxation, defined by both relaxation items (physical relaxation) and mindfulness items (at ease/peace). However, Corbeil tested college students in class (not after practicing relaxation or mindfulness), severely limiting the generalizability of her findings. The purpose of the present study was to explore the factor structure of self-reported mindfulness and relaxation among actual practitioners of yoga relaxation and mindfulness. Method: Participants were recruited from various yoga, meditation, and mindfulness organizations in the Chicago area. Graduate research assistants attended group sessions where they administered the M-Tracker 5, an updated version of the SRSI-3 (Smith, 2016), to participants after a session (n=119). Participants also included college students from a large Midwestern university (n=115) who filled out the M-Tracker 5 at the beginning of various courses. These students did not engage in any mindfulness or relaxation related exercises. Results: We conducted an exploratory factor analysis using orthogonal varimax rotation. Five factors were initially observed; however, two items loaded on single factors. We deleted these items, and repeated the analyses. This yielded three factors with eigenvalues ≥ 1. For surviving items, communalities were all ≥ .484. Internal consistencies were r ≥ .844. Only items loading ≥ .530 on one factor were considered as defining factor items. Discussion: Consistent with Corbeil’s study, we found three factors, which we name: Mindful Relaxation, Spirituality, and Positive Emotion. Our Mindful Relaxation factor is consistent with Benson’s model of a generalized nonspecific relaxation state. We found such a state includes self-reported mental relaxation (“at ease,” “at peace”) and mindfulness (“focused,” “centered,”). However, in examining this factor it is clear that it is most heavily defined by mindfulness items, rather than items related to mental or physical relaxation. For this reason, we suggest the term “relaxation response” is misleading, as is Corbeil’s factor name, “Basic Relaxation.” If there is a generalized state evoked by both relaxation and mindfulness exercises, this state is defined primarily by our most highly loading items (loadings higher than .70). Perhaps as Smith has suggested (2016), mindfulness is the core of all self-reported relaxation. To elaborate, Smith has suggested, that one does not necessarily have to practice open monitoring mindfulness in order to experience “Mindful Relaxation.” Yoga, or any effective self-relaxation approach such as deep breathing, progressive muscle relaxation, or autogenics may cultivate easy mindful focus, which in turn may lead to psychological and physical relaxation.

53. A longitudinal study exploring the role of mindfulness and reflective functioning in the social nteractions between mothers and babies.
Primary Topic: Theoretical and philosophical foundations
Subtopic: Mindfulness
Judy Pickard, PhD candidate, University of Wollongong,
Brin Grenyer, PhD, University of Wollongong
Michelle Townsend, PhD, University of Wollongong
Peter Caputi, PhD, University of Wollongong

The importance of attachment history to developmental outcomes and its propensity to cross generations is well documented (Bowlby, 1982; Sroufe, Egeland, Carlson, & Collins, 2005a). This has generated much research interest in the factors that may influence attachment security continuity and, potential discontinuity. To this end, mindfulness and reflective functioning; the ability to make sense of one’s underlying mental state, has been identified as influential in the process (Fonagy & Target, 2005; Shaver, Lavy, Saron, & Mikulincer, 2007). The current study followed 36 mothers from the Illawarra Born Cross-generation health study during the prenatal and postnatal period. Measures relating to attachment style, mindfulness , emotional regulation and reflective functioning were completed at 30 weeks gestation and again at 7-10 weeks and six months postpartum. Video recorded feeding and teaching sessions were recorded respectively during the two post partum data collection points. The videos were coded using the NCAST Teaching and Feeding Scales (Summer & Spietz, 1994), exploring the social interaction between mother and baby. It is proposed that mothers who score higher on the measures of mindfulness and reflective functioning and lower in regards to difficulty in emotional dysregulation will exhibit higher levels of positive maternal/ infant social interaction and contingent responding, independent of their attachment history. A sequential mediation relationship between the variables is explored, suggesting an avenue for therapeutic intervention in the development of positive parenting and discontinuity from the influence of an insecure attachment history. Bowlby, J. (1982). Attachment: Attachment and Loss (2nd ed. Vol. 1). New York: Basic Books. Fonagy, P., & Target, M. (2005). Bridging the transmission gap: An end to an important mystery of attachment research? Attachment and Human Development, 7(3), 333-343. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-27744441028&partnerID=40&md5=917097e48f5729922a91055ae9371f8e Shaver, P. R., Lavy, S., Saron, C. D., & Mikulincer, M. (2007). Social foundations of the capacity for mindfulness: An attachment perspective. Psychological Inquiry, 18(4), 264-271. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-36349000584&partnerID=40&md5=4b68cd73509be8ba41c6155d5af2b120 Sroufe, L. A., Egeland, B., Carlson, E., & Collins, W. A. (2005a). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. New York: Guildford. Summer, G., & Spietz, A. (1994). NCAST Caregiver/Parent-Child Feeding Manual. Seattle: NCAST Publications.

54. Self-Compassion Versus Self-Esteem as Predictors of Resilience and Well-Being
Primary Topic: Theoretical and philosophical foundations
Subtopic: Self-Compassion
Kimberley Schulz, MA, Alliant International University
Jill Stoddard, PhD, Alliant International University

Background: A concept only recently considered within the literature, self-compassion involves three core components that are demonstrated during times of suffering or failure: a) self kindness and understanding, b) seeing and accepting one’s own suffering as being a part of the larger human condition, and c) adopting a stance of nonjudgmental awareness toward one’s own pain without over-identification (Neff, 2003b; Neff & Tirch, 2013). Research suggests that self-compassion is an emotionally positive attitude toward the self that enhances mental health factors, life satisfaction, optimism, and overall health and well-being (Barnard & Curry, 2011; Neff, 2003b; Raes, 2010). Despite praise for the protective nature of self-compassion, emotional resilience (a well-researched construct) has yet to be directly examined within self-compassion research. There is therefore a need to inquire more thoroughly into the protective potential of self-compassion and to understand how such protection may differ from what is offered through other psychological constructs such as self-esteem, which differs in its protective functions and stability, as well as how it may enhance these factors. This project aimed to identify differences in the relationships between self-compassion, self-esteem, and various factors associated with mental health. It predicted self-compassion to be a more powerful predictor of resilience, positive affect, psychological flexibility, and life satisfaction than self-esteem. Method: Anonymous participants were administered electronic assessments that contained the Self-Compassion Scale (SCS; Neff, 2003a), Rosenberg Self-Esteem Scale (RSE; Rosenberg, 1979), and Connor Davidson Resilience Scale (CD-RISC 10; Campbell-Sills, Forde, & Stein, 2009), in addition to scales measuring other constructs associated with mental health, including positive affect, psychological flexibility, and satisfaction with life. Statistical results were analyzed to determine if positive and negative correlations existed between the SCS, RSE, and other measures, and if differences in the relationships between self-compassion, self-esteem, and various factors associated psychological well-being were indicated. Results: Based on the general adult sample (n=139), findings indicated those more likely to be resilient express more self-compassionate attitudes; participants who respond in a more self-compassionate way to stressors also scored significantly higher on self-reported resilience. As well, there was a significant inverse relationship between self-compassion and self-esteem, indicating that those possessing more self-esteem are less self-compassionate, and vice-versa (supporting previous research). An inverse relationship between self-esteem and resilience was indicated; participants possessing higher levels of self-esteem scored lower on self-reported resilience. Lastly, correlations with psychological flexibility indicated decreases in relation to higher levels of self-compassion and resilience, but increases in relation to higher self-esteem. Preliminary analysis suggest self-compassion to be a stronger predictor than self-esteem of resilience. Discussion: In directly studying the link between resilience and self-compassion, specifically in how this relationship differs from that with self-esteem, this study further clarifies self-compassion’s benefits and protective functions. A more precise understanding of the construct can aid in more effective utilization within mental health treatment.

55. Meaning in Life, Psychological Flexibility, and Valued Living: Birds of a Feather?
Primary Topic: Theoretical and philosophical foundations
Subtopic: Psychological Flexibility
Mathew A. Tkachuck, M.A., University of Mississippi
Lauren N. Weathers, M.A., University of Mississippi
I. Andrea Florez, M.A., University of Mississippi
Stefan. E. Schulenberg , Ph.D., University of Mississippi

Background: While theoretically, meaning and life and values appear closely related, scientifically, they are conceptualized differently and have been studied as separate constructs. One important area of research related to valued living includes psychological flexibility, or the ability to achieve one’s goals and values in the face of aversive psychological events. However, there is a paucity of research investigating psychological flexibility and meaning in life more directly. The current study investigated the relationship between psychological flexibility and both the presence of meaning and the search for meaning in relation to a new validated measure of valued living, the valuing questionnaire (VQ). Methods: Questionnaires were administered to undergraduate college students, including the acceptance and action questionnaire (AAQ), the VQ and the meaning in life questionnaire (MLQ). Results: Two hierarchical regression analyses were conducted for each of the meaning in life subscales (i.e., presence [n = 408] and search [n = 412] were the dependent variables) entering the AAQ in step one and both VQ subscales simultaneously in step two. Results suggest that psychological flexibility was a statistically significant predictor of both the presence of meaning in life even after (β = -0.13, p < .001) adding valued living to the model. When controlling for psychological flexibility, progress in valued living was found to be a statistically significant predictor of the presence of meaning (β = 0.58, p < .001), while obstruction of valued living had no significant effect (β = -0.02, p = .742). Over psychological flexibility, valued living accounted for an additional 23.5% of the variance of perceived meaning in life, a statistically significant difference (F = 80.117, p < .001). In relation to the search for meaning, psychological flexibility was also found to be a statistically significant predictor of the search for meaning even after (β = 0.11, p = .008) adding valued living to the model. When controlling for psychological flexibility, only obstruction of valued living was found to be a statistically significant predictor of search for meaning (β = 0.27, p < .001). Over psychological flexibility, valued living accounted for only 2.9% of additional variance in the search for meaning, a statistically significant difference (F = 6.489, p = .002). Discussion: Findings related to perceived meaning in life were as expected; more psychological flexibility and valued living lead to an increase in how meaningful one perceives their lives to be. However, search for meaning appears to be strongly related to both psychological inflexibility and obstruction of valued living, but not related to the enactment of values. In other words, searching for meaning is viewed as a barrier to valued living. Furthermore, the significant added effect of the VQ obstruction to the AAQ suggests that there are differences in these constructs in relation to search for meaning.

56. Reuniting RFT and therapy: Implications of theory within practice
Primary Topic: Theoretical and philosophical foundations
Subtopic: RFT, ACT, Middle level Terms
Andrew Ahrendt, M.A., University of Nevada, Reno
Fredrick Chin, M.S., University of Nevada, Reno
Amanda Munoz, M.S., University of Nevada, Reno

Background Within the contextual behavioral model, there is an emphasis on using middle-level terms that are supported and explained by basic functional processes. These terms enable mental health providers across psychotherapeutic approaches to effectively treat clients without having extensive knowledge of theoretical assumptions. As such middle level terms may provide a key role in the dissemination of empirically supported treatments. Methods/Results Authors evaluated the extant research connecting ACT processes to the underlying theoretical model. More specifically, researchers examined hexaflex processes and their level of fit between research, theory and practice. Based on the gaps that exist between middle level terms and basic functional processes, authors discuss the implications of this discrepancy, and provide specific empirically supported recommendations for future research aimed at clarifying the connection between basic and applied principles. Discussion Scientists need to be grounded to basic theory in order to ensure that their account remains consistent and coherent at all levels of analysis. Such coherence allows fluid movement between basic and applied science. While middle-level terms offer utility to practitioners, the inappropriate use may affect the efficiency and effectiveness of the treatment. Though efforts have been made to better connect ACT mid-level processes with basic science, we believe that future research can be done to strengthen the connection between the transformation of functional relationships and the verbal processes that are present within applied settings. Avenues to pursue this research line include specific preparations utilizing IRAP, delayed discounting paradigms, and other conditional discrimination tasks.

57. The relationship between childhood emotional neglect and emotional non-acceptance in adulthood: Evidence for experiential avoidance
Primary Topic: Theoretical and philosophical foundations
Subtopic: Experiential avoidance
Meaghan Lewis, M.S., Western Michigan University
Amy Naugle, Ph.D., Western Michigan University
Summer Chahin, Western Michigan University
Elise Trim, B.S., Battle Creek Veterans Affairs Medical Center

Contextual behavioral scientists are increasingly interested in emotional non-acceptance and the factors that contribute to its development. Emotional neglect is linked with a series of harmful consequences in adulthood such as depression and posttraumatic stress disorder (Valdez, Bailey, Santuzzi, & Lilly, 2014). While emotional neglect is associated with alexithymia (Aust, Härtwig, Heuser, & Bajbouj, 2013), few studies report information on the relationship between emotional neglect and general emotional non-acceptance. Experiential avoidance is one proposed paradigm for understanding functional classes of behavior that operate to escape or avoid emotion. Conceptually, individuals who experience emotional neglect in childhood may lack effective skills repertoires in effectively managing emotions such that they overemploy experiential avoidance. Overuse of experiential avoidance may take the form of harmful behaviors. The present study aimed to further elucidate the relationship between emotional neglect and non-acceptance of emotions through an experiential avoidance framework. It was hypothesized that experiential avoidance would mediate the effect of emotional neglect on non-acceptance of emotions. A sample of undergraduate students at a Midwestern university (N = 226) completed self-report measures using an anonymous survey regarding experiential avoidance, emotion dysregulation, childhood trauma history, and engagement in problem behaviors. Multiple regression analyses indicated that experiential avoidance predicted non-acceptance of emotions above and beyond emotional neglect in childhood. Experiential avoidance was also predictive of deliberate self-harm and restrictive eating beyond emotional neglect. A single mediation model was evaluated using non-parametric bootstrapping in Process software by Hayes (2013), revealing a partial mediating effect of experiential avoidance on the relationship between emotional neglect and non-acceptance of emotions. Early childhood repertoires in the development of workable emotion regulation strategies may play an important role in preventing emotional non-acceptance. Preventing harmful consequences of pervasive experiential avoidance will be discussed using an acceptance-based therapy framework.

58. The Role of Executive Attention in the Relationship between Mindfulness and Emotion Regulation.
Primary Topic: Theoretical and philosophical foundations
Subtopic: Mindfulness
Lindsey R. Wallace, M.A., Hofstra University

The mechanism through which mindfulness works to engender effects on cognitive and emotional outcomes is an unresolved question in the literature. The present study seeks to understand if attention mediates the relationship between mindfulness skills and improvements in emotional regulation. The Attention Network Test (ANT) was modified to examine attention network responses to both non-word cues and negative, positive, and neutral word cues. The “ANT-E” was modeled off of the Ainsworth, Eddershaw, Meron, Baldwin, and Garner (2013) paper. The task differs in that it includes positive word cues and the words were chosen based on arousal and valence from norming data. Participants completed the Five-Facet Mindfulness Questionnaire (FFMQ), the Difficulties in Emotion Regulation Scale (DERS), and the emotional variant of the ANT. Proposed results are that mindfulness scores will be inversely correlated with emotion dysregulation, and mindfulness will be positively correlated with executive control in the ANT-E. Expectations are that participants with stronger emotion dysregulation will have lower scores on executive attention for positive and negative cue words, but not for neutral cue words. Predictions are that executive function scores will mediate the relationship between mindfulness and emotion regulation. Results might suggest that mindfulness targets deficits in executive attention that are implicated in problems with emotion regulation. This study is novel in that it includes positive word cues. If results are as expected, it would lend support for the idea that individuals with emotion dysregulation have deficits in disengaging their attention from emotionally salient stimuli, regardless of their valence.

59. The Utility of Self-Compassion for Experiences of Ostracism: A Proposed Model
Primary Topic: Theoretical and philosophical foundations
Subtopic: Self-Compassion; Ostracism
Russell Anderson, M.S., University of Denver

Ostracism is a ubiquitous social phenomenon that has debilitating consequences, such as heightened aggression, decreased self-regulation, and suppressed immune and cardiovascular functioning (Wölfer & Scheithauer, 2013). Research suggests that self-esteem (SE) moderates the detrimental effects of ostracism, including poor health and risk behaviors. Interestingly, however, individuals with high SE have been shown to experience more stress on high rejection days compared to individuals with low SE (Ford & Collins, 2013). These results may suggest that individuals with high SE expect good outcomes and feel deserving of these outcomes; and ostracism, an unexpected contingency, results in increased stress. Perhaps, self-compassion, a related but different construct, offers a more functional alleviation to the effects of ostracism without the potential negative side effects of high SE. While self-esteem typically entails a comparison of one's self to another, self-compassion can be fostered independently of others through mindfulness in times of suffering, awareness of common humanity, and self-kindness (Neff, 2003). While self-compassion and ostracism have been researched extensively and independently, the extant literature on the relationship between self-compassion and ostracism is lacking. The purpose of this project is to examine the independent literature regarding these two constructs and propose a model for the relationship between self-compassion and ostracism. One prominent model of rejection reactions suggests that responses occur in five successive stages: immediate response (e.g., negative affect, lowered self-worth), construal (e.g., perceived unfairness), motivated response (e.g., prosocial response; withdrawal), achievement of restoration of sense of acceptance, and mental and physical health outcomes (Smart Richman & Leary, 2009). This author proposes that self-compassion moderates the relationship between the event that connotes rejection and the initial reaction stage of immediate response, thus transforming the succession of reactions following rejection. The functions of this mechanism are detailed in this paper from a synthesis of existing literature in self-compassion and ostracism research, elaborating on all three facets of self-compassion as they relate to coping with experiences of ostracism. While this conceptual project may propose a sound theoretical model, experimental studies need to be constructed to empirically test the relationship between self-compassion and ostracism. This task can be accomplished through experimental designs that include simple self-compassion interventions preceding and/or following ostracism manipulations, using established paradigms such as Cyberball (Williams & Jarvis, 2006). If this proposed model is supported by empirical research, then self-compassion interventions specific to ostracism can be justifiably formulated for dissemination to clinicians.

60. Experiential avoidance predicts impulse control difficulties in adulthood beyond childhood physical abuse
Primary Topic: Theoretical and philosophical foundations
Subtopic: Experiential avoidance
Meaghan Lewis, M.S., Western Michigan University
Dana Goetz, B.S., Western Michigan University
Amy Naugle, Ph.D., Western Michigan University
Elise Trim, B.S., Battle Creek Veterans Affairs Medical Center
Summer Chahin, Western Michigan University

Traumatic events experienced during childhood appear to be important distal risk factors in predicting deleterious outcomes in adulthood (Hovens et al., 2015). In particular, childhood trauma exposure is associated with harmful consequences such as risky sexual behavior, alcohol use, and psychological distress in adulthood (Min, Farkes, Minnes, & Singer, 2007; Walsh, Latzman, & Latzman, 2014). Yet the mechanisms by which childhood trauma exposure relates to adverse adulthood experiences are not well understood. From a behavior analytic perspective, difficulties regulating emotions with a negative valence in particular may be linked with a reinforcement history of avoiding said emotions. Indeed, there is emerging evidence to suggest experiential avoidance plays a critical role in maintaining a number of problem behaviors regardless of form (Kingston, Clarke & Remington, 2010). The present study collected data from a sample of primarily young adult undergraduate students at a Midwestern University. Data were collected in the form of an anonymous online survey regarding childhood trauma experiences, experiential avoidance strategies, and difficulties in emotion regulation. It was hypothesized that individuals with a history of childhood trauma may experience difficulties regulating emotions later in life. Difficulties regulating emotions was hypothesized to be maintained through an overreliance on experiential avoidance. At the bivariate level, experiential avoidance was strongly associated with both childhood trauma history and impulse control difficulties. Hierarchical linear regression analyses indicated that experiential avoidance predicated impulse control difficulties over and above a history of childhood physical abuse. Survivors of childhood physical abuse may be at particular risk for impulse control difficulties which may serve an experiential avoidance function. Implications for understanding this trajectory are discussed within a contextual behavioral framework.

61. A Comparison between Islamic Spiritual Therapy (IPS) and Acceptance Commitment Therapy (ACT)
Primary Topic: Theoretical and philosophical foundations
Subtopic: Comparision Islam and ACT
Associate Professor Dr Tahereh Seghatoleslam, University of Malaya/ Shahid Beheshti university of Medical Sciences tehran Iran
Professor Hussain Habil, Universitof Mahsa Malaysia

This study has 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 differences in ISP and ACT principles. However, in Islam, everything is related to Allah, and it is said that everything is done in the name Allah; therefore, the Holy Quran emphasises on some actions that are mentioned as “Wajib”, which means they are compulsory, and stresses on the importance of avoiding any unacceptable Islamic behaviour which is a cardinal sin in the Holy Quran. Whereas in ACT, cognitive avoidance is not encouraged. In Islam, there are five prayer times that are “Wajib” (Compulsory) for all Muslims. It is similar to mindfulness in ACT that is the cause of consciousness. The Holy Quran orders that you have to be conscious and be responsible for all of your actions and behaviour to yourself and to other people. Otherwise, you are committing Haram. “Haram” is a religious word that is opposite of Wajeb, which means “compulsory to be avoided”. In the Islamic point of view, it is also recommended that the values play an important role in both personal and social life. These values developed the framework of a cognitive life. Regarding the time as mentioned by ACT, the moment is one of the principles that was proposed by Steven Hays. Moreover, Islam mentions that you should always be aware of the future and think of life in the next world. It is also mentioned that if you care about life in the other world, your future will be blessed by Allah. These dimensions are considered completely in the original paper.

62. Problems with psychological testing for the behavior analyst: Issues of philosophical dissensions beyond semantics
Primary Topic: Theoretical and philosophical foundations
Subtopic: traditional psychological assessment
Lindsey Gagnon, Psy.D., private practice
Ragnar Storaasli, Ph.D., University of Denver

Traditional psychological testing is arguably the gold standard for clinical assessment and diagnosis in most areas of contemporary psychology. Consequently, the ability to competently administer and/or interpret tests impacts marketability for independent clinicians and agencies, particularly as pressure increases to offer outcome informed evidence based practice hinged on a diagnostic system. For the behavior analyst, however, traditional psychological assessment is at odds with the philosophical and theoretical foundations of contextual behavioral science and according therapeutic applications. Such odds are not just semantics that can be accommodated with choice of terminology, but rather begin at the level of worldview. Differences in worldview between behavior analysis and mainstream contemporary psychology are discussed with emphasis on major distinctions in relation to language, causality, and science plans, and how these distinctions directly apply to psychological assessment. The paper concludes with a discussion about how the behavioral analyst can approach testing given some fundamental philosophical dissensions that cannot be modified or translated via semantic changes.

Thursday, June 16, 8:00-9:00pm - Poster Session #2

1. Trauma and Somatic Symptoms: Psychological Flexibility as a Mediator
Primary Topic: Behavioral medicine
Subtopic: Adolescents
Anne I. Roche, B.S., University of Iowa
Emily B. Kroska, M.A., University of Iowa
Michael W. O'Hara, Ph.D., University of Iowa
Rosaura Orengo-Aguayo, M.A., University of Iowa

Background: Students who attend alternative high schools are at increased risk for a variety of adverse experiences, including having been victims of physical or sexual abuse (Lehr et al, 2009). Studies have consistently shown a relationship between a history of childhood traumatic events such as physical, sexual, and verbal abuse and various types of chronic pain (Goldberg & Goldstein, 2000). These relationships have been examined in patients with pelvic pain, lower back pain, fibromyalgia, facial pain, migraines, and gastrointestinal disorders (Goldberg and Goldstein, 2000). While previous research has examined these associations within the context of pain conditions, little research has focused on somatic symptoms that do not rise to the level of a diagnosable condition. Importantly, studies have indicated that engaging in pain acceptance rather than avoidance strategies results in better outcomes for chronic pain patients (McCracken et al, 2003). Pain acceptance is emphasized in Acceptance and Commitment Therapy (ACT), which has strong empirical support for the treatment of chronic pain. Research on the association between trauma and pain has not been examined in the context of psychological flexibility, which is the ability to engage in values-based behavior in the presence of difficult internal experiences. The current study seeks to understand the mechanism by which trauma leads to increased somatic symptoms (including pain) in the context of the ACT model. Method: The present study examined the mediating roles of avoidance and mindfulness in the relationship between traumatic experiences and somatic symptoms in a group of at-risk adolescents enrolled in an alternative high school in the Midwest (N=51). The sample was 60% female and 40% male, and students were 16.29 years old (SD=1.01) on average. Measures included the Early Trauma Inventory, Acceptance and Fusion Questionnaire-Youth, the Child Acceptance and Mindfulness Measure-10, and the Patient Health Questionnaire—Somatic Symptom Severity scale (PHQ-SSS). The mean number of traumatic experiences reported in this sample was nearly three times the average reported by healthy adults in the study validating this measure (M = 9.61; Bremner et al., 2007). Results: Mediation analyses were conducted in SPSS, version 23, using the PROCESS macro (Hayes, 2013). All direct pathways were significant (ps < .05). We tested the significance of the indirect effects using bootstrapping. The mediation analyses showed significant indirect effects through both avoidance (CI: 0.0019-0.2650) and mindfulness (CI: 0.0289-0.2953) in the association between traumatic events and somatic symptoms. The models accounted for a substantial amount of the variance in somatic symptoms: mindfulness and trauma (r2 = .4896), avoidance and trauma (r2 = 0.486). Discussion: The results indicate that avoidance and mindfulness significantly mediate the association between traumatic events and somatic symptoms. The findings underscore the importance of psychological flexibility as a point for intervention in the established association between trauma and physical symptoms. Furthermore, the current analyses provide support for the use of ACT as a prevention tool in traumatized or at-risk populations. Interventions aimed at decreasing avoidance and increasing mindfulness are of critical importance in improving outcomes.

2. From values identification to committed action in persons with chronic illness: Where does the rubber meet the road?
Primary Topic: Behavioral medicine
Subtopic: Chronic Illness
Abbie Beacham, Ph.D., Xavier University
Jennifer K. Altman, M.A., University of Louisville
Meghan Jones, B.A., Xavier University
Matthew Maley, M.A., Xavier University

Background: Values clarification can illuminate a path toward valued living. This process becomes motivational as the discrepancy between values and behaviors becomes apparent. Various modalities of values assessment have been applied in different populations and settings. Although identification of importance of valued domains and corresponding behaviors is necessary, it may not be sufficient to prompt action. We hypothesized that the Importance-Satisfaction discrepancy would be predictive of actions in valued domains. Method: We surveyed online Chronic Illness (CI) support group members between ages 20-84 (N=399; Mage=53.05, SD=12.49). Participants were primarily married/partnered (62.5%), Caucasian (90.7%), female (80.9%), well educated (Myrs=15.48, SD=2.57) and had an average of 2.34 CIs. The Valued Directions worksheet (Eifert & Forsyth, 2005) was adapted to assess ten domains: Family, Intimate Relationships, Parenting, Friends/Social, Work/Career, Education/Training, Recreation, Spirituality, Citizenship and Health/Physical. Participants rated (1=Not at all to 10=Very) “How important is this area to you?” and in areas regarded as important, “Overall, how satisfied are you with the quality and depth of your experience in this aspect of your life?” Followed by, “How often have you done something to move you forward in this area during the last week?” For each of the domains, an Importance-Satisfaction deviation score (I-SDiff) was calculated and predictors of actions specific to each domain were assessed. Those who rated Importance >=7 were selected for analyses. IVs entered into regression models were: I-SDiff, #CIs, Perceived Illness Disability, Mindfulness, Positive and Negative Affect, Experiential Avoidance and CI Acceptance (Activity Engagement and Willingness). Results: The primary focus of this study was to assess predictors of action in the Health/Self-care domain. However, domain specific I-SDiff scores were significant in each of the ten domains (Betas = -.320 to -.728, all p’s <.001). CI Acceptance - Activities Engagement predicted Action in 8 of 10 domains (Betas = .144 to .234, all p’s<.05). Models accounted for .239 to .629 of the total variance. Discussion: Notably, none of the other IVs in the models were significant. Counter to our a priori predictions, Mindfulness, Experiential Avoidance and Affect all failed to predict actions. Contradictory to previous findings, perceived illness disability failed to predict Action. Results underscore the need to assess not only the importance of patients’ valued domains, but the extent of the disparity with satisfaction in them.

3. Navy's First Functional Restoration Pain Program: Improving Readiness, Restoring Function, and Relieving Pain.
Primary Topic: Behavioral medicine
Subtopic: Biospsychosocial Chronic Pain Treatments
Kathleen A. McChesney, Psy.D., Naval Medical Center San Diego
M. Schumacher, Naval Medical Center San Diego
Steven Hanling, M.D., Naval Medical Center San Diego
Tara Sheridan, M.D., Naval Medical Center San Diego
Parisa Navahandi, Naval Medical Center San Diego
Sheila Medina-Torne, Naval Medical Center San Diego

A multimodal, interdisciplinary functional restoration pain program (FRPP) is a cost-effective way to reduce chronic musculoskeletal pain and to promote a speedier return to full active duty in some military personnel. Chronic pain is a significant issue in the military because of the associated escalating health care and disability costs as well as loss of productivity and income. Authors conducted this study to test the efficacy of the FRPP for increasing patients' physical and mental coping strategies and to encourage patient independence from medical treatment resources through the promotion of self-efficacy, independent & patient-driven active modes of self-care, acceptance, and enhanced resiliency with flexible functionality. The FRPP consists of five half days per week for 8 weeks and combines optimization of psychoeducation on the biopsychosocial model of health, medication management, utilization of psychological interventions including ACT, CBT, Motivational Interviewing, Mindfulness, Mind Body Medicine, provision of complementary alternative medicine modalities, nutrition, sleep care, and quantitatively directed progressive exercise rehabilitation. All the patients were diagnosed with musculoskeletal disorders with pain duration > 3 months and have not responded well to treatments such as high dose medication and other standard interventions. Outcome measures used include Pain Catastrophizing Scale, Chronic Pain Acceptance Questionnaire, and the NIH Patient-Reported Outcomes Measurement Information System measures of pain interference, physical function, fatigue, sleep-related impairment, depression, anxiety, anger, and social satisfaction. All patient data—pre and post FRPP—were collected using the Pain Assessment Screening Tool and Outcomes Registry (PASTOR), a tool that produces a comprehensive 3-page clinician report of a patient's chronic pain. PASTOR portrays the data in a longitudinal manner that improves clinic efficiency and allows patient and providers to easily see areas of improvement. Their pilot study found that 73% of the 22 active duty members included in the study were cleared for full duty upon completing the 8-week long program, enabling formerly limited service members to return to active duty status, retain their careers, and reduce healthcare and disability costs. This interdisciplinary education program teaches military service members and families to take a proactive self-regulation approach in managing their pain, in order to regain a sense of internal empowerment and commitment toward meaningful & value-based actions. Authoritative organizations and expert panels worldwide promote an active, as opposed to passive, approach to rehabilitation. This, in turn, creates a focus on restoration through education, exercise, pain-coping and pacing skills, and the use of stress-management techniques. While there may not be a cure for chronic pain, it is believed many people are able to regain a better quality of life, improve mood, anxiety, and experiential avoidance, and gain flexibility, strength, and endurance through this program. This study was funded by an award from the Congressionally Directed Medical Research Program.

4. Clinical utility and characteristics of the Chronic Illness Acceptance Questionnaire-Short Form
Primary Topic: Behavioral medicine
Subtopic: Primary Care
Abbie O. Beacham, PhD, Xavier University
John Forrette, M.A., Xavier University
Chava Urecki, M.A., Xavier University
Desiree Green, M.A., Xavier University
Mike Bruner, M.A., Xavier University

Background: Chronic illnesses (CI) and health conditions are among the most frequently diagnosed illnesses and costly in health care. In real world settings, patients seek “simultaneous” medical care for multiple co-morbid CIs and related symptoms (Grumbach, 2003; Starfield et al, 2003). We previously adapted a measure of Acceptance effectively utilized in chronic pain populations (Chronic Pain Acceptance Questionnaire; CPAQ; McCracken, Vowles, & Eccleston, 2004) for use with patients with heterogeneous CI diagnoses to create the Chronic Illness Acceptance Questionnaire (CIAQ; Beacham et al., 2015). The 20-item CIAQ replicated the CPAQ two factor structure - Activity Engagement (AE) and Willingness (W) - with adequate-to-good fit to the data. The AE factor reflects a commitment to engaging in valued activities even in the face of illness related symptoms and the W factor constitutes a willingness to experience sometimes painful or aversive symptoms if it means being able to participate in valued life activities (McCracken, 2010). Although there is high utility for this measure in a variety of medical populations and settings, there remains a need to have similar, but more brief, valid and reliable assessment instruments. Given that the majority of CIs are managed in primary care settings where behavioral healthcare consults and appointments are allotted 15-30 mins, brief measures of this nature are even more vital. The purpose of this study is to evaluate preliminary data and utility of a CIAQ-Short Form (CIAQ-SF). Method: In accordance with the development of the CPAQ-8 (Fish et al, 2010), we selected a total of 8 items from the CIAQ with the strongest factor loadings (4 per factor) as follows: AE .77 to .82 and W .58 to .75. Data collected from online (CI) support group sample participants (Ppts; N = 397) were analyzed. Ppts ranged in age from 20-84 years [Mean age = 53.18 (12.39)] and were diagnosed with 1-7 (M = 2.36; SD = 1.39) CIs. Items for the AE and W subscales were summed and had moderate-to-high Internal Consistencies (Alphas = .887, .679, respectively). Results: CIAQ- SF scores were strongly correlated with CIAQ long form scores (r’s = .888 - .922, p’s < .001). Consistent with previous results with the CIAQ long form, the CIAQ-SF subscale scores were associated with other measures of psychological flexibility and affect. Both the AE and W subscales were positively associated with Mindfulness and Positive Affect (r’s = .193 to .589) and inversely associated with Experiential Avoidance and Negative Affect (r’s = -.163 to -.507). Regression analyses (Method=Enter) again replicated previous findings. With all measures of psychological flexibility, affect and # CIs entered, 43.2% of variance was accounted for by the model [F (7, 277) = 31.885, p<.001]. Perceived Illness-Related Disability (DV), a “proxy” for functional outcomes in medical populations, was predicted by # of CIs (Beta= .188, p<.001), CIAQ-SF- AE (Beta = -.518, p<.001) and CIAQ-SF-W (Beta = -.166, p=.001). Discussion: These preliminary analyses of existing data suggest that the CIAQ-SF would perform adequately and similarly to the longer version. Although additional data collection and analyses are necessary, this brief CI Acceptance measure offers considerable utility in a variety of health care settings especially fast-paced primary care settings.

5. Valued Action in Breast Cancer survivors: What predicts Action in highly valued life domains?
Primary Topic: Behavioral medicine
Subtopic: ACT Assessment
Abbie O. Beacham, PhD, Xavier University
Stefanie Schmidbauer, M.A., Xavier University
David Downing, B.A., Xavier University
Stacy Lorenz, M.A., Xavier University

Background: Cancer diagnosis and survivorship can enhance potential for positive psychosocial and health behavior change (Andrykowski et al., 2006). Values consistent behavior change in cancer patients and survivors has been conceptualized as a response to an extraordinary opportunity for ‘growth’ and ‘benefit-finding’ (Antoni et al., 2001; Kissane et al., 2003; Stanton et al., 2002). Accordingly, in clinical application, the identification of one’s values can lay a sound foundation for movement toward increased satisfaction and function in valued life domains. Although identification of importance of valued domains and corresponding behaviors is necessary, it may not be sufficient to understand what facilitates action. We hypothesized that the Importance-Satisfaction discrepancy would be predictive of actions in highly valued domains in a sample of breast cancer survivors. Method: We surveyed online breast cancer (BrCA) support group members between ages 20-79 (N=286; Mage=55.01, SD=10.26). Participants were primarily Caucasian (87.8%), well educated (Myrs=15.45, SD=2.62) and 88.1% diagnosed with stage 0-II breast cancer. The Valued Directions worksheet (Eifert & Forsyth, 2005) was adapted to assess ten domains: Family, Intimate Relationships, Parenting, Friends/Social, Work/Career, Education/Training, Recreation, Spirituality, Citizenship and Health/Physical. Participants rated (1=Not at all to 10=Very) “How important is this area to you?” and in areas regarded as important, “Overall, how satisfied are you with the quality and depth of your experience in this aspect of your life?” Followed by, “How often have you done something to move you forward in this area during the last week?” Those in the sample who rated Importance >=7 in respective life domains were selected for each of the regression analyses. For each of the domains, an Importance-Satisfaction deviation score (I-SDiff) was calculated and predictors of actions specific to each domain were assessed. IVs entered into regression models were: age, education, Mindfulness, Positive and Negative Affect, Experiential Avoidance and Chronic Illness Acceptance (Activity Engagement and Willingness) and I-SDiff score for the corresponding life domain. Results: Notably, the primary focus of this study was to assess predictors of action in the Health/Self-care domain in a “medical” population. However, domain specific I-SDiff scores were significant predictors of Action in 9 of 10 domains (Betas = -.360 to -.666, all p’s <.001). Surprisingly, and counter to our a priori predictions and findings in other samples, none of the other IVs were significant with the exception of positive affect which predicted Action in 4 of 10 domains (Betas = .220 to .423, all p’s<.05). Models accounted for .259 to .441 of the total variance. We examined predictors of in the Health/Self-care domain more closely. Given that The I-SDiff score predicted Action (Beta = -.570) all other IVs were assessed as predictors of I-SDiff scores. Of these, Acceptance: Activity Engagement (Beta = -.300, p = .029) and Experiential Avoidance (Beta= .332, p = .034) predicted I-SDiff scores. Discussion: Taken together, results underscore the need to assess not only the importance of patients’ valued living domains, but the extent of the disparity between importance and satisfaction within them. Preliminary results also suggest that it may be useful to assess core ACT processes as they relate to the importance-satisfaction disparities. Certainly, in medical populations, there is merit to doing so especially in the area of health and self-care as those are germane to survivorship quality of life (Andrykowski et al, 2006).

6. Building Prosocial communities in Sierra Leone
Primary Topic: Clinical Interventions and Interests
Subtopic: Developing nations, prosocial, ACT, PTSD
Edmond Brandon, commit and act
Tien Mandell, commit and act, University of Glasgow

Sierra Leone is a land of powerful mixtures. scarred by a history of deprivation and conflict, the people value peace and resilience, living in a land of majestic mountains, lush greenery and many beautiful beaches. it is now faced with many challenges, such as teenage pregnancy, exploitation, violence against girls, female genital mutilation, ebola and many socio-economic problems. our charity, commit and act, has supported people through many of these problems. in our girl shelter, we provide individual and group counseling session for victims, parents, and caregivers. helping to heal the bodies inside and out with prosocial behavior change, food for daily sustenance, dignity kits, educational opportunities, medical support, legal support, support the caregiver, recreational facilities and follow-up visitations. commit and act centre practice prosocial and act in our meetings, trainings and workshops to change behavior. we have helped people to create rich, full and meaningful lives, whilst accepting that life inevitably brings pain. we use act mindfulness exercises to help handle painful thoughts and feelings, and the matrix to support them in taking valued directions to achieve the goals that really matter. in the recent fight against Ebola, we trained teachers that have gone into the communities to help to break the chain of transmission of Ebola in the Bo district with cultural-specific behavioral changes.

7. A Research Proposal: Self-Compassion as the Antidote for Shame in Transgender Adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: Transgender
Emily Ball, Gonzaga University

“Owning our story and loving ourselves through that process is the bravest thing that we will ever do.” (Brown, 2010) Background: Why is owning our story such a hard thing to do? Many would argue that it is difficult because “owning our story” means acknowledging and accepting our imperfections. Our imperfections are integral to our identity as human beings, yet as a human race we condemn the imperfections both that others display and that we display within ourselves. One population that is frequently condemned is the transgender population. Transgender individuals are often seen as sick, freakish, and threatening. These stigmas thrusted upon the transgender population often then become internalized by the transgender individual him/herself which leads to staggering rates of depression, anxiety, and suicide. This research examines one component of this internalized stigma—shame—and proposes a quantitative way of measuring shame and the reduction of shame via self-compassion therapeutic intervention. While the research has not yet been conducted, as I am only a first year graduate student, this proposal lays the groundwork for how professionals in the field of mental health may better reach their transgender clients. Hypothesis: Shame levels will decrease in transgender adolescents as self-compassion levels increase within transgender adolescents through self-compassionate therapeutic intervention. Method: Subjects - The subjects participating in this study will be from a nonrandom, purposive sample. Subjects will be 30 self-identifying transgender adolescents. For this study, adolescent is defined as a person aging from 13-17. Subjects will be individuals who are seeking out therapy due to some aspect of their status as a transgender person. Subjects will be fully informed of the process and assured that their identities will be kept anonymous. Subjects will also be assured that the resulting research will be a by-product of their therapy and that they may withdraw their information for research purposes at any time. Instruments - The instruments used in this study will be the Shame Inventory (Rizvi, 2010) and the Self-Compassion Scale (Neff, 2015).The Shame Inventory (Rizvi, 2010) is a self-report measure designed to assess an individual’s experience of shame both globally and in response to specific life events. The inventory has two parts. Part I examines general experiences of shame on a 5-point Likert scale, such as the frequency, intensity, and negative effects of shame. Part II looks at 50 potential shame cues. Subjects are asked to rate each cue on a 0–4 scale to indicate the intensity of their current levels of shame about that event or characteristic, or to indicate if they have never experienced the event/ behavior/characteristic. The total score is the average rating on selected items and ranges from 0 to 4, with 4 indicating higher degrees of shame. The Self-Compassion Scale is also a self-report inventory comprised of 26 questions about the participant’s typical behavior. The subjects rank how often they do or do not experience the specific behavior referenced rating from 1 (almost never) to 5 (almost always). Lower scores indicate lower levels of self-compassion, while higher scores indicate higher levels of self-compassion. Overall score is then averaged and coded accordingly. Design - The research design will be an experimental pre-test/post-test design using self-report inventories to measure the variables. The dependent variable studied will be shame and the independent variable studied will be self-compassion. Subjects will be given the Shame Inventory (Rizvi, 2010) and the Self-Compassion Scale (Neff, 2015) both at the start of therapy and at the end of therapy to measure baseline levels of shame and self-compassion and post-intervention levels of shame and self-compassion. The hope is that after self-compassion therapeutic intervention, shame levels will be reduced, as quantitatively measured by the Shame Inventory (Rizvi, 2010), and self-compassion levels will have increased, as quantitatively measured by the Self-Compassion Scale (Neff, 2015), thus resulting in a correlation between the two variables. Procedure - Transgender subjects will seek out self-compassion therapy on their own accord. I, as both the researcher and a licensed mental health counselor, will describe the self-compassion therapeutic process and its success in reducing negative states of being. If the client chooses to pursue therapy, he/she will sign off on the informed consent document. The counselor will then give the client the shame and self-compassion assessment tools to establish a research baseline. Germer and Neff (2013) suggest an outline for what each session should look like. I have chosen to allot 10 sessions per subject to ensure that rapport is established and that the client does not feel rushed at any point during the process. At the end of 10 sessions, the same instruments will be used to assess post-intervention levels of shame and self-compassion. The same process will be repeated until the researcher has collected data on 30 subjects. The gathering of data will sought to be completed over a span of 5 years or less. Subjects will receive counseling services at no charge. Results: I expect that after running the one-way repeated measure ANOVA test, my post-test data will differ significantly from the pre-test data. As the hypothesis suggests, I am anticipating there to be a negative correlation between shame and self-compassion. As self-compassion levels increase among subjects, shame levels decrease. Ideally, after running the test my ANOVA value would compute close to -1, demonstrating that not only does a relationship exist between the variables, but that there is a negative correlation between them—endorsing my intervention as a successful one. Discussion: The National Alliance on Mental Illness, NAMI, (2015) reports that “between 38-65% of transgender individuals experience suicidal ideation” and suicide remains to be a leading cause of death for transgender individuals. The time is now to develop effective strategies for helping transgender individuals—this includes within the counseling setting. Assuming my study yields significant results, this study would provide the counseling profession with a framework for working with transgender individuals, which is currently somewhat of uncharted territory. Shame is a common reported feeling across suicidal individuals, yet the shame a transgender person feels is a very unique kind of shame that most people will never experience. However, this does not mean that we cannot empathize or develop ways to preserve these lives and restore worth and self-compassion within the transgender population. My findings would indicate a way to do just that—preserve lives through an effective therapeutic relationship and restore self-worth by way of increasing self-compassion. The process of acceptance and tolerance must begin within the self. The results of my study would specify how to facilitate the rejection of shame and embark on the journey of self-compassion leading to feelings of worth and kindness to self, thus reducing suicidal ideation and self-hatred amongst the transgender population.

8. Acceptance and Commitment Therapy (ACT) for a female Chinese adolescent with Depression and Trichotillomania (Hair Pulling Disorder): A single case study.
Primary Topic: Clinical Interventions and Interests
Subtopic: Children and Youth, Trichotillomania, Depression
Celeste Cai Jieni, MA (Applied Psychology), KK Women's and Children's Hospital, Singapore

Background: Trichotillomania (TTM) is characterised by repeated hair pulling that results in noticeable hair loss (American Psychiatric Association, 2000). The highest incidence of the onset of TTM is experienced during childhood and adolescence (Huynh, Gavino, Magid, 2013) and prevalence of depression and anxiety is also common (Lewin et al., 2009). ACT Enhanced Behavioral Therapy (AEBT) for TTM has shown promising results for the treatment of adults (Twohig & Woods, 2004; Woods, Wetterneck, et al., 2006). However, there is limited empirical evidence regarding the efficacy of ACT in adolescent TTM and none of them has featured treatment of depression with TTM in adolescents. This single case study aims to illustrate the use of ACT in the treatment of a 14-year old female Chinese adolescent suffering from major depression and TTM. Zoe is a high achiever secondary school student whose depression was triggered by her poor performance in her exams during one of her school terms. To cope with her stressful experiences and negative feelings, she engaged in a hair-pulling habit which gradually developed into TTM. Method: 10 sessions were conducted using the AEBT protocol. Steps were taken to modify her treatment according to her needs and progress. To investigate the effectiveness of ACT, direct measures of trichotillomania, Massachusetts General Hospital (MGH) Hair Pulling Scale (Keuthen et al., 2007) was used at the start of every session. Acceptance and Action Questionnaire (AAQ-II) (Bond et al., 2011), and Beck Youth Inventories (BYI-II) (Beck, Beck, Jolly, Steer, 2005), were used at pre and post treatment intervals. Results indicated a reduction of experiential avoidance, decreased depression symptoms and decreased hair-pulling severity. Discussion: The third-generation cognitive behavioural therapies such as ACT can significantly improve negative feelings as it deals with the person's tendency to avoid, control or escape from thoughts, urges, emotions or any other unwanted internal experiences (Hayes, Strosahl, Wilson, 1999). In TTM, evidence has shown that the act of pulling controls these negative internal experiences and as such, the pulling is used to avoid or escape from them (Begotka, Woods, & Wetterneck, 2004; Norberg, Wetterneck, Woods, Conelea, 2007). The data from the present case report is one of the first to suggest that ACT may be a suitable treatment for adolescent with depression and TTM. Further research involving the application of ACT on TTM in adolescents is also therefore worth exploring.

9. Effects of brief-ACT on college student drinking and correlates of drinking: A pilot study
Primary Topic: Clinical Interventions and Interests
Subtopic: College student drinking
Justine A. Grosso, M.S., Baylor University, Waco, TX
Lauren L. Greenberg, Psy.D., George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
Jules C. Martowski, B.A., Baylor University
Alexis Humenik, B.A., The George Washington University, Washington, DC
Thomas A. Fergus, Ph.D., Baylor University, Waco, TX
Sara L. Dolan, Baylor University, Waco, TX

Existing empirically supported individual-level interventions for college student drinking reduction focus on changing perceptions of social norms and expectancies (e.g., social motives, conformity motives) in order to affect drinking outcomes. Researchers are beginning to target college student motives for drinking related to changing unpleasant internal experiences (e.g., coping motives) via brief mindfulness- and acceptance-based interventions. The current study examined the preliminary effectiveness of a single session of Acceptance and Commitment Therapy (ACT). Participants were 139 undergraduate students (77.7% women, M = 19.28 years old, 79.1% Caucasian) who completed questionnaires at baseline (BL), the intervention, and then questionnaires at follow-up (FU; two- to four-weeks post-intervention). The study investigated whether various drinking outcome variables (e.g., negative alcohol-related consequences, alcohol quantity and frequency) would significantly decline after the intervention as well as how drinking coping motives may be associated with these drinking outcomes. Statistically significant reductions were found in all drinking outcomes (Cohen’s d’s = .35 – 1.78) from BL to FU. Exploratory autoregressive analyses using hierarchical linear regression revealed significant positive associations between all drinking outcomes and coping motives for drinking (semi-partial r2s = .10 - .18, small effects). These findings suggest that this intervention may be associated with reducing some of the most impairing symptoms along the alcohol use disorder continuum. These data also suggest that drinking coping motives are an important target deserving of continued focus. It may be that certain processes targeted by ACT, such as experiential avoidance/acceptance and cognitive fusion/defusion, attenuate automatic alcohol coping behavior in response to unpleasant internal experiences.

10. Cognitive fusion: pre-post changes associated with a brief-ACT intervention and its moderating role on the relationship between baseline and follow-up negative alcohol-related consequences
Primary Topic: Clinical Interventions and Interests
Subtopic: Cognitive fusion
Justine A. Grosso, M.S., Baylor University, Waco, TX
Lauren Greenberg, Psy.D., George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
Jules Martowski, B.A., Baylor University, Waco, TX
Alexis Humenik, B.A., The George Washington University, Washington, DC
Thomas A. Fergus, Ph.D., Baylor University, Waco, TX
Sara L. Dolan, Ph.D., Baylor University, Waco, TX

Cognitive fusion, a theoretically-hypothesized mechanism of change in Acceptance and Commitment Therapy (ACT) has yet to be evaluated empirically in treatment studies. Participants were undergraduate students (N = 139; 77.7% women, M = 19.28 years old, 79.1% Caucasian) who completed questionnaires at baseline (BL), a single-session ACT intervention, and questionnaires at follow-up (FU; two- to four-weeks post-intervention). The present study examined pre-post changes in cognitive fusion as well as cognitive fusion’s moderating role on the relationship between BL and FU negative alcohol-related consequences. Cognitive fusion was measured using the Cognitive Fusion Questionnaire (Gillianders et al., 2014). There was a statistically significant reduction in cognitive fusion from BL (M = 26.07, SD = 9.33) to FU (M = 23.76, SD = 9.78), t(138) = 3.32, p <.001 (Cohen’s d = 0.24, small effect). Additionally, the interaction between BL cognitive fusion and BL negative alcohol-related consequences was statistically significant. Simple slope analyses indicated that BL and FU negative alcohol-related consequences were significantly positively associated at 1 SD below the mean of cognitive fusion (β = 0.26, p < .001) and significantly positively associated at 1 SD above the mean of cognitive fusion (β = 0.62, p < .05). The pattern of the interaction indicates that participants who had high BL levels of cognitive fusion had greater stability of negative alcohol-related consequences and those with lower levels of BL cognitive fusion had greater reductions of alcohol-related consequences from BL to FU. It may be that individuals who were high in BL cognitive fusion were so reactive to internal experiences that attachment to unpleasant thoughts and feelings were not weakened enough by the intervention. Results suggest that increasing session number or session duration to accommodate additional experiential exercises that facilitate defusion may further weaken urges to drink to cope with unpleasant internal experiences and subsequent negative alcohol-related consequences for individuals who were high in cognitive fusion at BL.

11. Effectiveness of Acceptance and Commitment Therapy (ACT) on resiliency of female with psoriasis
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy, Psoriasis, Resiliency
Asghar Aghaei, Professor, Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
Pariya Heidari, M.A. Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

Background: The purpose of this study was to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on resiliency of female with psoriasis in Isfahan(Iran) . Methods: This was an experimental study with pre-test, post-test and follow up.The statistical population were psoriasis patients referred to Sedighe Tahereh’s Skin and Leishmanias Research Center who have been referred by specialist Doctors and have records. Thirty patients were randomly selected and were contacted to come and involve in study. The selected patients were divided into two groups of 15 people as intervention group and non intervention.Acceptance and Commitment therapy in the experimental group during the post two month, in weekly meeting for 120 minutes was performed. The subjects completed the following questionnaire: Resiliency (Conner and Davidson, 2003). Results:The result of covariance analysis showed that there were significant differences between experimental and control groups(P<0.05). Discussion:The results of this research had shown that Acceptance and Commitment Therapy was effective in the increase resiliency .The result also showed a treatment effect was persistent during the follow up. So ACT may be considered to be an effective intervention approach for increase of resiliency in patient with psoriasis.

12. Effectiveness of acceptance and commitment therapy on family cohesion in spouses of drug dependent men
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy, family cohesion, family process, spouses of drug dependent men
Leyli Nourian, M.A., Islamic Azad University, Najafabad branch, Isfahan, Iran
Fereshteh Sedighi, M.A., Islamic Azad University, Najafabad branch, Isfahan, Iran
Asghar Aghaei, Ph.D., Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

Background: The purpose of this study was to determine the effectiveness of acceptance and commitment therapy on family cohesion in spouses of drug dependent men. Method: This research was a quasi-experimental research with pre-test, post-test and tow month fallow up with control group. The statistical population consisted of all spouses of drug dependent men who refereed to addiction treatment centers of Isfahan (Iran). 32 spouses of drug dependent men were selected with available sampling method among the statistical population (from two treatment centers). They were randomly incorporated to an experimental and a control group (16 per group). All participants were assessed by cohesion subscale of family processes scale (Samani, 2008) at pre-test, post-test and tow month after the treatment in the follow up stage. The intervention involved 10 sessions of acceptance and commitment therapy, each lasting for 90 minute, which were administered only to the experimental group. Results: The result of covariance analysis indicated a significant improvement in the experimental group in variables of family cohesion in post-test (p<0.05) and the results were sustainable in fallow up (p<0.05). Discussion: According to the findings of this research, use of this therapeutic approach is recommended to improve family cohesion in family of drug dependent men.

13. Psychological Flexibility as a Predictor of Quality of Life and Eating Disorder Risk in a Residential Treatment Setting
Primary Topic: Clinical Interventions and Interests
Subtopic: Eating Disorders
Eric B. Lee, MA, Utah State University
Ellen Bluett, MS, Utah State University
Clarissa Ong, BA, Utah State University
Ginger Lockhart, Ph.D., Utah State University
Michael Twohig, Ph.D., Utah State University
Tera Lensegrav-Benson, Ph.D, Avalon Hills Residential Eating Facility
Benita Quakenbush-Roberts, Ph.D., Avalon Hills Residential Eating Facility

Psychological flexibility has been hypothesized to be a mechanism of change within eating disorders. However, little data has examined this proposed relationship. Promoting psychological flexibility could potentially play an important role in improving ridged, perfectionistic thinking and obsessive behaviors often seen in those with eating disorders. It was hypothesized that increasing psychological flexibility would reduce eating disorder risk and improve quality of life of individuals with an eating disorder. The data presented in this talk were collected from 112 inpatients of a residential treatment facility. Sequential multiple regression analyses were performed to test whether pre-treatment levels of psychological flexibility longitudinally predicted quality of life and eating disorder risk after controlling for age and baseline effects. Pre-treatment psychological flexibility significantly predicted post-treatment quality of life. The incremental change in R2 at the final step was significant, Finc (1, 109) = 4.209, p<.05 and the adjusted R2 indicated that approximately 19% of the variation in post-treatment quality of life was attributable to age and pre-treatment psychological flexibility. Similar results were found when testing post-treatment eating disorder risk as an outcome, as pre-treatment psychological flexibility significantly predicted post-treatment eating disorder risk. The incremental change in R2 at the final step was significant, Finc (1, 110) = 4.367, p<.05 and the adjusted R2 indicated that nearly 30% of the variation in post-treatment eating disorder risk is attributed to age and pre-treatment psychological flexibility. These data were examined used change scores, with results indicating that improvement in psychological flexibility over the course of treatment lead to improved quality of life and eating disorder risk outcomes.

14. A Pilot Study of Acceptance and Commitment Therapy for Anger Dysregulation among Trauma-Exposed Military Veterans
Primary Topic: Clinical Interventions and Interests
Subtopic: Anger and Aggression
John Donahue, Psy.D., University of Baltimore
Andrew Santanello, Psy.D., Center for Deployment Psychology
Mary Marsiglio, Ph.D., VA Portland Health Care System
Lynn Van Male, Ph.D., VHA CO, Office of Public Health, Occupational Health Strategic Healthcare Group

Background: Anger dysregulation and attendant problem behaviors are commonly reported by treatment-seeking military veterans, particularly those with a history of trauma exposure. However, there is a paucity of studies examining interventions for dysregulated anger and aggressive behavior in this population. With its emphasis on promoting psychological flexibility, both theory and empirical evidence suggest Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) may be a viable and effective treatment for anger dysregulation among veterans. Method: The present study sought to examine the feasibility and preliminary effectiveness of an open trial of a 12-week ACT group intervention for trauma-exposed military veterans reporting difficulties with anger and aggressive behavior. Participants were recruited from mental health and primary care clinics at a large Veterans Health Administration (VHA) medical center in the northwestern United States. Participants were assessed at pre-treatment, post-treatment, and six-week follow-up on a variety of self-report measures, including anger (Dimensions of Anger Reactivity Scale), trait physical and verbal aggression (Aggression Questionnaire), psychological flexibility (Acceptance and Action Questionnaire - II), quality of life (Quality of Life Questionnaire), and a participant satisfaction survey. Results: Results indicated that treatment completers (n = 16) found the intervention favorable, participation was associated with improvements in trait physical aggression and psychological flexibility, while findings pertaining to changes in anger were mixed. Furthermore, changes in psychological flexibility accounted for substantial variance in participants' reduction in physical aggression, after accounting for relevant control variables. Discussion: Findings suggest a group-based ACT intervention for anger dysregulation is feasible among trauma exposed military veterans and warrants further investigation.

15. A Meta-Analytic Review of Functional Analytic Psychotherapy Single-Subject Research
Primary Topic: Clinical Interventions and Interests
Subtopic: Meta-Analysis
Sonia Singh, M.A., Bowling Green State University
Leah Bogusch, Bowling Green State University
William H. O'Brien, Bowling Green State University

Functional Analytic Psychotherapy (FAP) is a contextual behavior therapy that utilizes basic behavioral principles to within the therapy session to implement change in order to allow these changes to generalize outside of session. The therapist works to reduce problematic in-session behavior (CRB1s) and increase functional in-session behavior (CRB2s). A majority of the published studies in FAP are single-subject design. The current study synthesized data from FAP single-subject investigations using single-subject meta-analytic techniques. Percentage of non-overlapping data (PND) was calculated for graphed outcome data. The reliable change index (RCI) was calculated for questionnaire outcome data. Results indicated that cumulative PND for CRB1s was 57.76% and fell in the “moderately effective” range, and for CRB2s was 81.06% and fell in the “fairly effective” range. The overall RCI for was 4.03 which indicates that pre-post changes on questionnaire outcome data are large and statistically reliable.

16. A preliminary investigation of Acceptance and Commitment Therapy as a treatment for binge eating disorder in Japanese female adults.
Primary Topic: Clinical Interventions and Interests
Subtopic: binge eating disorder
Takashi Muto, Ph.D., Doshisha University
Kazuyo Kikuta, M. A., Clinical Center of Doshisha University
Takashi Mitamura, Ph.D., Ritsumeikan University
Aiko Ohya, Doshisha University

Binge eating disorder (BED) is one of the feeding-and-eating-disorders in DSM-5, characterized by recurrent binge eating (i.e., eating an unusually large amount of food, accompanied by a sense of loss of control and marked distress) in the absence of significant compensatory behaviors (e.g., self-induced vomiting, excessive exercise). Some individuals with BED have these disordered behaviors as a function of experiential avoidance, that is, a way of escaping and distracting themselves from difficult thoughts and emotions. Acceptance and Commitment Therapy (ACT) may be an effective intervention for individuals diagnosed with BED because it directly undermines experiential avoidance and promotes alternative valued behaviors. In this study, 4 Japanese female adults who met the criteria for BED (moderate severity level) were treated with 10 weekly sessions of ACT, followed by 6 biweekly booster sessions, and follow up was conducted at intervals of 3, 6, 12, 18, and 24 months. The effects of the intervention were assessed using a multiple probe across participants design. After the last ACT booster session, all participants self-reported having very few episodes of binge-eating behavior per week. At follow-up sessions, they reported that these improvements had been maintained and their weight had decreased. Moreover, questionnaire scores for disordered eating, depression, general mental health, experiential avoidance, and self-compassion were also improved and maintained over 2 years. This preliminary study suggests that ACT might be an effective treatment for Japanese female adults with BED.

17. Acceptance and Commitment Therapy: Focused Brief Intervention for Health-Related Behavioral Change.
Primary Topic: Clinical Interventions and Interests
Subtopic: Brief Interventions, ACT
Monica Barreto, MS., Western Michigan University
Scott Gaynor, Ph.D., Western Michigan University

Substance misuse, physical inactivity, and unhealthy eating and sleeping habits are important health-related behaviors for current life satisfaction and forestalling chronic health conditions. The current study examined the plausibility of offering a 1-session (60 minute) acceptance and commitment therapy (ACT) intervention for college students seeking health-related behavior change. In this ongoing study, the 22 participants who have received the ACT session reported a statistically significant increase in their confidence in making the desired health-related behavior change immediately following the session, t = 3.80, p = .001. Moreover, the 9 participants who have currently completed the 30-day follow-up period reported statistically significant changes in the health-related behavior targeted for change in the ACT session, t = 2.99, p = .02. Other non-targeted health-related behaviors showed no statistically significant change. These data suggested that a single session of focused ACT may be useful in promoting health-related behavior change.

18. The interaction between mindful awareness and acceptance in predicting couples satisfaction
Primary Topic: Clinical Interventions and Interests
Subtopic: Couples, Mindfulness
Jennifer E. Krafft, Utah State University
Jack Haeger, Utah State University
Benjamin Pierce, Utah State University
Michael E. Levin, Ph.D., Utah State University

Background: Previous studies have connected mindfulness to a wide range of relationship outcomes. Research on specific components of mindfulness is limited, but preliminary findings highlight the role of the awareness and acceptance components of mindfulness in relationship satisfaction (Khaddouma et al., 2015). Yet, no studies have investigated the possibility that the awareness and acceptance components of mindfulness interact to predict relationship outcomes (a moderating effect that has been found with other problems such as substance abuse; Eisenlohr-Moul et al., 2012). Method: This poster presents the results of an online survey assessing components of mindfulness and couples’ satisfaction in a sample of undergraduate students (n=135). The Couples Satisfaction Index (CSI; Funk & Rogge, 2007) and Philadelphia Mindfulness Scale (PHLMS; Cardaciotto et al., 2008) were administered. Results: Higher acceptance predicted higher couples satisfaction (β=.34, p<.001), but higher awareness predicted lower satisfaction (β =-.18, p=.035). There was a significant interaction effect for acceptance and awareness (ΔR2=.05, p=.004). Higher levels of awareness predicted lower couples’ satisfaction only when acceptance was low (β =-.21, p=.003), but not when acceptance was high (β =.04, p=.52). When switching the moderator and predictor variable, higher levels of acceptance predicted greater couples’ satisfaction when awareness was high (β =.22, p<.001), but not when awareness was low (β =.01, p=.82). Discussion: These results highlight the importance of the combination of awareness and acceptance for relationship satisfaction and suggest that components of mindfulness should be considered not just individually, but in terms of interactions.

19. Modeling the Cognitive Mechanisms Linking Autism Symptoms and Anxiety in Adults
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness and Acceptance
Max Maisel, Brigham Young University
Kevin Stephenson, Brigham Young University
Mikle South, Ph.D., Brigham Young University
Jacqui Rodgers, Ph.D., University of Newcastle
Mark H. Freeston, Ph.D., University of Newcastle
Sebastian Gaigg, Ph.D., City University London

Background: Emotional acceptance, alexithymia, and intolerance of uncertainty (IU) contribute to anxiety disorders in neurotypical populations. Their association with anxiety in people diagnosed with autism spectrum disorder (ASD) has not been studied. We aimed to model the contributions of these constructs on the relationship between dimensional measures of autism and anxiety. Method: Participants were 151 adults recruited from two sites, including those diagnosed with ASD (n=76) and a matched comparison group (n=75). All participants completed a battery of questionnaires measuring core autism symptoms, anxiety, emotional acceptance, alexithymia, and intolerance of uncertainty. Results: Structural equation modeling with mediation was used to examine directional relationships among these variables. Autism symptoms directly predicted less emotional acceptance and increased alexithymia and IU. Alexithymia and acceptance were shown to explain 64% of the effect between autism symptom severity and anxiety level. Discussion: This study suggests that people with ASD experience increased levels of anxiety because they are more likely to react aversively to their emotional experiences, while lacking the ability to identify and understand their emotions. Developing and implementing mindfulness-based interventions aimed at assuaging alexithymia and IU, while increasing emotional acceptance, may be especially helpful in treating anxiety in ASD.

20. Assessing the efficacy of a self-help ACT based program in the treatment of anxiety disorders: a single-case study
Primary Topic: Clinical Interventions and Interests
Subtopic: Self-help
Catherine Ethier, D.Psy (c), Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières
Frédéric Langlois, Ph.D., Université du Québec à Trois-Rivières

In North America, one person out of five suffers from an anxiety disorder. ACT has shown its efficacy in the treatment of a wide range of anxiety disorders. Self-help programs stand as a promising option to enhance accessibility to treatments while offering an excellent cost-efficiency ratio. This single-case study (N=4) with repeated measures (daily, weekly and pre/post treatment) aims to assess the efficacy of a six weeks self-help ACT based program relying on the book The Happiness Trap (Harris, 2008). Participants all suffered from anxiety at a clinical or subclinical level, diagnostics ranging from generalized anxiety disorder to social anxiety disorder and panic disorder. As expected, preliminary analysis show an association between the program and a enhancement in quality of life, as well as an improvement of the core change processes of ACT, connection to the present moment, acceptance and defusion. However, the intervention did not reduce anxiety symptoms for all participants. This study contributes to shed light on the potential effects of a self-help ACT based treatment and its limitations. The challenges related to the implantation of such an intervention and future directions will be discussed.

21. Telephone-supported Acceptance and Commitment Bibliotherapy for People with Multiple Sclerosis and Psychological Distress: A Randomised Controlled Feasibility Trial
Primary Topic: Clinical Interventions and Interests
Subtopic: Multiple Sclerosis
Barnaby, J, Proctor (BSc), The University of Nottingham, UK
Nima Moghaddam, The University of Lincoln, UK
Roshan Das Nair, The University of Nottingham, UK

Background: Telephone-supported self-help Acceptance and Commitment Therapy (ACT) may be a way of providing accessible and effective psychotherapy to people with Multiple Sclerosis (MS). The aim of this trial was to determine the feasibility of a randomised controlled trial (RCT) of telephone-supported ACT bibliotherapy compared to treatment-as-usual (TAU), and explore the effectiveness of the intervention. Methods: The study was a randomised control feasibility trial. The intervention was eight weekly support calls guiding participants through the ACT self-help text “Get Out Of Your Mind and Into Your Life” (Hayes, 2005). Participants were assessed at baseline and post-intervention using the Generalised Anxiety and Depression Measure (GAD) and the Patient Health Questionnaire (PHQ) as primary outcome measures. The EuroQol (EQ-5D-5L) and Multiple Sclerosis Impact Scale (MSIS-29) were secondary outcome measures, and the Acceptance and Action Questionnaire (AAQ-II) was a process measure. A sample of participants were interviewed to assess RCT feasibility. Results: 27 participants with MS with anxiety and/or depression were recruited from an outpatient MS clinic and an MS charity. The majority of participants found the different elements of the RCT acceptable. Overall attrition was 66%, and 64% in the intervention group. Linear mixed model analysis and effect size calculation found a significant effect (p=0.004) and large effect size (0.84 (95% confidence intervals 0.02-1.66)) at post-intervention in favour of the intervention on anxiety in intention-to-treat analysis. Smaller non-significant positive effects were found on other measures. Intervention completers had significantly lower scores on the MSIS and the AAQ-II at baseline. Discussion: Telephone-supported ACT bibliotherapy delivered in a RCT format may be a feasible research method for people with MS, and the intervention has the potential to be effective in reducing psychological distress. However, attrition rates must be addressed: practical changes to the method of delivery to increase participant retention are suggested.

22. Acceptance and commitment therapy for Tojikomori in Japanese older adults: A preliminary investigation
Primary Topic: Clinical Interventions and Interests
Subtopic: Tojikomori, Acceptance and commitment therapy (ACT), Japanese elderly
Kohei Hashimoto, M.A., Graduate School of Psychology, Doshisha University
Takashi Muto, Ph.D., Faculty of Psychology, Doshisha University

Tojikomori means being housebound in old age without any deficits in physical or cognitive functioning. Elderly people with Tojikomori have low levels of physical, psychological and social health, and Tojikomori is a risk factor for disability. It is thought that individuals with Tojikomori have psychological problems such as cognitive fusion with a damaged conceptualized self and feeling they have nothing to live for (i.e. unclear value and persistent inaction). In this study, 2 Japanese elderly women living in a nursing home who met criteria for Tojikomori (P1 and P2) were treated with acceptance and commitment therapy (ACT). The treatment was delivered in 7 weekly sessions and 2 biweekly booster sessions in participants’ living rooms. The effects of the intervention were assessed using a nonconcurrent multiple baseline across participants design. P1 whose acceptance and defusion processes were well at baseline showed a positive change in physical activity. Her psychological flexibility, psychological quality of life, and depression remained well across the treatment phase. P2 whose acceptance and defusion processes were unwell at baseline showed positive changes in psychological flexibility and psychological health across the treatment phase and improvements were maintained in 1 month. However, no improvements were observed in physical activity in this participant. One of the factor that inhibit the effectiveness of ACT for physical activity for P2 seemed to be a decline of physical function across the study duration. Implications and the distinctiveness of ACT as a treatment for Tojikomori are discussed.

23. Does imagination affect efficacy of ‘leaves floated down the river’ defusion exercise?
Primary Topic: Clinical Interventions and Interests
Subtopic: Defusion
Yuuka Nakatani, Doshisha University
Aika Shinomiya, Doshisha University
Yuri Shirouchi, Tsukuba University
Asako Sakano, M. A., Doshisha University
Takashi Muto, Ph. D., Doshisha University

Study objective: The present study examined whether the differences between low and high imagination have influences on the efficacy of cognitive defusion exercise needed mental operation. Design: Two Groups (low imagination (LI) or high imagination (HI)), pre-post comparison. Participants: Twenty-four undergraduates, 11 with high imagination and 13 with low imagination. Intervention: All participants completed cognitive defusion exercise, or ‘leaves floated down the river’. Measure: (1) a score of Cognitive Fusion Questionnaire (CFQ), and (2) the increasing ratio of tolerance time in cold pressor task. Results: (1) An ANOVA revealed that a score of CFQ didn’t significantly differ between two groups (LI and HI). (2) The t-test revealed that LI group reported significantly lower increasing ratio of tolerance time in cold pressor task than HI group. Conclusion: The present results suggested low imagination worked against the efficacy of ‘leaves floated down the river’ defusion exercise.

24. What is an effective defusion exercise for persons with low imagination?
Primary Topic: Clinical Interventions and Interests
Subtopic: Defusion
Aika Shinomiya, Doshisha University
Yuuka Nakatani, Doshisha University
Yuri Shirouchi, Tsukuba University
Asako Sakano, M.A., Doshisha University
Takashi Muto, Ph.D., Doshisha University

Study objective: The present study examined an effective defusion exercise for persons with low imagination. Design: Two-factor mixed design was used; Group (experimental group, control group) × time (pre, post). Participants: twenty-seven under-graduates with low imagination participated in this study. Intervention: A freight train exercise was used. Experimental group completed it in the real scene, whereas control group completed it with imagination only. Measures: (1) The increasing ratio of tolerance time in cold pressor task and (2) the score of Cognitive Fusion Questionnaire were used. Results: (1) There was no significant difference between experimental group and control group (t(23)=1.13, ns.). (2) Main effects of group and time were not significant (F(1,23)=0.002, ns. ; F(1,23)=.05, ns.). Interaction was significant (F(1,23)=5.98, p<.05), but all simple main effects were not significant. Conclusion: These results couldn’t clarify what defusion exercise might be effective for persons with low imagination.

25. Can ACT enhance effects of abstinence-based contingency management in patients with cocaine use disorder?
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT
Angela Stotts, Ph.D., University of Texas Health Science Center at Houston, McGovern Medical School
Kathryn Tipton, MA, University of Texas Health Science Center at Houston, McGovern Medical School

Background: Contingency management (CM) is a reinforcement-based approach that provides tangible rewards for objectively verified drug abstinence. CM is the most effective available behavioral intervention for cocaine use disorders; however, response to CM is variable, with significant rates of nonresponse. A secondary profile analysis of potentially modifiable cognitive–affective characteristics of cocaine dependent patients participating in a CM treatment found that CM nonresponders (i.e., continued users), relative to responders (i.e., abstinent), reported significantly higher levels of avoidance and behavioral inflexibility (p < .01) in the context of distressing cocaine-related thoughts, feelings, and bodily sensations (Stotts et al., 2015), as measured by the Avoidance and Inflexibility Scale (AIS). These data suggest that acceptance and commitment therapy (ACT) may serve as a therapeutic strategy for enhancing response to CM for cocaine use disorders. Methods: We adapted an opioid use disorder treatment manual to target cocaine use and pilot tested the first 6 sessions with two clients diagnosed with severe cocaine use disorder. Twice-weekly individual ACT therapy sessions focused on acceptance and defusion from unpleasant cocaine thoughts and cravings and were delivered in conjunction with high-magnitude abstinence-based CM. Results: Both participants attended 100% of treatment sessions and reported high rates of satisfaction at end-of-treatment. Participant #1 (54yo, AA, Fe) failed to achieve abstinence, defined as four consecutive cocaine-negative urine screens. This participant’s AIS scores at baseline and treatment Week 4 showed no change in response style to cocaine-related thoughts, feelings, and bodily sensations. In contrast, Participant #2 (42yo, AA, Ma) successfully achieved two weeks of cocaine abstinence and showed clinically meaningful reductions in AIS scores from baseline to Week 4. This participant’s scores on measures of emotional and physical distress tolerance showed similar improvement during ACT with CM treatment, relative to Participant #1. Therapist ratings of attention and engagement correlated with observed differences in treatment outcome, with Participant #1 described as “difficult to rouse and engage in therapy-related activities.” Discussion: Based on these first two pilot cases, we are encouraged about the feasibility of using ACT to enhance CM effects. Both therapist and participant feedback are being used to finalize the manual in preparation for a large-scale adaptive clinical trial.

26. Five facets of mindfulness and its associations with disordered eating behaviors among Japanese college samples: Implications of treatment for eating related problems.
Primary Topic: Clinical Interventions and Interests
Subtopic: mindfulness, disordered eating
Naoki Mampuku　B.A., Graduate School of Psychology, Doshisha University
Takashi Muto Ph.D., Faculty of Psychology, Doshisha University

Background: Many studies have examined the efficacy of mindfulness-based interventions in the treatment for disordered eating. However, few researchers have explored the associations between facets of mindfulness and eating behavior. This study aimed to investigate multiple facets of mindfulness (acting with awareness, non-reactivity, non-judging, describing, and observing) and its associations with three disordered eating behaviors (restrained, emotional, and external eating). Method: An online survey was conducted to assess the relationship between eating behavior and facets of mindfulness among a Japanese sample. In this study, Japanese undergraduate students (n=243, female: 147 male: 96) completed the Five Facets of Mindfulness Questionnaire and the Dutch Eating Behavior Questionnaire, in addition to filling out a demographic questionnaire. Results: Regression analysis revealed that “acting with awareness” and “non-reactivity” were negatively associated with emotional eating (β=-.14, p<.05, β=-.15, p<.05). “Non-judging” was inversely related to external eating (β=-.17, p<.05), independent of sex, age, and body mass index. Moreover, “observing” and “acting with awareness” were positively associated to restrained eating (β=.14, p<.05, β=.16, p<.05). Discussion: Different facets of mindfulness were associated with more restrained and less emotional and external eating in a Japanese college sample. These results are discussed considering the potential role of facets of mindfulness in disordered eating.

27. Self-help for Social Anxiety: Preliminary Results on a Mindfulness and Acceptance-based Approach
Primary Topic: Clinical Interventions and Interests
Subtopic: Social Anxiety
Nancy Kocovski, Ph.D., Wilfrid Laurier University
Jan Fleming, MD, Mindfulness Clinic
Meagan MacKenzie, Ph.D., Ryerson University
Alison Flett, Wilfrid Laurier University
Rebecca Blackie, M.A., Wilfrid Laurier University

Although there are empirically supported treatments for social anxiety, many people are not able to access them for various reasons (e.g., financial, lack of availability, stigma). Self-help may be one way to access these underserved populations. The present study reports preliminary results on the effectiveness of an ACT-based self-help book for social anxiety (Fleming & Kocovski, 2013). Community participants wanting help with social anxiety or shyness were recruited via flyers and online posts and randomly assigned to self-help or wait-list (N = 120 recruited; data collection in progress). Those assigned to self-help were given the book and asked to follow an 8-week plan, including the following strategies: mindfulness practice, values and goals, defusion, and exposure. At post-treatment (8 weeks; based on n = 90), compared to the control condition, those in the self-help condition reported being significantly less fused with thoughts, less socially anxious and depressed, and had higher levels of mindfulness and self-compassion. Data are also being collected at a one-month follow-up (data collection will be complete by time of conference). Given the difficulties with accessing treatment for some individuals with social anxiety, a mindfulness and acceptance-based self-help approach may be recommended.

28. A case study of acceptance and commitment therapy for a Japanese woman with chronic low back pain
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic pain
Asako Sakano, M.A., Graduate School of Psychology, Doshisha University
Takashi Muto, Ph.D., Faculty of Psychology, Doshisha University
Mie Sakai, Ph.D., Center for Clinical Psychology, Doshisha University
Masataka Ifuku, Ph.D., Ifuku Pain Clinic

In recent years, there has been an increase in the demand for psychological treatments for chronic pain in Japan. We examined the effects of acceptance and commitment therapy (ACT) on a Japanese woman in her 40s with chronic low back pain. The treatment program was delivered in ten sessions. Using an AB design with baseline and treatment phases, we assessed the effects of the program on outcome measures (activity based on her values, health-related quality of life, and other psychological variables) and process measures (AAQ, CFQ, and FFMQ). Results showed an increase in valued activity. Additionally, Short Form Health Survey (SF-36) scores significantly improved from pre- to post-treatment in terms of general health perception, vitality, role functioning/emotional, and mental health, while physical functioning improved from pre-treatment to the four-month follow up. The scores for physical disability, pain catastrophizing, anxiety, and depression also significantly improved and were maintained until the four-month follow up. Furthermore, process measures of ACT improved before changes to the outcome measures were observed. Overall, the results suggest that ACT helps participants with chronic low back pain by weakening the influence of pain-related thoughts or feelings on their behavior and improved functional performance and quality of life.

29. The Relationship of Experiential Avoidance and Value Importance with Related Behavioral Choices
Primary Topic: Clinical Interventions and Interests
Subtopic: Values
Jia Hui Chaw, M.A., Wichita State University
Dr. Robert Zettle, Wichita State University

Background: The ultimate goal of acceptance and commitment therapy is to enhance psychological flexibility or the ability to make behavioral adjustments necessary to live a life congruent with personal values. One barrier to psychological flexibility targeted by ACT is experiential avoidance (EA). The purpose of this project was to examine at both macro and microlevels of analyses how EA and the importance of personal values in various life domains contribute to related behavioral choices. Method: A total of 222 college students were included in this study. For the microanalysis, the Value-Congruent Behavior Scale (VCBS) was developed to assess scenario-specific, value-consistent actions within nine life domains. The Valued Living Questionnaire (VLQ) was administered for the macroanalysis. Participants also completed the Acceptance and Action Questionnaire-II (AAQ-II) and two measures on social desirability. Correlations and regression analyses were conducted to analyze the data. Results and discussion: While the interaction between levels of EA and the importance of values predicted value-consistent behavior at a macrolevel of analysis, similar findings were obscured by social desirability when examined at a microlevel with the VCBS. Discussion: The implications of the findings for further study of the contributions of EA and values to related behavior in addition to clinical practice are discussed. The use of ecological momentary assessment may be a viable alternative to measure value-congruent behaviors while minimizing the risk of social desirability and recall biases. If the interaction found is replicated in a clinical population, value-congruent behaviors can be increased in clinical work by either increasing the motivational impact of values or reducing the experiential barriers to these behaviors.

30. Long-term effectiveness of Group acceptance and commitment therapy for chronic dizziness: a pilot single-arm study
Primary Topic: Clinical Interventions and Interests
Subtopic: somatic symptom disorder
Masaki Kondo, Nagoya City University Graduate School of Medical Sciences
Wakako Igarashi, Kikuchi mental clinic
Keiko Ino, Nagoya City University Graduate School of Medical Sciences,
Toshitaka Ii, Nagoya City University Graduate School of Medical Sciences,
Sei Ogawa, 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: Chronic dizziness, so-called psychogenic dizziness, is characterized by dizziness or unsteadiness unexplained medically and existing most days for months or years. Chronic dizziness has a great impact on quality of life, and is assumed to be related to multi factors, such as vestibular function, somatic sensation, visual sensation, autonomic nervous system, and psychological elements. Cognitive behavioral therapy is one of the promising interventions, however, some patients seems to be reluctant to it because of their experiential avoidance. Therefore, we hypothesized that acceptance strategy may be functioning. The purpose of this preliminary study is to examine long-term effectiveness of group acceptance and commitment therapy for chronic dizziness. Methods: We enrolled adult outpatients at a special dizziness clinic who met the criteria of persistent postural-perceptual dizziness, which is the diagnosis criteria equivalent to chronic dizziness defined by the International Society for Neuro-Otology. Other vestibular diseases such as Ménière's disease, benign paroxysmal positional vertigo were accepted. Schizophrenia, bipolar disorder, depression, substance abuse and dependence, and severe medical condition were excluded. Participants received six weekly sessions of manualized group acceptance and commitment therapy combined with vestibular rehabilitation. The primary outcome was Handicap due to dizziness at six months after the intervention, measured by Dizziness Handicap Inventory. The secondary outcome was frequency of vestibular-related symptoms at six months after the intervention, measured by Vertigo Symptom Scale-short form. Paired t-test was conducted and within-subject effect size was calculated. Results: All nine participants received group acceptance and commitment therapy. Both handicap due to dizziness and frequency of vestibular-related symptoms were significantly decreased between pre-intervention and six months after the intervention with Hedges’s g = 1.56 and 1.09, respectively. . Conclusion: The results suggest that group acceptance and commitment therapy for chronic dizziness may remain effective for six months.

31. Long-term effectiveness of group acceptance and commitment therapy for chronic dizziness: a pilot single-arm study
Primary Topic: Clinical Interventions and Interests
Subtopic: somatic symptom disorder
Masaki Kondo, Nagoya City University Graduate School of Medical Sciences
Wakako Igarashi, Kikuchi mental clinic
Keiko Ino, Nagoya City University Graduate School of Medical Sciences
Toshitaka Ii, Nagoya City University Graduate School of Medical Sciences
Sei Ogawa, 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: Chronic dizziness, so-called psychogenic dizziness, is characterized by dizziness or unsteadiness which is unexplained medically and existing most days for months or years. Chronic dizziness has a great impact on quality of life, and is assumed to be related to multi-factors, such as vestibular function, somatic sensation, visual sensation, autonomic nervous system, and psychological elements. Cognitive behavioral therapy is one of the promising interventions, however, some patients seem to be reluctant to cognitive behavioral therapy because of their experiential avoidance. Therefore, we hypothesized that acceptance strategy may be functioning. The purpose of this preliminary study is to examine long-term effectiveness of group acceptance and commitment therapy for chronic dizziness. Methods: We enrolled adult outpatients at a neuro-otology clinic who met the criteria of persistent postural-perceptual dizziness, which is the diagnostic criteria equivalent to chronic dizziness defined by the International Society for Neuro-Otology. Other comorbid vestibular diseases such as Ménière's disease, benign paroxysmal positional vertigo were accepted. Schizophrenia, bipolar disorder, depression, substance abuse and dependence, and severe medical condition were excluded. Participants received six weekly sessions of manualized group acceptance and commitment therapy combined with vestibular rehabilitation. The primary outcome was handicap due to dizziness at six months after the intervention, measured by the Dizziness Handicap Inventory. The secondary outcome was frequency of vestibular-related symptoms at six months after the intervention, measured by Vertigo Symptom Scale-short form. Wilcoxon signed-rank test was conducted and within-subject effect size was calculated. Results: Nine participants received group acceptance and commitment therapy. Handicap due to dizziness was significantly decreased between pre-intervention and six months after the intervention (p<0.01, Hedges’s g = 1.56). Frequency of vestibular-related symptoms showed non-significant improvement between pre-intervention and six months after the intervention (p=0.051, Hedges’s g = 1.09). Conclusion: The results suggest that group acceptance and commitment therapy for chronic dizziness may remain effective for six months.

32. Psychometric properties of the Spanish version of the Valuing Questionnaire
Primary Topic: Clinical Interventions and Interests
Subtopic: Valuing Questionnaire, Values, ACT
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Juan C. Suárez-Falcón, Universidad Nacional de Educación a Distancia
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz

The Valuing Questionnaire (VQ) is a measure of valued living according to the definition of values of the acceptance and commitment therapy (ACT). It has a robust two-factor structure, comprising Progress and Obstruction. The VQ has shown good internal consistency and convergent and incremental validity. The current study analyzed the psychometric properties and factor structure of the Spanish version of the VQ in Colombia. The VQ was administered to a total sample of 1587 participants, including undergraduates, general population, and a clinical sample. Results were very similar to those obtained in the original VQ version. Internal consistency across the different samples was good (global Cronbach’s alpha of .85 for Progress and .84 for Obstruction). The two-factor model showed a good fit to the data, and measurement invariance was found across sample and gender. The mean Progress and Obstruction scores of the clinical sample were lower and higher, respectively, than the scores of the nonclinical samples. Correlations with other constructs were in the expected direction. The VQ was sensitive to the effects of a one-session ACT intervention. In conclusion, the Spanish version of the VQ shows good psychometric properties in Colombia.

33. Cognitive Defusion versus Cognitive Restructuring: An Analogue Examination of Potential Moderating Variables
Primary Topic: Clinical Interventions and Interests
Subtopic: Cognitive Defusion
Eric Richardson, M.A., Wichita State University
Robert Zettle, Ph.D., Wichita State University

The impact of negative self-referential thoughts on psychological problems has long been targeted in cognitive behavioral therapy (CBT) through cognitive restructuring. More recently, acceptance and mindfulness-based approaches within CBT have suggested cognitive defusion as an alternative strategy. The primary purpose of this analogue study was to compare the effects of brief cognitive restructuring and cognitive defusion protocols in reducing the believability and discomfort of targeted negative self-referential thoughts among college students. Its secondary purpose was to investigate whether levels of dysfunctional attitude endorsement and cognitive fusion differentially moderate the impact of the two interventions. While both protocols significantly reduced believability and discomfort to an equivalent degree, moderating effects were noted only for reducing emotional discomfort via cognitive defusion. The impact of this intervention was greatest for participants who endorsed dysfunctional attitudes to a lesser degree and reported greater entanglement with negative thoughts.

34. Designing a measure of generalized pliance: The Generalized Pliance Questionnaire
Primary Topic: Clinical Interventions and Interests
Subtopic: Generalized pliance, measurement
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Juan C. Suárez-Falcón, Universidad Nacional de Educación a Distancia
Paula Odriozola-González, Universidad de Valladolid
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz
Adrián Barbero-Rubio, Universidad de Almería
Juan C. López-López, Universidad de Almería
Nikolett Eisenbeck, Universidad de Almería

Pliance is a functional class of rule-governed behavior under the control of a history of socially mediated reinforcement for the correspondence between the rule and the person’s behavior (Zettle & Hayes, 1982). Generalized pliance occurs when social approval is established as the main, verbally constructed reinforcer across life domains (Luciano, Valdivia-Salas, & Ruiz, 2012; Törneke, Luciano, & Valdivia-Salas, 2008). The most relevant characteristic of individuals displaying generalized pliance is their hypersensitivity to social whim in a way that no consequences are important and/or contacted other that those socially mediated. This behavioral pattern is often problematic because traps the person in needing social approval, which is highly uncontrollable and unpredictable, and prevents contacting with many other naturally, positively reinforcing consequences. This study shows the development and psychometric properties of the Generalized Pliance Questionnaire (GPQ) in Spain and Colombia. Thirty-eight items were written by experts in relational frame theory and were applied to a Spanish sample of 130 undergraduates. According to the psychometric results, 20 items were eliminated and the 18-item questionnaire was applied to samples of undergraduates, general population, and clinical participants in both countries. The results showed that the GPQ has excellent psychometric properties and theoretically coherent correlations with other constructs.

35. Experiential avoidance mediates the relationship between generalized pliance and depression
Primary Topic: Clinical Interventions and Interests
Subtopic: Generalized pliance, Experiential avoidance, Depression
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Paula Odriozola-González, Universidad de Valladolid
Juan C. Suárez-Falcón, Universidad Nacional de Educación a Distancia
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz

Generalized pliance represents a rigid pattern of behavior regulation that can be summarized as behaving how it is supposed to in order to obtain others’ approval. It is often problematic because traps the person in needing social approval, which is highly uncontrollable and unpredictable, and prevents contacting with many other naturally, positively reinforcing consequences (e.g., Törneke et al., 2008). Thus, generalized pliance would potentially lead to negative thoughts and depressive feelings in reaction to negative life events mainly related to social issues. Even worse, generalized pliance often leads to patterns of experiential avoidance and psychological inflexibility because feeling good is usually connected to others’ approval and it is established as a necessary state to do other things in life (Luciano et al., 2012). The current study aimed to test whether experiential avoidance mediates the effect of generalized pliance in depression symptoms in diverse nonclinical and clinical samples from Spain and Colombia. The results were widely consistent with the previous assumption.

36. Group ACT Program for Patients with Panic Disorder.
Primary Topic: Clinical Interventions and Interests
Subtopic: Panic disorder
Keiko ino, Nagoya City University Graduate School of Medical Sciences
Toshitaka Ii, Nagoya City University Graduate School of Medical Sciences

【Background】 Panic disorder is a recurrent or chronic disease in the majority of cases. The most promising psychotherapy for panic disorder is cognitive behavioral therapy(CBT), and it works in a group setting as well as in individual. However, CBT works out controlling strategy, that sometimes allows patients to control anxiety in vain and then their symptoms remain. Acceptance and commitment therapy(ACT) developed opposite strategy that helps patients to release control and live for their value. ACT is promising therapy for treatment resistant panic disorder for this reason. Since ACT was introduced in Japan, it have been conducted in an individual setting in most cases. We started group ACT program specialized for panic disorder patients, which was the first attempt in Japan as far as we know. The aim of this study is to examine effectiveness of this program. 【Methods】We enrolled outpatients with chronic panic disorder in our university hospital. Participants received 12 weekly sessions which took 2 hours for each. One group was for 2 to 4 patients. We made our program reviewing “Acceptance and Commitment Therapy for Anxiety Disorder ” written by G.H. Eifert and J.P. Forsyth. The primary outcome is Panic Disorder Severity Scale(PDSS). We examined Cognitive Fusion Questionnaire and Acceptance and Action Questionnaire-Ⅱ as secondary outcome. 【Results】Two participants completed all the sessions and after a month follow up, as far as this abstract submission. On baseline assessment their PDSS scores located in 13 (markedly ill) and 9 (slightly ill). After the therapy, their scores improved to 7 (slightly ill) and 3 (borderline). One month after treatment, their PDSS scores are 1 (normal) and 2 (normal) and patient didn’t complain any symptoms. We are enrolling several patients and group therapy is now ongoing. 【Conclusion】Group ACT for panic patients may be effective. Patients improve their symptoms much better during one month after therapy. We will examine efficacy of this program with more participants and be ready for presentation at ACBS world conference, 2016.

37. Mindfulness and Acceptance for Type 2 Diabetes: A Meta-Analysis
Primary Topic: Clinical Interventions and Interests
Subtopic: Meta-analysis
Leah Bogusch, M.A., Bowling Green State University
Sonia Singh, M.A., Bowling Green State University
William O'Brien, Ph.D., Bowling Green State University
Tanya Watford, M.S., Bowling Green State University

Among people with Type 2 Diabetes Mellitus (T2DM), mindfulness and acceptance may be associated with decreased distress and improved health outcomes. The present study provides a quantitative review of studies utilizing mindfulness or acceptance interventions among individuals with T2DM to improve diabetes-related outcomes. A literature search yielded 12 unique treatment-outcome studies. Meta-analytic results of mindfulness- and acceptance-based interventions yielded a small and reliable effect size for pre-post changes on HbA1c and fasting blood glucose for treatment groups (d = .23, 95% CI = .06, .41), and an unreliable effect size for control groups (d = .11, 95% CI = -.12, .34). Treatment-control group comparisons at post-test were statistically unreliable for HbA1c and fasting blood glucose (d = -.07, 95% CI = -.46, .32). These results indicate that participation in mindfulness- or acceptance-based interventions likely confers improvement in metabolic functioning, though these effects may be partially attributable to unrelated factors.

38. Coping With Autism - Providing Functional Contextual Support for Parents in Crisis
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression, Coping, Autism, Parenting
Carmen McGuinness, EdD, BCBA-D, Chrysalis School, Chrysalis Center for Change, Nova University, Capella University
Larry J. Leech, Freelance author of memoirs

BACKGROUND: The diagnosis of autism can be devastating news for parents. Whether parents lean in and cope through engagement with their child, or avoid and deny the problem, is directly related to their sense of well-being. Parents who engage have a higher sense of well-being, while parents who deny or avoid have a lower sense of well-being. Children whose parents are actively engaged in parenting and treatment will have better outcomes than their peers whose parents deny or avoid. Parenting self-efficacy is also associated to coping strategies for parents of children with autism. When parents know what to do it is easier to cope by engaging. When parents do not know what to do parenting self-efficacy is low, which worsens sense of well-being as well as child outcome trajectory. METHOD: A single-subject quasi-experimental A-B-C research design study was conducted to investigate the effects of a 6-week parent training workshop in Applied Behavior Analysis on parent coping, parent self-efficacy, parent sense of well-being, and child compliance to parental requests. Baseline, treatment, and follow-up phase data were collected. During the treatment phase parents received training in behavior change procedures, the interaction of behavior and development, compliance training, thoughts as behaviors, parental coping, reinforcement and the physiology of thoughts, and reframing and defusion. Parents were taught to use applied behavior analysis for the management of their child’s behavior as well as their own behavior insomuch as it relates to their child’s behavior and their own sense of well-being. RESULTS: Phase data were graphed for visual analysis of repeated measures. Analysis included intensity of parental coping, parental self-efficacy, and parental sense of well-being, and frequency of child compliance. Results of this study indicate that parents’ engagement coping, parenting self-efficacy, parents’ sense of well-being, and child compliance to parental requests increased significantly following a 6-week parenting workshop. DISCUSSION: These findings point to the importance of functional contextual treatment of parents of children with autism in conjunction with instruction in behavior analytic practices for treatment of autism. With the rise in autism diagnoses, it is critical that therapists prepare for supporting parents of children with autism.

39. The Role of Psychological Flexibility in Living with Lipedema
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, lipedema
Joanna E. Dudek, M.A., University of Social Sciences and Humanities, Warsaw
Adam M. Kuczynski, University of Washington
Pawel Ostaszewski, Ph.D., University of Social Sciences and Humanities, Warsaw
Wojciech Białaszek, Ph. D., University of Social Sciences and Humanities, Warsaw
Tilly Smidt

Background Lipedema (lipoedema) is a chronic disease of unknown etiology that leads to uncontrollable, visible changes in body appearance and associated chronic pain. It affects approximately 11% of women in Western countries and is often mistaken as obesity given that the main symptom is fat accumulation on the extremities. Previous research shows that psychological flexibility (PF) positively predicts quality of life in women with lipedema when controlling for symptom severity. Methods 330 women suffering from lipedema were recruited from various international online groups. Each participant took an hour-long online survey to explore the association between psychological flexibility (PF) and quality of life while controlling for symptom severity, mobility, psychological functioning, and appearance related avoidance and distress. Results Using hierarchical multiple regression analysis, we replicated the results of existing research as well as demonstrated that PF remains a significant predictor of quality of life while controlling for other important variables. Discussion Results suggest that an intervention targeting psychological flexibility may be beneficial for women with lipedema.

40. Acceptance and Commitment Therapy in a Maximum Security Prison
Primary Topic: Clinical Interventions and Interests
Subtopic: Maximum Custody Offenders
Eric Rainey-Gibson, Ph.D., Washington State Penitentiary (WSP)
Jamie Davis, MA, Washington State Penitentiary (WSP)

Background: Both at the Federal and the State level, there is increasing attention being placed on segregated offenders in a prison population setting. Currently, there is a push coming down from the headquarters level of our state prisons to be providing programming to segregated offenders. As such, there is a 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, though relatively new to the prison culture is proving effective in working with this particular population. Method: Students are selected to participate in the Achieve Your Potential (AYP) program at Washington State Penitentiary’s (WSP’S) maximum security unit based on submitted applications, mental health diagnosis, and willingness to participate in programming. Students attend classes twice a week. Students learn Dialectical Behavior Therapy skills and Acceptance and Commitment Therapy Skills over the course of 8 weeks. Classes include psycho-education, group discussion, skills application, and homework assignments. Outcomes measures include the following self-report measurement: the Acceptance and Action Questionnaire (AAQ-II). The AAQ-II is administered pre-treatment, mid-treatment, and post-treatment. Preliminary results for 16 patients will be available for presentation in June 2016 together with a discussion on clinical implications and future research plans. Discussion implications of these results and future prison implementation will also be discussed. Future studies should include using ACT processes across different prison custody levels and prison settings (maximum custody, close custody, medium custody, minimum custody, residential treatment, women’s prison).

41. Exposure Therapy and Mindfulness for Agoraphobia in a Nursing Home Setting
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Mary Moeller, Bowling Green State University
Leah Bogusch, M.A., Bowling Green State University
William O'Brien, Ph.D., Bowling Green State University

BACKGROUND: Agoraphobia is one of few anxiety disorders that seem able to occur for the first time during old age (Flint, 1994). The widely-accepted treatment for agoraphobia is exposure therapy. Mindfulness can be used to increase willingness to approach uncomfortable situations (Treanor, 2011). Because teaching mindfulness is associated with improvement in emotion regulation, it may supplement exposure therapy well (Arch & Craske, 2006; Treanor, 2011). Very few studies have used mindfulness on nursing home residents, and this present case study also explores the feasibility and efficacy of using such an intervention with that population. METHODS: The participant in this study was a 59-year-old ambulatory Caucasian female who had lived in a nursing home for the past year and was experiencing symptoms of severe agoraphobia. Progress was measured using a pedometer to track the number of steps she took. Self-report measures were also used, including the Acceptance and Action Questionnaire (AAQ-II), Five Facet Mindfulness Questionnaire (FFMQ), daily rankings of depression and anxiety, and a brief questionnaire asking how many times she left her room each day and how many people she interacted with. The intervention was administered over the course of five weekly hour-long sessions. Baseline data were collected during the first two sessions, and it was during those sessions that exposure therapy was explained and the patient collaborated with the researchers to create a values hierarchy. A functional analytic model of her behavior was also created after two sessions with the client and was updated as needed throughout the study. The third, fourth, and fifth sessions focused on implementing progressive exposures based on her values hierarchy and brief mindfulness exercises. RESULTS: Therapy outcomes were analyzed using Reliability of Change Indices for the AAQ and FFMQ. They showed that the client had a significant reduction in psychological inflexibility (RCI: -4.46) and a significant increase in global mindfulness (RCI: 5.07). The percentage of non-overlapping data points for the number of steps taken by the client (33.33% above baseline) showed that the client increased her activity levels with treatment. The results also indicated through non-overlapping data points that the client had less anxiety (22.22% below baseline) and depression (22.22% below baseline) after the last session. DISCUSSION: Results indicate that the patient became more willing to face uncomfortable emotions and sensations associated with leaving her room. Increases in mobility may have psychological implications for her: among the nursing home population, increased mobility is associated with better mental health and quality of life (Aydin, Sari, Bingul, & Bulgan, 2014). These findings provide preliminary support for the use of mindfulness to supplement exposure therapy among nursing home residents with agoraphobia. They also support the use of mindfulness in a nursing home setting in general. References Arch,J. J., & Craske, M. G. (2006). Mechanisms of mindfulness: Emotion regulation following a focused breathing induction. Behaviour Research and Therapy, 44,1849-1858. Aydin, M., Sari, N., Bingul, B. M., & Bulgan, C. (2014). The effects of recreation activities on life quality of old age people in a local nursing home. International Journal of Academic Research, 6(1), 117-120. Flint, A. (1994). Epidemiology and comorbidity of anxiety disorders in the elderly. The American journal of psychiatry, 151(5), 640-650 Treanor, M. (2011). The potential impact of mindfulness on exposure and extinction learning in anxiety disorder. Clinical Psychology Review, 31, 617-625.

42. Policy and Prejudice: Implicit Bias Toward People in Poverty and its Predictive Relationship to Welfare Funding and Voting Behavior
Primary Topic: Functional contextual approaches in related disciplines
Subtopic: IRAP
A. Theodore Artschwager, B.A., University at Albany, State University of New York
Timothy R. Ritzert, M.A., University at Albany, State University of New York
John P. Forsyth, Ph.D., University at Albany, State University of New York

Background: Negative bias toward people in poverty is highly prevalent. Such response tendencies can manifest as a range of behaviors such as discrimination, stigmatization, and reduced willingness to contribute to social programs assisting people in poverty, resulting in negative outcomes. However, poverty bias research has been conducted solely using explicit self-report questionnaires, which are prone to social desirability influences. Indeed, poverty researchers have suggested it might be helpful to assess poverty bias using implicit measures, which do not require deliberate introspection and elaborated responding. Yet, no research has used implicit assessments to examine responses to people in poverty. Moreover, little research has explored the relation between poverty bias and important behaviors, such as voting. Such work is important considering attention given to social issues such as economic inequality during recent US elections. Better understanding how people respond to those in poverty, and how such tendencies relate to other behaviors, might increase understanding of voting behavior and aid in the design of interventions targeting reductions of economic inequality. Objective: The aims of this study are to evaluate explicitly- and implicitly-assessed poverty bias, the relation of poverty bias to relevant constructs, and the incremental predictive validity of implicitly assessing poverty bias in the prediction of voting behavior related to welfare programs and political candidates. Method: Data collection is ongoing, with 30 undergraduates completing a version of the Implicit Relational Assessment Procedure (IRAP; Barnes et al., 2006) designed to assess properties of relational responding toward people in poverty and middle-class individuals. The IRAP is an implicit measure, based on Relational Frame Theory (RFT), that assesses the strength of relational responses (i.e., the degree to which stimulus relations have been derived in the past). Participants are also completing self-report measures assessing beliefs about poverty causes, political party affiliation, and relevant constructs. Finally, participants are completing an assessment measuring willingness to allocate funds to government-run welfare programs and voting preference for US Presidential candidates. Conclusions/Expected Results: We expect participants to demonstrate IRAP effects indicative of an anti-poor/pro-middle-class relational bias, suggestive of histories of responding negatively to poor people. Furthermore, we expect IRAP effects correlate with related self-report measures and political party affiliation, such that individuals exhibiting traditionally conservative attributes (e.g., endorsement of the Protestant Work Ethic) will display stronger IRAP effects. Finally, we anticipate that IRAP effects will predict voting behavior, over and above explicit measures. Results will be discussed in the context of using a contextual behavioral science (CBS) approach to assessing the nature and impact of poverty bias. This work is consistent with recent efforts to expand the reach of CBS outside clinical psychology, using CBS to address a broad spectrum of social justice issues.

43. On Being Present in Therapy: Validation of a French Translation of the Therapeutic Presence Inventory
Primary Topic: Other
Subtopic: Therapeutic Presence
Marie-Eve Martel, M.A., Psy.D.(c), Université du Québec à Trois-Rivières
Joel Gagnon, Ph.D.(c), Université du Québec à Trois-Rivières
Maxime Bourgault, Psy.D.(c), Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières

Background: Despite the growing amount of research on mindfulness over the past few years, therapeutic presence seems to have only lately begun to spark interest in scientific research, and more research is needed to better understand its role in psychotherapy. Recently, the Therapeutic Presence Inventory (TPI; Geller, Greenberg, & Watson, 2010) has been developed to measure therapists’ presence in psychotherapy, but this self-report measure has yet to be translated and validated in French for clinicians or researchers. Method: This study aims to bring preliminary data on the factorial structure of a French translation of the 21-item TPI. The study was conducted among a sample of 151 French-speaking therapists in the province of Quebec (Canada). The majority of participants were women (70%), with a mean age of 46.3 (SD = 11.32). Results: Results from an exploratory factor analysis yielded a two-factor solution in which positively worded items represented one factor and negatively worded items represented the other factor. Confirmatory factor analyses were used to test for possible method effects based on the wording of items. Six alternative models were tested. Results showed that all the models controlling for method effects fit the data better than the two-factor solution. Discussion: These results suggest the presence of possible method effects based on the wording of items of the French TPI. Implications and future research directions will be put forward. Keywords: Therapeutic Presence; Mindfulness; Psychotherapist Training/Supervision/Development; Process Research; Translation.

44. Predicting psychological well-being of children based on their mothers psychological flexibility, mindfulness, mother-child relationships and demographic characteristics
Primary Topic: Other
Subtopic: psychological well-being, psychological flexibility, mindfulness, mother-child relationship
Leili Nourian, M.A., Islamic Azad University, Najafabad branch, Isfahan, Iran
Asghar Aghaei, Ph.D., Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

The aim of this study was to predict psychological well-being of children based on their mother’s psychological flexibility, mindfulness, mother-child relationship and demographical characteristics. The research employed a correlational method. The sample consisted of 472 children (221 boys, 251 girls) aged 9 to 13, who were selected through multi-stage random cluster sampling from elementary school students in Isfahan (Iran) in 2015. Research Instruments were String Children’s Well-being Scale (SCWBS), Parental Psychological Flexibility Questionnaire (PPF), Five Facet Mindfulness Questionnaire (FFMQ), Mother-Child Relationship Evaluation (MCRE), and demographic characteristic questionnaire. The results of stepwise regression analysis indicated that cognitive defusion and acceptance of mothers, age of fathers, mothers education and financial situation of family can predict children’s well-being (P<0.05). So, using treatment methods to help mothers to increase their acceptance and cognitive defusion skills is recommended to increase the children psychological well-being. Also some of demographic characteristics like financial situation of family, level of mother’s education and age difference between father and child, should be considered as influential variables on psychological well-being of children.

45. The Reliability and validity of the Korean version of Parental Acceptance Questionnaire(6-PAQ)
Primary Topic: Other
Subtopic: Parenting, children, psychological flexibility
Seunmin Kim, Seoul Women's university
Kyung Park, Ph.D, Seoul Women's unversity

Background: The purpose of this study focused on the validation of the korean version of the Parental Acceptance Questionnaire(6-PAQ) which was developed by Greene, Field, Fargo and Twohig(2015). The 6-PAQ assesses all six process of parental psychological flexibility. Recently, the researchs of the ACT for distressed parents has been conducted, and the therapeutic effects has been proven in korea. But for the general measure of psychological flexibility is uesed the Acceptance and Action Questionnaire-II. So, the development of measurement tools that adequately measure psychological flexibility in the parenting is needed in korea. Method: To develop the Korean version of 6-PAQ, after obtaining permission of the original authors, one clinical psychologist and professional translator translated the English version into korean. Then, two clinical psychologists and ACT professionals modified the korean version to preserve the conceptual equivalence of original version. The participants were parents of children between the ages of 3 and 12 who agree with the purpose of this study. The study materials included the K-6-PAQ, K-AAQ-II, KIMS, EQ, PWBS, PSOC, PSI/SF, PANAS and Hwa-Byung symptom scale. Results: Now, the collected data is in the process of conducting statistical analysis.

46. Impact Of A Routine Treatment Programme Applied in Addiction Centers In Turkey On Psychological Flexibility
Primary Topic: Other
Subtopic: drug addiction
Dr. M. Emrah Karadere, MD, Hittite University, School of Medicine, Department of psychiatry , Corum
Turkan Dogan, Eskişehir State Hospital, Eskişehir, Turkey
Basak Demirel, Konya Training and Research Hospital, Konya, Turkey
Esra Porgalı Zayman, Elazıg State Hospital For mental Health and Disorders
Sevinc Ulusoy, Elazıg State Hospital For mental Health and Disorders
Ece Yazla, Hittite University, School of Medicine, Department of psychiatry , Corum

Background: Substance use disorders are characterized by recurrent, maladaptive use of drugs and/or alcohol (1) which often leads to significant distress and impairment in social, interpersonal, and occupational settings (2,3). Several psychotherapy approaches and medications are being used in the treatment of addiction. SAMBA is a kind of psychoeducation programme applied in the form of group therapy in addiction centers of state hospitals in Turkey (4). Investigation the impact of SAMBA programme on psychological flexibility is aimed in this study. Method: According to DSM-V criteria, 15 inpatients with cannabis and opioid use disorders from three different addiction centers in Turkey were enrolled. Patients participated three-week and 9 session SAMBA programme. Clinical Global Impression scale (CGI), Beck depression inventory (BDI), Beck Anxiety Inventory (BAI) and Acceptance and Action Questionnaire-II (AAQ-II) were applied before and after the treatment programme to evaluate the clinical change. Also Addiction Severity Index (ASI) was used to evaluate disorder severity. Results: The mean age of participants was 27,63±8,67 and all of them were male. The 40% (6) were married, 47,7%(7) were single and 13,3% (2) were divorced. 53,3%(8) of the participants were primary school graduate, 33,3%(5) were high school graduate and 13,3%(2) were university graduate. Ratio of the subscales of ASI was: drug 0,45; alcohol 0,33; psychological 0,45; physical 0,22; family 0,46; employment 0,58. The initial mean scores of BDI, BAI, CGI and AAQ-II were 32,27±15,17; 23,60±15,69; 28,00±10,99; 3,87±1,06 respectively. A significant difference was found between the initial and after treatment mean scores of BDI and CGI (p<0,001). No significant difference was found between the initial and after treatment mean scores of BAI(p=0,042) and AAQ-II(p=0,046). Discussion: This paper shows the preliminary results of a study about psychological flexibility and psychoeducation weighted group therapy programme.Our results about BDI and BAI can show that change process may be related with metacognitive process like rumination rather than worry. It should be replicated in a large sample for certain results. Reference: 1. American Psychiatric Association, 2013. Diagnostic and statistical manual of mental disorders, 5th ed. American Psychiatric Publishing, Arlington, VA. 2. Henkel, D., 2011. Unemployment and substance use: a review of the literature (1990–2010). Curr. Drug Abuse Rev. 4, 4–27. 3. Mueller, S.E., Degen, B., Petitjean, S., Wiesbeck, G.A., Walter, M., 2009. Gender differences in interpersonal problems of alcohol-dependent patients and healthy controls. Int. J. Environ. Res. Public Health 6, 3010–3022. 4. Ögel K., Koç C., Aksoy A., Basabak .A, Evren C. Sigara, Alkol ve Madde Bağımlılığı Tedavi Programı (SAMBA). Yeniden Yayınları, İstanbul, 2012

47. Psychological Inflexibility Predicts Attitudes Toward Syrian Refugees and National Security Policies
Primary Topic: Other
Subtopic: Political Psychology
Arthur Hatton, M.S., Georgia Southern University
Michael Nielsen, Ph.D., Georgia Southern University

Our research examines whether psychological inflexibility predicts support for national security policies that limit civil liberties, unfairly target Muslims, and exclude Syrian refugees from entering the country. New research has suggested that high psychological inflexibility may be implicated in prejudice (Vilardaga, Estevez, Levin, & Hayes, 2012). According to that theory, inflexibility may contribute to discriminatory behaviors because it describes a person's tendency to engage in behaviors aimed at down-regulating internal distress. Recently, an enormous number of refugees from Syria have relocated from Syria into the EU, other Middle Eastern Countries, and in the United States. A political backlash to both the threat of terrorism and the large number of refugees has emerged in the United States, with a number of governors declaring that their states will not accept these refugees. We hypothesize that inflexibility may predict whether people support policies aimed at making the nation safer in light of terrorist threats, even if those policies restrict civil rights or unfairly target minorities. We surveyed 107 students from a southern American university to examine whether psychological inflexibility predicted support for a number of civil rights-restricting security policies, including policies that ban Syrian refugees from entering the country. We found that inflexibility was highly correlated with support for these policies. We then ran a regression to see which personality traits were most predictive of support for banning Syrian refugees from settling in the country. The results showed that political conservatism and inflexibility were both significant predictors, with inflexibility being slightly more predictive.

48. The Efficacy and Acceptability of Third Wave Behavioural and Cognitive eHealth Treatments: A Systematic Review and Meta-analysis of Randomised Controlled Trials
Primary Topic: Other
Subtopic: eHealth
Martin O'Connor, M.Sc., University College Dublin
Anita Munnelly, Ph.D., University College Dublin
Robert Whelan, Ph.D., University College Dublin
Louise McHugh, Ph.D., University College Dublin

Background: eHealth has the potential to improve access to third wave behavioural and cognitive therapies. This systematic review and meta-analysis aimed to determine the efficacy and acceptability of third wave eHealth treatments. Methods: A comprehensive search of electronic bibliographic databases including PubMed, PsychINFO and Web of Science was conducted to identify randomised controlled trials of third wave treatments in which eHealth was the main component. Results: Twenty-six studies were included in the review, 24 of which featured in the meta-analyses. Meta-analyses revealed that third wave eHealth significantly outperformed both inactive and active control conditions at post-treatment with small to medium effect sizes. The efficacy of third wave eHealth was not significantly different to that of comparison interventions. Conclusions: The findings of this review indicate that third wave eHealth treatments are acceptable to participants and efficacious in improving a range of psychological problems, but not more so than comparison interventions.

49. Unwillingness: Finding common ground among experiential avoidance, distress intolerance and related constructs
Primary Topic: Other
Subtopic: Measurement of core constructs
Tamara Loverich, PhD, Eastern Michigan University
Kate Happel Krautbauer, Eastern Michigan University
Jessica Baker, Eastern Michigan University
Sarah Webb, Eastern Michigan University

Experiential avoidance and distress intolerance are key transdiagnostic constructs in contextual behavioral science. Many studies utilize one or both concepts as indices of the unwillingness to adaptively experience private events, whether purely physiological, or more broadly cognitive or emotional in nature. Conceptually related constructs such as intolerance of uncertainty, low frustration tolerance, nonacceptance, and shame aversion have been similarly employed. Our science may be better served by further clarifying the conceptualization and measurement of unwillingness and its factors. This presentation will offer pilot data from a university sample using EFA and CFA to initially explore the convergence and distinctiveness of the dimensions of the AAQ-II, MEAQ, IUI-A, DTS, IUS, FDS, SSAS, DERS and the SHARQ, and discuss the potential for and implications of developing consensus around a single unifying unwillingness construct.

50. The Acceptance and Action Questionnaire - Stigma: An exploratory factor analysis using a Hispanic college student sample
Primary Topic: Prevention and Community-Based Interventions
Subtopic: stigma
Jessica Villarreal, Metropolitan State University of Denver
Maureen K. Flynn, Ph.D., Metropolitan State University of Denver
A. Solomon Kurz, M.A., University of Mississippi

The Acceptance and Action Questionnaire – Stigma (AAQ-S; Levin, Luoma, Lillis, Hayes, & Vilardaga, 2014) is a measure of psychological flexibility with stigmatizing thoughts. The AAQ-S has adequate internal consistency reliability and good construct validity (Levin et al., 2014). Regarding factor structure, the AAQ-S showed a two-factor solution using a principal components analysis (PCA) with a varimax rotation (Levin et al., 2014). Problems arise, however, when examining the factor structure of a measure using a PCA and varimax rotations and it is recommended that an exploratory factor analysis (EFA) with an oblique rotation be used instead (e.g., Preacher & MacCallum). To date, there are no published studies examining the factor structure of the AAQ-S using an EFA. The purpose of the current study was to examine the factor structure of the AAQ-S using an EFA. The current study’s sample consisted of 237 Hispanic college students enrolled in a university on the Texas/Mexico border. A parallel analysis was conducted to determine the number of factors in the AAQ-S. This examination suggested that three factors could be extracted from the data. Next, an EFA with a direct oblimin rotation using Maximum likelihood estimation was conducted. Results showed a three-factor solution. No items were removed due to high cross loadings with other factors. Implications and future directions will be discussed.

51. Effects of Mindful Food Parenting on Children’s Eating Habits and Behavior
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness
Lindsey Roberts, M.A., Bowling Green State University
Lynnel Goodman, B.S., Bowling Green State University
Jenna Marx, M.S., Bowling Green State University
Dara Musher-Eizenman, Ph.D., Bowling Green State University

Children’s eating habits and taste preferences are established early, with many children establishing lasting patterns and relations to food during the preschool years (e.g., Birch & Marlin, 1982). Although parental feeding practices have been studied in relation to children’s weight and food intake, relatively little attention has been paid to mindfulness and the ways in which it might relate to children’s eating habits and behavior. The current study (N = 481) looked at mindful food parenting for children 3 to 6 years old and hypothesized that increased parental mindfulness would be associated with healthier eating patterns and less problematic behavior by children. Two subscales--Present-Centered Awareness and Satiety Mindfulness— comprise the Mindful Food Parenting Scale (Meers, 2013). As hypothesized, linear regressions revealed that both subscales were negatively associated with children’s problematic mealtime behavior (r2 = .11, p < .001), emotional overeating (r2 = .23, p < .001), food fussiness (r2 = .15, p < .000), and food responsiveness (r2 = .16, p < .001); contrary to hypotheses, parental mindfulness did not predict children’s satiety responsiveness. Overall, these results suggest that promoting mindful feeding practices among parents could help children to establish healthy relations to food at a young age, with mindfulness serving as a low-cost, easily applicable intervention with long-lasting health implications.

52. Mindful Food Parenting Practices across Parenting Styles
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness, Parenting, Feeding
Lynnel Goodman, B.S., Bowling Green State University
Lindsey Roberts, M.A., Bowling Green State University
Jenna Marx, M.S., Bowling Green State University
Dara Musher-Eizenman, Ph.D., Bowling Green State University

Parents play an important role in developing their child(ren)’s eating habits, with research suggesting that parenting style is related to child weight and eating behaviors (e.g., Rhee, Lumeng, Appugliese, Kaciroti, & Bradley, 2006). However, very little research has examined the role of mindfulness in feeding. The present study (n = 475) examined how two aspects of mindful feeding—Present-Centered Awareness and Satiety Mindfulness—differed across three parenting styles (authoritative, authoritarian, and permissive), hypothesizing that authoritative parents would use more mindful feeding practices than would permissive or authoritarian parents. A one-way MANOVA revealed that mindful feeding significantly differs across parenting styles, Wilks’ λ =.834, F (4,562) = 13.34, p <.001. Pairwise comparisons revealed that authoritative parents (M = 3.87, SD = .74) were significantly higher in Present-Centered Awareness than authoritarian (M = 3.35, SD = .67) or permissive parents (M = 3.56, SD = .69). Authoritative parents were also significantly higher in Satiety Mindfulness (M = 4.25 SD = .61) than authoritarian (M = 3.70 SD = .70) or permissive parents (M = 3.84 SD = .70). Overall these results suggest that authoritative parents feed their children more mindfully than authoritarian or permissive parents, suggesting that mindfulness may be one mechanism through which authoritative parenting predicts positive feeding outcomes and may be important to include in feeding interventions.

53. ACT with At-Risk Adolescents: A Community-Based Preventive Intervention
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents
Emily B. Kroska, M.A., University of Iowa
Rosaura Orengo-Aguayo, M.A., University of Iowa
Michael O'Hara, PhD, University of Iowa
James Marchman, PhD, University of Iowa

Background: Acceptance and Commitment Therapy (ACT) has demonstrated improvements in functioning across mental and physical health domains and has garnered empirical support through hundreds of clinical trials. Community-based interventions and prevention research are a necessary step in both research and dissemination. The use of ACT as a prevention tool will help individuals to develop and implement psychological flexibility before the emergence of psychopathology. Recent research suggests that ACT may be particularly effective with youth (Horowitz & Garber, 2006). The current study addressed three gaps in the ACT research literature: 1) the application of ACT to prevention science, 2) the implementation of ACT in community settings, and 3) the use of ACT with adolescents. Method: The present study tested the effectiveness of a five-hour group ACT intervention with adolescents attending an alternative high school in Iowa. Fifty-three students were aged 14-18 volunteered to participate in the study. The intervention was based on the core ACT processes with the goal of increasing psychological flexibility. Experiential activities and discussion were used to clarify valued life directions, examine the workability of avoidance, and suggest mindfulness and acceptance as alternatives. Participants completed assessments at baseline (at time of enrollment), pre-intervention, one-month follow-up, three-month follow-up, six-month follow-up, and one-year follow-up. In addition, attendance and grades data were obtained at pre- and post-intervention. Results: Longitudinal analyses using mixed-effects modeling revealed significant improvements in the targeted processes (higher levels of mindfulness, reduced avoidance) and secondary outcomes (lower levels of depressive and anxiety symptoms). Objective data obtained from the school indicated that attendance increased between pre- and post-intervention (trend-level significance). Moderation analyses indicated that change over time varied as a function of the number of traumatic experiences reported at baseline. Simple effects analyses revealed that individuals who reported higher levels of trauma benefited most from the intervention across depression, anxiety, avoidance, and mindfulness. Discussion: The current study underscores the importance of applying ACT to prevention work and in community settings. The findings indicate that significant change was observed over time across outcome variables, and this change was moderated by number of traumatic experiences. Thus, the implementation of ACT in an alternative high school was feasible and acceptable. The effectiveness of this intervention should be further examined through a RCT.

54. Examining the Effectiveness of Group Based Acceptance and Commitment Therapy for Adolescents in a Community Outpatient Mental Health Setting
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents, Group Treatment, Transdiagnostic intervention, Anxiety, Depression
Tajinder Uppal Dhariwal, M.A., OISE/University of Toronto
Sheri Turrell, Ph.D., Trillium Health Partners
Mary Bell, M.S.W., R.S.W., Trillium Health Partners
Marci Gordeyko, M.A., OISE/University of Toronto

Background: Acceptance and commitment group therapy has been found to be effective for a transdiagnostic adult population within the hospital setting (Pinto et al., 2015). There is limited research of ACT group treatment with adolescents (Halliburton & Cooper, 2015). The effectiveness of ACT group treatment for adolescents diagnosed with heterogeneous psychiatric disorders in a community hospital has not yet been examined. Objective: The present study examined the effectiveness of 10 week group-based ACT treatment for adolescents presenting with primarily anxiety and depression-related psychiatric difficulties in a community outpatient mental health setting. Methods: Adolescents (n = 72) diagnosed with anxiety and depression-related psychiatric disorders took part in the present open trial. Data were collected prior to treatment, post-treatment and three months following the treatment. Participants completed outcome (anxiety and depression symptoms) and ACT process measures (cognitive fusion/experiential avoidance, mindfulness and values-based direction). The present study consists of data collected from fifteen groups run over three years. Results: Analyses revealed significant reductions in anxiety and depression symptoms from pre- to post-treatment. Significant reductions in anxiety and depression symptoms were also found from post-treatment to three months following the treatment. Changes in ACT process measures were determined to predict changes in anxiety and depression symptoms. Discussion: The present research provides support for ACT group treatment as a transdiagnostic approach for adolescents presenting with primarily anxiety and depression-related heterogeneous psychiatric disorders in the community. Future research comparing ACT group treatment and existing treatments in the community setting with a similar population is warranted. References Halliburton, A. E., & Cooper, L. D. (2015). Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. Journal of Contextual Behavioral Science, 4(1), 1–11. doi:10.1016/j.jcbs.2015.01.002 Pinto, R. A., Kienhuis, M., Slevison, M., Chester, A., Sloss, A., & Yap, K. (2015). The effectiveness of an outpatient Acceptance and Commitment Therapy Group programme for a transdiagnostic population. Clinical Psychologist. doi:10.1111/cp.12057

55. Implicit attitudes to female body size in women with high and low body dissatisfaction: An IRAP study.
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Alba Antequera-Rubio, M.Sc., University of Jaén, Spain
Monica Hernandez-Lopez, Ph.D., University of Jaén, Spain
Miguel Rodriguez-Valverde, Ph.D., University of Jaén, Spain

Background: Research on implicit attitudes to body size reveals the existence of a preference for images of thinness over images of fatness. Studies that have employed the Implicit Relational Assessment Procedure (IRAP) have shown that this attitudinal bias is specifically attributable to a pro-thin attitude, rather than to an anti-fat one. Method: In this study two groups of nonclinical female college students (22 women with high levels of body dissatisfaction and 21 women with low levels of body dissatisfaction, measured by the Body Shape Questionnaire) completed an IRAP with two labels (Pleasant and Unpleasant) and twelve targets (six photographs of underweight girls and six of overweight girls). Additionally they completed a visual analogue scale with the same photographs to measure explicit attitudes. Results:The IRAP results indicate that women with high levels of body dissatisfaction showed a pro-thin bias while women with low levels of body dissatisfaction did not. The explicit measure results revealed a general pro-overweight but not anti-thin attitude in both groups. The pro-overweight attitude was stronger in participants with high levels of body dissatisfaction. Discussion: Dissatisfaction with one's own body image appears to affect implicit attitudes to thinness and fatness.

56. Investigation of validity on the Kanji maze task as a defusion measure from verbal relation and relational responding.
Primary Topic: Relational Frame Theory
Subtopic: Depression Defusion
Yuki Shigemoto, Graduate School of Psychology, Doshisha University, JSPS Research Fellow
Takashi Muto Ph.D, Faculty of Psychology, Doshisha University

Background: The purpose of this study was to investigate whether the Kanji maze task is a valid measure of defusion. While the IRAP (Implicit Relational Assessment Procedure) is a useful tool for assessing defusion, it is difficult to implement in clinical interview due to its length. Thus, this study developed a new behavioral task, the Kanji maze task, to measure defusion and investigated its validity in regard to verbal relation and relational responding. Method: An alphabet-maze was the basis of the Kanji maze task. In this study two types of Kanji maze were developed. One is the depressed words Kanji maze and the other is the neutral words Kanji maze. A total of 73 undergraduate students completed the Ruminative Response Scale (RRS), Cognitive Fusion Questionnaire (CFQ), Acceptance and Action Questionnaire-II (AAQ-II) and Beck Depression Inventory-II (BDI-II) and performed the IRAP and Kanji maze task. Results: Two scores are calculated for the Kanji maze task: the reaction time as a measure of verbal relation ant the inflexibility score as a measure of relational responding. The validity of verbal relation was examined using reaction time on the Kanji maze task and the IRAP. No correlation was found between scores on these two tasks. However, those who scored higher on the BDI-II chose depressive words of Kanji maze faster than those with a lower BDI-II score. A 2 (high score / low score of questionnaire)×4 (4 trial types of IRAP) ANOVA was conducted. On the AAQ-II and CFQ, high-scoring individuals confirmed positive feelings more slowly and refused negative feelings faster than low-scoring ones. The validity of relational responding was examined through the inflexibility score of the Kanji maze and overall Dscore of the IRAP. A significant negative correlation between inflexibility score and overall Dscore was found. Discussion: The results of indicate that the reaction time on the Kanji maze task is not a valid measure of verbal relation. However, the results do suggest that the reaction time of depressive individuals is slower than that of minimal or mild depressive individuals. The finding for relational responding showed that the inflexibility score of the Kanji maze task has validity.

57. An Initial Application of Relational Frame Theory to Anorexia Nervosa
Primary Topic: Relational Frame Theory
Subtopic: Anorexia Nervosa
Kate Happel Krautbauer, B.A., Eastern Michigan University
Tamara Loverich, Ph.D., Eastern Michigan University

Background: Anorexia nervosa impacts approximately 0.4% of young women. This disorder is particularly concerning because it has a higher mortality rate than many other mental illnesses, with an estimated mortality rates between 5% and 15%. However, there is currently no clearly evidence-based treatment for the disorder in adults. Thus, improving current knowledge about anorexia is vital. Method: Data were collected as part of a larger qualitative study examining pro-anorexia (“pro-ana”) social media sites. Frequency counts for codes relating to thinness, desirability, social approval, fatness, and negative emotion were obtained to determine how often these codes occurred simultaneously. Results: Data are still being collected for this study, however preliminary results indicate high overlap between codes relating to thinness, desirability, and social approval. Preliminary results also suggest that codes related to fatness and disgust and anger demonstrate a high frequency of overlap. Discussion: The intersection between codes indicating “good” and “thinner than” and social desirability suggest that these concepts may have come to be linked in a relational frame by social media users reporting anorexia. It is also interesting to note the apparent opposite frame, “bad” related to “fatter than”. These results provide insight into the relational frames be maintaining factors in anorexia nervosa and may suggest an initial formulation of anorexia using an RFT framework.

58. Face off: implicitly and explicitly detecting “emotional threshold” by grading facial expressions.
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Annalisa Oppo Psy. D., SFU, Milan (ITALY)
Enrica Basile (ITALY), Kore University, Enna Italy
Valeria Squatrito, Kore University, Enna Italy
Giovambattista Presti, MD, Kore University, Enna Italy

In addition to different contextual stimuli successful social interactions may depend also from the recognition of some of them as “emotional”: facial expressions are the most salient among them. Research commonly uses marked exemplars of facial expressions and the role of soft expressions remain unclear at the explicit level and rarely investigated at the implicit level. The aim of this study was to assess an “emotional threshold” both at explicit and implicit level, using implicit relational assessment procedure (IRAP) for the latter one. Thirty-seven participants were enrolled in this study. Assessment included explicit measures that evaluated self-compassion skills and depressive symptoms. A standardized set of graded, from full expression to neutral, emotional faces developed by Tottenham et al. (2009) and adapted by Gao & Maurer, D. (2009) were used. Following the procedure described by Calder and colleagues (1996) and using MorphX software facial expressions at varying intensity levels were generated. In this study facial emotions of anger, fear, sadness, happiness, disgust, and surprise at 100% versus 25% were used. Each stimulus has a resolution of 506 X 650 pixels with RGB color. Results showed that the “emotional threshold” seems higher at the explicit level than at the implicit level. Furthermore depressive symptoms seems to moderate the threshold both at the implicit and at the explicit level. Preliminary results will be presented. References Calder, A. J., Young, A. W., Perrett, D. I., & Etcoff, N. L. (1996). Categorical perception of morphed facial expressions. Visual Cognition, 3, 81–117. Gao, X. & Maurer
, D. (2009). Influence of intensity on children’s sensitivity to happy, sad, and fearful facial expressions. Journal of Experimental Child Psychology. Journal of Experimental Child Psychology 102(4):503-21. Tottenham, N., Tanaka, J. W., Leon, A. C., McCarry, T., Nurse, M., Hare, T. A., et al (2009). The NimStim set of facial expressions: Judgments from untrained research participants. Psychiatric Research, 168, 242–249.

59. Diffusion of Defusion: A Mixed-Methods Approach to Longitudinally Measure the Implementation of Acceptance and Commitment Therapy in a Community Mental Health Center.
Primary Topic: Supervision, Training and Dissemination
Subtopic: Evidence-based practice implementation, Qualitative data
Sean P. Wright, MA, MS, LMHC, Lutheran Community Services Northwest
Sonia Combs, MS, LMHC, Lutheran Community Services Northwest
Monica Frost, MS, Grand Canyon University; Lutheran Community Services Northwest

In community mental health, dissemination and implementation of evidence-based practices (EBPs) traditionally involves a top-down approach in which particular EBPs are specified at the system level by funders or agency administration. Little is known about individual clinician preferences for specific EBPs as well as preferences for implementation of new EBPs in agency settings. To address this gap, we surveyed clinicians at our agency to capture their attitudes toward EBPs and measure specific interest and knowledge about Acceptance and Commitment Therapy (ACT) since ACT is currently not an official EBP at the agency and all training efforts are therefore voluntary. We measured demographic variables, qualitative responses to open-ended questions about EBPs using a grounded approach, ACT experience level using questions adapted from Long (2015), and knowledge of the ACT model using the ACT Knowledge Questionnaire (Luoma & Vilardaga, 2013). Using a diffusion of innovations framework, we hypothesized that clinician commitment to learning ACT will increase over time (and there will be reliable predictors of which clinicians voluntarily commit to training in and using ACT with clients). From a population (N = 39), we obtained a high response rate (56%, n = 22). Qualitative coding of data replicated previous findings in the literature that clinicians typically are in favor of proven interventions provided they are flexible to use, apply to client population, and are supported by supervisors. We also replicated the literature finding that clinicians face significant barriers to training in new EBPs such as large caseloads, concern about burnout, and lack of system support for the specific EBP. We confirmed our hypothesis that current levels of ACT experience and enthusiasm can be partially accounted for based on the clinician’s organizational ties to the two peer clinicians who are leading monthly trainings in ACT. The diffusion of innovation prediction that clinical knowledge will precede experience was confirmed: mean ratings of Likert-scale items for competence and confidence in the model were low; however, performance on the ACT knowledge questionnaire was significantly above chance performance for the 16 clinicians who agreed to have their knowledge tested (two-tailed t=2.144, p < 0.05). Together, these data suggest that our survey is a sensible way to measure the diffusion of ACT in a community mental health setting. It further suggests the need to design training interventions that address perceived barriers. Finally, our mixed method approach will be refined in preparation for a second round of data collection in May 2016, which will allow within subjects comparisons and model fitting. These forthcoming data will be incorporated into this poster. Long, D. (2015). Development and evaluation of an acceptance and commitment therapy online competency assessment: A contextual behavioral building block approach (Unpublished doctoral dissertation). University of Nevada, Reno. Luoma, J. B. & Vilardaga, J. P. (2013). Improving therapist psychological flexibility while training acceptance and commitment therapy: A pilot study, Cognitive Behavioral Therapy 42(1), 1-8.

60. ACT Workshop for teachers and staffs working for children having disabilities
Primary Topic: Supervision, Training and Dissemination
Subtopic: Teachers, staffs
Shinji Tani, Ph. D., Ritsumeikan University
Kotomi Kitamura, Ph.D., Osaka University of Human Sciences

Background: The ACT is expected to give benefits to children having disabilities. Teachers and staff learn the skills of ACT, and teach children mindfulness skills and other relating skills to ACT. That could be useful. Furthermore, teachers and staffs often have some mental health issues. Therefore, it could be beneficial for them to learn ACT on both children and themselves. Purpose: The purpose of this research is to show the effects of ACT WS on acquisition of knowledge and skills of ACT and mental health of participants. Method: 37 participants (six men and 31 women, ranged 23 to 68 years old) attended this research. They are teachers or staffs working at social service agents for children having disabilities. They attended the ACT WS, which was conducted in a group format and lasted for five hours. AAQ-II, FFMQ, and GHQ-28 were used to assess the effect of the WS. The knowledge test of ACT was conducted after the WS. Pre-test/post-test experiment design was used. Three questionnaires were implemented before starting the WS and a month after the WS. A textbook and a Power Point slide were used in the WS. Experiential exercises and metaphors were practiced in order to learn ACT skills and knowledge. Results: The statistical analysis revealed the score of AAQ-II, some of FFMQ were changed between pre-test and post-test significantly. There is no significant change on the score of GHQ-28. However, negative significant correlation was found between the score of AAQ-II at the pre-test and the change score of GHQ-28. This result indicated participants showing low psychological flexibility at the pre-test improved in psychological QOL (GHQ-28) after the WS. There were ten participants showing above six of the score of GHQ-28. The score of AAQ-II and GHQ-28 changed significantly among them. The result of the knowledge test showed the mean was 15.7 (11-20), SD was 2.5. There was no correlation with any measures. Discussion:The results showed the WS was effective for both of acquisition of knowledge and skills of ACT and mental health issues. The participants learned mindfulness skills. The participants showed lower QOL improved after the WS.

61. Therapist Agreement with Sensitivity to Context (TASC) and deictic relational complexity: Demonstration of an assessment prototype
Primary Topic: Supervision, Training and Dissemination
Subtopic: Assessment
Douglas M. Long, Ph.D., Alpert Medical School of Brown University

Background: This poster describes a prototypical demonstration of a procedure that extends the basic contextual behavioral science of language and cognition into the area of therapist skill assessment and training. While expert-guided consultation and experiential training are increasingly recognized as essential ingredients in efforts to address global health challenges through clinical workforce development, public health needs remain unmet in part because the processes by which expertise is transferred are not understood with a degree of precision necessary for efficient regulation of scarce training resources. Relational Frame Theory (RFT) provides an empirically progressive analysis of symbolic behavior that precisely specifies the manipulable social conditions under which otherwise arbitrary stimuli acquire behavior regulatory functions (Hayes, Barnes-Holmes, & Roche, 2001). RFT comports with the evolution science of language development, has demonstrated clinical utility in predicting and influencing cognitive skills – including those involved in perspective-taking, and can be used to guide clinician behavior in the delivery of any psychosocial intervention (Villate, Villate, & Hayes, 2016; Wilson, Hayes, Biglan, & Embry, 2014). Method: Therapist Agreement with Sensitivity to Context (TASC) is an assessment strategy whereby participant relational responses to contextual cues (i.e., videos of simulated therapy sessions) are compared to the relational responses of experts to those same stimuli. The TASC prototype presented in this poster was developed as a web-based competency assessment in Acceptance and Commitment Therapy (ACT) that was distributed to clinicians before and after participation in experiential training workshops (Long & Hayes, 2015). In an analysis of TASC responses provided by 76 therapists of varying skill levels, agreement with experts required participants to demonstrate perspective-taking responses of high relational complexity (i.e., “I see YOU seeing THAT process THEN which is DIFFERENT from THIS process I see HERE NOW”). Results: Variability in perspective-taking responses was mildly associated with number of years spent practicing as a clinician and with self-rated familiarity with RFT – even while statistically accounting for other ACT-consistent TASC responses -- creating a regression model with R-squared = .155, p = .007. Discussion: While this correlation was small, its specificity was notable, in that other therapist demographic and training-history variables did not display this relationship. This provides an empirical demonstration of the relevance of RFT to the development of clinical skill assessments that can be used to efficiently evaluate psychotherapy training practices.

62. Fostering Psychological Flexibility in Cancer Patients: A Chilean Experience
Primary Topic: Clinical Interventions and Interests
Subtopic: Cancer, Oncology, Psycho-Oncology
Cristian Soza, Ph.D., Oncoloop Foundation
Tatiana Corbeaux, Ph.D., Oncoloop Foundation
Fernando Parada, Oncoloop Foundation

Cancer is one of the main causes of morbidity and mortality around the world; In 2012 there were approximately 14 million new cases and 8,2 million Cancer-related deaths. It is expected that the number of new cases grow to an approximate of 70% in the next 20 years, this means that the annual Cancer cases will grow from 14 million in 2012 to 22 million in the next 2 decades. Of the new cases mentioned, over 60% come from Africa, Asia, Central and South America. These regions represent 70% of the Cancer Deaths around the World. The World Health Organization and the Panamerican Health Organization have dedicated great efforts to revert and prevent this situation, revealing that health institutions have a key role in this subject: "Organizing systems that articulate the access and continuity in health assistance". These systems should provide prevention tools, early diagnosis, treatment and paliative care against these diseases. In Chile, Cancer is the second cause of death after Cardiovascular Disease. From 20% to 25% of the deaths nationwide are caused by this disease. It is estimated that in 2008, 22 thousand people died from Cancer, this statistics are more similar to an industrialized than to a developing country. According to the National Health Ministry, the main objective in the battle against Cancer is to cure, prolong and improve quality of life, as well as to alleviate pain and suffering, which can be achieved in 90% of the cases. This is why both the private and public health system in Chile have organized to help offering paliative care for Cancer, being included as a part of the National Health Warranties (GES for Garantías Explícitas en Salud). As part of this nationwide effort to prevent and treat Cancer, the Oncoloop foundation emerges as an organization dedicated to the evaluation and improvement of the existent treatment protocols for Cancer in Chile, as well as to the design and implementation of new and evidence-based interventions for the effective approach and treatment of this disease. In this context, the Onocloop foundation is currently working in several areas related to well being and quality of life in Cancer patients, one of which is the Psychological area. Currently in Chile there is no unified protocol for the Psychological assistance of Cancer patients. Despite there's a significant amount of psychologists working in Oncology units and the existence of a Diploma in a State University regarding Pyscho-Oncology, there are no official protocols for the best evaluated psychological treatment for Cancer in Chile, which could be a problem when it comes to measuring and evaluating outcomes. Therefore, the Oncoloop Foundation is currently working in the Design and Implementation of a group protocol for people diagnosed with Cancer. This protocol is based on the studies and trials conducted in developed countries, such as Spain, England and United States, all related to the use of Acceptance and Commitment Therapy (ACT) and Mindfulness for the improvement of quality of life and mental health of these patients. The main goal for this protocol is to foster psychological flexibility in people diagnosed with Cancer, which has been related to improvements in their quality of life, distress and mood issues (Feros, et, al, 2013). In order to accomplish such goal, a 6 session protocol has been designed to aim specific Psychological Flexibility processes with participants, which are expected to foster these abilities and, therefore, improve their quality of life, distress and mood indicators. This is an ongoing investigation, results and conclusions will be published once the process is finished.