Understanding the effect of attachment styles in paranoid ideation: The mediator role of experiential avoidance
Castilho, P., Martins, M. J., Pinto, A. M., Viegas, R., Carvalho, S., & Madeira, N. (2017). Understanding the effect of attachment styles in paranoid ideation: The mediator role of experiential avoidance. Journal of Contextual Behavioral Science, 6(1), 42-46. https://doi.org/10.1016/j.jcbs.2016.11.007
Objectives
1) to evaluate different attachment styles depending on the attachment figure; 2) to explore the association between experiential avoidance and paranoid ideation frequency; 3) to test a mediation model in which the impact of adult attachment on frequency of paranoid ideation occurs through experiential avoidance.
Method
We assessed adult-attachment, experiential avoidance and paranoid ideation frequency in a sample of 37 (30 male and 7 female) outpatients and inpatients with a psychosis-spectrum diagnosis.
Results
The anxiety attachment pattern was significantly higher in all attachment figures. We found that attachment anxiety (mother) was associated with both experiential avoidance and paranoid ideation. An association between experiential avoidance and paranoid ideation frequency was also found. Results show that experiential avoidance mediated the relationship between attachment anxiety and paranoid ideation frequency.
Conclusion
Our study highlights the importance of addressing therapeutically the mechanisms people with psychosis use to cope with the internal experience elicited by insecure attachment styles, specifically experiential avoidance, and suggests the adequacy of acceptance and mindfulness-based therapies in promoting recovery for psychotic patients.
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Running acceptance and commitment therapy groups for psychosis in community settings
Butler, L., Johns, L. C., Byrne, M., Joseph, C., O’Donoghue, E., Jolley, S., … Oliver, J. E. (2016). Running acceptance and commitment therapy groups for psychosis in community settings. Journal of Contextual Behavioral Science, 5, 33–38. http://doi.org/10.1016/j.jcbs.2015.12.001
In this paper, we discuss the practice implications of our group Acceptance and Commitment Therapy for psychosis (ACTp) evaluations, in terms of the adaptations required to ACT interventions for group implementation in routine services for people with psychosis. ACTp shows promise as a brief individual intervention for people with psychosis to improve recovery, reduce future relapse, and reduce healthcare costs. Outcomes for group ACT interventions for non-psychotic severe mental illnesses support the potential for further cost-savings, through group delivery, and two recent trials suggest that adapting group ACT interventions to suit people with psychosis is both feasible and clinically effective. Trials were run from 2010–2014, and included people with psychosis and caregivers. Qualitative feedback was collected from group participants and service user co-facilitators. Based on this experience, we recommend psychosis-specific content for group interventions, and highlight process considerations to accommodate the particular needs of people with psychosis and their caregivers. With these adaptations, group ACTp can be feasible, acceptable, and effective as a routine frontline intervention in services for people with psychosis, however; this work is in the preliminary stages and further research is needed to consolidate the evidence base.
To find the full text version of this article and others (as well as download a full text .pdf.), ACBS members can visit the ScienceDirect homepage here.
Acceptance and Commitment Therapy for Depression following Psychosis: An Examination of Clinically Significant Change
White, R. G., Gumley, A. I., McTaggart, J., Rattrie, L., McConville, D., Cleare, S., McLeod, H. J., & Mitchell, G. (2015). Acceptance and commitment therapy for depression following psychosis: An examination of clinically significant change. Journal of Contextual Behavioral Science, 4, 203-209.
Depression following psychosis is common and can impact negatively on individuals’ quality of life. This study conducted post-hoc analyses on 14 participants with psychosis from a larger randomised controlled trial who presented with clinically important levels of depression at baseline. Eight of the participants received Acceptance and Commitment Therapy (ACT), whilst the remaining six individuals received treatment as usual (TAU). The focus was on investigating clinically significant change in outcome measures between baseline and 3-months post-baseline in the participants. Participants completed measures assessing depression and anxiety (HADS), psychosis symptoms (PANSS) and psychological inflexibility (AAQ-II) between baseline and at 3-month post-baseline assessments. Odds ratio analysis indicated that participants receiving ACT, compared to TAU, were 15 times more likely to achieve clinically significant decreases in depression scores (Fisher's Exact Test, p=0.05). Differences between the ACT and TAU groups in clinically significant changes in anxiety, psychological inflexibility, positive symptoms, negative symptoms and general level of psychopathology were not statistically significant. The study provides tentative support for the use of ACT to treat depression emerging in the context of psychosis.
To find the full text version of this article and others (as well as download a full text .pdf.), ACBS members can visit the ScienceDirect homepage here.