The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms
Authors:
Joseph R. Bardeen, Thomas A. Fergus
Abstract:
A review of acceptance and commitment therapy with anxiety disorders
Sharp, K. (2012). A review of acceptance and commitment therapy with anxiety disorders. International Journal of Psychology & Psychological Therapy, 12, 359-372.
Anxiety disorders are the most widespread cause of distress among individuals seeking treatment from mental health services in the United States. However, despite the prevalence of research on effective therapeutic interventions and their promising outcomes, significant shortcomings remain. In response to these drawbacks, a novel treatment, acceptance and commitment therapy (ACT), was developed in an attempt to reformulate the conceptualization and treatment of anxiety disorders. The new treatment takes advantage of the power of exposure therapies while simultaneously addressing issues of comorbidity, fear, and avoidance related to them, as well as emphasizing the commitment to clients’ chosen values. Although the research base is small, a review of the current literature supports the notion that the ACT model of anxiety may be appropriate for conceptualizing and subsequently treating these disorders.
Internet-delivered ACT for Health Anxiety / hypochondriasis
Added by Ditte Hoffman on August 20, 2014:
I'm currently developing a treatment program for patients with health anxiety in a hospital unit in Denmark.The program content is developed on a former group-based ACT manual, that has been tested in a larger RCT.
At the moment we hope to pilot test the program in the fall 2014, and run a larger trial in 2015-2016.
I'm very interrested in sharing ideas and knowledge in the field of developing self-help material, and also if anybody has experiences with ACT and patients with health anxiety.
The effectiveness of group Acceptance and Commitment Therapy on pain intensity, pain catastrophizing and pain-associated anxiety in patients with chronic pain
Nasiri, A., & Kazemi-Zahrani, H. (2015). The effectiveness of group Acceptance and Commitment Therapy on pain intensity, pain catastrophizing and pain-associated anxiety in patients with chronic pain. Asian Social Science, 11(26), 112-120. https://doi.org/10.5539/ass.v11n26p112
This study aimed to evaluate the effectiveness of group–Acceptance and Commitment Therapy (ACT) on the intensity of pain, catastrophizing it and pain-associated anxiety in patients with chronic pain. The research design was quasi-experimental with pretest-posttest and one-month follow-up with control group. The statistical population was all individuals referring to psychological clinics, physical medicine and health centers in Isfahan city who were diagnosed to have chronic pain disorder in 2014. Out of 67 registered patients, 30 patients who had the research criteria were selected by the convenience sampling method and were randomly assigned into two groups each with 15 members. The subjects of the two groups all responded to Chronic Pain Acceptance Questionnaire (CPAQ), Pain Intensity Scale (PIS), Pain Catastrophizing Scale (PCS), and Pain-Anxiety Symptoms Scale (PASS-20). The experimental group received 8 90-minute sessions of Group- Acceptance and Commitment Therapy once a week. The data was assessed in 3 stages of pretest, posttest, and follow-up and was analyzed by multivariable covariance analysis. The results showed that the experimental group had a significant improvement in pain intensity, pain catastrophizing, and pain-associated anxiety (P<0/01) and this improvement was consistent after one-month follow-up. It can be said that Acceptance and Commitment Therapy can be effective on experience of pain of patients with chronic pain.
Acceptance and Commitment Therapy (ACT) For Generalized Anxiety Disorder
Hasheminasab, M Babapour Kheiroddin, J Mahmood Aliloo, M Fakhari, A. (2015). Acceptance and Commitment Therapy (ACT) For Generalized Anxiety Disorder. Iranian Journal of Public Health, 44(5), 718-719.
Effectiveness of Acceptance and Commitment Therapy on interpersonal problems and psychological flexibility in female high school students with social anxiety disorder
Azadeh, S. M., Kazemi-Zahrani, H., & Besharat, M. A. (2016). Effectiveness of Acceptance and Commitment Therapy on interpersonal problems and psychological flexibility in female high school students with social anxiety disorder. Global Journal of Health Science, 8(3), 131-138. https://doi.org/10.5539/gjhs.v8n3p131
Social anxiety is a psychological disorder which has devastative and pernicious effects on interpersonal relationships and one's psychological flexibility. The aim of this research was to determine the effectiveness of Acceptance and Commitment Therapy on interpersonal problems and psychological flexibility in female high school students with social anxiety disorder. With a semi-experimental design, the subjects were assessed using the Social Anxiety Scale and clinical interview. The statistical population of the research was high school female students studying in 5 areas of Isfahan. 30 individuals were purposively selected as the sample. The subjects of the research were randomly assigned to the experimental and control groups. Acceptance and Commitment Therapy was given in 10 sessions of 90 minutes in the experimental group and the control group did not receive any treatment. Pre-test and post-test scores of Inventory of Interpersonal Problems, and Acceptance and Action Questionnaire were analyzed using multivariate analysis of variance & the results showed that after the intervention, there was a significant difference between the scores of the subjects in the experimental and control groups. This means that Acceptance and Commitment Therapy can influence interpersonal problems and their six dimensions and psychological flexibility as well.
Acceptance and Commitment Group Therapy (ACT-G) for health anxiety: A randomized controlled trial
Eilenberg, T., Fink, P., Jensen, J. S., Rief, W., & Frostholm, L. (2016). Acceptance and Commitment Group Therapy (ACT-G) for health anxiety: A randomized controlled trial. Psychological Medicine, 46(1), 103-115. https://doi.org/10.1017/S0033291715001579
BACKGROUND:
Severe health anxiety is frequent and costly, yet rarely diagnosed or treated. Earlier treatment studies show problems with recruitment, dropout and recovery. In the current study, the authors aimed to test the effect of acceptance and commitment group therapy (ACT-G) compared to waitlist in patients with severe health anxiety.
METHOD:
During March 2010 to April 2012, 126 consecutively referred patients meeting research criteria for severe health anxiety were block-randomized (1:1) to ACT-G or a 10 months' waitlist (Clinicaltrials.gov, no. NCT01158430). Patients allocated to ACT-G were treated in seven groups of nine patients between December 2010 and October 2012 and received nine weekly 3-h group sessions and a booster session consisting of ACT techniques. The primary outcome was decided a priori as the mean change in self-reported illness worry on the Whiteley-7 Index (WI) from baseline to 10 months' follow-up. Secondary outcomes were improvement in emotional distress and health-related quality of life at 10 months' follow-up.
RESULTS:
Intention-to-treat analysis showed a statistically significant mean difference of 20.5 points [95% confidence interval (CI) 11.7-29·4, p < 0.001] on the WI between the groups at 10 months, and the between-group effect sizes were large (Cohen's d = 0.89, 95% CI 0.50-1.29). The number needed to treat was 2.4 (95% CI 1.4-3.4, p < 0.001). Diagnosis and treatment were well accepted by the patients.
CONCLUSIONS:
ACT-G seems feasible, acceptable and effective in treating severe health anxiety.
The effect of Acceptance and Commitment Therapy in reducing the anxiety of female teenagers of Tehran City
Shahab, M. (2015). The effect of Acceptance and Commitment Therapy in reducing the anxiety of female teenagers of Tehran City. International Journal of Indian Psychology, 2(3), 147-151.
The present study aimed to determine the effectiveness of the "Acceptance and Commitment Therapy (ACT)" in reducing symptoms of anxiety in adolescent girls in Tehran. 30 girls of 14 and 18 years of age, who were referrers to the Ertebat ,Hamdardi ,Movaffaghiat Psychology Center of Tehran because of symptoms of anxiety, were selected and randomly assigned to a test group and a control group each one including 15 patients. The Acceptance and Commitment Therapy Protocol of 12 sessions were conducted on the experimental group. The control group received no intervention. The research method used in the study was the pretest- posttest semiexperimental method with the control group. To measure the symptoms of anxiety in the study, the dass-42 questionnaires were used and to analyze the data the SPANQVA test was applied. The data analysis results indicated the effectiveness of the Acceptance and Commitment Therapy in reducing the adolescent girls' symptoms of anxiety. The results indicate that the improvement of psychological flexibility which is the major component of the Acceptance and Commitment Therapy has a considerable effect on the dependent variable.
Physiological and behavioral indices of emotion dysregulation as predictors of outcome from cognitive behavioral therapy and acceptance and commitment therapy for anxiety
Davies, C. D., Niles, A. N., Pittig, A., Arch, J. J., & Craske, M. G. (2015). Physiological and behavioral indices of emotion dysregulation as predictors of outcome from cognitive behavioral therapy and acceptance and commitment therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 46, 35-43. https://doi.org/10.1016/j.jbtep.2014.08.002
Background and objectives
Identifying for whom and under what conditions a treatment is most effective is an essential step toward personalized medicine. The current study examined pre-treatment physiological and behavioral variables as predictors and moderators of outcome in a randomized clinical trial comparing cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for anxiety disorders.
Methods
Sixty individuals with a DSM-IV defined principal anxiety disorder completed 12 sessions of either CBT or ACT. Baseline physiological and behavioral variables were measured prior to entering treatment. Self-reported anxiety symptoms were assessed at pre-treatment, post-treatment, and 6- and 12-month follow-up from baseline.
Results
Higher pre-treatment heart rate variability was associated with worse outcome across ACT and CBT. ACT outperformed CBT for individuals with high behavioral avoidance. Subjective anxiety levels during laboratory tasks did not predict or moderate treatment outcome.
Limitations
Due to small sample sizes of each disorder, disorder-specific predictors were not tested. Future research should examine these predictors in larger samples and across other outcome variables.
Conclusions
Lower heart rate variability was identified as a prognostic indicator of overall outcome, whereas high behavioral avoidance was identified as a prescriptive indicator of superior outcome from ACT versus CBT. Investigation of pre-treatment physiological and behavioral variables as predictors and moderators of outcome may help guide future treatment-matching efforts.
The effectiveness of Acceptance and Commitment Therapy based on reducing anxiety and depression in students with social phobia.
Molavi, P., Mikaeili, N., Rahimi, N., & Mehri, S. (2014). The effectiveness of Acceptance and Commitment Therapy based on reducing anxiety and depression in students with social phobia. Journal of Ardabil University of Medical Sciences, 14(4), 412- 423.
Background & Objectives: Social phobia is one of the common anxiety disorders
characterized by fear of social situations, shame and embarrassment in communicating with
unfamiliar people. The aim of this study was to examine the effectiveness of acceptance and
commitment therapy in reducing anxiety and depression in students with social phobia.
Methods: An experimental pretest-posttest with control group design was used to conduct the
study. The population consists of all female students in Ardabil city, 2013-2014 academic
years. Using a multiple-stage cluster sampling method, a representative sample consists of
400 students was selected for the study. Then, among the students those with social phobia
(based on the cut-off point), 34 participants were randomly selected and divided into two
groups of 17 people (one experimental group and one control group). The participants in
experimental group received acceptance and commitment therapy for 10 sessions of 90
minutes. The control group did not receive any intervention. Anxiety, depression and social
phobia questionnaires were administered to the two groups before and after the intervention.
Descriptive statistics and multivariate ANOVA (MANOVA) were used for data analysis.
Results: The results of data analysis showed that treatment based on acceptance and
commitment therapy reduces anxiety, depression and social phobia of students in the
experimental group compared with the control group (p<0.001).
Conclusion: The present study showed that acceptance and commitment therapy for students
with social phobia can be used as a psychological intervention along with other intervention
mechanisms.