anxiety

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.

Mindfulness and Acceptance-Based Group Therapy (MAGT) for Social Anxiety Disorder (SAD) is based largely on Acceptance and Commitment Therapy (ACT; Hayes et al., 1999), with enhanced mindfulness mostly from Mindfulness-Based Cognitive Therapy (MBCT; Segal et al., 2002). The purpose of this study was to assess the feasibility and initial effectiveness of MAGT for the treatment of SAD. Forty-two SAD patients were invited to take part in an open trial of MAGT. Participants completed measures of social anxiety, mindfulness and acceptance, depression, and rumination at pretreatment, midtreatment (6 weeks), posttreatment (12 weeks), and at a 3-month follow-up session. Twenty-nine participants completed the treatment and these participants reported that the treatment was helpful. Effect sizes for treatment completers ranged from 1.00 to 1.17 for the social anxiety symptom measures at follow-up. Intent-to-treat analyses revealed significant reductions in social anxiety, depression, and rumination and significant increases in mindfulness and acceptance, with effect sizes ranging from .65 to .76 on the social anxiety measures. This study demonstrates that MAGT is feasible and acceptable to SAD patients and provides further support for the use of mindfulness and acceptance-based interventions for the treatment of SAD.

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. 

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.

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 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.

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.

Objective: The present study was conducted to examine the effectiveness of ‘Acceptance and Commitment Therapy’ (ACT) on reducing social anxiety in students with learning disability.

Method: In this experimental research, pretest-posttest and control group were utilized. Population of this study included all the middle-school male students with learning disability in Koohdasht City (2013-2014). The sample included 40 male students with learning disability who were randomly selected after structured clinical interview. Subjects were randomly put into experimental group and control group (20 individuals each). Instruments of this research included structured clinical interview, Raven IQ Test (1962), and Watson & Friend’s Anxiety Scale (1969). Pretest and posttest were administered for both groups. Experimental group received acceptance and commitment therapy model for 10 1-hour sessions, while the control group received no intervention. To analyze the data, Multivariate Analysis of Variance test (MANOVA) was used. Statistical Package for Social Science 16 (SPSS 16) program was used for statistical analysis.

Results: the results of MANOVA showed that acceptance and commitment therapy model training has been effective on decreasing social anxiety in students with learning disability (P <

0.001). The findings also showed that there is a significant difference in social anxiety between control group and experimental group.

Conclusion: According to the findings of this study, acceptance and commitment therapy model training reduces social anxiety in students with learning disability and it is possible to make use of this model as a suitable intervention method.