anxiety

Anxiety disorders are one of the most prevalent diagnoses in youth, often resulting in impaired social and school functioning. Research on treatments for youth anxiety is primarily based in traditional clinical settings. However, integrating youth psychotherapies into the school environment improves access to evidence-based care. The present study is a pilot, randomized waitlist-controlled trial of a school-based, group Acceptance and Commitment Therapy–based (ACT) intervention for adolescents with anxiety. Students at two separate schools (N = 26) with elevated anxiety were randomized to a 12-week waitlist or to immediate treatment. Participants in the immediate treatment condition reported statistically significant decreases in anxiety and class absences at posttreatment and follow-up compared to the waitlist group. No statistically significant differences were found between groups for depression, psychological flexibility, positive mental health, and student well-being. However, medium within-condition effect sizes were seen in the treatment group for all outcomes. Participants reported the treatment as favorable with good acceptance ratings. Overall, this study supports ACT as a viable intervention for schools and other clinical settings providing services to adolescents with anxiety.

Background

Not all women presenting risk factors for postpartum depression (PPD) develop depressive symptoms. Research has shown that acceptance-focused processes (nonjudgmental appraisal of thought content, psychological flexibility) and self-compassion play an important protective role in the development of psychological symptoms. However, considering the perinatal period, little is known about what variables can modify the negative impact of risk.

Methods

The sample consisted of 185 postpartum women at risk of developing PPD (Postpartum Depression Predictors Inventory-Revised > 5.5). Data were collected regarding depressive (Edinburgh Postnatal Depression Scale) and anxiety symptoms (Hospital Anxiety and Depression Scale), psychological flexibility (Acceptance and Action Questionnaire-II), nonjudgmental appraisal of thought content (Postnatal Negative Thoughts Questionnaire) and self-compassion (Self-Compassion Scale-Short Form).

Results

Women not presenting depressive and anxiety symptoms reported significantly higher levels of psychological flexibility, nonjudgmental appraisal of thought content and self-compassion than women presenting depressive and anxiety symptoms. Hierarchical logistic regression showed that women with higher levels of psychological flexibility (OR = 1.06, CI: 1.01–1.12) and nonjudgmental appraisal of thought content (OR = 1.33, CI: 1.15–1.53) had a significantly higher likelihood of not presenting depressive and anxiety symptoms.

Limitations

The limitations of this study were the cross-sectional design, the use of self-report questionnaires and the self-selected bias in recruitment.

Conclusions

This study emphasizes the important role of acceptance-based processes, suggesting that at-risk women who are more accepting of their private events may be more protected from developing psychological symptoms. Preventive interventions should consider the promotion of these processes to improve women's adjustment to this period.

Retrieved from https://jpe.atu.ac.ir/article_9039_2dbe6481683b54c326d5a77fa2a1f340.pdf

چکیده

وجود فرزند مبتال به اختالل نارسایی توجه/بیشفعالی در خانوادهها میتواند منجر به افسردگی و اضطراب

مادران، احساس ناتوانی در ایفای نقش والدینی و احساس عدم کفایت در امر تربیت فرزند شود. هدف

پژوهش حاضر تعیین اثربخشی درمان مبتنی بر پذیرش و تعهد بر افسردگی و اضطراب مادران دارای

فرزند با اختالل نارسایی توجه/بیشفعالی بود. در پژوهش حاضر که با روش نیمهآزمایشی و طرح یش

آزمون-پسآزمون با گروه گواه بود، گروه نمونه با روش نمونهگیری در دسترس و از مادران دارای

فرزند با اختالل نارسایی توجه/بیشفعالی مراجعهکننده به کلینیکهای روانشناسی و روانپزشکی شهر

سنندج انتخاب شدند. از بین این گروه تعداد 18 نفر بهطور تصادفی انتخاب و به دو گروه 32 نفره آزمایش

و گواه تقسیم شدند. در مرحله پیشآزمون از پرسشنامه افسردگی و اضطراب بک و پرسشنامه کانرز

والدین استفاده شد. گروه آزمایش تحت درمان مبتنی بر پذیرش و تعهد، طی 0 جلسه 5 ساعته قرار

گرفت و گروه گواه هیچگونه مداخلهای دریافت نکردند. در مرحله پسآزمون، پرسشنامههای فوق روی

هر دو گروه مجددأً اجرا شد. نتایج تحلیل کوواریانس نشان داد که در مرحله پسآزمون نمرات

افسردگی و اضطراب کاهش معناداری داشته است. بنابراین درمان مبتنی بر پذیرش و تعهد بر درمان

افسردگی و اضطراب مادران دارای فرزند با اختالل نارسایی توجه/بیشفعالی مؤثر بوده است. نتایج بر

اهمیت کاربرد این مداخله بر عالئم افسردگی و اضطراب در مادران دارای فرزند با اختالل نارسایی

توجه/بیشفعالی و ارائه افقهای جدید در مداخالت بالینی این مادران و فرزندان آنها تأکید دارد.

زمینه و هدف: نارسایی توجه/ فزونکنشی یکی از شایعترین اختاللها در بین کودکان است که با نشانههایی مانند فزونکنشی،

بیشبرانگیختگی، حواسپرتی، و نارسایی توجه همراه است. به دلیل مشکالتی که این کودکان در خانواده ایجاد میکنند، والدین آنها به

خصوص مادران از هیجانهای منفی بسیاری مانند اضطراب و تنیدگی رنج میبرند. بنابراین، هدف این پژوهش بررسی اثربخشی درمان مبتنی

بر پذیرش و تعهد برکاهش تنیدگی و اضطراب مادران دارای فرزند با اختالل نارسایی توجه/ فزونکنشی بود.

روش: پژوهش حاضر از نوع نیمهآزمایشی با طرح پیشآزمون - پسآزمون با گروه گواه بود. جامعه آماری این مطالعه شامل تمامی مادران

کودکان با اختالل نارسایی توجه/ فزونکنشی مراجعه کننده به مراکز مشاوره شهر اصفهان در سال تحصیلی 1396 بود که نمونهای به حجم

30 مادر بر اساس مالکهای ورود و خروج از پژوهش و با روش نمونهگیری در دسترس، انتخاب شده و به صورت تصادفی در دو گروه

آزمایش و گروه گواه جایدهی شدند )15 مادر در هر گروه(. هر دو گروه در دو مرحله پیشآزمون و پسآزمون با استفاده از فرم کوتاه

پرسشنامه اضطراب و تنیدگی )لوی باند، 1995 )مورد ارزیابی قرار گرفتند. افراد گروه آزمایش طی 8 جلسه 90 دقیقهای، درمان مبتنی بر

پذیرش و تعهد دریافت کردند؛ این در حالی بودکه گروه گواه هیچ گونه مداخلهای را دریافت نکردند. دادههای به دست آمده با آزمون

تحلیل کواریانس مورد وارسی قرار گرفتند.

یافتهها: نتایج نشان داد که پس از مداخله، میانگین نمرات اضطراب )01/0<P ، 13/22=F )و تنیدگی گروه آزمایش )01/0<P ،

17/18=F )به طور معناداری کمتر از گروه گواه بود.

نتیجهگیری: نتایج حاصل از پژوهش حاضر نشان دهنده سودمندی درمان مبتنی بر پذیرش و تعهد بر تنیدگی و اضطراب مادران دارای

کودک با اختالل نارسایی توجه/ فزونکنشی بود. این درمان به مادران آموزش داد تا بتوانند از افکار آزاردهنده رهایی یابند و به جای فاصله

گرفتن، رویدادها را بپذیرند. پذیرش در مادران هنگامی رخ میدهد که هیجانات در حیطه آگاهی باشند و به همان صورت که هستند،

تجربه شوند؛ بدون آنکه تالشی برای تغییر فراوانی یا شکل آنها انجام شود. 

Background and Purpose: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common disorders among children, which is associated with symptoms such as hyperactivity, hyperarousal, distraction, and attention deficit. Parents of these children, especially their mothers, suffer from negative emotions such as anxiety and stress. Therefore, this study aimed to investigate the effectiveness of acceptance and commitment therapy (ACT) on anxiety and stress in mothers of children with ADHD.

Method: This research was a quasi-experimental pretest-posttest control group design. The study population included all the mothers of children with ADHD referring to the counseling centers of Isfahan in 2017. The sample included 30 mothers selected by convenience sampling based on inclusion and exclusion criteria. They were assigned to either the experimental or control group (15 per group). Both groups were assessed by Anxiety and Stress Scale- Short Form (Lovibond, 1995) at pretest and posttest stages. The experimental group received eight 90-min sessions of (ACT), while the control group received no intervention. Data were analyzed by ANCOVA.

Results: Results showed that the mean anxiety score (F=22.13, P<0.01) and the mean stress score (F=18.17, P<0.01) significantly decreased in the experimental group in comparison to the control group.

Conclusion: The results of the study indicated that ACT was effective in reducing the stress and anxiety in mothers of children with ADHD. This therapy taught mothers to get rid of annoying thoughts and to accept the events instead of getting away from them. Acceptance occurs in mothers when the emotions are in the field of consciousness and are experienced as they are, without an effort to change their frequency or shape.

본 연구는 2005년부터 2018년 2월까지 국내에서 발표된 우울과 불안증상에 대한 수용-전념치료 기반 집단상담의 효과성을 메타분석으로 검증하였다. 연구결과를 살펴보면, 첫째, 우울증상에 대한 16편의 연구에서 산출된 17개의 효과크기를 종합한 평균 효과크기는 -.838로 큰 효과크기로 나타났다. 우울증상에 대한 치료적 효과는 집단구성원이 남녀 혼합인 경우, 대학생/대학원생인 경우, 준임상 집단일 때, 7∼8회기로 구성하였을 때, 실시기간이 4주 이하일때, 주당 2회 실시되었을 때, 회기 시간이 91∼120분 일 때, 집단원이 10명 이하인 경우와 무처치 통제집단이었을 때 더 큰 치료효과가 나타났다. 둘째, 불안증상에 대한 19편의 연구에서 산출된 26개의 효과크기를 종합한 결과, 평균 효과크기는 -.789으로 중간크기로 나타났다. 불안증상에 대한 치료적 효과는 남녀혼합 구성, 대학생/대학원생인 경우, 7∼8회기, 실시기간은 4주 이하, 주당 회기 수는 1회 또는 2회기, 회기 시간이 91∼120분, 집단원이 10명 이하로 구성되었을 때와 무처지 통제집단일 때 더 큰 치료효과가 나타났다. 이러한 결과를 바탕으로 시사점을 논의하였다.

Objective

Acceptance and Commitment Therapy (ACT) is a behavioral intervention demonstrating sustained improvements in anxiety in individuals with chronic anxiety and psychological distress. Because anxiety disorders are associated with the development of cardiovascular disease (CVD), we hypothesized that a novel 1-day ACT workshop would both lower anxiety and improve vascular function in persons with moderate/high anxiety.

Methods

In a randomized controlled study, 72 adults (age 33.9 ± 8.6 (SD) years) with baseline moderate/high anxiety completed a one-day ACT intervention (n = 44, age 33.9 ± 8.7 years) or control (n = 28, age 37.1 ± 10.1 years). Pre-specified secondary outcomes were measured over 12 weeks: aortic stiffness (carotid-femoral pulse wave velocity [cfPWV]), forearm vascular endothelial function (post-ischemic peak forearm blood flow [FBF] via plethysmography), and brachial artery flow-mediated dilation (FMD). Carotid artery stiffness (β-stiffness index), and inflammatory markers (C-reactive protein and tumor necrosis factor-alpha) were also explored.

Results

Although the intervention had a significant and sustained effect on the primary outcome of anxiety as measured by the Beck Anxiety Inventory, the 1-day ACT workshop was not associated with improvement in vascular or inflammatory endpoints. The intervention was unexpectedly associated with increases in β-stiffness index that were also associated with changing trait anxiety.

Conclusion

Anxiety improvements did not translate into improvements in any of the vascular function outcomes. This may reflect a less-than-robust effect of the intervention on anxiety, failure in design to select those with vascular dysfunction, or not intervening on a relevant causal pathway.

Self-compassion has been linked to less depression, anxiety and stress as well as positive body image and healthy lifestyle choices. The main purpose of this study was to examine the psychometric properties of the Self Compassion Scale in an Icelandic translation. Difference in self-compassion, depression, anxiety and stress between individuals with high and low BMI scores, i.e. in a sample of patients seeking treatment for obesity, and a sample of university students was also studied. The two samples consisted of 92 females and 22 males (student sample), and 50 females and 21 males (patient sample). Results showed a difference between the samples, on BMI, depression, anxiety and stress, where patients had higher scores compared to the student sample. Students had higher total self-compassion scores as well as higher scores on the subscales: mindfulness, self-kindness and common humanity than the patient sample. Gender difference was mostly not significant. The factor structure of the Icelandic version of the Self-Compassion Scale was found to have adequate structure with loading of six factors as intended for the original version in English. Reliability for four of six factors on the list were found to be good. The present findings support our hypothesis that obese patients have less self-compassion and more symptoms of anxiety, depression and stress than the student sample suggesting that more research on fostering self-compassion when dealing with adversities in life is warranted.

Music performance anxiety (MPA) is a complex and frequent problem among music performers that arises when they hit the stage. The study's main goal was to investigate whether individuals lower in self-compassion struggled more with MPA compared to those with higher self-compassion, as well as examining various factors of MPA in an Icelandic sample. A total of 79 Icelandic music performers of the classical genre - professionals and advanced students - completed a self-report questionnaire assessing their MPA, self- compassion, and general anxiety. Participants were split into groups based on their self- compassion levels (median-split: high vs. low), general anxiety (severe vs. moderate vs. low), and several demographic variables. Simple comparative tests revealed a difference in terms of gender and number of performances in the preceding 12 months but not for age-group, instrument, or music education completed. MPA was also higher for individuals suffering from severe anxiety than individuals with mild to moderate anxiety. Analysis of Covariance (ANCOVA) was used to test the difference between self-compassion levels on MPA controlling for general anxiety. The results revealed higher MPA among those reporting lower self-compassion as opposed to higher self-compassion. Furthermore, the six subscales of the Self-Compassion Scale revealed a link between MPA and each subscale, strongest with over-identification. The findings indicate that self-compassion may be useful in reducing the impact of MPA, but additional studies are needed.

Framkomukvíði er flókinn og algengur kvilli sem birtist hjá tónlistarfólki þegar það stígur á svið. Megin tilgangur rannsóknarinnar var að kanna hvort einstaklingar sem búa yfir lítilli samkennd í eigin garð þjáist af framkomukvíða í meiri mæli en þeir sem búa yfir meiri samkennd í eigin garð, auk þess að skoða ýmsa aðra áhrifaþætti á framkomukvíða í íslensku úrtaki. Alls svöruðu 79 tónlistarmenn og langt komnir tónlistarnemendur sjálfsmatskvörðum sem mátu framkomukvíða, samkennd í eigin garð og almennan kvíða. Þátttakendum var skipt í hópa byggt á stigi samkenndar (hátt eða lágt út frá miðgildi kvarða), hversu mikinn almennan kvíða þeir upplifðu (alvarlegan, miðlungs eða vægan) og ýmsum lýðfræðilegum breytum. Einföld samanburðarpróf sýndu marktækan hópamun fyrir kyn og tíðni framkoma síðastliðna 12 mánuði en ekki fyrir aldur, hljóðfæri eða tónlistarmenntun. Framkomukvíði var líka hærri hjá einstaklingum sem þjáðust af alvarlegum kvíða heldur en þeim sem þjáðust af vægum eða miðlungs kvíða. Samvikagreining (e. ANCOVA) var notuð til þess að prófa hvort mismunur væri á framkomukvíða byggt á stigi samkenndar í eigin garð með almennan kvíða sem stjórnbreytu. Niðurstöður sýndu hærri framkomukvíða hjá þeim sem greindu frá lítilli samkennd í eigin garð samanborið við þá sem greindu frá mikilli samkennd. Greining sex undirkvarða Samkenndarskalans sýndi ennfremur fram á samband framkomukvíða við hvern einstakan undirkvarða, sterkast þó við ofursamsömun (e. over-identification). Niðurstöður gefa til kynna að samkennd í eigin garð gæti möguleika dregið úr áhrifum framkomukvíða en frekari rannsókna er þörf.