women's mental health

Objective: This randomized comparative effectiveness trial evaluated a novel insomnia treatment using acceptance and commitment therapy (ACT) among women veterans. Participants received either the acceptance and the behavioral changes to treat insomnia (ABC-I) or cognitive behavioral therapy for insomnia (CBT-I). The primary objectives were to determine whether ABC-I was noninferior to CBT-I in improving sleep and to test whether ABC-I resulted in higher treatment completion and adherence versus CBT-I. 

Method: One hundred forty-nine women veterans with insomnia disorder (M_age = 48.0 years) received ABC-I or CBT-I. The main sleep outcomes were Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and sleep efficiency (SE) by actigraphy (objective) and sleep diary (subjective). Measures were collected at baseline, immediate posttreatment, and 3-month posttreatment follow-up. Treatment completion and adherence were assessed during the interventions. 

Results: Both interventions improved all sleep outcomes from baseline to immediate posttreatment and 3-month posttreatment follow-up. At immediate posttreatment, ABC-I was statically noninferior for sleep diary SE and objective SE, but noninferiority was not statistically confirmed for ISI or PSQI total scores. At 3-month posttreatment follow-up, ABC-I was noninferior for all four of the key outcome variables. There was not a statistically significant difference between the number of participants who discontinued CBT-I (11%) versus ABC-I (18%; p = .248) before completing treatment. ABC-I was superior to CBT-I for some adherence metrics. 

Conclusions: Overall, ABC-I was similar in effectiveness compared to CBT-I for the treatment of insomnia and may improve adherence to some behavioral elements of treatment.

Previous research has emphasized the importance of identifying the core mechanisms underlying eating disorder psychopathology. However, processes that bridge psychological flexibility (PF) and psychological inflexibility (PI) with eating disorder symptoms have yet to be fully clarified, particularly for racially diverse emerging adult women. To address this empirical gap, the current study employed network analysis to explore the interconnections among PF, PI, and eating disorder symptoms in a racially diverse sample of emerging adult women (N = 389). Analyses produced a sparse network, with bridge nodes identified using bridge expected influence (EI). Multiple bridge nodes were identified within the clusters of PI (i.e., lack of awareness), and eating disorder symptoms (i.e., body dissatisfaction). Specifically, results suggested that lack of awareness (PI) and body dissatisfaction (eating disorder symptoms) play essential roles in connecting eating disorder symptoms with PI, even after accounting for PF. In contrast, PF did not appear to be uniquely associated with the deactivation (or activation) of eating disorder symptoms above and beyond PI. These findings contribute to the development of nuanced treatment and prevention models, especially in process-based cognitive behavioral therapy (PB-CBT). Our study also highlights specific processes as primary targets that, when intervened on, could help alleviate eating disorder symptoms, especially for racially diverse emerging adult women.

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Background & objectives: Psychological factors play a major role in the escalation and relapse. Because Multiple Sclerosis is a chronic disease which is the leading cause of many psychological problems. Therefore, the aim of the present study was to investigate the effectiveness of acceptance and commitment therapy on psychological distress, marital satisfaction and quality of life in women with multiple sclerosis.

Method: This research was a quasi-experimental and pretest-posttest study design using control group for follow up. Among all women with Multiple Sclerosis at the Multiple Sclerosis Society of Iran, 24 MS patients with relapsing-remitting were selected through convenience sampling and they were randomly assigned to experimental and control groups respect to inclusion and exclusion criteria. Then, experimental group went under 8 treatment sessions of Acceptance and Commitment Therapy. During this period, the control group did not receive any intervention. Both groups were evaluated before and after treatment and at follow-up with QOL questionnaire, psychological distress and marital satisfaction questionnaires. Data were analyzed by descriptive statistics and inferential statistics including mixed analysis of variance (p<0.01 meaningful level) using SPSS-22 statistical software.

Results: The mean age in the experimental and control groups respectively, were 30±9.64 and 29± 10.25 years, and the mean of infection in intervention and control groups respectively, were 5±6.61 and 4±6.12 years. Both groups of patients were married and had relapsing-remitting Multiple Sclerosis. The results showed that average of variables such ad psychological distress, marital satisfaction and quality of life increased while; control group was not observed this trend. Also, mixed analysis of variance indicated that acceptance and commitment therapy resulted in a significant reduction in psychological distress, enhance the quality of life and marital satisfaction in women with Multiple Sclerosis, The effects lasted for up to three months after treatment.

Conclusion: According to the present study results and impact of psychological factors in process of MS, it is suggested that acceptance and commitment therapy should be used to improve the situation of women who suffering from Multiple Sclerosis.

The purpose of the present study was to examine the comparative effectiveness of acceptance and commitment therapy (ACT) in the treatment of metacognitions and anxiety among women with generalized anxiety disorder. In total, 40 self-referred female outpatients were examined within a randomized controlled trial. Patients were allocated to ACT and waitlist control groups. Metacognitions and anxiety symptoms were measured by the Metacognitions Questionnaire and the Beck Anxiety Inventory at baseline, posttreatment, and 2-month follow-up. Analyses showed that the therapeutic group had improved significantly whilst the control group had remained unchanged.

Full text: https://cjc-rcc.ucalgary.ca/article/view/61155

Introduction
Working mothers with small child face work and life difficulties and show low psychological well-being (PWB).

Objectives
This randomized controlled trial aimed to examine the effectiveness of a newly developed, fully automated internet-based Acceptance and Commitment Therapy (iACT) program, ‘Happiness Mom,’ on improving Ryff's PWB of working mothers with a preschool child.

Methods
The eligible participants were working mothers with at least one preschool child and were randomly assigned to either an iACT intervention group (n = 424) or a wait-list control group (n = 417). The intervention contained eight modules for 10 weeks. Primary outcomes were measured in six dimensions of Ryff's PWB (Ryff, 1989a; 1989b), using self-administered questionnaires at baseline, three months, and six months after the baseline. A mixed model for repeated measures conditional growth model analysis was conducted using a group*time interaction as an intervention effect.

Results
A total of 841 eligible working mothers participated in this study. For the main pooled analysis, positive relationship with others was significantly improved in the intervention group (pooled effect 0.41 [95% CI 0.08–0.74], t = 2.44, p = 0.015), while the effect size was small (Cohen's d = 0.18). There was no significant effect on autonomy, environmental mastery, personal growth, purpose in life, and self-acceptance.

Conclusions
The study demonstrated that the fully automated iACT program was effective in improving PWB in working mothers. However, the effect was small and shown in the limited domain of PWB. Further program improvement is required to achieve a greater effect size and impact on a wider range of PWB.

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Acceptance and commitment therapy (ACT) is one of the third-generation behavioral therapies in which it is attempted to increase the psychological relationship of an individual with his or her thoughts and feelings instead of changing cognition. The purpose of this study was the effectiveness of ACT on conflict resolution styles of incompatible marital women.

Methods: This is a semi-experimental, pretest and posttest design and a 3-month follow-up. The statistical population of the study consisted of all incompatible women who referred to counseling centers in Arak in 2018. Therefore, 24 participants were selected by convenience sampling method and randomly assigned to one test groups and one control group of 12 participants for each. Data were collected in the pretest, posttest and follow-up stages with (the Conflict Resolution Styles Scale or Rahim Organizational Conflict Inventory-II). The test group received a therapeutic intervention based on ACT for twelve 90-min sessions, but no therapy was provided for the control group. After the completion of treatment sessions, both groups were subjected to posttest. The data were analyzed using analysis of variance with repeated measures and Bonferroni post-hoc test.

Results: The results showed that there was a statistically significant difference between the posttest scores of the test group compared with that of the control group (P < 0.05), and the difference was suitably sustainable during the time.

Conclusion: ACT is considered as an effective intervention in improving conflict resolution styles.

https://doi.org/10.4103/iahs.iahs_8_19

Objective: To explore the relationship between cognitive fusion and the state of anxiety and depression of perinatal women and to provide empirical evidences for acceptance and commitment therapy in mental treatment of anxiety and depression in perinatal women.

Methods: 309 perinatal women collected by cluster random sampling were assessed with self-made general information questionnaire,Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS) and Cognitive Fusion Questionnaire (CFQ) in predelivcry period and 3-7 days after childbirth respectively.

Results: (1) CFQ scores in the predelivery or postpartum anxiety group ((32.18±10.78),(31.54±10.30))were higher than that in the normal group((21.49±9.56),(20.84±9.82)),and the difference was statistically significant (t=-8.26,-8.22;all P=0.000);CFQ scores in the predelivery or postpartum depression group ((26.74 ±11.76),(26.84 ± 12.11)) were higher than that in the normal group((23.06± 10.33),(21.79±9.90)),and the difference was statistically significant(t=-2.76,-3.71;P=0.006,0.000).(2)It was found that the predelivery or postpartum CFQ scores were positively associated with the SAS scores of predelivery periods and postpartum periods respectively(r=0.51,0.45,0.50,0.55;P=0.000);the predelivery or postpartum CFQ scores were positively associated with the SDS scores of predelive1y periods and postpartum periods respectively (r =0.26,0.31,0.21,0.38;P =0.000).(3) Hierarchical multiple regression analyses were then conducted.The predelivery CFQ had a significant effect on postpartum SAS(△R 2=0.02,P=0.006)and postpartum SDS respectively(△R 2=0.02,P=0.006),and the regression equations were statistically significant.

Conclusion: A function to predict the occurrence of matemal postpartum anxiety and depression is obtained from the cognitive fusion which is attributed to the risk of maternal postpartum anxiety and depression.

Full text available: http://caod.oriprobe.com/articles/48674718/Relationship_between_cognitive_fusion_and_the_state_of_anxiety_and_dep.htm

Background: Acceptance and Commitment Therapy is the third wave therapy with the greatest empirical evidence in the treatment of drug abuse. Method: Thirty-one women with substance use disorder (SUD) were randomly assigned to two conditions, an intervention based on Acceptance and Commitment Therapy (ACT) and a control group on a waiting list. All participants were assessed three times (before treatment, at the end, and at a six-month follow-up) using urinalysis, the Mini International Neuropsychiatric Interview (MINI), the Addiction Severity Index (ASI-6), the Anxiety Sensitivity Index, and the Acceptance and Action Questionnaire (AAQ-II). Results: After 16 ACT intervention sessions, abstinence rates of 27.8% were observed, increasing to 43.8% after six months. The treatment also promoted improvements in other areas, such as reductions in the percentage of comorbid psychopathology and anxiety sensitivity, and the increase of psychological flexibility, which, in general, were not documented in the comparison group. Conclusions: Clinical gains were achieved, and we consider ACT to be an effective and appropriate treatment to be applied in the prison context.

Terapia de Aceptación y Compromiso para el abuso de sustancias en mujeres encarceladas. Antecedentes: la Terapia de Aceptación y Compromiso (ACT) es una de las terapias de tercera generación que cuenta con mayor evidencia empírica en el tratamiento del abuso de sustancias (TUS). Método: treinta y un mujeres con TUS fueron asignadas al azar a dos condiciones: un tratamiento de 16 sesiones con base en ACT y un grupo de control en lista de espera. Todas fueron evaluadas en 3 momentos (pre, post y al cabo de seis meses de recibir el tratamiento) mediante analíticas de orina, la Mini International Neuropsychiatric Interview (MINI), el Addiction Severity Index (ASI-6), el Índice de sensibilidad a la Ansiedad y el Cuestionario de Aceptación y Acción (AAQ-II). Resultados: tras la intervención, se observó un porcentaje de abstinencia del 27,8% y del 43,8% al cabo de seis meses. La intervención también provocó mejorías en otras áreas, como reducciones en los porcentajes de psicopatología asociada y de sensibilidad a la ansiedad, así como aumento de la flexibilidad psicológica, que, en general, no se documentaron en el grupo de comparación. Conclusiones: se discuten estas ganancias clínicas y se ofrece ACT como un tratamiento apropiado para ser dispensado en mujeres reclusas con trastorno por abuso de sustancias.

The purpose of this research was to determine the effectiveness of acceptance and commitment therapy on emotional eating of obese women in Isfahan. The research used a quasi-experimental study with a pretest-posttest design and a one month follow up. Through convenience sampling method, 30 women with an obesity diagnosis were selected and then, were randomly assigned into experimental and control groups. All participants completed the Dutch Eating Behaviors Questionnaire (Forman & Herbert, 2009) before intervention, at the end of the intervention and one month after intervention. The intervention involved 8 sessions of acceptance and commitment therapy, each lasting for 90 minutes, which were administered only to the experimental group. Results of covariance analysis showed a significant decrease in the amount of emotional eating in the eating behavior subscale at the post-test, and follow up stages (P<0.05). In the eating desire subscale, there was a significant difference between the mean of experimental group and control group only in the follow up stage (P<0.05). The findings of this study confirmed the efficacy of acceptance and commitment therapy on emotional eating of obese women.

Introduction: Obesity is a rapidly growing health problem in every society. The purpose of this study was to determine the effectiveness of acceptance and commitment therapy on
the Body Mass Index (BMI) in women afflicted with obesity in Isfahan. 

Methods: Through a semi-experimental research with pre-test and post-test design with one month follow-up as well as using convenience sampling method, a number of 30 women
with an obesity diagnosis (Body Mass Index, BMI≥30), who were satisfied with the criteria for entering this research, were randomly incorporated into experiment and control groups
(15 each). The intervention involved 8 sessions each lasting for 90 minutes of acceptance and commitment therapy which was provided merely for experiment group. BMI was calculated by dividing weight (kg) by squared height ().

Results: The result of covariance analysis showed that there were no significant differences in body mass index between the experimental and control groups at post-test stage. But results showed a significant decrease in body mass index at follow up stage (p˂ 0.05).

Conclusion: The study showed that acceptance and commitment therapy can lead to reduction in body mass index in follow up stage, in women afflicted with obesity. Therefore,
using this therapeutic approach is recommended for the treatment of obesity.