Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder

University of Massachusetts Boston, USA.
Behaviour Research and Therapy (Impact Factor: 3.85). 11/2009; 48(3):238-45. DOI: 10.1016/j.brat.2009.11.006
Source: PubMed

ABSTRACT Based on the theory that generalized anxiety disorder (GAD) is maintained through a reactive and fused relationship with one's internal experiences and a tendency towards experiential avoidance and behavioral restriction, an acceptance-based behavior therapy (ABBT) was developed to specifically target these elements. Since ABBT has been shown to be an efficacious treatment in previous studies, the current study focuses on proposed mechanisms of change over the course of therapy. Specifically, the current study focuses on session-by-session changes in two proposed mechanisms of change: acceptance of internal experiences and engagement in meaningful activities. Overall, clients receiving ABBT reported an increase in the amount of time spent accepting internal experiences and engaging in valued activities. Change in both acceptance and engagement in meaningful activities was related to responder status at post-treatment and change in these two proposed mechanisms predicted outcome above and beyond change in worry. In addition, change in acceptance was related to reported quality of life at post-treatment.

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Available from: Lizabeth Roemer, Jul 28, 2015
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    • "Despite the preceding case that values are a potentially important and underutilized aspect of OCD treatment, the current study is crosssectional in nature, therefore limiting the strength of the conclusion. More studies similar to that of Hayes et al. (2010), who measured values, acceptance and anxiety symptoms across sessions could be useful in examining the relationships explored in this paper in the context of OCD treatment. Moreover, due to the cross-sectional nature of the current study, the directionality of the relationship between values and OCD severity is unknown. "
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    ABSTRACT: New interventions such as Acceptance and Commitment Therapy (ACT) have shown early promise in the treatment of OCD, focusing on aspects of psychological flexibility including valued living, mindfulness, and committed action. However, research is needed to explore the relationship between the various components of ACT and OCD. The present study sought to investigate the relationship between values (i.e., self-compassion, courage, and the Valued Living Questionnaire [VLQ; the extent to which one has values and is living out values in everyday life]) and OCD severity. Participants (N=115) who self-reported meeting criteria for OCD completed an online survey assessing levels of different values as well as ratings of importance and consistent living within these values. Analyses yielded significant relationships between OCD severity and self-compassion, courage, and the VLQ. A multiple regression analysis revealed the VLQ and courage to be significant predictors of OCD severity. Interpretation of the results and their implications is considered.
    10/2013; DOI:10.1016/j.jcbs.2013.09.002
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    • "nce or tolerance of unwanted internal experiences , developing inhibitory responses , or whether these even represent distinct mechanisms ( Craske et al . , 2008 ) . Whereas preliminary evidence suggests that experiential avoidance and psychological inflexibility may be malleable mediators of response to psycho - therapy ( Berking et al . , 2009 ; Hayes et al . , 2010 ) , additional research is warranted to clarify the influence of experiential avoid - ance and psychological inflexibility on trajectories of response to trauma over time , including response to treatment for PTSD . Strengths of the current study include the use of a gold - standard diagnostic interview and the inclusion of multiple , r"
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    ABSTRACT: Although much is known regarding predictors of posttraumatic stress disorder (PTSD), little of this knowledge directly informs treatment. This study examined whether higher scores on the Acceptance and Action Questionnaire—II (AAQ–II), a self-report measure that purportedly assesses experiential avoidance and psychological inflexibility, accounted for unique variance in PTSD symptoms compared with personality factors and other established predictors of PTSD. In addition, this study examined whether the construct measured by the AAQ–II accounts for unique variance in PTSD severity over and above the avoidance symptoms of PTSD. A sample of 109 trauma-exposed veterans of the wars in Iraq and Afghanistan, approximately half of whom met current PTSD criteria on the Clinician-Administered PTSD Scale (CAPS), completed self-report measures of PTSD, combat exposure, perceived life threat, peritraumatic dissociation, recent life stress, perceived postdeployment social support, and personality. Higher AAQ–II scores, which indicate higher levels of psychological inflexibility and experiential avoidance, accounted for unique variance in PTSD symptom severity after controlling for all other predictors (small effect size [ES] on the CAPS; large ES on the self-report PTSD measure). Significant effects for AAQ–II scores remained after controlling for the avoidance symptoms of PTSD (small ES on the CAPS; medium ES on the self-report measure). Scores on the AAQ–II appears to be an important predictor of PTSD that warrants further investigation. Research should continue to examine the malleability of the constructs assessed by the AAQ–II, which may be useful targets in treatment.
    Psychological Trauma Theory Research Practice and Policy 09/2013; 5(6):521-528. DOI:10.1037/a0030178 · 0.89 Impact Factor
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    • "" My thoughts and feelings do not get in the way of how I want to live my life " (Bond et al., 2011). Specific values questionnaires have also been used, although these often consist of predetermined values (Hayes et al., 2009; Vowels, McCracken and Eccleston, 2008). This restriction may result in endorsement of domains due to social desirability rather than relevance and importance. "
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    ABSTRACT: Background: There is limited research on the applicability and effectiveness of Acceptance and Commitment Therapy (ACT) for people experiencing psychotic disorders. Clinical trials suggest ACT may be efficacious in reducing distress and rehospitalization rates in psychosis. Mindfulness and reduced literal believability of thought content have been associated with reduced distress for this population. Aims: To better understand ACT for psychosis, this study investigated clients' perspectives of the hypothesized active therapeutic processes of ACT. Method: Semi‑structured interviews, conducted with nine adults diagnosed with schizophrenia or schizoaffective disorder and persistent positive symptoms, were analysed thematically. Results: Four themes emerged: Usefulness of therapy; Changes attributed to ACT; Understanding of therapy; and Non-specific therapy factors. All participants found therapy useful and recommended ACT. Mindfulness, defusion, acceptance and values work were described as the most useful therapy components and contributing to positive changes. Self-rated frequency of symptoms did not change; however a reduction in the intensity and distress associated with symptoms was reported. Non-specific therapy factors were deemed useful by participants but not directly related to outcome. Conclusions: These findings are consistent with the theoretically defined underlying active processes of ACT and are relevant for this population. The findings also indicate important clinical implications for ACT for this client group: greater attention to the client connecting metaphors and concepts to the intended meaning may be valuable; caution should be used with some mindfulness and defusion techniques for intense experiences; and values work may be particularly useful for this population.
    Behavioural and Cognitive Psychotherapy 03/2013; 42(4):1-19. DOI:10.1017/S1352465813000209 · 1.69 Impact Factor
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