Raimo Lappalainen

• Doctor of Philosophy
• University of Jyväskylä

Background Persistent physical symptoms (PPS) can significantly impair health-related quality of life (HRQoL) and are often accompanied by psychiatric comorbidity. Psychological flexibility (PF), characterized by the ability to adapt functionally and congruently to diverse situations based on personal values, may play a crucial role in determining...

Insomnia, i.e., difficulty falling asleep or staying asleep, is a common condition that is connected to many psychological and physical problems. Online-based Acceptance and Commitment Therapy (ACT) has recently been introduced as an option for treating insomnia. However, our understanding is yet limited on what happens during an online ACT interve...

This study investigated the impact of online psychological flexibility training and support provided by peers on self-rated health (SRH) and health-related quality of life (HRQoL) among adults with overweight. It was a secondary analysis of a single-arm multi-center intervention study that was conducted in a real-life context. In a 2-years acceptan...

Background Acceptance and commitment therapy provides a psychobehavioral framework feasible for digital and hybrid weight loss interventions. In face-to-face studies, group-based interventions yield more favorable outcomes than individual interventions, but the effect of the intervention form has not been studied in combination with eHealth. Objec...

BACKGROUND Acceptance and commitment therapy provides a psychobehavioral framework feasible for digital and hybrid weight loss interventions. In face-to-face studies, group-based interventions yield more favorable outcomes than individual interventions, but the effect of the intervention form has not been studied in combination with eHealth. OBJEC...

Psychological flexibility skills (PFS) have shown to be an important aspect of wellbeing among the general population, however, there is a gap in research exploring flexibility skills among athletes. The present study examined the effects of PFS on young athletes’ ( n = 106, M = 19.9) psychological wellbeing, symptomatology, and gender differences....

Background Psychological flexibility skills supporting athletes mental wellbeing. Objectives Investigate the association between psychological flexibility skills and mental well-being in Finnish athletes. Investigate the effects of sport-specific ACT intervention on athlete`s psychological flexibility skills, mental well-being and symptoms. Desin...

ABSTRACT Studies have shown that international students are at increased risk of experiencing poor mental health. The COVID-19 pandemic has had further negative impacts on the psychological well-being of students. In this quasi-experimental study, we examined the impact of a brief acceptance and commitment therapy (ACT) -based group intervention de...

[This corrects the article DOI: 10.3389/fpsyg.2021.640955.].

Background Behavioral processes through which lifestyle interventions influence risk factors for type 2 diabetes (T2DM), e.g., body weight, are not well-understood. We examined whether changes in psychological dimensions of eating behavior during the first year of lifestyle intervention would mediate the effects of intervention on body weight durin...

Virtual reality (VR) offers new and flexible ways to provide psychological interventions. The aim of this study was to develop and investigate the effectiveness of a VR intervention based on acceptance and commitment therapy (ACT) for social and public speaking anxiety. ACT is a process-based approach that aims to (a) increase individuals’ abilitie...

Background Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, p...

The mental health of international students has become a concern, as they face high levels of psychological distress. We designed a five-week acceptance and commitment therapy (ACT) workshop with two additional individual assessment meetings. The intervention aimed at helping international students attending a Finnish university to reduce their sym...

Introduction Relatively little is known about individual differences in adolescent psychological flexibility and its associations with symptoms of stress and depression. This study examined different profiles of adolescent stress and depressive symptoms and their associations with developing psychological flexibility before the critical educational...

Background: Early appearing temperamental differences and the psychological flexibility skills of individuals are proposed factors influencing stress and depression among adolescents. We test the theoretical assumption that temperament may form a basis for facing the outer world, while the development of psychological flexibility being another such...

Research indicates that international students report more psychological distress than domestic students. The aim of our research was to investigate levels of stress, depression, and anxiety, and in particular, psychological predictors for these symptoms among international students. International students (N= 103) from the University of Jyväskylä...

Objective: The aim of the present study was to investigate the extent to which initial levels and changes in ninth-grade adolescents’ (n = 243) psychological well-being were associated with their school engagement after the transition to upper secondary education. In addition, we investigated whether a brief guided online acceptance and commitment...

Introduction Persistent physical symptoms (PPS) refer to symptoms that cannot be fully explained by structural bodily pathology or by environmental factors. Their impact on daily functioning varies from mild to severe disability. So far, evidence-based treatments for PPS have resulted in only small to moderate effects. Treatment protocols with a st...

Studies of the effects of the COVID-19 pandemic have shown that this health emergency has affected especially young people. Supporting the well-being of children is thus particularly urgent. However, the high prevalence of ill-being among children requires novel approaches to providing help. Health care resources are limited, and many children did...

Background Although some adolescents managed to cope well with the challenges brought on by the COVID-19 pandemic, the well-being of many was adversely affected due to school closures, distance education, restrictions on gathering with friends, and limited access to mental health services. Many adolescents reported increased anxiety and depression...

Type 1 diabetes can be a challenging disorder to manage, and it needs a significant amount of self-care and daily management. Management tends to deteriorate during adolescence due to both physiological and psychological factors. This study aimed to investigate the use of methods based on acceptance and commitment therapy (ACT) for the purpose of i...

This study aimed to obtain novel understanding of the associations between psychological inflexibility and adolescents' engagement with upper secondary studies. The participants were 885 Finnish adolescents (mean age 15.74 at the outset) whose psychological inflexibility was measured with the short form of the Acceptance and Fusion Questionnaire fo...

Objective: This study investigated the roles of adherence and usage activity in adolescents' (n = 161) gains during a 5-week web intervention program based on acceptance and commitment therapy (ACT). Method: Program adherence was calculated as adherence percentage in relation to intended usage, whereas completion percentage, usage time, and usag...

The present study examined if an Acceptance and Commitment Therapy (ACT)–based online intervention for parents had indirect effects on their children’s quality of life mediated by changes in parental well-being, psychological flexibility and mindfulness skills. Participants were 74 adults, who either received an ACT-based guided online intervention...

University students often experience difficulties in social interactions. The current study examined the role of self-compassion and psychological flexibility among university students (N= 76) reporting high levels of social interaction and communication anxiety. We observed that high social interaction (SIAS) and communication anxiety (PRCA-24) we...

The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans’ social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and soug...

A population-based cross-sectional study was conducted during the first COVID-19 wave, to examine the impact of COVID-19 on mental health using an anonymous online survey, enrolling 9565 individuals in 78 countries. The current sub-study examined the impact of the pandemic and the associated lockdown measures on the mental health, and protective be...

With the increase in demand for mental health services globally, the need for technology-based interventions (e.g., mobile applications, self-help websites) has risen. Evidence suggests that guided online interventions can be as effective as in-person interventions, along with greater accessibility for populations that may otherwise struggle to rec...

Background Engagement with digital interventions is a well-known predictor of treatment outcomes, but this knowledge has had limited actionable value. Instead, learning why engagement with digital interventions impact treatment outcomes can lead to targeted improvements in their efficacy. Objective This study aimed to test a serial mediation model...

Background: The COVID-19 pandemic is a massive health crisis that has exerted enormous physical and psychological pressure. Mental healthcare for healthcare workers (HCWs) should receive serious consideration. This study served to determine the mental-health outcomes of 1,556 HCWs from 45 countries who participated in the COVID-19 IMPACT project, a...

While many children and adolescents experience psychological problems with up to 20 percent estimated to develop a mental health problem, only few receive treatment. Online interventions can help respond to the need of support among young people without requiring considerable resources. However, relatively few studies have examined the efficacy of...

BACKGROUND Engagement with digital interventions is a well-known predictor of treatment outcomes, but this knowledge has had limited actionable value. Instead, learning why engagement with digital interventions impact treatment outcomes can lead to targeted improvements in their efficacy. OBJECTIVE This study aimed to test a serial mediation model...

Abstract Background Association of physiological recovery with nutrition has scarcely been studied. We investigated whether physiological recovery during sleep relates to eating habits, i.e., eating behaviour and diet quality. Methods Cross-sectional baseline analysis of psychologically distressed adults with overweight (N = 252) participating in a...

Understanding adolescent usage activity and experiences in web-based psychological intervention programs helps in developing universal programs that can be adopted for promotion of adolescent well-being and prevention of mental health problems. This study examined the usage activity, perceived usefulness (i.e., learning of mindfulness, acceptance a...

Objective An increase in psychological flexibility has been found to be associated with health behavior changes. Peer-led interventions have been advantageous in improving physical activity among individuals at health risk. This study aimed to discover whether an ACT-based peer-tutored online intervention can increase self-reported physical activit...

Objectives: The objective of the present study was to investigate whether an acceptance and commitment therapy (ACT)-based web-intervention (Group 1, CareACT), or a standardized rehabilitation in a rehabilitation center (Group 2) was effective in enhancing the psychological well-being of family caregivers aged 60 and over compared to support provid...

This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological...

Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impac...

Background Family caregivers often report high levels of distress, including depressive symptoms, anxiety, and reduced quality of life. There is a need for a greater understanding of the factors influencing, explaining, and maintaining psychological distress in family caregivers. Aim The aim of this study was to examine whether avoidance strategie...

Acceptance and commitment therapy (ACT) programs have rarely been used as tools for promoting adolescents' career preparation. This randomized controlled trial examined the possibility to promote the career preparation of Finnish ninth-grade adolescents (n = 249, 49% females) with a web-based five-week ACT-based online intervention program. Partici...

Tulevaisuuden terveydenhuollossa asiakas asemoituu aivan uudella tavoin. Asiakkaan roolin vahvistuminen oman terveytensä edistämisessä ja ylläpitämisessä sekä asiakasymmärryksen lisääntyminen palveluorganisaatioissa muuttavat terveydenhuollon toimintaa entistä asiakaslähtöisemmäksi. Asiakasnäkökulmaa palveluiden kehittämiseen pyritään vahvistamaan...

Objective Many parents of children with chronic conditions and developmental disabilities experience high rates of burnout and psychological distress. The aim of the current study was to examine the effects of two differently delivered interventions based on acceptance and commitment therapy (ACT) on symptoms of burnout, depression, quality of life...

Self-reports are typically used to assess public speaking anxiety. In this study, we examined whether self-report, observer report, and behavioral and physiological reactivity were associated with each other during a speech challenge task. A total of 95 university students completed a self-report measure of public speaking anxiety before and after...

Purpose Mental health problems affect 10-20% of adolescents worldwide. Prevention and early interventions for promoting adolescent mental health are therefore warranted. The aim of this randomized controlled trial was to examine the effects of a 5-week web-intervention (Youth COMPASS) based on the principles of Acceptance and Commitment Therapy on...

Background The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affec...

Introduction: Weight/body dissatisfaction is common among overweight, obese, and even normal-weight individuals and it is influenced by several factors such as thin idealization and obesity stigmatization. Body dissatisfaction is associated with intentions to lose weight, but also with failure in weight control attempts and unhealthy behaviors. Ob...

Aim To study the psychometric properties, reliability, and validity of the FinDiab quality of life questionnaire (FDQL), a strength‐oriented quality of life (QOL) questionnaire for children and adolescents with type 1 diabetes (T1D). Methods Participants were 215 youths with T1D (aged 10–17 years). They completed FDQL and comparison questionnaires...

Objectives While interventions using mindfulness have been effective in treating burnout, the mechanisms of change need more research. This study investigated which of five mindfulness facets (observing, describing, acting with awareness, non-judging, and non-reacting) mediated the intervention effects on three burnout dimensions (exhaustion, cynic...

This study investigates the role of psychological flexibility in relation to glycaemic control (HbA1c) and quality of life among adolescents with poorly-controlled diabetes. Adolescents (n = 65, aged 12–16 years) completed the Children and Adolescents Mindfulness Measure (CAMM), the Diabetes Acceptance and Action Scale for Children and Adolescents...

This multicenter research investigates the effects of dance movement therapy (DMT) on participants diagnosed with depression. In total, 109 persons participated in the study in various locations in Finland. The participants were 39 years old, on average (range = 18–64 years), and most were female (96%). All participants received treatment as usual...

A coach-guided Acceptance and Commitment Therapy (ACT) intervention that uses a blended approach of two face-to-face and five online sessions (iACT; N = 33) has been found to be more effective than a waiting-list control condition (WLC; N = 35) at enhancing the wellbeing of university students while also reducing stress and depression. The present...

Background The present study investigated competence and adherence in an acceptance- and values-based intervention and their impact on the outcomes of treatment and early changes in depression. Method A total of 74 sessions delivered by novice therapists (n = 37) were rated for overall competence and adherence to treatment manual, as well as for p...

Self-reports are typically used to assess public speaking anxiety. In this study, we examined whether self-report, observer report, and behavioral and physiological reactivity were associated with each other during a speech challenge task. A total of 95 university students completed a self-reported measure of public speaking anxiety before and afte...

Aim To explore what thoughts, feelings, and learning processes were involved in obese participants’ lifestyle change during an acceptance and commitment therapy (ACT) lifestyle intervention delivered in primary health care. Background Previous studies have revealed that lifestyle interventions are effective at promoting initial weight loss, but re...

Background Psychological processes can be manifested in physiological health. We investigated whether acceptance and commitment therapy (ACT), targeted on psychological flexibility (PF), influences inflammation and stress biomarkers among working-age adults with psychological distress and overweight/obesity.Method Participants were randomized into...

Public speaking is an important skill for university students to learn and practice as they progress through education and into their careers. However, individuals often avoid facing public speaking, as they lack the skills to cope with the anxiety that arises when speaking in front of others. The current study aimed to investigate the relationship...

Psychological stress is a suggested risk factor of metabolic disorders, but molecular mediators are not well understood. We investigated the association between the metabolic profiles of fasting plasma and the improvement of psychological well-being using non-targeted liquid chromatography-mass spectrometry (LC-MS) platform. The metabolic profiles...

A novel eight-week program based on Acceptance and Commitment Therapy (ACT) principles was created to alleviate burnout-related ill-being and to enhance well-being. This randomized controlled trial investigated the effectiveness of the program and explored whether changes in psychological flexibility mediated the results of the intervention. The pr...

Though previous research has extensively reported that sudden gains are associated with superior treatment results, research on the long-term effects and stability of sudden gains is not as consistent. The current study explored the long-term stability of early sudden gains (ESGs) observed in a brief acceptance and values-based intervention for dep...

Internet-delivered cognitive and behavioral interventions have been shown to be effective in enhancing well-being and reducing symptoms of stress and depression. Internet-based interventions can be easily accessible, time-saving for counselors, and allow the clients to work independently at their own pace. However, there is still limited research e...

This study investigated whether beneficial intervention effects on burnout and mindfulness skills diffuse and facilitate the long-term development of different levels of subjective well-being: experiential (perceived stress), eudaimonic (psychological and social well-being), and evaluative (life satisfaction). Participants were Finnish employees wi...

Background: Sleep disturbances are a common health problem. New and more accessible alternatives are needed to improve the availability of psychological treatments for insomnia. Objective: The aim of the present study was to investigate the effects of a self-help Acceptance and Commitment Therapy-based web-intervention for sleep disturbances. Metho...

Acceptance and commitment therapy programs have rarely been used as preventive tools for alleviating stress and enhancing coping skills among adolescents. This randomized controlled trial examined the efficacy of a novel Finnish web- and mobile-delivered five-week intervention program called Youth COMPASS among a general sample of ninth-grade adole...

The aim of this paper was to investigate the associations between mindfulness and acceptance (MAA) skills and burnout-related ill-being at work (ILLB) after eliminating the impact of worksite (WS) and general well-being in life (WELLB) factors. The results were derived from data on employees (n = 168) of varying professional backgrounds, who experi...

Background: Weight management (WM) is an ongoing global challenge. The purpose of this study was to analyze motivators, barriers, and strategies of WM among Finnish adults. Methods: Data were collected in the ‘KULUMA’ (Consumers at the Weight Management Market) project among 667 community-dwelling adults in Eastern and Central Finland (Kuopio and...

Objective: This study examined the outcomes of a brief Acceptance and Commitment Therapy (ACT) intervention for depression delivered by novice therapists. Method: Participants (N = 115) were randomized either to the brief (six sessions) ACT or to a waitlist control condition (WLC). Outcomes were assessed with diagnoses of depressive episodes (ICD-1...

Objective The aim of this study was to explore early temporal patterns of change in a treatment delivered by novice therapists. We examined if early sudden gains (ESGs) in a six-session acceptance and values-based intervention would produce superior treatment outcomes when compared to slower improvements. Method The temporal patterns of change of...

Introduction: Weight management (WM) has become a common practice. In 2014 population survey in Finland, 35% of working-age women and 24% of working-age men had tried to lose weight during the previous year. However, success rates are low especially in the long term and most individuals regain 33 to 100% of the lost weight within five years. There...

This study investigated individual differences in changes in burnout symptoms during a brief mindfulness-, acceptance-, and value-based intervention. It also studied whether the changes in burnout were simultaneous with the changes in mindfulness skills. The role of practices and learning experiences in these changes were investigated. The particip...

This study evaluated the implementation of Acceptance and Commitment Therapy in Finnish Sign Language in a rehabilitation center for deaf people. Sixteen (16) clients and nine (9) staff members participated in this pilot study. Staff members received a brief training in Acceptance and Commitment Therapy (ACT) including 16 h lectures, 15 h supervisi...

Increased knowledge of the type of skills training that is beneficial for producing long-term changes in depressive symptoms might help in the development of more effective brief interventions. This study aims to explore whether changes in mindfulness facets (KIMS) were differentially associated with changes in depressive symptoms (BDI) both immedi...

Background: Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. Methods:...

This study reports on the body image of depressed psychiatric outpatients, and the impact thereon of a dance movement therapy (DMT) group. Body image is perceived as a tri-partite construct consisting of image-properties, body-self, and body memory. Depressed patients in an outpatient mental health service participated in a DMT group treatment cons...

Background: Parents of children with chronic conditions often experience a crisis with serious mental health problems for themselves as a consequence. The healthcare focus is on the children; however, the parents often worry about their children's health and future but are seldom offered any counselling or guidance. Aim: The aim of this study wa...

Objective Despite the promising results related to intuitive eating, few studies have attempted to explain the processes encouraging this adaptive eating behaviour. The focus of the present study was on exploring mechanisms of change in intuitive eating and weight in acceptance and commitment therapy (ACT) interventions. Mediation provides importan...

Brief interventions can be viable treatment options worth consideration in addressing the growing need for treatments of subclinical and clinical depressive symptoms. However, there is uncertainty regarding the long-term benefits of these interventions. The aim was to examine the long-term (5-year) effects of a 4-session Acceptance and Commitment T...

This pilot study of 20 chronically ill male inpatients with schizophrenia and a history of violence investigates the relationships between cognitive insight, clinical insight, reasoning, and symptoms in a forensic setting. The majority (75%) of the patients with schizophrenia made hasty decisions based on a small amount of information (the jumping-...

Background: Mobile phone apps offer a promising medium to deliver psychological interventions. A mobile app based on Acceptance and Commitment Therapy (ACT) was developed and studied in a randomized controlled trial (RCT). Objective: To study usage metrics of a mobile ACT intervention and dose-response relationship between usage and improvement...

Stress-related eating may be a potential factor in the obesity epidemic. Rather little is known about how stress associates with eating behavior and food intake in overweight individuals in a free-living situation. Thus, the present study aims to investigate this question in psychologically distressed overweight and obese working-aged Finns. The st...

Postnatal depression affects 10 to 15 percent of women after childbirth. Acceptance and commitment therapy (ACT) is associated with better mental well-being and lower levels of depression. Digital ACT solutions enable providing potentially cost-effective access to interventions. This paper reports the user experiences of an ACT-based mobile mental...

The aim of this study was to investigate the association between physical activity (PA) and objective heart rate variability (HRV)-based stress and recovery with subjective stress in a longitudinal setting. Working-age participants (n = 221; 185 women, 36 men) were overweight (body mass index, 25.3-40.1 kg/m(2) ) and psychologically distressed (≥3/...

Full-text freely available in http://urn.fi/URN:ISBN:978-951-39-6562-4

Background Improving attitudes of personnel towards self‐injurious patients leads to better working alliance and contributes to better patient outcomes. Previous research into the improvement of these attitudes has recorded the need for specific training in evidence‐based assessment and treatment of self‐injurious patients. Aim The current study d...