ACT

Relieve Generalized Anxiety and Depression with a 2-Session Acceptance and Commitment Therapy (ACT)

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Relieve Generalized Anxiety and Depression with a 2-Session Acceptance and Commitment Therapy (ACT)

 

By John M. de Castro, Ph.D.

 

“ACT is about acceptance and it is about change at the same time. Applied to anxiety disorders, patients learn to end the struggle with their anxiety-related discomfort and take charge by engaging in actions that move them related to their chosen life aims.” – Mohsen Hasheminasab 

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused.

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression.

 

There are a number of psychological therapies for anxiety and depression. But, les than half the patients treated respond to the therapy and do not relapse. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders. A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety. ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

In prior research Ruiz and associates have demonstrated that a 3 session Acceptance and Commitment Therapy (ACT) is effective Generalized Anxiety Disorder (GAD) and for depression. In today’s Research News article “Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial.” (See summary below or at: https://pubmed.ncbi.nlm.nih.gov/31944806/), Ruiz and colleagues examine the efficacy of a 2-session ACT for Generalized Anxiety Disorder (GAD) and for depression.

 

They recruited via social media patients diagnosed with either Generalized Anxiety Disorder (GAD) or depression and randomly assigned them to either a wait-list control condition or to receive 2 60-minute individual sessions of Acceptance and Commitment Therapy (ACT). They were measured before and after treatment and 1- and 3-months month later for anxiety, depression, perceived stress, perseverative thinking, experiential avoidance, cognitive fusion, valued living, and generalized pliance (rule governed behavior).

 

They found that in comparison to baseline and the wait-list control group, the patients who received Acceptance and Commitment Therapy (ACT) had significantly improved levels of all outcome measures including anxiety, depression, perceived stress, perseverative thinking, experiential avoidance, cognitive fusion, valued living, and generalized pliance that persisted at the 1- and 3-month follow-ups. Fully 91% of the patients receiving ACT had clinically significant changes in their Generalized Anxiety Disorder (GAD) or depression compared to 9% of the wait-list controls.

 

The findings are remarkable in that 2 1-hour sessions of Acceptance and Commitment Therapy (ACT) produced such large, significant and lasting improvements in patients with Generalized Anxiety Disorder (GAD) or depression. These disorders are widespread affecting a large number of people and are frequently debilitating or at least interfere with their ability to conduct their lives. It is exciting that a brief treatment that can be implemented cost-effectively is capable of relieving their suffering.

 

The study, however, lacked an active control condition, e.g. exercise, and so is open to a variety of confounding variables. Future research should include such an active control. The effects of confounding variables, however, generally fade fairly quickly over time. So, the fact that the current results were still large and significant 3-months later argues that the benefits were produced by ACT.

 

So, relieve generalized anxiety and depression with a 2-session Acceptance and Commitment Therapy (ACT).

 

“ACT has been used effectively to help treat workplace stress, test anxiety, social anxiety disorder, depression, obsessive-compulsive disorder, and psychosis.” – Psychology Today

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ruiz FJ, Peña-Vargas A, Ramírez ES, et al. Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial [published online ahead of print, 2020 Jan 16]. Psychotherapy (Chic). 2020;10.1037/pst0000273. doi:10.1037/pst0000273

 

Abstract

This parallel randomized controlled trial aimed to evaluate the effect of acceptance and commitment therapy (ACT) focused on disrupting repetitive negative thinking (RNT) versus a waitlist control (WLC) in the treatment of depression and generalized anxiety disorder (GAD). Forty-eight participants with a main diagnosis of depression and/or GAD were allocated by means of simple randomization to a 2-session RNT-focused ACT intervention or to the WLC. The primary outcomes were emotional symptoms as measured by the Depression, Anxiety, and Stress Scales-21. Process outcomes included ACT- and RNT-related measures: general RNT, experiential avoidance, cognitive fusion, values, and generalized pliance. At the 1-month follow-up, linear mixed effects models showed that the intervention was efficacious in reducing emotional symptoms (d = 2.42, 95% confidence interval [1.64, 3.19]), with 94.12% of participants in the RNT-focused ACT condition showing clinically significant change in the Depression, Anxiety, and Stress Scales-21 total scores versus 9.09% in the WLC condition (70% vs. 8% in intention-to-treat analysis). The intervention effects were maintained at the 3-month follow-up. No adverse events were found. A very brief RNT-focused ACT intervention was highly effective in the treatment of depression and GAD.

Clinical Impact Statement Question: What is the applied clinical practice question this paper is hoping to address?

To analyze whether a 2-session acceptance and commitment therapy (ACT) intervention focused on disrupting repetitive negative thinking (RNT) is effective in treating depression and GAD. Findings: How would clinicians meaningfully use the primary findings of this paper in their applied practice? Clinicians might use the RNT-focused ACT protocol to treat depression and GAD. Meaning: What are the key conclusions and implications for future clinical practice and research? The RNT-focused ACT protocol was highly effective in treating depression and GAD. Next Steps: Based on the primary findings and limitations of this paper, what are future directions to be explored in clinical practice and research? To analyze the long-term effects of the RNT-focused ACT protocol.

https://pubmed.ncbi.nlm.nih.gov/31944806/

 

Improve Quality of Life after a Heart Attack with Mindfulness

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Improve Quality of Life after a Heart Attack with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors.” – John Denninger

 

Cardiovascular disease is the number one killer. A myriad of treatments has been developed including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of cardiovascular disease patients decline participation, making these patients at high risk for another attack.

 

Contemplative practices have been shown to be safe and effective alternative treatments for cardiovascular disease. Practices such as meditation, tai chi, and yoga, have been shown to be helpful for heart health and to reduce the physiological and psychological responses to stress. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. So, it makes sense to study the efficacy of ACT for patients recovering from a heart attack.

 

In today’s Research News article “The Effectiveness of Acceptance and Commitment Therapy on Quality of Life in a Patient with Myocardial Infarction: A Randomized Control Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193234/), Ghahnaviyeh and colleagues recruited patients over 30 years of age who had had a myocardial infarction. They were randomly assigned to either receive 8 weekly 90 minute sessions of Acceptance and Commitment Therapy (ACT) or to a treatment as usual control condition. They were measured before and after therapy and 6 months later for health status and quality of life.

 

They found that after therapy and 6 months later the group that received Acceptance and Commitment Therapy (ACT) had significantly greater overall quality of life including significantly greater physical and psychological quality of life. These results suggest that ACT improves the quality of life of patients having had myocardial infarction. It remains for future research to determine the mechanisms of these effects of ACT.

 

So, improve quality of life after a heart attack with mindfulness.

 

“this practice may be clinically useful in the secondary prevention of cardiovascular disease.” – Heart Matters

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ahmadi Ghahnaviyeh, L., Bagherian, B., Feizi, A., Afshari, A., & Mostafavi Darani, F. (2020). The Effectiveness of Acceptance and Commitment Therapy on Quality of Life in a Patient with Myocardial Infarction: A Randomized Control Trial. Iranian journal of psychiatry, 15(1), 1–9.

 

Abstract

Objective: Acceptance and commitment therapy (ACT) interventions increase psychological flexibility and improve mental health and quality of life in patients with myocardial infarction.

Study design: A controlled clinical trial study was conducted to evaluate the efficacy of an ACT intervention in improving the quality of life in patients with MI in Isfahan, Iran.

Method : The present controlled clinical trial with a pre and post-test design was conducted on a statistical population consisting of patients with MI admitted to hospitals in Isfahan (n = 60) who were selected through sequential sampling based on the study inclusion criteria and were randomly divided into an intervention and a control group (n1 = n2 = 30). The case group received 8 weekly 90-minute sessions of ACT and the control group received no interventions. The pretest-posttest design was administered in both groups using a demographic questionnaire and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) designed to assess the health status of patients with heart failure in terms of quality of life. The data obtained were analyzed in SPSS-20 using descriptive statistics and the ANCOVA.

Results: In this study, 2 general areas of quality of life, including physical and mental health, were examined in the patients. There was a significant increase in the quality of life and subscales of mental and physical health in the experimental group (p < 0.001).

Conclusion: Considering the effectiveness of ACT in improving quality of life in these patients, this method of intervention can be used as a complementary therapy in health care centers to reduce the side-effects experienced by these patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193234/

 

Improve Major Depressive Disorder with Acceptance and Commitment Therapy

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Improve Major Depressive Disorder with Acceptance and Commitment Therapy

 

By John M. de Castro, Ph.D.

 

“Insecure attachment styles are more prevalent in individuals with mood disorders and has been associated with worse clinical outcomes, whereas a secure attachment is linked to more positive health behaviors, such as greater adherence to health plans and preventive health behaviors.” – Tamara Cassis

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating and difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time.

 

Attachment has been shown to affect the individual’s well-being. There are a variety of ways that individuals attach to others. They are secure, insecure, avoidant, ambivalent, fearful, preoccupied, and disorganized attachment styles. Secure attachment style is healthy and leads to positive development while all of the others are maladaptive and unhealthy. All of the  attachment styles, save secure attachment, are associated with depression.

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

It is possible that Acceptance and Commitment Therapy (ACT) may improve depression by affecting attachment. In today’s Research News article “Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137238/),  A-Tjak and colleagues explore this possibility. They recruited adult patients diagnosed with major depressive disorder and randomly assigned them to receive 18 weekly 50 minute sessions of Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT). They were measured before and after treatment and 6 months later for depressive symptoms, quality of life, attachment anxiety, and attachment avoidance. Implicit attachment was measured with a card sorting task.

 

They found that the two treatments were equally effective producing 75% to 80% rates of remission from depression and significant reductions in depression, attachment anxiety, and attachment avoidance and increases in quality of life. The effects were still present at the 6-month follow-up. The decreases in attachment anxiety and attachment avoidance were associated with decreases in depression and increases in quality of life while no relationships were present for implicit attachment.

 

The fact that Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) were equally effective for major depression is not surprising as ACT incorporates CBT. It is interesting that the magnitude in the changes in attachment anxiety and attachment avoidance were related to the improvements in depression and quality of life. But these results do not demonstrate causation, changes in attachment might cause changes in depression, changes in depression might cause changes in attachment, or therapy might change both independently. What is clear is that both ACT and CBT are highly effective and lasting treatments for major depressive disorder.

 

So, improve major depressive disorder with Acceptance and Commitment Therapy.

 

“Mindfulness training can “generate positive emotions by cultivating self-compassion and self-confidence through an upward spiral process.” – Amanda MacMillan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

A-Tjak, J., Morina, N., Boendermaker, W. J., Topper, M., & Emmelkamp, P. (2020). Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression. BMC psychiatry, 20(1), 155. https://doi.org/10.1186/s12888-020-02547-7

 

Abstract

Background

Attachment theory predicts that patients who are not securely attached may benefit less from psychological treatment. However, evidence on the predictive role of attachment in the effectiveness of treatment for depression is limited.

Methods

Explicit attachment styles, levels of attachment anxiety and attachment avoidance, as well as implicit relational self-esteem and implicit relational anxiety were assessed in 67 patients with major depressive disorder (MDD) receiving Acceptance and Commitment Therapy (ACT) or Cognitive Behavioral Therapy (CBT). ANOVA and hierarchical regression analyses were performed to investigate the predictive power of explicit and implicit attachment measures on treatment outcome.

Results

Explicit attachment avoidance at pre-treatment significantly predicted reduction of depressive symptoms following treatment. Reductions in attachment anxiety and avoidance from pre- to post-treatment predicted better treatment outcomes. Neither one of the implicit measures, nor change in these measures from pre- tot post-treatment significantly predicted treatment outcome.

Conclusions

Our findings show that attachment avoidance as well as reductions in avoidant and anxious attachment predict symptom reduction after psychological treatment for depression. Future research should use larger sample sizes to further examine the role of attachment orientation as moderator and mediator of treatment outcome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137238/

 

Improve Generalized Anxiety Disorder with Acceptance and Commitment Therapy (ACT)

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Improve Generalized Anxiety Disorder with Acceptance and Commitment Therapy (ACT)

 

By John M. de Castro, Ph.D.

 

“Acceptance and commitment therapy (ACT) is a type of psychotherapy gaining popularity in the treatment of anxiety disorders like generalized anxiety disorder (GAD). It is also used to treat other conditions including depression, eating disorders, chronic pain, and substance use disorders.” – Deborah Glasofer

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

 

A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT) and has also been shown to relieve anxiety. ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

In today’s Research News article “A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082425/), Ruiz and colleagues recruited 6 adults with Generalized Anxiety Disorder (GAD) and also depression. They received a 3 session Acceptance and Commitment Therapy (ACT) protocol of 90, 60, and 60 minutes focused on repetitive negative thinking implemented at different times on a multiple baseline. They were measured weekly over the internet for emotional symptoms (a combination of anxiety, depression and perceived stress), worry, experiential avoidance, cognitive fusion, perseverative thinking, and valuing.

 

They found that all participants demonstrated no significant changes during the 5 or more weeks of the baseline period in emotional symptoms or worry. But once Acceptance and Commitment Therapy (ACT) was provided all participants immediately demonstrated a precipitous decline in emotional symptoms, worry, experiential avoidance, cognitive fusion, and perseverative thinking that was maintained for 3 months. Effect sizes were very large and 5 of the 6 participants had clinically significant changes in emotional symptoms and worry.

 

It is well established that mindfulness training reduces anxiety, depression, perceived, stress, and worry. Nevertheless, the results of the present study are striking. Administration of a brief Acceptance and Commitment Therapy (ACT)  focused on repetitive negative thinking produced dramatic clinically significant improvements in the core symptoms of Generalized Anxiety Disorder (GAD) and depression. The fact that this was accomplished in 3-sessions is important as it reduces the investment of therapists in treatment, reducing costs and improving the numbers of people being able to be treated. These findings suggest that this brief form of mindfulness-based therapy be implemented for anxiety and deprressive disorders.

 

So, improve Generalized Anxiety Disorder with Acceptance and Commitment Therapy (ACT).

 

“ACT helps you take action on your values, instead of letting your anxiety dictate your decisions and your days.” –  Margarita Tartakovsky

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ruiz, F. J., Luciano, C., Flórez, C. L., Suárez-Falcón, J. C., & Cardona-Betancourt, V. (2020). A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression. Frontiers in psychology, 11, 356. https://doi.org/10.3389/fpsyg.2020.00356

 

Abstract

Repetitive negative thinking (RNT) is a core feature of generalized anxiety disorder (GAD) and depression. Recently, some studies have shown promising results with brief protocols of acceptance and commitment therapy (ACT) focused on RNT in the treatment of emotional disorders in adults. The current study analyzes the effect of an individual, 3-session, RNT-focused ACT protocol in the treatment of severe and comorbid GAD and depression. Six adults meeting criteria for both disorders and showing severe symptoms of at least one of them participated in the study. A delayed multiple-baseline design was implemented. All participants completed a 5-week baseline without showing improvement trends in emotional symptoms (Depression Anxiety and Stress Scale – 21; DASS-21) and pathological worry (Penn State Worry Questionnaire; PSWQ). The ACT protocol was then implemented, and a 3-month follow-up was conducted. Five of the six participants showed clinically significant changes in the DASS-21 and the PSWQ. The standardized mean difference effect sizes for single-case experimental design were very large for emotional symptoms (d = 3.34), pathological worry (d = 4.52), experiential avoidance (d = 3.46), cognitive fusion (d = 3.90), repetitive thinking (d = 4.52), and valued living (d = 0.92 and d = 1.98). No adverse events were observed. Brief, RNT-focused ACT protocols for treating comorbid GAD and depression deserve further empirical tests.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082425/

 

Improve Emotional Distress in The Elderly with Type 2 Diabetes with Mindfulness

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Improve Emotional Distress in The Elderly with Type 2 Diabetes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness based approaches has been found to be particularly effective in supporting diabetes management and the mental turmoil that is accompanied with a diagnosis of such as chronic physical illness. It can address the feelings of guilt, anger and aid self-acceptance to encourage the fulfilment of an unobstructed life. Mindfulness has also been found to have an enhanced clinical effect of glycemic control so not only aids psychological health but could potentially have a positive impact on the management of the physical condition.” – Diabetes UK

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. The problems resulting from diabetes get magnified in the elderly. So, it is important to study the efficacy of ACT for Type 2 Diabetes in the elderly.

 

In today’s Research News article “Efficacy of Acceptance And Commitment Therapy For Emotional Distress In The Elderly With Type 2 Diabetes: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802537/), Maghsoudi and colleagues recruited patients with Type 2 Diabetes over 60 years of age. They all continued on routine care while half were randomly selected to receive Acceptance and Commitment Therapy (ACT) in groups once a week for 90 minutes for 8 weeks. They were measured before and after training and 2 months later for diabetes-related emotional distress including the dimensions of emotional burden, physician-related distress, regimen-related distress and diabetes-related interpersonal distress.

 

They found that in comparison to baseline and the usual care group the patients who received Acceptance and Commitment Therapy (ACT) had significantly lower diabetes-related emotional distress. This lower diabetes-related emotional distress was maintained 2 months later. The study contained only a passive control condition, so caution must be exercised in interpreting the results. Nevertheless, ACT\ was a safe, effective, and lasting treatment to improve the emotions of elderly patients with Type 2 Diabetes.

 

So, improve emotional distress in the elderly with Type 2 Diabetes with mindfulness.

 

“Mindfulness training, including focused breathing and awareness training, helped U.S. veterans with diabetes significantly lower their diabetes-related distress and blood sugar levels and improve their self-management of the disease, researchers report.” – Science Daily

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Maghsoudi, Z., Razavi, Z., Razavi, M., & Javadi, M. (2019). Efficacy Of Acceptance And Commitment Therapy For Emotional Distress In The Elderly With Type 2 Diabetes: A Randomized Controlled Trial. Diabetes, metabolic syndrome and obesity : targets and therapy, 12, 2137–2143. doi:10.2147/DMSO.S221245

 

Abstract

Introduction

Diabetes is among the common diseases in the elderly which results in depression, anxiety, and emotional distress in the elderly and impacts the disease control by the individual. This study was conducted with the aim of exploring the effectiveness of acceptance and commitment therapy (ACT) in the improvement of emotional distress in the elderly with type 2 diabetes.

Materials and methods

In this randomized control trial, 80 elderly with type 2 diabetes aged ≥60 years were randomly selected among the individuals visiting Yazd Diabetes Research Center. Then, the patients were randomly divided into two 40 individual groups, ie, the intervention group and the control group. The intervention group underwent group ACT during eight 90-min sessions. The diabetes-related emotional distress questionnaire was completed before the intervention, after the end of the group sessions and 2 months after that. The statistical software SPSS version 21 was used for data analysis.

Results

The emotional mean scores in the intervention and control groups were not significantly different before the intervention. However, the mean score of the intervention group was lower than of the control group immediately after the intervention (p=0.02) and 2 months after the intervention (p=0.02).

Conclusion

ACT results in the improvement of diabetes-related emotional distress in the intervention group. Considering the effectiveness of ACT, this therapeutic method is recommended to be used for the amelioration of emotional distress in the elderly with type 2 diabetes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802537/

 

Improve the Well-Being of Mothers of Children with Autism with Mindfulness

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Improve the Well-Being of Mothers of Children with Autism with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Parents of children with autism spectrum disorder . . . who engage in a mindfulness-based practice see a decrease in their child’s aggression and challenging behaviors and an improvement in the child’s overall functioning.” – Katy Oberle

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost exacting a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Providing care for a child with autism can be particularly challenging. About one out of every 68 children is considered autistic. These children’s behavior is characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. These make it difficult to relate to the child and receive the kind of positive feelings that often help to support caregiving. The challenges of caring for a child with autism require that the parent be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. The application of mindfulness skills to the parents of children with autism is relatively new. So, it would seem reasonable to investigate the ability of ACT to improve the psychological well-being of mothers of children with autism.

 

In today’s Research News article “The Effectiveness of Group Based Acceptance and Commitment Therapy (ACT) on Emotion Cognitive Regulation Strategies in Mothers of Children with Autism Spectrum.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861729/?report=classic), Salimi and colleagues recruited mothers of children with autism and randomly assigned them to receive either a once a week for 2 hours for 8 weeks program of Acceptance and Commitment Therapy (ACT) or a health education control condition. They were measured before and after training for emotion regulation including self-blaming, blaming others and positive reevaluation, blaming, rumination, considering a situation as disastrous, reception, planning/positive refocuses.

 

They found that after treatment the mothers showed a significant increase in reception, planning/positive refocuses and significant decreases in self-blaming, blaming others and positive reevaluation, blaming, and considering a situation as disastrous. Hence, Acceptance and Commitment Therapy (ACT) significantly improved the ability of mothers of children with autism to regulate their emotions. This is very important as these mothers are extremely important for these children but under great stress and emotional turmoil. Being able to improve their psychological well-being is important for both the mother and child.

 

So, improve the well-being of mothers of children with autism with mindfulness.

 

“People who practice mindfulness learn to pay specific attention to what is happening in the moment — and that includes moments that are stressful or chaotic. It is easy to get overtaken by stress or negativity, but mindfulness teaches people to find distance from their negative thoughts by learning to acknowledge them and label them when they happen.” – Julianne Garey

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Salimi, M., Mahdavi, A., Yeghaneh, S. S., Abedin, M., & Hajhosseini, M. (2019). The Effectiveness of Group Based Acceptance and Commitment Therapy (ACT) on Emotion Cognitive Regulation Strategies in Mothers of Children with Autism Spectrum. Maedica, 14(3), 240–246. doi:10.26574/maedica.2019.14.3.240

 

Abstract

Background:Autism spectrum disorder has a big impact on family life. Mothers of children with autism face many challenges. This study was conducted to determine the effectiveness of group-based acceptance and commitment therapy on cognitive emotion regulation strategies in mothers of children with autism.

Method:This is a quasi-experimental study with a pretest-posttest control group design. The research population included mothers of children with autism spectrum disorder referring to exceptional schools, who were living in Tehran. After cluster random sampling, 30 mothers of children with autism spectrum disorder were selected and randomly assigned to two groups: an experimental group and a control group, each consisting of 15 women. Participants responded to the cognitive emotion regulation questionnaire vulbefore and after intervention. The experimental group received group-based acceptance and commitment therapy (eight two-hour sessions), while no intervention was given to the control group.

Results and conclusion:Covariance analysis of data showed that group-based acceptance and commitment therapy had a significant effect on positive/planning strategy refocusing (p=0.003), positive reappraisal (p=0.004), self-blaming (p=0.001), blaming others (p=0.007), considering a situation as disastrous (p=0.001), reception (p=0.008). However, there was not a significant difference in the dimensions of rumination (p=0.025). Therefore, it is recommended that welfare institutions and centers should provide a training plan based on acceptance and commitment therapy to improve the current cognitive emotion regulation strategies for mothers of children with autism spectrum.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861729/?report=classic

 

Mindfulness Produces Long-Term Reductions in Depression and Depression Relapse

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Mindfulness Produces Long-Term Reductions in Depression and Depression Relapse

 

By John M. de Castro, Ph.D.

 

“Instead of getting sucked into our emotions or our thoughts, which is what happens when we’re depressed or anxious, we see them as those thoughts again, or those feelings again, and that disempowers them.” – Daniel Goleman

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering.

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

Attention Bias Modification (ABM) involves simple computerized training to increase attention to positive stimuli. It is not known if ABM might supplement Acceptance and Commitment Therapy (ACT) to further decrease depression relapse rates. In today’s Research News article “Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727662/), Østergaard and colleagues examined the combination of Acceptance and Commitment Therapy (ACT) and  Attention Bias Modification (ABM) to reduce depression relapse.

 

They recruited participants who had a history of depression but were not currently in a depressive episode. They were randomly assigned to receive a single session of either Attention Bias Modification (ABM) training or a control condition that was very similar except that attention to both positive and negative stimuli were equally reinforced. They were then assigned to either receive 8 once a week, 2.5 hour session of Acceptance and Commitment Therapy (ACT) or no treatment. Participants were measured before and after training and each month over the subsequent year for depression, depression relapse, and feasibility and acceptability of treatments.

 

They found that Attention Bias Modification (ABM) did not significantly affect depression or relapse. On the other hand, Acceptance and Commitment Therapy (ACT) with or without prior Attention Bias Modification (ABM) training produced significant reductions in both self-report and clinician reported levels of depression that continued to decline over the year follow-up period. They also found that over the 12-month follow-up 79% of the participants who received ACT training did not have another depressive episode while only 55% of the control participants did not have a relapse. Hence, ACT significantly reduces depression levels and depression relapse over a year following treatment.

 

These are impressive results. Acceptance and Commitment Therapy (ACT) is not only a safe and effective mindfulness-based treatment to reduce depression and depression relapse in people with a history of depression but also has a sustained impact lasting for at least a year following treatment. It is unusual for studies to have such long-term follow-up. It is important that ACT has such sustained benefits.

 

So, produce long-term reductions in depression and depression relapse with mindfulness.

 

“Mindfulness is a valuable practice for improving the cognitive symptoms of depression, such as distorted thinking and distractibility. It helps individuals recognize these more subtle symptoms, realize that thoughts are not facts and refocus their attention to the present.” –  Margarita Tartakovsky

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Tom Østergaard, Tobias Lundgren, Ingvar Rosendahl, Robert D. Zettle, Rune Jonassen, Catherine J. Harmer, Tore C. Stiles, Nils Inge Landrø, Vegard Øksendal Haaland. Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up. Front Psychol. 2019; 10: 1995. Published online 2019 Aug 29. doi: 10.3389/fpsyg.2019.01995

 

Abstract

Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants with a history of depression, currently in remission (N = 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N = 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727662/

 

Improve Fibromyalgia Symptoms with Mindfulness

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Improve Fibromyalgia Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness training is a low-cost, side-effect-free addition to fibromyalgia treatment that almost anyone can try — research suggests it helps you improve negative emotions surrounding fibromyalgia pain and, over time, change the way you respond to and think about your fibromyalgia symptoms.” – Madeline Vann

 

Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. The studies are accumulating, so, it would make sense to pause and summarize what has been learned.

 

In today’s Research News article “Mindfulness- and acceptance-based interventions for patients with fibromyalgia – A systematic review and meta-analyses.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719827/), Haugmark and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials exploring the effectiveness of mindfulness- and acceptance-based interventions in the treatment of fibromyalgia. They found 9 published randomized controlled trials employing Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), or Acceptance and Commitment Therapy (ACT).

 

They found that the published research studies report that the mindfulness- and acceptance-based interventions produced small to moderate but significant improvements in the fibromyalgia patients’ levels of pain, depression, anxiety, sleep quality, health-related quality of life, and mindfulness. These benefits were sustained at follow-up but were diminished in magnitude. Hence, these interventions were safe and effective treatments for the suffering and psychological well-being of patients with fibromyalgia.

 

Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Acceptance and Commitment Therapy (ACT) are quite different therapies with some vastly different therapeutic techniques. But they all have in common, mindfulness training. So, it would appear that mindfulness training was the critical component responsible for the benefits. This should not be surprising as mindfulness has been shown in many studies of various healthy and distressed groups to improve pain, depression, anxiety, sleep quality, and health-related quality of life. But fibromyalgia has no cure and causes great suffering in its victims. It is very comforting to see that mindfulness training can, at least, mitigate the suffering.

 

So, improve fibromyalgia symptoms with mindfulness.

 

“people with fibromyalgia may have what’s called an “attentional bias” toward negative information that appeared to be linked to pain severity. Researchers suggested that mindfulness training may help manage this trait and therefore reduce pain.” – Adrienne Dellwo

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Haugmark, T., Hagen, K. B., Smedslund, G., & Zangi, H. A. (2019). Mindfulness- and acceptance-based interventions for patients with fibromyalgia – A systematic review and meta-analyses. PloS one, 14(9), e0221897. doi:10.1371/journal.pone.0221897

 

Abstract

Objectives

To analyze health effects of mindfulness- and acceptance-based interventions, including mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT) and acceptance and commitment therapy (ACT). Additionally, we aimed to explore content and delivery components in terms of procedure, instructors, mode, length, fidelity and adherence in the included interventions.

Methods

We performed a systematic literature search in the databases MEDLINE, PsychINFO, CINAHL, EMBASE, Cochrane Central and AMED from 1990 to January 2019. We included randomized and quasi-randomized controlled trials analyzing health effects of mindfulness- and acceptance-based interventions for patients with fibromyalgia compared to no intervention, wait-list control, treatment as usual, or active interventions. MBSR combined with other treatments were included. Predefined outcomes were pain, fatigue, sleep quality, psychological distress, depression, anxiety, mindfulness, health-related quality of life and work ability. The Template for Intervention Description and Replication (TIDieR) checklist and guide was used to explore content and delivery components in the interventions. Meta-analyses were performed, and GRADE was used to assess the certainty in the evidence.

Results

The search identified 4430 records, of which nine original trials were included. The vast majority of the participants were women. The analyses showed small to moderate effects in favor of mindfulness- and acceptance-based interventions compared to controls in pain (SMD -0.46 [95% CI -0.75, -0.17]), depression (SMD -0.49 [95% CI -0.85, -0.12]), anxiety (SMD -0.37 [95% CI -0.71, -0.02]), mindfulness (SMD -0.40 [-0.69, -0.11]), sleep quality (SMD -0.33 [-0.70, 0.04]) and health-related quality of life (SMD -0.74 [95% CI -2.02, 0.54]) at end of treatment. The effects are uncertain due to individual study limitations, inconsistent results and imprecision.

Conclusion

Health effects of mindfulness- and acceptance-based interventions for patients with fibromyalgia are promising but uncertain. Future trials should consider investigating whether strategies to improve adherence and fidelity of mindfulness- and acceptance-based interventions can improve health outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719827/

 

Improve the Psychological Well-Being of Lupus Patients with Mindfulness

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Improve the Psychological Well-Being of Lupus Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“For someone with lupus who suffers from persistent joint or muscular pain, the struggle to find relief can be stressful and exhausting. But mindfulness meditation is not about fighting. It’s all about acceptance. And once you have achieved calm, it can help you regain a much-needed sense of control when your disease brings you discomfort.” – Lupus Foundation

 

Autoimmune diseases occur when the body’s systems that are designed to ward off infection attack the individual’s own tissues. Lupus is an autoimmune disease that affects a variety of organ systems including kidneys, joints, skin, blood, brain, heart and lungs. Lupus can produce fever, joint pain, stiffness and swelling, butterfly-shaped rash on the face or rashes elsewhere on the body, skin lesions that appear or worsen with sun exposure, fingers and toes that turn white or blue when exposed to cold or during stressful periods, shortness of breath, chest pain, dry eyes, headaches, confusion and memory loss. Lupus strikes between 10 to 25 people per 100,000, or about 322,000 cases in the U.S.

 

The symptoms of Lupus can look like a number of other diseases so it is hard to diagnose lupus. It is tipped off in many patients by the distinctive facial rash. There are no known cures for lupus and treatment is targeted at symptom relief. Drug treatments include pain relievers, corticosteroids, immunosuppressants, and even antimalarial drugs. Mindfulness practices have been shown to be effective for a wide variety of illnesses and to improve the immune system. So, it is possible that mindfulness training could improve Lupus and its symptoms.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

In today’s Research News article “Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic Lupus Erythematosus (SLE) Patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702277/), Sahebari and colleagues recruited female lupus patients and were randomly assigned to receive 8 weekly sessions of Acceptance and Commitment Therapy (ACT) or treatment as usual. They were measured before and after treatment for depression, psychological distress, fatigue, disappointment, and psychasthenia.

 

They found that in comparison to baseline and the treatment as usual control condition, the lupus patients who received Acceptance and Commitment Therapy (ACT) had significantly lower levels of psychological distress, psychasthenia, and disappointment with large effect sizes. psychasthenia is a psychological disorder characterized by phobias, obsessions, compulsions, or excessive anxiety. Hence, ACT appears to be effective in improving the psychological state of lupus patients. It can be speculated that ACT has its benefits for lupus patients by increasing mindfulness and the patients’ ability to accept their situation without judgement.

 

So, improve the psychological well-being of lupus patients with mindfulness.

 

“Improvement was observed in several areas: patients’ increased ability to differentiate between themselves and the disease; increased ability to accept, rather than to actively fight the fact that one must live with the disease; and decreased behavioral avoidance. These observations speak to the significant therapeutic potential of mindfulness practice among SLE patients” – Danny Horash

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sahebari, M., Asghari Ebrahimabad, M. J., Ahmadi Shoraketokanlo, A., Aghamohammadian Sharbaf, H., & Khodashahi, M. (2019). Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic Lupus Erythematosus (SLE) Patients. Iranian Journal of Psychiatry, 14(2), 130–136.

 

Abstract

Objective: The aim of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) in the reduction of disappointment, psychological distress, and psychasthenia among patients with systemic lupus erythematosus (SLE).

Method : This quasi-experimental study was conducted on 24 females with lupus who referred to the Rheumatoid Disease Research Center (RDRC) of Ghaem hospital in Mashhad, Iran. This study had a pretest-posttest control group design. The participants were randomly assigned into 2 groups of experimental and control. The experimental group was treated with ACT. Data were collected using the Beck’s Hopelessness Scale, Kessler’s Psychological Distress Inventory, and Krupp’s Psychasthenia Inventory.

Results: Mean age and mean duration of illness were 37.25±4.61 and 5.12±2.33 years, respectively. The mean disappointment score and psychological distress in the experimental group were lower compared to those in control group at the post experimental stage (P<0.001). Moreover, there was a significant difference between the experimental and control groups in the mean scores of psychasthenia in the posttest stage (P<0.001).

Conclusion: According to the obtained results of this study, the enhancement of psychological flexibility based on ACT positively affected disappointment, psychological distress, and psychasthenia among the lupus patients. Therefore, it can be concluded that this therapeutic approach could reduce psychasthenia in patients through clarification of the values.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702277/

 

Improve Bulimia and Binge Eating Disorder with Mindfulness

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Improve Bulimia and Binge Eating Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness techniques. . . . can prevent destructive behaviors such as not eating, purging, or eating until uncomfortably full. If individuals take a step back and focus on the present moment and their feelings, they will be able to transform impulsive eating habits into healthy thoughts and behaviors.” – Eating Disorders Recovery

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder; either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Binge eating disorder involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating. Bulimia involves binge-eating and also involves purging (e.g., self-induced vomiting, compensatory exercise).

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders. Acceptance and Commitment Therapy (ACT) is a mindfulness-based therapy that has also been shown to alter eating behavior. Dialectical Behavior Therapy (DBT) produces behavior change by focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. Mindfulness and acceptance-based treatments in general produce change by targeting acceptance, mindfulness, psychological flexibility, cognitive diffusion/distancing, and emotion regulation.

 

Scientific studies of the application of mindfulness and acceptance-based treatments for eating disorders has been accumulating. So, it makes sense to step back and take a look at what has been learned. In today’s Research News article “Mechanisms and moderators in mindfulness- and acceptance-based treatments for binge eating spectrum disorders: A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570825/), Barney and colleagues review, summarize, and perform a meta-analysis of the published scientific research on the effectiveness of mindfulness and acceptance based therapies for the treatment of bulimia and binge eating disorder. They identified 39 studies, 7 utilizing ACT, 22 DBT, and 10 mindfulness-based interventions.

 

They report that the published research studies found that Acceptance and Commitment Therapy (ACT) produced significant improvements in bulimia and binge eating disorder and it appears that ACT has its effects by improving psychological flexibility. They also report that Dialectical Behavior Therapy (DBT) similarly produced significant improvements in bulimia and binge eating disorder and it appears that DBT has its effects by improving emotion regulation. Finally, they report that mindfulness-based interventions also produced significant improvements in bulimia and binge eating disorder and it appears that these therapies have their effects by improving mindfulness and awareness skills.

 

Hence, the published scientific research clearly establishes that mindfulness and acceptance-based therapies are safe and effective for the treatment of bulimia and binge eating disorder. It appears that the different therapies may work through different processes in having their effects on eating disorders. The authors conclude that there is a need to study factors that may moderate the effects of these mindfulness and acceptance-based therapies on eating disorders.

 

So, Improve Bulimia and Binge Eating Disorder with Mindfulness.

 

“Studies in mindfulness techniques has shown that participants practising mindfulness enjoyed significant reductions in weight and shape concern, dietary restraint, thin-ideal internalisation, eating disorder symptoms and psychosocial impairment.” – Janette Grant

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Barney, J. L., Murray, H. B., Manasse, S. M., Dochat, C., & Juarascio, A. S. (2019). Mechanisms and moderators in mindfulness- and acceptance-based treatments for binge eating spectrum disorders: A systematic review. European eating disorders review : the journal of the Eating Disorders Association, 27(4), 352–380. doi:10.1002/erv.2673

 

Highlights:

  • Analyses of mechanisms of action and moderators of treatment outcome in MABTs for BN and BED are crucial for enhancing the efficiency of treatment development and dissemination.
  • Research to date supports improvements in theoretically consistent mechanisms of action from pre- to post-treatment when using MABTs for BN and BED, however conclusions relevant to whether these changes are occurring as theorized are limited by the use of substandard mediation methods, inconsistent measurement tools across studies, and infrequent use of mid-treatment assessment points.
  • Recommendations for enhancing future research on mechanisms of action and moderators of treatment outcome are discussed.

Abstract

Objective:

Increasing evidence suggests that mindfulness- and acceptance-based psychotherapies (MABTs) for bulimia nervosa (BN) and binge-eating disorder (BED) may be efficacious however little is known about their active treatment components or for whom they may be most effective.

Methods:

We systematically identified clinical trials testing MABTs for BN or BED through PsychINFO and Google Scholar. Publications were categorized according to analyses of mechanisms of action and moderators of treatment outcome.

Results:

Thirty-nine publications met inclusion criteria. Twenty-seven included analyses of therapeutic mechanisms and five examined moderators of treatment outcome. Changes were largely consistent with hypothesized mechanisms of MABTs, but substandard mediation analyses, inconsistent measurement tools, and infrequent use of mid-treatment assessment points limited our ability to make strong inferences.

Discussion:

Analyses of mechanisms of action and moderators of outcome in MABTs for BN and BED appear promising but use of more sophisticated statistical analyses and adequate replication are necessary.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570825/