Emotional Disturbances and Crohn's Disease

Background: Multiple sclerosis (MS) is a chronic, common, and progressive disease of the nervous system, and the affected individuals suffer from its complications throughout their lives and experience different physical and emotional disorders. Objectives: The present study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and cognitive-behavioral ‎therapy (CBT) in enhancing resiliency and quality of life among MS patients. Methods: This randomized clinical trial was carried out on 30 MS patients referred to the Department of Neurology in Baqiyatallah Hospital (Tehran, Iran) during February 19 to September 1, 2017. The patients were randomly assigned to three groups: (1) ACT (n = 10, 8 sessions, 90-minute weekly‎ sessions), (2) CBT (n = 10, 10 sessions, 90-minute weekly‎ sessions), and (3) control group (n = 10, no sessions). The resilience and quality of life were measured in pre-test and post-test phases and 1.5 months after treatment using the Connor-Davidson Resilience and Multiple Sclerosis Impact Scales, respectively. Repeated measurement ANOVA and SPSS Software (version 24) were used in this study to analyze the collected data. Results: The study sample consisted of 30 MS patients (mean age = 31.7 ± 5.7, 60% female and 57% married). The three groups were homogeneous in terms of demographic and baseline variables. The results demonstrated that both ACT and CBT had the same effectiveness in increasing resiliency (mean difference in CBT = 0.9 vs ACT = 0.8 (P = 0.882); CBT = 0.9 vs. Control = -1.4 (P = 0.004); ACT = 0.8 vs. Control = -1.4 (P = 0.0041)) and quality of life (mean difference in CBT = 2.9 vs ACT = 3.1 (P = 0.051); CBT = 2.9 vs. Control = 0.6 (P = 0.002); ACT = 3.1 vs. Control = 0.6 (P = 0.014)) among the MS patients so that the participants’ post-test and follow-up scores increased significantly compared to the pretest scores. Conclusions: The present study results indicate that ACT and CBT can equally enhance resiliency and quality of life among MS patients.

سالمندی فرایند زیستی است که تمام موجودات زنده از جمله انسان‌ها آن را تجربه می‌کنند، از این رو توجه خاص و پیشگیری از اختلالاتی نظیر باورهای غیرمنطقی و نگرش منفی به مرگ در سالمندی بسیار مهم است. بنابراین مطالعه حاضر با هدف تعیین اثربخشی درمان مبتنی بر تعهد و پذیرش بر باورهای غیرمنطقی و نگرش به مرگ سالمندان انجام شد. روش پژوهش نیمه آزمایشی با طرح پیش‌آزمون-پس‌آزمون با گروه کنترل بود.جامعه آماری پژوهش کلیه سالمندان شهر خرم آباد در سال 1399 بودند. حجم نمونه پژوهش شامل 30 نفر سالمند (60 تا 70 سال) بود که با روش نمونه‌گیری در دسترس و با توجه به ملاک‌های ورود و خروج مطالعه انتخاب شدند. گروه آزمایش مداخله آموزشی را در قالب هشت جلسه 90 دقیقه‌ای هفتگی دریافت نمودند. پرسش‌نامه‌های مورد استفاده در این پژوهش شامل پرسش‌نامه باورهای غیرمنطقی اهواز و نیمرخ نگرش به مرگ وونگ بود. داده‌ها با تحلیل کوواریانس تک متغیره، با استفاده از نرم‌افزارSPSS نسخه 22 مورد تجزیه و تحلیل قرار گرفتند. یافته‌ها نشان داد که بین گروه‌های آزمایش و کنترل در پس­آزمون از نظر باورهای غیرمنطقی و نگرش به مرگ تفاوت معنی‌داری وجود داشت (001/0>P). به عبارت دیگر درمان مبتنی بر تعهد و پذیرش باعث کاهش باورهای غیرمنطقی و نگرش منفی به مرگ شد. منطبق با یافته‌های پژوهش حاضر می‌توان درمان مبتنی بر تعهد و پذیرش را به عنوان یک روش کارا جهت کاهش باورهای غیرمنطقی و نگرش منفی به مرگ سالمندان پیشنهاد داد.

Objective: Anxiety disorders in children are the most prevalent of mental health conditions, but also the most treatable. However, a significant number do not benefit from treatment and these places them at risk for future psychiatric disturbance. Whilst Acceptance and Commitment Therapy (ACT) is gaining rapid evidence for its utility in treating a variety of disorders, research in children and adolescence is at an early stage. This paper reports on 2 year follow-up (2YFU) outcomes of the first randomized controlled trial of ACT and traditional cognitive behavioral therapy (CBT) in children with a DSM-IV diagnosis of anxiety disorders. Method: Of the 111 children from urban Sydney, Australia who completed treatment (10-week group-based program of ACT or CBT). A total of 79 (40 ACT and 39 CBT) were assessed at 2YFU. Pre-treatment, posttreatment, 3 months (3MFU) and 2YFU assessments included clinician/self/parent-reported measures of anxiety, anxiety-related quality of life (QOL) and acceptance/defusion outcomes. Several baseline predictors of anxiety outcome were also examined. Results: Positive findings were obtained for both ACT and CBT in terms of long-term maintenance of gains. Across measures, highly significant improvements observed at post and 3MFU were maintained at 2YFU. At post approximately one-third of participants in both treatment groups no longer met criteria for any anxiety disorder, with further improvement evident at 3MFU. Continued improvement was observed at 2YFU, with 45% of ACT and 60% of CBT participants diagnosis free (non-significant difference). Both completer and intention to treat analyses found ACT and CBT to produce similar outcomes. The only significant predictors in the short-term were pre-treatment severity and age. At 2YFU, no significant predictors were identified. However, most participants were in the severe anxiety category pre-treatment, limiting the exploration of severity as a predictor. Conclusion: Both ACT and CBT have shown similar long terms benefits for children with anxiety disorders. There was no clear or strong pattern of baseline predictors of outcomes. Further research is needed to explore this area.

Although several interventions that target obesity have been examined, the success of these interventions in generating and maintaining positive results has yet to be confirmed. This study protocol therefore presents a trial aimed at analyzing the effectiveness of a well-being-centered acceptance and commitment therapy (ACT)- and mindfulness-based group intervention following the valued-based healthy living (VHL) approach (Mind&Life intervention) for individuals experiencing overweight-related distress. A randomized controlled trial with two parallel groups will be conducted in 110 adults attending primary care units with overweight or obesity. Participants will be randomly allocated to one of the two study conditions. Interventions will either be the treatment as usual (TAU) or the Mind&Life intervention—an ACT- and mindfulness-based intervention—plus the TAU intervention. Quality of life, weight self-stigma, general health status, eating habits, physical activity, eating behavior, anthropometric, body composition, cardiovascular, and physiological variables, as well as process variables, will be examined at baseline, posttreatment, 6-month follow-up, and 1-year follow-up. This trial aims to offer a novel psychological approach for addressing the psychological and physical impairments suffered by people with overweight or obesity in the current environment. ClinicalTrials.gov identifier: NCT03718728.

Background: Since current therapies for depression are effective but not for all patients alike, we need to further improve available treatments. Existing research suggests that acceptance and commitment therapy (ACT) may effectively treat major depressive disorder (MDD). We compared ACT with cognitive behavioral therapy (CBT) for depression, testing the hypothesis that CBT would outperform ACT. Methods: We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before and after treatment and at the 6-month follow-up, assessing diagnosis, symptom levels of depression, and quality of life. Results: After treatment, the rates of remission from depression were 75 and 80% for the ACT and CBT conditions, respectively. Patients in both conditions further reported significant and large reductions in depressive symptoms and improvement in quality of life from before to after treatment as well as at the follow-up. Our findings indicated no significant differences between the two intervention groups. Conclusion: Our results indicate that CBT is not more effective in treating depression than ACT. Further research is needed to investigate whether ACT and CBT work differently for different groups of patients with depression.

An acceptance and commitment therapy and mindfulness group intervention for the psychological and physical well-being of adults with body mass indexes in the overweight or obese range: The Mind&Life randomized controlled trial

Objective: Acceptance and Commitment Therapy (ACT) is an evidence-based psychological intervention that has gained increasing attention in recent years. While extensively studied for its effectiveness in adult populations, there has been growing interest in exploring the application of ACT in children and adolescents psychotherapy. This umbrella review aims to provide an overview of the current literature on the use and efficacy of ACT in children and adolescents, as well as to highlight potential considerations and future directions for research. Method : A comprehensive search was done in scientific databases, including Scopus, PubMed, and Web of Sciences, using keywords related to ACT, children, adolescents, and psychotherapy. Relevant articles were included, with a focus on systematic reviews and meta-analysis. Results: Our findings indicate consistent effectiveness for ACT and related interventions across various delivery formats, including in-person, group, and internet-based approaches, in reducing symptoms of internalizing and externalizing problems, as well as improving overall quality of life among children and adolescents. However, two articles comparing ACT with traditional cognitive behavioral therapy did not demonstrate superiority. Additionally, when comparing internet-based and in-person delivery modes, the included studies did not show significant differences between the two types. Conclusion: ACT shows promise as an effective therapeutic approach in children and adolescents psychotherapy. However, more research is warranted to establish its specific techniques and adaptations for different age groups and presenting problems. Additionally, future research should explore the feasibility and effectiveness of delivering ACT in varied settings.

Acceptance and Commitment Therapy (ACT) has a growing empirical base in the treatment of anxiety among adults and children with other concerns. This study reports on the main outcomes of a randomized controlled trial of ACT and traditional cognitive behavioral therapy (CBT) in children with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) anxiety disorder. Participants were 193 children from urban Sydney, Australia, who were block-randomized to a 10-week group-based program of ACT or CBT or a 10-week waitlist control (WLC). Completers included 157 children (ACT = 54, CBT = 57, WLC = 46; M = 11 years, SD = 2.76; 78% Caucasian, 58% female). Pretreatment, posttreatment, and 3 months posttreatment assessments included clinician/self/parent-reported measures of anxiety, quality of life (QOL; anxiety interference, psychosocial and physical health-related QOL), and acceptance/defusion outcomes. Completer and intention-to-treat analyses revealed that ACT and CBT were both superior to WLC across outcomes, reflecting statistically and clinically significant differences, with gains maintained at 3 months posttreatment. Both completer and intention-to-treat analyses found ACT and CBT to produce similar outcomes. There was some support for ACT having greater effect sizes for QOL outcomes but not for avoidance/fusion. Although this study does not suggest that ACT is equivalent to CBT or should be adopted in its place, it does provide evidence that ACT might be another empirically supported treatment option for anxious youth. Further research is needed to replicate these findings.

Psychological therapies delivered remotely for the management of chronic pain (excluding headache) in adults (Review)

This study was motivated by the need to examine the psychological distress experienced by cancer patients, and to understand how the illness affects different aspects of their daily lives—particularly emotional, social, and cognitive domains. It aims to highlight the role of Acceptance and Commitment Therapy (ACT) in alleviating symptoms of depression and promoting mental well-being, while also emphasizing the importance of sustained psychological support for this vulnerable group. The study further seeks to demonstrate the effectiveness of ACT in enhancing psychological flexibility—a crucial factor in helping patients adapt to the ongoing challenges of illness—and to underscore the significance of integrated psychological interventions involving collaboration between medical and mental health professionals. To achieve these objectives, the study presents a critical review and analysis of prior research on acceptance- and mindfulness-based interventions, focusing on key theoretical concepts, outcomes, and implications for practice. The findings suggest that ACT-based programs contribute significantly to improving psychological flexibility, which, in turn, supports better emotional regulation, coping skills, and overall quality of life. Moreover, the integration of psychological therapy into cancer treatment protocols contributes to providing comprehensive support for patients and enables medical teams to effectively address the psychological and social challenges associated with the cancer experience.

This meta-analysis systematically reviewed the evidence on standardized acceptance-/mindfulness-based interventions in DSM-5 anxiety disorders. Randomized controlled trials examining Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) were searched via PubMed, Central, PsycInfo, and Scopus until June 2021. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for primary outcomes (anxiety) and secondary ones (depression and quality of life). Risk of bias was assessed using the Cochrane tool. We found 23 studies, mostly of unclear risk of bias, including 1815 adults with different DSM-5 anxiety disorders. ACT, MBCT and MBSR led to short-term effects on clinician- and patient-rated anxiety in addition to treatment as usual (TAU) versus TAU alone. In comparison to Cognitive Behavioral Therapy (CBT), ACT and MBCT showed comparable effects on both anxiety outcomes, while MBSR showed significantly lower effects. Analyses up to 6 and 12 months did not reveal significant differences compared to TAU or CBT. Effects on depression and quality of life showed similar trends. Statistical heterogeneity was moderate to considerable. Adverse events were reported insufficiently. The evidence suggests short-term anxiolytic effects of acceptance- and mindfulness-based interventions. Specific treatment effects exceeding those of placebo mechanisms remain unclear. Protocol registry: Registered at Prospero on November 3rd, 2017 (CRD42017076810).

BackgroundExisting therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change.MethodsWe conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering, and experiential avoidance.ResultsPatients in both conditions reported significant and large reductions of depressive symptoms (d = − 1.26 to − 1.60) and improvement in quality of life (d = 0.91 to − 1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only.ConclusionsOur results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression.Trial registrationclinicaltrials.gov; NCT01517503. Registered 25 January 2012 - Retrospectively registered.

There is growing evidence supporting the use of third-wave psychological therapies, such as mindfulness-based interventions (MBIs) and acceptance and commitment therapy (ACT), for people with long-term or chronic physical health conditions. We conducted a systematic review and meta-analysis to critically evaluate the effectiveness of third-wave interventions for improving hearing-related distress and psychological well-being in people with audiological problems. We searched online bibliographic databases and assessed study quality. We conducted random-effects meta-analyses if at least two randomized controlled trials (RCTs) examined hearing-related distress, depression, anxiety, or quality of life in people with audiological problems. Findings of pre-post studies were summarized narratively. We identified 15 studies: six RCTs and nine pre-post studies. The methodological quality of studies was mostly poor to moderate, and sample sizes were typically small (overall n = 750). Most studies focused on tinnitus (n = 12), MBIs (n = 8), and ACT (n = 6). Statistically significant improvements in hearing-related distress were found with ACT and MBIs versus controls and other treatments at post-intervention in people with tinnitus, while improvements in depression and anxiety were only found for ACT versus controls at post-intervention. However, gains were either not maintained or not examined at follow-up, and there was no evidence for improvements in quality of life. At present, there is insufficient evidence to recommend the use of third-wave interventions for improving hearing-related distress or psychological well-being in people with audiological problems. There is some evidence that ACT and MBIs may be useful in addressing hearing-related distress in people with tinnitus, but only in the short term. However, findings should be interpreted with caution given the small number of studies with generally small sample sizes and mostly poor-to-moderate methodological quality. More high-quality, adequately powered, double-blind RCTs, particularly in audiological problems other than tinnitus, are needed to draw firm conclusions and meaningful clinical recommendations. https://doi.org/10.23641/asha.19735975.

Ever since Albert Ellis introduced his ABC-theory of emotional dysfunction in the 1950s one premise of cognitive-behavioral therapy (CBT) has been the idea that emotional disturbances are caused by beliefs. Following Stoic philosophy Ellis argued that emotional disturbances are a consequence (C) of beliefs (B) rather than of activating events themselves (A) (e.g., Ellis 1962). Since then, beliefs have been the focal point of CBT — be it Ellis’ rational emotive behavior therapy (REBT), Aaron T. Beck’s cognitive therapy (CT) or the so-called ‘new wave’ of cognitive-behavioral therapies such as acceptance and commitment therapy (ACT) (e.g., Beck 1979; Beck et al. 1979; Ellis and Blau 1998; Hayes, Follette and Linehan 2004).

The differential efficacy of acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT) for dementia family caregivers' is analyzed through a randomized controlled trial. Participants were 135 caregivers with high depressive symptomatology who were randomly allocated to the intervention conditions or a control group (CG). Pre-, postintervention, and follow-up measurements assessed depressive symptomatology, anxiety, leisure, dysfunctional thoughts, and experiential avoidance. Depression: Significant effects of interventions compared with CG were found for CBT (p < .001, d = 0.98, number needed to treat [NNT] = 3.61) and ACT (p < .001, d = 1.17, NNT = 3.53) at postintervention, but were maintained only at follow-up for CBT (p = .02, d = 0.74, NNT = 9.71). Clinically significant change was observed in 26.7% participants in CBT, 24.2% in ACT, and 0% in CG. At follow-up, 10.53% in CBT and 4% in ACT were recovered (0% CG). Anxiety: At postintervention, ACT participants showed lower anxiety than CBT participants (p < .05, d = 0.50) and CG participants (p < .01, d = 0.79, NNT = 3.86), with no effects at follow-up. At postintervention, 23.33% in CBT, 36.36% in ACT, and 6.45% in CG showed clinically significant change. At follow-up, 26.32% in CBT, 36% in ACT, and 13.64% in CG were recovered. Significant changes at postintervention were found in leisure and dysfunctional thoughts in both ACT and CBT, with changes in experiential avoidance only for ACT. Similar results were obtained for ACT and CBT. ACT seems to be a viable and effective treatment for dementia caregivers.