Psychoneuroendocrine evaluation of an acceptance and commitment based stress management training

Abstract

Background and Objectives: Acceptance and Commitment Therapy (ACT), a behavioral therapy that targets psychological flexibility (PF), has been shown to be efficacious across a wide range of problems, including chronic work-related stress and perceived stress. ACT’s effect on the multiple levels of the acute stress response (i.e., subjective and biological) is less well understood. The aim of the current study was to test whether ACT, by working toward PF, would reduce both the endocrine and subjective evaluations of participants’ acute stress response. Methods: Participants (n = 35) were randomized to an ACT condition or waitlist (WL). Participants in the ACT condition received a two-day ACT workshop on how to flexibly deal with stress. All participants completed a standardized laboratory stress test. Results: The ACT and WL groups did not differ on main comparisons of the endocrine response (i.e., cortisol) or subjective evaluation. Baseline levels of PF moderated some outcomes. Avoidant participants had a stronger endocrine stress reaction if they received the ACT intervention. Limitations: The control condition was a WL and not an active intervention comparison. Conclusions: ACT is not useful in reducing the acute stress response and may even be iatrogenic, at least during tasks with little real-world impact for their personal values.Clinical or methodological significance of this article:This was one of the first studies to investigate the impact of an ACT intervention on biological parameters.The short-term intervention did not attenuate acute endocrine stress levels or subjective stress appraisals.Future studies should investigate which interventions and under which conditions attenuate acute and long-term stress responses.