Acceptance Of Thoughts Research Articles

A Self-Help Online Intervention Is Associated with Reduced Distress and Improved Mental Wellbeing in Australian Farmers: The Evaluation and Key Mechanisms of www.ifarmwell.com.au

ABSTRACT Objectives: Farmers are faced with many stressors, along with numerous barriers to accessing traditional forms of mental health support. The ifarmwell online intervention was co-designed with farmers and is informed by Acceptance and Commitment Therapy to equip farmers with transferable coping strategies, particularly to help them cope with circumstances beyond their control. We aimed to evaluate the effect of ifarmwell on farmers’ short- and long-term distress and mental wellbeing. Methods: Australian farmers (21–73 years) who registered on www.ifarmwell.com.au completed measures at the commencement of module 1 (N = 228), the end of the intervention (N = 77) and 6-months post-intervention (N = 61). Primary outcomes included distress (Kessler Psychological Distress Scale) and mental wellbeing (Mental Health Continuum – Short Form). We also examined the relationship between distress, mental wellbeing, neuroticism (Quickscales-R) and ACT-based psychological mechanisms; psychological inflexibility (Acceptance and Action Questionnaire-II), cognitive fusion (Cognitive Fusion Questionnaire), believability of automatic thoughts (Automatic Thoughts Questionnaire-B), coping via acceptance (4 items from the situational COPE) and mindfulness (Five Facet Mindfulness Questionnaire-Short Form). Secondary outcomes of acceptability (Client Satisfaction Questionnaire-8) and usability (System Usability Scale) were also explored. Results: Pre- to post-intervention, farmers’ distress decreased and mental wellbeing increased. These effects were maintained at 6-month follow-up. Changes in these outcomes were greatest for participants who entered the intervention with high baseline distress (= −0.59, 95%CI =[−0.70, −0.47]) and low mental wellbeing (= −0.33, 95%CI = [−0.47, −0.19]). Decreases in distress and increases in mental wellbeing were associated with decreases in psychological inflexibility, cognitive fusion, and believability of thoughts, and increases in coping via acceptance and mindfulness. Levels of satisfaction (M = 26.92/32) and usability (M = 84.70/100) were high, and 94.6% of participants said they would recommend ifarmwell to a friend in need of similar advice and tools. Conclusions: ifarmwell is an effective and usable intervention that is likely to help farmers reduce their levels of distress and improve their mental wellbeing, by improving their psychological flexibility, ability to focus on the present and accept things beyond their control, as well as by reducing the extent to which they believe unhelpful thoughts.

Mechanisms of Smartphone Apps for Cigarette Smoking Cessation: Results of a Serial Mediation Model From the iCanQuit Randomized Trial.

BackgroundEngagement with digital interventions is a well-known predictor of treatment outcomes, but this knowledge has had limited actionable value. Instead, learning why engagement with digital interventions impact treatment outcomes can lead to targeted improvements in their efficacy.ObjectiveThis study aimed to test a serial mediation model of an Acceptance and Commitment Therapy (ACT) smartphone intervention for smoking cessation.MethodsIn this randomized controlled trial, participants (N=2415) from 50 US states were assigned to the ACT-based smartphone intervention (iCanQuit) or comparison smartphone intervention (QuitGuide). Their engagement with the apps (primary measure: number of logins) was measured during the first 3 months, ACT processes were measured at baseline and 3 months (acceptance of internal cues to smoke, valued living), and smoking cessation was measured at 12 months with 87% follow-up retention.ResultsThere was a significant serial mediation effect of iCanQuit on smoking cessation through multiple indicators of intervention engagement (ie, total number of logins, total number of minutes used, and total number of unique days of use) and in turn through increases in mean acceptance of internal cues to smoke from baseline to 3 months. Analyses of the acceptance subscales showed that the mediation was through acceptance of physical sensations and emotions, but not acceptance of thoughts. There was no evidence that the effect of the iCanQuit intervention was mediated through changes in valued living.ConclusionsIn this first study of serial mediators underlying the efficacy of smartphone apps for smoking cessation, our results suggest the effect of the iCanQuit ACT-based smartphone app on smoking cessation was mediated through multiple indicators of engagement and in turn through increases in the acceptance of physical sensations and emotions that cue smoking.Trial RegistrationClinical Trials.gov NCT02724462; https://clinicaltrials.gov/ct2/show/NCT02724462

Chatbot-Delivered Cognitive Defusion versus Cognitive Restructuring for Negative Self-Referential Thoughts: A Pilot Study

Conversational agents or chatbots are a novel, highly accessible, and low-resource method of psychological intervention delivery. The present research aims to compare two brief chatbot interventions that delivered cognitive restructuring and defusion interventions, respectively. It was hypothesized that a defusion chatbot would lead to reduced cognitive fusion and decreased thought believability relative to cognitive restructuring and a nonactive control. Participants (N = 223; M age of 28.01 [SD = 10.29]; 47 identified as male, 174 as female, and 2 as nonbinary) were randomized into one of three conditions (defusion, restructuring, control), engaged for 5 days completing thought and mood measures pre- and postintervention. Sixty-two participants (M age of 25.98; SD = 8.647 years) completed measures again at time 2 (49 identified as female, 12 as male, and 1 as nonbinary). No statistically significant differences were observed among groups on believability of thoughts (F[2, 25] = .79, p = .47, ηp2 = .06), negativity of thoughts (F[2,25] = 1.49, p = .25, η 2 = .11), discomfort associated with thoughts (F[2, 25] = .48, p = .62, ηp2 = .04), and willingness (F[2, 25] = 3.00, p = .07, ηp2 = .19) to have negative self-referential thoughts. Moreover, substantial attrition of 72% was observed. Acceptability and usability of the chatbots employed are discussed as contributing toward the limited effectiveness of interventions and elevated attrition. Various recommendations are presented to support researchers and clinicians in developing engaging and effective chatbots.

The Role of Acceptance in Eating Behaviors-Spanish Validation of Food Craving Acceptance and Action Questionnaire (FAAQ-S).

Background: The Food Craving Acceptance and Action Questionnaire (FAAQ) was developed to measure food craving acceptance, but has not yet been adapted to Spanish. The aim of this study was to validate the FAAQ to the Spanish population and to analyze its psychometric properties.Method: Two studies were conducted. In the first study, the sample consisted of 224 undergraduate students who participated in the comprehension of the Spanish version and the Confirmatory Factor Analysis (CFA). The second sample consisted of 378 participants from a community sample who completed the refined version of the FAAQ and similar and dissimilar measures.Results: Study (1) The CFA was conducted, showing an inadequate fit of the model (CFI = 0.74, RMSEA = 0.18). Therefore, FAAQ was refined and it was administered to the community sample. Study (2) After an exploratory factor analysis, two factors were obtained as in the original FAAQ, Acceptance (30.92% variance explained) and Willingness (36.05%). The internal consistency was adequate for both subscales (ω = 0.88 and ω = 0.87, respectively). Correlation between the factors was r = 0.07, which provides evidence that Acceptance and Willingness are different constructs. Correlations of Acceptance with similar variables (r between −0.30 and −0.52) were stronger than the dissimilar measures (r between −0.26 and 0.24). This did not occur for the Willingness subscale, since correlations were low in all cases (r between −0.22 and 0.25).Conclusions: Spanish version of the FAAQ showed evidence of its reliability and validity, and may be a measure to provide a better understanding of how acceptance of thoughts and emotions concerning food and willingness impact eating management behaviors.

Not just thinking, but believing: Obsessive beliefs and domains of cognitive fusion in the prediction of OCD symptom dimensions.

Cognitive fusion (CF) involves the tendency to "buy in" to thoughts and feelings and consists of three empirically established domains: somatic concerns, emotion regulation, and negative evaluation. CF is hypothesized to play a role in obsessive-compulsive disorder (OCD). The present study examined how well the CF domains, relative to traditional cognitive-behavioural constructs (i.e., obsessive beliefs such as inflated responsibility), predict OCD symptoms. Fifty-two treatment-seeking adults with OCD completed self-report measures of CF, obsessive beliefs, OCD symptoms, and general distress. Domains of CF were differentially associated with the responsibility for harm, symmetry, and unacceptable thoughts of OCD dimensions; yet after accounting for obsessive beliefs, only the negative evaluation domain of CF significantly predicted symmetry OCD symptoms. Obsessive beliefs significantly predicted all OCD dimensions except for contamination. These findings provide additional support for existing cognitive-behavioural models of OCD across symptom dimensions, with the exception of contamination symptoms, and suggest that the believability of thoughts and feelings about negative evaluation adds to the explanation of symmetry symptoms. Conceptual and treatment implications, study limitations, and future directions are discussed.

Mindfulness y rendimiento deportivo

Resumen: La inclusión del mindfulness en el deporte es un campo reciente. Mientras que la psicología del deporte ha dependido principalmente de la “segunda ola” de intervenciones cognitivo-conductuales durante las últimas cuatro décadas, una nueva aproximación que incluye al mindfulness se ha desarrollado recientemente: la “tercera ola”. Esta nueva aproximación asume la idea de que el rendimiento es un estado que no se basa en el auto-control o cambio del comportamiento, sino que es un estado que emerge del reconcomiendo y aceptación de los pensamientos, emociones y sensaciones corporales. La práctica del mindfulness permite aprender a observar y aceptar los pensamientos, emociones y sensaciones corporales sin intentar eliminarlos o modificarlos. Este trabajo revisa los dos principales programas de mindfulness para el rendimiento deportivo, ambos de la “tercera ola”: el Mindful Sport Performance Enhancement (MSPE) y el Mindfulness-Acceptance-Commitment (MAC). Mindfulness and sport performance Abstract: Mindfulness in sports is a recent field. While sport psychology relied mainly on “second wave” cognitive-behavioural interventions for the last four decades, a new approach has recently been developed in sport psychology including mindfulness: a “third wave” approach. This new approach assumes that ideal performance is a state that is not based on self-control or change in behaviour, but rather a state that arises from recognition and acceptance of thoughts, emotions and bodily sensations. Practicing mindfulness allows learns to observe and accept the thoughts, emotions, and body sensations, without making any attempt to eliminate or modify them. This paper reviews the main programs of mindfulness in sport performance both from the “third wave”: Mindful Sport Performance Enhancement (MSPE) and Mindfulness-Acceptance-Commitment (MAC).

Modifying the risk associated with an impulsive temperament: A prospective study of drug dependence treatment

The evidence linking the personality trait of impulsivity and substance misuse is well established. Importantly, impulsivity not only predicts substance misuse problems but has an association with duration in treatment, likelihood of completing treatment and time to relapse. Treatment that focuses on increasing awareness and acceptance of thoughts and emotions may potentially address impulsive behaviour and in this respect improve treatment outcomes for substance misuse. The current paper investigated the relationship between the facet of impulsivity that taps into poor inhibitory control and treatment outcome. In addition, there was a specific focus on ascertaining the impact of an increase in awareness and attentional control measured in 144 adult substance users receiving treatment in a residential therapeutic community. Impulsivity predicted poorer treatment outcome (measured as drug use severity). Increases in awareness and acceptance of emotions and thoughts during treatment were related to better outcome although this was not associated with baseline levels of impulsivity. Clinical and theoretical implications are discussed.

Les thérapies basées sur l’acceptation et la pleine conscience

Cognitive behavioral therapy (CBT) is one of the main approaches in psychotherapy. It teaches the patient to examine the link between dysfunctional thoughts and maladaptive behaviors and to re- evaluate the cognitive biases involved in the maintenance of symptoms by using strategies such as guided discovery. CBT is constantly evolving in part to improve its' effectiveness and accessibility. Thus in the last decade, increasingly popular approaches based on mindfulness and acceptance have emerged. These therapies do not attempt to modify cognitions even when they are biased and dysfunctional but rather seek a change in the relationship between the individual and the symptoms. This article aims to present the historical context that has allowed the emergence of this trend, the points of convergence and divergence with traditional CBT as well as a brief presentation of the different therapies based on mindfulness meditation and acceptance. Hayes (2004) described three successive waves in behavior therapy, each characterized by "dominant assumptions, methods and goals": traditional behavior therapy, cognitive therapy and therapies based on mindfulness meditation and acceptance. The latter consider that human suffering occurs when the individual lives a restricted life in order avoid pain and immediate discomfort to the detriment of his global wellbeing. These therapies combine mindfulness, experiential, acceptance strategies with traditional behavior principles in order to attain lasting results. There are significant points of convergence between traditional CBT and therapies based on mindfulness meditation and acceptance. They are both empirically validated, based upon a theoretical model postulating that avoidance is key in the maintenance of psychopathology and they recommend an approach strategy in order to overcome the identified problem. They both use behavioral techniques in the context of a collaborative relationship in order to identify precise problems and to achieve specific goals. They focus on the present moment rather than on historical causes. However, they also present significant differences: control vs acceptance of thoughts, focus on cognition vs behavior, focus on the relationship between the individual and his thoughts vs cognitive content, goal of modifying dysfunctional beliefs vs metacognitive processes, use of experiential vs didactic methods, focus on symptoms vs quality of life, strategies used before vs after the unfolding of full emotional response. The main interventions based on mindfulness meditation and acceptance are: Acceptance and Commitment Therapy, Functional Analytic Therapy, the expanded model of Behavioral Activation, Metacognitive Therapy, Mindfulness based Cognitive Therapy, Dialectic Behavior Therapy, Integrative Behavioral Couples Therapy and Compassionate Mind Training. These are described in this article. They offer concepts and techniques which might enhance therapeutic efficacy. They teach a new way to deploy attention and to enter into a relationship with current experience (for example, defusion) in order to diminish cognitive reactivity, a maintenance factor for psychopathology, and to enhance psychological flexibility. The focus on cognitive process, metacognition as well as cognitive content might yield additional benefits in therapy. It is possible to combine traditional CBT with third wave approaches by using psychoeducation and cognitive restructuring in the beginning phases of therapy in order to establish thought bias and to then encourage acceptance of internal experiences as well as exposure to feared stimuli rather than to continue to use cognitive restructuring techniques. Traditional CBT and third wave approaches seem to impact different processes: the former enhance the capacity to observe and describe experiences and the latter diminish experiential avoidance and increase conscious action as well as acceptance. The identification of personal values helps to motivate the individual to undertake actions required in order to enhance quality of life. In the case of chronic illness, it diminishes suffering by increasing acceptance. Although the evidence base supporting the efficacy of third wave approaches is less robust than in the case of traditional cognitive or behavior therapy, therapies based on mindfulness meditation and acceptance are promising interventions that might help to elucidate change process and offer complementary strategies in order to help patients.

How effective are acceptance strategies? A meta-analytic review of experimental results

Background and objectivesExperimental research on psychological acceptance strategies revealed discrepant results regarding superiority of these strategies compared to other emotion regulation strategies. A review examining results of experimental comparisons between acceptance and other emotion regulation strategies (e.g. suppression, distraction, reappraisal) is still missing. The present meta-analytic approach aims to fill this gap. MethodA literature search was performed using PsychInfo and PubMed and effect sizes (ES; Hedge's g) were calculated. ResultsThe search identified 30 relevant studies. Many studies reported that acceptance strategies were superior when compared to other emotion regulation strategies for the outcomes of pain tolerance, negative affect and believability of thoughts. Meta-analytic results replicate findings of primary studies for pain tolerance: A small to medium between-group ES was found favoring acceptance strategies (g = 0.43, p < 0.01, 95% CI[0.12, 0.73]). With respect to pain intensity and negative affect, meta-analysis did not show any significant differences between acceptance and other emotion regulation strategies.In sum, acceptance strategies proved to be superior to other emotion regulation strategies with respect to pain tolerance but not for pain intensity and negative affect. LimitationsFuture research should address which characteristics of participants lead to respond to either acceptance or to other emotion regulation strategies. ConclusionsAcceptance strategies are at least as useful in treatments for chronic pain and depression as other emotion regulation strategies.

Anorexia nervosa: Psychological considerations for nutrition counseling

This article presents the underlying psychological beliefs and self-perceptions held by individuals with anorexia nervosa. The intent of this article is to help dietitians and other nutrition counselors become more aware of the psychological characteristics of individuals with anorexia nervosa and become familiar with various counseling skills that can assist counselors when they are working toward reaching the goal of re-establishing normal eating patterns and attitudes about food. Counseling approaches that may be used by the nutrition counselor in an effort to deal effectively with the various psychological characteristics displayed by anorexics are provided. Nutrition counselors must be well informed of the psychodynamic aspects that prevail in the disorder, such as low self-esteem, frustration over gaining weight, and a distorted body image. In addition, nutrition counselors must be aware of the particular communication skills (e.g., attentive listening, empathic responses, and verbal encouragement) and basic therapeutic methods (e.g., encouraging self decision making and providing support and acceptance of thoughts, feelings, and actions) that can be used for effecting positive growth and changes in dietary behavior of individuals with anorexia. J Am Diet Assoc 88:49, 1988.