Contextual Behavioral Science Research Articles

Psychological inflexibility as a mediator of the relationship between depressive symptom severity and public stigma in depression

Psychological flexibility refers to attending to the present moment and accepting internal experiences in order to effectively adapt behavior in the pursuit of valued goals. Previous research has linked mental health stigma to lower levels of psychological flexibility (i.e., psychological inflexibility or experiential avoidance), resulting in negative attitudes toward those affected by mental health problems. In the current study, 570 individuals participated in an online survey in which they completed measures of depressive symptom severity, psychological inflexibility, and different types of public mental health stigma. Results showed that psychological inflexibility statistically mediated the relationship between depression symptomatology and public stigma toward others with depression, but not the relationship between depression symptomatology and stigma about others receiving treatment for depression. In other words, one's own depressive symptoms increased the likelihood of holding stigmatizing attitudes toward others with depression, and this process worked through increased levels of psychological inflexibility. In contrast, the relationship between people's increased depressive symptoms and stigmatizing attitudes about others receiving mental health treatment was not dependent on their psychological inflexibility level. The findings are discussed within an emerging contextual behavioral science model of stigma.

Carrying the baton: Evolution science and a contextual behavioral analysis of language and cognition

The contextual behavioral science (CBS) tradition is now carrying the baton passed forward by its progenitor, B. F. Skinner: a request to explore the implications of evolution science concepts for behavioral science. This article examines the 30-year history of Relational Frame Theory (RFT) research in the light of modern evolution science concepts. It distills an evolutionary approach into six interlocking features: variation, selection, retention, context, dimension, and level. Most of these dimensions have been touched upon in RFT research to date. By making the connection between CBS and evolution science explicit, however, important lines of existing and potential RFT research are emphasized and key evolutionary concepts that have not been emphasized are given greater weight. CBS researchers in general, and RFT researchers in particular, are positioned to carry the evolution science baton and to use it to help advance a natural science of behavior. It will need to be gasped firmly as CBS runs through the ultimate challenge faced by behavioral science: creation of a comprehensive and pragmatic analysis of human language and cognition.

Contextual behavioural coaching: An evidence-based model for supporting behaviour change

As coaching psychology finds its feet, demands for evidence-based approaches are increasing both from inside and outside of the industry. There is an opportunity in the many evidence-based interventions in other areas of applied psychology that are of direct relevance to coaching psychology. However, there may too be risks associated with unprincipled eclecticism. Existing approaches that are gaining popularity in the coaching field such as dialectic behavioural therapy and mindfulness enjoy close affiliation with Contextual Behavioral Science (CBS). In this article, we provide a brief overview of CBS as a coherent philosophical, scientific, and practice framework for empirically supported coaching work. We review its evidence base, and its direct applicability to coaching by describing CBS’s most explicitly linked intervention – Acceptance and Commitment Therapy/Training (ACT). We highlight key strengths of ACT including: its great flexibility in regard of the kinds of client change it can support; the variety of materials and exercises available; and, the varied modes of delivery through which it has been shown to work. The article lays out guiding principles and provides a brief illustrative case study of contextual behavioural coaching.

Perspectives on the use of acceptance and commitment therapy related mobile apps: Results from a survey of students and professionals

Although mobile apps have proliferated as self-help or adjunctive therapy supports, scant research has explored their implementation among mental health practitioners. Little is known about uses and perceptions of mental health apps among applied practitioners, nor are agreed-upon criteria for evaluating and choosing apps available. The present survey study examined the uses and perceptions of mental health apps among 356 professionals and students familiar with Acceptance and Commitment Therapy (ACT), as indicated by being a member of the Association for Contextual Behavioral Science. The survey found that practitioners are interested in using ACT-related apps, but that use of and familiarity with apps is low. As rated by participants, the most helpful app functions pertained to supporting out-of-session skills practice and the maintenance of therapy gains. The greatest barriers to app use included little guidance as to what apps to choose, app contents that are inconsistent with ACT, and ethical concerns related to app use. Suggested criteria for evaluating apps were consistent with the perceived benefits and barriers to use. Results of this study may be used to increase implementation and improve the development of mental health apps with ACT and other therapeutic communities.

How Bayesian estimation might improve CBS measure development: A case study with body-image flexibility in Hispanic students

The methods for examining questionnaires in psychology are steeped in conventional statistics. However, many within the social sciences have started exploring Bayesian methods as an alternative to the conventional approach. This paper highlights the usefulness of Bayesian methodology for factor analysis, using the Body Image Acceptance and Action Questionnaire (BI-AAQ) as a case study. In an all-Hispanic undergraduate sample (n=289), we compared techniques from Bayesian and frequentist estimation for examining the factor structure of the BI-AAQ. Results indicated Bayesian estimation was flexible and offered unique insights relative to the conventional frequentist approach. We conclude the BI-AAQ was a structurally valid measure for our all-Hispanic sample and that Bayesian methods may be fruitful for further evaluation within the contextual behavioral science community.

Evolución de ACT

Se presenta la evolucion de ACT a traves de escenarios temporales que van surgiendo al hilo de la necesidad de mejorar y ampliar la comprension del modelo, de los avances en la comprension de sus componentes y de la investigacion en lenguaje desde la Teoria del Marco Relacional. Primero, se presenta ACT en sus primeros anos. Segundo, se presenta un escenario de proliferacion de nuevos terminos, datos y libros, al que continua un escenario de reconsideracion y abordaje para conectar ACT a las bases teoricas y experimentales del lenguaje y la cognicion. Es este ultimo escenario el que se ocupa de intentar una definicion del r epertorio problematico y del nuevo repertorio a partir de las transformaciones que ocurren al responder verbalmente a la propia conducta. Se concluye resaltando la coherencia de formular ACT como una terapia conectada al conocimiento experimental del lenguaje y, por tanto, coherente con la Contextual Behavioral Science , ambito cientifico en el que ACT, como terapia contextual, es una parte de las aplicaciones de dicho conocimiento .

The Moderating Impact of Distal Regularities on the Effect of Stimulus Pairings.

Throughout much of the past century psychologists have focused their attention on a seemingly simple question: How do people come to like or dislike stimuli in the environment? Evaluative Conditioning (EC) - a change in liking due to the pairing of stimuli - has been offered as one avenue through which novel preferences may be formed and existing ones altered. In the current article, we offer a new look at EC from the perspective of Contextual Behavioral Science (CBS) and, more specifically, Relational Frame Theory (RFT). We briefly review the EC literature, introduce Contextual Behavioral Science (CBS), Relational Frame Theory (RFT), and then describe a behavioral phenomenon known as arbitrarily applicable relational responding (AARR). Afterwards, we examine the relationship between EC and AARR. This novel perspective offers ways to organize existing as well as predict new EC effects, contributes to debates on "genuine" EC, human versus nonhuman EC, and further facilitates the development and refinement of cognitive theories of EC.

Experiential avoidance, empathy, and anger-related attitudesin antisocial personality disorder

In prevailing opinion, a strong relation exists between lack of empathy and antisocial personality disorder (ASPD). However, recent data fail to wholly clarify this relation, especially in consideration of empathy dimensions. In this study our aim was to address ASPD and social functionality from a contextual behavioral science viewpoint. The present study was conducted with a sample of 34 individuals with ASPD and 32 healthy individuals as the control group. The participants were assessed with a sociodemographic form, Structured Clinical Interviews for DSM I and II (SCID-I and SCID-II), Social Functioning Scale (SFS), Acceptance and Action Questionnaire-II for measuring experiential avoidance, Interpersonal Reactivity Index for measuring empathy dimensions, and the State-Trait Anger Scale for anger-related attitudes. Experiential avoidance, dysfunctional anger regulation patterns, and lack of perspective-taking levels were higher in the ASPD group than in the control group. Experiential avoidance and perspective-taking processes were related with social functioning in ASPD. These findings may provide initial data for understanding ASPD clinical features and related social interaction problems. Further relations between scales and social functionality also analyzed and discussed.

The Progression of Programmatic Research in Contextual Behavioral Science: Response to O’Donohue, Snipes, and Soto

The criticisms of the target article are examined and discussed in the context of the larger goals of contextual behavioral science. The central claims of “Overselling” findings from a published dissertation to a peer-reviewed article and a self-help book are examined point-by-point. After clarifying the posited concerns, we find that they are dominantly based on misunderstandings of the assessment data used or improved data analytic methods employed. Criticisms of the larger literature of acceptance and commitment therapy (ACT) are examined, and the larger scientific strategy employed by the contextual behavioral science movement is described with an emphasis on replications in the area of processes of change for ACT (and modification of these processes) in order to improve diabetes as well as other health behaviors.

Illness cognitions, cognitive fusion, avoidance and self-compassion as predictors of distress and quality of life in a heterogeneous sample of adults, after cancer

ObjectiveThis study explored the predictive power of illness cognitions, cognitive fusion, avoidance and self-compassion in influencing distress and quality of life in people who have experienced cancer. MethodA quantitative cross-sectional design was used. 105 adults with various cancer diagnoses completed measures of cancer related thoughts, coping styles, self-compassion, cognitive fusion, distress and quality of life. Correlation, linear regression and conditional process analysis was used to explore relationships between predictor variables, distress and quality of life. ResultsAlthough predictors were individually related to distress and quality of life in theoretically consistent ways, regression analysis showed that cognitive fusion was the strongest predictor of anxiety symptoms, whilst cancer related cognitions and avoidant coping were the strongest predictors of depressive symptoms and quality of life. Threatening illness appraisals did not directly predict anxiety, rather cognitive fusion mediated this relationship. This path was also moderated by self-compassion, such that for those higher in self-compassion, the impact of threatening illness appraisals and fusion on anxiety was attenuated. Illness appraisals did not directly predict depressive symptoms, but their influence on depression was mediated by avoidant coping. For quality of life, both direct and indirect effects were observed. Illness cognitions, avoidance and fusion all directly influenced quality of life and this was not moderated by self-compassion. ConclusionsThreatening appraisals of cancer, cognitive fusion and avoidant coping were found to be the strongest predictors of distress and lowered quality of life after cancer. Interventions focused on reducing cognitive fusion and emotional avoidance, such as Acceptance and Commitment Therapy should be further explored in this population. Threatening illness cognitions directly influence both anxiety and quality of life. Conceptualisations of cognitive modification strategies from within contextual behavioural science could be useful in exploiting this potential treatment target, whilst staying theoretically consistent.

Functional relations and cognitive psychology: Lessons from human performance and animal research.

We consider requirements for effective interdisciplinary communication and explore alternative interpretations of "building bridges between functional and cognitive psychology." If the bridges are intended to connect radical behaviourism and cognitive psychology, or functional contextualism and cognitive psychology, the efforts are unlikely to be successful. But if the bridges are intended to connect functional relationships and cognitive theory, no construction is needed because the bridges already exist within cognitive psychology. We use human performance and animal research to illustrate the latter point and to counter the claim that the functional approach is unique in offering a close relationship between science and practice. Effective communication will be enhanced and, indeed, may only occur if the goal of functional contextualism extends beyond just "the advancement of functional contextual cognitive and behavioral science and practice" to "the advancement of cognitive and behavioral science and practice" without restriction.

Contextualism, psychological science, and the question of ontology

There has recently been a renewed interest in philosophy among some psychologists, particularly those working within the modern behavior analytic framework known as contextual behavioral science. Functional contextualism (FC) has emerged as an alternative to the dominant mechanistic view – generally associated with epistemological realism—within psychology. The most controversial feature of FC has been its so-called “a-ontological” stance, in which it is argued that any statements about even the mere existence of a reality independent of human sensation are meaningless. We argue that FC in fact requires the assumption of the existence of such a “reality,” which we term an “independent, textured substratum,” if it is to serve as an orienting function for psychological science. Moreover, wholesale rejection of any reference to any ontological dimension is itself incommensurate with the analytic goals of FC in that it unnecessarily alienates scientists who might otherwise find value in the sensitivities of FC.

Connect and shape: A parenting meta-strategy

The existing parenting literature is dominated by two worldviews: the behavioral worldview and the relational/emotional worldview. Points of tension between these worldviews are apparent within the scientific literature; however, both approaches can be fully incorporated into an evolutionary science paradigm including contextual behavioral science. Connect and shape is a parenting meta-strategy that combines behavioral and the relational/emotional strategies into a single parent–child interaction. The elements of connect and shape are not new. What is new is the combination of parental responsiveness/emotion coaching and behavioral parenting strategies into a single, clearly elucidated meta-strategy that can be easily incorporated into parenting intervention.

A Meta-Analysis of the Efficacy of Acceptance and Commitment Therapy for Clinically Relevant Mental and Physical Health Problems

Background: The current study presents the results of a meta-analysis of 39 randomized controlled trials on the efficacy of acceptance and commitment therapy (ACT), including 1,821 patients with mental disorders or somatic health problems. Methods: We searched PsycINFO, MEDLINE and the Cochrane Central Register of Controlled Trials. Information provided by the ACBS (Association of Contextual Behavioral Science) community was also included. Statistical calculations were conducted using Comprehensive Meta-Analysis software. Study quality was rated using a methodology rating form. Results: ACT outperformed control conditions (Hedges' g = 0.57) at posttreatment and follow-up assessments in completer and intent-to-treat analyses for primary outcomes. ACT was superior to waitlist (Hedges' g = 0.82), to psychological placebo (Hedges' g = 0.51) and to treatment as usual (TAU) (we defined TAU as the standard treatment as usual; Hedges' g = 0.64). ACT was also superior on secondary outcomes (Hedges' g = 0.30), life satisfaction/quality measures (Hedges' g = 0.37) and process measures (Hedges' g = 0. 56) compared to control conditions. The comparison between ACT and established treatments (cognitive behavioral therapy) did not reveal any significant differences between these treatments (p = 0.140). Conclusions: Our findings indicate that ACT is more effective than treatment as usual or placebo and that ACT may be as effective in treating anxiety disorders, depression, addiction, and somatic health problems as established psychological interventions. More research that focuses on quality of life and processes of change is needed to understand the added value of ACT and its transdiagnostic nature.

Where׳s the beef?: Reply to Kanter, Holman, and Wilson

This is a brief reply to Kanter, Holman, and Wilson׳s (2014) critique of our analysis of alexythimia, a behavioral deficit. First, we clarify the purpose of our original article. We also present a case for why analyses such as ours, which consider multiple functions of complex verbal behavior in intimate relationships (i.e., establishing operations, discriminative stimuli, response repertoires, and reinforcing functions), falls under the umbrella of contextual behavioral science. We also discuss some broader issues raised by Kanter and colleagues, such as private events, the need for middle-level terms and the role of behavior–behavior relations in contextual behavioral science.

The language of ontology is the subject matter of behavioral science

This paper examines one of the many points of contact between behavioral science and traditional issues in philosophy. Such points of contact involve an analysis of verbal practices of both fields. Specifically, the question is whether the scientific nonverbal and verbal practices of behavioral science allow for descriptions of “reality” or the “real world”. The key to answering this question is found in two pragmatically-based scientific systems, Functional Contextualism (Contextual Behavioral Science) and Radical Behaviorism (Behavior Analysis). Although both scientific systems acknowledge the physical world (or the one world), the case is made that there is no way to access the “real world” in and of itself. All behavior is inextricably related to multiple and interactive environmental variables over time, and thus it is impossible to make discriminations of “reality” that do not entail the influence of such variables. All such discriminations must be, in part, a function of a history in the relevant verbal community and culture. Critics might claim that the scientific perspectives described here also constitute ontology, but even if it qualifies as such under the language game of philosophy, the perspective still serves the pragmatic language game of science. Further, a scientific analysis of ontology might be possible through a functional analysis of the philosophical and psychological terms and practices involved with the language of ontology.

The global dissemination of psychological treatments: a road map for research and practice.

The global dissemination of psychological treatments: a road map for research and practice.

Where is the love? Contextual behavioral science and behavior analysis

This article explores some tensions between contextual behavioral science (CBS) and radical behaviorism or behavior analysis (BA), particularly with respect to the study of emotion. We contrast Darrow and Follette׳s (2014) discussion of alexithymia from a radical behavioral perspective, which we view as representing a traditional behavior analytic approach, with a CBS approach, as we understand it. As a convenient anchor for our discussion, we discuss how CBS and BA might view the term “love.” We present suggestions for how “love” may be used as a middle-level term in a CBS approach, and why usage of such middle-level terms is important to the mission of CBS to create a science more adequate to the challenges of the human condition.

Pragmatism, realism, and psychology: Understanding theory selection criteria

This paper examines some practical implications of philosophy for psychological scientists. A number of methodologists have emphasized the importance of philosophical assumptions in organizing scientific activity. Contextual Behavioral Science (CBS), for example, has been explicitly organized around a form of pragmatism. Beginning with the role of conceptual standards in guiding the theory development, this paper introduces readers to realism and pragmatism as divergent views of scientific progress. The concept of theory-selection criteria is proposed as a useful way of understanding the practical implications stemming from realism and pragmatism. Psychometric construct validity, and inter-theory construct coherency are examined as examples. It is proposed that while realists tend to treat construct validity and theory unification as necessary and sufficient indicators of progress, pragmatists tend to treat these qualities as only potentially progressive. Directions for future philosophical writing are suggested.

Advancing transdisciplinary translation for prevention of high-risk behaviors: introduction to the special issue.

Estimates of the total overall costs of substance abuse in the United States, including productivity and healthand crimerelated costs exceed $600 billion annually (National Drug Intelligence Center 2011). This includes approximately $181 billion for illicit drugs, $193 billion for tobacco, and $235 billion for alcohol. In the USA, the root cause for 25 % of the total deaths can be attributed to substance abuse (Kochanek et al. 2011). The most commonly used drug among American youth is alcohol. Alcohol, the most commonly used drug among American teenagers, kills youth 6.5 times more often than other drugs of abuse (Rehm et al. 2009). And in the larger population, a death toll of nearly 10,000 can be attributed to chronic alcohol abuse within a timeframe of 1 year. Drug consumption of all types generally begins during adolescence; by 13 years of age, over 30 % of teens report having used at least one illicit substance (www.monitoringthefuture.org). As staggering as these numbers are, they do not fully describe the breadth of destructive public health and safety implications of substance abuse, such as family disintegration, loss of employment, failure in school, domestic violence, and child abuse, as well as the association of substance abuse with risky sex, HIV and other sexually transmitted diseases, heart disease, and cancer. In response to the gravity of this issue, hundreds of millions of research dollars have been spent on preventive intervention programs aimed at curbing high-risk behaviors, such as substance abuse. At the National Institutes of Health (NIH) alone, $1,674 million was spent in 2010 on substance abuse; more so than any other neurobehavioral disease. Despite this enormous amount of scholarly effort, however, most prevention research on substance abuse has neither focused upon, nor sought to ameliorate generative and oftentimes malleable mechanisms (e.g., neurocognitive deficits, stress reactivity) in substance abuse and related risk behaviors. In effect, although some recipients of prevention programming engage positively and achieve long-term success across multiple domains of functioning, many others respond less favorably, showing a trajectory toward onset and escalation of behavioral maladjustments, drug use initiation and escalation, lack of intervention engagement, and persistent intervention resistance. This problem has led to calls by many (National Research Council and Institute of Medicine 2009; Sloboda and Bukoski 2003) for a multiple-systems transdisciplinary approach that incorporates perspectives from fields such as genetics, neuroscience, developmental epidemiology, contextual behavioral science, environmental sciences, and clinical practice. Such an approach is crucial if we are to significantly advance scientific knowledge and the development of successful interventions in this area. Translation of findings on etiological underpinnings of substance abuse and related behaviors will lead to a better understanding of the significant impact of the social and physical environment on neurogenetic systems in ways that will inform development of personalized prevention approaches.