Fusion Questionnaire Research Articles

The role of mindfulness and cognitive fusion in predicting self-compassion among patients with schizophrenia: a cross-sectional study

BackgroundThe exact connection between mindfulness, psychological flexibility, and severity of symptoms within schizophrenia spectrum disorders is mostly undefined and requires additional exploration. This study aimed to determine whether mindfulness, cognitive fusion, and symptom severity predict self-compassion among patients with schizophrenia.MethodsA cross-sectional descriptive research design was undertaken within the psychiatric in-patient department of Mansoura University Hospitals, situated in El-Mansoura, the administrative centre of Dakahlia governorate in the Delta area, Egypt. A total of 100 patients with schizophrenia participated in the study. Data were collected from October 2023 to January 2024 by using various tools: A socio-demographic questionnaire and clinical data sheet, the Positive and Negative Syndrome Scale (PANSS), the Mindful Attention Awareness Scale (MAAS), The Cognitive Fusion Questionnaire (CFQ), and The Self-Compassion Scale – Short Form (SCS-SF).ResultsThe findings show that mindfulness significantly impacts self-compassion among patients with schizophrenia. The results show that mindfulness significantly and positively impacts self-compassion, and cognitive fusion significantly and negatively impacts self-compassion. However, symptom severity did not significantly impact self-compassion (B = -0.02, t = -0.56, p = 0.57).ConclusionThe study concluded that people with schizophrenia need to be aware of their inner experience of negative feelings and thoughts at the moment and accept them. Thus, ACT, mindfulness-based, and compassion-based interventions may improve patients’ cognitive fusion, mindfulness, psychological flexibility, and self-compassion.

Emotion dysregulation and psychological inflexibility in adolescents: Discriminant validity and associations with internalizing symptoms and functional impairment

Emotion dysregulation and psychological inflexibility are widely regarded as key contributors to a range of mental health issues and are integral to several treatment models in the mental health field. However, no study has examined whether the two constructs reflect distinct aspects of psychological functioning or whether they can be clearly differentiated from mental health symptoms and associated impairment. Adolescence is a key period for the onset of mental health problems, making a better understanding of psychological processes involved in mental health in this age group important. The Difficulties in Emotion Regulation Scale (DERS-16, emotion dysregulation) and the Avoidance and Fusion Questionnaire for Youth (AFQ-Y8, psychological inflexibility) are widely used assessment tools of emotion dysregulation and psychological inflexibility, but critical evaluations of their validity are sparse. Using exploratory and confirmatory factor analysis, we examined the discriminant validity of emotion dysregulation and psychological inflexibility as measured via the DERS-16 and the AFQ-Y8 in a sample of 633 adolescents (Mage = 16.6 [1.98]). Emotion dysregulation and psychological inflexibility did not demonstrate discriminant validity. Instead, four strongly correlated factors emerged, each comprising a combination of items from both assessment tools: (1) interference stemming from distressing thoughts and emotions, (2) negative self-evaluation, (3) loss of control when emotional, and (4) confusion about one's emotions. These factors were strongly correlated and adequately captured by an overarching factor, which we termed the X factor, which in turn was very strongly correlated with core symptoms of anxiety and depression and functional impairment stemming from mental health issues. In conclusion, the constructs of emotion dysregulation and psychological inflexibility, as assessed by the DERS-16 and AFQ-Y8, do not show discriminant validity in adolescents. Furthermore, the constructs measured by these tools are almost empirically indistinguishable from anxiety, depression, and functional impairment.

Relationships Between Throwing Yips in Baseball, Experiential Avoidance, Cognitive Fusion, Values, and Social Factors

Despite the high prevalence of yips, a psychoneuromuscular impairment affecting fine motor skills in sports performance, the specific aspects of its causality and treatment have not been identified or verified. This cross-sectional study examined psychosocial factors relating to throwing yips in baseball. Amateur baseball players (N = 292) living in Japan completed a self-report questionnaire on their anxiety/fear about throwing the ball, the Acceptance and Action Questionnaire-II, the Cognitive Fusion Questionnaire, the Short Fear of Negative Evaluation Scale, and self-reports evaluating values and social factors relevant to baseball. A hierarchical multiple regression analysis indicated that a low values-based throwing score, a high Cognitive Fusion Questionnaire score, and overreprimanding others’ mistakes were positively associated with baseball players’ yips symptoms. These results suggest that changing the context of playing baseball, reducing cognitive fusion, and improving coaching methods could reduce the risk of baseball players’ throwing yips.

Early Maladaptive Schemas, Cognitive Fusion, and Anabolic-Androgenic Steroid Use Attitudes: The Mediating Role of Muscle Dysmorphia in Iran

In recent decades, the interest in having an ideal body in men has caused a pathological tendency to be muscular, followed by a tendency to use anabolic-androgenic steroids (AASs). This study was designed to evaluate the mediating role of muscle dysmorphia in the relationship between early maladaptive schemas and body image-related cognitive fusion with the tendency to use AAS in male athletes. Out of the total number of men referring to fitness clubs in Isfahan, Iran, 474 men were evaluated using a multistage random cluster sampling method. The questionnaires used in this research included the Muscle Dysmorphic Disorder Inventory, Cognitive Fusion Questionnaire—Body Image, Young Schema Questionnaire—Short Form, and Prototype Willingness Model Questionnaire. The results demonstrated that the relationship of AAS use with body image-related cognitive fusion and the three maladaptive schemas with the mediation of muscle dysmorphia is significant. The present study provides significant implications in the discussion of prevention and treatment of AAS addiction.

Cybervictimization and Non-Suicidal Self-Injury Among Chinese College Students: an Exploration Through the Lens of Experiential Avoidance Model.

Non-suicidal self-injury (NSSI) is a growing public health concern among college students, with cybervictimization (CV) emerging as a significant contributing factor. Grounded in the experiential avoidance theory, this study investigates the mediating roles of cognitive fusion and negative emotions in the relationship between CV and NSSI, providing new insights into these key variables. A convenience sample of 457 undergraduate students (29% male; mean age 18.36±0.66 years) from two universities in Fujian Province participated in this study. Data were collected using the Cyberbullying Victimization Scale, Cognitive Fusion Questionnaire, Positive and Negative Affect Schedule, and Non-Suicidal Self-Injury Scale. Descriptive statistics and Pearson correlation analysis were conducted using SPSS 25.0, while the mediating effects were analyzed using Process 3.5. (1) Significant positive correlations were found among CV, cognitive fusion, negative emotions, and NSSI (p < 0.01). (2) CV was directly associated with NSSI (β = 0.22, p < 0.001) and positively predicted both cognitive fusion (β = 0.17, p < 0.001) and negative emotions (β = 0.15, p < 0.01). Additionally, cognitive fusion (β = 0.16, p < 0.01) and negative emotions (β = 0.11, p < 0.05) significantly predicted NSSI. (3) Mediation analyses revealed that cognitive fusion and negative emotions mediated the CV-NSSI relationship through three pathways: CV→cognitive fusion→NSSI (mediation effect = 0.026), CV→negative emotions→NSSI (mediation effect = 0.02), and CV→cognitive fusion→negative emotions→NSSI (mediation effect = 0.01). The study confirms that CV influences NSSI indirectly through cognitive fusion and negative emotions, supporting the experiential avoidance model. These findings underscore the importance of addressing cognitive and emotional processes in interventions aimed at reducing NSSI among college students.

Evaluation of the Effectiveness of Psychological Flexibility Trainingon Enhancing Career Adaptability in High School Students

Objective: To assess the effectiveness of a psychological flexibility training course based on the Acceptance Commitment Therapy (ACT) DNA-V model in enhancing psychological flexibility and career adaptability among high school students, and to offer a reference for psychological health services. Methods: Collaborating with a high school in Chengdu, 110 second-year students were randomly assigned into three groups: a DNA-V face-to-face group (33 students), a DNA-V online group (40 students), and a control group receiving standard psychological education (37 students). The intervention consisted of a six-session course, with assessments using the Avoidance and Fusion Questionnaire for Youth and the Career Adaptability Scale conducted before, one week after, and two months after the sessions. Results: Data analyzed via linear mixed models showed that the face-to-face group experienced significant improvements in psychological flexibility and career adaptability at one week and two months post-intervention (P&lt;0.01), with no significant changes noted between these two times. The online group saw no significant changes, and the control group s gains reverted to baseline after two months. Conclusion: The face-to-face DNA-V course effectively enhanced psychological flexibility and career adaptability for at least two months, underscoring its potential for integration into student mental health programs.

Psychometric Properties of the Persian Version of the Trait and State Cognitive Fusion Questionnaire in Various Mental Disorders

Background: The Cognitive Fusion Questionnaire (CFQ) has two versions (trait and state) that assess taking thoughts literally and thinking as likely to dominate behavior. Objectives: The current study modified original version of CFQ, which was translated previously in Iran and have used CFQ and modified version as known as the State Cognitive Fusion Questionnaire (SCFQ) for psychometrically evaluated these measures. Methods: A sample of individuals with mental disorders (N = 196) completed the CFQ, SCFQ, and other measures of interest. Results: One-factor models emerged for each measure, and each demonstrated good internal consistency. The CFQ versions were associated with psychopathology, experiential avoidance, and life satisfaction measures. Conclusions: These findings provide initial support for using these measures in research and clinical contexts to further our understanding of cognitive fusion in the Iranian mental disorder population.

Is Psychological Inflexibility a Predictor of Depression and Anxiety of Pre-Adolescents?

Research on mental health issues, such as anxiety and depression, which have become prevalentamong pre-adolescents and lead to impaired functioning in family, academic, and social domains,is critically important. One prominent theoretical approach to explaining anxiety and depressionsymptoms is Acceptance and Commitment Therapy (ACT) and its Psychological InflexibilityModel. This study aims to elucidate the relationship between psychological inflexibility levels inpre-adolescents and their anxiety and depression levels. The Revised Children’s Anxiety andDepression Scale—Child Version (RCADS) and the Avoidance and Fusion Questionnaire for Youth(AFQ-Y8) Child Form were used as data collection tools. Data were collected from 327 sixth-gradestudents (178 male and 149 female) attending three different public schools in Gaziantep, and asimple linear regression model was established with the obtained data. The findings indicated thatpsychological inflexibility significantly predicts internalizing disorder levels (R = .716, R Square =.513; p &lt;.01), total anxiety levels (R = .668, R Square = .446; p &lt;.01) and depression levels (R = .692, RSquare = .479; p &lt;.01) of pre-adolescents. These results contribute to the literature on explaininganxiety and depression in pre-adolescents, and future studies should investigate the relationshipbetween psychological inflexibility and externalizing problems such as aggression and anger.

The relationship between growth mindset and cognitive fusion in college students is mediated by bias towards negative information

This study aimed to investigate the relationships among growth mindset, cognitive fusion, bias towards negative information, and bias towards positive information. The Growth Mindset Scale, the Attention to Positive and Negative Information Scale, and the Cognitive Fusion Questionnaire were employed. A total of 470 college students in China participated in the study. The findings showed a negative correlation between a growth mindset and cognitive fusion. In addition, a parallel mediation analysis demonstrated that bias towards negative information mediated the relationship between a growth mindset and cognitive fusion and that the indirect effect was significant. However, the mediation of bias towards positive information in this model was not significant. These results suggest that possessing a growth mindset is advantageous for mental health.

Relationship between Stigma, Psychological Flexibility, Positive and Negative Affect in Patients with Epilepsy

Background: Epilepsy is a neurological disorder that significantly impacts the daily lives of individuals, leading to psychological, social, and cognitive challenges. Despite advancements in its management, stigma remains a substantial issue for epilepsy patients. Objective: This study aimed to investigate the relationship between stigma, psychological flexibility, and positive and negative affect in patients with epilepsy. Methods: This cross-sectional study included 200 participants, with 100 epilepsy patients and 100 healthy individuals, aged 18 to 45 years, from four major cities in Punjab, Pakistan. Data were collected using convenience sampling. The instruments used were the Internalized Stigma of Mental Illness (ISMI) inventory (epilepsy version), the Cognitive Fusion Questionnaire (CFQ), the Acceptance and Action Questionnaire (AAQ-II), and the Positive and Negative Affect Schedule (PANAS). Data analysis was conducted using SPSS version 25. Descriptive statistics summarized the demographic and clinical characteristics, and independent samples t-tests were used to compare the groups. Results: Epilepsy patients had significantly higher levels of internalized stigma (ISMI total score: 84.05 ± 11.77) compared to healthy individuals (52.79 ± 13.67), t(198) = 17.33, p &lt; 0.01. They also exhibited lower psychological flexibility (AAQ-II score: 39.23 ± 8.92 vs. 26.04 ± 10.07), t(198) = 9.81, p &lt; 0.01, and higher cognitive fusion (CFQ score: 39.62 ± 9.19 vs. 27.56 ± 10.44), t(198) = 8.67, p &lt; 0.01. Positive affect was lower in epilepsy patients (12.58 ± 4.13) compared to healthy individuals (15.30 ± 4.08), t(198) = 4.68, p &lt; 0.01, while negative affect was higher (19.97 ± 4.51 vs. 14.89 ± 4.69), t(198) = -7.81, p &lt; 0.01. Conclusion: The study demonstrated significant relationships between stigma, psychological flexibility, and affect in epilepsy patients. Addressing these factors is crucial for improving the psychological well-being and quality of life for individuals with epilepsy.

START NOW WebApp—promoting emotion regulation and resilience in residential youth care and correctional institutions: study protocol for a cluster randomized controlled trial

BackgroundAdolescents and young adults in residential care and correctional institutions face various challenges, leading to negative life outcomes. Implementation barriers within these institutions, such as limited financial and spatial resources, pose significant hurdles to providing necessary support. Web-based approaches address these challenges by offering cost-effective, accessible solutions. This study aims to assess the efficacy of a newly developed web-based version of the existing evidence-based START NOW skills training in fostering emotion regulation and resilience among institutionalized adolescents and young adults. We present the study protocol (Version 5, August 2023) of the trial titled “Implementation of an e-version of the skills training START NOW for promoting emotion regulation and resilience in residential youth care and correctional institutions”.MethodsThe study is a monocentric, prospective, confirmatory randomized controlled trial with 150 institutionalized adolescents and young adults with a need to improve resilience (predefined cut-offs). Participating institutions will be randomized to one of three conditions: (i) 9-week web-based group training guided by a facilitator, (ii) 9-week web-based self-help training, (iii) and treatment as usual. The primary endpoint is the change in psychological flexibility, assessed by the Avoidance and Fusion Questionnaire for Youth score, from baseline to follow-up 12 weeks post skills training. Secondary objectives encompass assessing pre-post changes in psychological flexibility and other psychological health-related outcome measures in participating adolescents, young adults, and caretakers from baseline, to post training, and to 12- and 24-week follow-ups.DiscussionThis study evaluates the efficacy of START NOW as web-based training for institutionalized adolescents and young adults, providing valuable insights into web-based interventions and aiming to optimize support levels.Trial registration {2a and 2b}ClinicalTrials.gov NCT05313581. Registered on 6 April 2022.

A pilot study of the effect of group-administered psilocybin on psychological flexibility and outcomes

AbstractPsychological flexibility has been proposed as a core process of change when psychedelics are used for therapeutic purposes, but to date empirical outcomes have only documented changes on the Acceptance and Action Questionnaire (AAQ-II), a very general measure of psychological flexibility. This pilot study measured outcomes from psilocybin administered in a retreat setting across a range of measures assessing aspects of psychological flexibility. Nine participants attended a 7-day psilocybin retreat and completed measures at baseline, 2-, and 6-month follow up. Participants demonstrated significant improvements in cognitive defusion (Cognitive Fusion Questionnaire), valued living (Valuing Questionnaire), and Self-Compassion (Self-Compassion Scale), as well as a trend towards increased overall psychological flexibility (AAQ). Other outcome and process measures included measures related to acute effects of the psilocybin, belief in oneness, social safeness, mental health, burnout and emotion expressivity. These results offer preliminary evidence that therapeutic benefits obtained from psilocybin experiences may be linked to changes in psychological flexibility.

A randomized clinical trial: Efficacy of group-based acceptance and commitment therapy program for breast cancer patients with high fear of progression.

Fear of progression (FOP) is a common and significant concern among cancer patients, encompassing worries about cancer progression during active treatment. Elevated levels of FOP can be dysfunctional. This study aims to assess the efficacy of an Acceptance and Commitment Therapy (ACT)-based intervention on FOP, anxiety sensitivity (AS), and quality of life (QOL) in breast cancer patients. A clinical trial was conducted involving 80 stage I-III active-treatment breast cancer patients with a score greater than 34 on the Fear of Progression Questionnaire-Short Form scale. These patients were randomly assigned in a 1:1 ratio to either an intervention group, which received weekly 70-min sessions of 5-ACT-bsed group-therapy, or a control group that received usual treatment. Variables including FOP, AS, QOL, and ACT-related factors were assessed using ASQ, QLQ-C30, Cognitive Fusion Questionnaire, and Acceptance and Action Questionnaire-II at three time points: baseline, post-intervention, and 3-month follow-up. The efficacy of the intervention was evaluated using mixed model analysis across all time-points. The fidelity and acceptability of the ACT-based manual were confirmed using significant methods. A significant reduction in FOP was observed only in the ACT group at post-intervention (P-valueACT < 0.001; Cohen dACT=1.099). Furthermore, the ACT group demonstrated a more significant reduction in FOP at follow-up. Furthermore, all secondary and ACT-related variables, except for the physical symptoms subscale, showed significant improvement in the ACT group compared to the control group. Our ACT-based manual showed promise for reducing FOP, AS, and improving QOL, and ACT-related variables in breast cancer patients 3months following the intervention.

Standardization of the Korean Version of the Acceptance and Action Questionnaire for Obsessions and Compulsions in University Students and Patients With Obsessive-Compulsive Disorder.

The Acceptance and Action Questionnaire for Obsessions and Compulsions (AAQ-OC) is a version of the Acceptance and Action Questionnaire (AAQ) that specifically measures unwanted intrusive thoughts and responses (e.g., experiential avoidance) to them. This study aimed to investigate the reliability and validity of the Korean version of the AAQ-OC in clinical and nonclinical Korean samples. In this study, 561 university students and 121 patients with obsessive-compulsive disorder (OCD) completed the AAQ-OC and several other psychological scales. Descriptive, correlation, and exploratory and confirmatory factor analyses as well as group comparisons were conducted. The results of the exploratory and confirmatory factor analyses indicated a two-factor structure that best fits the data in the university sample: Factors 1 and 2 matched the original Valued Action and Willingness subscales, respectively. The reliability analyses revealed that the AAQ-OC and its factors had excellent internal consistencies. As regards the concurrent validity, the AAQ-OC and its factors had a positive correlation with the AAQ-II and Cognitive Fusion Questionnaire. Compared with the university students, the OCD patients had higher AAQ-OC scores, and their obsessive-compulsive symptoms, particularly the two symptom dimensions of responsibility for harm and mistakes and unacceptable thoughts, were significantly associated with the AAQ-OC and two subscales. The findings of this study confirm the reliability and validity of the Korean version of the AAQ-OC.

Differences in Psychological Inflexibility Among Men With Erectile Dysfunction Younger and Older Than 40 Years: Web-Based Cross-Sectional Study.

Psychological inflexibility is a core concept of acceptance and commitment therapy (ACT), which is a comprehensive, transdiagnostic interpretation of mental health symptoms. Erectile dysfunction (ED) is a condition that affects male sexual performance, involving the inability to achieve and maintain a penile erection sufficient for satisfactory sexual activity. Psychosocial factors primarily influence ED in men younger than 40 years, whereas biological factors are more likely to be the underlying cause in older men. This web-based cross-sectional study examined differences in depression, anxiety, and psychological inflexibility among men with ED younger and older than 40 years in a Japanese population. We used a web-based survey to gather data from various community samples. ED was assessed by the International Index of Erectile Function-5 (IIEF-5) questionnaire, while depression, anxiety, and psychological inflexibility were evaluated by the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Acceptance and Action Questionnaire-II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), and Valuing Questionnaire-Obstacle Subscale (VQ-OB) questionnaires. The chi-square test estimated the scores of PHQ-9 and GAD-7 among men with ED, comparing those younger than 40 years and those older than 40 years. Additionally, a two-way ANOVA was conducted with ED severity and age group as independent variables, assessing psychological inflexibility. Valid responses from 643 individuals (mean age 36.19, SD 7.54 years) were obtained. Of these, 422 were younger than 40 years (mean age 31.76, SD 5.00 years), and 221 were older than 40 years (mean age 44.67, SD 2.88 years). There was a statistical difference in the prevalence of depression as judged by PHQ≥10 between men with ED younger and older than 40 years (P<.001). On the other hand, there was no difference in the prevalence of anxiety as judged by GAD≥10 (P=.12). The two-way ANOVA revealed that the interactions for CFQ (P=.04) and VQ-OB (P=.01) were significant. The simple main effect was that men with ED younger than 40 years had significantly higher CFQ (P=.01; d=0.62) and VQ-OB (P<.001; d=0.87) scores compared to those older than 40 years in moderate ED and severe ED. Additionally, it was found that men younger than 40 years with moderate to severe ED had significantly higher CFQ (P=.01; d=0.42) and VQ-OB (P=.02; d=0.38) scores compared to men younger than 40 years without ED. On the other hand, no interaction was found for AAQ-II (P=.16) scores. To the best of our knowledge, this web-based cross-sectional study is the first to examine the relationship between psychological inflexibility and ED. We conclude that men with moderate and severe ED younger than 40 years have higher psychological inflexibility and might be eligible for ACT.

The Impact of Stress Inoculation Management Training on Negative Automatic Thoughts, Psychological Distress, and Cognitive Fusion among Students Preparing for University Entrance Exam

Objective: One of the approaches that can lead to changes in reducing psychological distress, negative automatic thoughts, and cognitive fusion among students preparing for university entrance exam is stress inoculation management. Therefore, the purpose of this study is to investigate the effect of stress inoculation management training on negative automatic thoughts, psychological distress, and cognitive fusion among students preparing for university entrance exam. Methods and Materials: This research is an applied study in nature and quasi-experimental in implementation, using a pre-test and post-test design with a control group. The population consisted of all female students preparing for university entrance exam in Kermanshah in the year 2023. From this population, 60 participants were selected using a convenience sampling method into two experimental groups and one control group. The research tools included the Kessler Psychological Distress Scale (Kessler et al., 2003), the Negative Automatic Thoughts Questionnaire (Kendall &amp; Hollon, 1980), and the Cognitive Fusion Questionnaire (Rachman &amp; Shafran, 1996). Data analysis was performed using multivariate covariance analysis. Findings: The results indicated that the stress inoculation management intervention had a significant effect on the psychological distress of the students preparing for university entrance exam in the post-test phase (p&lt;0.01). The intervention also significantly impacted negative automatic thoughts (p&lt;0.01) and cognitive fusion (p&lt;0.01) in the post-test evaluations. Conclusion: Stress inoculation management training is effective in impacting negative automatic thoughts, psychological distress, and cognitive fusion among students preparing for university entrance exam.

Effectiveness of Acceptance and Commitment Therapy on Cognitive Fusion and Social Anxiety in Women with Generalized Anxiety Disorder

Objective: The purpose of this study was to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on cognitive fusion and social anxiety in women suffering from generalized anxiety disorder. Methods: This study was an applied, quasi-experimental design with pre-test, post-test, and follow-up, including a control group. The population consisted of all women with generalized anxiety disorder who attended counseling centers in Sari city. The sample included 30 women with generalized anxiety disorder, selected via convenience sampling and randomly assigned to two groups: the experimental group receiving ACT for social anxiety disorder (Hayes, 2012) and a wait-list control group. Data were collected using the Social Anxiety Questionnaire (Watson &amp; Friend, 1969) and the Cognitive Fusion Questionnaire (Gillanders, 2014). Data were analyzed using repeated measures ANOVA with SPSS-26 software. Findings: The results showed significant differences between the ACT treatment group and the control group. ACT was effective in reducing cognitive fusion (F = 15.25, p &lt; .001) and social anxiety (F = 38.86, p &lt; .001) in women with generalized anxiety disorder (p &lt; .001). Conclusion: Therefore, it can be concluded that Acceptance and Commitment Therapy may serve as an effective intervention method for improving cognitive fusion and social anxiety in women with generalized anxiety disorder.

Examination of Psychological Symptoms in Adults Related to Adverse Childhood Experiences, Cognitive Fusion, Experiential Avoidance, and Perceived Social Support

The aim of the present study is to determine the relationships between psychological symptoms in adults, adverse childhood experiences, cognitive engagement, experiential avoidance, and perceived social support. Another aim of the study is to examine whether psychological symptoms differ according to demographic variables such as age, gender and education level. The sample of the study consists of adults between the ages of 18-65. Brief Symptom Inventory, Childhood Trauma Questionnaire Short Form, Cognitive Fusion Questionnaire, Acceptance and Action Questionnaire and Multidimensional Scale of Perceived Social Support were used as data collection instruments. Analyses showed that adverse childhood experiences, cognitive fusion and perveived social support predict psychological symptoms in adults. In addition, depression, anxiety, negative self and hostility symptoms were found to be higher in the participants aged 18-24 compared to the participants in the 25-40 and 41-65 age groups. It was thought that this study will contribute to understanding the nature of psychological symptoms and identfiying the intervention areas of psychotherapies.

Acceptance and commitment therapy as an add-on treatment for the management of patients with obsessive-compulsive disorder.

Obsessive compulsive disorder (OCD) is a chronic and long-lasting illness affecting approximately 2% of the population. Up to 40%-60% of patients with OCD do not have satisfactory outcomes, thereby leading to disability in performing daily routine activities. Acceptance and commitment therapy (ACT) provides a substitute for old-fashioned psychotherapies, as it involves the client directly experiencing the problematic emotion, that is, anxiety and obsessions in the case of OCD. To observe the effect of ACT on patients with OCD and compare its effect on obsessive compulsive symptoms, thought control, thought and action fusion, acceptance and action, and depression. A total of 62 patients diagnosed with OCD as per Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in the age range between 18 and 60 years, having duration of illness less than two years, both male and female, literate and illiterate, hailing from rural and urban background, were included in the study. For pre- and post-assessment Yale-Brown Obsessive and Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HDRS), acceptance and commitment questionnaire, thought control questionnaire, and thought and action fusion questionnaire were used in this study, and ACT was used for management of OCD. There is a significant difference between the groups treated with ACT and those treated as usual, on every domain of thought control questionnaire (TCQ) -- distraction (t = 9.07), social control (t = 11.13), worry (t = 11.93), punishment (t = 16.78), and re-appraisal (t = 16.47). Significance is also seen in the thought and action fusion in the moral domain (t = 16.22), the likelihood domain (t = 16.49), and others (t = 9.23). On Y-BOCS, HDRS, and acceptance and action questionnaire (AAQ) both groups show a significant difference between each other. The findings of the present study indicate that ACT is a productive method for patients with OCD as it encourages the patient to accept and integrate their lived experiences, challenges effective responses, and recognizes and eliminates the controlling dimensions.

Is Acceptance and Commitment Therapy Effective for Any Obsessive-Compulsive Symptom Dimensions?

Acceptance and commitment therapy (ACT) has been recently introduced for treating obsessive-compulsive disorder (OCD). Although there are data supporting the efficacy of ACT, only few studies have investigated the effectiveness of ACT against any obsessivecompulsive (OC) symptom dimension or a specific dimension alone. In total, 64 patients with OCD received an 8-session ACT group program. All measures were evaluated before and after treatment. The Dimensional Obsessive-Compulsive Scale was used to assess OCD severity across the four empirically supported symptom dimensions (i.e., contamination, responsibility for harm, unacceptable thoughts, and symmetry). ACT processes were evaluated using the Acceptance and Action Questionnaire-II (AAQ-II), Acceptance and Action Questionnaire for Obsessions and Compulsions (AAQOC), and Cognitive Fusion Questionnaire. After an 8-week program, there were significant reductions in all four OC symptom dimensions after ACT. The unacceptable thoughts and contamination domains had medium effect size. The responsibility for harm and symmetry dimensions had small effect size. The unacceptable thoughts dimension was significantly correlated with all ACT process measures. The symmetry dimension was significantly correlated with AAQ-OC and AAQ-II scores while the responsibility for harm dimension was correlated with AAQ-II alone. However, the contamination dimension was not associated with any process measures. ACT may be effective for managing all four symptom dimensions with small to moderate effect size. Moreover, depending on the symptom dimension, there may be different relationship patterns between symptom reduction and changes in ACT processes.