Self-as-context Research Articles

Focusing on the self in context as an emotion regulatory strategy: an evaluation of the “self-as-context” component of ACT compared to cognitive reappraisal in managing stress

ABSTRACT Background Self-as-Context (SAC) is one of the six core components of the Acceptance and Commitment Therapy model (ACT). Objective The aim of the current study was to investigate whether SAC is effective in reducing negative affect and maintaining positive affect in response to a personally relevant stressor relative to cognitive reappraisal (CR) and spontaneous coping strategies. Method An undergraduate sample (N = 105) completed baseline measures and were asked to discuss a recent personally relevant stressor which was audiotaped, before being randomized to one of three conditions. Participants randomized to the SAC and CR conditions received 5-minutes of training, whilst participants allocated to the control condition were asked to read a brochure for 5-minutes. All participants then listened to their recorded stressful experience before completed follow-up measures. Results The SAC group reported significantly less negative affect than participants in the control group post-training induction; although the CR group did not differ from the SAC or control participants in reductions in negative affect post-induction. There were no significant group differences for positive affect. Conclusions The findings provide preliminary evidence that SAC is an effective emotion regulatory strategy in reducing acute distress in a stress-exposed young adult sample.

Associations Between Mental Health, Interoception, Psychological Flexibility, and Self-as-Context, as Predictors for Alexithymia: A Deep Artificial Neural Network Approach.

Background: Alexithymia is a personality trait which is characterized by an inability to identify and describe conscious emotions of oneself and others.Aim: The present study aimed to determine whether various measures of mental health, interoception, psychological flexibility, and self-as-context, predicted through linear associations alexithymia as an outcome. This also included relevant mediators and non-linear predictors identified for particular sub-groups of participants through cluster analyses of an Artificial Neural Network (ANN) output.Methodology: Two hundred and thirty participants completed an online survey which included the following questionnaires: Toronto alexithymia scale; Acceptance and Action Questionnaire 2 (AQQII); Positive and Negative Affect Scale (PANAS-SF), Depression, Anxiety, and Stress Scale 21 (DAS21); Multidimensional Assessment of Interoceptive Awareness (MAIA); and the Self-as-Context (SAC) scale. A stepwise backwards linear regression and mediation analysis were performed, as well as a cluster analysis of the non-linear ANN upper hidden layer output.Results: Higher levels of alexithymia were associated with increased psychological inflexibility, lower positive affect scores, and lower interoception for the subscales of “not distracting” and “attention regulation.” SAC mediated the relation between emotional regulation and total alexithymia. The ANNs accounted for more of the variance than the linear regressions, and were able to identify complex and varied patterns within the participant subgroupings.Conclusion: The findings were discussed within the context of developing a SAC processed-based therapeutic model for alexithymia, where it is suggested that alexithymia is a complex and multi-faceted condition, which requires a similarly complex, and process-based approach to accurately diagnose and treat this condition.

The moderating roles of psychological flexibility and inflexibility on the mental health impacts of COVID-19 pandemic and lockdown in Italy

The Moderating Roles of Psychological Flexibility and Inflexibility on the Mental Health Impacts of COVID-19 Pandemic and Lockdown in Italy.Preliminary data suggest the COVID-19 pandemic has adverse effects on mental health in approximately a quarter of the general population. Few prior studies have identified contextual risk factors and no published study has explored factors that might moderate their adverse effects on mental health. Psychological flexibility is the cornerstone of psychological health and resiliency. This study investigated the roles of psychological flexibility and inflexibility in moderating the effects of COVID-19 risk factors on three mental health outcomes: COVID-19 peritraumatic distress, anxiety, depression. We hypothesized that psychological flexibility would mitigate and psychological inflexibility would exacerbate the adverse effects of COVID-19 risk factors on mental health. During the Italian national lockdown (M = 39.29 days, SD = 11.26), 1035 adults (79% female, M = 37.5 years, SD = 12.3) completed an online survey. Twelve COVID-19 risk factors were identified (e.g. lockdown duration, family infected by COVID-19, increase in domestic violence and in unhealthy lifestyle behaviours) and constituted a COVID-19 Lockdown Index. As predicted, results showed that after controlling for sociodemographic variables, global psychological flexibility and four of its sub-processes (self-as context, defusion, values, committed action), mitigated the detrimental impacts of COVID-19 risk factors on mental health. In contrast and as expected, global psychological inflexibility and four of its sub-processes (lack of contact with present moment, fusion, self-as-content, lack of contact with personal values) exacerbated the detrimental impacts of COVID-19 risk factors on mental health. Findings converge with those from the broader psychological flexibility literature providing robust support for the use of ACT-based interventions to promote psychological flexibility and mental health during the COVID-19 pandemic.

Preliminary investigation of self-as-context in people with fibromyalgia.

Acceptance and commitment therapy (ACT), based on the Psychological Flexibility (PF) model, has been recently applied to fibromyalgia (FM), and appeared effective in improving functioning. However, evidence for some of the processes within the PF model, self-as-context (SAC) in particular, is lacking within this population. The current study validates a measure of SAC, the Self Experiences Questionnaire (SEQ), and preliminarily investigates the role of SAC in relation to functioning in FM. Participants (N = 298, 93.3% women) self-reporting a diagnosis of FM were recruited via the Internet and completed an online survey. Measures included pain, pain acceptance and SAC, as processes, and pain interference, work and social adjustment, depression and depression-related interference, as outcomes. Confirmatory factor analysis of the SEQ suggested a bi-factor structure, with a general factor underlying all items and two sub-factors, self-as-distinction and self-as-observer (χ2 = 46.55, p = .06, comparative fit index (CFI) = .99, Tucker-Lewis Index (TLI) = .99, root mean square error of approximation (RMSEA) = .04). Component factors showed good reliability, Cronbach's α = .90, and construct validity, supported by significant Pearson's correlations between SEQ scores, acceptance and outcomes (r = -.14 to -.33). In multiple regression analyses, SEQ scores significantly predicted pain-related interference (β = -.17, p < .05), work and social adjustment (β = -.14, p < .05) and depression (β = -.21, p < .01), but not depression-related interference, after controlling for pain, but only significantly predicted depression after controlling pain acceptance. These preliminary results show potentially important associations between SAC and functioning in people with FM.

Effect of acceptance and commitment therapy on postoperative psychosocial adaptation in breast cancer patients

Objective To investigate the effects of acceptance and commitment therapy on postoperative psychosocial adaptation in breast cancer patients. Methods 120 breast cancer patients were divided into two groups by random number table: 58 cases in the observation group and 62 cases in the control group. They all received routine nursing care and the observation group also received acceptance and commitment therapy intervention, including acceptance, cognitive diffusion, being present, self as context, values and committed action. Psychological and Social Adaptation Questionnaire for Breast Cancer Patient (PSAQ-B) was used to investigate their psychosocial adaptation before and after the intervention. Results The intervention group was observed in patients with anxiety/depression, self-esteem and self-acceptance, attitude, sense of belonging, self-control and self-efficacy score was respectively (30.14 ± 5.08), (31.68 ± 5.77), (30.03 ± 5.35), (33.68 ± 5.56), (32.86 ± 5.63) points, the control group were (23.75 ± 3.68), (28.87±4.86), (26.12 ± 4.53), (29.18 ± 5.26), (29.06 ± 4.75) points, the difference between 2 groups was statistically significant (t = 6.016 -6.540, all P < 0.05). Conclusions Acceptance and commitment therapy can effectively improve the psychosocial adaptation status in breast cancer patients after surgery to help improve their quality of life. Key words: Breast neoplasms; Acceptance and commitment therapy; Psychosocial adaptation