Spontaneous Thoughts Research Articles

Dynamics of spontaneous thoughts: Exploration, attentional profile and the segmentation of the stream of thoughts

For a long time, clinical knowledge and first-person reports have pointed to individual differences in the dynamics of spontaneous thoughts, in particular in the extreme case of psychiatric conditions (e.g. racing thoughts in Attention Deficit / Hyperactivity Disorder, ADHD; rumination in depression). We used a novel procedure to investigate this individual variability by combining verbal fluency tasks and introspective reports of thought content. Our goal was twofold. First, we tested the hypothesis that a greater segmentation of the stream of thoughts would be associated with trait inattention, in line with subjective reports of ADHD patients. Second, we tested whether the segmentation of the stream of thoughts increased with an increased tendency for exploratory behavior, following recent theoretical claims on the mechanisms underpinning the generation of spontaneous thoughts. Our results support both hypotheses, shedding light on the factors contributing to the individual variability in the dynamics of the stream of thought.

Characterizing human spontaneous thoughts and its application in major depressive disorder

BackgroundSpontaneous thought is a universal, complex, and heterogeneous cognitive activity that significantly impacts mental activity and strongly correlates with mental disorders. MethodsUtilizing the think-aloud method, we captured spontaneous thoughts during rest from 38 diagnosed with depression, alongside 36 healthy controls and 137 healthy individuals. Through a comprehensive assessment of various dimensions of thought content, we compared thought content between individuals with depression and healthy controls, and between healthy women and men. Finally, we employed natural language processing (NLP) to develop regression models for multidimensional content assessment and a classification model to differentiate between individuals with and without depression. ResultsCompared to healthy controls, individuals with depression had more internally oriented and less externally oriented spontaneous thoughts. They focused more on themselves and negative things, and less on positive things, experiencing higher levels of negative emotions and lower levels of positive emotions. Besides, we found that compared to healthy men, healthy women's spontaneous thoughts focus more on interoception, the self, past events, and negative events, and they experience higher levels of negative emotions. Meanwhile, we identified the potential application of the think-aloud method to collect spontaneous thoughts and integrate NLP in the field of depression. ConclusionsThis study offers direct insights into the stream of thought during individuals' resting state, revealing differences between individuals with depression and healthy controls, as well as sex differences in the content of spontaneous thoughts. It enhances our understanding of spontaneous thought and offers a new perspective for preventing, diagnosing, and treating depression.

Allyship against interpersonal pregnancy discrimination: exploring observers’ spontaneous responses toward pregnancy self-disclosure, interpersonal discrimination and male allyship

PurposePregnant employees experience considerable interpersonal discrimination. This study explores the range of possible reactions of observers to pregnancy self-disclosure, interpersonal discrimination and various allyship interventions, and the attentional processes that lead to those reactions. Consequently, it uncovers socio-cognitive processes underlying support for and backlash toward pregnancy in the workplace.Design/methodology/approach This study used a thought-listing technique to explore observers’ spontaneous thoughts related to pregnancy. Working adults were randomly assigned to read through one of the six scenarios depicting pregnancy self-disclosure, interpersonal discrimination and male allyship interventions (i.e. stating the organization’s anti-discrimination policy, confronting the transgressor by calling out sexism, pivoting the conversation to highlight the strengths of the pregnant employee and a hybrid intervention combining highlighting strengths and confrontation) after which participants listed the top three thoughts that came to their mind (1,668 responses). Responses were thematically analyzed to explore spontaneous reactions toward the pregnant employee, transgressor and ally in the scenario.Findings Surprisingly, across all scenarios, the most sexist thoughts emerged during pregnancy self-disclosure, even in the absence of any transgression. After a transgression occurred, any allyship intervention was better than none in eliciting lesser sexist backlash against the pregnant employee. Stating the organization’s anti-discrimination policy was most beneficial for the pregnant employee in eliciting the least sexist backlash but at the cost of generating unfavorable impressions of the ally. Calling out the transgressor’s bias elicited the most sexist backlash toward the pregnant employee, yet it created favorable impressions of the ally. In contrast, highlighting the strengths of the pregnant employee created the most favorable impression of the ally while eliciting a few sexist thoughts about the pregnant employee. Overall, the hybrid intervention was the most effective at balancing the competing goals of generating support for the pregnant employee, creating favorable impressions of the ally, as well as holding the transgressor accountable.Originality/value This study demonstrates that the type of allyship intervention critically redirects the attentional focus of observers to certain aspects of a discrimination episode and relevant schemas which can generate support or backlash toward targets, transgressors and allies, thereby advancing or obstructing equity and inclusion in organizations.

A comprehensive guide to research protocols for collecting and coding involuntary past and future thoughts

The paper presents a comprehensive guide for researchers investigating mind-wandering and related phenomena such as involuntary past and future thinking. Examining such spontaneous cognitions presents a challenge requiring not only the use of appropriate laboratory-based procedures, but also the coding of complex qualitative data. This guide outlines two main stages of existing research protocols: data acquisition and data coding. For the former, we introduce an easily modifiable computerized version of the vigilance task, designed for broad application in studies focusing on eliciting and measuring involuntary thoughts in controlled laboratory conditions. Regarding data preparation and coding, we provide a detailed step-by-step procedure for categorizing and coding different types of thoughts, involving both participants and competent judges. Additionally, we address some of the difficulties that may arise during this categorization and coding process. The guide is supplemented by a clip demonstrating the main part of the experimental procedure and a step-by-step example of the subsequent data processing stages. We anticipate that this research guide will not only assist a broader group of researchers interested in investigating spontaneous cognition, but will also inspire future studies on spontaneous cognition and related phenomena.•There is a need for standardized approaches to working with qualitative data when investigating spontaneous thoughts.•The paper outlines a comprehensive protocol for collecting and coding involuntary past and future-oriented thoughts.•The paper also presents a detailed step-by-step procedure for data preparation and coding to categorize different types of thoughts, involving both participants and competent judges.

Revisiting alpha resting state dynamics underlying hallucinatory vulnerability: Insights from Hidden semi‐Markov Modeling

BackgroundResting state (RS) brain activity is inherently non-stationary. Hidden semi-Markov Models (HsMM) can characterize continuous RS data as a sequence of recurring and distinct brain states along with their spatio-temporal dynamics. New methodRecent explorations suggest that HsMM state dynamics in the alpha frequency band link to auditory hallucination proneness (HP) in non-clinical individuals. The present study aimed to replicate these findings to elucidate robust neural correlates of hallucinatory vulnerability. Specifically, we aimed to investigate the reproducibility of HsMM states across different data sets and within-data set variants as well as the replicability of the association between alpha brain state dynamics and HP. ResultsWe found that most brain states are reproducible in different data sets, confirming that the HsMM characterized robust and generalizable EEG RS dynamics on a sub-second timescale. Brain state topographies and temporal dynamics of different within-data set variants showed substantial similarities and were robust against reduced data length and number of electrodes. However, the association with HP was not directly reproducible across data sets. Comparison with existing methodsThe HsMM optimally leverages the high temporal resolution of EEG data and overcomes time-domain restrictions of other state allocation methods. ConclusionThe results indicate that the sensitivity of brain state dynamics to capture individual variability in HP may depend on the data recording characteristics and individual variability in RS cognition, such as mind wandering. Future studies should consider that the order in which eyes-open and eyes-closed RS data are acquired directly influences an individual’s attentional state and generation of spontaneous thoughts, and thereby might mediate the link to hallucinatory vulnerability.

Brain decoding of spontaneous thought: Predictive modeling of self-relevance and valence using personal narratives

The contents and dynamics of spontaneous thought are important factors for personality traits and mental health. However, assessing spontaneous thoughts is challenging due to their unconstrained nature, and directing participants' attention to report their thoughts may fundamentally alter them. Here, we aimed to decode two key content dimensions of spontaneous thought-self-relevance and valence-directly from brain activity. To train functional MRI-based predictive models, we used individually generated personal stories as stimuli in a story-reading task to mimic narrative-like spontaneous thoughts (n = 49). We then tested these models on multiple test datasets (total n = 199). The default mode, ventral attention, and frontoparietal networks played key roles in the predictions, with the anterior insula and midcingulate cortex contributing to self-relevance prediction and the left temporoparietal junction and dorsomedial prefrontal cortex contributing to valence prediction. Overall, this study presents brain models of internal thoughts and emotions, highlighting the potential for the brain decoding of spontaneous thought.

Understanding mechanisms of depression prevention: study protocol of a randomized cross-over trial to investigate mechanisms of mindfulness and positive fantasizing as intervention techniques for reducing perseverative cognition in remitted depressed individuals

BackgroundMajor Depressive Disorder (MDD) is one of the most prevalent psychiatric disorders, and involves high relapse rates in which persistent negative thinking and rumination (i.e., perseverative cognition [PC]) play an important role. Positive fantasizing and mindfulness are common evidence-based psychological interventions that have been shown to effectively reduce PC and subsequent depressive relapse. How the interventions cause changes in PC over time, is unknown, but likely differ between the two. Whereas fantasizing may change the valence of thought content, mindfulness may operate through disengaging from automatic thought patterns. Comparing mechanisms of both interventions in a clinical sample and a non-clinical sample can give insight into the effectivity of interventions for different individuals. The current study aims to 1) test whether momentary psychological and psychophysiological indices of PC are differentially affected by positive fantasizing versus mindfulness-based interventions, 2) test whether the mechanisms of change by which fantasizing and mindfulness affect PC differ between remitted MDD versus never-depressed (ND) individuals, and 3) explore potential moderators of the main effects of the two interventions (i.e., what works for whom).MethodsIn this cross-over trial of fantasizing versus mindfulness interventions, we will include 50 remitted MDD and 50 ND individuals. Before the start of the measurements, participants complete several individual characteristics. Daily-life diary measures of thoughts and feelings (using an experience sampling method), behavioural measures of spontaneous thoughts (using the Sustained Attention to Response Task), actigraphy, physiological measures (impedance cardiography, electrocardiography, and electroencephalogram), and measures of depressive mood (self-report questionnaires) are performed during the week before (pre-) the interventions and the week during (peri-) the interventions. After a wash-out of at least one month, pre- and peri-intervention measures for the second intervention are repeated.DiscussionThis is the first study integrating self-reports, behavioural-, and physiological measures capturing dynamics at multiple time scales to examine the differential mechanisms of change in PC by psychological interventions in individuals remitted from multiple MDD episodes and ND individuals. Unravelling how therapeutic techniques affect PC in remitted individuals might generate insights that allows development of personalised targeted relapse prevention interventions.Trial registrationClinicalTrials.gov: NCT06145984, November 16, 2023.

COVID-19 on mind: Daily worry about the coronavirus is linked to negative affect experienced during mind-wandering and dreaming.

Despite a surge of studies on the effects of COVID-19 on our well-being, we know little about how the pandemic is reflected in people's spontaneous thoughts and experiences, such as mind-wandering (or daydreaming) during wakefulness and dreaming during sleep. We investigated whether and how COVID-19-related general concern, anxiety, and daily worry are associated with the daily fluctuation of the affective quality of mind-wandering and dreaming, and to what extent these associations can be explained by poor sleep quality. We used ecological momentary assessment by asking participants to rate the affect they experienced during mind-wandering and dreaming in daily logs over a 2-week period. Our preregistered analyses based on 1,755 dream logs from 172 individuals and 1,496 mind-wandering logs from 152 individuals showed that, on days when people reported higher levels of negative affect and lower levels of positive affect during mind-wandering, they experienced more worry. Only daily sleep quality was associated with affect experienced during dreaming at the within-person level: on nights with poorer sleep quality people reported experiencing more negative and less positive affect in dreams and were more likely to experience nightmares. However, at the between-person level, individuals who experienced more daily COVID-19 worry during the study period also reported experiencing more negative affect during mind-wandering and during dreaming. As such, the continuity between daily and nightly experiences seems to rely more on stable trait-like individual differences in affective processing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Personality Moderates Intra-Individual Variability in EEG Microstates and Spontaneous Thoughts.

Variability in brain activity that persists after accounting for overt behavioral and physiological states is often considered noise and controlled as a covariate in research. However, studying intra-individual variability in brain function can provide valuable insights into the dynamic nature of the brain. To explore this, we conducted a study on 43 participants analyzing the EEG microstate dynamics and self-reported spontaneous mental activity during five-minute resting-state recordings on two separate days with a twenty days average delay between recordings. Our results showed that the associations between EEG microstates and spontaneous cognition significantly changed from one day to another. Moreover, microstate changes were associated with changes in spontaneous cognition. Specifically, inter-day changes in Verbal thoughts about Others and future Planning were positively related to bottom-up sensory network-related microstate changes and negatively associated with top-down, attention, and salience network-related microstates. In addition, we find that personality traits are related to inter-day changes in microstates and spontaneous thoughts. Specifically, extraversion, neuroticism, agreeableness, and openness to experience moderated the relationship between inter-day changes in EEG microstates and spontaneous thoughts. Our study provides valuable information on the dynamic changes in the EEG microstate-spontaneous cognition organization, which could be essential for developing interventions and treatments for neuropsychiatric disorders.

No evidence of association between autism spectrum quotient and spontaneous mental time travel in a general adult sample performing an online vigilance task

AbstractEvidence supports the dissociation of voluntary and spontaneous routes to past and future thinking, collectively referred to as mental time travel (MTT). If the diminished voluntary MTT ability found in autism spectrum disorders (ASD) is attributable to a deficit in constructive/generative processes not necessary for spontaneous MTT, ASD traits (Autism Spectrum Quotient score) in a general adult sample should not be related to total spontaneous thoughts, probability of past or future thoughts, or probability of specific thoughts during an undemanding vigilance task. Results supported this hypothesis: AQ was not associated with total spontaneous thoughts and did not significantly predict the other measures. This is the first study to explore spontaneous MTT in relation to ASD traits, further supporting the argument that voluntary MTT may be compromised in ASD due to reliance on constructive/generative processes and reinforcing the notion of dissociable cognitive routes to MTT.

The Structure and Function of Mind-Wandering in Chinese Regulated Verse

The aesthetics of poetry is intricately intertwined with the cognitive process of mind-wandering, where attention shifts from the current task and spontaneous thoughts emerge. While mind-wandering has been extensively studied in psychology and neuroscience, its potential relationship to poetry remains underexplored. This study investigates the experience of mind-wandering associated with traditional Chinese regulated verse (律詩), which effectively enables the exploration of inner emotions and perceptions within its concise form. Typically, the first couplet of a regulated verse poem describes how mind-wandering is triggered by a place or event rich in semantic information. The second and third couplets use parallelism to create two distinct mental spaces, with the primary goal of encouraging the mind to wander between them. By meditating on parallel words in these two couplets, readers can reflect upon their essence through creative thinking and sensory imagery. Finally, the fourth couplet serves as a metacognitive endpoint, revealing the self’s position in the universe by evaluating the content of mind-wandering. This study demonstrates how the structure of regulated verse artfully represents the poet’s experience of mind-wandering, providing readers with the opportunity to re-experience this process with spontaneous and controlled cognitive activity.

Individual differences in autobiographical memory predict the tendency to engage in spontaneous thoughts

ABSTRACT Individual differences in autobiographical memory have become a research area of interest, but little is known about its associations with other individual differences dimensions, such as the tendency to engage in spontaneous cognition. We report two studies examining individual differences in autobiographical memory, as measured by the Autobiographical Recollection Test (ART), in relation to eight trait-like measures of spontaneous thought and, in Study 2, also a measure of fantasy proneness. In Study 1, the ART correlated positively and systematically with six out of eight measures of spontaneous thought, even when controlling for age, gender, and trait positive and negative affect. The two exceptions concerned spontaneous thoughts specifically related to attentional deficits. Study 2 replicated these findings and extended them to a measure of fantasy proneness. The findings demonstrate that people who generally consider their autobiographical memories to be vivid, detailed, relevant, and coherent, report a higher tendency to engage in various forms of spontaneous cognition, including positive constructive daydreaming, spontaneous mind wandering, involuntary mental time travel, and vivid and immersive fantasy. We discuss these findings in terms of the role autobiographical memory plays in spontaneous thoughts.

Design and field trial of EmotionFrame: exploring self-journaling experiences in homes for archiving personal feelings about daily events

ABSTRACT Capturing people’s spontaneous thoughts or daily emotions in their everyday living space can be difficult and can pose a psychological burden from a clinical standpoint. To address this issue, we have developed EmotionFrame, which allows users to archive their daily experiences by recording videos of their current thoughts and emotions at home. EmotionFrame serves as a journaling device, and the parameters for journaling have been determined based on a depression assessment model. This study explores the benefits of users’ recording feelings about their daily events, which can also help with assessing depressive mood with the journaling data. Our three-week in-field study with eight participants showed that EmotionFrame could be integrated into participants’ daily routines based on their previous diary-writing habits. In addition, its harmonious frame shape fits in with the everyday environment. Being able to engage in spontaneous journaling in private spaces – and in a way that allowed them to see themselves – prompted the study participants to effectively record their sincere thoughts and emotions during the archiving process.

The Role of Spontaneous Thoughts in Human Cognition

Spontaneous thought is a cognitive process that ubiquitously happens in daily life. Humans spend 30-50% of their lives in spontaneous thinking, but the impact and consequence of spontaneous thought have not been widely studied in cognitive neuroscience. It is crucial to expand the research involving spontaneous thought since it benefits human's memory encoding and decision-making abilities. This review has two main aims: the first is to explore the cognitive impact of goal-directed and spontaneous thought; the second is to discover the benefits of spontaneous thought to humans. This paper concludes that spontaneous thought has the role of improving memory encoding and facilitating future planning.

Investigating the appraisal structure of spontaneous thoughts: evidence for differences among unexpected thought, involuntary autobiographical memories, and ruminative thought

Involuntary thinking occurs when mental states arise without intention. Such thoughts can take different forms, such as involuntary autobiographical memories (IAM), ruminative thoughts, and unexpected thoughts—all of which are popular areas of study, albeit in somewhat disparate literatures. Despite these mental states sharing a common thread of feeling involuntary in nature, it is nevertheless unclear what separates them phenomenologically. We conducted a set of exploratory and confirmatory experiments to elucidate the appraisal dimensions behind these forms of involuntary thought, with a particular interest in understanding the phenomenology behind unexpected thoughts that are predicted to violate expectations of both timing and content. Across two experiments, we found that unexpected thoughts had unique appraisal structures compared to the other two forms of involuntary thought: they were less identifiably cued, more surprising in content and timing, and offered new information (i.e., insight). We discuss how these distinctions support recent theories regarding the nature of unexpected thought and its relation to other forms of involuntary thinking, namely IAM and ruminative thought, which are the more commonly studied forms of involuntary thinking.

Coexistence of thought types as an attentional state during a sustained attention task

Some studies have asked participants about attentional state on a scale from on-task to off-task, which set the middle option as attention focused on both, including the possibility of the coexistence of thoughts. In addition, studies using multidimensional probes explicitly assumed coexistence within spontaneous thoughts and task-focus dimensions. Although several studies have assumed the coexistence of some thought dimensions, none has explored whether these are different types of thoughts (task-focus, mind-wandering, task-related, external stimuli-related). To examine whether this coexistence of thought types occurred, we used thought probes to determine the degree of immersion in each. The participants responded to probes presented at random during a sustained attention task. The results revealed a mixture of thought types in many self-reports. In addition, the state of attentional allocation behind self-reports was estimated using the hidden Markov model. We observed the following attentional states: task-focused, task-unrelated, task-related, external stimuli-focused, and task-focused—but also focused on other thoughts. These results suggest that individuals can simultaneously allocate attention to thought types and discriminate between reporting. In some cases, probe options should also be considered for this coexistence. We also examined the relationship between self-reports and behavioral indexes, and discussed the necessity of separately measuring the degree of immersion for each thought type.

Beyond mind wandering: Performance variability and neural activity during off-task thought and other attention lapses

To study the characteristics of attention lapses, a metronome response task and experience sampling were employed while recording fMRI data. Thought prompts queried several attention states (on-task, task-related interference, off-task, inattention). Off-task thoughts were probed on whether they arose in a spontaneous or constrained (i.e., directed) manner. Increased fMRI activation was observed in the default mode network during off-task thought and in subregions of the anterior cingulate cortex and inferior frontal gyrus during inattention. Activation also increased in the left hippocampus during constrained thoughts. Functional connectivity increased between the left superior temporal sulcus and right temporoparietal junction for constrained compared to spontaneous thoughts. Overall, behavioral results indicated a monotonic increase in performance variability from on-task to inattention. However, subtle but consistent differences were observed between self-reported attention state and performance. Results are discussed from perspectives of mind wandering frameworks, the function of brain networks, and the role of engagement in off-task thought.

Predicting the Level of Academic Stress Using Ineffective Attitudes and Spontaneous Thoughts with the Mediation of Mindfulness in Students

Background and Aim: One type of stress related to learning environments is academic stress, which affects millions of students worldwide annually. This study was conducted to predict the level of academic stress using maladaptive attitudes and self-defeating thoughts with the mediating role of mindfulness in high school students in Torkaman city. Methods: The research method was correlation. The statistical population of the study was all high school students in Torkaman city in the academic year 2020-2021. A sample of 361 students was selected using multi-stage sampling. The research instruments included the Gadzela academic stress questionnaire (1991), the Hollon and Kendall self-defeating thoughts questionnaire (1980), the long version of the Weisman and Beck irrational beliefs scale (1978), and the five-factor mindfulness questionnaire by Baer and colleagues (2006). Results: The results of the structural equation modeling indicated a direct relationship between maladaptive attitudes and academic stress (β = 0.42, p < 0.001), an indirect relationship between maladaptive attitudes and academic stress through mindfulness (β = -0.17, P < 0.05), a direct relationship between negative self-defeating thoughts and academic stress (β = 0.4, p < 0.001), and an indirect relationship between negative self-defeating thoughts and academic stress through mindfulness (β = -0.14, P < 0.05). Therefore, the research model was confirmed based on significant indices and fit. Conclusion: This study, by investigating the dimensions of academic stress, negative self-defeating thoughts, and maladaptive attitudes in students, has taken a preliminary step towards creating a psychological therapy model in the future.

Digital daydreaming: Introducing the spontaneous smartphone checking scale

AbstractSmartphones are a ubiquitous part of many people's lives, but little is known about their impact on everyday thought processes. Here we introduce the spontaneous smartphone checking scale (SSCS)—which measures the tendency to direct attention toward one's smartphone, unpreceded by external prompts (e.g., notifications, or alerts) and with no specific conscious goal in mind, as a parallel to mind‐wandering directed toward internal thoughts. The SSCS showed good psychometric properties and construct validity. It separated from measures of daydreaming and mind‐wandering by not loading on dimensions related to self‐consciousness, reflection, and rumination, but instead loading highly on a factor associated with other aspects of digital communication and concerns about public appearance on social media. This suggests that spontaneous smartphone checking serves different mental and social functions than internally generated spontaneous thought processes. We discuss possible long‐term effects of spontaneous smartphone checking taking up time for internally generated spontaneous thoughts.

The effectiveness of acceptance and commitment therapy (ACT) on alexithymia, concern about body image and negative spontaneous thoughts in patients with diabetes in Gorgan city

Background and Aim: Diabetes is one of the chronic diseases in the world. Economic growth, development of urban life, change in lifestyle, obesity and weight gain and decrease in activity of people are of special importance in the occurrence of diabetes. The present study was conducted with the aim of the effectiveness of acceptance and commitment therapy (ACT) on dyslexia, concern about body image and negative spontaneous thoughts in patients with diabetes in Gorgan city. Methods: The research method was quasi-experimental with a pre-test-post-test design with two experimental groups and a control group. The statistical population of this research included female patients aged 20 to 40 with type 2 diabetes who referred to Deziani Diabetes Clinic in Gorgan city in the summer quarter of 2011, their number was about 300. In the following, 30 patients were screened with Bagby et al.'s aphasia questionnaires (1994), Littleton's (2005) body image concerns, and Kendall and Hallon's (1980) negative spontaneous thoughts using purposive sampling as samples. were selected, and were randomly divided into two experimental (15 people) and control (15 people) groups. The subjects of the experimental group underwent acceptance and commitment therapy for 8 sessions (one 90-minute session per week for two months), and the control group did not receive any treatment. At the end of the treatment sessions, the subjects of both groups answered the mentioned questionnaires again as a post-test. Data analysis in this research was done using SPSS version 20 statistical software in two descriptive and inferential sections (MANCOVA multivariate covariance analysis test). Results: The results of data analysis showed that Acceptance and Commitment Therapy (ACT) reduced Alexithymia and its components (difficulty in recognizing emotions, difficulty in describing emotions, externally oriented thinking), body image concerns and Its components (dissatisfaction and shame of the person with his appearance, interference in social functioning), negative spontaneous thoughts and its components (individual incompatibility and desire to change, negative self-concepts / negative expectations, low self-esteem, helplessness) in the subjects of the experimental group in The post-test stage was done. Conclusion: It can be concluded that ACT is effective on alexithymia, concern about body image and negative spontaneous thoughts in patients with diabetes.