Acceptance and Commitment Therapy for Anxiety Disorders: Three Case Studies Exemplifying a Unified Treatment Protocol

Acceptance and Commitment Therapy (ACT) is an innovative acceptance-based behavior therapy that has been applied broadly and successfully to treat a variety of clinical problems, including the anxiety disorders. Throughout treatment ACT balances acceptance and mindfulness processes with commitment and behavior change processes. As applied to anxiety disorders, ACT seeks to undermine excessive struggle with anxiety and experiential avoidance––attempts to down-regulate and control unwanted private events (thoughts, images, bodily sensations). The goal is to foster more flexible and mindful ways of relating to anxiety so individuals can pursue life goals important to them. This article describes in some detail a unified ACT protocol that can be adapted for use with persons presenting with any of the major anxiety disorders. To exemplify this approach, we present pre- and posttreatment data from three individuals with different anxiety disorders who underwent treatment over a 12-week period. The results showed positive pre- to posttreatment changes in ACT-relevant process measures (e.g., reductions in experiential avoidance, increases in acceptance and mindfulness skills), increases in quality of life, as well as significant reductions in traditional anxiety and distress measures. All three clients reported maintaining or improving on their posttreatment level of functioning.     

Affect dynamics,bereavement and resilience to loss

This investigation applied Zautra and colleagues’ Dynamic Model of Affect (DMA; Zautra: 2003, Emotions, Stress and Health (Oxford University Press, New York); Reich et al.: 2003, Review of General Psychology 7(1), pp. 66–83) to help understand resilience among a sample of middle-aged participants coping with the recent death of a spouse or child. We replicated and extended this model by examining interaffect correlations (individual correlations between negative and positive affect over time) in resilient versus symptomatic bereaved people. As predicted by the DMA, resilient bereaved had weaker (or less negative) interaffect correlations than symptomatic bereaved even when controlling for self-reported distress. These findings suggest that resilient individuals possess a capacity for a more complex affective experience and that this capacity serves a salutary function in the aftermath of aversive life events. The research described in this article was supported by a grant from the National Institute of Health, R29-MH57274 (George A. Bonanno).     

Intra‐sentential context effects on the interpretation of logical metonymy⋆

Verbs such as enjoy in the student enjoyed the book exhibit logical metonymy: enjoy is interpreted as enjoy reading. Theoreticalwork [Computational Linguistics 17 (4) (1991) 409; The Generative Lexicon, MIT Press, Cambridge, MA, 1995] predicts that this interpretation can be influenced by intra‐sentential context, e.g., by the subject of enjoy. In this article, we test this prediction using a completion experiment and find that the interpretation of a metonymic verb is influenced by the semantic role of its subject. We present a Bayesian model that accounts for the interpretation of logical metonymy and achieves a good fit on our experimental data. We show that the parameters of the model can be estimated from completion data or from corpus data.     

Acting or listening: Adult age differences in source recall of enacted and nonenacted statements

This study explored age-related differences in item and source recall of enacted and nonenacted items in a sample of healthy adults between the ages of 35 and 80 years (N=1,000). Participants were screened on a variety of demographic, psychometric, and biological variables. They were presented with sentences (e.g., Lift the book) that they either read or enacted. They were then asked to recall the object of each stimulus sentence (item recall) and to identify its format of encoding (source recall). Age-related decrements were observed both in item and source memory, although age differences in source memory were more accentuated than in item memory. Further, the results indicated an overall impairment of source memory across age when individual differences in the demographic, psychometric, and biological variables were taken into consideration.     

Psychosocial correlates of eczema in a non-treatment-seeking population

Data from the Vietnam Experience Study were used to examine psychosocial correlates of eczema. Based upon the results of dermatologic examinations, three groups of male veterans were identified: (a) subjects with eczema (n = 80), (b) subjects with tinea (n = 282), and (c) subjects with no medical diagnosis (n = 176). These three groups were compared on measures of anxiety, depression, hostility, and social support. The Diagnostic Interview Schedule (Version III-A) was used to determine diagnoses of anxiety and depression and level of social support. MMPI Scales 2 and 7, the Wiggins content scale of Depression, and the Cook-Medley Hostility Scale were used to assess anxiety, depression, and hostility. Eczema subjects did not differ from tinea or no-disease control groups on dependent measures. These results are contrasted with previous studies of treatment-seeking patients, which showed greater prevalence of anxiety and depression among individuals with eczema. Directions for future research are suggested.This paper is taken from the first author's dissertation.