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.     

Adolescents' perceived ability to say "no" to unwanted sex

The authors examined the degree to which adolescents believe they can resist a dating partner's verbal pressure to have sex when they themselves really do not want to. 2472 10th-grade students of mean age 15.5 years from eight public high schools in Dade County, Florida, participated in the study. 49% were male, 27.8% White, 38.2% Hispanic, and 27.7% Black. 50.1% reported having ever experienced sexual intercourse. The female students were found to be more likely than males to believe that they could refuse unwanted sex. No consistent differences were found along ethnic and racial lines. The multivariate analysis identified the following as predictors of the ability to refuse sex: a less-permissive attitude toward sex, the low importance of peer influence, and, for females, a generalized sense of self-efficacy.     

How much self-presentation behavior do applicants from the United Arab Emirates exhibit?

Applicants from different cultures vary in their self-presentation behavior during job interviews. This study investigates self-presentation behavior in the United Arab Emirates (UAE), the second largest economy in the Arab world. Specifically, it examines self-presentation behavior of applicants from the UAE and compares it to the behavior of American, European, and Chinese applicants from previous studies. The randomized response technique was used to gather self-presentation prevalence data of 111 UAE applicants regarding self-presentation behavior in their last job interview. Prevalence rates were lower than those from the United States and from China but higher than those from Iceland and from Switzerland. Results indicate that though UAE culture values modesty, UAE applicants still engage in distinct self-presentation behavior.     

Longitudinal associations between mindfulness and well-being in people with multiple sclerosis

Background/Objective: Depression, anxiety, fatigue, and sleep problems are typical conditions reported in people with multiple sclerosis (MS), often resulting in a reduction of their quality of life (QOL) and well-being. Mindfulness is a multifaceted and complex construct that has been increasingly explored for its correlated to well-being. Despite preliminary evidence, longitudinal data about the impact of mindfulness on QOL in MS remain limited. In addition, Langerian mindfulness, one of the prominent approaches to mindfulness, is yet unexplored in this field. The study aims to examine the longitudinal relationships between two forms of mindfulness (Langerian and contemplative) and QOL, anxiety, depression, fatigue, and sleep. Method: Within a larger randomized controlled trial of an online mindfulness-based stress reduction intervention, a cohort of 156 people with MS was recruited and assessed for both mindfulness constructs, QOL, anxiety, depression, fatigue, and sleep problems. Assessments were repeated after 2 and after another 6 months. Results: Both mindfulness constructs were highly correlated with all investigated outcomes. Both Langerian and contemplative mindfulness predicted higher QOL, lower anxiety, depression, fatigue, and sleep, over time. Conclusions: In both approaches dispositional mindfulness is a protective factor against depression, anxiety, fatigue, and sleep in people with MS.     

Reducing Stereotyping Through Mindfulness: Effects on Automatic Stereotype-Activated Behaviors

We assessed whether mindfulness (active categorization) can prevent automatic stereotype-activated behaviors related to the elderly. Eighty participants (mean age = 24.4) were given a set of photographs to prime the dimension Old Age and were asked to categorize them multiple times, to see whether the effect of the prime could be reduced through increased mindfulness. Participants were randomly assigned to one of four conditions, where they were asked to categorize the photographs across (1) four self-generated categories; (2) four assigned categories; (3) a single category—Gender; or (4) a single category—Age. Participants’ walking speed (cf. Bargh et al. 1996, Experiment 2) was then measured, as they moved between the two experimental stations. The results show that greater mindfulness predicted greater walking speed, indicating a decrease in the effect of the automatic stereotype-activated behavior.

When linking is stronger than thinking: Associative transfer of valence disrupts the emergence of cognitive balance after attitude change

The present research investigated the role of cognitive balance vs. associative transfer of valence in attitude change. Participants first formed positive or negative attitudes toward several source individuals. Subsequently, participants were shown source–target pairs along with information about the source–target relationship (‘likes’/‘dislikes’). Afterwards, participants’ attitudes toward the sources were changed by means of information that was opposite to the initially induced attitude. In a control condition, initial source attitudes remained unqualified. Results in the control condition showed that initially formed attitudes and available relationship information produced target evaluations that were consistent with the notion of cognitive balance. However, when attitudes toward the sources changed, target evaluations directly matched attitudes toward individually associated sources, irrespective of the relation between source and target. These results suggest that associative transfer of valence can disrupt the emergence of cognitive balance after attitude change.     

演绎推理的形式和内容启动加工

聚焦推理加工初期,研究通过指导语操控主观加工倾向,考察不同指导语条件下内容可信度和形式有效性对演绎推理结果的影响,检验内容和形式两类加工过程的启动加工动态变化性。结果表明,指导语条件显著影响推理初期加工。在无提示指导语和形式判定指导语条件下,推理结果受到了形式有效性和内容可信度的影响;内容判定指导语下只受到了内容可信度的影响。证明主观加工倾向影响了内容和形式的启动加工关系,支持了动态变化性的假设。     

Stigma,staring, and discomfort: A novel-stimulus hypothesis

Three experiments were conducted in order to assess the validity of the novel-stimulus hypothesis as an explanation for why people who are physically different (i.e., novel) are avoided. The hypothesis states that avoidance is mediated by conflict over a desire to stare at novel stimuli and a desire to adhere to a norm against staring when the novel stimulus is another person. In the first two field experiments, subjects viewed photographs of novel (handicapped or pregnant) and familiar (physically normal) people under conditions where staring was sanctioned or not. It was found that staring increased with novelty when staring was unobserved (sanctioned); however, the reverse obtained when an observer was present. In the third experiment, subjects interacted with a crippled, pregnant, or physically normal partner. Half of the subjects were first given the opportunity to observe their partner through a one-way mirror. The reduction in stimulus novelty for this group resulted in reduced avoidance. The question of whether such avoidance of the disabled results from feelings of dislike or disgust as previously suggested, or from discomfort created by novelty, is discussed.     

Transcendental meditation, mindfulness, and longevity: an experimental study with the elderly

Can direct change in state of consciousness through specific mental techniques extend human life and reverse age-related declines? To address this question, 73 residents of 8 homes for the elderly (mean age = 81 years) were randomly assigned among no treatment and 3 treatments highly similar in external structure and expectations: the Transcendental Meditation (TM) program, mindfulness training (MF) in active distinction making, or a relaxation (low mindfulness) program. A planned comparison indicated that the "restful alert" TM group improved most, followed by MF, in contrast to relaxation and no-treatment groups, on paired associate learning; 2 measures of cognitive flexibility; mental health; systolic blood pressure; and ratings of behavioral flexibility, aging, and treatment efficacy. The MF group improved most, followed by TM, on perceived control and word fluency. After 3 years, survival rate was 100% for TM and 87.5% for MF in contrast to lower rates for other groups.