Group acceptance and commitment therapy (ACT) for bipolar disorder and co-existing anxiety – an open pilot study

Previous studies have supported acceptance and commitment therapy (ACT) for reducing impairment related to various chronic conditions. ACT may possibly be beneficial for bipolar disorder (BD) with co-existing anxiety, which is associated with a poorer treatment outcome. Efforts are needed to identify suitable psychological interventions for BD and co-existing anxiety. In this open clinical trial, we included 26 patients with BD type 1 or 2 at an outpatient psychiatric unit specializing in affective disorders. The intervention consisted of a 12-session manualized group treatment that included psychoeducation, mindfulness, engaging in values-based behaviour, cognitive defusion, acceptance and relapse prevention modules. Participants completed four self-report questionnaires covering anxiety symptoms (Beck Anxiety Inventory - BAI), depressive symptoms (Beck Depression Inventory - BDI-II), quality of life (Quality of Life Inventory - QOLI) and psychological flexibility (Acceptance and Action Questionnaire - AAQ-2) before, during and after the treatment. At post-treatment, the participants reported significant improvements in all outcome measures, with large effects (Cohen’s d between 0.73 and 1.98). The mean reduction in anxiety symptoms was 45%. At post-treatment, 96% of the patients were classified as responders on at least one of the outcome measures. A limitation is that the trial is uncontrolled. The results suggest that ACT has the potential to be an effective treatment for BD patients with co-existing anxiety. Further randomized studies are warranted.     

Therapeutisches Gruppenprogramm für Stalking-Opfer

Stalking victims show a high level of psychological disturbance and frequently need professional help. Thus, stalking must be considered as a serious issue in the field of psychosocial care. However, specific intervention programs to support stalking victims are not available. This paper reports on a pilot project that offers therapeutic help to stalking victims via a structured outpatient group therapy approach. The program aims at setting up appropriate behavior patterns concerning contact with the stalker, strengthening the victims’ self-efficacy and developing coping strategies for stalking-related stress situations. To investigate the effectiveness of the group program, an evaluation study has been conducted using self-report inventories, interview data and biological parameters. Preliminary results from 4 completed groups with 13 participants, indicating that the approach is highly effective, are reported. The potential of the group approach to improve psychosocial care provision for stalking victims is discussed. The need to integrate psychotherapeutic approaches into a multi-professional support system for stalking victims, comprising legal counsel, police measures and psychosocial interventions, is emphasized.     

Incentivizing physical activity using token reinforcement with preschool children

We combined several single‐subject designs to assess the effects of contingent and noncontingent token reinforcement on moderate‐to‐vigorous physical activity (MVPA) exhibited by 4 preschool‐aged children. Higher overall levels and longer bouts of MVPA reliably occurred when tokens were delivered contingent on MVPA for 3 of the 4 children when compared to baseline (no token) and for 2 of the 4 children when compared to noncontingent‐token conditions. The present study demonstrated that the delivery of tokens contingent on MVPA can increase and maintain MVPA exhibited by preschool‐aged children, resulting in more MVPA than in baseline conditions and conditions in which tokens are awarded without respect to MVPA. These results demonstrate that token economies can be used to increase MVPA and they add to the evidence base supporting the use of token economies to address a range of behavior problems.     

Lacking power impairs executive functions

Four experiments explored whether lacking power impairs executive functioning, testing the hypothesis that the cognitive presses of powerlessness increase vulnerability to performance decrements during complex executive tasks. In the first three experiments, low power impaired performance on executive-function tasks: The powerless were less effective than the powerful at updating (Experiment 1), inhibiting (Experiment 2), and planning (Experiment 3). Existing research suggests that the powerless have difficulty distinguishing between what is goal relevant and what is goal irrelevant in the environment. A fourth experiment established that the executive-function impairment associated with low power is driven by goal neglect. The current research implies that the cognitive alterations arising from powerlessness may help foster stable social hierarchies and that empowering employees may reduce costly organizational errors.     

Getting a grip on your feelings: effects of action orientation and external demands on intuitive affect regulation

The authors propose that volitional action is supported by intuitive affect regulation, defined as flexible, efficient, and nonrepressive control of own affective states. Intuitive affect regulation should be most apparent among action-oriented individuals under demanding conditions. Consistent with this, a demanding context led action-oriented individuals to down-regulate negative affect in self-reports (Study 1), in an affective Simon task (Study 2), and in a face discrimination task (Study 3). In line with the idea that intuitive affect regulation is guided by top-down self-regulation processes, intuitive affect regulation in a face discrimination task was mediated by increases in self-accessibility (Study 3). No parallel effects emerged among action-oriented participants in a nondemanding context or among state-oriented participants.     

A Reminiscence

The founding of the William Carlos Williams poetry competition for medical students is recounted. A few highlights from its nearly twenty-five years of operation are offered. Gleanings from the hearts and souls of some of the winning poets are shared.     

Author Index Volume 5

Authors Index

Author Index Volume 5     

Review and book note

Frank Whaling (ed.), Contemporary approaches to the study of religion: Vol. I, the humanities (ix + 492 pp., 1984); Vol . II, The Social Sciences (ix + 302 pp., 1985), Berlin, Mouton

Roy Wallis and Steve Bruce, Sociological Theory, Religion and Collective Action. Belfast, The Queen's University, 1986, xi + 395 pp.     

Conceptual Combinations and Subsequent Creativity

Conceptual combination has been advocated as an important component of creativity, but relatively little research has investigated its importance. Two experiments were designed to extend previous research on the relationship between performance on conceptual combination tasks and subsequent performance on creativity tasks. Both experiments involved the generation of category exemplars and manipulated the type of conceptual combination experience and whether the items presented were related or unrelated to one another. In the first experiment, this was followed by a brainstorming task (divergent thinking) and in the second experiment by a creative problem solving task (convergent thinking). Contrary to expectations, the condition that required conceptual combinations did not enhance the generation of the number and originality of exemplars. As predicted, exposure to unrelated items led to more original products than related ones. The conceptual combination task with related items was predictive of performance on the creative problem solving task but not the divergent thinking task. Performance on the divergent task was related to the generation of exemplars for unrelated items. These results suggest that the conceptual combination task taps creative problem solving rather than divergent creativity.