The present study extends the prior research on cognitive defusion byexamining behavioral change on a simulated slot machine. Participants wereexposed to an on-line slot machine fully manipulated by an experimenter. Arandomized control pretest-posttest design was used to assess the differences ingambling persistence and risk across groups (Defusion Control, Defusion withoutInformation, and Defusion with Information). Results yield a statisticallysignificant difference in persistence across time and a non-statistically significantdifference in risk across time. Findings from this study suggest that defusionexercises, when combined with accurate gambling related information, may helpreduce persistence of gambling behavior.

The current study tested the utility of the Implicit Relational Assessment Procedure (IRAP) as an analogue cognitive defusion intervention to alter implicit attitudes toward Abraham Lincoln and Adolf Hitler. One-hundred and twelve participants were randomly assigned to either a control or defusion condition. Participants first completed a series of self-report measures assessing psychological functioning and distress, as well as attitudes toward Lincoln and Hitler. Control condition participants then completed three IRAPs measuring implicit attitudes toward Hitler and Lincoln (H/L IRAP). Defusion conditions participants completed a pre-intervention H/L IRAP, received a rationale for defusion before completing a defusion IRAP, and then completed a post-intervention H/L IRAP. All participants finished the study by completing a second set of self-report measures. Results of the study indicated that when taking into account participant knowledge of defusion there were significant differences in IRAP performance post-intervention between conditions, although there were no significant differences in performance pre- to post-intervention within the defusion condition. Additionally, there were no differences between conditions on self-report measures at either time point, suggesting the IRAP was sensitive to changes in participant attitudes that self-reports were unable to detect. Thus, the results of this study indicate that the IRAP is a viable analogue defusion intervention, and future research should look to expand the defusion effect produced by the IRAP.

The current study tested the effects of a cognitive defusion intervention on implicit attitudes toward milk and lemon as measured by the Implicit Relational Assessment Procedure (IRAP). One-hundred and eleven participants were randomly assigned to one of four conditions: control math, control defusion, half defusion, or full defusion. Participants filled out a series of self-report measures at the beginning of the study on psychological functioning, as well as attitudes toward milk and lemon. Participants then completed a task specific to their condition, with control math participants completing a simple math task while defusion conditions completed a defusion intervention – word repetition technique (WRT) – for certain words. The control defusion condition completed the WRT for the words “car” and “rabbit,” the half defusion condition completed the WRT for the word “milk,” and the full defusion condition completed the WRT for the words “milk” and “lemon.” After completing the condition specific tasks, all participants completed a milk/lemon IRAP that included the words “milk” and “lemon” and pictures of milk and lemon. All participants finished the study by completing a final set of self-report measures. Results of the study indicated that IRAP performance was not significantly different between conditions following various levels of a defusion intervention. However, results showed that the pattern of IRAP response latencies did significantly vary between conditions, but this effect was driven by a significant difference on a single response latency between two conditions suggesting this finding is an artifact. Thus, the current study cannot conclude that a defusion intervention can significantly affect implicit attitudes towards common objects, and any future research should consider applying a defusion intervention to clinically relevant stimuli to further assess for defusion effects in the IRAP.

Aim: This thesis describes the development and initial validation of a questionnaire to measure Hayes, Strosahl and Wilson’s (1999) constructs of cognitive fusion and cognitive defusion. Within the literature there is currently no specific measure of these constructs. Design and Method: Principal Component Analysis was conducted on two independent samples (Study One n = 425 and Study Two n = 167). Reliability analyses were conducted for both Study One and Study Two and validation analyses were conducted in Study Two. All participants in both studies completed the Cognitive Fusion Questionnaire (CFQ). Participants in Study Two completed additional measures related to their satisfaction with life, their beliefs about worry, mindful responding to unpleasant thoughts and images and levels of experiential avoidance. Results: The final solution revealed a two component fifteen item questionnaire accounting for 54% of the variance. Based on item content, the components were labelled fusion and defusion. The items within the questionnaire reflected Hayes et al. (1999) constructs of cognitive fusion and cognitive defusion. Internal consistencies as measured by Cronbach’s alpha were .91 (fusion), .71 (defusion) and .88 (total scale). The measure correlated moderately to highly and in the expected directions with questionnaires measuring individual beliefs about worry, mindful responding to unpleasant thoughts and images and levels of experiential avoidance. Similarly, there was a significant negative correlation between the current questionnaire and a measure related to satisfaction with life. Conclusions: The findings of the above research provide initial support for the CFQ. The results show support for the validity of the scale including content and convergent validity of the CFQ.

Background: The aim of this thesis was to provide a systematic examination of the potential of a Verbal Thought Disruption Technique (VTDT) in reducing ruminative and intrusive thoughts (RATs). Thought Suppression (TS) is a commonly used tactic to deal with RATs. In contrast, very little is known about VTDT as a specific cognitive defusion technique in particular, or as a cognitive behavioural technique in general. Methodology: A mixed methods case series design was used for this project. 10 individuals were involved over a 12-week period. An ABACAB design was utilised in which each individual received no intervention (A), a VTDT intervention (B) and a TS intervention (C) over the course of the study. Change was monitored quantitatively utilising the Meta-Cognitive Questionnaire-30 (MCQ-30), Thought Control Questionnaire (TCQ) and the General Health Questionnaire (GHQ). Additionally the measures were also completed at a one-month follow-up alongside the completion of Client Change Interview Protocol. The quantitative data was analysed by calculating the effect sizes of the reported change and the qualitative data analysed by thematic analysis. Results: Use of VTDT appeared to have a positive impact on RATs five MCQ-30 sub-measures (Cognitive Confidence, Need for Control, Cognitive Self-Consciousness, Positive and Negative Beliefs). VTDT use showed a positive impact as measured by the TCQ in four areas Distraction, Punishment Re-appraisal and Worry. The GHQ showed positive effects for VTDT use in the areas of Anxiety and Insomnia, and Social Dysfunction. TS had a negative impact on all measures. VTDT decreased numbers of RATs and severity of Subjective Units of Distress (SUDs) and TS increasing them, indicating a beneficial effect for VTDT and a detrimental effect for TS. The size of this effect was greater on SUDs than on RATs. Qualitative analysis at follow up identified factors that supported the use of VTDT and of the lack of utility of TS protocols to deal with RATs. Moderating factors for the first technique were found in the lack of willingness of some participants to use it in the future. A new working model of RATs was proposed. Conclusions: Conclusions reached are that VTDT may be a useful addition to an already wide range of cognitive defusion techniques already used in Acceptance and Commitment Therapy (ACT), and that it deserves further systematic research. TS, as previously found, appeared not to be a useful technique in dealing with RATs on most of the measures used.

The current study examined the effectiveness of a computer-based cognitive defusion intervention on the degree of believability and discomfort of problematic thoughts in two adolescents and one young adult with Autism Spectrum Disorder (ASD) using a multiple probe design across participants. Participants identified a problematic thought that they often had during social interactions with peers which was then targeted throughout the intervention. Primary measures included rating scales for thought believability and discomfort and criterion for therapeutic change was a 30-increment decrease in the mean average of rating scores from baseline levels for three consecutive intervention sessions. Results demonstrated a significant change in the believability of one participant's thought believability that met the therapeutic criterion. However, the remaining participants' rating scores following the intervention did not decrease below the criterion. Secondary measures for cognitive fusion, psychological inflexibility, and mindfulness included the AAQ-II, BAFT, CFQ, and CAMM pre and posttests. Results from these pre and posttest measures did not indicate a significant therapeutic change following treatment. More research is needed to examine the effectiveness of an automated defusion intervention with this population.

No description available.

Tinnitus is a highly prevalent health condition creating moderate or severe interference on mood, sleep and daily functioning for a group of those affected. The aims of this thesis were 1) to explore the role of acceptance and psychological flexibility in understanding tinnitus interference both experimentally and with a longitudinal design 2) to evaluate the immediate and long-term outcomes of an acceptance based behaviour therapy (Acceptance and Commitment Therapy; ACT) in the treatment of people with tinnitus and, 3) to investigate the relationship between treatment outcome and processes assumed to be the active ingredients of treatment (acceptance and cognitive defusion). Study I (n=47) was an experiment comparing the impact of acceptance to that of thought suppression or a neutral instruction on the ability to maintain attention on an imagery task. Results indicated that participants could benefit from an acceptance strategy when performing the task. Study II (n=47) was a longitudinal trial studying the mediating role of acceptance on the relationship between tinnitus interference at baseline and tinnitus interference, anxiety, life quality, and depression at a seven-month follow-up. Full mediation was found for life quality and depression, and partial mediation for tinnitus interference. Study IV (n=64) was a randomised controlled trial evaluating the immediate and long-term effects of ACT in comparison to those of Tinnitus Retraining Therapy (TRT) and to a wait list control. Results showed that ACT had large immediate effects on tinnitus interference in comparison to wait list, and medium long-term effects in comparison to TRT. Results were also seen on secondary outcome. Self-reported tinnitus acceptance significantly mediated the immediate outcome of ACT. Study III (n=24) was a process study where the video recorded sessions of ACT from study IV were observed and rated with regard to client behaviour. Results showed that in-session acceptance and defusion behaviours rated early in therapy were predictors of sustained positive treatment effects of ACT. These associations continued to be substantial even when controlling for the prior improvement in outcome. This whereas prior symptom change could not predict process variables rated late in therapy. Participants in all trials were chronic tinnitus patients, mainly from different departments of audiology. These findings implicate that 1) acceptance and psychological flexibility may contribute to the understanding of tinnitus interference 2) ACT can reduce tinnitus interference in a group of normal hearing tinnitus patients and 3) acceptance and cognitive defusion are important processes in ACT, related to outcome. / Tinnitus är ett mycket vanligt hälsoproblem där en grupp av de drabbade upplever påtagliga besvär såsom påverkan på sömn, välbefinnande och funktionsnivå. Denna avhandlings syften var att 1) utforska den roll acceptans och psykologisk flexibilitet har för förståelsen av tinnitusbesvär såväl experimentellt som med en longitudinell design 2) utvärdera de omedelbara och långsiktiga effekterna av en acceptansinriktad beteendeterapi (Acceptance and Commitment Therapy; ACT) vid behandling av personer med tinnitus samt 3) undersöka relationen mellan behandlingsutfall och processer som antas utgöra behandlingens aktiva komponenter (acceptans och kognitiv defusion). Studie I (n=47) var ett experiment där man jämförde förmågan att bibehålla uppmärksamheten på en mental bild vid tre olika betingelser: acceptans, tankesuppression eller en neutral betingelse. Resultaten indikerade att deltagarna som slumpats till acceptans var hjälpta av denna strategi i genomförandet av uppgiften. Studie II (n=47) var en självrapportstudie med longitudinell design där det undersöktes om acceptans fungerade som en mediator i sambandet mellan tinnitusbesvär i baslinjen och livskvalitet, depression, ångest och tinnitusbesvär vid en uppföljning efter sju månader. För variablerna livskvalitet och depression visade resultaten en fullständig mediation och för tinnitusbesvär en partiell mediation. Studie IV (n=64) var en randomiserad kontrollerad prövning av de omedelbara och långsiktiga effekterna av ACT i jämförelse med Tinnitus Retraining Therapy (TRT) och en väntelistekontrollgrupp. Resultaten visade att ACT hade en stor omedelbar effekt på tinnitusbesvär i jämförelse med väntelistan och en medelstor effekt i jämförelse med TRT. Även sekundära utfallsmått visade på effekter. Utfallet i ACT medierades av självrapporterad acceptans av tinnitus. Studie III (n=24) studerade processer i ACT-behandlingen genom observation och skattning av klientbeteenden under de videoinspelade sessionerna. Resultaten visade att klienternas acceptans- och defusionbeteende under sessioner tidigt i terapin predicerade det långsiktiga utfallet i behandlingen. Dessa samband kvarstod även när man kontrollerade för symtomförbättring fram till den skattade sessionen. Detta medan tidigare symtomförbättring inte predicerade klientbeteende senare i behandling. Deltagare i samtliga studier var patienter med kronisk tinnitus, huvudsakligen rekryterade från reguljär hörselvård. Resultaten från dessa studier indikerar att 1) acceptans och psykologisk flexibilitet kan bidra till förståelsen av tinnitusbesvär 2) ACT kan minska tinnitusbesvär hos en grupp normalhörande patienter 3) acceptans och kognitiv defusion är viktiga processer i ACT vilka är relaterade till behandlingutfallet.

The present study used a basic behavioral paradigm derived from Relational Frame Theory (RFT), a contemporary behavioral account of language and cognition, to validate principle-based definitions of the cognitive interventions of defusion and reappraisal. Ninety-one participants first underwent an RFT learning paradigm that established symbolically generalized avoidance. Participants were then randomized to a defusion, reappraisal, or control condition. The main outcomes were equivalence responding—indicative of the trained relational network and analogous to the content of cognition—and avoidance—analogous to the behavioral impact of cognition. Defusion and reappraisal significantly reduced avoidance responding, providing support for the hypothesis that these interventions target the behavior of relational framing. Mediation analyses, conducted on an exploratory basis, revealed differences between the mechanisms of defusion and reappraisal and provided preliminary support for the classification of these interventions as a functional context intervention and a relational context intervention, respectively.

This dissertation is structured around three original studies that offer unique insights into the challenges of change in business-to-business markets. All three studies share as an important starting point that firms rely on other firms to achieve strategic flexibility in volatile business environments. This means that firms source critical resources from business relationships in order to reduce long-term investments in times of change. From this perspective, firms' competitive advantages cross the boundaries of the firm and are embedded in their business partner networks. Thus, firms' business relationships and networks have become an important locus of organizational change in order to respond to turbulence in firms' business environments. Study one of this dissertation recognizes the importance of supplier relationships as a mechanism to react to changing business environments. The article focuses on the dynamic capabilities that enable firms to structurally reconfigure their supplier portfolios or supply networks in order to access necessary resources. The framework of relationship management capabilities introduced, is structured around three important sub-dimensions: relationship initiation, development, and ending capabilities, which collectively enable a firm to manage the reconfiguration of resource portfolios accessed via supplier relationships. The key implication for management relates to thinking beyond firms' established supply chains in times of change. While to a certain degree change can be absorbed within firms' existing supply chains, there might be a need to be 'agile', i.e. search for other suppliers who are better suited to more efficiently and effectively address such changes affecting firm competitiveness in the long run. While study one highlights the importance of firms' agility in adapting their supply chains in response to changes in their business environment, study two of this dissertation, although with a focus on the demand side of the business model, addresses the managerial challenges associated with such an agile adaptation process. Study two conceptualizes a framework for business model change and provides managers guidance to approach business model redesign. In particular, study two focuses on service business models and introduces the concepts of service infusion and defusion as important processes of business model redesign. The service infusion and defusion framework provides a pragmatic and systematic approach to understanding the nature of the business model change that companies have to manage, as well as linking these changes with knowledge creation and transfer processes. These are shown to be key for successfully managing such a business model redesign. While studies one and two assume strategy and its implementation to be key to a successful response to changes in firms' business environment, study three draws attention to the difficulties of arriving at such an appropriate or fitting response strategy in the first place, given the available information. In particular, this study examines the link between sensing changes in firms' business environments and managerial decision making in the form of strategy choice. Thereby, the study shows that strategy change causes disruptions, which eventually affect firm performance. This effect is compounded with increasing sensitivity to change as well as increasing number of factors that trigger change, and thus impairs the long term benefits of such strategy change. Thus, the effectiveness of strategy or business model changes and their implementation is inevitably contingent on distinguishing key signals from noise that disturb or misguide firms' strategic decisions.