In the tradition of acceptance and commitment therapy (ACT), cognitive fusion is a transdiagnostic risk factor and occurs when one becomes overly attached to or "caught up" in their thoughts, leading to a more narrowed behavioral repertoire and difficulty taking effective action in response to life's demands. Cognitive defusion is ACT's curative answer to fusion, and denotes the process of taking a step back, seeing thoughts as "simply thoughts," thereby reducing the negative impact of distressing or anxiety-provoking thoughts. While these components have been widely studied in neurotypical (NT) samples, the purpose of this study was to extend findings to people diagnosed on the autism spectrum (AS). Specifically, this study aimed to examine the impact of cognitive fusion in this population and the effectiveness of a brief defusion technique. Forty-two AS participants and fifty-five neurotypical participants were given a battery of questionnaires measuring psychological distress and dispositional levels of cognitive fusion. Participants were then randomized into either a brief cognitive fusion technique or a brief active distraction technique. In both conditions participants chose a distressing thought and rated it on a visual analogue scale (VAS) in terms of thought discomfort and believability. They were then read a rationale regarding their assigned technique, practiced the technique, and applied the technique to their chosen distressing thought. After the intervention participants immediately re-rated the thought on the same VAS. Throughout the study, participants' heart rate and skin conductance were monitored to determine physiological effects of the conditions. Finally, a follow-up survey was sent at a one-week and two-week follow-up, where participants re-rated the believability and discomfort of their thoughts. Results of this study showed that the AS group had higher overall levels of fusion than the NT group, and that fusion was moderately to strongly related to psychological distress in the AS group and the NT group. In terms of the intervention effects, all interpretation statements must be taken with caution, as there were significant pre-group differences despite randomization. Both defusion and distraction worked equally well in immediately reducing thought believability and thought discomfort for AS and NT groups. Furthermore, treatment effects were maintained at the two-week follow-up period for all groups except for the AS group in the defusion condition. There were no treatment effects for physiology. The current study provides evidence that cognitive fusion may be an important factor in the psychiatric comorbidity that people with AS experience, and a brief technique can be effectively used.

This investigation evaluated the use of multiple exemplar instruction (MEI) to teach perspective-taking skills to adolescents with high-functioning autism. The first experiment used a multiple probe design to examine the use of MEI to teach participants to respond appropriately to the deictic frames of I-You, Here-There, and Now-Then. Participants were instructed and tested using developmentally appropriate perspective-taking protocols, and generalization of perspective-taking skills to a more natural social interaction format was also assessed. The second experiment used a multiple probe design to examine the use of MEI to facilitate defusion from negative thoughts and feelings related to social interaction. Participants were trained to discriminate between different aspects of their own perspective (i.e., self-as-content and self-as-context). Defusion was measured using ratings of the believability and comfort associated with negative thoughts, and the percentage of time engaged in appropriate social interaction was recorded for each participant. Results from Experiment 1 showed the emergence of deictic relational responding in the presence of novel relations for all participants following MEI, and varying degrees of generalization of perspective-taking skills to a natural presentation of social interaction were observed based on the complexity of the deictic relation. Results from Experiment 2 revealed a decrease in believability and an increase in comfort associated with problematic thoughts for all participants following MEI in the absence of directly observed changes in social interaction in the natural environment. These results support the use of MEI as an instructional strategy for teaching perspective-taking skills to individuals with autism. Findings are discussed according to a Relational Frame Theory analysis of perspective-taking.

MAJOR PROFESSOR: Dr. Ruth Anne Rehfeldt The aim of this study was to evaluate the effects of a defusion exercise in combination with perspective- taking interactions as a brief protocol based on the Relational Frame Theory (RFT). The protocol was designed to alter verbal statements about the self through the implementation of training on deictic frames (I-YOU, HERE-THERE, AND NOW-THEN) in conjunction with an exercise of defusion. A pre-post design with a control group was implemented to evaluate the effects of the protocol on the frequency rate of self-as-context and self-as-content statements. Adolescents with disabilities were selected and assigned to each group based on the frequency rate of self-as-content statements. After the assignment of the participants to each group, each participant was interviewed individually through a structured interview aimed at identifying deictic frames and negative statements. Then, participants in the treatment group received the protocol of defusion and deictic frames individually, and participants in the control group received a social skills session on an individual basis. Finally, participants were interviewed individually through an interview based on the identification of deictic relationships and negative statements about the self. Results showed a significant effect in reducing the number of self-as-content statements and increasing the number of self-as-context statements for participants in the treatment group; however, changes did not reach the statistical significance when comparing the post-tests scores between the treatment and control group. Limitations of this study are discussed and future research is recommended.

Det finns lite forskning kring metoder och arbete med par såväl internationellt som i Sverige. Syftet med denna studie har varit att undersöka om tillägg av upplevelsebaserade övningar med fokus på defusion bidrar till ytterligare ökning av den relationella tillfredsställelsen jämfört med traditionell familjerådgivning. Defusion är en av processerna i Acceptance and Commitment Therapy. Studien har bestått av en undersökningsgrupp (n=16, 8 par) som erhållit en work-shop med upplevelsebaserade övningar med fokus på defusion samt en kontrollgrupp (n=16, 8 par). Vi valde att undersöka följande: Finns det en skillnad i utfall vad gäller relationell tillfredsställelse mellan grupperna efter tre sessioner? Finns det en skillnad mellan grupperna vad gäller utfall efter tre sessioner vad gäller: anpassningsförmåga rörande områdena enighet, sammanhållning, tillfredsställelse samt känslouttryck, frekvens av valideringsbeteenden samt grad av kognitiv sammanblandning och upplevelsebaserat undvikande. Resultatet visar på en signifikant skillnad i undersökningsgrupp jämfört med kontrollgrupp avseende sammanhållning samt tillfredsställelse i relationen. Måttliga effektstorlekar har också kunnat påvisas. Slutsatsen som drogs var att denna typ av tillägg vid behandling av par visar lovande resultat och bör väcka intresse för ytterligare forskning och metodutveckling.

No description available.

Para abordar nossa pergunta como se dá a sublimação na melancolia, tomaremos a escrita como modelo sublimatório, acreditando que ela demonstraria, com maior nitidez, os mecanismos que buscaremos descrever. Escolhemos como objeto de nossa investigação teórica, a obra de Ana Cristina César artista carioca, ícone da poesia dos anos 70 no Brasil. A particularidade de sua escrita é o entrelaçamento com sua vida, cuja autobiografia ficcional traz o que acreditamos ser um discurso melancólico. Através de uma leitura sistemática do legado literário e biográfico da autora, cuja escrita transitou entre cartas, poemas, diário e tradução, investigaremos os enlaces e desenlaces entre sublimação e melancolia. Faremos um exame apurado da metapsicologia freudiana da melancolia, do conceito de desfusão pulsional e da sublimação, tentando entender a relação entre as dimensões tópica, dinâmica e econômica. A fim de melhor atingir nossos objetivos traçados, buscamos nosso aporte teórico também nas obras de autores pós-freudianos que se dedicaram ao tema, como, por exemplo, Klein, Winnicott, Lambotte e Rosenberg. Foi realizada uma análise, observando a singularidade da pesquisa que inclui o campos da literatura e da psicanálise. Descobrimos que o processo sublimatório, quando faz uso do trabalho de melancolia, e não do trabalho de luto, aumenta o risco de desfusão pulsional. A partir da investigação da dimensão temporal e das instâncias ideais que possuem características próprias na melancolia, observamos que há uma especificidade da sublimação nesta afecção / In order to better approach our central question, how the sublimation occurs in melancholy, we are going to take writing as a sublimatory model, which pointedly demonstrates the mechanisms that we will try to describe. We have chosen as object of analysis for this theoretical investigation, the work of Ana Cristina César, artist from Rio de Janeiro, iconic in Brazils 1970s poetry. The particularity of her writing is the intertwining with her personal life, whose fictional autobiography surfaces what we believe to be a melancholic discourse. Through a systematic reading of the authors literary and biographical legacy, which covers a variety of genres and forms, such as collections of poetry, diaries, as well as translations, we will persecute the connections and outcomes in the processes of sublimation and melancholy. We are going to do an acute examination of the Freudian metapsychology of melancholy, the concept of pulsional defusion as well as sublimation, in an attempt to understand the relationship between the topic, dynamic, and economic dimensions. Such achievements will not be possible without the contributions of post-Freudian scholars, such as Klein, Winnicott, Lambotte, and Rosenberg, whose works will be our theoretical apparatus. Our analysis observed the particularity of the researche that embrace both the fields of psychology and literature. We have reached the conclusion that when the sublimatory process uses the work of melancholy, not grief, the risk of pulsional defusion increases. Through the investigation of the temporal dimensions and the ideal instances that possess proper characteristics in melancholy, we observed that there is a specificity of sublimation in this condition

Objective: The concept of recovery has become an integral part of modern mental health care. Understanding the outcomes and underlying mechanisms of key recovery interventions, such as Wellness Recovery Action Planning (WRAP), is essential in order to expand the theoretical understanding of recovery and inform how to target recovery in treatment. Therefore a systematic review of the literature was conducted to evaluate the mental health outcomes of WRAP for adults. The empirical study then explored three constructs in relation to WRAP and recovery. These were social problem solving, cognitive defusion and social identification. Method: The systematic review of the mental health outcomes of WRAP was conducted by searching four databases, contacting the authors of WRAP research and seeking evaluative information from organisations that deliver WRAP. Fourteen relevant studies met the inclusion criteria. Whereas, the empirical study recruited participants on a trans-diagnostic basis from across Scotland. Using a quantitative cross sectional design, 109 participant's completed 5 self-report questionnaires. These were the Knowledge, Attitudes and Beliefs about WRAP Questionnaire (WRAP beliefs), the Recovery Assessment Scale - Short (RAS-S), the Social Problem Solving Inventory - Revised - Short (SPSI-R-S), the Four Item Measure of Social Identification (FISI) and the Cognitive Fusion Questionnaire (CFQ). Correlation, regression and mediation analysis were used to explore relationships, and in particular, the predictors and mediators of recovery. Results: The systematic review provided strong evidence that WRAP has a significant positive impact on hope and also reduces the symptoms of mental illness. However, whether WRAP improves personal levels of recovery was unclear and a possible risk of disempowerment was found. Promising preliminary mental health outcomes in the areas of confidence in managing mental health, quality of life, service use, self-advocacy and knowledge attitudes and beliefs about recovery were highlighted. Only studies that did not use peer facilitators failed to find significant increases in hope compared to treatment as usual control groups. In the empirical study, the results indicated that all the constructs examined were correlated to recovery. In the regression analysis, WRAP beliefs, social problem solving and cognitive defusion also demonstrated a predictive relationship with recovery. Mediation analysis indicated that, social problem solving mediated two distinct relationships. One between WRAP beliefs and recovery, and another between cognitive defusion and recovery. The social problem solving subscales also showed how the two predictors relate to recovery through social problem solving in different ways. Social identification with the WRAP group did not significantly predict or mediate recovery. Conclusions: The systematic review indicated having peer facilitators delivering WRAP is key to helping participants foster hope and that a further randomised control trial could help clarify if improved personal recovery is an outcome of WRAP. It additionally suggested how the relationship between WRAP beliefs and recovery could be explored, as per the design of the empirical study. Findings from the empirical study implied that improving participants' social problem solving and cognitive defusion should be specifically targeted in WRAP delivery. The studies combined indicate that to achieve the best recovery results interventions, like WRAP, should target inspiring hope through peer support, improving knowledge, attitudes and beliefs about recovery and cognitive defusion from unhelpful thoughts.

Kognitiv beteendeterapi (KBT) har mest evidens vid social fobi, och på senare år har även guidad självhjälp baserad på KBT visat goda resultat. Acceptance and commitment therapy (ACT) är en del av den tredje vågens KBT och har visat lovande resultat vid ångestsyndrom. Företrädare för ACT har varnat för riskerna med tekniker för att utmana negativa automatiska tankar. Studien syftar till att med en single case experimentell design med multipel baslinje (N=9) studera effekterna av kognitiv omstrukturering (KO) och kognitiv defusion (KD) i form av guidad självhjälp på social ångest, socialt undvikande, psykologisk flexibilitet, defusion, samt frekvens av och trovärdighet hos negativa automatiska tankar. Resultaten visade att KO och KD inte enbart påverkade de processer som teorierna predicerar utan även den andra behandlingens processer.

Para abordar nossa pergunta como se dá a sublimação na melancolia, tomaremos a escrita como modelo sublimatório, acreditando que ela demonstraria, com maior nitidez, os mecanismos que buscaremos descrever. Escolhemos como objeto de nossa investigação teórica, a obra de Ana Cristina César artista carioca, ícone da poesia dos anos 70 no Brasil. A particularidade de sua escrita é o entrelaçamento com sua vida, cuja autobiografia ficcional traz o que acreditamos ser um discurso melancólico. Através de uma leitura sistemática do legado literário e biográfico da autora, cuja escrita transitou entre cartas, poemas, diário e tradução, investigaremos os enlaces e desenlaces entre sublimação e melancolia. Faremos um exame apurado da metapsicologia freudiana da melancolia, do conceito de desfusão pulsional e da sublimação, tentando entender a relação entre as dimensões tópica, dinâmica e econômica. A fim de melhor atingir nossos objetivos traçados, buscamos nosso aporte teórico também nas obras de autores pós-freudianos que se dedicaram ao tema, como, por exemplo, Klein, Winnicott, Lambotte e Rosenberg. Foi realizada uma análise, observando a singularidade da pesquisa que inclui o campos da literatura e da psicanálise. Descobrimos que o processo sublimatório, quando faz uso do trabalho de melancolia, e não do trabalho de luto, aumenta o risco de desfusão pulsional. A partir da investigação da dimensão temporal e das instâncias ideais que possuem características próprias na melancolia, observamos que há uma especificidade da sublimação nesta afecção / In order to better approach our central question, how the sublimation occurs in melancholy, we are going to take writing as a sublimatory model, which pointedly demonstrates the mechanisms that we will try to describe. We have chosen as object of analysis for this theoretical investigation, the work of Ana Cristina César, artist from Rio de Janeiro, iconic in Brazils 1970s poetry. The particularity of her writing is the intertwining with her personal life, whose fictional autobiography surfaces what we believe to be a melancholic discourse. Through a systematic reading of the authors literary and biographical legacy, which covers a variety of genres and forms, such as collections of poetry, diaries, as well as translations, we will persecute the connections and outcomes in the processes of sublimation and melancholy. We are going to do an acute examination of the Freudian metapsychology of melancholy, the concept of pulsional defusion as well as sublimation, in an attempt to understand the relationship between the topic, dynamic, and economic dimensions. Such achievements will not be possible without the contributions of post-Freudian scholars, such as Klein, Winnicott, Lambotte, and Rosenberg, whose works will be our theoretical apparatus. Our analysis observed the particularity of the researche that embrace both the fields of psychology and literature. We have reached the conclusion that when the sublimatory process uses the work of melancholy, not grief, the risk of pulsional defusion increases. Through the investigation of the temporal dimensions and the ideal instances that possess proper characteristics in melancholy, we observed that there is a specificity of sublimation in this condition

No description available.