A large body of research has examined the appropriate time course of psychotherapy across a variety of therapeutic modalities. Research in the area of Acceptance and Commitment Therapy (ACT) has indicated the efficacy of single-session interventions in improving anxiety, depression, and even weight loss. These findings, though promising, are accompanied by the question of how much ACT is enough to make a statistically and clinically significant difference in symptoms. The present study sought to clarify this question among individuals with depression. Adults (N = 271) with elevated depressive symptoms were recruited via mass emails for a study comparing the relative effectiveness of time-variant single-session ACT interventions (90 minutes, 3 hours, 6 hours). Inclusion criteria included PHQ-8 score 10, no history of TBI, no current psychotherapy, and no medication changes in the past 60 days. Eligible participants completed a screening interview, which included modules from the M.I.N.I. Exclusion criteria included active suicidality, past or current mania, and past or current psychoses. If interested in participating (n=351), eligible participants could complete the baseline measure after enrolling in the study. Participants were randomized to a single-session 90-minute, 3-hour, or 6-hour group ACT intervention. About half (51.2%) of enrolled and randomized participants completed their assigned group intervention. Follow-up assessments were completed at 1-month and 3-months post-intervention with limited attrition. Longitudinal mixed-effects modeling was used to examine change over time and between conditions. Findings indicated that depressive symptoms and avoidance decreased over time, and social satisfaction increased over time. Differences between conditions and interactions between time and condition were not observed. Equivalency analyses revealed that the 3- and 6-hour groups were not within the margin of equivalence in terms of depressive symptoms. Mindfulness analyses revealed that at 3-month follow-up, the 3- and 6-hour groups reported higher mindfulness than the 90-minute group. The findings have public health implications in terms of reaching a larger number of patients with increased efficiency. Given the far greater patient demand than number of therapists available, increased access and efficiency are of great importance. The results also suggest that individuals with depression can make rapid, sustainable changes, and this is of critical importance clinically. Limitations included a homogenous sample of primarily white, highly educated females, and the lack of a no-treatment control group. The findings of the current study indicate that brief group ACT interventions can result in change in both processes (avoidance, mindfulness) and functioning (depressive symptoms, social satisfaction) months after the single-session intervention. Future research should examine the effectiveness of brief interventions with other symptomatology as compared to a no-treatment control or a more traditional course of psychotherapy.

While there is evidence to support the efficacy of mindfulness-based treatment for substance use, the mechanisms through which they lead to therapeutic outcomes have received less attention. A growing body of literature suggests that the ways in which people respond to cravings may be an important mediator of change. Individuals with substance use problems may use them to cope with or avoid negative experiences, which could include the experience of craving itself. Thought suppression in particular has been investigated as a specific form of experiential avoidance, and findings suggest that thought suppression strategies may interfere with attempts to quit using substances. While mindfulness training should be expected to reduce the tendency to suppress or avoid cravings, evidence to support this expectation is limited, largely because no measures yet exist that assess the suppression of craving. Therefore, the purpose of the present study was to develop a self-report measure of the suppression of craving. Existing measures of other types of thought suppression and experiential avoidance were examined to identify items that could be adapted for use in the Craving Suppression Scale (CSS). To assist with the item development process, a focus group was also conducted at a local residential treatment facility. Participants were asked to discuss what they do when they are experiencing cravings and what thoughts go through their minds when cravings come up. Their responses were used to guide content development for the CSS items. Items were developed for two sub-scales: suppression of craving and beliefs about craving. Items were administered to a sample of inpatients in substance use treatment and an online sample of individuals reporting current or previous substance use problems (total N = 208). Factor analysis of the remaining items supported a two-factor structure for the CSS as hypothesized. Relationships were examined between the CSS and other measures of other forms of experiential avoidance/suppression, craving, and emotional distress. The CSS scales correlated well with other measures of suppression but had mixed relationships with other constructs of interest. Evidence for the validity and potential utility of the CSS are discussed along with theoretical and treatment implications.

Self-compassion refers to one’s kind, mindful, and self-referential response to the perception of one’s painful experiences and has been linked to a number of positive aspects of psychological well-being (Neff, 2003a, 2003b). Despite this, thus far, there has been very little research examining how this concept relates to various aspects of social relationships. The current study investigates whether levels of reported self-compassion are related to rejection sensitivity and excessive reassurance seeking from others. Furthermore, aspects of recalled parenting are examined to determine whether those who recalled their parents as unsupportive of their negative displays of emotion also demonstrated low self-compassion, a relationship proposed to be mediated by perceived mattering and experiential avoidance. Questionnaires measuring these constructs were administered online to 241 undergraduate students. Parental validation of negative displays of emotion was found to lead to increased self-compassion, a relationship which was mediated by experiential avoidance and perceived mattering. Parental invalidation was not related to self-compassion. In turn, increased mattering and self-compassion led to lower rejection sensitivity, whereas increased experiential avoidances led to excessive reassurance seeking. Further research in this area is needed in order to experimentally assess the cause and effect relationships between parenting, self-compassion, rejection sensitivity, and reassurance seeking. / Social Sciences and Humanities Research Council: Joseph-Armand Bombardier CGS Master’s Scholarship

No description available.

This study examined if levels of self-reported mindfulness and experiential avoidance were associated with subjective and physiological outcomes following exposure to distressing film clips. Participants consisted of 108 college-aged young adults who completed self-report measures assessing levels of mindfulness, experiential avoidance, and negative affect. Several devices designed to monitor physiological activity, specifically sympathetic nervous activation, were also attached to participants. Participants were shown four brief film clips of neutral and unpleasant stimuli while these devices were attached. After each film, subjective distress ratings were gathered every 20 seconds for a period of two minutes to determine extent of emotional recovery. Results showed that, contrary to predictions, self-reported mindfulness was positively correlated with subjective distress following particular emotional film clips. Furthermore, self-reported mindfulness was largely unrelated to changes in physiological activity during the film clips, in addition to subjective and physiological recovery from the films. Although most findings were nonsignificant, this investigation contributes to the existing literature by being the first to include a measure of self-report mindfulness in combination with an array of subjective and physiological instruments to evaluate responses to aversive stimuli.

Tinnitus is the experience of sounds in the ears without any external auditory source and is a common, debilitating, chronic symptom for which we have yet to develop sufficiently efficacious interventions. Cognitive behavioral therapy (CBT) has evolved over the last 20 years to become the most empirically supported treatment for treating the adverse effects of tinnitus. Nevertheless, a significant proportion of individuals do not benefit from CBT-based treatments. In addition, the theoretical underpinnings of the CBT-model are poorly developed, the relative efficacy of isolated procedures has not yet been demonstrated, and the mechanisms of therapeutic change are largely unknown. These significant limitations preclude scientific progression and, as a consequence, leave many individuals with tinnitus suffering. To address some of these issues, a contextual multi-method, principle-focused inductive scientific strategy, based on pragmatic philosophy, was employed in the present thesis project. The overarching aim of the thesis was to explore the utility of a functional dimensional process in tinnitus: Experiential avoidance—experiential openness/acceptance (EA). EA is defined as the inclination to avoid or alter the frequency, duration, or intensity of unwanted internal sensations, including thoughts, feelings or physical sensations. The thesis is based on experimental work (Study II, VI), process and mediation studies (Study I, III, V), and on randomized controlled trials (Study III, IV). Three main sets of findings supported the utility of EA in tinnitus. First, an acceptance-based treatment (i.e.,Acceptance and Commitment Therapy, ACT) was found to be effective in controlled trials. Study III demonstrated that face-to-face ACT was more effective than a wait-list control and a habituation-based sound therapy. Study IV showed that internet-delivered ACT was more effective than an active control condition (internet-discussion forum) and equally effective as an established internet-delivered CBT treatment. Second, processes research (Study I, III, V) showed that key postulated processes of change were linked to the specific technology of ACT and that these changes in processes were associated with therapeutic outcomes. Specifically, Study V found evidence to that decreases in suppression of thoughts and feelings over the course of treatment were uniquely associated with therapeutic gains in ACT as compared with CBT. Third, experimental manipulations of experiential avoidance and acceptance processes provided support to the underlying dimension (Study II, VI). That is, Study II, employing an experimental manipulation, found that controlling background sounds were associated with reduced cognitive efficiency and increased tinnitus interference over repeated experimental trials. In addition, in normal hearing participants, experimentally induced mindfulness counteracted reduced persistence in a mentally challenging task in the presence of a tinnitus-like sound stemming from initial effortful suppression of the same sound (Study VI). It is concluded that a principle-, contextual-focused approach to treatment development may represent an efficient strategy for scientific progression in the field of psychological treatments of tinnitus severity. / Tinnitus är upplevelsen av ljud i frånvaro av en extern ljudkälla och är ett vanligt, långvarigt och svårbehandlat hälsotillstånd. Kognitiv beteendeterapi (KBT) har det starkaste forskningsstödet för att behandla de negativa konsekvenserna av tinnitus. Detta till trots svarar inte en stor andel på KBT-baserade behandlingar för tinnitus. Behandlingsutvecklingen av KBT försvåras som konsekvens av att teorier som behandlingen vilar på är dåligt utvecklade, effekten av isolerade tekniker har inte bevisats, och att förändringsmekanismer är till största del okända. Föreliggande avhandling avsåg att adressera några av ovanstående problem genom att tillämpa en induktiv, flermetod, principstyrd vetenskaplig strategi baserad på pragmatisk kontextuell filosofi. Det övergripande syftet med avhandlingen var att undersöka användbarheten i en funktionell processdimension vid tinnitus: upplevelsemässigt undvikande—upplevelsemässig acceptans (EA). EA definieras som benägenheten att undvika eller förändra frekvensen, durationen eller intensiteten av icke-önskade inre sensationer som tankar, känslor och fysiologiska sensationer. Avhandlingen är baserad på experimentella studier (Studie II, VI), process och mediationsstudier (Studie I, III, V) och randomiserade kontrollerade studier (Studie III, IV). Tre övergripande fynd bekräftade användbarheten av EA vid tinnitus. För det första kunde det påvisas i randomiserade, kontrollerade studier att en acceptans-baserad behandling (Acceptance and Commitment Therapy, ACT) hade effekt på tinnitusbesvär. Studie III fann stöd för att ACT var mer effektiv än en väntelistekontroll och en habitueringsfokuserad ljudterapi. Studie IV fann stöd för att internet-förmedlad ACT var mer effektiv än en aktiv kontrollbetingelse (internet-diskussionsforum) och lika effektiv som en etablerad internet-förmedlad KBT-behandling. För det andra kunde processforskning (Studie I, III, V) påvisa att teoretiskt viktiga processer var relaterade till specifika tekniker i ACT och att dessa processer var i sin tur associerade med behandlingsutfall. Exempelvis kunde Studie V styrka att minskning i individers benägenhet att tränga undan tankar och känslor i relation till tinnitus var unikt associerat med behandlingsutfall i ACT i jämfört med KBT. För det tredje påvisade experimentella manipulationer av acceptans- och undvikande-processer användbarheten av EA (Studie II, VI). Studie II fann stöd för att kontroll över maskeringsljud var associerad med minskad kognitiv prestationsförmåga och ökade besvära av tinnitus över upprepade experimentella manipulationer i jämfört med att inte ha kontroll över maskeringsljudet. Slutligen visade Studie VI att bland normalhörande kunde experimentellt inducerad mindfulness motverka minskad förmåga att hålla ut i en mentalt krävande uppgift i närvaro av ett tinnitusliknande ljud till följd av initial suppression av samma ljud. Den övergripande konklusionen av vetenskapliga arbeten som sammanfattas i avhandlingen var att en principstyrd och kontextuell vetenskaplig strategi kan vara en framkomlig väg för att utveckla psykologiska behandlingar för tinnitusbesvär.

No description available.

Experts have argued that hoarding disorder occurs in part because hoarding behaviors help individuals avoid distress and feel positive emotions in the moment. For example, when people who hoard choose to save something rather than discard it, they may avoid feelings of anxiety, and when people who hoard acquire something new, they may feel excited. However, no previous studies have examined whether or not these changes actually occur in the moment. These processes could also potentially be altered by how individuals respond to their emotions in the moment. For example, individuals who hoard may have stronger emotional reactions, distinguish less between different emotions, tend to avoid their emotions more, or tend to be inattentive of their experience, which could change how their emotions in the moment affect their behavior. Therefore, this study examined whether or not the anticipated effects of hoarding behaviors on mood occurred, and whether or not there were differences between those with higher and lower hoarding scores on how they respond to their emotions, in a sample of 61 college students. Participants completed two online surveys one week apart, and responded to questions on their mobile phone throughout the week. As expected, the students with higher hoarding scores had stronger emotional reactions to stress, avoided their emotions more often, and were less attentive to their ongoing experience. Both those with higher hoarding scores and lower hoarding scores vi reported that they acquired new items primarily to feel good. However, acquiring, discarding, working with items, and looking for items did not change either group’s mood in the moment. Overall, these findings suggest that people who hoard do have differences in how they respond to their emotions, which could mean that treatments that target these responses may be useful for these people. They also show the importance of understanding why working to put yourself in a good mood through acquiring is problematic for some people and not others, and suggest that there may be a difference between how these behaviors are intended to perform and their actual results.

No description available.

Experiential avoidance (EA), or the evasion of unpleasant internal experiences, is key to changes in emotional responsivity in Posttraumatic Stress Disorder (PTSD). EA has been linked to altered negative emotional reactivity in PTSD, but it remains unclear whether EA is linked to altered positive reactivity in PTSD, i.e. anhedonia. Therefore the study examined how manipulating EA influences emotional responsiveness in a non-clinical adult population (N=74). Positive emotion reactivity (self-report and psychophysiology) was measured before and after viewing a laboratory analogue trauma induction, with half of participants instructed to adopt the detached protector (DP) mode as an example of EA during trauma viewing and half of participants in an uninstructed control condition. Following the DP mode instructions reduced negative emotion experience during the trauma induction, relative to the control condition. However counter to prediction, there was no carry over onto blunted positive emotion experience or psychophysiological response in the experimental condition (relative to the control condition) when recalling positive memories and imagining positive future events. No significant relationships were identified between trait EA levels and anhedonia symptoms or pre-manipulation positive emotional responsiveness in the laboratory. Overall, the current findings offer no support for the hypothesis that EA contributes to anhedonia.