A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression

Abstract

Repetitive negative thinking (RNT) is a core feature of generalized anxiety disorder (GAD) and depression. Recently, some studies have shown promising results with brief protocols of acceptance and commitment therapy (ACT) focused on RNT in the treatment of emotional disorders in adults. The current study analyzes the effect of an individual, 3-session, RNT-focused ACT protocol in the treatment of severe and comorbid GAD and depression. Six adults meeting criteria for both disorders and showing severe symptoms of at least one of them participated in the study. A delayed multiple-baseline design was implemented. All participants completed a 5week baseline without showing improvement trends in emotional symptoms (Depression Anxiety and Stress Scale -21; DASS-21) and pathological worry (Penn State Worry Questionnaire; PSWQ). The ACT protocol was then implemented, and a 3-month followup was conducted. Five of the six participants showed clinically significant changes in the DASS-21 and the PSWQ. The standardized mean difference effect sizes for single-case experimental design were very large for emotional symptoms (d = 3.34), pathological worry (d = 4.52), experiential avoidance (d = 3.46), cognitive fusion (d = 3.90), repetitive thinking (d = 4.52), and valued living (d = 0.92 and d = 1.98). No adverse events were observed. Brief, RNT-focused ACT protocols for treating comorbid GAD and depression deserve further empirical tests.

Effectiveness of acceptance and commitment therapy for mental illness in cancer patients: A systematic review and meta‐analysis of randomised controlled trials

“…In contrast to traditional CBT, ACT encourages individuals to experience and manage negative emotions and thoughts; although there is an overlap between ACT and traditional CBT, ACT does not attempt to eliminate or change negative thoughts, implying a series of training exercises to help patients become motivated, active, and develop “psychological resilience.” Therefore, ACT has the potential to reduce the psychological burden of cancer patients. In recent years, a number of researchers have made advances in studying the effectiveness of ACT to reduce mental illness in cancer patients, and some researchers found that it can reduce depression and anxiety in cancer patients, 10–12 Feros et al 13 discovered that ACT can reduce psychological distress, improve psychological resilience, increase mental flexibility, and improve the quality of life of cancer patients; Datta et al 14 demonstrated that ACT is effective in improving cancer patients’ level of acceptance of the disease, as well as their quality of life.…”

Repetitive negative thinking mediates the relationship between addictive Facebook use and suicide-related outcomes: A longitudinal study

“…Furthermore, the Acceptance and Commitment Therapy (ACT) (Hayes et al, 2012 ; Tanhan, 2019 ), specifically the Repetitive Negative Thinking-focused ACT (RNT-focused ACT) (Ruiz et al, 2016 ) could also serve as a protective strategy against the interaction between addictive Facebook use and RNT and its impact on suicide-related outcomes. Identification of main triggers of RNT, taking distance from them, and the focus on valued actions that are important for the individual in the longer-term belong to the different training steps of RNT-focused ACT (Ruiz et al, 2020 ). These steps could support the individual to identify the potential negative effect of excessive online behavior and to determine valued alternative behavior.…”

Habit reversal therapy in the management of body focused repetitive behavior disorders

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