Early sudden gains in an acceptance and values-based intervention: Effects on treatment outcome for depression and psychological flexibility

Keinonen, Katariina; Kyllönen, Heidi; Astikainen, Piia; Lappalainen, Raimo

doi:10.1016/j.jcbs.2018.07.010

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…In fact, accumulating evidence suggests that psychological inflexibility is associated with higher levels of depressive symptoms in individuals with chronic pain [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Additionally, ACT for chronic pain alleviates depressive symptoms by improving psychological inflexibility [ 22 , 25 , 26 , 27 , 28 , 29 , 30 ]. One study [ 31 ] found that psychological inflexibility predicted severe depressive symptoms in 144 patients with chronic pain, independent of the effect of their pain intensity, mindfulness, and pain-related acceptance.…”

Section: Introductionmentioning

confidence: 99%

Effect of Psychological Inflexibility on Depressive Symptoms and Sleep Disturbance among Japanese Young Women with Chronic Pain

Kato

2020

IJERPH

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Background: Psychological inflexibility based on an acceptance and commitment therapy model is theoretically well-established as a process to exacerbate psychological distress, such as depressive symptoms and sleep disturbance. This study aimed to examine the associations of psychological inflexibility with depressive symptoms and sleep distribution. We hypothesized that psychological inflexibility would be associated with higher levels of depressive symptoms and sleep disturbance in women with chronic pain. Methods: Female college students in Japan answered a questionnaire on pain status, treatment, and psychological inflexibility as measured by the Acceptance and Action Questionnaire-Ⅱ before answering questionnaires on depressive symptoms and sleep disturbance eight months after. Results: Women with chronic pain (n = 320) reported more severe depressive symptoms and sleep disturbances compared to women without chronic pain (n = 90). Hierarchical multiple regressions revealed that psychological inflexibility predicted higher levels of depressive symptoms and sleep disturbance, independent of the pain intensity, whether they consulted a doctor or used pain medication. Conclusion: Based on our findings self-management interventions aimed at reducing psychological inflexibility should be developed for individuals who are experiencing chronic pain.

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Section: Introductionmentioning

confidence: 99%

Effect of Psychological Inflexibility on Depressive Symptoms and Sleep Disturbance among Japanese Young Women with Chronic Pain

Kato

2020

IJERPH

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“…The delayed effect of participant 1 reached significance after two weeks. A study by Keinonen et al ( 2018 ) found that 25% of patients can experience a sudden gain (an abrupt reduction in symptom severity after which they stabilize) after the first two sessions of an ACT intervention. It seems likely, also looking at his graph, that participant 1 experienced a sudden gain in depression scores after session two.…”

Section: Discussionmentioning

confidence: 99%

Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases

Rauwenhoff

Bol

Peeters

et al. 2022

Neuropsychological Rehabilitation

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Patients with acquired brain injury (ABI) often experience symptoms of anxiety and depression. Until now, evidence-based treatment is scarce. This study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) for patients with ABI. To evaluate the effect of ACT for people with ABI, a non-concurrent multiple baseline design across four cases was used. Participants were randomly assigned to a baseline period, followed by treatment and then follow-up phases. Anxiety and depressive symptoms were repeatedly measured. During six measurement moments over a year, participants filled in questionnaires measuring anxiety, depression, stress, participation, quality of life, and ACT-related processes. Randomization tests and NAP scores were used to calculate the level of change across phases. Clinically significant change was defined with the Reliable Change Index. Three out of four participants showed medium to large decreases in anxiety and depressive symptoms (NAP = 0.85 till 0.99). Furthermore, participants showed improvements regarding stress, cognitive fusion, and quality of life. There were no improvements regarding psychological flexibility, value-driven behaviour, or social participation. This study shows that ACT is possibly an effective treatment option for people experiencing ABI-related anxiety and depression symptoms. Replication with single case or large scale group studies is needed to confirm these findings.

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“…Value affirmation interventions have been shown to help improve grades and to help support the sense of personal worth and integrity [ 31 ]. Past clinical trials that used value-based interventions reported reduced severity of depression symptoms in patients [ 39 ]. Additionally, results from our recently published study on Kenyan adolescents, in which this value-based approach—a component of the Shamiri intervention—was used, suggest that promoting value reflection may reduce mental health problems and improve psychosocial outcomes in adolescents in sub-Saharan Africa [ 20 , 34 ].…”

Section: Interventionsmentioning

confidence: 99%

Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial

Venturo‐Conerly

Osborn

Wasil

et al. 2021

Trials

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Background Treatments for youth mental disorders are a public health priority, especially in sub-Saharan Africa (SSA), where treatment options remain limited due to high cost, elevated stigma, and lack of trained mental health professionals. Brief, accessible, and non-stigmatizing community-based interventions delivered by lay providers may help address treatment needs in SSA. One such intervention, the Shamiri Intervention, consisting of three elements (growth mindset, gratitude, and value affirmation) has been tested in randomized controlled trials with school-going Kenyan adolescents. This three-element Shamiri Intervention has been shown to significantly reduce depression and anxiety symptoms and improve social support and academic performance relative to a control group. In this trial, we aim to investigate the effects of each element of the Shamiri Intervention. Methods In this five-arm randomized controlled trial, we will test each of the intervention components (growth mindset, gratitude, and value affirmation) against the full Shamiri Intervention and against a study skills control intervention. Students (Nplanned = 1288) at participating secondary schools who are interested in participating in this universal intervention will be randomized in equal numbers into the five groups. The students will meet in groups of 8–15 students led by local high school graduate lay providers. These lay providers will receive a brief training, plus expert supervision once a week throughout the intervention delivery. Multi-level models will be used to compare trajectories over time of the primary outcomes (depressive symptoms, anxiety symptoms, academic performance, and wellness) and secondary outcomes in each intervention group to the control group. Multi-level models will also be used to compare trajectories over time of the primary outcomes (depressive symptoms, anxiety symptoms, academic performance, and wellness) and secondary outcomes of participants in the single-element interventions compared to the full Shamiri Intervention. Finally, effect sizes (calculated as mean gain scores) will be used to compare all groups on all measures. Discussion This trial will shed light on the mechanisms and outcomes targeted by each individual intervention, helping prioritize which mental health interventions are most important to disseminate. Trial registration PACTR Trial ID: PACTR202104716135752. Approved on 4/19/2021.

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Early sudden gains in an acceptance and values-based intervention: Effects on treatment outcome for depression and psychological flexibility

Abstract: This is a self-archived version of an original article. This version may differ from the original in pagination and typographic details.

Cited by 7 publications

References 25 publications

Effect of Psychological Inflexibility on Depressive Symptoms and Sleep Disturbance among Japanese Young Women with Chronic Pain

Effect of Psychological Inflexibility on Depressive Symptoms and Sleep Disturbance among Japanese Young Women with Chronic Pain

Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases

Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial

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