Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms

Abstract

Relapse rates following a depressive episode are high, with limited treatments available aimed at reducing such risk. Acceptance and commitment therapy (ACT) is a cognitivebehavioral approach that has gained increased empirical support in treatment of depression, and thus represents an alternative in relapse prevention. Psychological flexibility (PF) plays an important role in mental health according to the model on which ACT is based. This study aimed to investigate the role of PF and its subprocesses in reducing residual symptoms of depression and in improving positive mental health following an 8-week group-based ACT treatment. Adult participants (75.7% female) with a history of depression, but currently exhibiting residual symptoms (N = 106) completed measures before and after intervention, and at 6 and 12-month follow-up. A growth curve model showed that positive mental health increased over 12-months. Multilevel mediation modeling revealed that PF significantly mediated these changes as well as the reduction of depressive symptoms, and that processes of acceptance, cognitive defusion, values and committed action, in turn, mediated increased PF.

Knowledge of COVID-19 and Its Influence on Mindfulness, Cognitive Emotion Regulation and Psychological Flexibility in the Indian Community

“…When one can achieve this, coping with the pandemic and its related aspects definitely gets easier, and as a result, the feeling of being overwhelmed, stressed, anxious, or depressed decreases. Conclusively, an increase in psychological flexibility brings about a decrease in depression, anxiety, and stress and vice versa (Kashdan and Rottenberg, 2010;Fledderus et al, 2013;Wersebe et al, 2018;Østergaard et al, 2020). With regard to the knowledge of COVID-19, it is obvious that the more aware an individual is of the current circumstances with respect to the virus, its nature, symptoms, safety measures, treatment options, and support provided by the government in dealing with the pandemic, the less likely it is for them to have mental health issues regarding the same.…”

Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report

“…However, enhancing decentering-related abilities in the initial stages of remission can significantly reduce relapse risk. In a recent study with adults experiencing remission, ACT was associated with lower residual depression after 12 months and this was mediated by increases in cognitive defusion and psychological flexibility (40.77 ± 11.9 years) 78 . Decentering also increased in adults in remission who received follow-up care using MBCT and this predicted lower residual depression symptoms after 6 months (44.8 ± 9.4 years) 74 .…”

Exploratory Study of Common Changes in Client Behaviors Following Routine Psychotherapy: Does Psychological Flexibility Typically Change and Predict Outcomes?

“…Nevertheless, ACT has demonstrated effectiveness in reducing the symptoms of various psychological disorders and behavior challenges like anxiety, depression, somatic health problems, suicide, and substance misuse (A-Tjak et al 2014;Ducasse et al 2018;Ii et al 2019). Moreover, studies have indicated potential for ACT in preventing behavioral health concerns in high risk populations and promoting well-being (Dindo et al 2018;Grègoire et al 2018;Ostergaard et al 2020).…”