ACT-Enhanced Behavior Therapy for a Hispanic Adult With Trichotillomania: A Case Report

Trichotillomania, also known as Hair-Pulling Disorder, is characterized by recurrent pulling out of one’s hair over brief episodes or sustained periods of time and results in hair loss. ACT-enhanced behavior therapy (A-EBT) has been shown to be an effective approach in the treatment of trichotillomania by promoting psychological flexibility around hair pulling urges and teaching stimulus control and habit reversal training. However, there is limited support of A-EBT for clients with an ethnic minority identity. This case report focuses on an adult, Hispanic female client, Luna (pseudonym), who received eight sessions of A-EBT for the treatment of trichotillomania. At post-treatment, Luna showed significant improvements in number of hairs pulled, trichotillomania specific psychological flexibility, depression and anxiety. Luna’s case highlights barriers to care such as potential resistance in seeking mental health services, the influence of family members’ beliefs on receiving mental health services, and the limited access to specialized treatment of trichotillomania

Acceptance and Commitment Therapy (ACT) Among U.S. Veterans: A Systematic Review

Veterans of the United States military represent a large sample of the population and a distinctive culture. Veterans have a high prevalence rate of a variety of psychological disorders and disabilities. Research on treatments that meet the needs of this culturally unique group is essential. Acceptance and Commitment Therapy (ACT) may meet this need with its unified treatment approach and its focus on functioning rather than diagnosis. In this study we examine the current state of the literature of ACT for U.S. Veterans. A systematic review of 249 papers found 34 unique relevant studies involving 21 single arm studies, eight randomized clinical trials, two non-randomized controlled trials, and three case studies that met inclusion criteria. Overall, results suggest ACT is a promising intervention for Veterans across multiple conditions (e.g., anxiety disorders, depression, chronic pain) as well as intervention delivery (in-person and telehealth) and type (group and individual therapy). Limitations highlighted include recruitment methods of studies included, lack of active control conditions, and the limited number of randomized trials. Future researchers should continue to examine which presentations respond to ACT and seek to understand what types of adaptations may be necessary to increase the effectiveness of ACT for U.S. Veterans

Examining the Role of Experiential Avoidance and Valued Action in the Negative Effects of Weight Self-Stigma

Harmful effects of weight self-stigma on quality of life and health behaviors have been well-established. However, the processes that lead to these negative outcomes are less understood. Psychological inflexibility is defined as a pattern of rigid psychological reactions dominating over values and meaningful actions. A lack in valued action is characterized by the absence of activities that are connected to what is personally meaningful. In this secondary analysis, we aim to extend research by examining two subprocesses of psychological inflexibility, experiential avoidance and lack of valued action, as statistical mediators of the relations between weight self-stigma and quality of life/health behavior outcomes. Baseline data from a clinical trial comparing weight loss maintenance interventions in a sample of 194 adults living with overweight or obesity and seeking treatment is analyzed. Results show that greater experiential avoidance and lower valued action were significantly related to lower quality of life and satisfaction with social roles, as well as greater depression, anxiety, and binge eating. Further, results from a parallel mediation analysis indicated that weight self-stigma is indirectly related to anxiety, disinhibited eating, and hunger through the relationship with experiential avoidance and lack of valued action

Disentangling Trait and State Psychological Inflexibility: A Longitudinal Multilevel Approach

An individual\u27s trait-like thoughts, feelings, and behaviors are characteristic patterns that occur across time, whereas state-like iterations of these variables are isolated to specific moments in time. Although highly correlated, variables at the trait and state levels measure different phenomena and should be examined separately. In this longitudinal study, we examine the disaggregation of trait and state-level psychological inflexibility among college students. Specifically, we investigated which psychological inflexibility subprocess would significantly predict positive affect, negative affect, and meaningful activity, both at the trait and state-levels. In addition to pre- and post-assessments, participants (n = 168) completed ecological momentary assessment (EMA) surveys (n = 2251) assessing each of these variables via text message three times per day over the course of a week. Results suggested that while a greater number of state-like subprocesses significantly predict negative affect, positive affect, and meaningful activity, trait-like subprocesses hold more weight. Dominance analyses showed trait-level inaction to be the most important predictor for positive and negative affect, and trait-level of lack of contact with values to be the most important predictor for meaningful activity. Differentiating trait and state variables can enable contextual behavioral scientists to better understand pathological and therapeutic processes of change