Acceptance and Commitment Therapy (ACT) is a psychological intervention that aims to increase psychological flexibility through six core processes:
ACT may be suitable for GADbecause it targets experiential avoidance, cognitive fusion, and values-inconsistent behaviors, which are common maintaining factors in GAD. By cultivating acceptance,mindfulness, and valued living, ACT can help reduce the impact of anxiety.
Key Points
Rationale
Generalized anxiety disorder (GAD) is a common, chronic and costly emotional disorder that impairs quality of life and functioning.
Several biological, cognitive, behavioral and emotional risk factors are involved in GAD development, including deficits in emotional processing, which is considered a core mechanism (McNamara et al., 2016).
Irrational beliefs and rumination also play a key role in creating and perpetuating GAD through negative cognitive appraisals.
While pharmacotherapy alone is insufficient to address all of the complex, multidimensional issues in GAD, psychological treatments in conjunction with medication may enhance outcomes and prevent relapse. Acceptance and commitment therapy (ACT) is one treatment that has shown promise foranxiety disorders.
However, no prior studies have specifically examined ACT’s impact on emotional processing, irrational beliefs and rumination in GAD patients. This study sought to address that research gap and investigate ACT’s effectiveness in targeting those key cognitive-emotional factors to informGAD treatment.
Method
Procedure
Patients with GAD were recruited from daily psychiatric treatment centers in Golpayegan, Iran in early 2019.
30 eligible participants were selected based on inclusion and exclusion criteria and randomly allocated to an ACT treatment group (n=15) or control group (n=15).
The ACT group attended 8 weekly ACT therapy sessions lasting 90 minutes each, focused on core ACT processes like acceptance, cognitive defusion, present-moment awareness, self-as-context, values, and committed action.
The control group did not receive the ACT intervention during the study period. All participants completed study measures before and after the intervention phase.
Sample
People were excluded if they had disease recurrence, hospitalization, or a physical illness preventing attendance, missed 3+ sessions, or experienced unforeseen accidents during the study.
Measures
Statistical Analysis
The data were analyzed using analysis of covariance (ANCOVA) with SPSS-24 software. ANCOVA compared the post-treatment scores of the ACT and control groups on the dependent variables while controlling for pre-treatment scores.
Results
The ANCOVA results showed that compared to the control group, the ACT group had significantly greater improvements in:
This indicates ACT was effective at enhancing emotional processing abilities, reducing irrational thinking, and decreasing ruminative tendencies in GAD patients.
Insight
This study provides insight into how acceptance and commitment therapy can effectively target several important cognitive and emotional factors involved in generalized anxiety disorder.
By increasing acceptance, diminishing cognitive fusion with anxious thoughts, enhancing present-focused awareness, and promoting action aligned with values, ACT was able to significantly improve patients’ ability to adaptively process emotions, decrease irrational beliefs that exacerbate anxiety, and reduce maladaptive rumination.
This builds on prior research showing ACT’s benefits for anxiety while uniquely demonstrating its impact on the specific mechanisms of emotional processing, irrational beliefs, and rumination in GAD.
The findings suggest targeting those factors in an acceptance andmindfulness-basedapproach can lead to significant clinical gains.
Future studies should replicate this with larger samples while examining longer-term effects and mediating variables. Therapy-component research would also clarify the active ingredients.
Overall, this study points to ACT’s promise as an effective, process-based therapy for generalized anxiety disorder.
Strengths
The study had several methodological strengths:
Limitations
Some limitations should be noted:
Implications
This study has significant clinical implications, suggesting acceptance and commitment therapy may be an effective treatment choice for generalized anxiety disorder.
By targeting emotional processing deficits, irrational beliefs, and rumination – key factors in GAD’s onset and persistence – ACT provides an avenue for meaningful symptom relief and improved functioning.
The findings support training therapists in ACT for GAD and making it more widely available, especially given the high prevalence and healthcare costs of the disorder.
Still, individual patient characteristics and preferences should guide treatment selection, and ACT should be integrated with other evidence-based approaches like pharmacotherapy.
Policymakers and mental health organizations may look to this research to inform treatment guidelines and recommendations for GAD.
Further research is still needed on ACT’s efficacy and mechanisms across diverse GAD samples to refine its clinical application.
References
Primary reference
Ara, B. S., Khosropour, F., & Zarandi, H. M. (2023). Effectiveness of acceptance and commitment therapy (act) on emotional processing, irrational beliefs and rumination in patients with generalized anxiety disorder.Journal of Adolescent and Youth Psychological Studies (JAYPS),4(4), 34-44.https://doi.org/10.61838/kman.jayps.4.4.5
Other references
MacNamara, A., Kotov, R., & Hajcak, G. (2016). Diagnostic and symptom-based predictors of emotional processing in generalized anxiety disorder and major depressive disorder: An event-related potential study.Cognitive therapy and research,40, 275-289.https://doi.org/10.1007/s10608-015-9717-1
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Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
