One year follow-up and mediation in Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for adult depression

Experiential Avoidance ◽

Behavioral Therapy ◽

Dysfunctional Attitudes ◽

Abstract Background Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change. Methods We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering , and experiential avoidance. Results Patients in both conditions reported significant and large reductions of depressive symptoms ( d = -1.26 to -1.60) and improvement in quality of life ( d = 0.91 to -1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Conclusions Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression.

One year follow-up and mediation in Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for adult depression

10.21203/rs.2.16655/v3 ◽

2020 ◽

Author(s):

Jacqueline G.L. A-Tjak ◽

Nexhmedin Morina ◽

Maurice Topper ◽

Paul M.G. Emmelkamp

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Experiential Avoidance ◽

Behavioral Therapy ◽

Dysfunctional Attitudes ◽

Abstract Background Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change.Methods We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering , and experiential avoidance.Results Patients in both conditions reported significant and large reductions of depressive symptoms (d = -1.26 to -1.60) and improvement in quality of life (d = 0.91 to -1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Conclusions Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression.

One year follow-up and mediation in Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for adult depression

10.21203/rs.2.16655/v2 ◽

2020 ◽

Author(s):

Jacqueline G.L. A-Tjak ◽

Nexhmedin Morina ◽

Maurice Topper ◽

Paul M.G. Emmelkamp

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Experiential Avoidance ◽

Behavioral Therapy ◽

Dysfunctional Attitudes ◽

Abstract Background Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change.Methods We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering , and experiential avoidance.Results Patients in both conditions reported significant and large reductions of depressive symptoms (d = -1.26 to -1.60) and improvement in quality of life (d = 0.91 to -1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Conclusions Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression.Trial registration clinicaltrials.gov; NCT01517503. Registered 25 January 2012 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01517503?term=NCT01517503&rank=1

One year follow-up and mediation in cognitive behavioral therapy and acceptance and commitment therapy for adult depression

BMC Psychiatry ◽

10.1186/s12888-020-03020-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jacqueline G. L. A-Tjak ◽

Nexhmedin Morina ◽

Maurice Topper ◽

Paul M. G. Emmelkamp

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Experiential Avoidance ◽

Behavioral Therapy ◽

Dysfunctional Attitudes ◽

Abstract Background Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change. Methods We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering, and experiential avoidance. Results Patients in both conditions reported significant and large reductions of depressive symptoms (d = − 1.26 to − 1.60) and improvement in quality of life (d = 0.91 to − 1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Conclusions Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression. Trial registration clinicaltrials.gov; NCT01517503. Registered 25 January 2012 - Retrospectively registered.

One year follow-up and mediation in Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for adult depression

10.21203/rs.2.16655/v4 ◽

2021 ◽

Author(s):

Jacqueline G.L. A-Tjak ◽

Nexhmedin Morina ◽

Maurice Topper ◽

Paul M.G. Emmelkamp

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Experiential Avoidance ◽

Behavioral Therapy ◽

Dysfunctional Attitudes ◽

Abstract Background Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change.Methods We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering , and experiential avoidance.Results Patients in both conditions reported significant and large reductions of depressive symptoms (d = -1.26 to -1.60) and improvement in quality of life (d = 0.91 to -1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Conclusions Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression.Trial registration clinicaltrials.gov; NCT01517503. Registered 25 January 2012 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01517503?term=NCT01517503&rank=1

Quality of Life Improvements after Acceptance and Commitment Therapy in Nonresponders to Cognitive Behavioral Therapy for Primary Insomnia

Psychotherapy and Psychosomatics ◽

10.1159/000365173 ◽

2014 ◽

Vol 83 (6) ◽

pp. 371-373 ◽

Cited By ~ 16

Author(s):

Elisabeth Hertenstein ◽

Nicola Thiel ◽

Marianne Lüking ◽

Anne Katrin Külz ◽

Elisabeth Schramm ◽

...

Keyword(s):

Quality Of Life ◽

Behavioral Therapy ◽

Primary Insomnia ◽

Cognitive Behavioral ◽

Commitment Therapy ◽

The Effectiveness of Acceptance and Commitment Therapy and Cognitive-Behavioral ‎Therapy in Enhancing Resiliency and Quality of Life Among Multiple Sclerosis Patients: A Randomized Clinical Trial Study

Iranian Journal of Psychiatry and Behavioral Sciences ◽

10.5812/ijpbs.107467 ◽

2022 ◽

Vol In Press (In Press) ◽

Author(s):

Mohsen Karimi ◽

Fatemeh Narenji Thani ◽

Zahra Naqhsh ◽

Tahereh Ghazaghi

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Behavioral Therapy ◽

Acceptance And Commitment ◽

Post Test

Background: Multiple sclerosis (MS) is a chronic, common, and progressive disease of the nervous system, and the affected individuals suffer from its complications throughout their lives and experience different physical and emotional disorders. Objectives: The present study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and cognitive-behavioral ‎therapy (CBT) in enhancing resiliency and quality of life among MS patients. Methods: This randomized clinical trial was carried out on 30 MS patients referred to the Department of Neurology in Baqiyatallah Hospital (Tehran, Iran) during February 19 to September 1, 2017. The patients were randomly assigned to three groups: (1) ACT (n = 10, 8 sessions, 90-minute weekly‎ sessions), (2) CBT (n = 10, 10 sessions, 90-minute weekly‎ sessions), and (3) control group (n = 10, no sessions). The resilience and quality of life were measured in pre-test and post-test phases and 1.5 months after treatment using the Connor-Davidson Resilience and Multiple Sclerosis Impact Scales, respectively. Repeated measurement ANOVA and SPSS Software (version 24) were used in this study to analyze the collected data. Results: The study sample consisted of 30 MS patients (mean age = 31.7 ± 5.7, 60% female and 57% married). The three groups were homogeneous in terms of demographic and baseline variables. The results demonstrated that both ACT and CBT had the same effectiveness in increasing resiliency (mean difference in CBT = 0.9 vs ACT = 0.8 (P = 0.882); CBT = 0.9 vs. Control = -1.4 (P = 0.004); ACT = 0.8 vs. Control = -1.4 (P = 0.0041)) and quality of life (mean difference in CBT = 2.9 vs ACT = 3.1 (P = 0.051); CBT = 2.9 vs. Control = 0.6 (P = 0.002); ACT = 3.1 vs. Control = 0.6 (P = 0.014)) among the MS patients so that the participants’ post-test and follow-up scores increased significantly compared to the pretest scores. Conclusions: The present study results indicate that ACT and CBT can equally enhance resiliency and quality of life among MS patients.

Long Term Effect of Cognitive Behavioral Therapy in Patients with Health Anxiety

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1887 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S111-S112

Author(s):

K.E. Veddegjaerde

Keyword(s):

Quality Of Life ◽

Behavioral Therapy ◽

Health Anxiety ◽

Term Effect ◽

Cognitive Behavioral ◽

Long Term Effect

IntroductionCognitive-behavioral therapy (CBT) has been found to be an effective treatment of excessive health anxiety (HA), but the long-term effect over 18months has not been examined.ObjectivesSeveral studies have shown effect of CBT for HA-patients. However, these effects have been short or immediate after therapy. To our knowledge no studies have examined long-term effect of CBT for HA over 18 months.AimsTo investigate the long-term effect of CBT on HA, focusing on level of HA, quality of life, subjective health complaints and general anxiety. Follow-up time was at least 10 years. Our hypothesis was that the effect was sustained.MethodsPatients with HA received 16 sessions of CBT over a period of 12–18 months, and were followed up over at least 10 years. All patients fulfilled criteria for F45.2, hypochondriacal disorder according to ICD-10.The patients answered several questionnaires, exploring areas such as HA, Quality of life, somatization, and mental health problems. Questionnaires were answered before CBT, after CBT and at follow up. Mixed model analysis was performed in SPSS 23.0 for all questionnaires.ResultsAll scores were found to be significant in the Pre-CBT–Post-CBT and Pre-CBT–FU (0.034– < 0.001), and none were found to be significant in the Post-CBT–FU.ConclusionsOur findings suggest that for the majority of patients with HA, CBT has a significant and lasting long-term effect. This effect lasts up to ten years post therapy.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Comparative Effectiveness of Group-Delivered Acceptance and Commitment Therapy versus Cognitive Behavioral Therapy for Smoking Cessation: A Randomized Controlled Trial

Nicotine & Tobacco Research ◽

10.1093/ntr/nty268 ◽

2018 ◽

Vol 22 (3) ◽

pp. 354-362 ◽

Cited By ~ 6

Author(s):

Jennifer B McClure ◽

Jonathan Bricker ◽

Kristin Mull ◽

Jaimee L Heffner

Keyword(s):

Smoking Cessation ◽

Randomized Trial ◽

Behavioral Therapy ◽

Sensitivity Analyses ◽

Acceptance And Commitment ◽

Point Prevalence Abstinence

Abstract Introduction Preliminary trial data suggest group-delivered acceptance and commitment therapy (ACT) might be effective for smoking cessation. If so, this could offer a viable alternative to mainstream behavioral therapies, such as those grounded in cognitive behavioral therapy (CBT). The goal of the current study was to compare the effectiveness of group-delivered ACT versus group-delivered CBT in a rigorous randomized trial design with long-term follow-up. Methods Participants (n = 450) were recruited from the Kaiser Permanente Washington health care system and randomized to either ACT-based group counseling or an attention-matched CBT-based group program. All were prescribed an 8-week course of nicotine patches. The primary outcome was self-reported 30-day point prevalence abstinence at 12 months post-randomization assessed with missing values imputed as smoking. Sensitivity analyses using multiple imputation and complete cases were examined, as were biochemically confirmed and 6-month outcomes. Results Thirty-day point prevalence abstinence rates at the 12-month follow-up did not differ between study arms in the primary analysis (13.8% ACT vs. 18.1% CBT, adjusted odds ratio = 0.68 [95% CI = 0.35 to 1.27], p = .23) or the sensitivity analyses. Conclusions Group-based ACT and CBT had similar long-term quit rates in this methodologically rigorous randomized trial. Group-based ACT is a reasonable alternative to group-based CBT for smoking cessation. Implications This study compared the effectiveness of group-based ACT with group-based CBT for smoking cessation using a rigorous, large-scale, attention-matched, randomized trial with 1-year follow-up. One-year cessation rates did not differ between group-based ACT and CBT, suggesting ACT-based intervention is a reasonable alternative to CBT-based counseling for smoking cessation. The results add to the nascent but growing literature assessing ACT and other mindfulness-based treatments for smoking cessation.

O1.05: Cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for dementia family caregivers: follow-up results of a randomized clinical trial

European Geriatric Medicine ◽

10.1016/s1878-7649(14)70088-9 ◽

2014 ◽

Vol 5 ◽

pp. S46 ◽

Cited By ~ 3

Author(s):

A. Losada ◽

M. Márquez-González ◽

R. Romero-Moreno ◽

J. López ◽

V. Fernández-Fernández ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Family Caregivers ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Commitment Therapy ◽

Therapist-Guided Internet-Based Treatments for Loneliness: A Randomized Controlled Three-Arm Trial Comparing Cognitive Behavioral Therapy and Interpersonal Psychotherapy

Psychotherapy and Psychosomatics ◽

10.1159/000516989 ◽

2021 ◽

pp. 1-8

Author(s):

Anton Käll ◽

Malin Bäck ◽

Camilla Welin ◽

Hanna Åman ◽

Rasmus Bjerkander ◽

...

Keyword(s):

Quality Of Life ◽

Primary Outcome ◽

Behavioral Therapy ◽

Interpersonal Psychotherapy ◽

Cognitive Behavioral ◽

Control Group ◽

Wait List

Introduction: Chronic loneliness has been linked to many adverse outcomes, including mental health problems. Psychological treatment of loneliness can be effective, but the evidence base is limited. Objective: To investigate the efficacy of 2 internet-based interventions based on cognitive behavioral therapy (ICBT) and interpersonal psychotherapy (IIPT) relative to a wait-list control group and each other. Methods: A total of 170 participants were recruited and randomized to either 9 weeks of ICBT (n = 68), IIPT (n = 68), or a wait-list condition (n = 34). The primary outcome was loneliness, measured using the UCLA Loneliness Scale before, during, and after treatment. Secondary measures of psychiatric disorders and quality of life were administered before and after treatment. Follow-up was conducted 4 months after the treatment had ended. Primary outcome data were analyzed using growth curve modeling. Secondary outcomes were analyzed using robust regression models. The trial was preregistered (ClinicalTrials.gov ID: NCT03807154). Results: The ICBT condition had a significantly greater impact on loneliness compared to the wait-list and IIPT conditions. Effect sizes were moderate to large (Cohen d = 0.71) compared to the wait-list and moderate (d = 0.53) compared to IIPT. The IIPT condition did not differ significantly from the wait-list. Both active treatments led to significant increases in quality of life. Only the ICBT group had significantly lower symptoms of depression and generalized anxiety compared to the wait-list group. Treatment gains were maintained but not improved at follow-up. Conclusions: ICBT can be an efficacious option for alleviating loneliness. The IIPT intervention was not as effective.