Mindfulness-Based Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is one of the latest mindfulness-based behavior therapies shown to have compelling evidence and efficacy with a wide range of clinical conditions. ACT is so hard to categorize that it is often described as an amalgamation of existential, humanistic, cognitive-behavioural therapy. ACT is often referred as process-based CBT and is one of the ‘third-wave' of behavioural therapies. It is currently the fastest growing evidence-based therapy in the world, with currently at least 304 Randomized Control Trials (RCTs) being recorded all over the world. It has proven effective in different cultural contexts with a diverse set of clinical conditions, from depression, Obsessive-compulsive disorder, chronic pain, grief, loss and terminal illness, anxiety, and workplace stress.

Adverse Childhood Experiences (ACE) Among Prolific Young Robbery Offenders in London: Targeting Treatment for Desistance?

Research Question How prevalent are various types of adverse childhood experiences among prolific young robbery offenders in London, with what implications for treatment and desistance of these people from serious offending? Data Of the 1249 suspects under 26 years of age who were arrested for robberies in London in 2019, 81 (6.5%) of them had been arrested for four or more robberies, totalling 24% of all robbery arrests of that age group (465 out of 1936). Of those 81 arrestees, 65 of them (80%) percent had used a knife or threatened with a knife to commit their crime. In total, the 81 had criminal histories as suspects in 939 offences covering 34 offence types, most commonly theft from person (201), possession of drugs (164) and violence with injury (89). Methods This study gathered extensive life history data for the 81, with a special emphasis on adverse childhood experiences (ACE) including criminal victimisation by parents or other adults. The analysis compares the prevalence of ACE in the most prolific young robbery suspects to prevalence in general population samples. Findings The 81 prolific robbery offenders had extremely high prevalence of ACEs: 80% had previously been victims of crime themselves (highest offence categories assault with bodily harm, robbery and domestic violence). Reported to police as missing is 63%, school exclusions 49%, incarceration of a family member 35% and known to social services 91%. The prevalence of 4 or more ACEs among the 81 prolific robbery offenders is two to five times higher than it is in other estimates for London (random sample) or England (children in need). Conclusions A substantial proportion of all London arrests for robbery identify young people with disproportionately high levels of adverse childhood experiences. Most of the ACEs are to some extent treatable by cognitive behavioural therapies and related treatments aimed at post-traumatic stress disorder (PTSD). One possible pathway to promote desistance from high-harm crime in this population may be the development and testing of a police role in helping to ensure that these few most chronic, high-harm arrestees received effective treatment for the consequences of ACEs.

The socio-cognitive theory of personality and its clinical applications

Personality is a cognitive-affective processing system, which, according to the socio-cognitive theory, creates four dimensions. They are reflected in the skills, beliefs, standards and goals of the individual, which are consistent and consistent patterns of behaviour. Self-efficacy judgments and self-patterns determine the choice of goals and persistence in achieving them. On the other hand, the emotions preceding and accompanying the achievement of goals affect coping with stress and problems. The review of the clinical and therapeutic applications of this theory included stress inoculation training, REBT rational emotive therapy, Beck's cognitive depression therapy, schema therapy and modelling methods. The great advantage of this theory is the possibility of verifying its theoretical assumptions and confirming their huge amount of research. Besides, it has a practical application as many types of cognitive-behavioural therapies have been developed on its basis.

Autism and Inner Speech: A Computational Model of Language Functions in Autistic Flexible Behaviour

Experimental and computational studies propose that inner speech boosts categorisation skills and executive functions, making human behaviour more focused and flexible. In addition, many clinical studies highlight a relationship between poor inner-speech and an executive impairment in autism spectrum condition (ASC), but contrasting findings are reported. Here we investigate the latter issue through a previously implemented and validated computational model of the Wisconsin Cards Sorting Tests.In particular, the model was applied to detect the individual differences in cognitive flexibility and inner speech contribution in ASC and neurotypical participants. Our results suggest that the use of inner-speech increases along the life-span of neurotypical participants but is absent in ASC ones. Although we found more attentional failures in autistic children/teenagers and more perseverative behaviours in autistic young/older adults, only ASC children and ASC older adults exhibited a lower performance than matched control groups. Overall, our results corroborate the idea that the lower use of inner speech in ASC teenagers and young adults is compensated by alternative cognitive strategies (e.g., visual thinking), but it could represent a disadvantage for children (for the missing support of development) and older adults (for the missing compensation of cognitive decline). Moreover, the results suggest that cognitive-behavioural therapies should focus on developing inner speech skills in ASC children as this could provide cognitive support along their whole life span.

Adapting behavioural interventions to compensate for cognitive dysfunction in persons with opioid use disorder

Treatment for opioid use disorder (OUD) is often in the context of biobehavioural interventions, consisting of medication for OUD (for example, methadone and buprenorphine), which is accompanied by psychoeducation and/or behavioural therapies. Patients with OUD often display weaknesses in cognitive function that may impact the efficacy of such behavioural interventions.A review of the literature was conducted to: (1) describe common cognitive dysfunction profiles among patients with OUD, (2) outline intervention approaches for patients with OUD, (3) consider the cognitive demands that interventions place on patients with OUD and (4) identify potential accommodation strategies that may be used to optimise treatment outcomes.Cognitive profiles of patients with OUD often include weaknesses in executive function, attention, memory and information processing. Behavioural interventions require the patients’ ability to learn, understand and remember information (placing specific cognitive demands on patients). Accommodation strategies are, therefore, needed for patients with challenges in one or more of these areas. Research on accommodation strategies for patients with OUD is very limited. We applied research from populations with similar cognitive profiles to form a comprehensive collection of potential strategies to compensate for cognitive dysfunction among patients with OUD. The cognitive profiles and accommodation strategies included in this review are intended to inform future intervention research aimed at improving outcomes among patients with OUD.

Prospective mental imagery in depression: Impact on reward processing and reward-motivated behaviour

Background Mental imagery has long been part of cognitive behavioural therapies. More recently, a resurgence of interest has emerged for prospective mental imagery, i.e. future-directed imagery-based thought, and its relation to reward processing, motivation and behaviour in the context of depression. Method We conducted a selective review on the role of prospective mental imagery and its impact on reward processing and reward-motivated behaviour in depression. Results Based on the current literature, we propose a conceptual mechanistic model of prospective mental imagery. Prospective mental imagery of engaging in positive activities can increase reward anticipation and reward motivation, which can transfer to increased engagement in reward-motivated behaviour and more experiences of reward, thereby decreasing depressive symptoms. We suggest directions for future research using multimodal assessments to measure the impact of prospective mental imagery from its basic functioning in the lab to real-world and clinical implementation. Conclusion Prospective mental imagery has the potential to improve treatment for depression where the aim is to increase reward-motivated behaviours. Future research should investigate how exactly and for whom prospective mental imagery works.

Genetic interactions with stressful environments in depression and addiction

SUMMARYStress is the most important proximal precipitant of depression, yet most large genome-wide association studies (GWAS) do not include stress as a variable. Here, we review how gene × environment (G × E) interaction might impede the discovery of genetic factors, discuss two examples of G × E interaction in depression and addiction, studies incorporating high-stress environments, as well as upcoming waves of genome-wide environment interaction studies (GWEIS). We discuss recent studies which have shown that genetic distributions can be affected by social factors such as migrations and socioeconomic background. These distinctions are not just academic but have practical consequences. Owing to interaction with the environment, genetic predispositions to depression should not be viewed as unmodifiable destiny. Patients may genetically differ not just in their response to drugs, as in the now well-recognised field of pharmacogenetics, but also in how they react to stressful environments and how they are affected by behavioural therapies.