Comparing paths to quality of life: Contributions of ACT and cognitive therapy intervention targets in two highly anxious samples

Psychological flexibility, cognitive emotion regulation and mental health outcomes among patients with asthma in Pakistan

Background/Objective

Adults with asthma who experience difficulties in emotion regulation are prone to developing psychopathological symptoms that may affect their self-management activities and symptom control. The current research investigated the role of psychological flexibility and cognitive emotion regulation strategies in relation to mental health outcomes (psychological distress and quality of life) among patients with asthma in Pakistan.

Method

A sample of 200 adults, diagnosed with asthma (32% men, 68% women; M_age = 42.32, SD_age = 16.99), completed the acceptance and action questionnaire (AAQ-II) cognitive emotion regulation questionnaire (CERQ), depression, anxiety, stress scale-21 (DASS-21), asthma-related quality of life questionnaire (AQLQ) and a self-structured demographic sheet.

Results

Results of Pearson product moment correlation showed that most of the adaptive cognitive emotion regulation strategies (positive refocusing, refocus on planning, and positive reappraisal) were positively correlated with psychological flexibility and quality of life, whereas negatively correlated with psychological distress. All the maladaptive strategies of cognitive emotion regulation had a significant inverse relationship with psychological flexibility and quality of life, while positively correlated with psychological distress. Results of serial mediation analysis through PROCESS MACRO showed that catastrophising and anxiety fully mediated the relationship between psychological flexibility and asthma-related quality of life.

Conclusion

Evidence-based interventions should focus on developing psychological flexibility and identifying maladaptive patterns of cognitive emotion regulation strategies for improved mental health and quality of life outcomes for adults with asthma.

Case Study of Acceptance and Commitment Therapy and Functional Analysis for Emetophobia

Acceptance and Commitment Therapy (ACT) is a third-wave behavioral therapy that is an empirically supported treatment for various mental health concerns. ACT has been found to be efficacious for treating different types of anxiety disorders. This case study presents the conceptualization (functional analysis), treatment (ACT), and treatment outcomes of a client who presented with emetophobia, a phobia of vomiting, complicated by a metabolic disorder. Measures of emetophobia symptoms, mindfulness, cognitive fusion, thought control strategies, and believability of anxious thoughts and feelings, were collected at pretreatment, posttreatment, 6-month follow-up, and 12-month follow-up. The Reliable Change Index was used to evaluate changes across time. Large and clinically significant decreases on all measures were observed at posttreatment. At 12-month follow-up, improvements were maintained on all measures except the Reappraisal subscale of the Thought Control scale. The implications of this study are discussed, and recommendations are made for clinicians using ACT for the treatment of emetophobia.