Compassion-focused acceptance and commitment therapy for women with restrictive eating and problematic body-checking: A multiple baseline across participants study

Reciprocal longitudinal associations between positive body image and wellbeing among early-adult women

This longitudinal study examined the prospective associations between body appreciation and wellbeing (i.e., self-esteem, depression, and emotional wellbeing) as well as body image flexibility and wellbeing among 490 women between 18-35 years of age (M = 28.63; SD = 4.27) residing in the United States. Women were contacted in three waves, each two months apart, and completed measures relating to each construct online. As a prerequisite of longitudinal analyses, this study found evidence of configural, metric, scalar, and strict invariance over time for each relevant measure. Cross-lagged panel modeling evidenced bidirectional associations between body appreciation and self-esteem between all waves and unidirectional associations between body appreciation and subsequent depression (negative) and body appreciation and subsequent emotional wellbeing (positive). Results showed bidirectional associations between body image flexibility, self-esteem, depression, and emotional wellbeing, although these bidirectional associations never occurred during the same interval between waves. This study evidences that higher body appreciation and body image flexibility are prospectively associated with increases in self-esteem, emotional wellbeing and decreases in depression, and also shows scenarios where the inverse associations also hold true. We also describe how this study complements existing cross-sectional research and the need to examine associations among more diverse participant groups.

A Systematic Quality Review of Single-Case Experimental Designs Using Acceptance and Commitment Therapy in Adult Clinical Populations

Recent publications within Contextual Behavioral Science provided a rationale for the expansion of intervention efficacy research using methods that capture idiographic factors and processes. We conducted a systematic review of the use and quality of single-case experimental designs (SCED) within the Acceptance and Commitment Therapy (ACT) literature in adult clinical populations. The systematic review was conducted according to PRISMA guidelines and the databases CINAHL, MEDLINE, PsycINFO, PsycArticles and OpenGrey were searched for peer-reviewed articles. Further studies were sought through review of reference lists of all full text studies. Studies were assessed against What Works Clearinghouse (WWC) single-case design standards. Twenty-six studies met eligibility criteria and were conducted within research teams all implementing multiple-baseline designs. Twenty-four studies did not meet WWC standards with most failing to ensure a degree of concurrence across participants. The extent of randomisation methods was also captured. The review highlights the sparsity of SCEDs within ACT literature in clinical populations and current methodological practices. Limitations of the review and implications for future research are discussed.

"Like putting on an old pair of gloves" or "realising i am actually over it": a qualitative study exploring the impact of the COVID-19 pandemic lockdown restrictions on eating disorder recovery in the UK

The COVID-19 pandemic lockdown restrictions posed unique challenges for people living with eating disorders (EDs), particularly relating to social isolation and changes in treatment access. However, less is known about the experience of lockdown for people 'in recovery' from EDs or disordered eating (DE) (i.e., with an ED/DE history). This study explored: (i) how people with a self-reported ED/DE history responded to and managed the experience of lockdown, specifically in relation to their recovery, and (ii) coping strategies for the management of recovery. Semi-structured interviews were conducted between June and August 2020 with 20 adults with a self-reported ED/DE history living in the UK. Data were analysed using inductive thematic analysis within a critical realist framework. Three overarching themes were identified: (1) Seeking safety and stability during a pandemic, (2) Lockdown prompting realisations about recovery, and (3) Exploring self-compassion as a more adaptive approach. While most participants experienced a resurgence in ED symptoms during lockdown, many reflected on the successful management of these as reinforcing their recovery. These findings have important implications for understanding ED recovery, in addition to informing interventions to better promote recovery during the COVID-19 pandemic and beyond.

Supplementary information

The online version contains supplementary material available at 10.1007/s12144-023-04353-2.

Self-compassion in Acceptance and Commitment Therapy for chronic pain: a pilot study

OBJECTIVES

Evidence shows that Acceptance and Commitment Therapy (ACT) is an empirically supported psychological approach for chronic pain (CP) management. Although self-compassion is not explicitly a target of ACT, it seems to be one mechanism of change in ACT for CP. However, research is lacking on the benefits of including explicit self-compassionate exercises in ACT for CP. The current study pilot tested a Compassionate ACT 8-session group program (COMP.ACT; n=9), as well as an ACT-only 8-session group program (ACT; n=7), in a sample of women with CP.

METHODS

The current study follows a quasi-experimental design, and conducts Reliable and Significant Change analyses comparing pre- to post-intervention scores of self-report measures.

RESULTS

No differences were found between conditions at baseline, nor between completers and drop-outs. Although preliminary, results showed COMP.ACT led to greater clinical improvements in depression and anxiety, while ACT led to greater improvements in stress and uncompassionate self-responding. Reliable and Significant Change analysis showed that some participants improved significantly (in psychopathological symptoms, valued living and uncompassionate self-responding) in both conditions, while the majority did not change significantly.

CONCLUSIONS

More research is needed to conclude whether explicit self-compassion exercises are useful in ACT for CP. Limitations and implications are further discussed.