Efficacy of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer: a pre- and post-test clinical trial

The pain and relief of grief: Mental pain and mental pain acceptance associations with post-loss pathologies and growth among young widows and widowers

Mental pain is a core symptom of bereavement, yet its study with grief pathologies is still scarce. Mental pain acceptance may also affect the associations between mental pain, grief pathologies, and post-loss growth (PLG). The current study aims to investigate the associations between mental pain, mental pain acceptance, and post-loss outcomes in a sample of young widow(er)s. 257 young Israeli widow(er)s completed questionnaires assessing mental pain, mental pain acceptance, depression, complicated grief (CG), suicidal risk and PLG. Paths analyses revealed that depression mediated the positive associations between mental pain and suicidal risk and CG, and mental pain acceptance moderated the positive association between mental pain and depression. Mental pain acceptance also moderated the negative association between mental pain and PLG. The study's findings highlight the crucial role of mental pain and mental pain acceptance in the associations between adverse and favorable post-loss outcomes among bereaved individuals.

Acceptance and commitment therapy reduces psychological distress in patients with cancer: a systematic review and meta-analysis of randomized controlled trials

Objective

This study aimed to systematically review and meta-analyze the clinical efficacy of acceptance and commitment therapy (ACT) in patients with cancer and psychological distress.

Methods

Randomized controlled trials (RCTs) from seven English electronic databases were systematically investigated from inception to 3 October 2023. A total of 16 RCTs from 6 countries with 711 participants were included in this study. Estimated pooled effect sizes (ESs) were calculated via inverse-variance random-effects or fixed-effects (I2 ≤ 50%) model and presented by standardized mean difference (SMD). Subgroup analyses were performed to reduce confounding factors and heterogeneity, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to evaluate the quality of the pooled ESs.

Results

The pooled ESs revealed that statistically significant improvements in anxiety [postintervention SMD = -0.41 (95% confidence interval (CI), -0.71, -0.11); p = 0.008; I2 = 65%; follow-up SMD = -0.37 (95% CI, -0.66, -0.08); p = 0.01; I2 = 29%], depression [postintervention SMD = -0.45 (95% CI, -0.63, -0.27); p < 0.001; I2 = 49%; follow-up SMD = -0.52 (95% CI, -0.77, -0.28); p < 0.001; I2 = 0%], and psychological flexibility [postintervention SMD = -0.81 (95% CI, -1.50, -0.11); p = 0.02; I2 = 84%; follow-up SMD = -0.71 (95% CI, -1.12, -0.31); p = 0.0006; I2 = 38%] in ACT-treated participants were observed compared to patients treated with control conditions. However, other outcomes, such as physical symptom alleviation, were not significantly associated.

Conclusion

The findings of this systematic review and meta-analysis suggest that ACT is associated with improvements in anxiety, depression, and psychological flexibility in patients with cancer.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022320515.

Gender Socialization as a Predictor of Psychosocial Well-Being in Young Women with Breast Cancer

This study aimed to explore the relationship between gender socialization and psychosocial well-being among young women diagnosed with and treated for breast cancer. A total of 113 women between the ages of 18-49 completed a one-time questionnaire package. Four key measures of gender socialization were included: Gender Role Socialization Scale (GRSS), Objectified Body Consciousness Scale (OBCS), Mental Freedom Scale (MFS), and Silencing the Self Scale (SSS). Two measures of psychosocial well-being were included: Functional Assessment of Cancer Therapy-Breast (FACT-B) and Experience of Embodiment Scale (EES). Correlational and regression analyses were conducted to assess the relationship between gender socialization variables and well-being. In multiple regression models, GRSS and MFS added significant increments to the prediction of variance of the FACT-B (R² = 23.0%). In contrast, the OBCS and MFS added significant increments to the prediction of variance of the EES (R² = 47.0%). Findings suggested that women with greater endorsements to proscribed gender socialization were associated with poor well-being scores. Women who endorsed a critical stance, resisting traditional gender-role expectations, objectification pressures, and other social discourses, were associated with greater well-being scores. Future studies are needed to examine the impact of gender socialization on the well-being of young people with breast cancer.