Effects of acceptance and commitment therapy on cognitive function: A systematic review

Cognitive function is essential for daily activities. Acceptance and commitment therapy (ACT) may improve cognitive function by enhancing psychological flexibility, but the underlying mechanism is unknown. This systematic review evaluated the effectiveness of ACT on cognitive function. Seven research databases (PubMed, ProQuest Dissertations and Theses, Web of Science, EBSCOhost, CNKI, Scopus, Wanfang) were searched to collect articles with trials published in English and Chinese. After applying inclusion and exclusion criteria, we identified 12 studies published between 1994 and 2022 that included a combined total of 904 participants. Among the included studies were within-group (N = 3) and randomized controlled trial (RCT, N = 9) study designs. Outcome measures included cognitive scales and behavioral measurements. Of the 12 articles, 10 studies showed improvements in certain domains of cognitive function due indirectly to ACT intervention. We found that the ability of ACT intervention to promote psychological flexibility is due to its transdiagnostic nature. Also, the effects of the ACT intervention were observed in multiple cognitive domains: attention, subjective cognitive function, executive function, and memory. In conclusion, cognitive trainers could consider practicing ACT as part of their strategy to enhance an individual's psychological flexibility and cognitive function.

Web-delivered Acceptance and Commitment Therapy (ACT) for smoking cessation: Is it engaging and efficacious for US Hispanic/Latinx adult smokers?

Hispanic/Latinx adult smokers in the United States (US) face barriers to receiving and utilizing evidenced-based cessation treatments compared with other racial/ethnic groups. The lack of efficacious and accessible smoking cessation treatments for this population further contributes to such smoking disparities. In a secondary analysis, we explored the efficacy of an Acceptance and Commitment Therapy (ACT)-based website (WebQuit.org) versus a US Clinical Practice Guidelines (USCPG)-based website (Smokefree.gov) for smoking cessation in a subset of Hispanic/Latinx adult participants enrolled in the WebQuit trial. Of the 2,637 participants who were randomized in the parent trial, 222 were Hispanic/Latinx (n = 101 in WebQuit, n = 121 in Smokefree). Smoking cessation outcomes were measured at 3, 6, and 12-months. The primary outcome was self-reported complete-case 30-day point prevalence abstinence (PPA) at 12-months. Treatment engagement and satisfaction, change in acceptance of urges to smoke, and commitment to quitting smoking were compared across conditions. Retention rate was 88% at 12-months. WebQuit participants had higher odds of smoking cessation compared to Smokefree participants at 12-months (40% vs. 25%; OR = 1.93 95% CI: 1.04, 3.59). Findings were similar using multiple imputation. WebQuit participants engaged more with the website than Smokefree participants through multiple indicators of engagement, including spending more time using the website (IRR = 2.32; 95% CI: 1.68, 3.20). Although WebQuit participants engaged more with the website than Smokefree participants, there was no evidence that differences in quit rates were mediated by engagement level. This study provides initial empirical evidence that digital interventions may be efficacious for helping Hispanic/Latinx adults quit smoking.