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When individuals are engaging in behavior that is under aversive control, the behavior becomes relatively insensitive to changes in the environment except for escape or avoidance contingencies. Teaching individuals to increase behavioral and psychological flexibility in the presence of potentially aversive stimuli is a goal of Acceptance and Commitment Therapy (ACT). ACT therapists use personal values to motivate clients to engage in meaningful behaviors despite ever-changing, and often aversive, contexts. The aim of the current study was to examine the effects of a values intervention on participant's willingness to approach established aversive stimuli. College students (n = 200) completed questionnaires and participated in behavioral approach tasks with aversive stimuli. Individuals were more likely to approach if approach was related to a personal value versus a relatively arbitrary reward (i.e. tickets) or without any specified consequence. Psychological inflexibility did not moderate the relationship between condition and approach. However, the values intervention condition did produce greater levels of approach than the control conditions. Previous studies have examined the impact of combined values and acceptance interventions. The evidence from this study suggests that values interventions alone may influence behavior. • Subjects in values condition completed more steps in BAT than other conditions. • Subjects in tickets only condition completed more BAT steps than those in control. • Psychological inflexibility did not moderate condition and outcome variable. [ABSTRACT FROM AUTHOR]

Behavioral researchers are concluding that conventional group-based analyses often mask meaningful individual differences and do not necessarily map onto the change processes within the lives of individual humans. Hayes et al. (2018) have called for a renewed focus on idiographic research, but with methods capable of nuanced multivariate insights and capable of scaling to nomothetic generalizations. To that end, we present a statistical technique we believe may be useful for the task: the dynamic p-technique. The dynamic p-technique can accommodate multivariate longitudinal data and may be used to conduct single-subject and group-level analyses. After introducing the dynamic p-technique, we provide several examples of how it may be used in practice by presenting the step-by-step analyses of single-subject daily-diary dataset wherein we examined the day-to-day associations between ADHD difficulties and psychotropic medication. Although it has been underutilized by behavioral researchers, we believe p-technique analyses are particularly well-suited to model personal dynamics with nuance and within context and allow researchers to inductively build from idiographic patterns to nomothetic trends. For a fine-grain walk-through of the analyses presented, including the data and statistical code, link to our supplemental materials https://osf.io/cbyj3/ • Behavioral processes are often complex and person centered. • Statistical frameworks should accommodate person-centered and group-based data. • The dynamic p-technique is such a framework. [ABSTRACT FROM AUTHOR]

Abstract There is a long tradition in suicide research, accompanied by recent developments in nonsuicidal self-injury (NSSI) research, of examining cognitive processes as potential precursors of risk. But these cognitive processes are often studied separately, and are rarely integrated or directly compared with each other. In an effort to synthesize this literature, this systematic review (n= 109 longitudinal studies conducted over the past 10 years) demonstrates how specific cognitive processes predict self-injurious thoughts and behaviors (SITBs), and examines whether intervening on features of cognition may help mitigate SITB risk. Our review reveals that cognitive processes, measured using self-report and behavioral measures, are most often linked to recurrent suicidal ideation. Overall, several patterns emerged. First, SITB-themed cognitions were robust risk factors and proximally associated with SITB outcomes. Second, negatively-valenced cognitive risk factors were the most commonly studied risk factors, relatively robust, and modestly related to SITB outcomes. Third, cognitive deficits (i.e., basic cognitive processes not characterized by thematic content or negative valence) produced mixed findings that suggest a more distal relationship to SITB outcomes. Moreover, our review of treatment articles revealed that while many interventions are informed by the cognitive literature, potential cognitive mechanisms of treatment change are rarely studied. We conclude by outlining key ways that future research can generate more comprehensive cognitive profiles of self-injurious and suicidal individuals. Highlights • Cognition may help predict and prevent self-injurious thoughts and behaviors (SITBs). • Most research on cognition and SITBs pertains to recurrent suicidal ideation. • Evidence for SITB-themed cognitions is preliminary, and reveals robust and proximal risk factors. • Negatively-valenced cognitive risk factors are common, robust, yet modestly predictive. • Treatment research should examine the mediating and moderating effects of cognition. [ABSTRACT FROM AUTHOR]

Recent research suggests that meaning in life relates to processes of social judgments and could facilitate relationships between racially diverse individuals. At this time however, there is no study that examines factors that influence the relationship between meaning, racial prejudice, and values. To fill this gap, the present study examined whether (1) self-transcendence and (2) psychological inflexibility mediates the relationship between perceived meaning in life and prejudice. The study was conducted with 253 White students (females, 77.9%; males, 22.1%) from a university located in the southern United States. Standard path-analytic approaches through the macro PROCESS program were used to examine a parallel mediational model. Results evidenced that self-transcendence and psychological inflexibility had a significant indirect effect on the relationship between meaning in life and prejudice, and that reversely, meaning also functioned as a mediator of self-transcendence and prejudice and psychological inflexibility and prejudice. Findings suggest that among White college students the effect of meaning on prejudice changes in the context of self-transcendence and psychological inflexibility, and that without self-transcendence and psychological flexibility, meaning could actually result in greater prejudice. [ABSTRACT FROM AUTHOR]

Highlights • Sexual racism is a unique stressor for men of color who have sex with men (MCSM). • Experienced sexual racism is related to higher body dissatisfaction in MCSM. • MCSM report higher engagement in muscularity-increasing behaviors than White MSM. • Body image inflexibility (BIF) was related to higher body dissatisfaction. • BIF moderated the relationship between sexual racism and body dissatisfaction. Abstract Body image research with men who have sex with men (MSM) has largely focused on White MSM. The current study aimed to investigate whether men of color who have sex with men (MCSM) report similar levels of body dissatisfaction as White MSM. We also studied whether (a) the experience of sexual racism, a unique stressor for MCSM, is related to body dissatisfaction and (b) body image inflexibility moderates the relationship between sexual racism and muscularity-oriented behaviors. White MSM and MCSM (total N = 887) recruited through Amazon Mechanical Turk completed questionnaires assessing body dissatisfaction, body image flexibility, and experienced sexual racism on Qualtrics. We found that MCSM report more engagement in behaviors aimed at changing their bodies than White MSM. Additionally, experiencing sexual racism was related to higher body dissatisfaction and body image inflexibility in MCSM. In addition, body image inflexibility moderated by strengthening the association between experiencing sexual racism and muscularity-oriented behaviors. The present study highlights the need for further research with this understudied population, including intervention studies on mitigating the impact of experiencing sexual racism by increasing psychological and body image flexibility and studies aimed at reducing the incidence of sexual racism. [ABSTRACT FROM AUTHOR]

Self-compassion has recently emerged as a component of psychological health. Research on self-compassion processes shows that self-compassion is related to lower levels of psychological distress and higher levels of positive affect. The current study examined the extent to which self-compassion is related to the quality of romantic relationships. Undergraduates ( n  = 261) completed online self-report questionnaires assessing self-compassion and relationship quality. Correlational and hierarchical multiple regression analyses were conducted in order to assess the relation between self-compassion and relationship quality. Results indicated that self-compassion was moderately positively correlated with relationship quality, and that self-compassion was a unique, if weak, predictor of relationship quality. Implications of these findings for romantic relationships are discussed. [ABSTRACT FROM AUTHOR]

Stainless steel containers are widely used in the pharmaceutical and biopharmaceutical industry for the storage of buffers, process intermediates, and purified drug substance. They are generally held to be corrosion resistant, biocompatible, and nonreactive, although it is well established that trace amounts of metal ions can leach from stainless steel equipment into biopharmaceutical products. We report here that the use of stainless steel containers in conjunction with magnetic stirring bars leads to significantly aggravated metal contamination, consisting of both metal particles and significantly elevated metal ions in solution, the degree of which is several orders of magnitude higher than described for static conditions. Metal particles are analyzed by scanning electron microscopy with electron-dispersive X-ray spectroscopy, and metal content in solution is quantitated at different time points by inductively coupled plasma-mass spectrometry. The concentration of iron, chromium, nickel, and manganese increases with increasing stirring time and speed. We describe the impact of buffer components on the extent of metal particles and ions in solution and illustrate the effect on model proteins. [ABSTRACT FROM AUTHOR]

Despite efforts to improve university retention, many low-income students are leaving college without a degree. The current study evaluated the preliminary effectiveness of Acceptance and Commitment Training for low-income students at risk for academic failure. In general, participants exhibited improved academic performance the following semester, which was predicted from valued living. Fifty-seven percent of participants graduated within six years, surpassing the graduation rate of a comparison group and exceeding national graduation rates. [ABSTRACT FROM AUTHOR]

This study evaluates whether a randomized school-based intervention for adolescent teenage mothers successfully helped participants achieve better financial independence and economic prospects. Project Mothers and Schools (PMAS) is an initiative intended to modify attitudes and beliefs related to self-sufficiency, parenting, educational goals and achievement, career goals, health behaviors, and interpersonal relationships with family members. PMAS participants were surveyed at baseline and 12months after intervention enrollment to evaluate the receipt of financial support from 11 sources. The 48 "core group" participants received a basic level of services, whereas the 43 "core-plus group" participants received the same basic services and additional enhanced services. Wilcoxon signed-rank tests were used to identify statistically significant changes in participant responses from baseline to 12months post-intervention. Both groups reported higher levels of employment 12months post-intervention compared to baseline. The core-plus group used more Food Stamps 2.673, p=0.008) and reported receiving more child support (z=2.236, p=0.025) 12months post-intervention versus baseline. PMAS benefited all participants by promoting employment 12months post-intervention versus baseline. The enhanced services offered to the core-plus group appeared to also increase participant access to Food Stamps and child support, sources which assist participants down the path toward eventual financial independence. [ABSTRACT FROM AUTHOR]

Abstract: This article explores some tensions between contextual behavioral science (CBS) and radical behaviorism or behavior analysis (BA), particularly with respect to the study of emotion. We contrast Darrow and Follette׳s (2014) discussion of alexithymia from a radical behavioral perspective, which we view as representing a traditional behavior analytic approach, with a CBS approach, as we understand it. As a convenient anchor for our discussion, we discuss how CBS and BA might view the term “love.” We present suggestions for how “love” may be used as a middle-level term in a CBS approach, and why usage of such middle-level terms is important to the mission of CBS to create a science more adequate to the challenges of the human condition. [Copyright &y& Elsevier]

Abstract: Acceptance and mindfulness components are increasingly incorporated into treatment for eating disorders with promising results. The development of measures of proposed change processes would facilitate ongoing scientific progress. The current series of studies evaluated one such instrument, the Body Image-Acceptance and Action Questionnaire (BI-AAQ), which was designed to measure body image flexibility. Study one focused on the generation and reduction of items for the BI-AAQ and a demonstration of construct validity. Body image flexibility was associated with increased psychological flexibility, decreased body image dissatisfaction, and less disordered eating. Study two demonstrated adequate internal consistency and test–retest reliability of BI-AAQ. Study three extended findings related to structural and construct validity, and demonstrated an indirect effect of body image dissatisfaction on disordered eating via body image flexibility. Research and clinical utility of the BI-AAQ are discussed. The BI-AAQ is proposed as a measure of body image flexibility, a potential change process in acceptance-oriented treatments of eating disorders. [Copyright &y& Elsevier]

Abstract: The present article describes the nature, scope, and purpose of Contextual Behavioral Science (CBS). Emerging from behavioral psychology but expanding from those roots, CBS is based on contextual assumptions regarding the centrality of situated action, the nature of epistemology versus ontology, and a pragmatic truth criterion linked to the specific goal of predicting-and-influencing psychological events with precision, scope, and depth. These assumptions and goals explain the characteristic features of CBS including its environmentalism, focus on theory and principles, and its reticulated or networked program of theory development, research and practice. Domains of development include increased linkage to multi-dimensional and multi-level evolution science; development of principles that describe the interaction of behavior and symbolic events with genetic, epigenetic, and cultural dimensions; expansion of theoretical and model development to a broader range of areas of human complexity; advances in measurement theory and practice; the development of techniques and components linked to contextual processes and principles; broad testing of these methods; additional research on mediation and moderation; more concern for effectiveness and training; and enhancement of a diverse development community. [Copyright &y& Elsevier]

Abstract: Acceptance and commitment therapy (ACT) has been shown to have broad applicability to different diagnostic groups, and there are theoretical reasons to consider its use with clients with chronic mental health problems. We report an innovative treatment development evaluation of ACT for a heterogeneous group of ”treatment-resistant clients” (N =10) who had attended a mean of 3.5 previous psychological interventions. All clients had Axis I presentations and half met diagnostic criteria for Axis II disorders. Functioning, assessed at pre- and postintervention, and at 6- and 12-month follow-up, showed improvements over time on all primary outcome measures, driven largely by significant changes occurring between baseline and 6-month follow-up. Improvements were associated with ACT processes of change. The data thus suggest that a broad range of clients who had not benefited from standard care may benefit from ACT. [Copyright &y& Elsevier]

Abstract: Data suggest that individuals dealing with a cancer diagnosis are less likely to suffer from depression, anxiety, and psychological distress when they cope with their condition from a stance of emotional and cognitive acceptance (e.g. Dunkel, et al., 1992; Stanton, et al., 2000). Although traditional CBT often includes some acceptance-oriented elements, recent variants of CBT, such as Acceptance and Commitment Therapy (ACT), have acceptance as a central focus. ACT targets emotional distress directly through acceptance of difficult thoughts and emotions. The current study is a preliminary comparison of ACT and treatment as usual (TAU) in the treatment of emotional distress among women with late-stage ovarian cancer. Forty-seven women diagnosed with Stage III or IV ovarian cancer were randomly assigned to one of two treatment conditions. Treatment consisted of 12 face-to-face meetings with a therapist, each following a TAU or ACT protocol. Results indicate that both groups showed improved mood and quality of life following the intervention. The ACT group showed significantly greater improvements compared to the TAU group. Furthermore, mediation analyses indicate that the effects of treatment were mediated by cognitive avoidance. Although the study is limited by the implementation of treatment in both conditions by a single therapist, the TAU group showed improvements that were consistent with effect sizes available in the literature, suggesting that the intervention was a credible and effective control treatment. These findings provide preliminary support for the use of ACT in ovarian cancer populations. Further work is needed to investigate the effectiveness in other oncology populations as well as investigate potential patient characteristics which may interact with these interventions. [Copyright &y& Elsevier]

Abstract: Many clients who undergo methadone maintenance (MM) treatment for heroin and other opiate dependence prefer abstinence from methadone. Attempts at methadone detoxification are often unsuccessful, however, due to distressing physical as well as psychological symptoms. Outcomes from an MM client who voluntarily participated in an Acceptance and Commitment Therapy (ACT)–based methadone detoxification program are presented. The program consisted of a 1-month stabilization and 5-month gradual methadone dose reduction period, combined with weekly individual ACT sessions. Urine samples were collected twice weekly to assess for use of illicit drugs. The participant successfully completed the program and had favorable drug use outcomes during the course of treatment, and at the 1-month and 1-year follow-ups. Innovative behavior therapies, such as ACT, that focus on acceptance of the inevitable distress associated with opiate withdrawal may improve methadone detoxification outcomes. [Copyright &y& Elsevier]

Approximately 14% of the working-age Swedish population are either on long-term sick leave or early retirement due to disability. Substantial increase of sick listing, reports of work disabilities and early retirement due to stress and musculoskeletal chronic pain suggest a need for methods of preventing loss of function resulting from these conditions. The present preliminary investigation examined the effects of a brief Acceptance and Commitment Therapy (ACT) intervention for the treatment of public health sector workers who showed chronic stress/pain and were at risk for high sick leave utilization. ACT was compared in an additive treatment design with medical treatment as usual (MTAU). A group of 19 participants were randomly distributed into 2 groups. Both conditions received MTAU. The ACT condition received four 1-hour weekly sessions of ACT in addition to MTAU. At post and 6-month follow-up, ACT participants showed fewer sick days and used fewer medical treatment resources than those in the MTAU condition. No significant differences were found in levels of pain, stress, or quality of life. Improvements in sick leave and medical utilization could not be accounted for by remission of stress and pain in the ACT group as no between-group differences were found for stress or pain symptoms. [ABSTRACT FROM AUTHOR]

The present study compared methadone maintenance alone to methadone maintenance in combination with 16 weeks of either Intensive Twelve-Step Facilitation (ITSF) or Acceptance and Commitment Therapy (ACT) in a preliminary efficacy trial with polysubstance-abusing opiate addicts who were continuing to use drugs while on methadone maintenance. Results showed that the addition of ACT was associated with lower objectively assessed opiate and total drug use during follow-up than methadone maintenance alone, and lower subjective measures of total drug use at follow-up. An intent-to-treat analysis which assumed that missing drug data indicated drug use also provided support for the reliability of objectively assessed total drug use decreases in the ACT condition. ITSF reduced objective measures of total drug use during follow-up but not in the intent-to-treat analyses. Most measures of adjustment and psychological distress improved in all conditions, but there was no evidence of differential improvement across conditions in these areas. Both ACT and ITSF merit further exploration as a means of reducing severe drug abuse. [ABSTRACT FROM AUTHOR]

Acceptance and Commitment Therapy (ACT) views cognition and emotion differently in their roles in psychological problems. Both popular culture and many models of psychopathology conceive of negative thoughts and emotions as states that must be eliminated, reduced, or supplanted. ACT posits that these negative emotional, cognitive, and bodily states may or may not produce behavior problems. Further, ACT suggests that attempts to control these states may actually worsen mental health problems. Strategies to control, eliminate, or suppress negative states, called experiential avoidance, are directly targeted. ACT seeks to treat the functional class of experiential avoidance rather than specific diagnostic categories. However, ACT has been applied to a number of DSM-IV disorders. We detail the application of ACT to an adolescent diagnosed with anorexia and comment on the treatment implemented by . We discuss the broad assessment issues necessitated by the type of difficulties a patient with anorexia may have. The general structure of an ACT intervention is elaborated on, including values, exposure, defusion, and empowerment. [Copyright &y& Elsevier]

Opinion. Comments on David H. Barlow's article `Promises to Keep' concerning issues related to behavior therapy. Examination of the changes in the health care delivery; Role of doctoral-level psychologists within the emerging health delivery system; Argument on the role of doctoral-level psychologists in the modern health care system.

Outlines three distinguishing features of the behavior therapy movement. Approach of defining problems in the context of identifiable behavioral excesses and benefits; Derivation of clinical solutions from experimentally validated theoretical principles; Rigorous tests of resulting interventions.

Objective: To evaluate the cost-effectiveness of providing contraceptive implants in school-based health centers (SBHCs) compared to the practice of referring adolescents to non-SBHCs in New York City.Study Design: We developed a microsimulation model of teen pregnancy to estimate the cost-effectiveness of immediate provision of contraceptive implants at SBHCs over a 3-year time horizon. Model parameters were derived from both a retrospective chart review of patient data and published literature. The model projected the number of pregnancies as well as the total costs for each intervention scenario. The incremental cost-effectiveness ratio was calculated using the public payer perspective, using direct costs only.Results: The health care cost of immediate provision of contraceptive implants at SBHCs was projected to be $13,719 per person compared to $13,567 per person for delayed provision at the referral appointment over 3 years. However, immediate provision would prevent 78 more pregnancies per 1000 adolescents over 3 years. The incremental cost-effectiveness ratio for implementing in-school provision was $1940 per additional pregnancy prevented, which was less than the $4206.41 willingness-to-pay threshold. Sensitivity analyses showed that the cost-effectiveness conclusion was robust over a wide range of key model inputs.Conclusion: Provision of contraceptive implants in SBHCs compared to non-SBHCs is cost-effective for preventing unintended teen pregnancy. Health care providers and policymakers should consider expanding this model of patient-centered health care delivery to other locations. [ABSTRACT FROM AUTHOR]

Abstract: Background: While agonist replacement therapies are effective for managing opioid dependence, community treatment programs are increasingly choosing detoxification. Unfortunately, success rates for opioid detoxification are very low, in part, due to physical and psychological symptoms associated with opioid withdrawal. Few behavior therapies specifically address the distressing experiences specific to opioid withdrawal. A novel behavioral treatment, acceptance and commitment therapy (ACT), works from the premise that the avoidance of unpleasant private experiences (thoughts, feelings, bodily sensations) is ubiquitous yet may be pathogenic, resulting in treatment drop-out and further drug use. Methods: This Stage I pilot study developed and tested an ACT-based opioid detoxification behavioral therapy. Opioid dependent patients (N =56) who were attending a licensed methadone clinic were randomized to receive either 24 individual therapy sessions of ACT or drug counseling (DC) in the context of a 6-month methadone dose reduction program. Results: While no difference was found on opioid use during treatment, 37% of participants in the ACT condition were successfully detoxified at the end of treatment compared to 19% of those who received DC. Fear of detoxification was also reduced across time in the ACT condition relative to DC. Conclusion: This first study of ACT to assist opioid detoxification indicates promise. Research is needed to refine specific treatment strategies for this population to further strengthen effects. [Copyright &y& Elsevier]

Abstract: Aggregation of the amyloid-β protein (Aβ) plays a pathogenic role in the progression of Alzheimer’s disease, and small molecules that attenuate Aβ aggregation have been identified toward a therapeutic strategy that targets the disease’s underlying cause. Compounds containing aromatic structures have been repeatedly reported as effective inhibitors of Aβ aggregation, but the functional groups that influence inhibition by these aromatic centers have been less frequently explored. The current study identifies analogs of naturally occurring coumarin as novel inhibitors of Aβ aggregation. Derivatization of the coumarin structure is shown to affect inhibitory capabilities and to influence the point at which an inhibitor intervenes within the nucleation dependent Aβ aggregation pathway. In particular, functional groups found within amyloid binding dyes, such as benzothiazole and triazole, can improve inhibition efficacy. Furthermore, inhibitor intervention at early or late stages within the amyloid aggregation pathway is shown to correlate with the ability of these functional groups to recognize and bind amyloid species that appear either early or late within the aggregation pathway. These results demonstrate that functionalization of small aromatic molecules with recognition elements can be used in the rational design of Aβ aggregation inhibitors to not only enhance inhibition but to also manipulate the inhibition mechanism. [Copyright &y& Elsevier]

Abstract: Water consumed before a meal has been found to reduce energy intake among nonobese older adults. However, it is unknown whether this effect is evident among overweight and obese older adults, a population who would benefit from strategies to improve energy intake regulation. Our purpose was to determine whether premeal water consumption reduces meal energy intake in overweight and obese older adults. Twenty-four overweight and obese adults (body mass index=34.3±1.2), mean age 61.3±1.1 years, were given an ad libitum standardized breakfast meal on two randomly assigned occasions. Thirty minutes before the meal, subjects were given either a 500-mL water preload or no preload. Energy intake at each meal was covertly measured. Meal energy intake was significantly less in the water preload condition as compared with the no-preload condition (500±32 vs 574±38, respectively; P=0.004), representing an approximate 13% reduction in meal energy intake. The percentage reduction in meal energy intake following the water preload was not related to sex, age, body mass index, or habitual daily water consumption (all P>0.05). Given the high prevalence of overweight and obesity among older adults, future studies should determine whether premeal water consumption is an effective long-term weight control strategy for older adults. [Copyright &y& Elsevier]