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Despite the high prevalence of yips, a psychoneuromuscular impairment affecting fine motor skills in sports performance, the specific aspects of its causality and treatment have not been identified or verified. This cross-sectional study examined psychosocial factors relating to throwing yips in baseball. Amateur baseball players (N = 292) living in Japan completed a self-report questionnaire on their anxiety/fear about throwing the ball, the Acceptance and Action Questionnaire-II, the Cognitive Fusion Questionnaire, the Short Fear of Negative Evaluation Scale, and self-reports evaluating values and social factors relevant to baseball. A hierarchical multiple regression analysis indicated that a low values-based throwing score, a high Cognitive Fusion Questionnaire score, and overreprimanding others' mistakes were positively associated with baseball players' yips symptoms. These results suggest that changing the context of playing baseball, reducing cognitive fusion, and improving coaching methods could reduce the risk of baseball players' throwing yips. [ABSTRACT FROM AUTHOR]

This article presents principles and practical guidelines for how managers can succeed in growing the intelligence of their organizations by harnessing the complementary strengths of humans and artificial intelligence (AI). Organizational intelligence is the ability of collectives of intelligent human and digital actors to solve problems and adapt. Six principles for human-AI collaboration in organizations are explored—addition, relevance, substitution, diversity, collaboration, and explanation—and how they play out in leading organizations is discussed. Finally, practical guidelines are outlined for how leaders can enable their organizations to successfully make the change. [ABSTRACT FROM AUTHOR]

Consumers regularly attempt to improve themselves. This research examines how consumers think about flexibility during goal pursuit, for themselves and others. Flexibility involves leaving details of a plan, such as when to go to the gym or what to eat, open or easy to change, whereas rigid plans determine those details in advance. Here, several studies across a variety of goals show that people usually choose rigid plans for others. However, people are more likely to opt for some flexibility in their own plans. This occurs because many people believe flexible plans are less effective, but also more appealing (or less unpleasant), than rigid ones. Choosing for oneself, versus for someone else, increases the degree to which one follows one's heart (i.e., relies on feelings and desires), which makes people more likely to choose the more appealing option, flexibility. Asking people to "follow their heads" instead (i.e., rely on logic and reason) causes people to choose similar (rigid) plans for themselves and others. Finally, the authors use this framework to increase preferences for rigid fitness plans in a field experiment. This research provides insight into the psychology of flexibility and how to nudge consumers to set themselves up for success. [ABSTRACT FROM AUTHOR]

Background: Breast cancer patients face significant psychological challenges, including difficulties in accepting the diagnosis, treatment, and long-term impact of the disease. Acceptance and Commitment Therapy (ACT) has shown promise in enhancing acceptance and psychological flexibility in various populations. This study aims to investigate the effectiveness of ACT in promoting disease acceptance among breast cancer patients through a randomized controlled trial. Methods: This study will recruit 90 breast cancer patients and randomly allocate them to an ACT intervention or control group. The ACT intervention, focusing on acceptance, mindfulness, value clarification, and committed action, will be delivered over 4 weeks. Meanwhile, the control group will receive standard care with non-therapeutic intervention. The study's primary outcome is disease acceptance, while secondary outcomes include depression, anxiety, social support, quality of life (QoL), and psychological inflexibility. Data will be collected at three points: baseline, post-intervention, and three-month follow-up. Statistical analysis will compare outcomes between groups to evaluate the effectiveness and mechanism of this intervention using covariance and mediation analysis. Discussion: This study evaluates the effectiveness of ACT in promoting disease acceptance among breast cancer patients. It hypothesizes that the ACT group will show higher disease acceptance and improvements in social support, QoL, and psychological flexibility compared to the control group. The findings will contribute to research on psychological interventions and demonstrate ACT's effectiveness in enhancing disease acceptance. Trial registration: The research project is registered in the ClinicalTrials (NCT05327153). [ABSTRACT FROM AUTHOR]

Background: The exact connection between mindfulness, psychological flexibility, and severity of symptoms within schizophrenia spectrum disorders is mostly undefined and requires additional exploration. This study aimed to determine whether mindfulness, cognitive fusion, and symptom severity predict self-compassion among patients with schizophrenia. Methods: A cross-sectional descriptive research design was undertaken within the psychiatric in-patient department of Mansoura University Hospitals, situated in El-Mansoura, the administrative centre of Dakahlia governorate in the Delta area, Egypt. A total of 100 patients with schizophrenia participated in the study. Data were collected from October 2023 to January 2024 by using various tools: A socio-demographic questionnaire and clinical data sheet, the Positive and Negative Syndrome Scale (PANSS), the Mindful Attention Awareness Scale (MAAS), The Cognitive Fusion Questionnaire (CFQ), and The Self-Compassion Scale – Short Form (SCS-SF). Results: The findings show that mindfulness significantly impacts self-compassion among patients with schizophrenia. The results show that mindfulness significantly and positively impacts self-compassion, and cognitive fusion significantly and negatively impacts self-compassion. However, symptom severity did not significantly impact self-compassion (B = -0.02, t = -0.56, p = 0.57). Conclusion: The study concluded that people with schizophrenia need to be aware of their inner experience of negative feelings and thoughts at the moment and accept them. Thus, ACT, mindfulness-based, and compassion-based interventions may improve patients' cognitive fusion, mindfulness, psychological flexibility, and self-compassion. [ABSTRACT FROM AUTHOR]

Background: The benefits of positive psychology interventions (PPIs) have become increasingly popular. While there is an emerging evidence base on the effectiveness of applying positive psychology in curriculum as preventive, early mental health intervention for higher education students, little is known about the content and pedagogy in these promising courses. Objective: This article describes (a) the rationale for and development of a positive psychology course embedded into the curriculum that aims to foster posttraumatic growth, psychological flexibility, and socio-emotional competencies for higher education students; and (b) a mixed-method non-randomised pre-post study to evaluate the effectiveness of the positive psychology course in achieving positive participant outcomes. Methods: Higher education students from different disciplines will be enrolled to a general education course, "Positive Psychology and Personal Growth", where they will learn progressive topics and complete summative assessments related to key areas in positive psychology. In addition to lectures, participants will engage in constructivist-based experiential activities that are guided by research on PPIs, life-design interventions and constructivist learning principles. The primary outcome is posttraumatic growth, and the secondary outcomes are psychological flexibility, and socio-emotional competencies. Expected results: We hypothesised that after the curriculum-embedded PPI, participants will have significantly higher levels of posttraumatic growth, psychological flexibility, and socio-emotional competencies. Results derived from the questionnaire survey will be supported by corroborating evidence identified from qualitative analysis of participants' summative assessments and follow-up semi-structured interviews on their perceptions of the present course. Discussion: The current study will fill in a gap in existing intervention research and practise in curriculum-embedded PPIs and promote research transparency and pedagogical advancement. The intervention provides guidance and recommendations for educators to consider embedding positive psychology into the formal curriculum as cost-effective, low-intensity, structured, and sustainable educational interventions for higher education students. [ABSTRACT FROM AUTHOR]

Background and aims: Giulia, an 11-year-old girl diagnosed with ligyrophobia, has been experiencing intense anxiety related to loud noises since the age of two. This case report aims to explore the efficacy of Third-Wave Cognitive Behavioral Therapy, specifically Acceptance and Commitment Therapy (ACT), in addressing Giulia's anxiety and avoidance behaviors. The primary goal is to examine the impact of ACT on reducing ligyrophobic symptoms and enhancing psychological flexibility. Methods: The therapeutic intervention spanned 24 sessions and was divided into two phases. The initial phase focused on emotional competence using characters from the movie "Inside Out," aiding Giulia in recognizing and understanding her emotions. The subsequent phase targeted the six processes of psychological inflexibility identified in ACT, fostering increased flexibility. Results: Throughout the intervention, Giulia demonstrated significant improvements in anxiety symptoms, as evidenced by a decrease in Subjective Units of Distress (SUD) scores. Avoidance behaviors also diminished, and Giulia exhibited enhanced mindfulness skills. She became more cognizant of her emotional experiences and more certain of her personal ideals as a result of the therapy. Giulia's active participation and commitment to exposure exercises led to a substantial reduction in ligyrophobic reactions. Discussion: The successful application of ACT in Giulia's case suggests that targeting psychological inflexibility through mindfulness and values clarification can be effective in treating ligyrophobia in children. The integration of metaphors and creative exercises proved valuable in engaging Giulia and fostering therapeutic progress. The findings underscore the importance of a tailored, third-wave therapeutic approach in addressing specific phobias in pediatric populations. [ABSTRACT FROM AUTHOR]

Background: Psychological flexibility (PF) is defined as the ability to pursue valuable life goals despite the existence of distress. The Personalized Psychological Flexibility Index (PPFI) is a new measure of psychological flexibility that can address existing deficiencies. This study aimed to translate and validate the psychometric characteristics of the Chinese version of the PPFI among medical college students. Methods: The study was conducted in two phases. Phase 1 involved the translation and cross-cultural adaptation of the PPFI according to guidelines recommended by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Phase 2 was a cross-sectional survey conducted on 945 medical college students in China. The psychometric performances of the scale were assessed using construct validity, divergent validity, criterion validity, incremental validity, internal consistency, and test-rest reliability. Results: The exploratory factor analysis (EFA, n1 = 440) showed that the Chinese version of the PPFI consisted of 3 factors, with a total of 15 items. The confirmatory factor analysis (CFA, n2 = 440) showed that the three-factor structure fit well (χ2/ df =2.469, SRMR = 0.051, RMSEA = 0.058, GFI = 0.94, CFI = 0.985). The total Chinese PPFI score had a moderate positive association with the Comprehensive Assessment of Acceptance and Commitment Therapy (CompACT, r = 0.344) and a negative association with the Acceptance and Action Questionnaire-II (AAQ-II, r = -0.334). Furthermore, the Chinese PPFI demonstrated good internal consistency (Cronbach's α = 0.826) and test–retest reliability (ICC = 0.817, p < 0.001). Conclusion: The 15-item Chinese version of the PPFI is a reliable and valid tool for measuring PF in Chinese medical students. However, additional studies are needed to validate its psychometric properties in more generalizable samples and other contexts. [ABSTRACT FROM AUTHOR]

The study aimed to investigate the relative contribution of each of psychasthenia, psychological flexibility, suggestibility, and conspiracy beliefs in predicting the anxiety of vaccination with the anti COVID-19 vaccine among faculty members at Ain Shams University (ASU). Examining the difference in the sample's scores on the vaccination anxiety scale and its sub-factors according to the variables (age—chronic diseases—academic specialization—previous infection with COVID-19—gender), the sample of the study included 139 faculty members at Ain Shams University aged ranged from 23 to 78 years, with a mean of 49.52 years, and a standard deviation of 13.29 years. The vaccination anxiety scale, psychasthenia scale, psychological flexibility scale, suggestibility scale, and conspiracy beliefs scale were used to collect data. The results revealed that the variables of suggestibility and conspiracy beliefs significantly contribute to predicting the vaccination anxiety among faculty members at Ain Shams University. There is a significant difference in the average scores on the vaccination anxiety scale according to age, with the difference in favor of the age group less than fifty years, as well as according to the presence/absence of a previous infection with COVID-19, with the vaccination anxiety being higher for those who were previously infected. There has been no observed significant difference according to the presence/absence of chronic diseases or academic specialization. [ABSTRACT FROM AUTHOR]

Stress is a known contributor to psychosocial pathological conditions and reduction of well‐being. The literature has highlighted the role of emotional schemas and psychological flexibility as psychological processes underlying this relationship in the short term. This two‐wave longitudinal study analyses the mediating role of psychological flexibility and emotional schemas in the relationship between stress responses to COVID‐19‐related events and mental health 6 months later. Two hundred and seventy‐six individuals were included in this study, completing measures of stress responses, emotional schemas, psychological flexibility and positive and negative mental health. Negative evaluation of emotions was a significant mediator in the longitudinal relationship between stress responses and negative mental health. Valued action and openness to experience mediate the longitudinal relationship between stress responses and positive mental health. This study underscores the importance of the different dimensions of psychological processes, suggesting that over time, more maladaptive psychological processes play a significant role in elucidating the relationship between stress responses and negative mental health. Similarly, it suggests that more adaptive processes may help explain the relationship between stress responses and positive mental health. This contributes to a better understanding of the stability of these processes, which is important for determining which intervention targets should be prioritised. [ABSTRACT FROM AUTHOR]

Hypersexuality refers to the inability to control sexual desire. Despite it has shown serious consequences for physical, psychological and social health, the evidence of available psychological interventions is still insufficient. In this open-label pilot study, an Acceptance and Commitment Therapy (ACT) intervention was conducted with adults with clinically significant levels of hypersexuality aimed to examine its feasibility and usefulness. The intervention consisted of eight weekly online individual psychological intervention sessions. Outcome self-report measures were administered at baseline, after the intervention and a 3 months follow-up. Behavioral and subjective informed changes in sexual practices were weekly assessed through self-monitoring. Twelve participants (M age = 38.8 ± 11.5 years, 83.3% male, 66.7% homo or bisexual) completed the intervention. The feasibility was found to be good, with all the participants completing the training and high levels of satisfaction. Hypersexuality, psychological flexibility, cognitive fusion and mindfulness scores significantly improved after the ACT intervention, with large effect sizes. Clinically significant changes in hypersexuality were found for the vast majority of participants, besides reductions in the time dedicated to planning and practicing sex and the sexualized drug use. Results indicate that ACT-based interventions may be considered feasible and potentially effective therapeutic alternatives for hypersexuality. [ABSTRACT FROM AUTHOR]

• There is no established treatment for problematic chemsex. • Problematic chemsex can be comorbid with sexual addiction. • Results of this exploratory study using ACT with MSM engaging in chemsex are promising. • Preliminary results suggest the efficacy of ACT towards associated psychological inflexibility, anxiety, depression, and sexual addiction. • Further research on ACT for chemsex in MSM is needed. Chemsex, a phenomenon involving the use of psychoactive substances in sexual contexts to facilitate or enhance sexual experiences, is substantially increasing among men who have sex with men (MSM), and has been described as a significant risk factor for mental and physical illness. However, no specialized treatment approach has yet been established. Acceptance and commitment therapy (ACT) could potentially be an appropriate psychotherapeutic framework, especially considering the MSM and sexual minority unique challenges and the role of psychological flexibility in this context. The present paper describes the assessment and ACT interventions, reports and discusses the results, of 10 adult MSM who self-referred to an outpatient psychiatry and addiction department in France for self-reported problematic chemsex that interfered with their quality of life. They completed symptom- and process-based measures at three different timepoints. Results were quantitatively analyzed, and the clinician's session notes and patients' experiences/accounts, recorded verbatim, served as a support for evaluating the global effects of ACT interventions. Results on outcome measures showed clinically notable and statistically significative improvements in psychological flexibility, anxiety and depression symptoms, as well as sexual addiction intensity between pre- and posttreatment, which were all persistent at 3- to 4-month follow-up. Process measure results indicated a high and consistent therapeutic alliance throughout therapy. This exploratory study, directly derived from clinical practice, suggests promising preliminary results. It can provide clinicians with a useful resource for using ACT as a potentially effective approach for problematic chemsex and comorbidities, and may guide future investigation to inform treatment development efforts, especially for MSM and sexual minority communities. [ABSTRACT FROM AUTHOR]

ABSTRACT This study aims to explore the differences in psychological flexibility, psychological capital and the perception of marital quality between parents of children with and without autism and to examine whether psychological capital could serve as a moderator of the association between psychological flexibility and the perception of marital quality. One‐hundred fifty parents of children with autism and 192 parents of children without autism completed an online survey. Parents of children with autism had lower psychological flexibility and psychological capital than the comparison group. The levels of psychological flexibility and psychological capital were also found to be significantly and positively correlated with the perception of marital quality of parents in both groups. Amongst parents of children with autism, hope significantly moderated the association between psychological flexibility and the perception of marriage quality. Hope buffers the relationship between psychological flexibility and the perception of marital quality amongst parents of children with autism. Designing unique, specific and tailored therapeutic interventions for parents of children with autism is recommended. [ABSTRACT FROM AUTHOR]

Purpose: Intensive Care Unit (ICU) staff report that a large part of the workrelated distress they experience is related to communication situations with colleagues, patients, and relatives. Based on these findings, the aim of the present study was to preliminary evaluate the effects of a novel Communication Skills Training (CST) program on mental health among ICU staff. Methods: The CST program was delivered to the entire work force of an ICU at a Swedish hospital and was evaluated as an uncontrolled clinical trial with three repeated measures. 100 participants were eligible and included in the analyses. The theoretical framework for the program was learning theory and cognitive behavioral therapy. The program was delivered by two psychologists and included one full-day lecture and three subsequent two-hour supervision sessions. Changes in mental health was evaluated with self-report questionnaires measuring perceived stress, general mental health, work engagement, and psychological flexibility. Results: Analyses of three repeated measures showed significant improvements with 1.3 points lower perceived stress and 2.0 points lower general mental health after the intervention. No differences were seen in measures of work engagement or psychological flexibility. Conclusion: Findings of the study supports the utility of the CST program as an intervention to target perceived stress and general mental health within intensive care. These findings should be further validated in trials with improved design. [ABSTRACT FROM AUTHOR]

Increased psychological flexibility (PF) may underlie the lasting positive effects of psychedelic experiences on mental well-being. The associations between different components of PF, psychological inflexibility (PI), and well-being with psychedelic use are not well understood. We conducted a cross-sectional internet survey of participants (N = 629) with experience of classical psychedelics. Using network analysis, we examined how aspects of a single psychedelic experience (mystical-type features and psychological insights) and the frequency of past psychedelic use, were associated with current PF and PI components, as well as with mental well-being and ill-being. Mediation analyses explored whether PF mediated the relationship between past psychedelic use and well-being or ill-being. The network analysis linked psychological insight to the PF component Acceptance, with no association found between the frequency of past use and PF. Mediation analyses showed PF mediates the association between past psychedelic use and well-being and ill-being. These results suggest that the quality and depth of the psychedelic experience, rather than the frequency of use, are primarily linked to psychological flexibility, particularly Acceptance, and overall well-being. This underscores the importance of treating PF as a multidimensional construct to better understand the long-term mental health benefits of psychedelics. [ABSTRACT FROM AUTHOR]

Pain is a central feature of inflammatory rheumatic diseases and is associated with psychological distress. Pain is widely recognized not as a mere physical sensation, but as a complex, multidimensional phenomenon with an affective component. A plethora of research has conceptualized adaptation to pain by focusing on minimizing the pain experience. However, pain in autoimmune inflammatory rheumatic diseases is often neither avoidable nor curable. This cross-sectional study aimed to investigate the processes explaining how pain intensity may be associated with low well-being and why some patients may live well despite pain. Drawing upon the psychological (in)flexibility model and the process model of emotion regulation, we propose that cognitive reappraisal moderates the association between pain and euthymia through experiential avoidance. Ninety-seven patients with rheumatoid arthritis, psoriatic arthritis, or axial spondyloarthritis were included for analyses (mean age = 53.4; mean time since diagnosis = 9.2 years). Most patients were women (75%), married/cohabitant (71%), and attended high school (47%). Results indicate that experiential avoidance may explain how severe pain is associated with lowered euthymia. This indirect negative effect of pain intensity on euthymia became non-significant at high levels of cognitive reappraisal, suggesting that cognitive reappraisal may serve as a protective factor for patients with autoimmune inflammatory rheumatic diseases. This study paves the way for future research in this promising context by providing an initial step towards integrating emotion regulation and psychological inflexibility in pain conditions. [ABSTRACT FROM AUTHOR]

The aim of this clinical article is to propose the relevance of the acceptance and commitment therapy (ACT) model Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. [2011. Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7(1), 141–168. https://doi.org/10.1146/annurev-clinpsy-032210-104449] to alleviate climate-induced psychological suffering. After a brief introduction establishing the need for climate-informed mental health intervention, the article is divided into three sections. The first section briefly presents ACT, highlighting the six core components of psychological flexibility. The second section provides a discussion to broaden and deepen psychotherapists’ understanding of eco-emotions, particularly eco-anxiety and eco-anger. The third section presents how this framework is relevant to assessing psychological flexibility in the context of climate change, using a hypothetical clinical example partly based on empirical findings. [ABSTRACT FROM AUTHOR]

Body image flexibility is a specific type of psychological flexibility relevant to body image. The development of the Body Image Flexibility and Inflexibility Scale (BIFIS) expands the concept and structure of body image flexibility and provides more detailed measurement indicators for theoretical research and clinical practice. However, the tool's applicability to the Chinese population is still unclear. This study aims to test the reliability and validity of the BIFIS among Chinese college students. A total of 1446 Chinese college students were surveyed and completed a series of scales, including the Chinese version of the BIFIS (i.e., C-BIFIS). A total of 99 participants were retested one month later. Confirmatory factor analysis supported the second-order factor structure of the BIFIS. The C-BIFIS showed measurement invariance across genders. The scale also exhibited good internal consistency and test–retest reliability. The higher-order body image flexibility and inflexibility factors were significantly correlated with unidimensional body image flexibility, body satisfaction, body appreciation, intuitive eating, and life satisfaction. Incremental validity tests indicated that two higher-order factors remained unique predictors of intuitive eating and life satisfaction. In conclusion, the Chinese version of the BIFIS has good psychometric properties and could be used to study body image flexibility in Chinese college student populations. [ABSTRACT FROM AUTHOR]

Background: Myocardial infarction (Ml) is a condition characterized by the death of heart muscle cells due to a lack of oxygen, frequently resulting in death. Disease and health-related beliefs may play a function in the progression of Ml. The current study aimed to examine the effectiveness of acceptance and commitment therapy on psychological flexibility of patients with Ml. Methods: The current research was semi-experimental research with a control group. The statistical population included all patients with Ml referred to Nasiriyah Heart Center, Nasiriyah, Iraq, in 2021 and 2022 (n = 473). In the current study, 90 individuals were selected by simple random sampling and divided evenly between intervention and control groups. The Cognitive Flexibility Inventory (CFI) was utilized for data collecting. Utilizing SPSS software, the analysis of covariance (ANCOVA) method was performed. The statistical significance level was considered to be 0.05. Results: Acceptance and commitment therapy was effective in psychological flexibility (F = 116.17, P < 0.001) in patients with Ml. Besides, the results of a one-way ANCOVA indicated that the subscales, including avoidance (F = 8.27, P < 0.001), acceptance (F = 13.86, P < 0.001), and harnessing (F = 6.14, P < 0.001), improved significantly. Conclusion: Acceptance and commitment therapy has increased the psychological flexibility of patients with Ml and is effective non-pharmaceutical therapy for the psychological management of these patients. [ABSTRACT FROM AUTHOR]

Objectives Design Methods Results Conclusions Appearance concerns following burn injuries are common. Psychological factors are important in maintaining such concerns. However, there is a lack of longitudinal or prospective research investigating their development. This study investigated whether psychological flexibility and self‐compassion at hospital admission predicted subsequent appearance concerns.A multi‐centre prospective cohort study across six burn services.Adults (n = 175; 67% male) in hospital following burn injuries were recruited. Questionnaires measuring appearance concerns, psychological flexibility, self‐compassion, post‐traumatic stress disorder symptoms and perceived noticeability were completed during hospital admission and two‐ and six‐months later. Demographic and burn injury information was collected.Correlational analyses showed that increased psychological flexibility and self‐compassion at admission were associated with decreased appearance concerns cross‐sectionally and prospectively at two‐ and six‐month follow‐up. These associations remained significant when controlling for key covariates (i.e. gender, age, ethnicity, percentage total body surface area burnt, perceived noticeability, PTSD symptoms). Multiple linear regression analyses revealed that psychological flexibility and self‐compassion predicted appearance concerns during hospital admission. Although psychological flexibility significantly predicted appearance concerns over time, it became non‐significant when controlling for baseline appearance concerns.Psychological flexibility has a protective role against appearance concerns soon after burn injuries, although this protective role is reduced when accounting for baseline appearance concerns. Early interventions targeting psychological flexibility (i.e. acceptance and commitment therapy) may be beneficial after burns if adapted to address appearance‐related concerns. [ABSTRACT FROM AUTHOR]

Purpose: People who seek psychotherapy often have problems tolerating distress. The purpose of the current systematic review was to understand whether treatments successfully reduce distress intolerance. We intentionally focused both on treatments developed specifically to target distress intolerance and we also evaluated whether any type of treatment resulted in reduced distress intolerance. Methods: We reviewed 106 papers covering (a) interventions specific to improving distress intolerance, and (b) pre-post reductions in distress intolerance over the course of any intervention, with a transdiagnostic and trans-intervention lens. Intervention was broadly construed to include laboratory single-session experimental treatments. Included studies required a measure of distress intolerance, and both self-report and behavioral measures were examined. Results: Across all papers reviewed, there were a variety of samples (people with psychopathology, non-clinical samples, etc.) and treatments (mindfulness-and-acceptance based treatment, cognitive-behavioral treatments, one-time workshops, etc.) relevant for distress intolerance. Findings generally support the notion that self-reported distress intolerance declines as a function of treatment across modalities, while studies that included behavioral measures were less consistent. Specifically, mindfulness and acceptance-based approaches appear to be at the core of most successful treatments for distress intolerance. Conclusion: Distress intolerance may be a useful transdiagnostic treatment target, with reductions in distress intolerance indicating decreased avoidance and greater psychological flexibility. [ABSTRACT FROM AUTHOR]

Background People with cancer who have completed treatment still experience negative effects, such as an increased risk of experiencing cancer-related pain. Psychological factors tend to influence cancer patients' ability to cope with pain in various dimensions. Although personal resources are an important factor in buffering total pain, still little is known about the intervening variables and underlying mechanisms. Purpose The current study examined the relationship between psychological flexibility, self-esteem, and total pain, while considering fear of recurrence, meaning-making, and coping as potential mediating factors. Methods Adults (N = 304) who completed medical treatment (radiotherapy, chemotherapy, and combined therapy) participated in this study. They completed questionnaires measuring the aforementioned variables. Structural equation models were used to examine mediation effects. Results Psychological flexibility, and partly self-esteem, were negatively related to the dimensions of total pain. However, to a large extent, these relationships were serially and parallelly mediated by fear of recurrence, meaning-making, and emotion-oriented coping. Conclusions Consistent with the meaning-making model, cognitive (meaning-making), and affective (fear of recurrence and emotional coping) factors may be potential mechanisms underlying the association between psychological flexibility, self-esteem, and total pain in posttreatment cancer patients. In this study, they tended to interact in the area of physiological and psychosocial experiences of cancer-related pain. [ABSTRACT FROM AUTHOR]

Adverse events have a profound impact on surgeons. This impact extends to physical and mental health, psychological wellbeing, and professional performance. Surgeons are ill prepared for these consequences of adverse events and are under-supported when they inevitably occur. Here we review the data on how adverse events affect surgeons. We explore the efforts made to date to both prepare surgeons before and support them after such events and we make recommendations regarding how this should and could be done better. [ABSTRACT FROM AUTHOR]

Cognitive flexibility is a personality trait, which can influence how effectively a healthcare professional can manage a challenging clinical situation. This study explored the cognitive flexibility of undergraduate dental hygiene students at two universities in Asia to gather baseline information in order to consider whether there was an educational need for pre-clinical students with regards to this personality factor. Participants were all undergraduate dental hygiene students in the 2022 academic year at Tokyo Medical and Dental University (TMDU; n = 79) and Taipei Medical University (TMU; n = 88). An anonymous questionnaire was distributed, which included questions on demographic information and the Cognitive Flexibility Inventory (CFI). The response rates were 97.5% (TMDU) and 89.8% (TMU). The CFI total scores were 91.77 for TMDU and 95.87 for TMU, and there was no significant difference between the two schools. The Alternatives scores were significantly higher in TMU than TMDU (P = 0.044), but there were no significant differences in the Control scores between the two schools. There were also no significant differences between school years of both universities. The dental hygiene students from both dental schools exhibit moderate cognitive flexibility. The educators in both dental schools may consider whether they should investigate and develop this personality factor further during the undergraduate training of their dental hygiene students. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to investigate the effectiveness of forgiveness therapy on psychological distress and psychological flexibility in women with marital conflicts. Methods: The research method was quasi-experimental, with a pre-test-post-test design and a control group. The statistical population included all women with marital conflicts who referred to health centers in District 3 of Tehran in 2022. The sample consisted of 30 women who scored lower in psychological flexibility and distress tolerance. They were selected through non-random voluntary sampling and were randomly assigned to experimental and control groups. Data were collected using the Distress Tolerance Scale by Simons and Gaher (2005) and the Psychological Flexibility Questionnaire by Dennis and Vander Wal (2010) in both pre-test and post-test stages. The session content was prepared according to the forgiveness therapy model by Enright and Fitzgibbons (2015). Data were analyzed using descriptive statistics and covariance analysis. Findings: The results of the covariance analysis indicated that the mean scores of psychological distress and psychological flexibility and their components in the experimental group significantly decreased compared to the control group (P = 0.05). Conclusion: Therefore, forgiveness therapy was effective in reducing psychological distress and enhancing psychological flexibility in women with marital conflicts. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic resulted in disruption of competitions and training for most athletes globally. Singapore underwent an unprecedented lockdown that forced cessation of sporting activities, following which, restrictions were lifted. This research aimed to investigate: (a) the impact of COVID-19 across Circuit Breaker (P1; full-lockdown) and Phase 2 (P2; fewer restrictions) on youth male and female athletes' mental health in Singapore through examining psychological distress, (b) the specific challenges faced by athletes, and (c) the moderating effects of psychological resilience and psychological flexibility as protective factors on mental health. A total of 117 national youth athletes (Mage = 16.83 years, SD = 1.75), across 15 sports completed an online survey across both phases including demographic information, validated scales to assess psychological distress (Kessler Psychological Distress Scale), psychological flexibility (Acceptance and Action Questionnaire-II) and psychological resilience (Brief Resilience Scale), as well as questions adapted from an International Olympic Committee survey and an open-ended question on challenges faced. Athletes reported facing significantly higher psychological distress (p <.001), had more difficulties managing sport and studies (p =.011), as well as sleep and recovery (p =.018) in P2 as compared to P1. Psychological flexibility and psychological resilience were significant moderators of poor mental health in P2 (p <.001). Qualitative responses corroborated findings that athletes faced a greater variety of challenges in P2. The findings shed light on how the Covid-19 pandemic impacted youth athletes' mental health, the challenges they faced, and the protective factors that could combat psychological distress. [ABSTRACT FROM AUTHOR]

This clinical trial aims to assess the effectiveness of internet-based Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) during the COVID-19 pandemic in reducing stress, anxiety, and depression, and psychological flexibility. 40 adolescents with subclinical features of emotional disorder randomly divided into two groups of intervention and control. The participants first completed DASS-21 and AAQ-2 questionnare online. Then, the intervention group received 12 sessions of UP-A through video calls on WhatsApp, 2 days per week each for 45 min. UP-A is an emotion-focused, cognitive-behavioral therapy consisting of 5 core modules or components that target temperamental characteristics, particularly neuroticism and resulting emotion dysregulation. Eventually the stress, anxiety, and depression levels decreased in intervention group and their psychological flexibility increased immediately and 3 months after the intervention. Clinical trial registration This study was registered by Iranian Registry of Clinical Trials (Prospective, ID: IRCT20210428051113N1, Registration date: 14/06/2021; https://en.irct.ir/trial/55900). [ABSTRACT FROM AUTHOR]

The present study investigated whether study engagement is predicted by personal resources (i.e., self-efficacy and psychological flexibility) and achievement goals. A total of 223 French first-year humanities and social sciences students were invited to complete an online questionnaire comprising scales measuring the three predictors. The results of regression analyses showed that 43.3% of the variance in study engagement was predicted by self-efficacy, psychological flexibility, and achievement goals, implying that these three factors could be used as levers to promote study engagement. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the predictive roles of psychological flexibility and frustration discomfort on marital adjustment among married women. Specifically, it sought to assess how these psychological constructs influence marital satisfaction and cohesion. Methods and Materials: A cross-sectional design was employed, sampling 350 married women from various counseling centers in Tehran in 2023. Participants completed standardized questionnaires measuring marital adjustment (Dyadic Adjustment Scale), psychological flexibility (Acceptance and Action Questionnaire - II), and frustration discomfort (Frustration Discomfort Scale). Multiple linear regression analyses were conducted using SPSS version 27 to explore the predictive value of psychological flexibility and frustration discomfort on marital adjustment, adjusting for potential confounders such as age and gender. Findings: The results revealed that both psychological flexibility (ß = 0.25, p < 0.01) and frustration discomfort (ß = 0.29, p < 0.01) significantly predicted marital adjustment, accounting for 42% of the variance in marital adjustment scores. These findings indicate that higher levels of psychological flexibility and lower levels of frustration discomfort are associated with better marital satisfaction and cohesion. Conclusion: The study underscores the importance of psychological flexibility and frustration discomfort in influencing marital adjustment. It suggests that interventions aimed at enhancing psychological flexibility and reducing frustration discomfort may contribute to improving marital satisfaction and stability. These findings highlight the need for a holistic approach in marital counseling and therapy that considers these psychological constructs. [ABSTRACT FROM AUTHOR]

Test anxiety negatively affects the academic development and psychological health of adolescents. High test anxiety may cause a decrease in the academic performance of adolescents. In this study, the role of psychological resilience in the relationship between test anxiety and academic resilience was examined. This study was conducted with a total of 565 adolescents (65.5% female and 34.5% male) aged between 12 and 19 in Turkiye (with a mean age of 14.04 and a standard deviation of 1.43). Adolescents completed Test Anxiety–Acceptance and Action Questionnaire‐Adolescents, Westside Test Anxiety Scale, and The Academic Resiliency Scale. For data analysis, the Pearson correlation coefficient and structural equation modeling were utilized to examine the relationships between variables. Acording to the results of the study, there was a positive relationship between academic resilience and psychological flexibility, a negative relationship between psychological flexibility and test anxiety, and a significant negative relationship between psychological flexibility and test anxiety. Academic resilience was found to predict psychological resilience positively and test anxiety negatively. In addition, psychological resilience had a significant negative effect on test anxiety. Academic resilience and psychological resilience explained 52% of the variance in test anxiety. psychological flexibility alone accounts for approximately 49% of the variance, while academic resilience independently explains about 36% of the variance in test anxiety. In addition, the significant mediating role of psychological flexibility in the relationship between academic resilience and test anxiety was confirmed. According to these results, it seems important to improve both academic resilience and psychological in adolescents to reduce test anxiety. [ABSTRACT FROM AUTHOR]

University students with higher experiential avoidance may not manage the adverse effects of dysfunctional family dynamics and develop interpersonal difficulties and suicidal risks. The purpose was to examine the mediating roles of experiential avoidance and interpersonal needs (i.e., thwarted belongingness, and perceived burdensomeness) in the relationship between family-of-origin dynamics and suicidality. Seven hundred ninety-four Turkish university students responded to a survey package measuring the constructs of self-differentiation, triangling, interpersonal needs, experiential avoidance, suicidality, and demographic information. Specific indirect effects -in two separate structural equation models- testing mediation effects of latent variables with bootstrapping revealed that participants with greater self-differentiation reported lower levels of experiential avoidance, perceived burdensomeness, thwarted belongingness (in serial), and suicidality (Model 1). Participants with higher triangling reported higher experiential avoidance, perceived burdensomeness, thwarted belongingness (in serial), and suicidality (Model 2). Perceived burdensomeness might be a predominant predictor of suicidality in the context of intergenerational family dynamics. Suicidality may increase as university students use avoidant coping strategies. The integrative perspective of the current study contributed to the literature that family-of-origin dynamics have a role in understanding the psychological flexibility and suicidal risks of university students. Implications may include assisting university students in greater self-differentiation and psychological flexibility. Mental health specialists may also consider strategies that university students achieve 'de-triangling' in their family of origin. [ABSTRACT FROM AUTHOR]

Background: Systematic reviews and meta-analyses reveal the importance of an accepting attitude towards cancer for mental health and functional coping. The aim of this study was to examine the psychometric properties of the German translation of the Peace, Equanimity, and Acceptance in the Cancer Experience (PEACE) questionnaire (Mack et al., 2008) and to investigate its associations with mental health, health-related quality of life (HRQoL) and related constructs. Methods: The German version of the PEACE (PEACE-G) was created and validated with cancer patients in a cross-sectional two center questionnaire study. Construct validity was tested with confirmational factor analyses (CFA); Cronbach's alpha was used to determine internal consistency of items. We further examined associations with depression (PHQ-8), anxiety (GAD-7), distress (NCCN distress thermometer), HRQoL (SF-12), psychological flexibility (AAQ-II), resilience (RS-11) and acceptance scales, to evaluate concurrent and divergent validity. Results: N = 213 cancer patients with different tumor entities participated in this study. Results of the CFA replicated the two-factor solution of the original PEACE (peaceful acceptance and struggle with illness) with satisfactory psychometric properties. Peaceful acceptance showed negative associations with depression, anxiety, distress, psychological inflexibility, and positive associations with HRQoL, acceptance, resilience, and mindfulness. Results of sensitivity analyses indicate a third factor (injustice/anger). Conclusions: The results demonstrate the validity and reliability of PEACE-G in cancer patients and point to the essential role of acceptance- and mindfulness-based interventions in psycho-oncology. Further studies are needed to investigate the different facets of struggle with the cancer illness. [ABSTRACT FROM AUTHOR]

Stigma reduction is a key objective in mental health policies. In the present study, a virtual reality programme, called Virtu-ACT, based on Acceptance and Commitment Therapy was created to promote psychological flexibility and reduce stigma in university students. The research was pretest-posttest randomized controlled experimental trial. A total of 208 students from the Faculty of Education of the University of Almeria participated. The experimental group (N = 143) went through Virtu-ACT and the control group (N = 67) used a virtual reality programme unrelated to mental health. A pre-, post- and one-week follow-up was conducted and two stigma assessment questionnaires, the Attributional Questionnaire Abbreviated Version (AQ-14) and the Acceptance and Action Questionnaire-Stigma (AAQ-S), were used. Results showed that the experimental group significantly increased psychological flexibility and reduced stigma. These results were maintained at follow-up. The significance of these results and the usefulness of using new technologies in this field are discussed. [ABSTRACT FROM AUTHOR]

This paper examines how employees make sense of their long work hours. We use a case study of an administrative unit at a public university in the United States, where expectations of working long hours are relatively low and employees have organizational resources to achieve work-life balance. Even so, we find that many employees still work more than expected and feel the need to work over the weekends. These employees overwhelmingly attribute their long hours to their personalities. Because many employees view their work as central to their existence, they invest their emotional energy and drive themselves to work longer hours than is expected from their supervisors and the institution. This individualized understanding that uses personality as a cultural frame persists and operates as a justification for long work hours even when other causes, such as staff shortage, were present. These findings imply that removing organizational expectations and rewards for long work hours alone is not enough for employees to achieve work-life balance because personal work ethics can still drive working long hours in the cultural context that puts high moral values on long work hours. In the conclusion, we discuss policies and cultural shifts needed to address these problems. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic held considerable health-related outcomes worldwide, including mental health challenges, with elevated risk of psychiatric sequelae. Methods: This study aimed to test the longitudinal (1 year) predictive role of psychosocial factors on post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms in SARS-CoV-2 survivors (N = 209 at T1; N = 61; attrition rate 70.83%), through Pearson's correlation analyses and longitudinal multiple regression analyses. Participants (age M = 35.4, SD = 10.1) completed online selfreport questionnaires of psychosocial variables, PTSD, anxiety, and depression. Results: Depression and anxiety symptoms were increased, and 42% of survivors presented clinically meaningful PTSD symptoms. PTSD symptoms were longitudinally predicted by having children (β = 0.32, p < 0.01), number of recent major life events (β = 0.34, p < 0.01), and psychological flexibility (β = -0.36, p < 0.01). Number of major life events (β = 0.29, p < 0.05) and psychological flexibility (β = -0.29, p < 0.05) predicted anxiety. Number of recent major life events (β = 0.32, p < 0.01) was the sole predictor of depressive symptoms. Discussion: Psychosocial variables contribute to the long-term harmful effects of the COVID-19 pandemic on psychopathological symptoms. These results suggest that, during the pandemic, mental health was impacted by both sociocontextual factors and individual self-regulatory skills, namely the ability to respond flexibily to contextual cues and guide behavior according to the direct experience. Specifically, results point out the importance of societal incentives to reduce parental burden and socioeconomic losses, as well as to promote adaptive psychological skills such as psychological flexibility. [ABSTRACT FROM AUTHOR]

Adaptive behaviour is crucial for well‐being and independence. The Adaptive Behaviour Assessment System (ABAS‐3) is often used to plan individualised support in specialist educational settings, drawing on both teacher and parent informants. In practice, however, little is known about the extent of variation between informants. We examined informant discrepancies in a naturally occurring dataset of 28 ABAS‐3 assessments (21 male, seven female), performed by teachers and by parents post‐admission at an autism specialist school. We found that in real‐life practice, teachers rated the adaptive functioning capabilities of their students significantly more highly than parents across all ABAS‐3 domains, a discrepancy significantly greater than validation studies with this instrument, and interestingly, non‐uniform across domains. The magnitude of this discrepancy was largest in the Conceptual domain, where differences between informants were greater in older children. The skill area most affected was 'self‐direction', which includes aspects of executive function. Existing guidance for adaptive functioning assessment in specialist education is extremely limited; while considering potential sources of informant discrepancy, our findings corroborate the need for further guidance on the use and scope of tools like the ABAS‐3 in educational settings. While such discrepancies may confound population‐level data, individually, these skills may be indicative of greater need to support generalisation across contexts, and may indicate the particular skill areas that are most amenable to intervention. [ABSTRACT FROM AUTHOR]

Introduction: Public speaking skills are crucial skills for medical students, enabling effective communication in their academic and future professional roles. However, public speaking anxiety (PSA) can hinder their full potential and warrant early intervention. This study aims to determine the prevalence of PSA and associated factors among medical undergraduates at a Malaysian public university. Materials and methods: A cross-sectional study was conducted using a validated and reliable online self-administered questionnaire. The Personal Report of Public Speaking Anxiety (PRPSA) questionnaire was used to assess PSA level and other factors such as sociodemographic, English proficiency level, public speaking training and experience, and the CompACT questionnaire for psychological flexibility. Descriptive, bivariate, and multivariate analyses were performed. Results: The analysis included a total of 362 respondents. The prevalence of moderate and high PSA was 49.3%. There was a significant association between race, psychological flexibility, public speaking experience, public speaking training, and PSA (p<0.05). Multiple logistic regression analysis showed that having high to moderate PSA was significantly linked to being 19-21 years old (AOR: 1.70, 95% CI: 1.081-2.678) and never having had public speaking training (AOR: 1.865, 95% CI: 1.067-3.261). On the other hand, being more psychologically flexible was a protective factor (AOR: 0.944, 95% CI: 0.925-0.964). Conclusion: The high prevalence of PSA among medical students highlights the need for early recognition, screening, and intervention within the education system. Incorporating public speaking training and interventions to enhance psychological flexibility within the curriculum can be beneficial to prevent PSA for better-quality graduates. [ABSTRACT FROM AUTHOR]

Background: Personal recovery is a persisting concern for people with psychotic disorders. Accordingly, mental health services have adopted frameworks of personal recovery, prioritizing adaptation to psychosis alongside symptom remission. Group acceptance and commitment therapy (ACT) for psychosis aims to promote personal recovery alongside improved mood and quality of life. Aims: The objectives of this uncontrolled, prospective pilot study were to determine whether 'Recovery ACT' groups for adults are a feasible, acceptable and safe program within public mental health services, and assess effectiveness through measuring changes in personal recovery, wellbeing, and psychological flexibility. Method: Program feasibility, acceptability and safety indicators were collected from referred consumers (n =105). Adults (n =80) diagnosed with psychotic disorders participated in an evaluation of 'Recovery ACT' groups in Australian community public mental health services. Participants completed pre- and post-group measures assessing personal recovery, wellbeing, and psychological flexibility. Results: Of 101 group enrollees, 78.2% attended at least one group session (n =79); 73.8% attended three or more, suggesting feasibility. Eighty of 91 first-time attendees participated in the evaluation. Based on completer analyses (n =39), participants' personal recovery and wellbeing increased post-group. Outcome changes correlated with the linear combination of psychological flexibility measures. Conclusions: 'Recovery ACT' groups are feasible, acceptable and safe in Australian public mental health services. 'Recovery ACT' may improve personal recovery, wellbeing, and psychological flexibility. Uncontrolled study design, completer analyses, and program discontinuation rates limit conclusions. [ABSTRACT FROM AUTHOR]

Tom MacDonald's success in the music industry can provide valuable insights for leaders and founders, particularly in the context of high-reliability organization (HRO) theory—MacDonald's approach to music challenges conventional wisdom and societal norms, promoting open communication and adaptability. HROs should prioritize open channels, invest in training, and support continuous learning. Clear communication is crucial for employees to understand the organization's roles, responsibilities, and goals, facilitating collaboration and problem-solving. It also helps manage change and prevents crises. Investing in communication skills and practices is essential for driving organizational success and resilience in today's fast-paced business environment. [ABSTRACT FROM AUTHOR]

Recent literature suggests that acceptance and commitment therapy (ACT) may be an effective approach for treating symptoms of depression and anxiety symptoms in adolescents. This review meta-analyzes the efficacy of ACT on adolescent depression and anxiety, emphasizing the role of process variables (i.e., psychological flexibility). We systematically searched MedLine, PsycInfo and Scopus for randomized controlled trials (RCT) investigating the effect of ACT on anxiety/depression in adolescents. Studies were combined using the inverse variance method in a random effects model. Additional subgroup and meta-regression analyses were performed, and risk of bias was assessed. The review was pre-registered (PROSPERO registration number: CRD42023483300). Our review included 27 RCTs with a total of 2860 participants. ACT did not outperform CBT but was significantly more effective than other active controls (e.g., treatment as usual) for depression symptoms and inactive controls for all outcomes. ACT was more effective than inactive controls for all outcomes. Improvements in psychological flexibility significantly predicted reductions in between-group depression and anxiety. Younger age and a higher percentage of women predicted better outcomes for some outcomes. It should be noted that this results may be limited by the fact that all included studies were rated as having a high risk of bias. This is mainly due to the self-reported nature of the measures and the lack of crucial methodological information (e.g., process of randomization and allocation, treatment fidelity assessment). Our findings support ACT's efficacy for adolescents, particularly in treating depression symptoms. The proposed mechanism of change (psychological flexibility) plays a significant role in the improvements. ACT is comparable in efficacy to CBT, suggesting its potential as an alternative to traditional cognitive-behavioral approaches. • This review meta-analyzes ACT efficacy on adolescent depression/anxiety symptoms. • ACT outperformed active controls for depression and inactive controls for all outcomes. • Psychological flexibility predicted depression and anxiety symptom improvements. • ACT could be an alternative intervention to traditional CBT in adolescents. [ABSTRACT FROM AUTHOR]

Background: Although depression and anxiety often co-occur, the relationship between their symptoms has not been explored in non-clinical populations. Moreover, the relationship between these affective symptoms and psychological flexibility (PF) requires further investigation to improve intervention sensitivity. This study used a network approach to examine the comorbidities of depression and anxiety, and their relationship with PF. Methods: The study sample included 1,059 Korean community participants. Two separate networks were established using items that assess depression, anxiety, and PF. Bridge strength centrality was calculated to identify the components that acted as bridges between different clusters in the network. Results: The results indicated that the major symptoms related to depression and anxiety symptom clusters were depressed mood, restlessness, and irritability. Additionally, the PF value process was positively associated with combined symptom clusters. Conclusions: These findings provide a nuanced understanding of how symptoms and protective processes interact with and influence each other. Clinical implications and future research directions have been discussed. [ABSTRACT FROM AUTHOR]

Multiple studies have investigated the efficacy of acceptance and commitment therapy (ACT) in improving psychological flexibility among overweight and obese individuals. However, to date, no specific reviews have focused on ACT and weight-related difficulties in this population. This systematic review of the literature aims to identify and assemble all ACT interventions in randomized controlled trials (RCT) that address weight-related difficulties in the treatment of overweight and obese adults. The PRISMA 2020 framework was used for the systematic review, includes manual and computerized database searches. Five databases (Medline, PubMed, Scopus, PsycInfo, and Google) were utilized to gather all articles that: (a) published in English; (b) adopted the RCT design; (c) used ACT as an intervention; (d) included adult participants aged over 18 years with BMI of over 25 kg/m2, and (e) included weight-related difficulties and weight as outcome measures. The review identified seven studies comprising 698 overweight or obese participants of both genders. Improvements were reported in weight-related difficulties and percentage of weight loss in the ACT group and the non-ACT group. The present review supports ACT as an effective intervention that can help adults with weight-related difficulties and excess body weight. Further studies should be conducted in various overweight or obese populations with a more systematic RCT research design to establish the effectiveness of ACT in this area. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic brought with it significant social, economic and health uncertainties. These were proposed to impact young people more compared to adults, leading adolescents to report more mental health problems during the pandemic. The current study examined whether differences in cognitive risk (tolerance of uncertainty) and protective (psychological flexibility) factors accounted for age-related differences in depression and anxiety. Methods: These associations were investigated in the COVID-19 Risks Across the Lifespan (CORAL) cohort (N = 2280, 11–89 years). Results: The results showed that adolescents experienced greater intolerance of uncertainty and lower psychological flexibility compared to adults and older adults. Tolerance of uncertainty did not account for age-related differences in depression or anxiety. However, psychological flexibility conferred more protective advantage for anxiety in adults compared to adolescents. Conclusion: The observed age-related differences in risk and protective factors advance our understanding of developmental vulnerabilities to depression and anxiety. Implications for mental health interventions in the context of future pandemics are discussed. [ABSTRACT FROM AUTHOR]

The current case describes the implementation of Acceptance and Commitment Therapy (ACT) and self-compassion interventions with a 37-year-old Queer Hispanic woman "Cynthia" (pseudonym). Cynthia presented to a university training clinic, reporting pervasive difficulties with anxiety, an associated pattern of depressive episodes, and a trauma history. The therapist conceptualized Cynthia's presenting problems through an ACT-based psychological flexibility framework. Functional analysis indicated intolerance of uncertainty, fusion to self-critical thoughts, and experientially avoidant behaviors (e.g., pervasive worry) contributed to Cynthia's anxiety. Values clarification, as well as mindfulness- and acceptance-based interventions, were met with gains in quality-of-life scores and decreases in worry scores as treatment progressed. Additionally, self-compassion interventions were implemented to address pervasive self-criticism and feelings of low self-worth. Across 37 sessions, from pre-to-post treatment, Cynthia's quality of life scores increased by 62.5%, and worry decreased by 52.8%. These results provide support for using ACT and self-compassion interventions for anxiety and co-occurring depression with a Queer, Hispanic woman. [ABSTRACT FROM AUTHOR]