Corrigendum: A multiple-baseline evaluation of acceptance and commitment therapy focused on repetitive negative thinking for comorbid generalized anxiety disorder and depression.

[This corrects the article DOI: 10.3389/fpsyg.2020.00356.].

Acceptance and Commitment Therapy for improving the performance of chess players suffering from anxiety disorders

Previous research has suggested that brief protocols based on acceptance and commitment therapy (ACT) are efficacious in improving elite chess players' performance without clinical problems. These promising results warranted the examination of the effect of longer ACT interventions with chess players suffering from emotional difficulties. This study advances in this direction by presenting two case studies of elite chess players experiencing anxiety disorders. Each participant was matched to a control participant with similar characteristics. The ACT interventions were conducted in 5 sessions and with occasional follow-ups during the following year. The primary dependent variable was an objective measure of chess performance (ELO Performance). Data analysis was conducted using the JZS+AR Bayesian hypothesis testing for single-case designs and the nonparametric Tau-U statistic. Control participants did not significantly improve their chess performance during the follow-up, but chess players who received the intervention showed significant increases in their performance. Both treated participants experienced clinically significant reductions in symptomatology and improved valued living after the intervention. This study provides empirical evidence regarding the potential benefit of applying ACT to improve chess performance in players with clinical problems (AU)

Mejora del razonamiento analógico en ancianos / Improving Analog Reasoning in the Elderly

Analogical reasoning is perhaps the core element of intelligent behavior and it has been related to successful aging. The present study aimed to impact the analogical reasoning of the elderly individuals through the application of an analogies protocol based on promoting fluency and flexibility (FFA) in relational responding. The FFA protocol was designed specifically for this study and according to the available information on relational behavior. A pre-post design with two conditions, five participants each ranged of 69 to 89 years old. At pre-test, participants responded to two WAIS subscales as well as to three analogies tasks specifically designed for the study. Then, fluency and flexibility analogies protocol (FFA) was applied to the participants of the experimental condition throughout a week. Subsequently, in post-test, the same measures used in the pre-test were applied. The FFA protocol had a significant impact on three of the five measures. The sensitivity of the tests was discussed as well as different ways to improve the protocol impact were all discussed. The relevant effect produced for most of the participants are discussed and highlighted (AU)

Is this a Joke? Altering the Derivation of Humor Behavior

Despite the vast number of studies analyzing humor and its relation to other psychological variables, there is no consensus regarding under which conditions humor emerges. The current study aims to explore in this direction using three experimental protocols designed to alter the context of several jokes: the Reality protocol, to respond as if being in the situation described in the joke; the Identification protocol, to take the perspective of the characters in the jokes; and the Discomfort protocol, to respond to aversive functions given to these characters. Twenty-three participants were assigned to one of two conditions: in the Experimental condition, the first three jokes were preceded by one of the experimental protocols, whereas in the Control condition, the same jokes were presented without any contextual manipulation. Then, all participants were re-exposed to the jokes with no manipulation in a second phase. Facial responses and self-reports were used as measures of humor. Results show that the experimental protocols altered the emergence of humor in a replicable manner (mainly with the Reality and the Discomfort protocols) by reducing the humor responses and affecting their agreement. However, a decrease in humor responses as well as variability in the agreement between measures was observed in both conditions when re-exposed to the same jokes. These findings are discussed according to the contextual components defining each experimental protocol and highlight the functions that might be derived according to the interaction between the jokes and the participants’ histories of relating events (AU)

Transfer of conditioned fear and avoidance: Concurrent measurement of arousal and operant responding.

A reversal design was employed for the analysis of transfer of fear and avoidance through equivalence classes. Two 5-member equivalence classes (A1-B1-C1-D1-E1 and A2-B2-C2-D2-E2) were established. Then B1 and C1 were paired with shock (CS+) and served as SD s in avoidance training (B2 and C2 were trained as CS-/S∆ s for avoidance). Further avoidance training followed with D1 and E1 (as SD s) and D2 and E2 (as S∆ s), with the first presentation of each of these stimuli serving as the first transfer test. Afterwards, aversive conditioning contingencies were reversed: B2 and D2 were paired with shock and trained as SD s for avoidance, B1 and D1 were presented without shock (CS-/S∆ s). Transfer was tested again with C1, E1, C2 and E2. This reversal was implemented to allow for the within-subject replication of transfer effects upon changes in the function of only a subset of each class's elements. Avoidance (key presses) and conditioned fear (skin conductance and heart rate) were simultaneously measured. Results show a clear transfer effect for avoidance, with between- and within-subject replications. For physiological measures, transfer effects in the first test could only be imputed on the basis of group-based inferential statistical analysis. Evidence for between-subject replication was weaker, with only a limited proportion of participants meeting the individual criterion for transfer.

A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression.

Repetitive negative thinking (RNT) is a core feature of generalized anxiety disorder (GAD) and depression. Recently, some studies have shown promising results with brief protocols of acceptance and commitment therapy (ACT) focused on RNT in the treatment of emotional disorders in adults. The current study analyzes the effect of an individual, 3-session, RNT-focused ACT protocol in the treatment of severe and comorbid GAD and depression. Six adults meeting criteria for both disorders and showing severe symptoms of at least one of them participated in the study. A delayed multiple-baseline design was implemented. All participants completed a 5-week baseline without showing improvement trends in emotional symptoms (Depression Anxiety and Stress Scale - 21; DASS-21) and pathological worry (Penn State Worry Questionnaire; PSWQ). The ACT protocol was then implemented, and a 3-month follow-up was conducted. Five of the six participants showed clinically significant changes in the DASS-21 and the PSWQ. The standardized mean difference effect sizes for single-case experimental design were very large for emotional symptoms (d = 3.34), pathological worry (d = 4.52), experiential avoidance (d = 3.46), cognitive fusion (d = 3.90), repetitive thinking (d = 4.52), and valued living (d = 0.92 and d = 1.98). No adverse events were observed. Brief, RNT-focused ACT protocols for treating comorbid GAD and depression deserve further empirical tests.

Derived false memories using a respondent-type (ReT) procedure.

The present investigation used a respondent-type (ReT) training procedure to generate derived false memories. A one-to-many ReT training procedure was implemented in order to establish two stimulus equivalence classes, each consisting of one shape and 24 random words (i.e., Class 1 and Class 2). A partial test for stimulus equivalence with a subset of stimuli from each class followed. Failing an equivalence test resulted in additional ReT training and equivalence testing on new subsets of stimuli. After passing an equivalence test, participants were presented with 12 study-list words from Class 1 for memorization, followed by a distraction task. Finally, free recall and recognition tests for the study-list words were implemented. False recall and false recognition were more frequent for nonstudied Class 1 words than for nonstudied Class 2 words. These derived false-memory effects were more pronounced among those participants exhibiting more training and testing cycles and higher accuracy on stimulus equivalence tests. Furthermore, false recall and false remembering of nonstudied Class 1 words were more frequent for words that had been equivalence-tested than for words that had not been equivalence-tested. These results show how responses to contiguous stimuli could produce derived false memories and also highlight the role played by the equivalence test in increasing their emergence.

The self and responding to the Own's Behavior. Implications of coherence and hierarchical framing

The analysis of human behavior is a difficult endeavour, because of its variability, its generativity, and because of the influence of private events in our own acting. Behavior Analysis provided the first experimental bases to study these difficulties from a functional philosophy of behavior and, in 70', unexpected research findings opened the door towards an excellent avenue for the analysis of complex human behavior. Then, Relational Frame Theory began to be rooted and language, as a relational behavior, as framing, was experimentally approached. Several relational behaviors were identified, among others, deictic and hierarchical framing. As well coherence emerged as a historically established function of the behavior of framing. This presentation is focused on coherence and hierarchical framing as the key points of self/one's behavior and responding to the one's own behavior. Its implications extend to a wide range of scientific fields where a contextual human behavior approach is helpful (AU)

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Effect of a one-session ACT protocol in disrupting repetitive negative thinking: a randomized multiple-baseline design

Repetitive negative thinking (RNT) in the form of worry and rumination has been robustly identified as a transdiagnostic process implicated in the onset and maintenance of emotional disorders. Recent research suggests that both forms of RNT are particularly counterproductive experiential avoidance strategies because individuals usually engage in them as the first response when experiencing distress. This leads to the extension of relational networks and discomfort as well as to the engagement in additional experiential avoidance strategies that soon provoke meaningful life limitations. The current study analyzed the effect of a one-session Acceptance and Commitment Therapy (ACT) protocol in reducing RNT through altering the discriminative functions of the most relevant self-related thought to engage in RNT. We used a two-arm, randomized multiple-baseline design. Participants were 11 adults experiencing RNT that had interfered with their functioning for at least the last six months and were suffering from moderate emotional symptoms. Four RNT-related measures were administered: a daily RNT self-register, measures of pathological worry, rumination (brooding), and frequency of negative thoughts. Nine participants showed significant reductions in at least three out of the four RNT measures during the 6-week follow-up. Effect sizes were very large in all RNT-related measures and in emotional symptoms, experiential avoidance, cognitive fusion, and valued living. Testing an ACT version for emotional disorders specifically focused on disrupting RNT is warranted (AU)

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The role of common physical properties and augmental functions in metaphor effect

Metaphor is a tool frequently used in psychotherapy such as Acceptance and Commitment Therapy (ACT), a contextual behavioral model of psychological intervention rooted in an approach to human language and cognition known as Relational Frame Theory (RFT). This experimental analogue study aimed to analyze the effect of two variables in the metaphor effect on promoting psychological flexibility according to RFT: (a) the presence of common physical properties between the individual’s experience and the metaphor, and (b) the specification of appetitive augmental functions in the metaphor content. A 2x2 factorial design was implemented where the presence/absence of the above-mentioned variables was manipulated. Eighty-three participants first responded to measures of experiential avoidance, cognitive fusion, and generalized pliance. Subsequently, they were exposed to a cold-pressor task at pretest. Afterwards, participants were randomly assigned to four experimental protocols consisting of a metaphor that included: (a) common physical properties and augmental functions, (b) only common physical properties, (c) only augmental functions, and (d) none of these variables. Then, participants were re-exposed to the cold-pressor task (posttest). The results showed that both variables had a statistically significant effect on the pain tolerance induced by the cold-pressor task (AU)

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Dificultades y barreras del terapeuta en el aprendizaje de la Terapia de Aceptación y Compromiso (ACT) / Difficulties and Therapist’s Barriers while Learning ACT

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Contextual therapies are at its peak nowadays, as plenty of workshops, expertise courses, conferences on this matter are given every year around the world. Acceptance and Committment Therapy (ACT) is a contextual therapy that gathers a vast empirical evidence, and its application is currently widespread to multiple contexts. Nevertheless, when learning ACT some difficulties can arise, especially when theory and practice, as the two sides of the same coin, are set apart. Learning ACT involves the theotherical-applied dimension about the laws concerning human behavior, especially about human language. Moreover, about the conditions under which these laws applied to the processes and methods to generate psychological flexibility. While learning ACT, one of the main problems is related to learn ACT methods or tools without a basic, systematic, precise and contextualized training. An additional problem is related to the difficulties that emerge in the therapists themselves when interacting upon their clients behavior. Their actions might not to be frequently adjusted to the function of their clients’ behaviors -and, consequently, there should not be the appropriate context for helping the client to interact with his/her own private events without losing the direction of a valued-life. These latter difficulties have been named "the therapist's barriers". The present article addresses part of this problem. The experience gathered in researching and training professionals in ACT is briefly described, and some effective interventions are presented. This study advances over the need in isolating, experimentally, these ways of proceeding (AU)

Acceptance of relapse fears in breast cáncer patients: effects o fan act-based abridged intervention / Aceptación de miedos a la recaída en pacientes con cáncer de mama: efectos de una intervención abreviada basada en la ACT

Objective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients. Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a 'defusion' exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and 'anxious preocupation' were also evaluated through standardized questionnaires. Results: The analysis revealed that 'defusion' contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity of fear, distress, anxious preoccupation and hypochondria were also observed. Conclusions: Exposure through 'defusion' techniques might be considered a useful option for treatment of persistent fears in cancer patients. This study provides evidence for therapies focusing on psychological acceptance in cancer patients through short, simple and feasible therapeutic methods

Objetivo: El miedo a la recidiva es una secuela psicológica habitual en supervivientes de cáncer. El objetivo de este estudio es valorar los efectos de una versión breve de la Terapia de Aceptación y Compromiso (ACT) en pacientes de cáncer de mama. Método: Se realizó un ensayo abierto en el que participaron 12 pacientes no-metastásicas distribuidas en 2 condiciones, ACT y lista de espera. La intervención se aplicó en una única sesión individual y se centró en la aceptación del miedo por medio de un ejercicio de «defusión». Después de cada intervención y en el seguimiento trimestral se midieron la interferencia y la intensidad del miedo mediante escalas subjetivas. Además, las participantes completaron las escalas HADS, MINIMAC e IBQ. Resultados: El 87% de pacientes que recibieron la intervención mostró disminuciones clínicamente significativas en interferencia del miedo a la recidiva en el seguimiento trimestral, lo que no ocurrió en ninguna paciente en lista de espera. Los cambios en interferencia fueron estadísticamente significativos en las comparaciones pre, post y seguimiento, y también en la comparación con lista de espera. Asimismo se observaron cambios en intensidad, malestar emocional, preocupación ansiosa e hipocondría. Conclusiones: La exposición mediante técnicas de «defusión» puede ser considerada una alternativa terapéutica para el tratamiento de miedos persistentes en pacientes de cáncer. El estudio aporta evidencia de la utilidad de técnicas orientadas a promover la aceptación psicológica en pacientes oncológicos aplicadas mediante métodos terapéuticos breves y sencillos que son bien admitidos por los pacientes

The effect of relational training on intelligence quotient: a case study.

BACKGROUND: Relational training protocols based on Relational Frame Theory (RFT) are showing promising results in increasing intelligence quotient. This case study aimed at analyzing the effect of a training protocol in fluency and flexibility in relational responding on intelligence quotient with a 4-year-old child. METHOD: The child’s cognitive and psychomotor development was evaluated before and after the implementation of the training protocol using the McCarthy’s Aptitudes and Psychomotricity Scale (MSCA). The training protocol consisted of a multiple-exemplar-training (MET) in relational framing in accordance with COORDINATION (Phases 1 and 2), OPPOSITION (Phase 3 and 4), and COMPARISON (Phases 5 and 6). The MET protocol was implemented in approximately 12 hours throughout five and one half months. RESULTS: The training was effective in establishing relational responding in OPPOSITION and COMPARISON frames as well as in promoting fluency and flexibility in all the three types of trained relations. After this training, the child showed an increase above 1.5 SD in the General Cognitive Index of the MSCA (from 106 to 131). CONCLUSIONS: This case study adds further empirical evidence of the potential of RFT training to improve cognitive abilities and intelligence.

The effect of relational training on intelligence quotient: a case study / El efecto del entrenamiento en comportamiento relacional sobre el cociente de inteligencia: un estudio de caso

BACKGROUND: Relational training protocols based on Relational Frame Theory (RFT) are showing promising results in increasing intelligence quotient. This case study aimed at analyzing the effect of a training protocol in fluency and flexibility in relational responding on intelligence quotient with a 4-year-old child. METHOD: The child's cognitive and psychomotor development was evaluated before and after the implementation of the training protocol using the McCarthy's Aptitudes and Psychomotricity Scale (MSCA). The training protocol consisted of a multiple-exemplar-training (MET) in relational framing in accordance with COORDINATION (Phases 1 and 2), OPPOSITION (Phase 3 and 4), and COMPARISON (Phases 5 and 6). The MET protocol was implemented in approximately 12 hours throughout five and one half months. RESULTS: The training was effective in establishing relational responding in OPPOSITION and COMPARISON frames as well as in promoting fluency and flexibility in all the three types of trained relations. After this training, the child showed an increase above 1.5 SD in the General Cognitive Index of the MSCA (from 106 to 131). CONCLUSIONS: This case study adds further empirical evidence of the potential of RFT training to improve cognitive abilities and intelligence

ANTECEDENTES: los protocolos de entrenamiento relacional basados en la Teoría del Marco Relacional (TMR) están mostrando resultados prometedores en el incremento del cociente de inteligencia. El objetivo de este estudio de caso fue analizar el efecto de un entrenamiento en fluidez y flexibilidad en comportamiento relacional sobre el cociente de inteligencia en un niño de 4 años. MÉTODO: se evaluó el desarrollo cognitivo y psicomotor del niño a través de las Escalas de Aptitudes y Psicomotricidad de McCarthy (MSCA). La intervención consistió en un entrenamiento relacional en múltiples ejemplos para enmarcar en COORDINACIÓN (Fases 1 y 2), OPOSICIÓN (Fases 3 y 4) y COMPARACIÓN (Fases 5 y 6). El entrenamiento se aplicó en 12 horas aproximadamente durante cinco meses y medio, y resultó eficaz en generar comportamiento relacional para enmarcar en OPOSICIÓN y COMPARACIÓN y en promover fluidez y flexibilidad en los tres marcos relacionales. RESULTADOS: el niño mostró un incremento superior a 1.5 DT en el Índice Cognitivo General del MSCA (de 106 a 131). CONCLUSIONES: este estudio añade evidencia al potencial de los entrenamientos basados en la TMR para mejorar las habilidades cognitivas e inteligencia

Common physical properties among relational networks improve analogy aptness.

Relational frame theory (RFT) conceptualizes analogy as the establishment of a relation of coordination among common types of relations. This study provided an initial RFT analysis of analogy aptness. Twenty participants initially learned to respond to the structure of analogical tests after which they were trained on two separate relational networks, each consisting of three equivalence classes (Network: 1 F1-G1-H1, F2-G2-H2, F3-G3-H3; Network 2: M1-N1-O1, M2-N2-O2, M3-N3-O3). The node stimuli always appeared with color spots on their backgrounds (F1 and M1: yellow; F2 and M2: red; F3 and M3: blue). In the critical test, participants had to select the more correct response from two options: relating combinatorial relations of coordination with the same color in the node stimuli (e.g., relating G1H1 to N1O1) versus relating combinatorial relations with different colors in the node stimuli (e.g., relating G1H1 to N2O2). The colors of the node stimuli did not appear on the critical test. Ninety percent of participants selected the analogies with common color properties as the more correct ones. Practical implications of these findings are discussed.

Disruption of hypnotic behavior

Hypnosis has often been considered a mysterious phenomenon. In recent decades, procedures have been developed that have allowed us to explain this behavior in terms of variables of social or cognitive theories. However, previous approaches have not permitted formulating or delimiting the conditions that are responsible for following suggestions or their explanation in terms of involuntariness. For this purpose, two experiments were performed. In the first one, two hypnotic protocols were compared, the differences of which were aimed at influencing the voluntary and involuntary explanation of following suggestions and the effect of multiple exposure to both protocols. In the second experiment, four procedures to facilitate the voluntary interpretation of behavior were incorporated. The results of the first experiment yielded no statistically significant differences. However, in the second experiment, it was noted that changing the assessment questionnaire of the hypnotic experiences decreased following suggestions by 26%, and together with this, the use of explicit instructions did so by 67%. These results are discussed with regard to changes in rule-governed or instructional behavior in the so-called hypnotic phenomenon (AU)

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Brief ACT Protocol in at-risk adolescents with conduct disorder and impulsivity

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The aim of this preliminary research is to explore the effect of a brief protocol based on acceptance and commitment therapy (ACT) applied to five adolescents (15-17 years old) with conduct disorder and impulsivity, who had received treatment for the last few years without positive results. Problematic behaviors were aggressive, impulsive, and oppositional reactions at school, home, and neighborhood (e.g., drugs or alcohol consumption, legal violations, oppositionist and defiant reactions, etc.). A brief ACT protocol was designed to functionally suit the presence of impulsivity and the absence of self-control repertory of these adolescents as well as the resistance to psychological treatment. The brief protocol was focused on four aspects: (a) to set a context between the therapist and the adolescents to promote the sense of personal responsibility, (b) to confront the adolescents with the effect of their behavior regulation (pros and cons) and the experience of creative hopelessness, (c) to clarify personally important valued directions, and (d) to promote defusion skills so that the adolescents could take charge of their private experiences and choose actions according to their values. Four 90-min, individual sessions were implemented over two weeks. Participants and teachers’ reports obtained before, during, and after the treatment implementation showed a high positive change. In addition, 1-year follow-up information showed an important change in a wide range of areas such as family, social relationships, school achievement, and occupational status. These results suggest that brief ACT protocols can have a great impact on at-risk population. Limitations were discussed (AU)

A further Experimental Step in the Analysis of Hierarchical Responding

This study is a step forward in the difficult task of analyzing the transformation of functions via hierarchical relations. Eight participants underwent a computer task with five phases. During Phase 1, four stimuli were trained to become the following relational cues: INCLUDES, BELONGS TO, SAME, and DIFFERENT. In Phase 2, three equivalence classes were trained and tested (A1-B1-C1-D1; A2-B2-C2-D2; A3-B3-C3-D3). During Phase 3, inclusion relations were first established, by using the INCLUDES and BELONGS TO relational cues, between the to-be lower levels of the hierarchy, namely A1/B1, A2/B2, and A3/B3; and stimuli X.1, X.2, and Y.1, respectively. Then, the INCLUDES relational cue was used to establish inclusion relations between X.1/X.2 and X, and between Y.1 and Y, so that X and Y would become the most inclusive levels of two separate hierarchical networks. In Phase 4, X.1 was established as cold, D2 as heavy, and C3 as sweet. Lastly, in Phase 5 (Critical Test), seven stimuli from both hierarchical networks were tested for the transformation of functions. Five of the six participants who made it to this test responded correctly. Implications, limitations, and further research are discussed (AU)

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Effects of an acceptance/defusion intervention on experimentally induced generalized avoidance: a laboratory demonstration.

This study tests the effectiveness of an acceptance/defusion intervention in reducing experimentally induced generalized avoidance. After the formation of two 6-member equivalence classes, 23 participants underwent differential conditioning with two elements from each class: A1 and B1 were paired with mild electric shock, whereas A2 and B2 were paired with earning points. Participants learned to produce avoidance and approach responses to these respective stimuli and subsequently showed transfer of functions to non-directly conditioned equivalent stimuli from Class 1 (i.e., D1 and F1 evoked avoidance responses) and Class 2 (i.e., D2 and F2 evoked approach responses). Participants were then randomly assigned to either a motivational protocol (MOT) in which approaching previously avoided stimuli was given a general value, or to a defusion protocol (DEF) in which defusion (a component of Acceptance and Commitment Therapy) was trained while approaching previously avoided stimuli was connected to personally meaningful examples. A post-hoc control group (CMOT) was conducted with 16 participants to control for differences in protocol length between the former two groups. All participants in the DEF group showed a complete suppression of avoidance responding in the presence of Class 1 stimuli (A1-F1 and additional novel stimuli in relation to them), as compared to 40% of participants in the MOT condition and 20% in the CMOT condition. The acceptance/defusion protocol eliminated experimentally induced avoidance responding even for stimuli that elicited autonomic fear responses.

An Empirical Investigation of Hierarchical versus Distinction Relations in a Self-based ACT Exercise

Since its inception, ACT has placed a significant emphasis on the use of self-based techniques, and the self was defined initially through the three selves (i.e., self as content, self as process, and self as context). In addition, RFT provided a more technical account of self in terms of the deictic relational frames. However, the overlap between ACT’s mid-level terms (e.g., self as context) and RFT’s derived relations has been the subject of limited empirical scrutiny. The current study investigated the relative utility of manipulating distinction deictic versus hierarchical deictic relations in a self as context exercise designed to reduce experimentally induced emotional distress. The findings demonstrated superiority of the intervention that focused on hierarchical, rather than distinction, deictic relations in terms of reducing distress. The implications of the data for the potential overlap between ACT and RFT are discussed (AU)

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