Using meditation in a control vs. acceptance context: A preliminary evaluation of relations with anxiety, depression, and indices of well-being.

BACKGROUND AND OBJECTIVES: Meditation practices have been marketed broadly to ameliorate human suffering. As such, individuals may seek out and use meditation to control or manage unpleasant thoughts and emotions. Emotion and thought control research suggest that meditation used in this way may potentiate unpleasant private experiences and contribute to negative outcomes. We aimed to evaluate the function or purpose guiding meditation and its relations with anxiety, depression, and other indices of well-being. DESIGN AND METHODS: In a cross-sectional design, undergraduate meditators (N = 98) reported intentions guiding their meditation practice (i.e., experiential/emotional control or acceptance/openness) and completed an assessment battery. RESULTS: Most participants (58.2%) indicated using meditation to manage, control, or avoid difficult experiences. Participants using meditation with control-based intentions reported greater worry, anxiety, depression, negative affect, and lower mindfulness relative to their acceptance-guided counterparts. After controlling for level of anxiety, viewing anxiety as a problem increased the likelihood of using meditation with control-based intentions. Similar relations were observed between viewing stress as a problem and the likelihood of using meditation for experiential control. CONCLUSIONS: Findings suggest that (a) how people meditate is significantly related to psychological distress and (b) highlight the importance of evaluating intentions guiding meditative practices, particularly in individuals struggling with unpleasant emotional or psychological experiences.

Evaluating ACT Processes in Relation to Outcome in Self-Help Treatment for Anxiety-Related Problems.

Evaluating how, for whom, and under what conditions psychosocial treatments work is an important component of anxiety disorder treatment development. Yet, research regarding mediators and moderators of self-help interventions is sparse. The current project is a secondary analysis of mediators, moderators, and correlates of outcome of a randomized wait-list-controlled trial assessing acceptance and commitment therapy (ACT) self-help bibliotherapy for anxiety and related problems. Participants (n = 503) were randomized to an immediate workbook (n = 256) or wait-list condition (n = 247). Nonparametric bootstrapped mediation analyses showed that pre-post positive changes in ACT treatment processes accounted for the relation between treatment and pre-post improvement on the primary outcomes of anxiety symptoms, depressive symptoms, and quality of life. Results indicated no baseline variables were significant moderators. Finally, hierarchical regression analyses indicated that the degree of improvement for each primary outcome was positively correlated with the degree to which participants reported applying the workbook material to their day-to-day life, over and above how much of the book they reported reading. This study provided support for the ACT model of change in a self-help context and highlighted the importance of actively applying self-help material, addressing theoretical and practical questions about how and why ACT self-help works.

Validation of the distress tolerance scale-short form in obsessive compulsive disorder.

OBJECTIVE: This study aimed to develop and validate the Distress Tolerance Scale-Short Form (DTS-SF), a modification of the original Distress Tolerance Scale, in a severe/complex sample of individuals with obsessive compulsive disorder (OCD). Currently, there are multiple self-report measurements of distress tolerance (DT), highlighting the need for a more refined measure. METHOD: Participants included 222 individuals with a primary diagnosis of OCD (57% male, average age = 31) seeking intensive/residential treatment. Participants completed surveys at admission, discharge, and each week. RESULTS: An exploratory factor analysis revealed a one-factor solution representing overall DT ability. The DTS-SF was found to be sensitive to treatment effects. Appropriate associations between the DTS-SF and other measures were also found, with lower DT associated with greater OCD and depression severity and lower reported quality of life. CONCLUSION: The DTS-SF was found to be a valid and reliable measure with high clinical utility for quickly and accurately measuring DT.

How willing are you? Willingness as a predictor of change during treatment of adults with obsessive-compulsive disorder.

OBJECTIVE: Exposure and response prevention (ERP) is an effective treatment for individuals with obsessive-compulsive disorder (OCD), yet a substantial number of individuals with OCD do not fully respond to this intervention. Based on emerging experimental and clinical research on acceptance, this study sought to explore whether willingness to experience unpleasant thoughts, emotions, and bodily sensations during ERP was associated with improved treatment response. METHODS: Two hundred eighty-eight adults with OCD receiving residential ERP provided self-rated willingness and other exposure-related variables during each daily coached ERP session. Obsessive-compulsive and depressive symptom severity was assessed every week. Multilevel modeling was used to study the impact of willingness on treatment outcome during the first 6 weeks of residential care. RESULTS: Data indicated that individuals with higher willingness during ERP reported faster symptom reduction during residential treatment, even when controlling for length of stay, psychopharmacological intervention, depression, adherence, and rituals performed during ERP. These results appear to have both statistical and clinical significance. CONCLUSIONS: Willingness to fully experience unpleasant and unwanted thoughts, emotions, and bodily sensations during exposures appears to be a marker of successful exposure therapy in adults with OCD. Future research should examine how willingness may enhance extinction learning during ERP.