Education Commons^™

Differential Effects Of Mindful Breathing And Loving Kindness Meditations: A Component Analysis Study, Sarah J. Bolognino, Tyler L. Renshaw, Mary L. Phan

Psychology Faculty Publications

Objective: Mindful breathing meditation (MBM) and loving-kindness meditation (LKM) are common components of effective mindfulness-based interventions (MBIs). This study examined the differential effects of MBM and LKM on purported therapeutic process variables and mental health outcomes via component analysis.

Method: The research design was a randomized controlled trial with four conditions: MBM, LKM, combined (MBM + LKM), and a relaxation control. All conditions consisted of 10-min. audio-recorded guided meditations that were self-implemented over the course of two weeks. Participants were college undergraduates (N = 52).

Results: Findings indicated statistically significant and very large main effects of time, regardless of …

A Randomized Trial Of Acceptance And Commitment Therapy And Traditional Cognitive-Behavioral Therapy Self-Help Books For Social Anxiety, Jennifer Krafft, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

Background: Self-help resources such as books may help meet critical mental health needs in college students, but there is insufficient evidence on whether and how such books work. This randomized trial compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (tCBT) self-help books for social anxiety, a common concern with notable barriers to treatment seeking.

Methods: A sample of college students (n = 102) with social anxiety was randomly assigned to use one of the two self-help books over eight weeks.

Results: Improvements were observed in both conditions across all outcomes (social anxiety, general well-being, and social …

A Randomized Dismantling Trial Of The Open And Engaged Components Of Acceptance And Commitment Therapy In An Online Intervention For Distressed College Students, Michael E. Levin, Jennifer Krafft, Elizabeth T. Hicks, Michael P. Twohig, Benjamin G. Pierce

Psychology Faculty Publications

This dismantling trial compared the effects of a full online Acceptance and Commitment Therapy (ACT) intervention to the isolated effects of the Open (i.e., acceptance, cognitive defusion) and Engaged (i.e., values, committed action) components of ACT. A sample of 181 distressed college students were randomized to one of four conditions: a 12-session full ACT website (Full), a version targeting the Open components (Open), a version targeting the Engaged components (Engaged), or waitlist. Participants in active conditions were also randomized to receive phone coaching or just email prompts to increase program adherence. All three ACT conditions significantly improved over time relative …

Pilot Evaluation Of The Stop, Breathe & Think Mindfulness App For Student Clients On A College Counseling Center Waitlist, Michael E. Levin, Elizabeth T. Hicks, Jennifer Krafft

Psychology Faculty Publications

Objectives: College counseling centers face significant challenges meeting the mental health needs of their students and waitlists are common. Mobile apps offer a promising solution to increase access to resources while students wait for services. Methods: This pilot randomized controlled trial evaluated the feasibility and acceptability of a publicly available mindfulness app. Students on a counseling center waitlist (n=23) were randomized to use the app or not, with assessments completed over four weeks. Results: Recruitment over three semesters was slow, leading to an underpowered trial. Participants reported high satisfaction and moderate app usage. Very preliminary support was found for potential …

Examining Processes Of Change In An Online Acceptance And Commitment Therapy Dismantling Trial With Distressed College Students, Michael E. Levin, Jennifer Krafft, Michael P. Twohig

Psychology Faculty Publications

This secondary analysis examined the processes of change from a randomized dismantling trial evaluating the Open (i.e., cognitive defusion, acceptance) and Engaged (i.e., values, committed action) components of acceptance and commitment therapy (ACT). Analyses were conducted with 161 distressed college students randomly assigned to a full online ACT program (Full n=40), online ACT targeting the Open components (Open n=41) or targeting the Engaged components (Engaged n=39), or a waitlist condition (Waitlist n=41). The intervention occurred over six weeks followed by a post-treatment assessment with mental health symptoms as the primary outcome. Consistent with predictions, pre- to …

An Ecological Momentary Assessment Study Investigating The Function Of Hoarding, Jennifer Krafft, Clarissa W. Ong, Rick A. Cruz, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

This study examined the function of hoarding behaviors and the relations between hoarding and a series of cognitive and affective processes in the moment using ecological momentary assessment. A matched-groups design was used to compare college students with higher hoarding symptoms (n = 31) and matched controls (n = 29). The two groups did not differ in what function they reported acquiring served, and positive automatic reinforcement was the most commonly reported function in both groups. Engaging in hoarding-relevant behaviors did not predict change in positive or negative affect when controlling for previous affect. Emotional reactivity and experiential avoidance in …

Longitudinal Effects Of A 2-Year Meditation And Buddhism Program On Well-Being, Quality Of Life, And Valued Living, Brooke M. Smith, Clarissa W. Ong, Tyson S. Barrett, Ellen J. Bluett, Timothy A. Slocum, Michael P. Twohig

Psychology Faculty Publications

Objectives: Most research on mindfulness and meditation has focused on structured therapeutic interventions, such as mindfulness-based stress reduction, or meditation retreats. Such programs have received moderate empirical support for improving psychological outcomes in clinical and nonclinical populations, but there remains a paucity of research on intensive or long-term mindfulness or meditation programs for experienced practitioners, especially those that incorporate Buddhist teachings. The purpose of the current study was to investigate the effects of a long-term integrated mindfulness/meditation and Buddhism program, Dharma in Daily Life (DIDL).

Methods: Well-being, quality of life, valued living, and theorized processes of change were …

Evaluating The Open And Engaged Components Of Acceptance And Commitment Therapy In An Online Self-Guided Website: Results From A Pilot Trial, Julie M. Petersen, Jennifer Krafft, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

Online acceptance and commitment therapy (ACT) is promising for treating a range of psychological problems. Component research can further clarify which components are needed for optimal outcomes in what contexts. Online platforms provide a highly controlled format for such research. In this pilot trial, 55 adults were randomized to: ACT-Open (i.e., acceptance, defusion components), ACT-Engaged (i.e., values, committed action), or ACT-Combined (i.e., acceptance, defusion, values, committed action). Each condition was 12 sessions over six weeks, with assessments at baseline, posttreatment, and four-week follow-up. ACT-Open, ACT-Engaged, and ACT-Combined all significantly improved from pre- to post-treatment on mental health, psychosocial functioning, and …

Does A Brief Mindfulness Training Enhance Heartfulness In Students? Results Of A Pilot Study, Myriam Rudaz, Thomas Ledermann, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

(1) Background: There is robust evidence that mindfulness trainings enhance mindfulness as operationalized in Western psychology, but evidence about their effect on aspects of heartfulness is sparse. This study seeks to test whether a brief mindfulness training enhances heart qualities, including self-compassion, gratitude, and the generation of feelings of happiness.

(2) Methods: Eighteen students enrolled in a mindfulness training that was offered as part of an interdisciplinary class. The training consisted of five training sessions and four booster sessions of 45 minutes each over the course of nine weeks. Mindfulness was measured with the Five Facet Mindfulness Questionnaire-Short Form (FFMQ-SF) …

Comparing Cognitive Fusion And Cognitive Reappraisal As Predictors Of College Student Mental Health, Jennifer Krafft, Jack Haegar, Michael E. Levin

Psychology Faculty Publications

Transdiagnostic cognitive behavioral interventions target different cognitive processes to promote mental health, including cognitive fusion and cognitive reappraisal. Determining the relative impact of cognitive fusion and reappraisal on a range of student mental health concerns could help interventions target psychopathological cognitive processes more effectively. Therefore, this study examined the longitudinal impact of cognitive fusion and reappraisal on mental health and functioning outcomes. A series of hierarchical regression models tested the effects of cognitive fusion and reappraisal in a sample of college students (n = 339). When controlling for reappraisal and baseline symptoms, fusion predicted distress, depression, generalized anxiety, social anxiety, …

When Is Experiential Avoidance Harmful In The Moment? Examining Global Experiential Avoidance As A Moderator, Michael E. Levin, Jennifer Krafft, Benjamin G. Pierce, Sarah Potts

Psychology Faculty Publications

Background and Objectives: Although experiential avoidance has been shown to predict a wide range of mental health problems, there has been minimal research to-date on the more immediate effects of engaging in experiential avoidance in the moment or the moderators that predict when it is more or less harmful.

Methods: An ecological momentary assessment (EMA) study was conducted with 70 undergraduate students who completed assessments three times a day, over seven days as well as a baseline assessment of global questionnaires.

Results: Both greater global experiential avoidance and momentary experiential avoidance independently predicted greater momentary negative affect, lower positive affect, …

Assessing Psychological Inflexibility In University Students: Development And Validation Of The Acceptance And Action Questionnaire For University Students (Aaq-Us), Michael E. Levin, Jennifer Krafft, Jacqueline Pistorello, John R. Seeley

Psychology Faculty Publications

This study sought to develop and validate a domain-specific measure of psychological inflexibility for university students, the acceptance and action questionnaire for university students (AAQ-US). Generic versions of the AAQ tend to not be as sensitive to changes in campus-specific functioning —a key outcome of interest in this population. An online survey was conducted with 425 undergraduate students. Psychometric analyses led to the refinement of a 12-item, single factor scale with strong internal consistency. Evidence for convergent validity was found with moderate to large correlations between the AAQ-US and measures of academic outcomes, mental health, and psychological inflexibility. The AAQ-US …

The Role Of Experiential Avoidance In Problematic Pornography Viewing, Michael E. Levin, Eric B. Lee, Michael P. Twohig

Psychology Faculty Publications

Research suggests that online pornography use can have harmful consequences for some individuals, but the psychological processes that contribute to problematic viewing are unclear. This study sought to evaluate the role of experiential avoidance in the negative consequences of online pornography viewing in a small cross sectional survey sample of 91 male college students who reported viewing. Results indicated that viewing pornography for experientially avoidant motivations was related to more frequent viewing and predicted self-reported negative consequences of viewing over and above other motivations (e.g., sexual pleasure, curiosity, excitement seeking). Although more frequent viewing was related to more self-reported negative …

Comparing In-The-Moment Skill Coaching Effects From Tailored Versus Non-Tailored Acceptance And Commitment Therapy Mobile Apps In A Non-Clinical Sample, Michael E. Levin, Cynthia Navarro, Rick A. Cruz, Jack Haegar

Psychology Faculty Publications

Mobile apps are promising for teaching how to practice psychological skills in high-risk and in vivo momentary situations, but there has been minimal research on the immediate effects of app-based skill coaching on mental health in-the-moment. This study analyzed the mobile app data in a non-clinical sample of 39 adults participating in a larger randomized controlled trial, with participants randomized to an acceptance and commitment therapy (ACT) mobile app that tailors skill coaching based on in-the-moment variables (n = 17) or an app that provides randomly selected skill coaching (n = 22). Data was collected before and after each ACT …

Comparing Cognitive Defusion And Cognitive Restructuring Delivered Through A Mobile App For Individuals High In Self-Criticism, Michael E. Levin, Jack Haegar, Woolee An, Michael P. Twohig

Psychology Faculty Publications

There are ongoing questions regarding the similarities and differences in the clinical impact and processes of change for cognitive restructuring and cognitive defusion. This clinical component test compared 87 adults high in self-criticism randomized to a cognitive defusion mobile app, restructuring app, or waitlist condition for two weeks. Equivalent improvements were found from the defusion and restructuring apps relative to the waitlist in self-criticism and distress as well as decentering, self-compassion, and dysfunctional attitudes. However, the defusion condition had a more consistent pattern of improvements relative to waitlist. Improvements in cognitive decentering, self-compassion, and dysfunctional attitudes mediated effects for cognitive …

An Examination Of The Role Of Psychological Inflexibility In Hoarding Using Multiple Mediator Models, Clarissa W. Ong, Jennifer Krafft, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Hoarding is associated with functional impairment and impacts quality of life. One process that has been theorized to explain how hoarding develops and leads to impairment is psychological inflexibility, in which behavior is rigidly controlled by a perceived need to regulate internal experiences, at the expense of more effective, valued actions. The present study aimed to test the mediational role of psychological inflexibility in the development of hoarding and its impact on life satisfaction with a sample of 489 college students completing an online survey. Results indicated that multiple measures of psychological inflexibility (overall inflexibility, inattention, and values obstruction) mediated …

Tailoring Acceptance And Commitment Therapy Skill Coaching In-The-Moment Through Smartphones: Results From A Randomized Controlled Trial, Michael E. Levin, Jack Haegar, Rick A. Cruz

Psychology Faculty Publications

There is growing evidence for the efficacy of acceptance and commitment therapy (ACT) interventions delivered through smartphones, but research has not yet focused on how to optimize such interventions. One benefit of mobile interventions is the ability to adapt content based on in-the-moment variables. The current randomized controlled trial evaluated whether an ACT app that tailored skill coaching based on in-the-moment ecological momentary assessments (EMAs) would be more efficacious than the same app where skill coaching was random or an EMA-only condition. A sample of 69 adults interested in using a self-help app were randomized to one of three app …

Mindfulness And Acceptance-Based Trainings For Fostering Self-Care And Reducing Stress In Mental Health Professionals: A Systematic Review, Myriam Rudaz, Michael P. Twohig, Clarissa W. Ong, Michael E. Levin

Psychology Faculty Publications

This review summarizes the effectiveness of Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), Mindful Self-Compassion (MSC), and Acceptance and Commitment Therapy (ACT) to foster self-care and reduce stress in mental health professionals. Twenty-four quantitative articles from PsycInfo and PubMed were identified that focused on mindfulness, self-compassion, psychological flexibility, stress, burnout, or psychological well-being. All MBSR and MBCT studies lacked active control conditions, but some of the ACT studies and one MSC study included an active control. Most studies support evidence that all training programs tend to improve mindfulness and some also self-compassion. In addition, psychological flexibility was measured in …

The Interaction Of Mindful Awareness And Acceptance In Couples Satisfaction, Jennifer Krafft, Jack Haegar, Michael E. Levin

Psychology Faculty Publications

Past studies indicate that the awareness and acceptance facets of trait mindfulness both independently predict relationship satisfaction. However, this study hypothesized that the combination of awareness and acceptance might be a stronger contributor to relationship functioning than either in isolation. Regression analyses were used to test whether mindful awareness and acceptance interact in predicting couples satisfaction in a sample of dating or married college students (n = 138). Acceptance was positively associated with couples satisfaction, while awareness was unrelated. These two mindfulness facets interacted such that greater awareness was related to poorer satisfaction when acceptance was low, but was …

Evaluating An Adjunctive Mobile App To Enhance Psychological Flexibility In Acceptance And Commitment Therapy, Michael E. Levin, Jack Haegar, Benjamin G. Pierce, Rick A. Cruz

Psychology Faculty Publications

The primary aims of this study were to evaluate the feasibility and potential efficacy of a novel adjunctive mobile app designed to enhance the acquisition, strengthening, and generalization of acceptance and commitment therapy (ACT) skills being taught in therapy. A sample of 14 depressed/anxious clients receiving ACT used the ACT Daily app for two weeks in a pre-post, open trial design. Participants reported a high degree of program satisfaction. Clients significantly improved over the two-week period on depression and anxiety symptoms as well as a range of psychological inflexibility measures. Analyses of mobile app data indicated effects of …

Web-Based Self-Help For Preventing Mental Health Problems In Universities: Comparing Acceptance And Commitment Training To Mental Health Education, Michael E. Levin, Steven C. Hayes, Jacqueline Pistorello, John R. Seeley

Psychology Faculty Publications

No abstract provided.

An Initial Meta-Analysis Of Acceptance And Commitment Therapy For Treating Substance Use Disorders, Eric B. Lee, Woolee An, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Background: In the past decade, multiple studies have examined the effectiveness ofAcceptance and Commitment Therapy (ACT) for substance use disorders relative to other active treatments. The current meta-analysis examined the aggregate effect size when comparing ACT to other treatments (e.g., CBT, pharmacotherapy, 12-step,treatment as usual) specifically on substance use outcomes. Method: A total of 10 randomized controlled trials were identified through systematic searches. Results: A significant small to medium effect size was found favoring ACT relative to active treatment comparisons following treatment. Effect sizes were comparable across studies for smoking cessation (k = 5) and for other drug use disorders …

Feasibility Of An Acceptance And Commitment Therapy Adjunctive Web-Based Program For Counseling Centers, Michael E. Levin, Jacqueline Pistorello, Steven C. Hayes, John R. Seeley, Crissa Levin

Psychology Faculty Publications

Web-based adjunctive tools provide a promising method for addressing the challenges college counseling centers face in meeting the mental health needs of students. The current study tested an initial adjunctive prototype based on Acceptance and Commitment Therapy (ACT) in a pre-post open trial with 30 counselors and 82 student clients across 4 counseling centers. Results indicated high ratings of program satisfaction and usability with counselors and students. The majority of students completed at least part of the program. Significant improvements were found across almost all outcome and ACT process measures with student clients. Improvements in student outcomes were predicted by …

Decoupling As A Mechanism Of Change In Mindfulness And Acceptance: A Literature Review, Michael E. Levin, Jason B. Luoma, Jack Haegar

Psychology Faculty Publications

A growing body of research within the acceptance and mindfulness-based therapies suggests these treatments may function in part by reducing or eliminating (i.e., decoupling) the normative relationships between internal experiences and other internal/overt behavior. Examples of decoupling effects found in this review include reduced relationships between urges to smoke and smoking behavior, between dysphoric mood and depressive cognitions, and between pain intensity and persistence in a painful task. A literature review identified 44 studies on acceptance and mindfulness that demonstrated decoupling effects. Overall, preliminary evidence for decoupling effects were found across a broad range of problem areas including substance abuse, …

Which Facets Of Mindfulness Are Related To Problematic Eating Among Patients Seeking Bariatric Surgery?, Michael E. Levin, Kristy Dalrymple, Susan Himes, Mark Zimmerman

Psychology Faculty Publications

There has been growing research indicating the potential positive benefits of mindfulness-based interventions for obesity, but few studies have examined the relationship of mindfulness processes to obesity-related behaviors, particularly among clinical populations such as bariatric surgery candidates. The current study examined the relationship of specific mindfulness facets to a variety of problematic eating behaviors assessed through diagnostic interviews in a clinical sample of 820 patients seeking bariatric surgery. Results indicated that greater mindfulness on specific facets, particularly acting with awareness, were related to less binge and emotional eating. Greater mindfulness was also related, though less consistently, to less habitual overeating …