Jennifer C. Plumb

A Randomized Clinical Trial of Acceptance and Commitment Therapy Versus Progressive Relaxation Training for Obsessive-Compulsive Disorder

OBJECTIVE Effective treatments for obsessive-compulsive disorder (OCD) exist, but additional treatment options are needed. The effectiveness of 8 sessions of acceptance and commitment therapy (ACT) for adult OCD was compared with progressive relaxation training (PRT). METHOD Seventy-nine adults (61% female) diagnosed with OCD (mean age = 37 years; 89% Caucasian) participated in a randomized clinical trial of 8 sessions of ACT or PRT with no in-session exposure. The following assessments were completed at pretreatment, posttreatment, and 3-month follow-up by an assessor who was unaware of treatment conditions: Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory-II, Quality of Life Scale, Acceptance and Action Questionnaire, Thought Action Fusion Scale, and Thought Control Questionnaire. Treatment Evaluation Inventory was completed at posttreatment. RESULTS ACT produced greater changes at posttreatment and follow-up over PRT on OCD severity (Y-BOCS: ACT pretreatment = 24.22, posttreatment = 12.76, follow-up = 11.79; PRT pretreatment = 25.4, posttreatment = 18.67, follow-up = 16.23) and produced greater change on depression among those reporting at least mild depression before treatment. Clinically significant change in OCD severity occurred more in the ACT condition than PRT (clinical response rates: ACT posttreatment = 46%-56%, follow-up = 46%-66%; PRT posttreatment = 13%-18%, follow-up = 16%-18%). Quality of life improved in both conditions but was marginally in favor of ACT at posttreatment. Treatment refusal (2.4% ACT, 7.8% PRT) and dropout (9.8% ACT, 13.2% PRT) were low in both conditions. CONCLUSIONS ACT is worth exploring as a treatment for OCD.

An Experimental Study of Emotional Responding in Women With Posttraumatic Stress Disorder Related to Interpersonal Violence

Although posttraumatic stress disorder (PTSD) is defined by the experience of intense negative emotions and emotional numbing (American Psychiatric Association, 1994), empirical study of emotional responding in PTSD has been limited. This study examined emotional responding among women with and without PTSD to positive and negative film stimuli across self-reported experience, facial expression, and written expression. Consistent with previous findings, no evidence for generalized numbing was found. In general, women with PTSD exhibited higher levels of negative activation and expressed more negative emotion words to both positive and negative film stimuli, whereas no group differences emerged in facial expressivity. Results are interpreted within the context of the current literature on emotional deficits associated with PTSD.

Mindfulness from the Bottom Up: Providing an Inductive Framework for Understanding Mindfulness Processes and their Application to Human Suffering

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In Search of Meaning: Values in Modern Clinical Behavior Analysis

Skinner described behavior analysis as the field of values and purpose. However, he defined these concepts in terms of a history of reinforcement and failed to specify whether and how human and nonhuman values might differ. Human values have been seen as theoretically central within a number of nonbehavioral traditions in psychology, including humanism and positive psychology. However, these approaches have failed to provide explanations of the behavior-environment relations involved in valuing that might allow prediction and influence with respect to this phenomenon. Modern clinical behavior analysis in the form of acceptance and commitment therapy (ACT), however, succeeds in providing a functional definition of human values that meets this latter criterion. ACT is rooted in behavior analysis and relational frame theory (RFT) and defines values in terms of verbally established motivation. ACT empirical research into values has begun to blossom in recent years, and ACT-RFT researchers are currently investigating the concept at the most basic empirical level as well as in the applied clinical arena, heralding new interest in and insight into values within clinical behavioral psychology.

The development and psychometric evaluation of the emotional reactivity and numbing scale.

Recent research has highlighted the role of hyperresponsivity and numbing of emotions in posttraumatic stress disorder. Preliminary research suggests that emotional numbing symptoms impact the development, maintenance, and treatment of posttraumatic stress disorder. However, research in this area has been hindered, in part, due to the absence of a psychometrically sound, conceptually based measure of emotional numbing. The present study examined the psychometric properties of the Emotional Reactivity and Numbing Scale in a sample of 92 trauma-exposed men and women veterans. Results provide preliminary support for the internal consistency, test-retest reliability, convergent, and discriminant validity of the measure. Implications for future research are discussed.