Psychological flexibility in depression relapse prevention: processes of change and positive mental health in Group-Based ACT for residual symptoms
Zettle, Robert D.
Landro, Nils Inge
Haaland, Vegard Oksendal
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Ostergaard, Tom; Lundgren, Tobias; Zettle, Robert D.; Landro, Nils Inge; Haaland, Vegard Oksendal. 2020. Psychological flexibility in depression relapse prevention: processes of change and positive mental health in Group-Based ACT for residual symptoms. Frontiers in Psychology, vol. 11:art. no. 528
Relapse rates following a depressive episode are high, with limited treatments available aimed at reducing such risk. Acceptance and commitment therapy (ACT) is a cognitive-behavioral approach that has gained increased empirical support in treatment of depression, and thus represents an alternative in relapse prevention. Psychological flexibility (PF) plays an important role in mental health according to the model on which ACT is based. This study aimed to investigate the role of PF and its subprocesses in reducing residual symptoms of depression and in improving positive mental health following an 8-week group-based ACT treatment. Adult participants (75.7% female) with a history of depression, but currently exhibiting residual symptoms (N = 106) completed measures before and after intervention, and at 6 and 12-month follow-up. A growth curve model showed that positive mental health increased over 12-months. Multilevel mediation modeling revealed that PF significantly mediated these changes as well as the reduction of depressive symptoms, and that processes of acceptance, cognitive defusion, values and committed action, in turn, mediated increased PF.
© 2020 Ostergaard, Lundgren, Zettle, Landro and Haaland. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.