Effects of group Acceptance and Commitment Therapy (ACT) on anxiety and depressive symptoms in adults: A meta-analysis.

BACKGROUND: A comprehensive meta-analysis quantitatively examining the effects of group Acceptance and Commitment Therapy (ACT) on anxiety and depressive symptoms is required to advance our understanding of its efficacy and moderating factors. METHODS: Four electronic databases were searched in August 2018. An update search was conducted in November 2021. Forty-eight randomised controlled trials (RCTs) were included in this review (3292 participants: anxiety = 34 RCTs, depression = 40 RCTs). RESULTS: The overall effect size for anxiety symptoms was medium-to-large (g = 0.52, p < 0.001; 95% CI = 0.30-0.73), while the overall effect size was small-to-medium for depressive symptoms (g = 0.47, p < 0.001; 95% CI = 0.31-0.64). Subgroup analyses demonstrated that group ACT was significantly superior to non-active controls (e.g., waiting list) in reducing anxiety and depressive symptoms. Group ACT was only significantly superior to active controls (e.g., CBT) in reducing depressive symptoms. Subgroup analyses also demonstrated that the effect size can vary depending on the number of sessions provided and the primary condition of participants recruited. LIMITATIONS: The number of studies included in each category of subgroup analyses was small and the risk of bias varied across studies. There was high heterogeneity among the included studies, and this might have affected the results. CONCLUSION: The current evidence suggests that group ACT may be effective in treating anxiety and depressive symptoms, perhaps more so for depressive symptoms when compared to other well-established treatments. The intensity of treatment and the targeted population may need to be considered when delivering group ACT.

Generalização de mandos aprendidos pelo PECS (Picture Exchange Communication System) em crianças com transtorno do espectro autista / Generalization of mands learned by PECS (Picture Exchange Communication System) in children with autism / Generalización de mandos aprendidos por PECS (Picture Exchange Communication System) en los niños autistas

O ensino de comportamento verbal com o uso de comunicação alternativa é um instrumento para melhorar a interação social de crianças com Transtorno do Espectro Autista (TEA). O objetivo do estudo foi ensinar mandos com o Picture Exchange Communication System (PECS) e avaliar a sua generalização entre ambientes. Os mandos treinados consistem na troca de cartões com estímulos visuais pelos próprios itens. Participaram do estudo quatro crianças diagnosticadas com TEA, com idade entre 6 e 12 anos. Após treino do PECS, professora e mães receberam instruções e registraram a emissão de mandos (teste de generalização) nos ambientes escolar e domiciliar. Os resultados mostraram que para três crianças o ensino de mandos foi bem sucedido e que ocorreu a generalização para outros itens nos dois contextos avaliados. É discutida a necessidade de maior controle de variáveis que interfiram no treino para a aquisição de mandos, além de planejamento da generalização pelas crianças para ambientes, pessoas e itens diferentes.

Verbal training with the use of alternative communication is a tool for improving the social interaction of children with Autism Spectrum Disorder (TEA). The aim of this study was to promote generalization of trained mands through the Picture Exchange Communication System (PECS). Trained mands comprise the exchange of pictures with visual stimuli by the items themselves. There were 4 autists aged between 6 and 12 years old, who took part in the study. After the PECS training, the teacher and the mothers were instructed to take notes of the mands performed in school and home settings. Results have shown that 3 children met the learning criterion for PECS and that there was a generalization for other settings. The need for greater control of the variables that interfere with mand acquisitions and the children planning for generalization of environment, people and different items have been discussed.

Entrenamiento verbal con el uso de la comunicación alternativa es una herramienta para mejorar la interacción social de los niños con trastorno del espectro autista (TEA). El objetivo era enseñar a los comandos con el Sistema Picture Exchange Communication (PECS) y evaluar su generalización. Mandos entrenados consisten en el intercambio de cartas con los estímulos visuales por elementos propios. Los participantes del estudio fueron cuatro niños diagnosticados con TEA, de 6 a 12 años. Después del entrenamiento del PECS, profesor y madres fueron instruidos y grabó las exigencias de emisiones (prueba de generalización) en el entorno escolar y el hogar. Los resultados mostraron que a tres hijos demandas del entrenamiento fue un éxito y lo que pasó generalización a otros artículos en los dos contextos evaluados. Se discutió la necesidad de mayores variables de control que interfieren con lo entrenamiento para adquirir comandos y la generalización de la planificación para los niños a los ambientes, personas y diferentes elementos.