Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases.

Patients with acquired brain injury (ABI) often experience symptoms of anxiety and depression. Until now, evidence-based treatment is scarce. This study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) for patients with ABI. To evaluate the effect of ACT for people with ABI, a non-concurrent multiple baseline design across four cases was used. Participants were randomly assigned to a baseline period, followed by treatment and then follow-up phases. Anxiety and depressive symptoms were repeatedly measured. During six measurement moments over a year, participants filled in questionnaires measuring anxiety, depression, stress, participation, quality of life, and ACT-related processes. Randomization tests and NAP scores were used to calculate the level of change across phases. Clinically significant change was defined with the Reliable Change Index. Three out of four participants showed medium to large decreases in anxiety and depressive symptoms (NAP = 0.85 till 0.99). Furthermore, participants showed improvements regarding stress, cognitive fusion, and quality of life. There were no improvements regarding psychological flexibility, value-driven behaviour, or social participation. This study shows that ACT is possibly an effective treatment option for people experiencing ABI-related anxiety and depression symptoms. Replication with single case or large scale group studies is needed to confirm these findings.

Loneliness in patients with somatic symptom disorder.

OBJECTIVES: Patients with somatoform disorders often experience loneliness. They feel misunderstood and socially rejected. Whereas loneliness is related to several medical conditions, social support can minimize loneliness. In the current study, differences in loneliness and the evaluation of social support between patients with Somatic Symptom Disorder (SSD) and healthy controls were investigated using standardized questionnaires. In addition, the relation between loneliness and somatic symptoms was investigated. METHODS: In a cross-sectional study design, a group of patients with SSD (n=75) was compared to a healthy control group (n=112). It was hypothesized that [1] patients with SSD experience more loneliness and evaluate their social support more negatively than healthy controls and [2] loneliness will correlate positively with experienced somatic symptoms. RESULTS: In comparison to healthy controls, patients with SSD experienced more loneliness and their evaluation of social support was more negative. In addition, loneliness correlated positively with the degree of experienced somatic symptoms. CONCLUSIONS: Patients with SSD experienced lower social support, more loneliness, and across the two groups loneliness was positively associated with somatic symptoms. Effect sizes were all large. Therefore, these results may have implications for the treatment of SSD.

Loneliness and Mental Health: The Mediating Effect of Perceived Social Support.

Social connectedness is a fundamental human need. The Evolutionary Theory of Loneliness (ETL) predicts that a lack of social connectedness has long-term mental and physical health consequences. Social support is a potential mechanism through which loneliness influences health. The present cross-sectional study examined the relationship between loneliness and mental health, and the mediating effects of social support in a Dutch adult sample (N = 187, age 20 to 70). The health variables included in the study are anxiety, depression, somatic symptoms as measured by the SCL-90, and the DSM-5 diagnosis somatic symptom disorder. The results indicated that social support partially mediated the relationship between loneliness and anxiety, depression, and somatic symptoms. These results indicate that social support partially explains the relationship between loneliness and physical and mental health issues. The relationship between loneliness and being diagnosed with somatic symptom disorder was not mediated by social support. This suggests that the mechanisms through which loneliness relates to either somatic symptoms or somatic symptom disorder are different.

Associations of Affect, Action Readiness, and Sexual Functioning.

INTRODUCTION: Emotions are theorized to contain the components of affect and action readiness. Affect guides behavior by causing an approach or withdrawal orientation. Action readiness is the individual's degree of willingness to interact with the environment. Emotions contribute to changes in behavior and physiological responses. AIM: The present study applied these notions to sexuality and examined the associations between affect, action readiness, and sexual functioning. METHODS: Participants were male patients with urologic condition (N = 70) with and without sexual problems. MAIN OUTCOME MEASURE: Affect and action readiness were jointly assessed using the latent factor of affective polarity of the Positive and Negative Affect Schedule. Trait affective polarity was assessed questioning generally experienced feelings. State affective polarity was assessed after exposure to an erotic stimulus and questioning momentaneously experienced feelings. Sexual functioning was assessed using the International Index of Erectile Functioning questionnaire. RESULTS: A significant increase of approach-oriented action readiness was found after erotic stimulation, relative to trait levels. In addition, significant associations were found between state approach-oriented action readiness and various aspects of sexual functioning. Interventions based on principles of positive psychology might be developed to reinforce action readiness in men with erectile dysfunction. The strength of the current research concerns the introduction of action readiness as a potential psychological factor implied in sexual functioning. Limitations pertain to the use of the algorithm used to calculate state approach-oriented action readiness and the use of the current sample of patients with urological conditions, limiting generalizability of findings. CONCLUSION: Action readiness was found to correlate positively with all aspects of sexual functioning. Further research into the role of action readiness in sexuality is recommended. Henckens MJMJ, de Vries P, Janssen E, et al. Associations of Affect, Action Readiness, and Sexual Functioning. Sex Med 2020;8:691-698.

Automatic Sex-Liking and Sex-Failure Associations in Men With Sexual Dysfunction.

Current models of sexual functioning imply an important role for both automatic and controlled appraisals. Accordingly, it can be hypothesized that erectile dysfunction may be due to the automatic activation of negative appraisals at the prospect of sexual intercourse. However, previous research showed that men with sexual dysfunction exhibited relatively strong automatic sex-positive instead of sex-negative associations. This study tested the robustness of this unexpected finding and, additionally, examined the hypothesis that perhaps more specific sex-failure versus sex-success associations are relevant in explaining sexual dysfunction and distress. Male urological patients (N = 70), varying in level of sexual functioning and distress, performed two Single-Target Implicit Association Tests (ST-IATs) to assess automatic associations of visual erotic stimuli with attributes representing affective valence ("liking"; positive versus negative) and sexual success versus sexual failure. Consistent with the earlier findings, the lower the scores on sexual functioning, the stronger the automatic sex-positive associations. This association was independent of explicit associations and most prominent in the younger age group. Automatic sex-positive and sex-failure associations showed independent relationships with sexual distress. The relationship between sexual distress and sex-failure associations is consistent with the view that automatic associations with failure may contribute to sexual distress.