Document Type : Research Article
Authors
1 M. A. in General Psychology, Department of Psychology, Rahbord Shomal Institute of Higher Education, Rasht, Iran
2 Assistant Professor, Department of Psychology, Rahbord Shomal Institute of Higher Education, Rasht, Iran
Abstract
This study aimed to examine the effectiveness of acceptance and commitment therapy (ACT) on suicidal ideation, emotional self-regulation, and psychological flexibility in adolescents with suicidal ideation who were referred to a social emergency center. The research method was a quasi-experimental pretest-posttest design with a control group. The population of the study included all adolescents with suicidal ideation who visited the counseling center of the social emergency in Astaneh-ye Ashrafiyeh city in 2021. Thirty participants (15 in the control group and 15 in the experimental group) were selected from this population by purposive sampling and randomly assigned to two groups. The experimental group received eight 90-minute sessions of group ACT, while the control group was put on a waiting list. Data were collected using the Acceptance and Action Questionnaire (AAQ-2), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Beck Scale for Suicide Ideation (BSSI). Data were analyzed using the analysis of covariance (ANCOVA) test. The results showed that there was a significant difference between the experimental and control groups in the posttest mean scores of the reappraisal component of emotion regulation and suicidal ideation. However, there was no significant difference in the flexibility and suppression components of emotion regulation. Based on the results of this study, it is recommended that psychologists and psychotherapists working in social emergency centers or with adolescents use the results of this study to improve emotion regulation and reduce suicidal ideation in their adolescent clients
Keywords
- Emotional self-regulation
- Psychological flexibility
- Suicidal thoughts
- Acceptance and commitment therapy
Main Subjects
Allmann, A. E., Coyne, L. W., Michel, R., & McGowan, R. (2020). Acceptance and commitment therapy–enhanced exposures for children and adolescents. In Exposure Therapy for Children with Anxiety and OCD (pp. 405-431). Academic Press. https://doi.org/10.1016/B978-0-12-815915-6.00017-2
Andriessen, K., Krysinska, K., Kõlves, K., & Reavley, N. (2019). Suicide postvention service models and guidelines 2014-2019: A systematic review. Frontiers in psychology, 10, 2677. https://doi.org/10.3389/fpsyg.2019.02677
Anis, J., Fathi Ashtiani, A, Salimi, S. H., & Ahmadi Nodeh, K. (2005). Assessing the reliability and validity of the Beck Suicidality Scale in soldiers. Journal of Military Medicine, 7(1), 37-33. SID. https://sid.ir/paper/
Balzarotti, S., & John, O. (2010). An Italian Adaptation of the Emotion Regulation Questionnaire. European Journal of Psychological Assessment, 26(1), 61-67. http://dx.doi.org/10.1027/1015-5759/a000009
Beck, A. T., & Steer, R. A. (1990). The Beck Anxiety Inventory manual. San Antonio, TX: Psychological Corporation.
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., ... & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676-688. https://doi.org/10.1016/j.beth.2011.03.007
Denckla, C. A., Consedine, N. S., Chung, W. J., Stein, M., Roche, M., & Blais, M. (2018). A double-edged sword? Sub-types of psychological flexibility are associated with distinct psychiatric disorders. Journal of Research in Personality, 77, 119-125. https://doi.org/10.1016/j.jrp.2018.10.004
Deval, C., Bernard-Curie, S., & Monestès J-L. (2017). Effects of an acceptance and commitment therapy intervention on leaders’ and managers’ psychological flexibility. Journal de Thérapie Comportementale et Cognitive, 27(1), 34-42. https://doi.org/10.1016/j.jtcc.2016.10.002
Drach, R. D., Orloff, N. C., & Hormes, J. M. (2021). The emotion regulatory function of online social networking: Preliminary experimental evidence. Addictive Behaviors, 112, 106559. https://doi.org/10.1016/j.addbeh.2020.106559
Ersan, C. (2020). Physical aggression, relational aggression and anger in preschool children: The mediating role of emotion regulation. The Journal of General Psychology, 147(1),18-42. https://doi.org/10.1016/j.ejon.2017.08.006
Esmail zadeh, L., Gholamali Lavasani, M., & Qasimzadeh, S. (2021). Comparing the effectiveness of schema therapy and therapy based on acceptance and commitment on the difficulty of emotional self-regulation of intelligent teenagers. Social health, 8(3), 441-452. https://doi.org/10.22037/ch.v8i3.31232
Gonzalez-Fernandez, S, Fernandez-Rodrlguez, C., Mota-Alonso, M. J., Garcla-Teijido, P., Pedrosa, I. & Perez-alvarez, M. (2017). Emotional state and psychological flexibility in breast cancer survivors. European Journal of Oncology Nursing, 30, 75-83. https://doi.org/10.1016/j.ejon.2017.08.006
Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348-362. https://psycnet.apa.org/doi/10.1037/0022-3514.85.2.348
Halliburton, A., & Cooper, L. (2015). Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. Journal of Contextual Behavioral Science, 4(1), 1-11. https://doi.org/10.1016/j.jcbs.2015.01.002
Hayes, S. C. (2016). Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies - Republished Article. Behavior Therapy, 47(6), 869-85. https://doi.org/10.1016/j.beth.2016.11.006
Hayes, S. C. (2019). A Liberated Mind How to Pivot Toward What Matters, Newyork: an imprint of Penguin Random House.
Hayes, S. C., Strosahl, K. D., & Wilson, K.G. (2012). Acceptance and Commitment Therapy: The process and practice of mindful change. New York: Guilford Press.
Jamali, S., Najafi, M., Qureshi, F. S., & Rahimian Bogar, I. (2021). The effectiveness of acceptance and commitment therapy on suicidal thoughts and psychological flexibility of patients with bipolar disorder. Psychological studies, 17(1), 7-22. https://doi.org/10.22051/psy.2021.34436.2376
Khorani, J., Ahmadi, V., Mami, SH, & Valizadeh, R. (2019). The Effects of Acceptance and Commitment Therapy on the Meaning of Life, Life Satisfaction, Cognitive Flexibility, and Suicidal Ideation in Individuals with Depression. Middle Eastern Journal of Disability Studies, 10, 112-112. http://dorl.net/dor/20.1001.1.23222840.1399.10.0.166.5
Kiani, A., Ghasemi, N., & Pourabbas, A. (2013). The Comparsion of the Efficacy of Group Psychotherapy Based on Acceptance and Commitment Therapy, and Mindfulness on Craving and Cognitive Emotion Regulation in Methamphetamine Addicts. Etiadpajoji, 6 (24), 36-27. file:///C:/Users/NPFEC000916/Downloads/etiadpajoh-v6n24p27-en%20(2).pdf
Kim, I. s. & Lee, J. W. (2019). Effects of Acceptance Commitment Therapy Based Recovery Enhancement Program on psychological Flexibility, Recovery Attitude, and Quality of Life For Inpatients with Mental Illness. Journal of Korean Academy of psychiatric and Mental Health Nursing, 28(1), 79-90. https://doi.org/10.12934/jkpmhn.2019.28.1.79
Kiuru, N., Puolakanaho, A., Lappalainen, P., Keinonen, K., Mauno, S., Muotka J, et al. 2021). Effectiveness of a web-based acceptance and commitment therapy program for adolescent career preparation: A randomized controlled trial. Journal of Vocational Behavior, 127, 103-578. https://doi.org/10.1016/j.jvb.2021.103578
Kudinova, A. Y., Owens, M., Burkhouse, K. L., Barretto, K. M., Bonanno, G. A., & Gibb, B. E. (2015). Differences in emotion modulation using cognitive reappraisal in individuals with and without suicidal ideation. Journal of Cognition and Emotion, 10(2), 221– 230. https://doi.org/10.1080/02699931.2015.1036841
Lewin, R. K., Acuff, S. F., Berlin, K. S., Berman, J. S., & Murrell, A. R. (2021). Group-based acceptance and commitment therapy to enhance graduate student psychological flexibility: Treatment development and preliminary implementation evaluation. Journal of American College Health, 71(2), 1-10. http://dx.doi.org/10.1080/07448481.2021.1881522
Lian, Q., Zuo, X., Mao, Y., Luo, S., & Zhang, S. (2017). Anorexia nervosa, depression and suicidal thoughts among Chinese adolescents: a national school-based cross-sectional stud. Environ Health Prev Med, 22(1), 22-30. https://doi.org/10.1186/s12199-017-0639-2
Lotfi Azimi, A. (2022). The Effectiveness of Acceptance and Commitment Group Therapy on Students' Cognitive Flexibility and Emotional Self-Regulation. Biquarterly Journal of Cognitive Strategies in Learning, 10(18), 249-269. https://doi.org/10.22084/j.psychogy.2021.24788.2361
Mars, B., Heron, J., Klonsky, E. D., Moran, P., O'Connor, R. C., Tilling, K., Gunnell, D. (2019). Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-harm: a population-based birth cohort study. The Lancet Psychiatry, 6(4), 327-337. https://doi.org/10.1016/s2215-0366(19)30030-6
Mousavi Chalak, S. H. (2021). Social emergency in Iran from idea to practice. Shellac Publications.
Nam, B., Wilcox, H. C., Hilimire, M. & DeVylder, J. E. (2018). Perceived need for care and mental health service utilization among college students with suicidal ideation. Journal of American College Health, 31, 1-8. https://doi.org/10.1080/07448481.2018.1434779
Orri, M., Scardera, S., Perret, L. C., Bolanis, D., Temcheff, C., Séguin, J. R., Boivin, M., Turecki, G., Tremblay, R. E., Côté, S. M., & Geoffroy, M. C. (2020). Mental health problems and risk of suicidal ideation and attempts in adolescents. Pediatrics, 146(1). https://doi.org/10.1542/peds.2019-3823
Pan, Y. J., Juang, K. D., Lu, S. R., Chen, S. P., & Wang, Y. F. (2017). Longitudinal risk factors for suicidal thoughts in depressed and non-depressed young adolescents. Aust N Z J Psychiatry, 51 (9), 930-937. https://doi.org/10.1177/0004867417717795
Pico-Perez, M., Radua, J., Steward, T., Menchon, J. M., & Soriano-Mas, C. (2017). Emotion regulation in mood and anxiety disorders: A meta-analysis of fMRI cognitive reappraisal studies. Prog Neuropsychopharmacol Biol Psychiatry, 79(Pt B), 96-104. https://doi.org/10.1016/j.pnpbp.2017.06.001
Rezai Sharif, A., Sobhi Qara Maleki, N., Pourabdel, S., Zargham Hajbi, M., & Beiki, M. (2021). The effectiveness of treatment based on acceptance and commitment on academic self-regulation and psychological flexibility of students with special learning disabilities. Psychological studies, 17(3), 115-136.
Russell, K., Allan, S., Beattie, L., Bohan, J., MacMahon, K., & Rasmussen, S. (2019). Sleep problem, suicide and self-harm in university students: A systematic review. Sleep medicine reviews, 44, 58-69. https://doi.org/10.1016/j.smrv.2018.12.008
Spidel, A., Lecomte, T., & Kealy, D. (2018). Acceptance and Commitment Therapy for Psychosis and Trauma: Improvement in Psychiatric Symptoms, Emotion Regulation, and Treatment Compliance Following a Brief Group Intervention. Psychology and Psychotherapy: Theory, Research and Practice, 91, 248-261. https://doi.org/10.1111/papt.12159
Tighe, J., Nicholas, J., Shand, F. & Christensen, H. (2018). Efficacy of acceptance and commitment therapy in reducing suicidal ideation and deliberate self-harm: systematic review. JMIR mental health, 5(2), 1-12. https://doi.org/10.2196/10732
Walser, R. D., Garvert, D. W., Karlin, B. E., Trockel, M., Ryo, D. M., & Taylor, C. B. (2015). Effectiveness of acceptance and commitment therapy in treating depression and suicidal ideation in veterans. Journal of Behavior Research and Therapy, 74, 25-31. https://doi.org/10.1016/j.brat.2015.08.012
Wersebe, H., Lieb, R., Meyer, A. H., Hofer, P. & Glaster, A. T. (2018). The link between stress,well-being, and psychological Flexibility during an Acceptance and Commitment Therapy self-help intervention. International Journal of clinical and Health psychology,18(1), 60-68. https://doi.org/10.1016/j.ijchp.2017.09.002
Wetherell, J. L., Liu, L., Patterson, T. L., Afari, N., Ayers, C.R, Thorp, S. R., Stoddard, J. A., Ruberg, J., Kraft, A., Sorrell, J. T., & Petkus, A. J. (2011). Acceptance and commitment therapy for generalized anxiety disorder in older adults: A preliminary report. Behavior therapy.42(1) ,127-134. https://doi.org/10.1016/j.beth.2010.07.002
Wynne, B., McHugh, L., Gao, W., Keegan, D., Byrne, K., Rowan, C., Hartery, K., Kirschbaum, C., Doherty, G., Cullen, G., & Dooley, B. (2019). Acceptance and commitment therapy reduces psychological stress in patients with inflammatory bowel diseases. Gastroenterology, 156(4), 935-945. https://doi.org/10.1053/j.gastro.2018.11.030
Zettle, Robert., D. & Hayes, Steven C. (1980). Conceptual and Empirical Status of Rational-Emotive Therapy. Progress in behavior modification,9, 125-166. https://doi.org/10.1016/B978-0-12-535609-1.50009-X
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