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| Behavioral Applications in Medical Populations |
| Monday, May 28, 2007 |
| 9:00 AM–10:20 AM |
| Edward AB |
| Area: CBM; Domain: Applied Research |
| Chair: Lindsay B. Fletcher (University of Nevada, Reno) |
| Discussant: Claudia Drossel (University of Nevada, Reno) |
| Abstract: In a nation where HMOs reign, the demand for cost-effective treatments is on the rise. The utility of behavioral interventions in medical populations is becoming increasingly recognized. Acceptance and commitment therapy (ACT) provides a model of experiential avoidance that may contribute to many medical presentations. Here we discuss how ACT has been applied to two different prevalent and insidious health problems: obesity and insomnia. We will first discuss the application of ACT in treating stigma with clients in a weight maintenance program. We will then present a multiple baseline study that uses ACT to treat insomnia. Results indicate that this is a useful approach with these problems. Finally, a longitudinal study examining the link between experiential avoidance and healthcare utilization in college students and the implications for a clinical intervention will be presented. |
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| Acceptance and Commitment Therapy for the Treatment of Obesity-Related Stigma and Weight Maintenance. |
| JASON LILLIS (University of Nevada, Reno), Steven C. Hayes (University of Nevada, Reno), Kara Bunting (University of Nevada, Reno), Ainsley McPherson (University of Nevada, Reno) |
| Abstract: Obesity has been referred to as a dangerous epidemic and one of the most important public health challenges of the 21st century. Well controlled, comprehensive weight loss programs achieve significant weight loss results. However, weight lost is almost always regained over time. Typically, half the weight lost is regained in the first year following treatment, and by 3-5 years posttreatment, 80% of patients have returned to or exceeded their pretreatment weight (Perri, 1998; Wadden et al., 1989; Wing, 1998). In addition, obesity stigma is a major problem. The stigma of being overweight may be the most debilitating stigma in our society because it cannot be concealed and it is seen as a controllable condition (Crocker, Cornwell, & Major, 1993). Obesity stigma is rarely directly targeted in comprehensive weight loss programs. The current study examines a 1-day ACT workshop for obesity stigma and weight control. Subjects had completed 6 months of a comprehensive weight loss program prior to receiving the ACT workshop. Subjects were randomly assigned to receive the ACT workshop or treatment as usual (TAU). Data will be presented on 80 completed subjects on measures of stigma, weight maintenance, experiential avoidance, and quality of life. |
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| Acceptance and Commitment Therapy for Chronic Insomnia: A Preliminary Study. |
| LINDSAY B. FLETCHER (University of Nevada, Reno), Steven C. Hayes (University of Nevada, Reno), William Torch (Washoe Sleep Disorders Clinic ) |
| Abstract: Lack of sleep is a chronic, pervasive, and culturally supported phenomenon that is costly on an individual and societal level. Insomnia affects 30-40% of Americans, second only to depression for incidence of a psychological disorder. Consequences of insomnia include work absenteeism, impaired concentration and memory, increased use of medical services, and increased risk for motor vehicle accidents. In addition, insomnia is highly comorbid with other psychological and medical problems, particularly depression and anxiety. However, there is presumably less stigma associated with seeking treatment for a sleep problem than for other psychological problems, and treatments for sleep problems may provide relief for comorbid problems as well. An 8-week behavioral treatment for insomnia was developed that incorporates the principles of Acceptance and Commitment Therapy. This pilot trial is a multiple baseline study, with each subject serving as their own control. Sleep was measured daily using self-report measures and actigraphy, a watch-like device that measures movement when worn at night. In addition to the ACT skills covered in session, clients were instructed to practice a formal mindfulness exercise daily. Preliminary results will be presented. |
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| Predicting Student Attrition and Healthcare Utilization: Examining the Role of Experiential Avoidance. |
| MIKAELA J. HILDEBRANDT (University of Nevada, Reno), Jacqueline Pistorello (University of Nevada, Reno), Steven C. Hayes (University of Nevada, Reno) |
| Abstract: The transition from high school graduation to college enrollment has been identified as a stressful transition for many college students. It is estimated that 40% of college students drop out of college nationwide (Porter, 1990). The current study aims to identify psychological factors predictive of student attrition and healthcare utilization and to examine the potential mediating relationship experiential avoidance plays in these predictions. Two hundred and ten undergraduate students were recruited to participate in the current study. Upon enrollment, each participant provided demographic information and completed a packet of questionnaires, including outcome and process measures. Each student also provided a release of their academic records and healthcare information. Two hierarchical regression analyses were conducted. The results suggest that experiential avoidance, as measured by the AAQ, independently predicts the average healthcare visits per year the student is enrolled, accounting for 19% of the variance
(p < .05). The AAQ marginally predicts student attrition (p < .096). Additional regression analyses suggest that the AAQ predicts both healthcare utilization and healthcare utilization beyond other psychological factors. Given support for these regression models and the role experiential avoidance plays in determining outcomes, future research could implement prevention strategies for students at risk for dropout. |
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