A pilot randomized controlled trial of online acceptance and commitment therapy versus compassion-focused therapy for chronic illness.
acceptance and commitment therapy
chronic illness
compassion focused therapy
low intensity
online intervention
randomized controlled trial
Journal
Clinical psychology & psychotherapy
ISSN: 1099-0879
Titre abrégé: Clin Psychol Psychother
Pays: England
ID NLM: 9416196
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
revised:
28
05
2021
received:
26
03
2021
accepted:
06
07
2021
pubmed:
17
7
2021
medline:
15
4
2022
entrez:
16
7
2021
Statut:
ppublish
Résumé
Literature suggests that acceptance and commitment therapy (ACT) is effective in improving well-being and in reducing psychopathological symptoms commonly experienced by people with chronic illness (CI). Compassion-focused therapy (CFT) reduces psychological distress, especially in individuals with high levels of shame and self-criticism, but few studies have explored CFT in CI. Additionally, studies almost exclusively compared ACT and CFT with inactive controls (wait-list; treatment as usual). Also, there is an interest in developing cost-effective mental health solutions, such as low-intensity online psychological interventions. This randomized controlled trial (RCT) aimed to assess the acceptability and compare the efficacy of four-session online ACT (n = 25) and CFT (n = 24) interventions in a sample of people with CI. Results showed both interventions were acceptable, with attrition rates at post-intervention comparable to those found in similar studies (around 50%). Intention-to-treat analyses showed that participants presented significantly less illness-related shame, less uncompassionate self-responding and more valued living after the intervention, although no difference was found between conditions. Results were sustained at 3- and 6-month follow-up. Results did not find statistical differences between conditions through reliable change index (RCI). Correlation between demographics and RCI showed that, at post-intervention, younger participants presented more behavioural awareness, men presented more valued action, and participants with CI for shorter periods presented less uncompassionate self-responding and less anxiety. Results suggest that low-intensity (four sessions) online ACT and CFT are cost-effective approaches to promote mental health of individuals with CI. Results and limitations are thoroughly discussed.
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
524-541Informations de copyright
© 2021 John Wiley & Sons, Ltd.
Références
Ashworth, F., Clarke, A., Jones, L., Jennings, C., & Longworth, C. (2015). An exploration of compassion focused therapy following acquired brain injury. Psychology and Psychotherapy: Theory, Research and Practice, 88(2), 143-162. https://doi.org/10.1111/papt.12037, https://doi.org/10.1111/papt.12037
Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: A cross-sectional study. The Lancet, 380(9836), 37-43. https://doi.org/10.1016/s0140-6736(12)60240-2
Bayliss, K. (2018). Confirmatory factor analysis and further validation of the comprehensive assessment of acceptance and commitment therapy processes (CompACT) (dissertation).
Becker, L. A. (2000). Effect size (ES). Dictionary of Statistics & Methodology. https://doi.org/10.4135/9781412983907.n624
Bergmo, T. S. (2015). How to measure costs and benefits of eHealth interventions: An overview of methods and frameworks. Journal of Medical Internet Research, 17(11), e254. https://doi.org/10.2196/jmir.4521
Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain, 10(4), 287-333. https://doi.org/10.1016/j.ejpain.2005.06.009
Carlyle, M., Rockliff, H., Edwards, R., Ene, C., Karl, A., Marsh, B., … Morgan, C. J. A. (2019). Investigating the feasibility of brief compassion focused therapy in individuals in treatment for opioid use disorder. Substance Abuse: Research and Treatment, 13, 117822181983672. https://doi.org/10.1177/1178221819836726
Castilho, P., Pinto-Gouveia, J., & Duarte, J. (2015). Evaluating the multifactor structure of the long and short versions of the self-compassion scale in a clinical sample. Journal of Clinical Psychology, 71(9), 856-870. https://doi.org/10.1002/jclp.22187
Chakraborty, H. & Gu, H. (2009). A mixed model approach for intent-to- treat analysis in longitudinal clinical trials with missing values. RTI Press publication No. MR-0009-0903. Research Triangle Park: RTI International. Retrieved from http://www.rti.org/rtipress. https://doi.org/10.3768/rtipress.2009.mr.0009.0903
Cheli, S., Cavalletti, V., & Petrocchi, N. (2020). An online compassion-focused crisis intervention during COVID-19 lockdown: A cases series on patients at high risk for psychosis. Psychosis, 12(4), 359-362. https://doi.org/10.1080/17522439.2020.1786148
Coutinho, M., Trindade, I. A., & Ferreira, C. (2021). Experiential avoidance, committed action and quality of life: Differences between college students with and without chronic illness. Journal of Health Psychology, 26(7), 1035-1045. https://doi.org/10.1177/1359105319860167
Craig, C., Hiskey, S., & Spector, A. (2020). Compassion focused therapy: A systematic review of its effectiveness and acceptability in clinical populations. Expert Review of Neurotherapeutics, 20(4), 385-400. https://doi.org/10.1080/14737175.2020.1746184
Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W. S., & Karoly, P. (2012). Fear-avoidance model of chronic pain. The Clinical Journal of Pain, 28(6), 475-483. https://doi.org/10.1097/ajp.0b013e3182385392
Dantzer, R. (2009). Cytokine, sickness behavior, and depression. Immunology and Allergy Clinics of North America, 29(2), 247-264. https://doi.org/10.1016/j.iac.2009.02.002
de Ornelas Maia, A. C., de Braga, A., Brouwers, A., Nardi, A. E., & de Oliveira e Silva, A. C. (2012). Prevalence of psychiatric disorders in patients with diabetes types 1 and 2. Comprehensive Psychiatry, 53(8), 1169-1173. https://doi.org/10.1016/j.comppsych.2012.03.011
Dindo, L., Van Liew, J. R., & Arch, J. J. (2017). Acceptance and commitment therapy: A Transdiagnostic behavioral intervention for mental health and medical conditions. Neurotherapeutics, 14(3), 546-553. https://doi.org/10.1007/s13311-017-0521-3
Dinis, A., Carvalho, S., Gouveia, J. P., & Estanqueiro, C. (2015). Shame memories and depression symptoms: The role of cognitive fusion and experiential avoidance. International Journal of Psychology and Psychological Therapy, 15(1), 63-86.
Dolezal, L., & Lyons, B. (2017). Health-related shame: An affective determinant of health? Medical Humanities, 43(4), 257-263. https://doi.org/10.1136/medhum-2017-011186
Duivis, H. E., de Jonge, P., Penninx, B. W., Na, B. Y., Cohen, B. E., & Whooley, M. A. (2011). Depressive symptoms, health behaviors, and subsequent inflammation in patients with coronary heart disease: Prospective findings from the heart and soul study. American Journal of Psychiatry, 168(9), 913-920. https://doi.org/10.1176/appi.ajp.2011.10081163
Evers, A. W., Verhoeven, E. W., van Middendorp, H., Sweep, F. C., Kraaimaat, F. W., Donders, A. R., … van Riel, P. L. (2013). Does stress affect the joints? Daily stressors, stress vulnerability, immune and HPA axis activity, and short-term disease and symptom fluctuations in rheumatoid arthritis. Annals of the Rheumatic Diseases, 73(9), 1683-1688. https://doi.org/10.1136/annrheumdis-2012-203143
Farrand, P., & Woodford, J. (2015). Effectiveness of cognitive Behavioural self-help for the treatment of depression and anxiety in people with long-term physical health conditions: A systematic review and meta-analysis of randomised controlled trials. Annals of Behavioral Medicine, 49(4), 579-593. https://doi.org/10.1007/s12160-015-9689-0
Francis, A. W., Dawson, D. L., & Golijani-Moghaddam, N. G. (2016). The development and validation of the comprehensive assessment of acceptance and commitment therapy processes (CompACT). Journal of Contextual Behavioral Science, 5, 134-145. https://doi.org/10.1016/j.jcbs.2016.05.003
Gallucci, M. (2019). GAMLj: General analyses for linear models. [jamovi module]. Retrieved from https://gamlj.github.io/
Geller, K., Lippke, S., & Nigg, C. R. (2016). Future directions of multiple behavior change research. Journal of Behavioral Medicine, 40(1), 194-202. https://doi.org/10.1007/s10865-016-9809-8
Gerin, W., Zawadzki, M. J., Brosschot, J. F., Thayer, J. F., Christenfeld, N. J., Campbell, T. S., & Smyth, J. M. (2012). Rumination as a mediator of chronic stress effects on hypertension: A causal model. International Journal of Hypertension, 2012, 1-9. https://doi.org/10.1155/2012/453465
Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, 15(3), 199-208. https://doi.org/10.1192/apt.bp.107.005264
Gilbert, P. (2010). Compassion focused therapy: Distinctive features. Routledge. https://doi.org/10.4324/9780203851197
Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6-41. https://doi.org/10.1111/bjc.12043
Gilbert, P. (2019). Explorations into the nature and function of compassion. Current Opinion in Psychology, 28, 108-114. https://doi.org/10.1016/j.copsyc.2018.12.002
Gilbert, P., Catarino, F., Duarte, C., Matos, M., Kolts, R., Stubbs, J., Ceresatto, L., Duarte, J., Pinto-Gouveia, J., & Basran, J. (2017). The development of compassionate engagement and action scales for self and others. Journal of Compassionate Health Care, 4(1), 1-24. https://doi.org/10.1186/s40639-017-0033-3
Gilbert, P., McEwan, K., Matos, M., & Rivis, A. (2011). Fears of compassion: Development of three self-report measures. Psychology and Psychotherapy: Theory, Research and Practice, 84(3), 239-255. https://doi.org/10.1348/147608310X526511
Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy, 13(6), 353-379. https://doi.org/10.1002/cpp.507
Gillanders, D. T., Bolderston, H., Bond, F. W., Dempster, M., Flaxman, P. E., Campbell, L., Kerr, S., Tansey, L., Noel, P., Ferenbach, C., Masley, S., Roach, L., Lloyd, J., May, L., Clarke, S., & Remington, B. (2014). The development and initial validation of the cognitive fusion questionnaire. Behavior Therapy, 45(1), 83-101. https://doi.org/10.1016/j.beth.2013.09.001
Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., & Karekla, M. (2020). The empirical status of acceptance and commitment therapy: A review of meta-analyses. Journal of Contextual Behavioral Science, 18, 181-192. https://doi.org/10.1016/j.jcbs.2020.09.009
Gooding, H., Stedmon, J., & Crix, D. (2020). ‘All these things don't take the pain away but they do help you to accept it’: Making the case for compassion-focused therapy in the management of persistent pain. British Journal of Pain, 14(1), 31-41. https://doi.org/10.1177/2049463719857099
Graham, C. D., Gouick, J., Krahé, C., & Gillanders, D. (2016). A systematic review of the use of acceptance and commitment therapy (ACT) in chronic disease and long-term conditions. Clinical Psychology Review, 46, 46-58. https://doi.org/10.1016/j.cpr.2016.04.009
Grierson, A. B., Hickie, I. B., Naismith, S. L., & Scott, J. (2016). The role of rumination in illness trajectories in youth: Linking trans-diagnostic processes with clinical staging models. Psychological Medicine, 46(12), 2467-2484. https://doi.org/10.1017/s0033291716001392
Hacker, T., Stone, P., & MacBeth, A. (2016). Acceptance and commitment therapy-Do we know enough? Cumulative and sequential meta-analyses of randomized controlled trials. Journal of Affective Disorders, 190, 551-565. https://doi.org/10.1016/j.jad.2015.10.053
Halamová, J., Kanovský, M., Pačutová, A., & Kupeli, N. (2020). Randomised controlled trial of an online version of compassion mind training in a nonclinical sample. Europe's Journal of Psychology, 16(2), 262-279. https://doi.org/10.5964/ejop.v16i2.1683
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1-25. https://doi.org/10.1016/j.brat.2005.06.006
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.
Henrich, J. F., Gjelsvik, B., Surawy, C., Evans, E., & Martin, M. (2020). A randomized clinical trial of mindfulness-based cognitive therapy for women with irritable bowel syndrome-Effects and mechanisms. Journal of Consulting and Clinical Psychology, 88(4), 295-310. https://doi.org/10.1037/ccp0000483
Heyworth, I. T., Hazell, M. L., Linehan, M. F., & Frank, T. L. (2009). How do common chronic conditions affect health-related quality of life? British Journal of General Practice, 59(568), e353-e358. https://doi.org/10.3399/bjgp09x453990
Hudson, M. P., Thompson, A. R., & Emerson, L.-M. (2019). Compassion-focused self-help for psychological distress associated with skin conditions: A randomized feasibility trial. Psychology & Health, 35(9), 1095-1114. https://doi.org/10.1080/08870446.2019.1707829
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12-19. https://doi.org/10.1037/0022-006x.59.1.12
Keles, H., Ekici, A., Ekici, M., Bulcun, E., & Altinkaya, V. (2006). Effect of chronic diseases and associated psychological distress on health-related quality of life. Internal Medicine Journal, 37(1), 6-11. https://doi.org/10.1111/j.1445-5994.2006.01215.x
Kioskli, K., Scott, W., Winkley, K., Godfrey, E., & McCracken, L. M. (2020). Online acceptance and commitment therapy for people with painful diabetic neuropathy in the United Kingdom: A single-arm feasibility trial. Pain Medicine, 21(11), 2777-2788. https://doi.org/10.1093/pm/pnaa110
Kirby, J. N. (2016). Compassion interventions: The programmes, the evidence, and implications for research and practice. Psychology and Psychotherapy: Theory, Research and Practice, 90(3), 432-455. https://doi.org/10.1111/papt.12104
Kirby, J. N., Tellegen, C. L., & Steindl, S. R. (2017). A meta-analysis of compassion-based interventions: Current state of knowledge and future directions. Behavior Therapy, 48(6), 778-792. https://doi.org/10.1016/j.beth.2017.06.003
Leaviss, J., & Uttley, L. (2015). Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychological Medicine, 45(5), 927-945. https://doi.org/10.1017/s0033291714002141
Leibovici, V., Canetti, L., Yahalomi, S., Cooper-Kazaz, R., Bonne, O., Ingber, A., & Bachar, E. (2010). Well-being, psychopathology and coping strategies in psoriasis compared with atopic dermatitis: A controlled study. Journal of the European Academy of Dermatology and Venereology, 24(8), 897-903. https://doi.org/10.1111/j.1468-3083.2009.03542.x
Lerman, S., Shahar, G., & Rudich, Z. (2012). Self-criticism interacts with the affective component of pain to predict depressive symptoms in female patients. European Journal of Pain, 16(1), 115-122. https://doi.org/10.1016/j.ejpain.2011.05.007
Lin, J., Klatt, L., McCracken, L. M., & Baumeister, H. (2018). Psychological flexibility mediates the effect of an online-based acceptance and commitment therapy for chronic pain: An investigation of change processes. Pain, 159(4), 663-672. https://doi.org/10.1097/j.pain.0000000000001134
Matos, M., Duarte, C., Duarte, J., Pinto-Gouveia, J., Petrocchi, N., Basran, J., & Gilbert, P. (2017). Psychological and physiological effects of compassionate mind training: A pilot randomised controlled study. Mindfulness, 8(6), 1699-1712. https://doi.org/10.1007/s12671-017-0745-7
Matos, M., Duarte, J., Duarte, C., Gilbert, P., & Pinto-Gouveia, J. (2018). How one experiences and embodies compassionate mind training influences its effectiveness. Mindfulness, 9(4), 1224-1235. https://doi.org/10.1007/s12671-017-0864-1
Mechanic, D. (1986). The concept of illness behaviour: Culture, situation and personal predisposition. Psychological Medicine, 16(1), 1-7. https://doi.org/10.1017/s0033291700002476
Michie, S., Yardley, L., West, R., Patrick, K., & Greaves, F. (2017). Developing and evaluating digital interventions to promote behavior change in health and health care: Recommendations resulting from an international workshop. Journal of Medical Internet Research, 19(6), e232. https://doi.org/10.2196/jmir.7126
Mitchell, A. E., Whittingham, K., Steindl, S., & Kirby, J. (2018). Feasibility and acceptability of a brief online self-compassion intervention for mothers of infants. Archives of Women's Mental Health, 21(5), 553-561. https://doi.org/10.1007/s00737-018-0829-y
Murberg, T. A., Furze, G., & Bru, E. (2004). Avoidance coping styles predict mortality among patients with congestive heart failure: A 6-year follow-up study. Personality and Individual Differences, 36(4), 757-766. https://doi.org/10.1016/s0191-8869(03)00130-2
Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223-250. https://doi.org/10.1080/15298860309027
O'Connor, M., Munnelly, A., Whelan, R., & McHugh, L. (2018). The efficacy and acceptability of third-wave behavioral and cognitive eHealth treatments: A systematic review and meta-analysis of randomized controlled trials. Behavior Therapy, 49(3), 459-475. https://doi.org/10.1016/j.beth.2017.07.007
Ong, C. W., Lee, E. B., & Twohig, M. P. (2018). A meta-analysis of dropout rates in acceptance and commitment therapy. Behaviour Research and Therapy, 104, 14-33. https://doi.org/10.1016/j.brat.2018.02.004
Öst, L. (2014). The efficacy of acceptance and commitment therapy: An updated systematic review and meta-analysis. Behaviour Research and Therapy, 61, 105-121. https://doi.org/10.1016/j.brat.2014.07.018
O'Toole, M., Bovbjerg, D., Renna, M., Lekander, M., Mennin, D., & Zachariae, R. (2018). Effects of psychological interventions on systemic levels of inflammatory biomarkers in humans: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 74, 68-78. https://doi.org/10.1016/j.bbi.2018.04.005
Pace, T. W., Negi, L. T., Adame, D. D., Cole, S. P., Sivilli, T. I., Brown, T. D., Issa, M. J., & Raison, C. L. (2009). Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress. Psychoneuroendocrinology, 34(1), 87-98. https://doi.org/10.1016/j.psyneuen.2008.08.011
Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychology, Health & Medicine, 12(2), 225-237. https://doi.org/10.1080/13548500500524088
R Core Team. (2020). R: A Language and environment for statistical computing. [Computer software]. Retrieved from https://cran.r-project.org/
Rockliff, H., Karl, A., McEwan, K., Gilbert, J., Matos, M., & Gilbert, P. (2011). Effects of intranasal oxytocin on 'compassion focused imagery'. Emotion, 11(6), 1388-1396. https://doi.org/10.1037/a0023861
Shattuck, E. C., & Muehlenbein, M. P. (2015). Human sickness behavior: Ultimate and proximate explanations. American Journal of Physical Anthropology, 157(1), 1-18. https://doi.org/10.1002/ajpa.22698
Shih, M., & Simon, P. A. (2008). Health-related quality of life among adults with serious psychological distress and chronic medical conditions. Quality of Life Research, 17(4), 521-528. https://doi.org/10.1007/s11136-008-9330-9
Sirois, F. M., Molnar, D. S., & Hirsch, J. K. (2015). Self-compassion, stress, and coping in the context of chronic illness. Self and Identity, 14(3), 334-347. https://doi.org/10.1080/15298868.2014.996249
Sommers-Spijkerman, M., Trompetter, H., Schreurs, K., & Bohlmeijer, E. (2018). Pathways to improving mental health in compassion-focused therapy: Self-reassurance, self-criticism and affect as mediators of change. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.02442
Soo, H., Burney, S., & Basten, C. (2009). The role of rumination in affective distress in people with a chronic physical illness: A review of the literature and theoretical formulation. Journal of Health Psychology, 14(7), 956-966. https://doi.org/10.1177/1359105309341204
Spinhoven, P. H., Ormel, J., Sloekers, P. P. A., Kempen, G. I. J. M., Speckens, A. E. M., & Van Hemert, A. M. (1997). A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychological Medicine, 27(2), 363-370. https://doi.org/10.1017/s0033291796004382
Stewart, J. C., Rand, K. L., Muldoon, M. F., & Kamarck, T. W. (2009). A prospective evaluation of the directionality of the depression-inflammation relationship. Brain, Behavior, and Immunity, 23(7), 936-944. https://doi.org/10.1016/j.bbi.2009.04.011
Strine, T. W., Chapman, D. P., Balluz, L. S., Moriarty, D. G., & Mokdad, A. H. (2008). The associations between life satisfaction and health-related quality of life, chronic illness, and health behaviors among US community-dwelling adults. Journal of Community Health, 33(1), 40-50. https://doi.org/10.1007/s10900-007-9066-4
The Jamovi Project. (2020). Jamovi. (Version 1.1) [Computer Software]. Retrieved from https://www.jamovi.org
Thompson, E. M., Destree, L., Albertella, L., & Fontenelle, L. F. (2021). Internet-based acceptance and commitment therapy: A transdiagnostic systematic review and meta-analysis for mental health outcomes. Behavior Therapy, 52(2), 492-507. https://doi.org/10.1016/j.beth.2020.07.002
Tóthová, V., Bártlová, S., Dolák, F., Kaas, J., Kimmer, D., Maňhalová, J., Martinek, L., & Olišarová, V. (2014). Quality of life in patients with chronic diseases. Neuro Endocrinology Letters, 35(Suppl 1), 11-18.
Trindade, I. A., Duarte, J., Ferreira, C., Coutinho, M., & Pinto-Gouveia, J. (2018). The impact of illness-related shame on psychological health and social relationships: Testing a mediational model in students with chronic illness. Clinical Psychology & Psychotherapy, 25(3), 408-414. https://doi.org/10.1002/cpp.2175
Trindade, I. A., Ferreira, C., & Pinto-Gouveia, J. (2017). Chronic illness- related shame: Development of a new scale and novel approach for IBD patients' depressive symptomatology. Clinical Psychology & Psychotherapy, 24(1), 255-263. https://doi.org/10.1002/cpp.2035
Trindade, I. A., Ferreira, C., & Pinto-Gouveia, J. (2020). Shame and emotion regulation in inflammatory bowel disease: Effects on psychosocial functioning. Journal of Health Psychology, 25(4), 511-521. https://doi.org/10.1177/1359105317718925
Trindade, I. A., Ferreira, C., & Pinto-Gouveia, J. (2018). Assessment of chronic illness-related cognitive fusion: Preliminary development and validation of a new scale with an IBD sample. Journal of Clinical Psychology in Medical Settings, 25(4), 356-366. https://doi.org/10.1007/s10880-017-9536-5
Trindade, I. A., Ferreira, N. B., Mendes, A. L., Ferreira, C., Dawson, D., & Golijani-Moghaddam, N. (2021). Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT): Measure refinement and study of measurement invariance across Portuguese and UK samples. Journal of Contextual Behavioral Science. https://doi.org/10.1016/j.jcbs.2021.05.002
Trindade, I. A., Guiomar, R., Carvalho, S. A., Duarte, J., Lapa, T., Menezes, P., Nogueira, M. R., Patrão, B., Pinto-Gouveia, J., & Castilho, P. (2021). Efficacy of online-based Acceptance and Commitment Therapy for chronic pain: A systematic review and meta-analysis. The Journal of Pain. https://doi.org/10.1016/j.jpain.2021.04.003
Trindade, I. A., Irons, C., Ferreira, C., Portela, F., & Pinto-Gouveia, J. (2019). The influence of self-criticism on depression symptoms among ambulatory patients with inflammatory bowel disease. Clinical Psychology & Psychotherapy, 26(6), 743-750. https://doi.org/10.1002/cpp.2398
Trindade, I. A., Marta-Simões, J., Ferreira, C., & Pinto-Gouveia, J. (2018). Chronic illness-related cognitive fusion explains the impact of body dissatisfaction and shame on depression symptoms in breast cancer patients. Clinical Psychology & Psychotherapy, 25(6), 886-893. https://doi.org/10.1002/cpp.2323
Trindade, I. A., & Sirois, F. (2021). The prospective effects of self-compassion on depressive symptoms, anxiety, and stress: A study in inflammatory bowel disease. Journal of Psychosomatic Research, 146, 110429. https://doi.org/10.1016/j.jpsychores.2021.110429
Trompetter, H. R., Bohlmeijer, E. T., Fox, J., & Schreurs, K. M. (2015). Psychological flexibility and catastrophizing as associated change mechanisms during online acceptance & commitment therapy for chronic pain. Behaviour Research and Therapy, 74, 50-59. https://doi.org/10.1016/j.brat.2015.09.001
Viganò, C. A., Beltrami, M. M., Bosi, M. F., Zanello, R., Valtorta, M., & Maconi, G. (2018). Alexithymia and psychopathology in patients suffering from inflammatory bowel disease: Arising differences and correlations to tailoring therapeutic strategies. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00324
Vowles, K. E., Fink, B. C., & Cohen, L. L. (2014). Acceptance and commitment therapy for chronic pain: A diary study of treatment process in relation to reliable change in disability. Journal of Contextual Behavioral Science, 3(2), 74-80. https://doi.org/10.1016/j.jcbs.2014.04.003
White, V., Linardon, J., Stone, J. E., Holmes-Truscott, E., Olive, L., Mikocka-Walus, A., Hendrieckx, C., Evans, S., & Speight, J. (2020). Online psychological interventions to reduce symptoms of depression, anxiety, and general distress in those with chronic health conditions: A systematic review and meta-analysis of randomized controlled trials. Psychological Medicine, 1-26. https://doi.org/10.1017/s0033291720002251
World Health Organization (WHO). (2018). Noncommunicable diseases. Retrieved from http://www.who.int/mediacentre/factsheets/fs355/en/
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x