Multiple Sclerosis MS is a chronic degenerative disease of the central nervous system' MS often deve

1
Living Well With Multiple Sclerosis Evaluation
of a Half-Day ACT Workshop and Quality of Life
Outcomes JeanMarie Bianchi, Sean C. Sheppard,
John P. Forsyth, Edward J. Hickling, Daniel
Silverman
INTRODUCTION
DISCUSSION
RESULTS

• Multiple Sclerosis (MS) is a chronic
  degenerative disease of the central nervous
  system. MS often develops during the prime of
  life and is characterized by unpredictable
  neurological and behavioral impairments. In
  addition to the physical component, MS is also
  accompanied by significant emotional and
  psychological difficulties such as anxiety and
  depression.
• A growing body of evidence indicates Acceptance
  and Commitment Therapy (ACT) has great potential
  to be effective for many psychological problems
  common to those suffering with MS, namely anxiety
  (Roemer Orsillo, 2007), depression (Zettle
  Rains, 1989) and chronic pain ( Dahl, Wilson,
  Nilsson, 2004).
• The chronic and debilitating nature of MS
  highlights the need for interventions aimed at
  improving quality of life. The current project
  investigated the effectiveness of a brief ACT
  intervention coupled with a three month self-help
  protocol on health and behavioral outcomes in a
  sample of adults suffering with MS.
• Our intent was to evaluate the usefulness of the
  ACT workshop focusing on acceptance, mindfulness,
  and value-guided action, in terms of its impact
  on psychological, behavioral, and quality of life
  outcomes linked with MS.

CORRELATION MATRIX

• A brief half-day ACT workshop appeared to confer
  some benefit on extent of thought suppression,
  pain impairment, and depression. Though the
  effect sizes were large, other assessed indices
  did not differ significantly from Time 1 to Time
  2. This may be an issue of the tests being
  underpowered. Though preliminary, the present
  results suggest that a brief ACT intervention may
  be helpful for persons suffering from MS.
• We are currently wrapping up data collection for
  the control condition and some remaining workshop
  attendees. This will position us to rule out
  competing explanations for the observed effects
  in the workshop group (e.g., regression to the
  mean, repeated testing) while also improving
  statistical power and our ability to draw more
  meaningful conclusions from the data.
• Interestingly, greater levels of mindfulness
  were strongly associated with more
  self-compassion, lower thought suppression,
  better mental health, lower depression scores,
  and decreased effects of pain on behavior. As
  mindfulness is a main target of the workshop, we
  anticipate that it may confer broadband benefits
  across a wide range of psychological and
  emotional indices of mental health and suffering
  linked with MS.
• Significant zero-order correlations indicate
  that that many of the symptoms and difficulties
  commonly experienced by individuals with MS (e.g.
  depression, the effect of pain, etc.) are related
  to ACT-central constructs such as suppression,
  mindfulness, and self-compassion. These findings
  suggest the importance of acceptance and its
  corollaries in countering the toxic effects of
  suppression and avoidance.
• Taken together, these results suggest that
  mindfulness and acceptance based approaches, such
  as ACT, have the potential to improve quality of
  life and affect positive change for individuals
  suffering from MS.
• Ongoing data collection and analyses will focus
  on comparisons from Time 1 to Time 2 between the
  experimental and wait-list control conditions to
  further explore the potential benefit of
  mindfulness and acceptance-based interventions in
  improving quality of life and other positive
  behavioral outcomes for individuals with MS and
  other chronic diseases. Future work will
  involve exploration of factors that might improve
  the effectiveness of the workshop and self-help
  protocol while decreasing attrition.

plt.01 plt.05

• The significant zero-order correlations
  calculated from Time 1 scores across both
  conditions serve as preliminary evidence that the
  incorporated measures are accurately measuring
  the constructs in the manner in which they were
  intended.
• As expected, the lower levels of mental health
  (i.e., MHI) were associated with greater thought
  suppression, more depression, and more negative
  effects of pain on behavior. By contrast,
  ACT-related concepts, namely self-compassion and
  mindfulness, were both positively associated with
  greater levels of mental health.
  

METHODS

• Participants
  
  
• Participants included 30 individuals suffering
  from MS (Male 9 Female 21). The majority of
  participants were Caucasian (80.6), Black
  (3.2), and Hispanic (3.2) The average age of
  participants was 49.3 years (Sd 10.31), and
  average age of onset of MS was 33.73 years (Sd
  14.73).
• Procedure
• Participants were recruited through physician
  referral and were assigned to either an
  experimental (n 18) or a wait-list control (n
  12) group.
• The experimental group attended a half-day ACT
  workshop designed to provide experiential
  training in mindfulness skills, defusion
  strategies, and value-guided action.
  Additionally, they were provided with a self-help
  CD-ROM and worksheet exercises designed to
  reinforce the content of the workshop. The
  control group will be offered the same workshop
  and self-help protocol after the 3 month
  experimental phase.
• The experimental group was assessed immediately
  post-workshop (Time 1) and again after 3 months
  (Time 2). The control group was assessed over
  equivalent time intervals in concordance with the
  staggered enrollment procedure.
• Measures

ANOVA
REFERENCES

• Dahl, J., Wilson, K.G., Nilsson A. (2004)
  Acceptance and commitment therapy and the
  treatment of persons at risk for long-term
  disability resulting from stress and pain
  symptoms A preliminary randomized trial.
  Behavior Therapy, 35, 785-802.
• Roemer, L., Orsillo, S.M. (2007) An open
  trial of an acceptance-based behavior therapy for
  generalized anxiety disorder. Behavior
  Therapy, 38, 72-85.
• Zettle, R.D., Rains, J.C. (1989) Group
  cognitive and contextual therapies in treatment
  of depression. Journal of Clinical Psychology,
  45(3), 436-445.

Note. F (1,8). RD right direction. N 9

• Beck Depression Inventory (BDI)
• Mental Health Inventory (MHI)
• Pain Effects Scale (PES)

• Mindful Attention Awareness Scale (MAAS)
• Self-Compassion Scale (SCS)
• White Bear Suppression Inventory (WBSI)

• In the experimental condition, significant
  positive differences were found between Time 1
  and Time 2 for the WBSI, the PES, and the BDI.
• No other effects were significant though
  changes are in the right direction.