Effectiveness of Acceptance Commitment Therapy (ACT) in Social Anxiety Disorder: Application of a Longitudinal Method for Evaluation of Mediation Role of Acceptance, Cognitive Fusion and Values

Abstract

Objectives: The purpose of the current study was to examine the effectiveness of ACT on symptom severity, fear about negative evaluation, quality of life and mediation role of acceptance, cognitive fusion and value among patients with Social Anxiety Disorder (SAD). Methods: Thirty patients diagnosed with SAD were randomized in the intervention (n=15) or waiting list groups (n=15). The Social Phobia and Anxiety Inventory (SPAI), Brief Fear of Negative Evaluation Scale (BFNE), WHO Quality of Life (WHOQOL), Social Anxiety - Acceptance and Action Questionnaire (SA-AAQ), Cognitive Fusion Questionnaire (CFQ) and Valued Living Questionnaire (VLQ) were administered before, immediately after, and at one month follow up. Repeated measurement design was used in the intervention group to investigate the changes of mediation and outcomes variables in the pretest, during, and post- therapy. Twenty-four patients completed the study. One-way analysis of covariance, Multivariate analysis of covariance and repeated measures was used for analysis. Results: Results showed that there were differences between the intervention and waiting list groups on the severity of symptoms (p=0.001), fear of negative evaluation (p=0.002), and quality of life (p=0.03), as well as in terms of specific measures of SA-AAQ(p=0.001), cognitive fusion (p=0.001), and important section of VLQ(p=0.001). Repeated measurement result showed that acceptance and action of social anxiety and cognitive fusion had a mediating role in the severity of anxiety, fear about negative evaluation, and quality of life. Discussion: Results of the study indicate the effectiveness of ACT for SAD and highlighted mediator contribution acceptance and action and cognitive fusion in severity of social anxiety.