UNASSIGNED: The underlying mechanisms of the effectiveness of cognitive behavioural interventions for @entity1118 need further clarification. The role of, and associations between, @entity158 -related @entity458 ( @entity458 ) and @entity158 catastrophizing (PC) were examined during a randomized controlled trial on internet-based Acceptance _ Commitment Therapy (ACT) for @entity1118 . We assessed (1) the unique and combined indirect effects of @entity458 and PC on outcomes, and (2) the causality of relations between @entity458 , PC and the primary outcome @entity158 interference in daily life (MPI) during ACT. A total of 238 @entity158 sufferers were allocated to either ACT, a control condition on Expressive Writing, or a waiting list condition. Non-parametric cross-product of coefficients mediational analyses and cross-lagged panel designs were applied. Compared to control conditions, both baseline to post-intervention changes in @entity458 and PC seemed to uniquely mediate baseline to three-month follow-up changes in @entity158 interference and psychological distress. Only @entity458 mediated changes in @entity158 intensity. Indirect effects were twice as large for @entity458 (k    =  .09-.19) than for PC (k   PCS  =  .05-.10). Further assessment of changes during ACT showed, however, that only @entity458 , and not PC, predicted subsequent changes in MPI, while early and late changes in both @entity458 and PC predicted later changes in each other. In conclusion, only @entity458 functioned as a direct, causal working mechanism during ACT, with larger indirect effects that occurred earlier than changes in PC. Additionally, PC may function as an indirect mechanism of change during ACT for @entity1118 via its direct influence on @entity458 .

Psychological flexibility and catastrophizing as associated change mechanisms during online Acceptance _ Commitment Therapy for XXXX .

@entity1118 :: ('MESH:D059350', 'Disease') :: ['chronic pain'] @entity458 :: ('MESH:D020018', 'Disease') :: ['psychological flexibility', 'PF'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity1118 :: (MESH:D059350,Disease) :: ['chronic pain']
