The Effect of an Acceptance and Commitment Therapy-Based Intervention on Executive Functioning and Risk of Suicidal Behavior in Adults with Depression
Creators: name: Grand Jaramillo, Valentina
name: Arbeláez Herrera, María Camila
name: Grisales, Andrés Mauricio
name: Landinez Martínez, Daniel Alfredo
name: Castaño Ramirez, Oscar Mauricio
Publisher: name: Mediterranean Journal of Clinical Psychology
Year: 2024
Subjects: ACT; Clinical Psychology; Depression; Executive Functioning; Suicidal Behavior.

description: Background: Suicidal behavior (SB) is a global public health issue, particularly due to its significant increase in recent years. Affective disorders, such as depressive disorder (DD), are strongly linked to suicidal ideation (SI), suicide attempts (SA), and completed suicides. Cognitive difficulties are among the hallmark features of DD, forming a part of its nosological definition,specifically, those related to executive functioning. The acceptance and commitment therapy (ACT) has been used as an intervention for different affective disorders, generating significant improvements in symptoms, but also, it strengthens psychological flexibility, attention, working memory and planning in people with various pathologies.To date, few studies in Colombia have investigated the effects of an ACT-based intervention on EF and SB risk in adults with DD.


Methodology: Thirty-two adults diagnosed with depressive disorder were randomly assigned to two groups: Experimental Group (EG) and Active Control Group (ACG). The following assessments were administered: Sociodemographic Survey, Suicidality Scale (SS), Patient Health Questionnaire (PHQ-9), and executive functioning subtests: Wechsler Adult Intelligence Scale (working memory index), and Neuropsi: attention and memory. For the statistical analyses, descriptive statistics were calculated to summarize the sociodemographic variables and the normalized instrument scores for both groups. The Shapiro-Wilk test was used to assess the normality of the distributions, an important step given the small sample size (50), which influenced the choice of non-parametric methods. Group comparisons were made using the Mann-Whitney U test for independent samples and the Bayesian Wilcoxon signed-rank test.


Results: The variables “Successive Series” and “Working Memory Index” showed statistically significant differences between the two groups, with a Bayesian factor providing anecdotal evidence in favor of the alternative hypothesis. For the remaining variables, Bayesian factors suggested evidence in favor of the null hypothesis, indicating insufficient evidence to confirm differences between the groups in these specific skills. 


Conclusions: The results of this study indicate that the effects of an ACT-based intervention are evident in visuospatial working memory, as well as in tasks involving verbal fluency, inhibitory control, and language in the experimental group (EG). For the other cognitive variables, their p-values do not show significant differences. About the clinical variables, while it is not possible to attribute the reduction in suicidality scale scores solely to the effect of the ACT intervention, it can be concluded that both ACT and the intervention in the active control group (ACG) show promising results in reducing the suicide risk in this population.
description: Mediterranean Journal of Clinical Psychology, Vol 12, No 3 (2024)