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Evaluation of mediators of change in the treatment of epilepsy with Acceptance and Commitment Therapy
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Department of Psychology, University of Nevada, Reno, NV, USA.
2008 (English)In: Journal of behavioral medicine, ISSN 0160-7715, E-ISSN 1573-3521, Vol. 31, no 3, 225-235 p.Article in journal (Refereed) Published
Abstract [en]

The present study examined the mediators of change accounting for outcomes of a previously published study on Acceptance and Commitment Therapy for the self-management of epilepsy and its life restricting impact. Conducted with 27 poor South Africans, a nine-hour ACT protocol that included seizure management methods was shown to greatly reduce epileptic seizures and to increase quality of life over the next year as compared to an attention placebo control. A series of bootstrapped non-parametric multiple mediator tests showed that pre to follow-up changes in: seizures, quality of life, and well-being outcomes were mediated to a degree by ACT process measures of epilepsy-related acceptance or defusion, values attainment, persistence in the face of barriers, or their combination. The results of this study contribute to the understanding of the contextual conditioning mechanisms at work for those suffering from epilepsy and may show that helping people live vital lives may also help to reduce seizures.

Place, publisher, year, edition, pages
2008. Vol. 31, no 3, 225-235 p.
Keyword [en]
Acceptance and Commitment Therapy, mediational analysis, epilepsy, values, acceptance, defusion, psychological flexibility, South Africa
National Category
Psychology
Identifiers
URN: urn:nbn:se:uu:diva-16419DOI: 10.1007/s10865-008-9151-xISI: 000256090000005PubMedID: 18320301OAI: oai:DiVA.org:uu-16419DiVA: diva2:44190
Available from: 2008-05-22 Created: 2008-05-22 Last updated: 2017-12-08Bibliographically approved
In thesis
1. ACT Treatment of Epilepsy: Time for a behavioral model?
Open this publication in new window or tab >>ACT Treatment of Epilepsy: Time for a behavioral model?
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present dissertation contributes to the understanding of behavioral treatment of epilepsy and supports the integration of medical and behavioral science to develop a treatment model to help those who suffer from drug refractory epilepsy. There is a lack of well-designed randomized controlled trials evaluating behavioral therapy for epilepsy. Medical science has contributed significantly to the development of antiepileptic drugs for seizure control, yet despite these efforts approximately 1/3 of patients suffer from recurrent seizures. The comorbidity between epilepsy and psychiatric problems is significant and quality of life is lower for those who suffer from epilepsy compared to those who suffer from other chronic illnesses. The purpose of the present dissertation is to develop and evaluate a behavioral treatment model for those who suffer from recurrent epileptic seizures and associated problems. Acceptance and commitment therapy (ACT) is compared to supportive treatment and yoga. Outcome variables are seizure frequency, seizure index (frequency * duration) and quality of life. The dissertation consists of three studies; two studies with randomized controlled group designs to evaluate treatment effects and one mediational analysis study evaluating the effect of specific therapeutic processes. The mediational analysis examines specific ACT processes such as value attainment, epilepsy related psychological flexibility and persistency in overcoming barriers. The results of the two randomized controlled trials show a significant decrease in seizure frequency and seizure index in favor of the ACT group compared to the control groups and significant changes in life quality. The results of the mediational study indicate that the evaluated processes, alone or in combination, had a mediational role in three of the four outcome variables. In conclusion, the present dissertation supports the integration of behavior and medical science to help those who suffer from epilepsy and associated problems.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 53 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 68
National Category
Psychology
Identifiers
urn:nbn:se:uu:diva-151778 (URN)978-91-554-8084-4 (ISBN)
Public defence
2011-05-31, Sal IX, Universitetshuset, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2011-05-10 Created: 2011-04-18 Last updated: 2011-07-01Bibliographically approved

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