A Preliminary Investigation of Defusion and Self As Context ACT Processes in Persons with Traumatic Experience

Author

Morgan Battle, Southern Illinois University CarbondaleFollow

Date of Award

8-1-2024

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Habib, Reza

Second Advisor

Lee, Eric

Abstract

More than half of both men and women living in the United States report experiencing at least one traumatic event in their lifetime (Kessler et al., 1995). While not all individuals who experience a traumatic event will develop posttraumatic stress disorder, individuals with traumatic experience exhibit higher levels of functional impairment, suicidality, and are more likely to meet criteria for anxiety, depressive, and alcohol use disorders (Beckham et al., 1998; Marshall et al., 2001). Acceptance and Commitment Therapy (ACT) may aid those who have experienced a traumatic event in reducing avoidance and engaging in valued action in the presence of distressing private experiences (Walser & Hayes, 2006). Those who receive an ACT-oriented treatment may learn behavioral skills consistent with six processes that foster non-judgment, broadened perspective, and acceptance of experiences occurring in the here-and-now (Hayes et al., 2012). Few studies have been conducted to examine the relative effects of component processes within the ACT framework, and among the existing literature little attention has been given to self as context (Carrasquillo & Zettle, 2014; Hayes et al., 2006). All six processes are considered to have some degree of overlap (Hayes et al., 2006). Namely, self as context, a process that involves broadening present moment perspective and objectively relating to self-oriented content, shares similarities with defusion, a process involving objective observation of cognitive phenomenon. Evidenced and conceptual overlap among component processes may lead to measurement concerns, fluid used of interventions, and lack of clinical clarity. The current study examined the relative effects of defusion and self as context in persons who have experienced a traumatic event, using a novel treatment design (counterbalanced alternating treatments SCED) and measurement plan (Ecological Momentary Assessment). Specifically, this study assessed treatment utility of self as context and defusion for individuals who have experienced a traumatic event, evaluated the validity of component interventions, and examined effects of self as context in particular as a core ACT process. This study did not provide evidence that self as context is more or equally as efficacious as defusion as an intervention for persons with past traumatic experience. Several factors may have impacted results of the current study, including individual variability, lack of a clinical sample, and significant time spent explaining intervention rationale and processing intervention experience (all of which was beyond the scope of the current study). Further research is needed to assess unique contributions of component processes of change within the ACT model.