ACT-based change processes as predictors of post-stroke depression among stroke survivors

Area of Science:

• Psychology
• Neurorehabilitation
• Clinical Psychology

Background:

• Stroke survivors frequently experience depression, necessitating targeted interventions.
• Acceptance and Commitment Therapy (ACT) offers potential mechanisms for addressing depression in this population.
• Understanding specific contextual-behavioural change processes is crucial for optimizing ACT-based interventions.

Purpose of the Study:

• To investigate the relationship between psychological flexibility, cognitive fusion, valued living, stroke impact, and depression in stroke survivors.
• To identify key change processes within ACT that can be targeted to reduce depression post-stroke.
• To examine the mediating role of cognitive fusion in the association between psychological flexibility and depression.

Main Methods:

• An online questionnaire survey was administered to 81 stroke survivors.
• Measures included depression (PHQ-9), psychological flexibility (AAQ-ABI), cognitive fusion (CFQ), valued living (VLQ), and stroke impact (SF-SIS).
• Hierarchical linear regression and mediation analyses were employed to analyze the data.

Main Results:

• Cognitive fusion, stroke impact, gender, and ethnicity independently predicted depression, explaining 60.2% of the variance.
• Cognitive fusion significantly mediated the relationship between psychological flexibility and depression.
• Psychological flexibility's impact on depression was largely explained by its effect on cognitive fusion.

Conclusions:

• ACT-based interventions show promise for reducing depression in stroke survivors.
• Cognitive de-fusion emerges as a critical targetable change process for mitigating post-stroke depression.
• Cognitive de-fusion may aid in rebuilding personal identity, thereby positively impacting depression levels.