Depression in psychosis: associations with psychological flexibility and emotion regulation

Background: Depressive symptoms have been found to accompany and develop following psychosis. Depression following psychosis has been associated with negative self-cognitions. Acceptance and Commitment Therapy (ACT) posits that avoidance of distressing internal experiences can lead to psychological inflexibility and the maintenance of distress. Aims: The study conducted a preliminary investigation into the effectiveness and acceptability of a brief ACT-based defusion intervention aimed at increasing psychological flexibility and reducing distress associated with negative self cognitions. This research also explored the extent to which levels of depression experienced by individuals with psychosis are associated with internal shame, psychological flexibility and emotion regulation difficulties. Method: A randomised controlled trial design was used in phase 1 of the study. Individuals were randomised to either a brief defusion intervention (N=8) or a control condition (N=8).An exploratory correlational design was used in phase 2 of the research.Sixteen participants completed questionnaires. Results: Levels of depression in individuals with psychosis were associated with internal shame, psychological inflexibility and difficulties with emotion regulation. A trend approaching significance suggested that the change in levels of distress related to a negative self cognition in the defusion group was greater than the corresponding change for the control group. Conclusions: Individuals randomised to a defusion exercise found the intervention acceptable and it appears to offer promise for reducing distress associated with negative self cognitions