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Effects of acceptance and commitment therapy on psychological and health-related outcomes in stroke patients: a systematic review and meta-analysis of randomized controlled trials

Xiaohuan Li, Huang Weijin, Ying Gao, Yu'e Wu, Ping Wang

Frontiers in Neurology 2026 Vol. 17, pp. 1953111
https://doi.org/10.3389/fneur.2026.1953111

خواندن متن کامل ۱۸ صفحه · خواندن آنلاین · خارج از سقف مطالعه

چکیده

Background Stroke is a leading cause of disability worldwide and is frequently accompanied by psychological and functional impairments. Acceptance and Commitment Therapy (ACT), a third-wave behavioral intervention focusing on psychological flexibility, has been increasingly applied in stroke rehabilitation. Although previous reviews have suggested beneficial effects of ACT in stroke patients, whether these benefits persist in the short term after the intervention ends, and the certainty of the evidence, remain unclear. Methods A systematic review and meta-analysis was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420261325108). Randomized controlled trials evaluating ACT in stroke patients were included. Pooled effects were calculated using random-effects models, with separate analyses for post-intervention and follow-up outcomes. Sources of heterogeneity were explored using subgroup analyses and meta-regression. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and certainty of evidence was evaluated using the GRADE framework. Results Twenty-two RCTs involving 1,975 participants were included. ACT may be associated with reductions in depressive symptoms (post-intervention: SMD = −1.32, 95% CI: −1.80 to −0.84; follow-up: SMD = −0.76, 95% CI: −1.07 to −0.45) and anxiety symptoms (post-intervention: SMD = −1.36, 95% CI: −1.90 to −0.82; follow-up: SMD = −0.51, 95% CI: −1.42 to 0.40, not significant); depressive symptoms remained statistically significant at follow-up. Heterogeneity was considerable for both outcomes at post-intervention ( I 2 = 93.68% for depression and 93.60% for anxiety), so the pooled estimates represent average effects across studies. ACT may also be associated with improvements in psychological flexibility, quality of life, and sleep quality; however, these outcomes were based on a limited number of studies and showed considerable heterogeneity ( I 2 = 74.68 to 92.26%), so they should be interpreted cautiously. However, no statistically significant effects were observed for activities of daily living, neurological function, or hope. ACT did not appear to increase dropout rates in the available studies ( K = 16; RR = 0.99, 95% CI: 0.58–1.69). Meta-regression analyses indicated that intervention duration may not be a significant moderator of treatment effects. The certainty of evidence ranged from very low to moderate, mainly due to risk of bias and inconsistency. Conclusion Acceptance and Commitment Therapy may be a useful adjunctive intervention for improving psychological outcomes in people with stroke. However, evidence for functional recovery remains insufficient. Future high-quality RCTs with standardized protocols, larger samples, and longer follow-up are needed to confirm the long-term effectiveness of ACT. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , identifer CRD420261325108.

موضوع‌ها و کلیدواژه‌ها

درمانروان‌درمانیمداخلات روانشناسیدرمان مبتنی بر پذیرش و تعهدActivities of daily livingDepressive symptomsSleep qualityanxiety symptomspsychological flexibilityquality of lifestroke rehabilitation

ارجاع

Li, X., Weijin, H., Gao, Y., Wu, Y., & Wang, P. (2026). Effects of acceptance and commitment therapy on psychological and health-related outcomes in stroke patients: a systematic review and meta-analysis of randomized controlled trials. Frontiers in Neurology, 17, 1953111. https://doi.org/10.3389/fneur.2026.1953111

(Li et al., 2026)

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  1. با احترام و بدون توهین، تحقیر، برچسب‌زنی یا حمله‌ی شخصی با دیگران گفتگو کنید.
  2. از نوشتن هرگونه اطلاعات هویتی یا قابل‌شناسایی مراجعان، بیماران یا اشخاص ثالث، از جمله نام، شماره‌ی تماس، تصویر، نشانی، محل کار یا جزئیات منحصربه‌فرد پرونده خودداری کنید.
  3. اگر درباره‌ی یک تجربه‌ی بالینی سؤال می‌کنید، اطلاعات را تا حد ممکن بی‌نام و کلی بیان کنید تا امکان شناسایی فرد وجود نداشته باشد.
  4. این بخش برای یادگیری و گفت‌وگوی علمی است و جایگزین ارزیابی، تشخیص، مشاوره یا روان‌درمانی شخصی نیست.
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  6. انتشار تبلیغات، معرفی خدمات شخصی، شماره‌ی تلفن، شناسه‌ی شبکه‌های اجتماعی، پیوند تبلیغاتی یا درخواست جذب مراجع در این بخش مجاز نیست.
  7. در بیان ادعاهای علمی، به‌ویژه درباره‌ی اثربخشی درمان‌ها، تشخیص یا یافته‌های پژوهشی، تا حد امکان نام منبع معتبر، مقاله یا راهنمای علمی را ذکر کنید.
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  9. پاسخ‌هایی که کارشناسان فکر بنیان می‌دهند با برچسب «پاسخ فکر بنیان» یا «کارشناس فکر بنیان» نمایش داده می‌شوند و سایر نوشته‌ها بیانگر نظر کاربران هستند.
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Psychological Adaptation and Intervention Strategies for Generations Alpha and Beta: A Comparative Study on Evolving Lifestyles and Mental Health Needs

Sayyed Hashim International Journal of Science and Research (IJSR), 2026, Vol. 15, Issue 10, pp. 2119-2121 https://doi.org/10.21275/sr261029112315

چکیده

Generation Alpha (born 2010-2024) and Generation Beta (born 2025-2039) represent an unprecedented developmental archetype defined by total digital integration and ubiquitous artificial intelligence (AI). This empirical study evaluated specialized psychological adaptation mechanisms, parenting models, and mental health intervention frameworks across these cohorts. Utilizing a mixed-methods design, quantitative data were gathered from $N = 300$ parents (Gen Alpha parents and expectant/early Gen Beta parents) using the Modified Parental Stress Scale (PSS) and Child Behavior Checklist (CBCL), supplemented by qualitative interviews with $N = 20$ pediatric mental health experts. Independent samples $t$-tests confirmed that Gen Alpha/Beta display significantly higher digital dependency anxiety ($M = 38.60, p < .001$) alongside superior visual-spatial intelligence ($M = 44.10, p < .001$) relative to normative baselines. Crucially, a proactive "Digital Integration" co-navigation parenting framework yielded significantly lower parental stress ($M = 29.50$) compared to rigid "Digital Detox" restriction models ($M = 42.80, p < .001$). A preventive clinical framework focusing on Social-Emotional Learning (SEL) and cognitive impulse management is proposed.

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The Seen Anxiety: Psychotherapists' Classification of Text‐Described Observable Anxiety Markers Across Three‐ and Five‐Level Rating Formats

Yuval Geiger; Amir Avrahamy; Gideon Emanuel Anholt Counselling and Psychotherapy Research, 2026, Vol. 26, Issue 4 https://doi.org/10.1002/capr.70240

چکیده

ABSTRACT Introduction Anxiety is central to the psychotherapy process, yet psychotherapists routinely infer a client's anxiety intensity from observable behaviour rather than from formal measurement, with no widely accepted framework to organise which observable markers indicate which levels of anxiety. This exploratory study examined how therapists make such classifications. Method Ninety‐one mental health professionals were randomly assigned to classify 41 text‐described behavioural and physiological markers using either a 5‐level or a simplified 3‐level category system, both derived from an integrated model of state anxiety in psychotherapy. Results Response distributions departed significantly from uniformity for nearly all markers in both formats, and the rank ordering of markers by intensity was highly consistent across formats, suggesting that therapists may share broad intuitions about relative marker intensity. Which markers elicited agreement, however, was far less reproducible, depending substantially on the response format. Convergence also depended on where the agreement criterion was set, declining from 90.2% to 51.2% of markers in the 3‐level format and from 63.4% to 22.0% in the 5‐level format as the criterion rose from > 0.50 to > 0.70. The 3‐level format yielded more classifiable markers at every criterion, although this advantage was not consistent across indices, whereas the 5‐level format elicited fewer ‘Insufficient to Determine’ responses. Markers placed at the highest intensity levels were classified most consistently. Discussion These findings offer preliminary groundwork for research on marker operationalisation, contextualised rating tasks and the development of training materials for psychotherapy process research.

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Virtual reality social exposure for social anxiety in bullying victims

Baiq Ade Winanda Agustia Ayu; Sofa Amalia; Miqdad Daly Ahmad; Rachmatul Az-Zahra Ayu Pramutri Cognicia, 2026, Vol. 14, Issue 2, pp. 120-129 https://doi.org/10.22219/cognicia.v14i2.46792

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Experiences of bullying can have significant psychological consequences, including an increased risk of social anxiety. This study aimed to examine changes in social anxiety following Virtual Reality Social Exposure (VRSE) among bullying victims. A one-group pretest–posttest design without a control group was employed with 12 participants. The intervention consisted of three gradual exposure sessions in virtual environments representing social situations. Social anxiety was measured before and after the intervention, and the data were analyzed using the Wilcoxon Signed-Rank Test. The results indicated a statistically significant decrease in social anxiety scores following the intervention (p = 0.002), with a reported effect size of 0.974. These findings suggest that VRSE may be a promising approach for reducing social anxiety among bullying victims. However, the absence of a control group and the small sample size limit conclusions regarding its effectiveness and safety. Further studies with larger samples, control groups, and systematic safety assessments are needed.

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Intolerance of Uncertainty and Psychological Distress among Emerging Adults

Dubey Jyoti Jagdish International Journal of Science and Research (IJSR), 2026, Vol. 15, Issue 10, pp. 2011-2013 https://doi.org/10.21275/mr261028080211

چکیده

This study examined the association between intolerance of uncertainty and psychological distress among emerging adults aged 18-29 years. A quantitative, cross-sectional correlational design was used with online convenience sampling. Of 181 survey submissions, one record was excluded because age was missing and one because the respondent was aged 17 years; a further 18 respondents who reported a previous mental-health diagnosis were excluded. The final analytical sample comprised 161 participants (M age = 23.60, SD = 3.09; 67.1% women). Intolerance of uncertainty was measured with the 12-item Intolerance of Uncertainty Scale (IUS-12), and nonspecific psychological distress with the Kessler Psychological Distress Scale (K10). Mean IUS-12 and K10 scores were 32.11 (SD = 9.44) and 24.31 (SD = 8.09), respectively. Internal consistency estimates were .887 and .913. Pearson's correlation indicated a positive association between IUS-12 and K10 scores, r(159) = .632, p < .001, 95% CI [.529, .717]. Spearman's correlation was also positive and significant (rs = .595, p < .001, 95% bootstrap CI [.475, .699]). Higher intolerance of uncertainty was associated with greater self-reported psychological distress in this sample. The cross-sectional design, convenience sampling, self-report measures, and diagnosis-based screening limit causal inference and generalisability.

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A Comparative Study of VR Therapy and Traditional Methods for Stress Management

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چکیده

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