Background: The current study presents the results of a meta-analysis of 39 randomized controlled trials on the efficacy of acceptance and commitment therapy (ACT), including 1,821 patients with mental disorders or somatic health problems. Methods: We searched PsycINFO, MEDLINE and the Cochrane Central Register of Controlled Trials. Information provided by the ACBS (Association of Contextual Behavioral Science) community was also included. Statistical calculations were conducted using Comprehensive Meta-Analysis software. Study quality was rated using a methodology rating form. Results: ACT outperformed control conditions (Hedges' g = 0.57) at posttreatment and follow-up assessments in completer and intent-to-treat analyses for primary outcomes. ACT was superior to waitlist (Hedges' g = 0.82), to psychological placebo (Hedges' g = 0.51) and to treatment as usual (TAU) (we defined TAU as the standard treatment as usual; Hedges' g = 0.64). ACT was also superior on secondary outcomes (Hedges' g = 0.30), life satisfaction/quality measures (Hedges' g = 0.37) and process measures (Hedges' g = 0. 56) compared to control conditions. The comparison between ACT and established treatments (cognitive behavioral therapy) did not reveal any significant differences between these treatments (p = 0.140). Conclusions: Our findings indicate that ACT is more effective than treatment as usual or placebo and that ACT may be as effective in treating anxiety disorders, depression, addiction, and somatic health problems as established psychological interventions. More research that focuses on quality of life and processes of change is needed to understand the added value of ACT and its transdiagnostic nature.

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Objective High anxiety sensitivity predicts poor smoking cessation outcomes. Aerobic exercise reduces anxiety sensitivity and aspects of the risk conferred by anxiety sensitivity. In the current study, we examined whether exercise can aid smoking cessation in adults with high anxiety sensitivity. Method Participants were sedentary and low activity adult daily smokers (N = 136) with elevated prescreen anxiety sensitivity. Participants received 15 weeks of standard smoking cessation treatment (ST: cognitive behavioral therapy plus nicotine replacement therapy). Additionally, participants were simultaneously randomized to 15 weeks of either an exercise intervention (ST+EX; n = 72) or a wellness education control condition (ST+CTRL; n = 64). Self-reported smoking abstinence was assessed weekly during the intervention, at the end of treatment (10 weeks following the target quit date), and at 4 and 6 months following the target quit date. Abstinence was verified by expired carbon monoxide readings and saliva cotinine. Results Results indicated that point prevalence abstinence (PPA) and prolonged abstinence (PA) rates were significantly higher for ST+EX than for ST+CTRL at each of the major end points among persons with high anxiety sensitivity (PPA: b=−.91, SE=.393, t(1171)=−2.33, p=.020; PA: b=−.98, SE=.346, t(132)=−2.84, p=.005), but not among those with low anxiety sensitivity (PPA: b=−.23, SE=.218, t(1171)=−1.06, p=..29; PA: b=−.31, SE=.306, t(132)=−1.01, p=.32) Conclusions The present results suggest that exercise faciliates the odds of quit success for smokers with high levels of anxiety sensitivity, and therefore, may be a useful therapeutic tactic for this high-risk segment of the smoking population.

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Clinical effectiveness, treatment adherence, and patient satisfaction outcomes are comparable for VTH and in-person delivery of psychotherapy and psychiatric consultation services. Clinical applications for VTH have expanded in an effort to provide mental health care to difficult to reach, underserved populations. VTH is less costly than in-person care when assuming that patients could employ existing personal technologies. VTH delivery offers a safe and effective option for increasing access to mental health care for patients who face logistical and stigma-related barriers to receiving in-person treatment. VTH should be routinely offered to patients as an option for receiving care, maximizing patient choice, and coordination of care.

To protect and manage an intact neotropical carnivore guild, it is necessary to understand the relative importance of habitat selection and intraguild competition to the ecology of individual species. This study examined habitat use of four carnivores in the Mountain Pine Ridge Forest Reserve, Belize. We calculated photographic trap success (TS) rates for jaguars Panthera onca, pumas Puma concolor, ocelots Leopardus pardalis, grey foxes Urocyon cinereoargenteus, potential prey and humans at 47 remote camera stations spaced along roads and trails within the 139 km 2 study site. At each station, we used manual habitat sampling in combination with geographic information systems to estimate habitat characteristics pertaining to vegetation cover. We used negative binomial models to analyse species-specific TS as a response to habitat (including vegetation and landscape variables, prey activity and human activity) and co-predator activity rates. Jaguars [TS = 7.56 AE 1.279 (SE) captures per 100 trap-nights (TN)] and grey foxes (31.5 AE 6.073 captures per 100 TN) were commonly captured by cameras, while pumas (0.66 AE 0.200 captures per 100 TN) and ocelots (0.55 AE 0.209 captures per 100 TN) were rare. Model selection via Akaike's information criterion (AIC) revealed that models including habitat variables generally performed better than models including co-predator activity. Felid captures were positively associated with small bird TS and with the width or length of surrounding roads, while fox counts showed few habitat associations. Ocelot activity was positively related to jaguar captures, an effect probably explained by their shared preference for areas with more roads. Pumas were negatively related to human activity and jaguars showed a similar, though non-significant, trend, suggesting that these felids may be sensitive to human disturbance even within protected areas. Results suggest that these predators do not spatially partition habitat and that the jaguar could function as an umbrella species for smaller sympatric carnivores.