Predicting clinical outcomes in a blended care intervention for early psychosis: Acceptance and Commitment Therapy in Daily-Life (ACT-DL)

Description

Predicting clinical outcomes in a blended care intervention for early psychosis: Acceptance and Commitment Therapy in Daily-Life (ACT-DL) Abstract ACT in Daily Life (ACT-DL) is a blended-care Ecological Momentary Intervention that extends ACT into the daily life of individuals, improving psychotic distress, negative symptoms, and global functioning. However, it remains unclear whether ACT-DL works equally for everyone. We investigated whether moderators (i.e., sociodemographic information, personality, and trauma history) determine clinical outcomes in individuals with early psychosis receiving ACT-DL. Seventy-one participants from the INTERACT trial, using ACT-DL, were analyzed. Outcomes included psychotic distress, negative symptoms, global functioning, and psychological flexibility. Using multivariate-multilevel models, we evaluated the effects of sociodemographics, personality, and childhood trauma across baseline, post-intervention, and six- and 12-month follow-ups. Sociodemographic characteristics and personality predicted clinical outcomes. Higher education demonstrated more substantial improvement in global functioning at 6- ( B = 7.43, p = 0.04) and 12-FU ( B = 10.74, p = 0.002) compared to lower education. Higher extraversion showed less improvement in negative symptoms at 12-FU ( B = 1.24, p = 0.01) and more improvement in global functioning at post-intervention ( B = 0.39, p = 0.046) and 6-FU ( B = 1.40, p = 0.02) compared to lower extraversion. Higher negative affectivity showed more improvement in negative symptoms at 12-FU ( B = −1.59, p = 0.001) and higher psychological flexibility at 12-FU (