Roger Vilardaga, Ana Estévez, Michael E. Levin and Steven C. Hayes University of Nevada, Reno

1. Empirical Support for the Utility of a Three-Step Perspective Taking Model for the Developmentof Psychosis Proneness in College Students Roger Vilardaga, Ana Estévez, Michael E. Levin and Steven C. Hayes University of Nevada, Reno and Universidad de Deusto WC ABCS, Reno NV, June 22, 2010

2. Key points of presentation • Study conducted in colaboration with Ana Estévez from the Universidad de Deusto in Bilbao, Spain • Contextual behavioral approach • DV: Social anhedonia • IVs: Experiential Avoidance, Empathy, Perspective taking • Design: Cross-sectional • Results suggest three processes that together can help us understand psychosis pronenness and that can be targetted in future ACT protocols for psychosis

3. Background • Social anhedonia has been shown to predict psychosis (Chapman et al, 1994; Kwapil et al, 1997; Gooding et al, 2005) • And it relates to features that are characteristic of schizophrenia: • Social adjustment (Mishlove et al, 1985) • Lack of friends (Kwapil, 1998) • Working memory (Gooding et al 2003) Psychosis proneness

4. Relational Frame Theory • Behavioral account of language and cognition • Verbal stimuli have an impact on human behavior through their participation in relational frames • Relational frames allow individuals to interact with the world more effectively without the need to experience it directly • There are multiple kinds of relational frames (i.e., coordination, hierarchy, opposition)

5. Limoo Betrang Betrang attention salivation salivation sour sour bumpy bumpy rushian? yellow yellow lemonade lemonade citrus citrus Defining properties of relational frames 1. Mutual Entailment what? 3. Transformation of Functions 2. Combinatorial Entailment Note: Slide borrowed from Ian Stewart, 2008, June.

6. RFT preliminary studies (Villatte et al, 2008, 2009, 2010) • Deficits in a specific type of relational framing among individuals diagnosed with psychosis and/or high social anhedonia • RFT can provide: • A more fine-grained analysis of psychosis proneness • Key targets for the remediation of deficits in individuals with high social anhedonia and schizophrenia

7. Contextual control Excitement Hate Joy Sadness Affection Fear 3 step model and predictions IRI (Davis, 1983) DRT (Vilardaga et al, 2009) AAQ (Hayes, 2004) Social Anhedonia + + Now/Then I/You I/You I/You Here/There - - + rSAS (Eckblad, 1982)

8. Development of new deictic protocol with more ecological validity • We made the wording of trials more appropriate for an adult population: each single trial added a new content: • We eliminated simples and simplified reversals: • i.e., instead of “if I were you and you were me”, we asked “If you were me” or “If I were you” and balanced it

9. Example of deictic assessment trial Duke is watching the sunset on the rooftop, and Dafney is watching TV in the living room. If the rooftop was the living room, what would Duke be watching? The TV The sunset 18 to go

10. Example of deictic assessment trial Now Floyd is digging a hole in Death Valley, and next winter he will be making snow angels in the Alps. If Death Valley was the Alps and now was later, what would Floyd be doing now? Digging a hole Making snow angels 1 to go

11. Improvements in procedure • Thanks to Ruth Anne Rehfeldt we elaborated on her basic VBA code and created a new automated procedure • Data was automatically written in a text file: • Accuracy • Fluency (response time) • Mistake latency • Less social desirability effects • We solved ceiling effects of previous empathy ratings by adding more empathy questions

12. Participants • College students from University of Deusto (Bilbao, Spain): N=110 • Criteria: • Being fluent in Spanish • Sample characteristics: • 88.2% female • Mean age: 20 (range: 18-32) • Caucasian • Participant’s father: 9% college degree, 20% high school, 25% school diploma, 13% professional school

13. Note: *p< .05, **p≤ .001, †p< .10 Predictors of social anhedonia;Sequential multiple regression

14. Marginally significant in predicted direction r = .13† Non significant but in predicted direction r = .03ns Social Anhedonia Significant at 3rd and last step (β = -.26*) in predicted direction Significant at 2nd and 3rd step (β= -.23*) but not last (p=.056) in predicted direction Significant at last step (β = .35**) in predicted direction 26% 15% 10% Significant (p=.000) 26% variance Medium effect size

15. Limitations and future directions • Early study • Non-clinical population • Cross-sectional design / need stronger methods --- • Test the same model longitudinally and experimentally • Behavioral measures of empathic concern and experiential avoidance are highly needed • Further basic research to understand the contextual factors that give rise to each of these behavioral processes • We have collected data from 162 participants responding to the same measures

16. Conclusion This data suggests that in addition to psychological flexibility, future ACT protocols for psychosis might consider targeting individuals’ ability to engage in deictic framing and their ability to transform its functions. We recommend this is done with the development of behavioral tasks to train/measure each of these processes.

17. The essence of the ACT model

18. is a Contextual Behavioral Strategy

19. Thanks for your attention Contact information/resources: A ppt/audio version of thispresentationwill be posted in thefollowingwebsite: Association for Contextual Behavioral Science: http://contextualpsychology.org/ Roger Vilardaga, M.A.: roger.vilardaga@gmail.com