Effect of a group-based acceptance and commitment therapy intervention on cognitive emotion regulation and psychological flexibility in patients with bipolar disorder

Psychol Psychother. 2026 Apr 11. doi: 10.1111/papt.70061. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examined the efficacy of group-based acceptance and commitment therapy (ACT) in improving cognitive emotion regulation (CER) and psychological flexibility (PF) in patients with bipolar disorder (BD).

METHODS: Fifty-five Chinese patients with BD type I or II from the inpatient psychiatric unit of a Grade-A tertiary psychiatric hospital in China participated in the intervention. Twenty-eight patients were randomized to the ACT+ treatment as usual (TAU) group (10 group sessions) and 27 to TAU alone. The Young Mania Rating Scale (YMRS), Self-rating Depression Scale (SDS), Cognitive Emotion Regulation Questionnaire (CERQ), Cognitive Fusion Questionnaire-Fusion (CFQ-F) and Acceptance and Action Questionnaire II (AAQ-II) were used to assess the participants’ CER ability, PF and mania and depressive symptoms at a pre-treatment time-point (baseline) and a post-treatment time-point (5 weeks). ANOVA analysis was conducted to compare the scores before and after treatment in the two groups.

RESULTS: The ACT + TAU group demonstrated more substantial improvements in CER, PF, as well as residual mania and depression, compared to the TAU group.

CONCLUSIONS: Our findings indicate that combining ACT intervention into treatment as usual can play better results in enhancing the CER ability and PF of patients with BD in a clinical setting.

PMID:41964330 | DOI:10.1111/papt.70061