The main purpose of this placebo controlled trial is to test the efficacy of a one-session From Fear to Purpose ACT intervention in reducing self-reported death anxiety levels. Another objective of this study is to investigate whether reductions in death anxiety levels are associated with reductions in depression and anxiety levels, thus testing if death anxiety is a transdiagnostic factor involved in psychopathology.
This is a placebo controlled trial where the main objective is to test if the one-session From Fear to Purpose ACT intervention is effective in reducing self-reported death anxiety levels. A secondary objective is to investigate whether reductions in death anxiety levels are associated with reductions in depression and anxiety levels, thus testing if death anxiety is a transdiagnostic factor involved in psychopathology. Participants will be selected based on death anxiety levels (moderate-high scores) and depression and anxiety symptoms (subclinical levels). Minors, people with suicidal ideation, people with current psychological/psychiatric diagnosis (excepting depression or anxiety diagnosis), people in active psychological/psychiatric treatment will be excluded. Recruited participants will be randomized into two groups: the experimental group (will receive the From Fear to Purpose ACT intervention) and the placebo group. The placebo condition will be undergoing a group-based attentional control activity. Participants will be blinded to the study condition. The From Fear to Purpose intervention protocol is based on Acceptance and Commitment Therapy (ACT) strategies, build around identifying and committing to personal values. The intervention will be group-based (90 minutes session). The intervention will be administered by experienced psychotherapists. The primary outcome is death anxiety, while secondary outcomes are depression and anxiety symptoms, well-being, psychological flexibility, experiential avoidance and valued living.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
The From Fear to Purpose ACT Protocol is based on Acceptance and Commitment Therapy (ACT) strategies, build around identifying and committing to personal values. The intervention will be group-based (90 minutes session).
The placebo condition consists of a group-based attentional control intervention.
Change from baseline Death Anxiety score to the follow-up moment (6 weeks duration)
Death anxiety measured with Death Anxiety Beliefs and Behaviours Scale (Menzies, Sharpe, Dar-Nimrod, 2022). Scores range from 18 to 90, with higher scores indicating higher death anxiety levels.
Time frame: From enrolment to follow-up (6 weeks time frame)
Change from baseline Depression score to the follow-up moment (6 weeks duration)
Depression measured with Patient Health Questionnaire - 9 (Kroenke, 1999). Scores range from 0 to 27 with higher scores indicating more severe depression symptoms.
Time frame: From enrolment to follow-up (6 weeks time frame)
Change from baseline Anxiety score to the follow-up moment (6 weeks duration
Anxiety measured with Generalized Anxiety Disorder - 7 (Spitzer, 2006). Scores range from 0 to 27, with higher scores indicating more severe anxiety symptoms.
Time frame: From enrolment to follow-up (6 weeks time frame)
Change from baseline Well-being score to the follow-up moment (6 weeks duration)
Distress measured with The World Health Organization-Five Well-Being Index (WHO-5; WHO, 2024). Scores range from 0 to 25 with higher scores indicating better well-being.
Time frame: From enrolment to follow-up (6 weeks time frame)
Change from baseline Psychological Flexibility to the follow-up moment (6 weeks duration)
Psychological Flexibility measured with Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT) (Francis, 2016). Scores range from 0 to 138 with higher scores indicating better psychological flexibility.
Time frame: From enrolment to follow-up (6 weeks time frame)
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Enrollment
175
Change from baseline Experiential Avoidance score to the follow-up moment (6 weeks duration
Experiential Avoidance measured with Brief Experiential Avoidance Questionnare (Gamez, 2011). Scores range from 15 to 90 with higher scores indicating higher experiential avoidance.
Time frame: From enrolment to follow-up (6 weeks time frame)
Change from baseline Valued Living score to the follow-up moment (6 weeks duration
Valued Living measured with Valuing Questionnare (Smout, 2014). The measure has two subscales: 1. Progress, where scores range from 0 to 30, higher scores indicating a closer alignment between one's internal values and one's actions. 2. Obstruction, where scores range from 0 to 30, higher scores indicating more interference with living consistently with one's values.
Time frame: From enrolment to follow-up (6 weeks time frame)