The Effects of Acceptance and Commitment Therapy (ACT) Intervention on Inflammation and Stress Biomarkers: a Randomized Controlled Trial

Elina Järvelä-Reijonen (Corresponding Author), Sampsa Puttonen, Leila Karhunen, Essi Sairanen, Jaana Laitinen, Mikko Kolehmainen, Jussi Pihlajamäki, Urho M. Kujala, Riitta Korpela, Miikka Ermes, Raimo Lappalainen, Marjukka Kolehmainen

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    Background: Psychological processes can be manifested in physiological health. We investigated whether acceptance and commitment therapy (ACT), targeted on psychological flexibility (PF), influences inflammation and stress biomarkers among working-age adults with psychological distress and overweight/obesity. Method: Participants were randomized into three parallel groups: (1) ACT-based face-to-face (n = 65; six group sessions led by a psychologist), (2) ACT-based mobile (n = 73; one group session and mobile app), and (3) control (n = 66; only the measurements). Systemic inflammation and stress markers were analyzed at baseline, at 10 weeks after the baseline (post-intervention), and at 36 weeks after the baseline (follow-up). General PF and weight-related PF were measured with questionnaires (Acceptance and Action Questionnaire, Acceptance and Action Questionnaire for Weight-Related Difficulties).Results: A group × time interaction (p =.012) was detected in the high-sensitivity C-reactive protein (hsCRP) level but not in other inflammation and stress biomarkers. hsCRP decreased significantly in the face-to-face group from week 0 to week 36, and at week 36, hsCRP was lower among the participants in the face-to-face group than in the mobile group (p =.035, post hoc test). Age and sex were stronger predictors of biomarker levels at follow-up than the post-intervention PF. Conclusion: The results suggest that ACT delivered in group sessions may exert beneficial effects on low-grade systemic inflammation. More research is needed on how to best apply psychological interventions for the health of both mind and body among people with overweight/obesity and psychological distress. Trial Registration: Identifier: NCT01738256, Registered 17 August, 2012.
    Original languageEnglish
    Pages (from-to)539-555
    JournalInternational Journal of Behavioral Medicine
    Issue number5
    Publication statusPublished - 1 Oct 2020
    MoE publication typeA1 Journal article-refereed


    • ACT
    • Low-grade inflammation
    • Mindfulness
    • Obesity
    • Psychological flexibility
    • Stress


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