Acceptance and commitment therapy for enhancing mental health in military personnel: A comprehensive review and meta-analysis

doi:10.5498/wjp.v15.i3.100959

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World Journal of Psychiatry

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Meta-Analysis

World J Psychiatry. Mar 19, 2025; 15(3): 100959
Published online Mar 19, 2025. doi: 10.5498/wjp.v15.i3.100959

Acceptance and commitment therapy for enhancing mental health in military personnel: A comprehensive review and meta-analysis

Jun-Qiao Wang, Xin-Zhe Wang, Wen-Xiao Wang

Jun-Qiao Wang, Xin-Zhe Wang, Wen-Xiao Wang, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250100, Shandong Province, China

Co-first authors: Jun-Qiao Wang and Xin-Zhe Wang.

Author contributions: Wang JQ contributed to conceptualized the study, conducted the systematic review, and performed the meta-analysis. Drafted the initial manuscript and contributed to data interpretation; Wang XZ contributed to coordinated data acquisition, assisted in statistical analysis, and reviewed and revised the manuscript. Oversaw the methodology and ensured adherence to Joanna Briggs Institute guidelines; Wang WX supervised the entire project, provided critical insights into the study design, and addressed key revisions to the manuscript. Corresponded with the journal and managed all administrative aspects of the submission process. All authors have read and approved the final version of the manuscript.

Conflict-of-interest statement: The author declares no conflict of interest.

PRISMA 2009 Checklist statement: This systematic review and meta-analysis was conducted and reported in accordance with the PRISMA 2009 guidelines.

Corresponding author: Wen-Xiao Wang, MD, Nurse Practitioner-in-charge, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi Road, Lixia District, Jinan 250100, Shandong Province, China. nfmwwx@126.com

Received: August 31, 2024
Revised: November 25, 2024
Accepted: January 22, 2025
Published online: March 19, 2025
Processing time: 178 Days and 18.6 Hours

Abstract

BACKGROUND

Military personnel frequently face unique psychological challenges due to high-stress environments, which increase the risk of mental health issues like anxiety and depression. Acceptance and commitment therapy (ACT) has shown potential in addressing these issues by enhancing psychological flexibility and resilience.

AIM

To systematically evaluate the effectiveness of ACT in improving the mental health of military personnel. Through a scoping review and meta-analysis, we quantitatively assess the impact of ACT on psychological outcomes, guiding future research and clinical practice.

METHODS

Relevant literature was searched systematically from database inception to June 30, 2023, across multiple databases, including PubMed, Web of Science, Cochrane Library, and Embase. The Joanna Briggs Institute's (JBI) scoping review guidelines were used as the methodological framework. Meta-analysis was performed using a random-effects model, and publication bias was assessed through Egger's regression test and Begg's funnel plot.

RESULTS

Twenty-six studies were included, highlighting the application of ACT in addressing PTSD, chronic pain, anxiety, and depression among military personnel. The meta-analysis of eight studies demonstrated a significant positive effect of ACT on mental health, with a pooled mean difference of -4.99 (95%CI: -6.53 to -3.45). Despite high heterogeneity (I² = 63%), sensitivity analyses confirmed the robustness of the findings.

CONCLUSION

This study underscores the potential of ACT as an effective intervention for improving the mental health of military personnel. Future research should focus on large-scale, multi-center RCTs to further validate these findings, particularly within diverse military populations.

Keywords: Acceptance and commitment therapy; Military health; Meta-Analysis; Psychological therapy; Post traumatic stress disorder management

Core Tip: The study assesses acceptance and commitment therapy (ACT)'s impact on military mental health, offering a new intervention perspective. It confirms ACT reduces post-traumatic stress disorder (PTSD) symptoms and increases resilience. Findings highlight ACT's significant reduction of PTSD and improvement in coping skills. Strict assessments ensure the study's reliability and robustness. The research supports mental health interventions in military settings, encouraging tailored treatment advancements.