Article

Understanding psychological flexibility: A multimethod exploration of pursuing valued goals despite the presence of distress

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Abstract

Psychological flexibility (PF), defined as the ability to pursue valued life aims despite the presence of distress, is a fundamental contributor to health (Kashdan & Rottenberg, 2010). Existing measures of PF have failed to consider the valued goals that give context for why people are willing to manage distress. Using 4 independent samples and 3 follow-up samples, we examined the role of PF in well-being, emotional experience and regulation, resilience, goal pursuit, and daily functioning. We describe the development and psychometric properties of the Personalized Psychological Flexibility Index (PPFI), which captures tendencies to avoid, accept, and harness discomfort during valued goal pursuit. Correlational, laboratory, and experience-sampling methods show that the PPFI measures a trait-like individual difference dimension that is related to a variety of well-being and healthy personality constructs. Unlike existing measures of PF, the PPFI was shown to be distinct from negative emotionality. Beyond trait measures, the PPFI is associated with effective daily goals and life strivings pursuit and adaptive emotional and regulatory responses to stressful life events. By adopting our measurement index, PF may be better integrated into mainstream theory and research on adaptive human functioning.

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... AAQ-II has been criticized regarding whether it measures psychological inflexibility and whether it discriminates between psychological inflexibility as a process, such as an attitude towards one's feelings and thoughts, and the supposed outcomes, such as the emotional problems (Rochefort et al., 2018;Tyndall et al., 2019;Chawla & Ostafin, 2007;Wolgast, 2014). As a result, many other instruments assessing PF or variants of it have been or are under development, including Open Engaged State Questionnaire (Benoy et al., 2019), Comprehensive Assessment of Acceptance and Commitment Therapy (Francis et al., 2016), Personalized Psychological Flexibility Index (PPFI; Kashdan et al., 2020) and Multidimensional Experiential Avoidance Questionnaire (Gámez et al., 2011). However, AAQ-II still remains the most widely used measure of PF and it has been demonstrated that the AAQ-II explains additional variance above established measures of symptomatology (e. g., Gloster et al., 2011) and scores on AAQ-II seem to be stable across time, despite fluctuations in current emotional disorder (e. g., Spinhoven et al., 2014Spinhoven et al., , 2016. ...
... AAQ-II was also negatively, significantly associated with health, and economic well-being. These results are consistent with published reports on AAQ-II (e. g., Eisenbeck & Szabó- Bartha, 2018;Karekla & Panayioutou, 2011;Kashdan et al., 2006Kashdan et al., , 2020. ...
... Meanwhile, the construct of psychological flexibility as defined in the context of Acceptance and Commitment Therapy, includes more dimensions than just experiential avoidance. Currently, several promising measures are developed to capture the PF (e. g., PPFI, Kashdan et al., 2020;MPFI, Rolffs et al., 2019;CompACT, Francis et al., 2016). ...
Conference Paper
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The objective of this study was to assess the psychometric properties of the Latvian version of the Acceptance and Action Questionnaire-II (AAQ-II), measuring psychological flexibility described as the ability to act according to chosen values while consciously being in contact with subjectively unpleasant present moment experiences. The scale provides a single score across 7 items. The original AAQ-II was translated to Latvian and then back to English. The Satisfaction with Life Scale, Flourishing Scale and Meaning in Life Questionnaire was applied for testing the convergent validity of the AAQ-II. Participants of the study were 191 people, ranged in age from 19 to 68 (159 women, mean age M = 30.62, SD = 9.50). Reliability analysis, exploratory and confirmatory factor analysis (EFA and CFA) of the scale were performed. EFA indicated a one-factor structure. Results showed that the Latvian version of AAQ-II has good psychometric properties and convergent validity. Testing of the original model by CFA resulted in acceptable fit indices.
... Yet, many have begun to critique the AAQ-II's psychometric properties. Research on the AAQ-II suggests it has variable reliability and discriminant validity (Gámez et al., 2011;Kashdan et al., 2020;Tyndall et al., 2019;Vaughan-Johnston et al., 2017;Wolgast, 2014). Some researchers have concluded the AAQ-II is not a measure of PF at all, but rather assesses neuroticism and negative affect (Gámez et al., 2011;Kashdan et al., 2020;Rochefort, Baldwin, & Chmielewski, 2018). ...
... Research on the AAQ-II suggests it has variable reliability and discriminant validity (Gámez et al., 2011;Kashdan et al., 2020;Tyndall et al., 2019;Vaughan-Johnston et al., 2017;Wolgast, 2014). Some researchers have concluded the AAQ-II is not a measure of PF at all, but rather assesses neuroticism and negative affect (Gámez et al., 2011;Kashdan et al., 2020;Rochefort, Baldwin, & Chmielewski, 2018). Many have also faulted the AAQ-II for treating PF as a unidimensional construct, despite the fact that ACT posits PF is comprised of six interrelated processes (Gámez et al., 2011;Rolffs, Rogge, & Wilson, 2016). ...
... We assessed six measurement properties: content validity, internal consistency, discriminant validity, test-retest reliability, interpretability, and definition/measure alignment (see Terwee et al., 2007 for definitions and scoring criteria). Given the importance of measures of PF being distinguishable from constructs such as negative affect, neuroticism, and emotional disturbance (e.g., depression/anxiety; Kashdan et al., 2020), we specifically assessed discriminant validity in this way. A score of 2 was given if the assessed measure demonstrated discriminability (i.e., correlation(s) ≤ 0.70 with one or more of the above-mentioned constructs) or 0 if no discriminant validity was established from these constructs, if correlation(s) were ≥ 0.70 with any one of the above construct(s), or if no information was available. ...
Article
Psychological flexibility (PF) is a popular construct in clinical psychology. However, similar constructs have existed since the mid-20th century, resulting in different terms, definitions and measures of flexibility, hindering the advancement of the field. The main measure of PF – the Acceptance and Action Questionnaire (AAQ-II; Bond et al., 2011) – has also been heavily criticized. To move towards definitional consensus and improved measurement, we surveyed the literature to map extant PF and related-terms, examined definitional overlaps, and assessed the psychometric quality of prominent flexibility measures. A scoping review was conducted in two databases (PsycNET and SCOPUS). Twenty-three flexibility constructs appeared across 220 articles and twelve measures included and rated for quality. PF, psychological inflexibility (PI), and cognitive flexibility (CF) were most prominent. Definitional similarities among prominent flexibility constructs emerged, namely handling distress or interference, taking action, and meeting goals or values. The Personalized Psychological Flexibility Index (PPFI; Kashdan, Disabato, Goodman, Doorley, & McKnight, 2020) appears to be the best measure available to assess PF. Problems with the current use of the AAQ were apparent, hindering current knowledge of PF. Definitional consensus and measurement development are vital to advance the field. To this end, recommendations and next steps for researchers and practitioners are outlined.
... One such proposed mechanism is psychological flexibility (25,26,27). Psychological flexibility can be succinctly defined as the pursuit of values despite the presence of pain or distress (25,28). More specifically, psychological flexibility involves adapting to changing situational demands, allocating mental resources, shifting perspective, and finding balance amongst competing demands (26). ...
... More specifically, psychological flexibility involves adapting to changing situational demands, allocating mental resources, shifting perspective, and finding balance amongst competing demands (26). Psychologically flexible individuals are less invested in controlling uncomfortable internal states with the sole aim to maximize pleasant and minimize unpleasant feelings (28). Psychological inflexibility has been positively associated with a range of mental health conditions and emotional disturbances (29,30,31,32,33,34). ...
... As a result, other instruments aimed at operationalizing psychological flexibility have recently been developed i.e. The Multidimensional Psychological Flexibility Index (39) or the Personalized Psychological Flexibility Index (PPFI) (28). However, the AAQ-II continues to have widespread use, and this is supported by findings of discriminant validity with negative affect, suggesting that the scale explains variance beyond that captured by measures of psychological distress (40). ...
Article
Primary objective: In this study, we examined the psychometric properties of measures of psychological flexibility in a mild traumatic brain injury (mTBI) sample. Method and Procedures: Adults who sustained a mTBI (n = 112) completed the Acceptance and Action Questionnaire – Acquired Brain Injury reactive avoidance subscale (AAQ-ABI (RA). Exploratory factor analysis and Rasch analysis were conducted to evaluate the facture structure, dimensionality, and differential item functioning. Construct validity was determined by correlating the AAQ-ABI (RA) with the Acceptance and Action Questionnaire-Revised (AAQ-II) and Fear Avoidance after Traumatic Brain Injury (FAB-TBI). Main outcome and Results: The AAQ-ABI (RA) was found to have strong internal consistency (Cronbach’s α = 0.87). Consistent with previous findings, the AAQ-ABI (RA) had one distinct factor. Fit to the unidimensional Rasch model was adequate (χ 2 (18) = 22.5, p = .21) with no evidence of differential item functioning across person factors examined. The AAQ-ABI (RA) also had expected relationships with theoretically relevant constructs. Conclusions: The AAQ-ABI (RA) appears to be a psychometrically sound measure of psychological flexibility in mTBI.
... When these measures do consider values, it is often done at a global level, which may be hard for participants to self-report accurately to (e.g., "My painful experiences and memories make it difficult for me to live a life that I would value"; Bond et al., 2011). Kashdan et al. (2020) sought to fill existing gaps in the literature by designing a reliable and valid self-report measure of PF. They believed that existing scales ignored a core tenant of PF: that individuals are managing their distress for a purpose -the pursuit of values and meaningful goals. ...
... The PPFI is a self-report index based on a reflective model, which was designed for literate adult population samples. In their scale development paper, Kashdan et al. (2020) recognized three factors named as avoidance (avoiding negative emotions related to meaningful goals, or postponing the pursuit of those goals), acceptance (acceptance of negative emotions related to the goals, or temporary setbacks in goal pursuit), and harnessing (using problems and negative emotions to motivate yourself to the pursuit of meaningful goals). In the self-report PPFI, participants are asked to focus on an important personal goal when responding to items. ...
... Lastly, we tested incremental validity of PPFI scores predicting well-being, goal-directed traits, and life orientations above and beyond two popular self-report measures of experiential avoidance (i.e., BEAQ, AAQ-II). Therefore, the present study sought to replicate the unique nomological network of the PPFI found in Kashdan et al. (2020). ...
Article
Popular measures of psychological flexibility (PF), such as the Acceptance and Action Questionnaire (AAQ-II) and Brief Experiential Avoidance Questionnaire (BEAQ) have been criticized for questionable psychometric properties. The critiques include poor divergent validity with negative emotionality and disregarding PF's theoretical definition of flexible contact with the present moment while acting in the service of chosen values. Recently, the Personalized Psychological Flexibility Index (PPFI) has been proposed as an alternative self-report measure of PF that attempts to address these issues above. The current study sought to test the psychometric properties of the PPFI in a large sample of Iranians from the general population who completed a cross-sectional survey. Back translation and cognitive interviews were used to translate the PPFI into Persian. Exploratory factor analysis indicated that the Persian version of the PPFI, like the English version, has a three-factor structure mapping onto the avoidance, acceptance, and harnessing subscales. Confirmatory factor analyses supported a three-factor solution, showed a good model fit, and good internal consistencies. Correlational analyses supported the construct validity of the Persian PPFI with relations to well-being, goal-directedness, and life orientations in expected directions. Furthermore, the Persian PPFI demonstrated excellent divergent validity from negative emotionality (r = -.38). Test of incremental validity indicated the Persian PPFI explained more variance in 10 of 15 outcomes than the BEAQ or AAQ-II. The current findings provide psychometric evidence for use of the PPFI in Persian-speaking populations as well as further support for evaluating PF ideographically and in line with theoretical definitions.
... Although according to the ACT framework psychological flexibility is the core mechanism of change, almost all of the work on psychological flexibility over the past 20 years has hinged on studies that have explored its opposite: psychological inflexibility and in particular its sub-process experiential avoidance , defined as unwillingness to remain in contact with aversive internal experiencing (e.g., thoughts, memories, bodily sensations), which in turn is related to inflexible responses to these difficult experiences . Most of the research on the effectiveness of ACT interventions and the causes and consequences of psychological flexibility is based on the use of two self-report measures of psychological inflexibility, the Acceptance and Action Questionnaire (AAQ-I and AAQ-II; Bond et al., 2011;Hayes et al., 2004) and the Brief Experiential Avoidance Questionnaire (BEAQ; Gámez et al., 2014), which are used as a proxy for psychological flexibility (e.g., Kashdan et al., 2020;Rochefort et al., 2018;Tyndall et al., 2019;Wolgast, 2014). Nevertheless, these instruments suffer from poor discriminant validity as they overlap highly with several measures of psychopathology including, depression, anxiety, stress and substance abuse (Bond et al., 2011;Doorley et al., 2020). ...
... In fact, a small but growing body of research evidence shows that the AAQ-II and the BEAQ assess distress and negative emotionality rather than psychological inflexibility or psychological flexibility by proxy Rochefort et al., 2018;Tyndall et al., 2019;Wolgast, 2014). Based on these findings, it has been proposed that rather than measuring the ability to respond effectively to unwanted inner experiencing, the AAQ-II and the BEAQ instead assess the inner experiences to which participants are responding (e.g., Kashdan et al., 2020;Ong et al., 2020;Tyndal et al., 2019;Wolgast, 2014). This differentiation is crucial, especially in clinical settings where ACT researchers and practitioners are primarily interested in how a person responds to their difficult thoughts and feelings rather than the distress the person is experiencing. ...
... In contrast to the abovementioned research on the AAQ-II and the BEAQ, the discriminant validity findings of two recently developed psychological flexibility measures show promise Ong et al., 2020). Results of these studies indicate that the Personalized Psychological Flexibility Index (PPFI; Kashdan et al., 2020) and the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT; Francis et al., 2016) evinced good discriminant validity with negative emotionality and distress, although the CompACT had weak structural validity Ong et al., 2020). However, there is no published data on the discriminant validity of the recently developed Multidimensional Psychological Flexibility Inventory (MPFI; Rolffs et al., 2016). ...
Article
The psychological flexibility model of behavior change underpins acceptance and commitment therapy (ACT). However, the measurement of psychological flexibility over the past 20 years has mostly hinged on the use of measures with poor discriminant validity and fuzzy boundaries with distress and negative emotionality. The current study analyzed the structure of psychological flexibility as assessed with the recently developed Multidimensional Psychological Flexibility Inventory (MPFI) and examined its link with distress. We used data from an online cross-sectional survey (N = 1,542) which assessed psychological flexibility with the MPFI and the Acceptance and Action Questionnaire-II (AAQ-II), as well as anxiety, and depression. Exploratory and confirmatory factor analyses highlighted that the six psychological flexibility processes of the MPFI loaded on a psychological flexibility factor, while anxiety, depression and the AAQ-II loaded on a distress factor, supporting the discriminant validity of the MPFI in assessing psychological flexibility. Findings were consistent with those from prior studies which suggest that the AAQ-II is more of a measure of global distress than psychological inflexibility or by proxy, psychological flexibility. The 30-item MPFI psychological flexibility scale demonstrated good construct and discriminant validity. Overall, findings support psychological flexibility as a construct that is empirically distinct from distress.
... Psychological flexibility includes 6 main components: 1. acceptance, 2. self as context, 3. cognitive defusion, 4. being present, 5. Contact with values and 6. committed action (Hayes et al., 2006). Recently, Kashdan et al. (2020), have conceptualized a new concept called personalized psychological flexibility. This wellestablished concept refers to adaptive reactions to any existing distress and obstacles in pursuit of completely personalized meaningful goals. ...
... According to the findings by Bhambhani et al. (2020) psychological flexibility mediated the relation between experiencing sexual racism and depression, anxiety, and stress (i.e., psychological distress) after controlling for demographic characteristics. More recent studies by Kashdan et al. (2020) and Akbari, Disabato, et al. (2021) found a negative association between personalized psychological flexibility and distress intolerance. One candidate mediator in our belief is personalized psychological flexibility. ...
... Recently,Kashdan et al. (2020) have developed a new measure of psychological flexibility to assess individual's ability to pursue their valued life goals while different obstacles may exist in the way. Participants are asked to think about their personal main goal and answer the items in the following. ...
Article
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The global COVID-19 outbreak has put the human race's distress tolerance abilities to the test. And, the distress experienced getting worse with each pandemic wave; however, the more flexible the person, the greater the chance of surviving. Thus, the current study aimed to examine the mediating role of personalized psychological flexibility (PPF) in the link between distress intolerance to psychological distress during the fourth wave of the pandemic in Iran. A total of 576 individuals (Meanage 34.80, ±10.9, females 55.6 %) took part in the online survey. In this national sample, PPF partially played a role in mediating the association mentioned above. Interestingly, this mediation was independent of demographic factors (age, gender, marital status, and educational level) and fear of COVID-19, mindfulness, and satisfaction with life. So, despite the mentioned variables, accepting and using unpleasant emotions as fuel to achieve valued goals rather than avoiding them would mitigate the psychological distress during the pandemic. Consequently, public health services can aim to provide psychological flexibility enhancing interventions to decay COVID-19-related mental distress.
... Based on DMM theory, we argue that humans are a hardy species, with most being well prepared to use protective strategies to cope with stress and danger, even if they experience feelings of distress. Nevertheless, maladaptation can occur when a protective strategy is rigidly misapplied to a new threat (Coifman & Summers, 2019;Crittenden & Heller, 2017;Kashdan et al., 2020;Kashdan & Rottenberg, 2010) or when psychological traumas from childhood activate PTSD in adulthood (Crittenden & Heller, 2017;Lewis-Schroeder et al., 2018). In other words, no one is exempt from risk, because all strategies can be applied to dangers to which they are not suited; the variable conditions in which strategies function create varied risks (Crittenden, 2016). ...
... Moreover, a strategy that is adaptive in one context might become maladaptive in another (Crittenden, 1997). This suggests the importance of flexibility of protective strategy in the context of new threats (Coifman & Summers, 2019;Kashdan et al., 2020;Kashdan & Rottenberg, 2010). ...
... A critical issue is each worker's flexibility in the use of their preferred protective strategy (Coifman & Summers, 2019;Kashdan et al., 2020;Kashdan & Rottenberg, 2010). When the strategy cannot either be "turned off" when danger is not present, or co-exist with other colleagues' strategies, then a specialistic consultation might be indicated. ...
Article
There is concern for the mental health of healthcare providers during the COVID-19 pandemic. In this article, we focus on the protective strategies that all people, but in this case healthcare providers, use when facing danger and how specific preventive responses could reduce the mental health burden to nurses, doctors, and emergency medical personnel working in hospitals. Our primary contributions are to demonstrate that healthcare providers are not a homogeneous group regarding mental health risks and that, consequently, individuals might need different forms of preventive and ameliorative response. We propose some (a) universally beneficial approaches, (b) strategy-specific approaches, and (c) strategy-specific contra-indicated approaches. Our two central points are that there are important psychological differences among healthcare providers and that these create different mental health needs in the COVID-19 crisis and require different protective solutions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Given the well documented concerns over the construct and discriminant validity of the AAQ-II (e.g., Kashdan et al., 2020;Rochefort et al., 2019;Tyndall et al., 2019;Wolgast, 2014), there is an imperative to provide psychometric evidence on measures of psychological flexibility such as the Portuguese CompACT. Moreover, there is potential for conceptual confusion in the postpartum literature in that the AAQ-II has been administered to assess psychological flexibility (e.g., Monteiro et al., 2019;Whittingham & Mitchell, 2021), but also experiential avoidance (e.g., Fonseca et al., 2018), which is a sub-component process of psychological inflexibility. ...
... However, the data from the present study underscores the acknowledged difficulty in the literature (see Ong et al., 2020;Kashdan et al., 2020) The present data generally support Ong et al.'s (2020) finding that the CompACT has good discriminant validity properties, insofar as non-significant associations with scales measuring negative emotionality and loneliness were observed. Moreover, the data also augment Ong et al.'s suggestion that researchers and clinicians should focus more on the three separate component factors rather than rely on calculating a total psychological flexibility score when linking psychological wellbeing and behavior changes to interventions designed to alter levels of psychological flexibility in clients. ...
Article
Full-text available
An 18-item Portuguese-language version of the CompACT scale has recently been proposed for the Portuguese population. This study aims at conducting the first Confirmatory Factor Analysis of the Portuguese CompACT in participants from two different samples (community adults and women in the post-partum period; total N = 1090). Given that the CompACT had yet to be subjected to gender invariance testing, the present study also presents an invariance analysis between male and female community participants. The measurement invariance of the Portuguese CompACT between community and post-partum women was also examined. The current study additionally explored the scale's relationships with theoretically relevant outcomes associated in the literature with psychological flexibility. Results showed that the three-factor correlated model of the Portuguese CompACT was an adequate fit for the data taken from the complete sample, with most items presenting statistically and practically significant loading values. The Portuguese CompACT presented acceptable to good internal consistencies for all factors-Openness to Experience (OE), Behavioral Awareness (BA), and Valued Action (VA). Full measurement invariance was found, with results further indicating that community women presented lower scores in BA than community men, and that women in the post-partum period scored higher than community women in BA and VA, and lower in OE. The three subscales of the Portuguese CompACT, that underpin the overarching construct of psychological flexibility, demonstrated different patterns of association from one another with various aspects of individual functioning. Although those associations were in the expected directions with flexibility being associated with lower distress, some forms of psychological flexibility 3 assessed by the CompACT were not significantly associated with measures of positive affect or resilience. This result underscores the difficulty of measuring psychological flexibility as a single construct, as it comprises a number of sub-component processes. Further implications of findings are discussed.
... Many terms have been used to study "flexibility" in affective science. For example, "regulatory flexibility" and "psychological flexibility" refer to a broad set of mental and behavioral processes that subsumes but are not exclusive to emotion regulation strategies (Bonanno and Burton, 2013;Doorley et al., 2020;Kashdan et al., 2020), whereas "expressive flexibility" refers to modulation of emotional expression (Zhu and Bonanno, 2017). In this research program, we use the term "emotion regulation flexibility," which is defined as shifting use of emotion regulation strategies based on contextual demands . ...
... Results did not meaningfully differ. In addition, our pre-registered analytical plan included trait-level analyses examining how participants with SAD and controls differ on questionnaires measuring emotional controllability (Implicit Theories of Emotion- Tamir et al., 2007;Beliefs about Emotions Questionnaire-De Castella et al., 2013) and flexibility (Personalized Psychological Flexibility Index- Kashdan et al., 2020;Brief Experiential Avoidance Measure-Gámez et al., 2014). For theoretical clarity and precision, we decided to focus this manuscript on daily measures. ...
Article
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Background Emotion regulation flexibility is a person's tendency to shift their use of emotion regulation strategies in response to contextual demands. A lack of flexibility is thought to underlie affective disorders, yet conceptualizations of “flexibility” vary widely, and few studies have empirically assessed flexibility. In this study, we outline methods for measuring emotion regulation flexibility and then examine evidence for inflexibility in people with a common affective disorder: social anxiety disorder (SAD). Methods Participants were community adults diagnosed with SAD and a psychologically healthycontrol group who completed a 14-day experience-sampling study. Participants recorded their most anxiety-provoking event each day, how they evaluated contextual demands (i.e., perceived controllability, emotional intensity) of these events, and their use of seven emotion regulation strategies to manage anxiety. Hypotheses and analyses were preregistered with the Open Science Framework (https://osf.io/s7kqj/). Results Participants with SAD demonstrated some evidence of inflexibility. They used three disengagement strategies (rumination, thought suppression, expressive suppression) more often than controls and did so independently of contextual demands (specifically, perceived controllability). Nonetheless, participants with SAD largely demonstrated similar regulatory patterns as controls, most notably in their use of engagement strategies (acceptance, cognitive, reappraisal, problem-solving). Limitations We measured two of many possible contextual demands, did not compare to a mixed clinical group or other affective disorders (e.g., depression), and did not assess temporal sequences of strategy use. Conclusions People with SAD demonstrate some inflexibility in their use of disengagement regulation strategies.
... Therefore, we need measurements that evaluate EA in a contextsensitive manner. Measures that assess psychological flexibility across a specific timeframe (Gloster et al., 2021) or in the pursuit of specific, personalized values (Kashdan et al., 2020;Akbari et al., 2021a;Akbari et al., 2021b) are a step forward. Such measures can also help shift research on EA to be more consistent with the framework of process-based therapy . ...
... The variability in effect sizes across measurement types, and the high correlations EA measures share with trait anxiety and distress measures, suggest serious concerns in whether EA is being measured as intended. A new wave of state EA measures (Kashdan et al., 2014) and contextualized EA measures (Kashdan et al., 2020) may lead to a more precise understanding of the impact of EA. Measuring and analyzing EA as a dynamic process and considering non-linear relationships between EA and psychopathology may also lead to new breakthroughs. ...
Article
Although numerous studies on experiential avoidance and its relationship to psychopathology have been conducted, systematic summaries of this research are lacking. The current systematic review and meta-analysis evaluated the transdiagnostic role of experiential avoidance across depression, anxiety and related disorders (obsessive-compulsive and related disorders [OCRDs] and post-traumatic stress disorder [PTSD]) as well as potential moderators of these relations. A total of 441 eligible studies including 135,347 participants (66.16% female, mean age = 31.53) and 899 effect-sizes were summarized. Results indicated a moderate-to-large association of experiential avoidance with anxiety (r = .506) and depressive symptoms (r = .562), major depressive disorder (r = .453), worry (r = .516), generalized anxiety disorder (r = .588), social anxiety disorder (r = .461), panic and agoraphobia (r = .340), specific phobias (r = .431), OCRDs (r = .406), and PTSD (r = .489). Anxiety sensitivity moderated the relationship of experiential avoidance to anxiety and depression. Moreover, depression moderated the relationship of experiential avoidance to generalized anxiety disorder and OCRDs. Correlations varied by mean experiential avoidance value, suggesting a potentially nonlinear relationship of experiential avoidance to psychological symptoms. Other potential moderators including type of population, type of measure, comorbidity, and clinical status were investigated. Results support the hypothesized role of experiential avoidance as a transdiagnostic and transcultural process relevant to depression, anxiety, OCRDs, and PTSD. However, experiential avoidance has largely been measured as a generalized trait; future research would be enhanced by measuring experiential avoidance as a dynamic and contextualized process.
... The 15 items of the Personal Psychological Flexibility Index (Kashdan et al., 2020) were used for measuring the trait-like ability to pursue valued life aims and daily goals despite the presence of distress. In the present research, a COVID-19 pandemic and health-related distress were targeted, and therefore the scale instruction was reformulated accordingly: "Please take a few moments to think of an important goal that you are working on related to your health maintenance during COVID-19 pandemic. ...
... A 7-point Likert scale was applied for recording the answers from strongly disagree to strongly agree. The alpha coefficient of the total scale was 0.84, while test-retest reliability was also appropriate (Kashdan et al., 2020). In this study, Cronbach's alpha was 0.75, 0.88, and 0.72 for acceptance, avoidance, and harnessing, respectively. ...
Article
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Background Positive and negative focus in information processing associated with age has a diverse role in COVID-19 vaccine uptake. The aim of the study was the exploration of the generational diversity among psychological predictors of COVID-19 vaccine uptake. Methods A cross-sectional research was conducted. The sample included 978 Hungarian women. Based on former literature findings, the COVID-19 vaccine uptake predictors were chosen from the health beliefs model, COVID-19 vaccine hesitancy, and psychological flexibility. Multivariate logistic regression analysis was conducted to investigate the predictors of COVID-19 vaccine uptake in women of Gen X, Gen Y, and Gen Z. Results In Gen X women, the influence of significant predictors are more prone to the positivity in COVID-19 vaccine uptake behavior, perceived benefits being the most relevant, increasing the likelihood of vaccine uptake more than four times. In Gen Y women, perceived barriers, lack of confidence/skepticism and avoidance significantly reduce the probability of vaccine uptake, showing an accentuated negative focus in information processing related to COVID-19 vaccination. The vaccine uptake in Gen Z is predicted only by the perceived benefits , and the likelihood of COVID-19 vaccine uptake is heightened in chance more than 19 times. Conclusion Women belonging to Gen X or Gen Y, the perceived benefits hold the key to vaccine uptake, while in women of Gen Z, low risks, lack of threats, and accessibility could motivate the decision of vaccine uptake. The findings are useful in generation-adapted vaccination campaigns and can also serve as inspiration for evolutionary psychology studies on health behavior and the broad area of study in cognitive biases in health information processing.
... Coping is altijd situatief en persoon lijk en is geslaagd als het probleem is opgelost of het doel bereikt. 17,18 Kies dus die interventie die het beste bij de sporter en zijn of haar uitdaging past. Tot slot worden er in de literatuur enkele aanbevelingen gegeven over Psychologische flexibiliteit in de sportpsycho logische praktijk Wendy Roozendaal: 'Vanuit ACT ben je niet meer bezig om dingen om te buigen naar het positieve, maar zet je in op het vergroten van de bereidheid om ervaringen en gedachten actief en bewust te accepteren. ...
... het onderwerp psychologische flexi biliteit. 17 Een eerste aanbeveling is gebruik te blijven maken van een lange psychologische traditie over flexibele zelfregulatie. In deze tradi tie is veel kennis opgedaan over de bouwstenen en determinanten van flexibele coping. ...
Article
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Sporters kunnen gebruik maken van sportpsychologische begeleiding om hun prestaties en/of algemene mentale gezondheid te verbeteren. Er zijn meerdere sportpsychologische benaderingen, met elk hun eigen aannames, theorieën en interventies. Meer inzicht in de overeenkomsten en verschillen daartussen kan het begeleidingsteam, de trainer en de sporter helpen de beste keuze te maken.
... Research shows that flexibly assessing situations and prioritising necessary emotional responses in alignment with goals and values, without relying on dominant default beliefs or strategies, is also associated with reduced psychological distress Bonanno & Burton, 2013). Furthermore, individuals with a flexible mindset generally are more accepting and have a greater sense of control over their emotions (Kashdan et al., 2020;Predatu et al., 2020). Consequently, individuals may flexibly shift beliefs in accordance with situational demands, thus producing a flexible approach to the regulation of emotions (i.e., sometimes controlling, sometimes accepting). ...
Article
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Objective: The process model of emotion regulation posits beliefs about emotions inform regulation processes, affecting mental-health outcomes. Beliefs that emotions can be controlled (i.e., control beliefs, underpinning traditional Cognitive Behaviour Therapy) and accepted (i.e., acceptance beliefs, underpinning Acceptance and Commitment Therapy), though seemingly opposing, are both associated with lower psychological distress. This study tested the hypothesis that emotion regulation flexibility (i.e., using and applying a range of regulation strategies at the right times) may mediate the relationship between these beliefs and distress. Method: 177 participants (87.6% female, Mage = 42.7) completed the 21-item Depression, Anxiety and Stress Scale, the Emotion Belief Questionnaire-General Controllability Composite, and two measures developed for this study: the Emotion Belief Questionnaire-Acceptance Variant and Emotion Regulation Flexibility Questionnaire. Results: Emotion regulation flexibility mediated the relationship between control and acceptance beliefs and distress, such that stronger control and acceptance beliefs were associated with lower distress via higher emotion regulation flexibility. Conclusions: Our results are consistent with theorising that both control and acceptance beliefs are useful for mental health; these beliefs may inform usage of control or acceptance based emotion regulation strategies, which may reduce distress levels if applied flexibly. These findings are discussed regarding corresponding therapeutic interventions
... The challenge of understanding the interpersonal aspects of psychological flexibility was recently highlighted [90], and it would seem our findings confirm that this is indeed difficult, perhaps one that necessitates a whole separate line of studies. Adding to the complexity, a recent review paper [91] criticizes the lack of coherence in defining PF in the applied research literature, and suggests the use of a newly developed, more idiographically flexible measure [92], which would be interesting and challenging to adapt to group level settings. After creating the GNI measure and collecting the data used in this study, we were made aware of an effort to develop an organizational level measure of psychological flexibility [93], which found a correlation with individual-level psychological flexibility (measured with the WAAQ) similar to that of the GNI. ...
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Background This paper describes the development and psychometric evaluation of a behavioral assessment instrument primarily intended for use with workgroups in any type of organization. The instrument was developed based on the Nurturing Environments framework which describes four domains important for health, well-being, and productivity; minimizing toxic social interactions, teaching and reinforcing prosocial behaviors, limiting opportunities for problem behaviors, and promoting psychological flexibility. The instrument is freely available to use and adapt under a CC-BY license and intended as a tool that is easy for any group to use and interpret to identify key behaviors to improve their psychosocial work environment. Methods Questionnaire data of perceived frequency of behaviors relevant to nurturance were collected from nine different organizations in Sweden. Data were analyzed using confirmatory factor analysis, Rasch analysis, and correlations to investigate relationships with relevant workplace measures. Results The results indicate that the 23-item instrument is usefully divided in two factors, which can be described as risk and protective factors. Toxic social behaviors make up the risk factor, while the protective factor includes prosocial behavior, behaviors that limit problems, and psychological flexibility. Rasch analysis showed that the response categories work as intended for all items, item fit is satisfactory, and there was no significant differential item functioning across age or gender. Targeting indicates that measurement precision is skewed towards lower levels of both factors, while item thresholds are distributed over the range of participant abilities, particularly for the protective factor. A Rasch score table is available for ordinal to interval data transformation. Conclusions This initial analysis shows promising results, while more data is needed to investigate group-level measurement properties and validation against concrete longitudinal outcomes. We provide recommendations for how to work in practice with a group based on their assessment data, and how to optimize the measurement precision further. By using a two-dimensional assessment with ratings of both frequency and perceived importance of behaviors the instrument can help facilitate a participatory group development process. The Group Nurturance Inventory is freely available to use and adapt for both commercial and non-commercial use and could help promote transparent assessment practices in organizational and group development.
... Higher scores represented a higher sense of purpose. Previous work has demonstrated that this measure correlates with other assessments for sense of purpose (Hill et al., 2016), health behaviors (Hill et al., 2020), and other variables across the adult lifespan with which other purpose measures have also been associated (Hill et al., 2016;Hill and Strecher, 2021;Kashdan et al., 2020;Scott and Cohen, 2020). Using the psych package (Psych Package), Cronbach's alphas were calculated for each month, ranging between 0.93 and 0.95. ...
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Background Sense of purpose is a salient predictor of health outcomes, at least partially because individuals with a higher sense of purpose appear to engage in healthier lifestyle behaviors. Yet, little work has considered the role that greater physical activity may play in allowing individuals to maintain or develop a higher sense of purpose. Methods Using five waves of monthly data (total n = 2337), the current study investigates the bi-directional association between sense of purpose and monthly reports of average time spent per day in moderate and vigorous physical activity utilizing Random Intercept Cross-Lagged Panel models. Results and Discussion. Findings suggested differences based on physical activity intensity. For moderate physical activity, concurrent within-person associations revealed that during months when sense of purpose was higher relative to a person's usual level, they also spent more time than usual engaging in moderate physical activity. Bi-directional cross-lagged effects indicated that higher sense of purpose predicted more next-month moderate physical activity, and vice versa. Only between-person associations were evident for vigorous physical activity, such that people with a higher sense of purpose on average spent more time in vigorous physical activity on average. The discussion focuses on the methodological advances of the current study, as well as implications for future research.
... The discriminant validity of the questionnaires was not investigated in this study, which should be further examined in future research, especially given the growing concern regarding the discriminant validity of the AAQ-II (41). Several studies have found that it measures psychological distress or neuroticism rather than psychological flexibility (42,43), which is a matter of concern and has to be taken into account when using the AAQ-II. The AAQ-ABI is based on the AAQ-II and therefore there might be doubts regarding the discriminant validity of the AAQ-ABI as well. ...
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Purpose Acceptance and Commitment Therapy (ACT) is used increasingly for individuals with psychological distress following acquired brain injury (ABI) in different countries. However, questionnaires measuring ACT-processes are often not validated for this patient group and need cross-cultural validation. This study investigated the psychometric properties of the Acceptance and Action Questionnaire for Acquired Brain Injury (AAQ-ABI; measuring psychological flexibility related to thoughts and feelings about ABI) and the Cognitive Fusion Questionnaire (CFQ-7; measuring cognitive defusion). Materials and methods Score distribution, reliability, and convergent validity of the AAQ-ABI and the CFQ-7 were examined in Dutch individuals with ABI. Results Seventy-three patients with ABI were included. The AAQ-ABI showed good reliability (Cronbach’s α = 0.87) and the CFQ-7 excellent reliability (Cronbach’s α = 0.97). Both did not show a floor or ceiling effect, nor a skewed distribution. There were strong to moderate correlations between the questionnaires and measures of psychological flexibility, mood, quality of life, and value-driven behavior (AAQ-ABI: r = −0.70–0.81; CFQ-7 = −0.67–0.84). Inter-item total correlations indicate that the questions within each questionnaire measured the same construct (AAQ-ABI: r = 0.40–0.78; CFQ-7: r = 0.84–0.93). Conclusions The current study shows that the Dutch AAQ-ABI and CFQ-7 have acceptable to good psychometric properties when measuring psychological flexibility and cognitive defusion in patients with ABI.
... Rather than ruminating about the past and worrying about the future, they are better able to step back from their unhelpful thoughts and observe their presence in a nonreactive way (Østergaard et al., 2020). By effectively disrupting their unhelpful thought processes and skillfully handling their unpleasant emotional states, they can continue to focus on, and engage in, doing what matters (Kashdan et al., 2020). In this regard, they can lead personally meaningful lives despite the presence of difficulties and challenges (Finkelstein-Fox et al., 2020). ...
Article
Sexual identity stress may damage the well-being of lesbian, gay, and bisexual (LGB) individuals, but limited research has examined the potential protective factors in this context. The present study addressed this research gap by testing a psychological flexibility model of sexual identity development and positive mental health among LGB individuals. We hypothesized that psychological flexibility would be associated with greater engaged living (i.e., valued living and life fulfillment), which would, in turn, be linked to lower sexual identity stress (i.e., identity uncertainty, acceptance concern, internalized homonegativity, sexuality concealment, and difficult process of identity development) and then better well-being (i.e., emotional, psychological, and social well-being). A total of 401 LGB individuals completed questionnaire measures of psychological flexibility, engaged living, sexual identity stress, and well-being. Structural equation modeling showed that psychological flexibility was related to greater engaged living, which was, in turn, related to lower sexual identity stress and then better well-being. Bootstrap analyses further revealed that psychological flexibility had significant indirect effects on sexual identity stress via engaged living and on well-being via engaged living and sexual identity stress. In addition, multigroup analyses demonstrated that the mediation model held across women and men and across lesbian/gay and bisexual individuals. Theoretically, this study elucidated how psychological flexibility could enable LGB individuals to reduce sexual identity stress and improve well-being through living a valuable and fulfilling life. Practically, this study pointed to the utility of psychological flexibility training in facilitating LGB individuals to develop a positive sexual identity and enhance positive mental health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Attempting to address these gaps, we created the Personalized Psychological Flexibility Index (PPFI; Kashdan, Disabato, Goodman, Doorley, & McKnight, 2020). Rather than measuring distress itself or vague consequences of negative emotions (e.g., "Emotions cause problems in my life; " Bond et al., 2011), the PPFI asks respondents to think about a presently important goal and answer questions about how they respond to the distress that arises while pursuing this goal (cf. ...
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Psychological flexibility is the tendency to respond to situations in ways that facilitate valued goal pursuit. Psychological flexibility is particularly useful when challenges arise during goal pursuit that produce distress. In acceptance and commitment therapy, psychological flexibility is considered the pinnacle of emotional health and well-being. A growing body of research demonstrates that psychological flexibility leads to psychological benefits and adaptive behavior change. Yet, much of what we know, or think we know, about psychological flexibility hinges on a single measurement approach using the Acceptance and Action Questionnaire (AAQ and AAQ-II). Research suggests the AAQ-II is highly correlated with distress itself rather than flexible responses to distress. Existing approaches that assess psychological flexibility ignore the context in which flexibility matters most: the pursuit of valued goals. Below, we review theory and research on psychological flexibility, including its associations with healthy functioning, its measurement, and its overlap with related constructs. We discuss how gaps between theory and measurement impede our understanding and review promising evidence for a new measure of psychological flexibility. We provide new research directions in an effort to create a more generalizable foundation of knowledge. Soc Personal Psychol Compass. 2020;e12566. wileyonlinelibrary.com/journal/spc3
... Зокрема, відомо, що AAQ-II корелює з Опитувальником депресії Бека на рівні 0,7-0,71, і це, ймовірно, вказує на суттєву близькість показників, які вимірюються цими двома опитувальниками (Kashdan et. al, 2020). Натепер дискусія щодо дискримінантної валідності AAQ-II триває. ...
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Purpose. The aim of the study is to evaluate the main psychometric properties of the Ukrainian version of the Acceptance and Action Questionnaire-II (AAQ-II). Normative scores, internal consistency, factor structure, test-retest reliability, convergent and discriminant validity, and sensitivity to distinguish between non-clinical and subclinical samples were explored.Methods. Data from six non-clinical (N= 817) and three subclinical samples (N= 142) were collected. A sample of 43 students was used to assess test-retest reliability, over 3 weeks period. Acceptance Scale, CompACT, OQ-45.2, GAD-7, PHQ-9 and TIPI were used to determine convergent and discriminant validity of AAQ-II.Results. Normative scores of AAQ-II were 19 ± 9 for men and 24 ± 11 for women. There was no significant correlation between psychological inflexibility and age. AAQ-IIshowed a good internal consistency with Cronbach’sα coefficient in 9 samples between 0.89–0.95. Results of exploratory factor analysis and confirmatory factor analysis indicated that AAQ-II is unidimensional questionnaire with 7 items (RMSEA=0.093, SRMR = 0.028, GFI= 0.966, NFI=0.974, CFI=0.979, N=817). AAQ-II demonstrated an acceptable level of test-retest reliability (r = 0.85) in three weeks period. AAQ-II had good convergent validity with another measure of psychological flexibility (CompACT) (r= - 0.65), as well as with the measures of distress (OQ-45.2) (r= 0.58–0.80), anxiety (GAD-7) (r= 0.52–0.60) and depression (PHQ-9) (r= 0.52–0.60). AAQ-ІІ highly correlated with distress and didn’t correlate with the ability to accept the negative experiences per se. AAQ-ІІ had good discriminant validity with measure of personal traits (TIPI), as theoretically predicted. The questionnaire was sensitive to distinguish between non-clinical and subclinical samples, and between people on the different stages of the rehabilitation and progress of the disease.Conclusions. Ukrainian version of Acceptance and Action questionnaire (AAQ-II) demonstrated acceptable and promising psychometric properties. The results in terms of reliability and validity of AAQ-II were consistent with previous studies. The questionnaire is recommended to use in research and psychotherapy practice.Key words: questionnaire adapting, evidence-based psychotherapy, psychological flexibility, acceptance and commitment therapy, validity, reliability. Мета. Метою дослідження є визначенняосновних психометричних показників україномовного варіанту опитувальника AAQ-ІІ, а саме нормативних показників, внутрішньої узгодженості тверджень, факторної структури, тест-ретестової надійності, конвергентної та дискримінантної валідності та чутливості до розрізнення нормативних та субклінічних груп, а також осіб на різних етапах реабілітації та лікування.Методи. Адаптація проводилася на 6 нормативних (N=817) та 3 субклінічних (N=142) групах досліджуваних, 43 студенти взяли участь у процедурі оцінки тест-ретестової надійності опитувальника протягом 3 тижнів. Для оцінки конвергентної та дискримінантної валідності AAQ-ІІ були використані шкала прийняття, опитувальники CompACT, OQ-45.2, GAD-7, PHQ-9 та TIPI.Результати. Нормативними показниками AAQ-ІІ можна вважати 19±9 для чоловіків та 24±11 для жінок. Вираженість психологічної негнучкості не залежать від віку досліджуваних. Показник внутріш-ньої узгодженості тверджень AAQ-ІІ Альфа Кронбаха в межах 0,89-0,95. AAQ-ІІ є однофакторним опитувальником, який складається з 7 тверджень, і на це вказують результати як експлораторного, так і кон-фірматорного факторного аналізу (RMSEA=0,093, SRMR = 0,028, GFI= 0,966, NFI=0,974, CFI=0,979, N=817). AAQ-ІІ демонструє прийнятний рівень тест-ретестової надійності (r=0,85). Отримано значущий рівень конвергентної валідності опитувальника з психологічною гнучкістю (CompACT) (r= - 0,65), а також дистресом (OQ-45,2) (r = 0,58–0,80), тривогою (GAD-7) (r= 0,52–0,60) та депресією (PHQ-9) (r=0,52–0,60). Показник AAQ-ІІ пов’язаний з дистресом у житті особи і не має зв’язку із самою по собі його здатністю до прийняття негативного досвіду. Психологічна негнучкість не корелює з особистісними рисами (TIPI), що вказує на дискримінантну валідність опитувальника. ЗначенняAAQ-ІІ дозволяють статистично розрізнити нормативні та субклінічні групи, а також осіб на різних етапах реабілітації та перебігу захворювання.Висновки. Україномовна версія «Опитувальника прийняття та дії» (AAQ-II) має надійні психометричні показники, отримані результати загалом узгоджуються з даними попередніх досліджень. Опитувальник може бути рекомендований для використання у вітчизняних дослідженнях та психотерапевтичній практиці.Ключові слова: адаптація опитувальника, доказова психотерапія, психологічна гнучкість, терапія прийняття та зобов’язання, валідність, надійність.
... In that validation study using multiple samples, the measure illustrated a single factor structure, showed strong correlations with existing measures of sense of purpose, and predicted multiple outcomes of relevance to the emerging adult period, such as selfimage concerns, depressive symptoms, and perceptions of adult status, illustrating convergent validity. Furthermore, this measure has been used in other studies further supporting its validity (Kashdan, Disabato, et al., 2020;Scott & Cohen, 2020). Participants responded to each item on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree). ...
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Background: Sense of purpose, or the extent to which one perceives their lives to have meaningful goals and directions, may aid in initiating satisfying and stable new connections while positively maintaining old ones for college students. Purpose: The current study sought to evaluate how a college students' sense of purpose during their first week of college may predict their satisfaction with different relationship types throughout their first semester of university. Research Design: At the beginning of the semester, students reported their sense of purpose, and every week of the semester they reported their weekly relationship satisfaction across a variety of domains (i.e., parents, home friends, university friends, roommates, resident assistants, and significant others). Study Sample: The current study followed-up first year college students ( n = 364) from a private Midwestern university who all participated in the same Psychology of Young Adulthood class. Data Analysis: Multilevel models were conducted to evaluate mean-level relationship satisfaction trajectories throughout the first semester and whether sense of purpose predicted those trajectories when accounting for gender and the Big Five personality traits. Results: Friendships with home friends and university friends as well as parental relationships increased in satisfaction during the first semester, while relationships with roommates and resident assistants decreased. Furthermore, a higher sense of purpose was associated with greater relationship satisfaction with university friends and parents, even when accounting for the Big Five personality traits, as well as greater relationship satisfaction stability. Conclusions: Findings paint a nuanced and equivocal nature of relationships during the first semester, and point to the need to better understand how and when sense of purpose does or does not yield positive relationships over time.
... In addition to the aforementioned limitations, these measures have been criticized for their low construct and discriminant validity. More recently, the AAQ-II and the BEAQ (the most widely used measures of psychological inflexibility) have been shown to capture difficult thoughts and feelings to which individuals respond, rather than measuring individuals' tendency to react inflexibly to undesirable inner experiences (Kashdan et al., 2020;Landi, Pakenham, Crocetti, et al., 2021;Ong et al., 2020;Tyndall et al., 2019;Wolgast, 2014). ...
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The Multidimensional Psychological Flexibility Inventory (MPFI) is a new 60-item self-report scale developed to assess the specific components of psychological flexibility and inflexibility proposed in the Hexaflex model of Acceptance and Commitment Therapy (ACT). The present study sought to examine the psychometric properties of the Persian version of the MPFI-60 in a community sample of 307 Iranian adults. The original study supported a 12-factor second-order structure consisting of 6 dimensions for psychological flexibility and 6 dimensions for psychological inflexibility. The Persian MPFI-60 demonstrated acceptable semantic and test content, internal structure, correlations with other variables, and internal consistency. It also evidenced in relation to anxiety, stress, depression, and self-compassion. Overall, the results indicate that the Persian MPFI-60 is a psychometrically sound measure in the Iranian context that enables researchers and clinicians to comprehensively assess the components of psychological flexibility and inflexibility within the Hexaflex model.
... Research on goal-related striving (Steger et al., 2013) that uses idiographic mea sures of valued goals and assessments of success in achieving those goals might also in form future research. This was the strategy used in the newly developed Personalized Psychological Flexibility Index (Kashdan et al., 2020). Examples of qualitative studies in clude one of people with chronic pain, which found they differentiated between valued domains (Casey et al., 2020), and another qualitative study described how people re sponded to a values workshop (Fitzpatrick et al., 2016). ...
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While the concept of values has been present in behavioral traditions dating back to Skinner, the analysis of the role of values in modern contextual behavioral science (CBS) in relation to motivation has greatly expanded over the past 30 years. In particular, values are important in a modern understanding of the role of human language in modifying how reinforcement occurs. This chapter outlines values work as a foundational component of Acceptance and Commitment Therapy (ACT) and analyzes values through a CBS and Relational Frame Theory lens. The chapter includes an extensive review of the empirical literature on the role of values in ACT and discusses values measures commonly used in CBS research and clinical practice. Finally, we offer recommendations for next steps to expand our understanding of this essential process.
... The Acceptance and Action Questionnaire-II (AAQ-II; Bond et al., 2011) is the most widely used measure of psychological (in)flexibility (Kashdan, Disabato, Goodman, Doorley, & McKnight, 2020) defined as "rigid dominance of psychological reactions over chosen values and contingencies in guiding reactions." Its 7 items range from 1 (never true) to 7 (always true) and represents 6 core facets of psychological flexibility. ...
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This study tested the novel hypothesis that CBT-treated IBS patients who learn to self-manage painful GI symptoms by targeting rigid cognitive style show improvement in cognitive flexibility, GI symptoms (e.g., abdominal pain), and quality of life. Participants included 130 Rome-III diagnosed IBS patients (M age = 40.3, F = 83%) with moderate-to-severe symptoms randomly assigned to either cognitive behavioral therapy (CBT; N = 86) or a nonspecific education/support (EDU) comparator (N = 44). Participants completed an assessment battery at baseline and post-treatment 2 weeks after 10-week acute treatment phase. Measures included cognitive flexibility, psychological flexibility, emotion regulation strategies, IBS symptom severity, quality of life (QOL), and distress. CBT but not EDU patients showed significant improvement from baseline to post-treatment in cognitive flexibility. For CBT patients, changes in cognitive flexibility were significantly associated with changes in IBS symptom severity, abdominal pain, and IBS QOL. Neither condition showed significant changes in psychological flexibility (Acceptance and Action Questionnaire-II) or use of emotion regulation strategies (Emotion Regulation Questionnaire). The ability to self-manage painful IBS symptoms refractory to conventional medical and dietary treatments is related to the ability to respond flexibly across shifting contexts using cognitive change procedures featured in CBT for IBS.
... It is possible that with the use of other CBS-informed measures, such as the Personalized Psychological Flexibility Index (PPFI; Kashdan et al., 2020), Multidimensional Psychological Flexibility Inventory (MPFI; Rolffs et al., 2018), and Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT; Francis et al., 2016), we may see other patterns of interaction effects among open, centered, and engaged response styles on certain distress variables. As such, it may be that open, centered, and engaged response styles may augment one another (e.g., when centered response style is greater, the strength of inverse association between active response style and a distress variable is greater), rather than suppressing one another as was seen in the present study in the context of experiencing depression. ...
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Objectives In this cross-sectional study with a sample of racially diverse emerging adults, we examined whether mindfulness moderated the association between engaged living and a range of psychological distress variables (i.e., depression, anxiety, stress). Methods The study sample comprised 1020 university students, aged 18–25 (M = 19.5, SD = 1.6), recruited from a public university in Hawaiʻi. Engaged living, mindfulness, and psychological distress were measured by the Engaged Living Scale (ELS), Five Facet Mindfulness Questionnaire (FFMQ), and short‐form version of the Depression Anxiety and Stress Scale (DASS-21), respectively. Hierarchical regression analyses were conducted to examine the conditional effect of engaged living on psychological distress variables at varying levels of mindfulness. Results We found a significant two-way interaction effect between engaged living and mindfulness on depression, but not on anxiety or stress. Specifically, the inverse relationship between engaged living and depression was attenuated in 3 with high levels of mindfulness. Conclusions These results suggest that clarity of values and life fulfillment, processes that are captured by the construct of engaged living, are relevant to depression, particularly when mindfulness is low, and that both mindfulness and engaged living serve as unique salutary pathways in the context of experiencing anxiety and stress.
... For instance, Psychological Flexibility (PF), the ability to reduce the automaticity of behaviour (e.g., avoidance) in relation to private events (e.g., anxiety), has been shown in two studies (Tyndall, Waldeck, Riva, Wesselmann, & Pancani, 2018;Waldeck et al., 2017) to moderate the distress felt by those who experience ostracism: at low levels of PF, ostracised individuals felt greater distress. Interventions to increase psychological flexibility can employ a range of therapeutic processes, but most such interventions include acceptance and values clarification (AV) exercises, as these are central to the development of PF (Kashdan, Disabato, Goodman, Doorley, & Mcknight, 2020). In this context, acceptance is often defined as "the voluntary adoption of an intentionally open, receptive, flexible, and non-judgmental posture with respect to moment-to-moment experience" (Hayes, Strosahl, & Wilson, 2012, p. 272) and values clarification as a process through which the individual discovers and labels patterns in their own behaviour which result in appetitive consequences (see Wilson & Dufrene, 2009). ...
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Low social resilience (e.g., susceptibility to social anxiety, and social avoidance) has been associated with poor mental and physical health outcomes, and can lead to ostracism. Support services such as university counselling centres, which deal with non-diagnosable psychological distress, linked to low social resilience, require effective yet brief interventions deliverable by non-experts to meet service demands. As it is not always possible to prevent subjectively negative experiences, acceptance-based interventions aim to change how we respond behaviourally to such experiences. The present study tests the efficacy of an ultra-brief (1hr) non-expert delivered acceptance- and values-based (AV) coaching intervention to increase resilience to negative social interactions. This was compared to a comparable dose of a cognitive restructuring and relaxation-based (CRR) analogue, and a psycho-education and progressive muscle relaxation-based (PE-PMR) control. Participants (N=60) were assessed on perceived burdensomeness, belonging, and 3 scenarios measuring anxiety and likelihood to engage in social situations. Participants then played Cyberball, an ostracising task, before recompleting the aforementioned measures. Physiological measures indicated Cyberball was an aversive experience. In the AV condition only, we observed an improved behavioral intention to engage with social scenarios (dppc2 = .57). Ultra-brief AV-based coaching interventions delivered by non-expert coaches appear promising in increasing participant’s likelihood to continue engaging in social interactions after a stressful social experience. We tentatively conclude that gains in committed action may increase the propensity of at-risk individuals to seek social support.
... Researchers have begun to develop comprehensive tools to measure psychological flexibility. Kashdan et al. (2020) created the Personalized Psychological Flexibility Index (PPFI) that includes dimensions of avoidance, acceptance, and harnessing. Preliminary research has shown that PPFI has good reliability and validity and is not conflated with negative emotionality. ...
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Acceptance and Commitment Therapy (ACT) improves mental health by augmenting psychological flexibility. Studies showed that psychological flexibility affects mental health; however, although studies have examined individual aspects of psychological flexibility, few have comprehensively examined an entire psychological flexibility model, especially in China. The Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT) is a comprehensive evaluation method that reflects psychological flexibility. The objectives of this study were to develop a Chinese version of CompACT that fits with Chinese culture and examine its reliability and validity. We studied 4999 non-clinical Chinese civil servants and explored the characteristics of the Chinese version of CompACT. Exploratory factor analysis was used to measure Openness to Experience, Behavioral Awareness, and Valued Action that explained 54.3% of the total variance. Confirmatory factor analysis provided support for the three-factor model. The Cronbach’s α-coefficient of the scale was 0.87, suggesting that the Chinese version of the CompACT is reliable. The Chinese CompACT total score represents the overall level of psychological flexibility; it is significantly negatively correlated with negative emotions and positively associated with well-being. Our findings suggest that the Chinese version of the CompACT accurately assesses psychological flexibility in Chinese adults.
... It was developed in order to overcome the limitations of the most widely used measure of psychological flexibility in the ACT literature, the Acceptance and Action Questionnaire-II (AAQ-II; Bond et al., 2011). The AAQ-II only assesses the overarching dimension of psychological inflexibility and has often been used as a proxy for psychological flexibility Kashdan et al., 2020). In contrast, the MPFI was developed to measure both psychological flexibility and inflexibility and each of their respective sub-processes (Rolffs et al., 2016). ...
Article
The Multidimensional Psychological Flexibility Inventory (MPFI) is a recently developed measure of psychological flexibility and inflexibility based on the psychological functioning model of behavior change that underpins Acceptance and Commitment Therapy (ACT). The present study sought to develop a validation of this measure in Italian language from its English original version and explored the factor structure and reliability as well as convergent and concurrent validity of the Italian version of the MPFI. A total of 1,542 participants (71% female, M=38.6 years old, SD=15.0 years) completed an online cross-sectional survey including the Italian MPFI, other measures of psychological flexibility, and measures of metal health (anxiety, depression, and well-being). Confirmatory factor analysis replicated the factor structure of the original MPFI. The Italian MPFI had a two second-order factor structure composed of six first-order factors of flexibility and six first-order factors of inflexibility, with good construct validity. The Italian MPFI evinced good internal consistency, and convergent and concurrent validity. It also exhibited measurement invariance for gender, age, and mental health status. The Italian MPFI is a psychometrically sound measure of psychological flexibility and inflexibility in the Italian context. The Italian MPFI offers new tools in ACT theoretical and intervention research in Italy.
... The authors developed this scale to overcome the limitations of the most widely used measure of psychological flexibility, the Acceptance and Action Questionnaire-II (AAQ-II) [10]. One weakness of the AAQ-II is that instead of measuring psychological flexibility, it assesses psychological inflexibility and is used as a proxy for psychological flexibility [11,12]. In addition, Wolgast [13] has argued that the AAQ-II is confounded with distress-outcome variables, and Francis et al. [9] argued that the AAQ-II is limited in its assessment of the six psychological flexibility processes due to a preponderance of items that focus on acceptance/experiential avoidance and defusion/fusion processes, neglecting other important processes (i.e., values and committed action, contact with the present moment and self-as-context) within the ACT model. ...
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Purpose: The Comprehensive assessment of Acceptance and Commitment Therapy (ACT) processes (CompACT) is a 23-item self-report questionnaire assessing psychological flexibility, which is the overarching construct underpinning the ACT framework. We conducted a two-phase project to develop validated versions of the CompACT in three languages: phase 1-cross-cultural adaptation; and phase 2-psychometric validation of the questionnaire for use in Italy, Germany and Spain. This article focuses on the first phase. Methods: We translated and culturally adapted the CompACT in the three target languages, following the ISPOR TCA Task Force guidelines. The process was overseen by a translation panel (three translators, at least two multiple sclerosis (MS) researchers and a lay person), ACT experts and clinicians from the research team of each country and the original CompACT developers. We debriefed the new questionnaire versions via face-to-face interviews with a minimum of four adults from the general population (GP) and four adults with MS in each country. Results: The translation-adaptation process went smoothly in the three countries, with some items (7 in Italy, 4 in Germany, 6 in Spain) revised after feedback from ACT experts. Cognitive debriefing showed that the CompACT was deemed easy to understand and score in each target country by both GP and MS adults. Conclusions: The Italian, German and Spanish versions of the CompACT have semantic, conceptual and normative equivalence to the original scale and good content validity. Our findings are informative for researchers adapting the CompACT and other self-reported outcome measures into multiple languages and cultures.
... However, a growing body of research suggests that dichotomizing strategies into putatively adaptive and maladaptive categories makes the erroneous assumption that strategies are uniformly effective (e.g., Aldao et al., 2015;Bonanno & Burton, 2013;Ford & Troy, 2019). Affective scientists have called for more emotion regulation research addressing contextual factors (Aldao, 2013), such as flexibility of strategy use (e.g., Kashdan et al., 2020), situational goals (e.g., hedonic goals vs. instrumental goals; e.g., Tamir et al., 2008), and situational demands (e.g., Kobyli nska & Kusev, 2019) that influence emotion regulation effectiveness. ...
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Much is known about the types of strategies people use to regulate emotions. Less is known about individual differences that influence emotion regulation strategy selection. In this study, we tested the moderating role of negative emotion differentiation (NED; i.e., the ability to label and describe subtle differences among negative emotions) on the relationship between the intensity of stressful daily events and the strategies used to regulate distress arising from these events. Prior research shows that NED is associated with low endorsement of disengagement emotion regulation (e.g., substance use), but less is known about the link to engagement regulation (e.g., problem-solving, seeking social support). Participants were college students (N = 502) completing a 30-day daily diary survey for each of four college years. We preregistered hypotheses that 1) the intensity of each day's most stressful event would be associated with greater use of disengagement and engagement regulation strategies, and 2) people higher in NED would be less likely to use disengagement and more likely to use engagement strategies when highly stressed. Results suggest that higher stress intensity is associated with greater use of all regulation strategies. Greater NED is associated with less use of disengagement regulation strategies, whereas NED was unrelated to engagement regulation strategies and did not moderate the relationship between stress and engagement strategies. The majority of hypothesized moderation effects of NED were nonsignificant, prompting a reconsideration of whether, when, and how NED plays a role in stress responding. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... The Behavioral Activation for Depression Scale Short Form (Manos et al., 2011) assesses the extent to which people have been active over the previous week (e.g., "I engaged in many different activities"), or avoidant (e.g., "I engaged in activities that would distract me from feeling bad"). More recently, the Personalized Psychological Flexibility Index (Kashdan et al., 2020) assesses psychological flexibility in relation to a valued goal, but in theory, these are only valid valued goals insofar as people understand what it is that they value. Other measures of values assess stuff that we value, such as the Valued Living Questionnaire (Wilson et al., 2010), asking users to rate the importance of various life domains (e.g., parenting, work etc.) on a scale of 1-10, which is not in line with the quality of character definition of values within ACT. ...
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Engaging in behavior that is congruent with the qualities of character to which we aspire is the key behavioral outcome sought in several evidence-based psychotherapies (e.g., “valued action” within Acceptance and Commitment Therapy) and moral education (e.g., “character sought” within Neo-Aristotelian Character Education). However, we cannot deliberately engage in valued action without first thinking through the qualities of character to which we aspire. We therefore developed a novel measure of “value clarity” and established its construct validity. Across two adult samples and one adolescent sample, we established the following psychometric properties of the seven-item Value Clarity Questionnaire: factor structure, concurrent validity, discriminant validity, internal reliability, rest-retest reliability, predictive validity, and incremental criterion validity. Value clarity predicted multiple aspects of flourishing including engaged living, depression, behavioral activation, assertiveness, productiveness, and energy levels over and above known predictors. This measure will be especially useful for assessing the efficacy of values/moral clarification interventions.
... experiential avoidance) were over and above the contributions of distress. As recommended by Cherry et al. (2021), who provided a research review based critique of the AAQ-II, future research could usefully select alternative measures relating to experiential avoidance such as the Personalized Psychological Flexibility Index (Kashdan, Disabato, Goodman, Doorley, & McKnight, 2020) which measures the pursuit of valued life aims despite the presence of internal distress. In addition, the extent to which we could assess people's values was limited to the method of values assessment utilised, namely the Personal Values Questionnaire (PVQ). ...
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Previous research identifies people with Borderline Personality Disorder (BPD) place high levels of importance on values across a variety of life domains but have significantly lower levels of values commitment, desire to improve and success at living in line with what is valued. The current study aims to identify the factors impeding people’s ability to engage more successfully with what is valued so that they can be more effectively targeted in treatment. In this study, participants were 106 consumers attending an outpatient clinic for BPD treatment. Participants completed a comprehensive assessment of values (Personal Values Questionnaire) as well as selfreport measures of experiential avoidance (Acceptance and Avoidance Questionnaire- 2), alexithymia (Toronto Alexithymia Scale) and symptoms of depression, anxiety and stress (Depression, Anxiety and Stress Scale-21). Correlations demonstrated that depression, stress, difficulty identifying feelings and describing feelings and experiential avoidance were negatively associated with values engagement. However, regression analysis revealed that only depression and experiential avoidance significantly predicted values engagement after controlling for the other predictor variables in the model. Experiential avoidance and depressive symptomology are likely to be particularly important targets to improve successful values pursuit in individuals seeking treatment for BPD.
... Sense of purpose was assessed using the Brief Purpose Measure , a measure originally developed to assess sense of purpose levels in emerging adulthood. However, it has shown convergent validity with other sense of purpose measures used across the lifespan and is related to variables also associated with these other sense of purpose measures Hill, Burrow, & Strecher, 2021;Kashdan, Disabato, et al., 2020;Scott & Cohen, 2020). Furthermore, this measure was also used to assess dispositional sense of purpose at baseline for the hourly and weekly studies. ...
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Sense of purpose can be understood as the extent to which one feels that they have personally meaningful goals and directions guiding them through life. Though the predictive value of this construct is well-established based on the robust research illustrating that it predicts a host of desirable cognitive, physical, and well-being benefits, the nature of sense of purpose is still under-researched. In particular, little is known regarding the extent to which this construct fluctuates within an individual and what is tied to those fluctuations. The current study addresses this gap by utilizing data from four separate studies (total N = 3,390) with lag variability to explore three primary questions. First, how much within-person variability do people exhibit in sense of purpose at the hourly, daily, weekly, and monthly level? Second, how does sense of purpose variability compare to positive and negative affect variability? Third, does dispositional sense of purpose predict short-term sense of purpose variability, and does age have a linear and/or quadratic association with sense of purpose variability? The current project finds that approximately 50-70% of the variability in sense of purpose scores occurs between-person, with the monthly reports exhibiting the least amount of within-person variability. Furthermore, the within-person variability of sense of purpose is often comparable to positive and negative affect depending on the time between measurement occasions. Finally, higher levels of dispositional sense of purpose do not appear to be strongly tied to how much variability an individual experiences in their purposefulness from one time period to next. However, depending on the amount of time between measurement occasions, higher age may be tied to experiences of variability. The discussion focuses on what these findings mean for the trait-like nature of sense of purpose, short-term sense of purpose measurement, lifespan development, and intervention efforts. https://openscholarship.wustl.edu/art_sci_etds/2724
... Some authors, such as Kashdan et al. (2020), propose a "personalized" measure of psychological flexibility using the Personalized Psychological Flexibility Index (PPFI), which has notable psychometric qualities. This questionnaire seems to distinguish 3 factors: avoidance, acceptance, and harnessing. ...
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Psychological flexibility is a key process in mental health, both in a psychopathological approach and from a quality of life and well-being perspective. The notion seems to suffer from a conceptual vagueness with multiple definitions, stemming from different conceptual propositions, with a frequent opposition between a “neuropsychological” approach or assessment and a “clinical and therapeutical” approach. The objective of this article is to propose a theoretical review of the literature, aiming at understanding the notion of psychological flexibility according to the different approaches. To do so, we propose a presentation of the notions, as well as perspectives to improve actual assessment, especially in its ecological aspects. Finally, we wish to underline the relevance of a convergence of measures by reflecting on the limits of current tools and proposing mixed ecological protocols between “objective” and “subjective” measures in a perspective of mutual enrichment, both theoretical and clinical.
... The findings suggested that psychological flexibility can be high and enhance employee career success when their competency development, EOR and empowering leadership impact career success. In contrast (Kashdan et al., 2020), have postulated that the pursuit of valued goals despite the presents of distress. They have also addressed that psychological flexibility is associated with adaptive personality traits, including openness to experience and lower negative emotions. ...
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This present study examines the relationship among competency development, empowering leadership, employee-organisation relationship, psychological flexibility and career success in the Chinese hotel industry. Using the survey data of 560 employees working in 45 hotels, the salient results of PLS-SEM suggest that the interplays of competency development and empowering leadership significantly enhance the employee-organisation relationship and career success. Empowering leadership also significantly affects the competency development of the employee. Furthermore, this study highlighted that the impact of psychological flexibility is much higher when employees excel in the employee-organisation relationship and career success. Finally, the employee-organisation relationship significantly enhances employee career success. These results advance the understanding of past research and suggest that career success should be the employee's target following influencing factors in the hotels. These findings suggest that career success may be expanded to include the JD-R theory and is valid in the Chinese employee career setting.
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World Health Organization defines pandemic as a large-scale epidemic that affects much of the inhabited world. COVID-19 disease appeared at the end of 2019 in China and very quickly took on pandemic proportions. The primary aim of this study was to examine the mediating effect of COVID-19 concerns on the association between some personal determinants with psychological distress and COVID-19-related safety behaviors. One of the problems concerned the mediating effect of concerns about COVID-19 on the association between psychological inflexibility and psychological distress as well as on the association between psychological inflexibility and safety behaviors related to COVID-19. Another problem concerned the mediating effect of concerns about COVID-19 on the association between psychological vulnerability and psychological distress, or safety behaviors related to COVID-19. Furthermore, the aim of the study was to inspect gender differences in the mentioned variables. 656 physicians (71.3% female) participated in the study. The COVID-19 Anxiety Scale was used to measure COVID-19 concerns, while The COVID-19 Safety Behavior Checklist was used as a measure of safety behaviors. Acceptance and Action Questionnaire (AAQ-II) was used as a measure of psychological inflexibility, and the Brief Resilience Scale (BRS) for resilience. A short version of the Clinical Outcome in Routine Evaluation-YP (CORE-YP) was used as a measure of psychological distress. The results showed the existence of gender differences for all variables where women achieve higher results than men. The results showed the existence of gender differences for all the above variables in the direction that women achieve higher results than men. Mediation analysis showed complete mediation of concerns about COVID-19 to the association between psychological vulnerability and psychological inflexibility with safety behaviors. Also, partial mediation of concerns about COVID-19 to the association between psychological vulnerability and psychological inflexibility with psychological distress was demonstrated. The direct effect of psychological inflexibility was greater than the direct effect of psychological vulnerability. The implication of these results speaks in favor of encouraging psychological flexibility and psychological resilience in physicians as protective factors against the negative impacts of a pandemic on mental health.
Article
The current studies examined whether psychological flexibility and inflexibility, as assessed with the Multidimensional Psychological Flexibility Inventory (MPFI; Rolffs et al., 2018), are associated with eudaimonic and hedonic well-being. In two cross-sectional studies, undergraduate participants (N’s = 315 and 345, respectively) completed the MPFI along with multiple measures of eudaimonic well-being (in Study 1) or of hedonic well-being (in Study 2). In both studies, psychological flexibility and inflexibility composite scores were significantly and independently related to well-being. In Study 2, the relationship between hedonic well-being and MPFI composite scores persisted when controlling for meaning in life and psychological need satisfaction/frustration. These findings point to the relevance of the ACT framework and the dimensions of psychological flexibility and inflexibility for the understanding of well-being and suggest ways in which psychological flexibility/inflexibility could be studied further in relation to well-being outcomes.
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The COVID-19 pandemic has brought unprecedented situations (government lockdowns, quarantines, etc.) and stressors (a seemingly “phantom” virus that can be lurking anywhere) causing uncertainty for the future, uncontrollable and unpredictable situations. It appears that especially during times of uncertainty and high stress, conspiracy theories flourish and these can affect the way individuals behave, especially in response to governmental recommendations for social isolation and quarantine. Psychological flexibility, we hypothesized, may act as a protective factor in the relation between COVID-19 distress, conspiracy theory beliefs and consequent behaving. In this respect, the aim of this paper was to examine how conspiracy theory beliefs, COVID-19 distress, adherence behavior, and psychological flexibility interact. Participants were 1001 individuals (802 women; Mage=35.59years, SD= 10.07), who completed an online survey approximately one month after the first governmental measures of self-isolation and quarantine were enforced. Psychological flexibility was found to mediate the relation between conspiracy theory beliefs and compliance behavior. Further, being highly stressed appeared to increase the probability that a person will believe conspiracy theories, while such beliefs influenced whether a person would follow public health recommendations. Psychological flexibility appeared to be a protective factor at low and moderate distress levels. However, at high levels of COVID-19 distress, individuals prone to conspiracy theory beliefs would be less likely to conform to governmental public health recommendations irrespective of their psychological flexibility levels.
Article
People's psychological response to the COVID-19 pandemic is significantly affected by their psychological inflexibility. One possible mechanism explaining the association between psychological inflexibility and psychological functioning concerns coping styles. While avoidance and approach coping styles were previously found to mediate this association, the mediating role of meaning-centered coping has not yet been explored. However, meaning-centered coping it is likely to be crucial in circumstances as uncertain as those at the onset of the COVID -19 pandemic. This study explored the mediating role of the three coping styles in the relationship of psychological inflexibility with ill-being and well-being. Slovenian adults (N = 1365) aged 18–81 years provided self-reports on the Acceptance and Action Questionnaire, the Depression Anxiety Stress Scale, the PERMA Profiler, the Brief COPE Inventory, and the Meaning-Centered Coping Scale. In the context of the highly stressful beginning of the pandemic, psychological inflexibility contributed to higher ill-being and lower well-being directly and through increased use of avoidance coping, decreased use of meaning-centered coping, and, to a lesser extent, decreased use of approach coping. Avoidance coping predicted higher levels of ill-being, suggesting a maladaptive effect of this coping strategy. Approach coping positively but weakly predicted well-being, indicating a diminished value of this coping style in low-controllable circumstances of the pandemic. Finally, meaning-centered coping appeared to be the most beneficial in such circumstances, as it was associated with both lower levels of ill-being and higher levels of well-being. This finding suggests that meaning-centered coping should be studied as a stand-alone strategy, rather than as a combination of specific approach coping strategies. Consistent with previous research, this study demonstrates the importance of psychological inflexibility in effectively adapting to and actively coping with aversive situations. Furthermore, the results suggest that seeking or making meaning is vital, at least in a context characterized by low levels of control and high levels of uncertainty.
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Self-compassion (SC) facilitates healthy responses to stressful events among athletes. Existing findings are predominantly retrospective, however, and questions remain about the role of SC in college athletes’ daily emotion regulation and sport performance. Sixty-seven college athletes completed daily diaries for 14 consecutive days during their competitive seasons. We tested whether SC predicted 1) emotion regulation strategy use and effectiveness following negative events and 2) sport performance rebound following subjectively poor performances the previous day. We also compared the effects of SC with grit, sport-specific hope, and sport-related self-confidence, each in separate models. Results showed that SC and sport-specific hope predicted greater use of cognitive reappraisal in response to negative events. Interestingly, social support seeking was associated with higher negative emotions on average. However, higher levels of SC, grit, and sport-specific hope (but not sport self-confidence) mitigated this association. When athletes’ subjective performance during practice fell 1 SD below their two-week mean, SC, grit, and sport-specific hope predicted improved subjective performance during the next day’s practice by 7.8–10.9%. Sport confidence had no effect, suggesting that coaches and sport psychology consultants might consider shifting their focus toward cultivating SC instead.
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Acceptance and Commitment Therapy (ACT) interventions aim to increase psychological flexibility (PF) leading to positive treatment outcomes. It has been suggested that successful development of PF may depend on cognitive flexibility (CF), however there is a lack of clear empirical evidence accounting for the relationship between the two constructs. The current study investigated the relationship between PF and CF in a large nonclinical sample of younger adults (N = 246). Participants completed self-report measures of PF, and both self-report and task-based measures of CF. Results indicated that self-report, but not task-based, CF correlated with and predicted PF (r = −0.49, 95% BCa CI [-0.58, −0.38], R² = 0.236). The results are discussed with reference to rule-governed behaviour, approaches to measurement and ACT, with suggestions for future research.
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Objectives Physiotherapists increasingly deliver treatment informed by cognitive-behavioural therapy, including Acceptance and Commitment Therapy (ACT), for persistent pain. This study explored patients’ experiences of ACT-informed physiotherapy to better understand therapeutic processes and outcomes. Design A qualitative descriptive study was conducted. Focus groups explored participants’ experience of ACT-informed physiotherapy in the context of a pain management programme. Responses were audio recorded, transcribed verbatim, and analysed using a hybrid inductive-deductive reflexive thematic analysis. Setting A single tertiary care pain management service. Participants The sample consisted of fifteen patients from two treatment groups who completed an intensive multidisciplinary ACT-based pain management programme. Participants were included irrespective of their treatment response. Results One overarching theme (living more and struggling less) and four interconnected themes were generated from the data: 1) awareness and openness help to approach physical activities flexibly; 2) from battling against to working with the body compassionately; 3) from narrow focus to curiosity, freedom, and expansion; and 4) social connection is a catalyst for openness and engagement. Conclusions Participants experienced ACT-informed physiotherapy as helping them to live more and struggle less with pain; this occurred in the context of a psychologically flexible relationship with the physiotherapist and was catalysed by social connection. These findings should be seen as preliminary given the small number and relatively brief duration of focus groups conducted. Further research is needed to explore how principles within ACT-informed physiotherapy may support patients and clinicians to respond effectively to the challenges that persistent pain can bring.
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Background Evidence suggests that psychedelic-assisted therapy carries transdiagnostic efficacy in the treatment of mental health conditions characterized by low mood and the use of avoidance coping strategies. Aims While preliminary evidence suggests that psychological flexibility and emotion regulation processes play an important role within psychedelic therapy, this prospective study addressed methodological gaps in the literature and examined the ability of ayahuasca to stimulate acute states of cognitive reappraisal and long-term changes in psychological flexibility and mood. The study also explored whether moderating factors predisposed participants to experience therapeutic changes. Methods Participants ( N = 261) were recruited from three Shipibo ayahuasca retreat centers in Central and South America and completed assessments on mood, psychological flexibility, and acute ceremonial factors. Expectancy, demand characteristics, and invalid responding were controlled for with several validity scales. Results/Outcomes Participants reported significant reductions in negative mood after three months, as well as increases in positive mood and psychological flexibility. Acute experiences of reappraisal during the ayahuasca ceremony exerted the strongest moderating effects on increases in positive mood and psychological flexibility. Increases in psychological flexibility statistically mediated the effects of acute psychological factors, including reappraisal, on changes in positive mood. Conclusions/Interpretation These results highlight the role of acute psychological processes, such as reappraisal, and post-acute increases in psychological flexibility as putative mechanisms underlying positive outcomes associated with psychedelics. These results also provide support for the integration of third-wave and mindfulness-based therapy approaches with psychedelic-assisted interventions.
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Emerging adulthood (EA) is a time of self-exploration as new opportunities for independence and autonomy arise. Yet, for some youth, this may also contribute to instability, uncertainty, and anxiety. Consequently, evidence suggests that rates of exposure to various forms of violence increase in EA. This study examined changes in experiences of bullying and sexual violence (SV) victimization among a sample of post-high school emerging adults who were exposed to a primary prevention program, Sources of Strength (Sources). We also examined whether Sources skills (e.g., healthy coping and help-seeking) buffer against these experiences. Participants were 102 emerging adults (73.5% identifying as female, 36.3% as Latinx, and 22.6% as LGBQ), who completed surveys at three time points: 1 month prior to graduation and at 6- and 12-months post-graduation. Results suggest that as youth transition into emerging adulthood, experiences of bullying victimization were relatively low and slightly decreased whereas experiences of SV were also relatively low, but stable over time. Notably, bullying victimization was lower when female-identifying participants, relative to males, had higher levels of healthy coping. In addition, SV victimization for participants identifying as non-white was higher at lower levels of coping than those identifying as white; however, at higher levels of coping, non-white participants reported lower rates of SV victimization, while rates were relatively stable for white participants at high and low levels of coping. These findings provide some support for the Sources program model where engaging in healthy coping may protect young women from bullying exposure and buffer against SV victimization for racial and ethnic minoritized young adults. Implications for violence prevention are discussed.
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Метою статті є теоретичне обґрунтування та емпіричне дослідження взаємозв’язку між рисами характеру, толерантністю до невизначеності та компонентами особистісного благополуччя сту- дентів-психологів. Методи. У дослідженні використано такий діагностичний інструментарій, як: «Шкала психологіч- ного благополуччя К. Ріфф» (адаптація Т.Д. Шевеленкова, Т.П. Фесенко); П’ятифакторний опитуваль- ник (The Big Five Inventory, BFI, автори: Олівер Джон, Крістофер Сото (Oliver P. John, Christopher J. Soto, 2015; адаптація С.А. Щебетенко, А.Ю. Калугіна, А.М. Мишкевича, 2018); «Шкала загальної толерант- ності до невизначеності МакЛейна» (адаптація Е.Г. Луковицької, 1998, ревалідизація Е.М. Осіна, 2004). Результати. У статті теоретично обґрунтовано та викладено результати емпіричного дослідження взаємозв’язку між рисами характеру, толерантністю до невизначеності та компонентами особистісного благополуччя студентів-психологів. Дослідження проведено зі 311 студентами Київського університету імені Бориса Грінченка за спеціальністю «Психологія». Досліджено взаємозв’язки між показниками благополуччя особистості, толерантності до невизначеності та рисами характеру. Виявлено значущий зв’язок між загальним показником благополуччя особистості та толерантності до невизначеності. Про- ведено наскрізний аналіз та виявлено значущий зв’язок між компонентною «Особистісне зростання» (психологічне благополуччя), субшкалами «Ставлення до невизначених ситуацій», «Перевага новизни», «Ставлення до складних задач» (шкала МакЛейна) та рисами характеру «Екстраверсія-Наполегливість», «Сумлінність-Відповідальність», «Відкритість досвіду» (BFI). Висновки. У статті наведено стислий огляд зарубіжних підходів до становлення дослідження фено- менів благополуччя особистості та толерантності до невизначеності, узагальнено та сформульовано визначення понять «особистісне благополуччя» і «толерантність до невизначеності». Проаналізовано кореляційні зв’язки між показниками особистісного благополуччя, толерантності до невизначеності та рисами характеру. Виявлено характерологічні диспозиції толерантності до невизначеності у сис- темі особистісного благополуччя студентів-психологів. Визначено перспективи подальших досліджень впливу на стан особистісного благополуччя студентів-психологів. Ключові слова: психологічне благополуччя, особистісне благополуччя, невизначеність, толерантність до невизначеності, толерування ситуації, риси характеру.
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The present study combines two separate research traditions that have been found to explain the way students deal with their university study and other challenges: psychological flexibility and cognitive-attributional strategies. The aim of this study is to explore the interrelationships between students’ psychological flexibility, cognitive-attributional strategies and academic emotions, and their relationship to study success. Further, the study compares students with low, middle and high scores on psychological flexibility. A total of 247 arts students participated in the study. The interrelationships between psychological flexibility, cognitive-attributional strategies, academic emotions, study success and study pace were analysed with correlational analyses and structural equation modelling. Comparisons of different score groups were analysed with one-way ANOVA and Tukeýs tests. The results showed that psychological flexibility, cognitive-attributional strategies and academic emotions are closely related to each other. Psychological flexibility was positively related to success expectations and positive emotions and negatively related to task avoidance and negative emotions.
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Elevated psychosocial distress, pain and existential dread are prevalent among those living with a palliative illness with consequential negative impacts on quality of life (QoL). Psychological flexibility (PF) is a protective factor related to better psychosocial outcomes in various adverse health contexts. This study tests the applicability of the PF framework in accounting for variability in four palliative patient outcomes (death attitudes, distress, pain and QoL) and the stability of these variables over one month. Fifty-four palliative patients and 21 of their carers completed a questionnaire at Time 1 and one month later (Time 2). Informal carers provided proxy ratings of the patient's QoL. Results indicated no change in PF or patient outcomes, and that higher Time 1 total PF significantly predicted better Time 2 outcomes across QoL, distress, and death attitudes. The acceptance PF dimension evidenced the strongest beneficial associations, whereas unexpectedly the values-based action PF dimension predicted higher death escape attitudes, and the mindfulness PF dimension failed to predict any outcome, although at the bivariate level it was related to better outcomes across QoL, death attitudes and distress. Unexpectedly, the values-based action PF dimension was correlated with worse pain outcomes. Overall, these findings support the role of PF in improving palliative patient outcomes, and prior calls for the evaluation of Acceptance and Commitment Therapy (ACT), which targets PF, in palliative care. The unexpected findings regarding the two PF dimensions of mindfulness and values-based action, suggest that these PF processes need further investigation and require fine tuning in ACT interventions to ensure sensitivity to the palliative care context. These findings are currently being utilised to inform the development and evaluation of a self-help ACT resource for palliative patients.
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Background The mental health of doctors is an ongoing concern, both prior to and during the COVID-19 pandemic. This study aimed to: i) assess the prevalence of symptoms of depression, anxiety, PTSD, and burnout in UK doctors and final year medical students during the pandemic, and ii) analyse the hypothesised relationships between psychological flexibility, intolerance of uncertainty and resilience with these mental health outcomes. Methods A cross-sectional online study of UK-based doctors and final year medical students was conducted between 27/09/2020 and 31/01/2021. Outcomes were measured using the PHQ9, GAD7, PCL-5, and aMBI. Independent variables included the CompACT-SF, IUS-12, and CD-RISC-10. Descriptive statistics, between-group analyses, and multiple regression were performed. Results Prevalence of anxiety symptoms was 26.3%, depression 21.9%, PTSD 11.8%, and burnout 10.8%. Psychological flexibility negatively predicted all outcomes, apart from low personal achievement. Intolerance of uncertainty positively predicted anxiety and PTSD scores. Resilience negatively predicted scores on burnout subscales. Limitations Cross-sectional design and non-probability sampling method means that assumptions about causality cannot be made and may have implications for bias and generalisability of results. Conclusion Doctors and medical students in the UK reported high levels of mental health symptoms during the pandemic, between September 2020 and January 2021. All three independent variables explained significant variance in mental health outcomes. Psychological flexibility was the most consistent predictor, over and above sociodemographic variables and other psychological predictors. These findings have implications for interventions to improve retention of our essential medical workforce, and for providing support at future times of national crisis.
Article
A large array of randomized controlled trials and meta-analyses have determined the efficacy of Acceptance and Commitment Therapy (ACT). However, determining that ACT works does not tell us how it works. This is especially important to understand given the current emphasis on Process-Based Therapy, the promise of which is to identify manipulable causal mediators of change in psychotherapy, and how their effectiveness is moderated by individual contexts. This paper outlines four key areas of concern regarding ACT’s status as a Process-Based Therapy. First, the relationship between ACT and Relational Frame Theory has been widely asserted but not yet properly substantiated. Second, most of the studies on ACT’s core process of change, psychological flexibility, have used invalid measures. Third, while lots of research indicates means by which individuals can be helped to behave consistently with their values, there is virtually no research on how to help people effectively clarify their values in the first instance, or indeed, on an iterative basis. Finally, the philosophy underlying ACT permits a-moral instrumentalism, presenting several ethical challenges. We end by making several recommendations for coherent methodological, conceptual, and practical progress within ACT research and therapy.
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Background and purpose: Stress and burnout among healthcare workers are significant public health concerns. The primary aim of this pilot study was to conduct preliminary assessments of safety, feasibility, and participant satisfaction with a psychotherapy incorporating equines (PIE)-based resiliency intervention for healthcare workers. The overarching goal was to lay the groundwork for future, more rigorous investigations. Lastly, a very preliminary assessment of using the Acceptance and Action Questionnaire II (AAQII) to assess for changes in psychological flexibility (PF) associated with PIE was conducted. Materials and methods Thirty-seven staff members from a medical center participated in a four-hour PIE-based resiliency retreat. Pre- and post-intervention instruments were utilized to assess participants’ self-perception of physical and psychological health (PROMIS Global Short Form) and enjoyment of (Physical Activity Enjoyment Scale) and satisfaction with (Client Satisfaction Questionnaire) the intervention, as well as changes in PF (AAQII). Results There were no adverse effects on participants, staff, or equines. Preliminary results suggested that the intervention was perceived as enjoyable by participants. However, the intervention was not fully utilized. Finally, there was a significant (p = 0.02) pre-to post-intervention change in AAQII scores. Conclusion This study provides a foundation for future rigorous studies of PIE-based resiliency interventions for medical staff. Given the limitations of this pilot work, firm conclusions cannot be drawn regarding safety and feasibility. However, the preliminary results suggest that future studies of this intervention are warranted and that the AAQII may be a useful instrument to assess for possible changes in PF.
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The COVID-19 public health emergency created an aversive environment for people all around the world. Acceptance and commitment therapy (ACT), born of behavior analysis, can help address some of these problems by encouraging behavioral change and increasing psychological flexibility. The mindful action plan (MAP) is designed to create a simple approach to utilizing the ACT principles. The MAP utilizes the traditional ACT hexagon model and provides a checklist for learning and following through on the 6 components that, when combined, lead to psychological flexibility. The MAP guides people to act in the direction of their values and to be influenced by their verbal behavior while saying, “I am here now, accepting my feelings and noticing my thoughts while doing what I care about.” Specific instructions and exercises are provided so the MAP can be used by behavior analysts to assist their actions during stressful and anxiety-provoking times.
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This study examines relationships between emotion beliefs and emotion regulation strategy use among people with social anxiety disorder (SAD) and a psychologically healthy control group. Using experience-sampling methodology, we tested group differences in 2 types of emotion beliefs (emotion control values and emotion malleability beliefs) and whether emotion beliefs predicted trait and daily use of cognitive reappraisal and emotion suppression. People with SAD endorsed higher emotion control values and lower emotion malleability beliefs than did healthy controls. Across groups, emotion control values were positively associated with suppression (but unrelated to reappraisal), and emotion malleability beliefs were negatively associated with suppression and positively associated with reappraisal. We also addressed 2 exploratory questions related to measurement. First, we examined whether trait and state measures of emotion regulation strategies were related to emotion control values in different ways and found similar associations across measures. Second, we examined whether explicit and implicit measures of emotion control values were related to daily emotion regulation strategy use in different ways-and found that an implicit measure was unrelated to strategy use. Results are discussed in the context of growing research on metaemotions and the measurement of complex features of emotion regulation. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Psychological inflexibility and experiential avoidance are key constructs in the Acceptance and Commitment Therapy (ACT) model of behavior change. Wolgast (2014) questioned the construct validity of the Acceptance and Action Questionnaire-II (AAQ-II), the most used self-report instrument to assess the efficacy of ACT interventions. Wolgast suggested that the AAQ-II measured psychological distress rather than psychological inflexibility and experiential avoidance. The current study further examined the construct validity of the AAQ-II by conducting an online cross-sectional survey (n = 524), including separate measures of experiential avoidance and psychological distress. Confirmatory factor analyses indicated that items from the AAQ-II correlated more highly with measures of depression, anxiety, and stress than the Brief Experiential Avoidance Questionnaire (BEAQ). Implications include that, as broad measures of experiential avoidance, the AAQ-II and BEAQ may not measure the same construct. In terms of psychological distress, the BEAQ has greater discriminant validity than the AAQ-II, and perhaps an alternative instrument of psychological inflexibility might be needed to assess core outcomes in ACT intervention research.
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Psychological flexibility is the act of being open to internal experiences while pursuing valued life directions and has been implicated in positive mental health. A lack of psychological flexibility has been implicated in a wide range of mental health problems. In most research, assessment of psychological (in) flexibility has been done with the Acceptance and Action Questionnaire – II (AAQ-II), yet researchers have noted that items on the AAQ-II may not adequately discriminate between responses to experiences and the experiences themselves. Furthermore, little research has examined whether items on the AAQ-II function as intended in terms of assessing psychological (in) flexibility and whether items function differently across populations. The present study used an item response theory framework to examine item functioning in the AAQ-II across items (within the measure) and across non-distressed student, distressed student, outpatient, and residential samples. The analyses identified differences in functioning between items, with some items being more sensitive to differences in psychological inflexibility. No items performed well in assessing psychological flexibility (as opposed to inflexibility) or positive functioning. Items functioned similarly across samples, yet patterns of responding differed in the non-distressed student versus residential and outpatient samples. Implications for use of the AAQ-II in clinical and research contexts are discussed.
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Clinical science seems to have reached a tipping point. It appears that a new paradigm is beginning to emerge that is questioning the validity and utility of the medical illness model, which assumes that latent disease entities are targeted with specific therapy protocols. A new generation of evidence-based care has begun to move toward process-based therapies to target core mediators and moderators based on testable theories. This could represent a paradigm shift in clinical science with far-reaching implications. Clinical science might see a decline of named therapies defined by set technologies, a decline of broad schools, a rise of testable models, a rise of mediation and moderation studies, the emergence of new forms of diagnosis based on functional analysis, a move from nomothetic to idiographic approaches, and a move toward processes that specify modifiable elements. These changes could integrate or bridge different treatment orientations, settings, and even cultures.
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This study sought to develop and validate a domain-specific measure of psychological inflexibility for university students, the acceptance and action questionnaire for university students (AAQ-US). Generic versions of the AAQ tend to not be as sensitive to changes in campus-specific functioning —a key outcome of interest in this population. An online survey was conducted with 425 undergraduate students. Psychometric analyses led to the refinement of a 12-item, single factor scale with strong internal consistency. Evidence for convergent validity was found with moderate to large correlations between the AAQ-US and measures of academic outcomes, mental health, and psychological inflexibility. The AAQ-US was a stronger predictor of academic outcomes than the AAQ-II (a general measure of psychological inflexibility) whereas the AAQ-II was more strongly related to mental health outcomes than the AAQ-US. Incremental validity for the AAQ-US was found for predicting both academic and mental health outcomes while controlling for the AAQ-II, though effects were stronger for academic outcomes. Overall, results indicate that the AAQ-US is a reliable and valid measure of psychological inflexibility among university students and may be particularly relevant in the context of academic outcomes.
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The Big Five Inventory–2 (BFI-2) uses 60 items to hierarchically assess the Big Five personality domains and 15 more-specific facet traits. The present research develops two abbreviated forms of the BFI-2—the 30-item BFI-2-S and the 15-item BFI-2-XS—and then examines their measurement properties. At the level of the Big Five domains, we find that the BFI-2-S and BFI-2-XS retain much of the full measure’s reliability and validity. At the facet level, we find that the BFI-2-S may be useful for examining facet traits in reasonably large samples, whereas the BFI-2-XS should not be used to assess facets. Finally, we discuss some key tradeoffs to consider when deciding whether to administer an abbreviated form instead of the full BFI-2.
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People regulate their emotions not only for hedonic reasons but also for instrumental reasons, to attain the potential benefits of emotions beyond pleasure and pain. However, such instrumental motives have rarely been examined outside the laboratory as they naturally unfold in daily life. To assess whether and how instrumental motives operate outside the laboratory, it is necessary to examine them in response to real and personally relevant stimuli in ecologically valid contexts. In this research, we assessed the frequency, consistency, and predictors of instrumental motives in negative emotion regulation in daily life. Participants (N = 114) recalled the most negative event of their day each evening for 7 days and reported their instrumental motives and negative emotion goals in that event. Participants endorsed performance motives in approximately 1 in 3 events and social, eudaimonic, and epistemic motives in approximately 1 in 10 events. Instrumental motives had substantially higher within- than between-person variance, indicating that they were context-dependent. Indeed, although we found few associations between instrumental motives and personality traits, relationships between instrumental motives and contextual variables were more extensive. Performance, social, and eudaimonic motives were each predicted by a unique pattern of contextual appraisals. Our data demonstrate that instrumental motives play a role in daily negative emotion regulation as people encounter situations that pose unique regulatory demands. (PsycINFO Database Record
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Grit has been presented as a higher order personality trait that is highly predictive of both success and performance and distinct from other traits such as conscientiousness. This paper provides a meta-analytic review of the grit literature with a particular focus on the structure of grit and the relation between grit and performance, retention, conscientiousness, cognitive ability, and demographic variables. Our results based on 584 effect sizes from 88 independent samples representing 66,807 individuals indicate that the higher order structure of grit is not confirmed, that grit is only moderately correlated with performance and retention, and that grit is very strongly correlated with conscientiousness. We also find that the perseverance of effort facet has significantly stronger criterion validities than the consistency of interest facet and that perseverance of effort explains variance in academic performance even after controlling for conscientiousness. In aggregate our results suggest that interventions designed to enhance grit may only have weak effects on performance and success, that the construct validity of grit is in question, and that the primary utility of the grit construct may lie in the perseverance facet.
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Flexibility in self-regulatory behaviors has proved to be an important quality for adjusting to stressful life events and requires individuals to have a diverse repertoire of emotion regulation abilities. However, the most commonly used emotion regulation questionnaires assess frequency of behavior rather than ability, with little evidence linking these measures to observable capacity to enact a behavior. The aim of the current investigation was to develop and validate a Flexible Regulation of Emotional Expression (FREE) Scale that measures a person's ability to enhance and suppress displayed emotion across an array of hypothetical contexts. In Studies 1 and 2, a series of confirmatory factor analyses revealed that the FREE Scale consists of 4 first-order factors divided by regulation and emotional valence type that can contribute to 2 higher order factors: expressive enhancement ability and suppression ability. In Study 1, we also compared the FREE Scale to other commonly used emotion regulation measures, which revealed that suppression ability is conceptually distinct from suppression frequency. In Study 3, we compared the FREE Scale with a composite of traditional frequency-based indices of expressive regulation to predict performance in a previously validated emotional modulation paradigm. Participants' enhancement and suppression ability scores on the FREE Scale predicted their corresponding performance on the laboratory task, even when controlling for baseline expressiveness. These studies suggest that the FREE Scale is a valid and flexible measure of expressive regulation ability. (PsycINFO Database Record
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We examined whether individual differences in susceptibility to the illusion of control predicted differential vulnerability to depressive responses after a laboratory failure and naturally occurring life stressors. The illusion of control decreased the likelihood that subjects (N= 145) would (a)show immediate negative mood reactions to the laboratory failure, (b) become discouraged after naturally occurring negative life events, and (c) experience increases in depressive symptoms a month later given the occurrence of a high number of negative life events. In addition, the stress-moderating effect of the illusion of control on later depressive symptoms appeared to be mediated in part by its effect on reducing the discouragement subjects experienced from the occurrence of negative life events. These findings provide support for the hopelessness theory of depression and for the optimistic illusion-mental health link.
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Cognitive behavior therapy (CBT) is considered effective for chronic pain, but little is known about active treatment components. Although acceptance correlates with better health outcomes in chronic pain patients, no study has examined its mediating effect in an experimental design. The aim of the present study is to investigate acceptance as a mediator in acceptance and commitment therapy (ACT), a third wave CBT intervention, for chronic pain. A bootstrapped cross product of coefficients approach was used on data from a previously published RCT evaluating ACT for chronic pain. To address the specificity of acceptance as a mediator, anxiety and depression were also tested as mediators. Outcome variables were satisfaction with life and physical functioning. Two change scores, pre-assessment to 6-month follow-up (n = 53) and pre-assessment to 12-month follow-up (n = 32), were used. Acceptance was found to mediate the effect of treatment on change in physical functioning from pre-assessment to follow-up at 6 months. Further, a trend was shown from pre-assessment to follow-up at 12 months. No indirect effect of treatment via acceptance was found for change in satisfaction with life. This study adds to a small but growing body of research using mediation analysis to investigate mediating factors in the treatment of chronic pain. In summary, the results suggest that acceptance may have a mediating effect on change in physical functioning in ACT for persons with chronic pain. However, given the small sample size of the study, these findings need to be replicated.
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People respond to stressful events in different ways, depending on the event and on the regulatory strategies they choose. Coping and emotion regulation theorists have proposed dynamic models in which these two factors, the person and the situation, interact over time to inform adaptation. In practice, however, researchers have tended to assume that particular regulatory strategies are consistently beneficial or maladaptive. We label this assumption the fallacy of uniform efficacy and contrast it with findings from a number of related literatures that have suggested the emergence of a broader but as yet poorly defined construct that we refer to as regulatory flexibility. In this review, we articulate this broader construct and define both its features and limitations. Specifically, we propose a heuristic individual differences framework and review research on three sequential components of flexibility for which propensities and abilities vary: sensitivity to context, availability of a diverse repertoire of regulatory strategies, and responsiveness to feedback. We consider the methodological limitations of research on each component, review questions that future research on flexibility might address, and consider how the components might relate to each other and to broader conceptualizations about stability and change across persons and situations. © The Author(s) 2013.
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How do people flexibly regulate their emotions in order to manage the diverse demands of varying situations? This question assumes particular importance given the central role that emotion regulation (ER) deficits play in many forms of psychopathology. In this review, we propose a translational framework for the study of ER flexibility that is relevant to normative and clinical populations. We also offer a set of computational tools that are useful for work on ER flexibility. We specify how such tools can be used in a variety of settings, such as basic research, experimental psychopathology, and clinical practice. Our goal is to encourage the theoretical and methodological precision that is needed in order to facilitate progress in this important area.
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People perceive psychological situations on the “Situational Eight” DIAMONDS characteristics (Duty, Intellect, Adversity, Mating, pOsitivity, Negativity, Deception, Sociality; Rauthmann et al., 2014). To facilitate situational assessment and economically measure these dimensions, we propose four ultra-brief one-item scales (S8-I, S8-II, S8-III-A, S8-III-P) validated against the already existing 24-item S8*. Convergent/discriminant validity of the four S8-scales was examined by analyses of the multi-characteristics multi-measures matrix, and their nomological associations with external criteria were compared. Application areas of the scales are discussed.
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Emotion regulation research links regulatory responding to important outcomes in psychological well-being, physical health, and interpersonal relations, but several fundamental questions remain. As much of the previous research has addressed generalized regulatory habits, far less is known about the ways in which individuals respond to emotions in daily life. The literature is particularly sparse in explorations of positive emotion regulation. In the current study, we provide an assessment of naturalistic experiences and regulation of emotion, both positive and negative in valence. Using an electronic experience sampling methodology, participants reported on their use of 40 regulatory strategies in response to 14 emotions for 10 consecutive days. On average, participants used 15 different regulatory strategies in response to negative emotions over this time, most frequently relying on acceptance, behavioral activation, and rumination. Participants used a similarly large repertoire of strategies, approximately 16 total, in response to positive emotions, particularly savoring, future focus, and behavioral activation. Participants' mood ratings following strategy use, however, indicated that the most frequently used strategies were often not the most effective strategies. The results of this study provide estimates of the frequency and effectiveness of a large number of emotion regulation strategies in response to both negative and positive emotions. Such findings characterize naturalistic emotion regulation, and estimates of normative emotion regulation processes are imperative to determining the ways in which deviations (e.g., small emotion regulation repertoires, insufficient attention to regulation of positive emotions) impact emotional functioning. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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Objective To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder. Method Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n = 25) or ACT (n = 25) for DSM-IV social anxiety disorder. Results Multilevel modeling analyses revealed significant non-linear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the non-linear effect) of experiential avoidance during treatment significantly mediated post-treatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of AAQ at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower post-treatment social anxiety and depressive symptoms. Conclusions Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT.
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Structural equation modeling (SEM) is a vast field and widely used by many applied researchers in the social and behavioral sciences. Over the years, many software pack-ages for structural equation modeling have been developed, both free and commercial. However, perhaps the best state-of-the-art software packages in this field are still closed-source and/or commercial. The R package lavaan has been developed to provide applied researchers, teachers, and statisticians, a free, fully open-source, but commercial-quality package for latent variable modeling. This paper explains the aims behind the develop-ment of the package, gives an overview of its most important features, and provides some examples to illustrate how lavaan works in practice.
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The 62-item Multidimensional Experiential Avoidance Questionnaire (MEAQ) was recently developed to assess a broad range of experiential avoidance (EA) content. However, practical clinical and research considerations made a briefer measure of EA desirable. Using items from the original 62-item MEAQ, a 15-item scale was created that tapped content from each of the MEAQ's six dimensions. Items were selected on the basis of their performance in 3 samples: undergraduates (n = 363), psychiatric outpatients (n = 265), and community adults (n = 215). These items were then evaluated using 2 additional samples (314 undergraduates and 201 psychiatric outpatients) and cross-validated in 2 new, independent samples (283 undergraduates and 295 community adults). The resulting measure (Brief Experiential Avoidance Questionnaire; BEAQ) demonstrated good internal consistency. It also exhibited strong convergence with respect to each of the MEAQ's 6 dimensions. The BEAQ demonstrated expected associations with measures of avoidance, psychopathology, and quality of life and was distinguishable from negative affectivity and neuroticism. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
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Despite the increased attention that researchers have paid to social anxiety disorder (SAD), compared with other anxiety and mood disorders, relatively little is known about the emotional and social factors that distinguish individuals who meet diagnostic criteria from those who do not. In this study, participants with and without a diagnosis of SAD (generalized subtype) described their daily face-to-face social interactions for 2 weeks using handheld computers. We hypothesized that, compared with healthy controls, individuals diagnosed with SAD would experience fewer positive emotions, rely more on experiential avoidance (of anxiety), and have greater self-control depletion (feeling mentally and physically exhausted after socializing), after accounting for social anxiety, negative emotions, and feelings of belonging during social interactions. We found that compared with healthy controls, individuals with SAD experienced weaker positive emotions and greater experiential avoidance, but there were no differences in self-control depletion between groups. Moreover, the differences we found could not be attributed to comorbid anxiety or depressive disorders. Our results suggest that negative emotions alone do not fully distinguish normal from pathological social anxiety, and that assessing social anxiety disorder should include impairments in positive emotional experiences and dysfunctional emotion regulation (in the form of experiential avoidance) in social situations. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
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Background: There is limited research on the applicability and effectiveness of Acceptance and Commitment Therapy (ACT) for people experiencing psychotic disorders. Clinical trials suggest ACT may be efficacious in reducing distress and rehospitalization rates in psychosis. Mindfulness and reduced literal believability of thought content have been associated with reduced distress for this population. Aims: To better understand ACT for psychosis, this study investigated clients' perspectives of the hypothesized active therapeutic processes of ACT. Method: Semi‑structured interviews, conducted with nine adults diagnosed with schizophrenia or schizoaffective disorder and persistent positive symptoms, were analysed thematically. Results: Four themes emerged: Usefulness of therapy; Changes attributed to ACT; Understanding of therapy; and Non-specific therapy factors. All participants found therapy useful and recommended ACT. Mindfulness, defusion, acceptance and values work were described as the most useful therapy components and contributing to positive changes. Self-rated frequency of symptoms did not change; however a reduction in the intensity and distress associated with symptoms was reported. Non-specific therapy factors were deemed useful by participants but not directly related to outcome. Conclusions: These findings are consistent with the theoretically defined underlying active processes of ACT and are relevant for this population. The findings also indicate important clinical implications for ACT for this client group: greater attention to the client connecting metaphors and concepts to the intended meaning may be valuable; caution should be used with some mindfulness and defusion techniques for intense experiences; and values work may be particularly useful for this population.
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Syndromal classification is a well-developed diagnostic system but has failed to deliver on its promise of the identification of functional pathological processes. Functional analysis is tightly connected to treatment but has failed to develop testable, replicable classification systems. Functional diagnostic dimensions are suggested as a way to develop the functional classification approach, and experiential avoidance is described as 1 such dimension. A wide range of research is reviewed showing that many forms of psychopathology can be conceptualized as unhealthy efforts to escape and avoid emotions, thoughts, memories, and other private experiences. It is argued that experiential avoidance, as a functional diagnostic dimension, has the potential to integrate the efforts and findings of researchers from a wide variety of theoretical paradigms, research interests, and clinical domains and to lead to testable new approaches to the analysis and treatment of behavioral disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The psychometric adequacy of the Social Interaction Anxiety Scale (SIAS; R. P. Mattick & J. C. Clark, 1989), a measure of social interaction anxiety, and the Social Phobia Scale (SPS; R. P. Mattick & J. C. Clark, 1989), a measure of anxiety while being observed by others, was evaluated in anxious patients and normal controls. Social phobia patients scored higher on both scales and were more likely to be identified as having social phobia than other anxious patients (except for agoraphobic patients on the SPS) or controls. Clinician-rated severity of social phobia was moderately related to SIAS and SPS scores. Additional diagnoses of mood or panic disorder did not affect SIAS or SPS scores among social phobia patients, but an additional diagnosis of generalized anxiety disorder was associated with SIAS scores. Number of reported feared social interaction situations was more highly correlated with scores on the SIAS, whereas number of reported feared performance situations was more highly correlated with scores on the SPS. These scales appear to be useful in screening, designing individualized treatments, and evaluating the outcomes of treatments for social phobia. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This article introduces a single-item scale, the Affect Grid, designed as a quick means of assessing affect along the dimensions of pleasure–displeasure and arousal–sleepiness. The Affect Grid is potentially suitable for any study that requires judgments about affect of either a descriptive or a subjective kind. The scale was shown to have adequate reliability, convergent validity, and discriminant validity in 4 studies in which college students used the Affect Grid to describe (a) their current mood, (b) the meaning of emotion-related words, and (c) the feelings conveyed by facial expressions. Other studies (e.g., J. Snodgrass et al; see record 1989-13842-001) are cited to illustrate the potential uses of the Affect Grid as a measure of mood. (PsycINFO Database Record (c) 2012 APA, all rights reserved)