Acceptance And Action Questionnaire-II Research Articles

The effects of the acceptance and commitment therapy on the experiential avoidance and intolerance of uncertainty of mothers with hearing-impaired children

Background and Aim: Children's hearing loss affects not only their speech and language dev­elopment but also their mothers’ mental health. This study aimed to determine the effect of acc­eptance and commitment therapy (ACT) on the intolerance of uncertainty and experiential avoi­dance of mothers with hearing-impaired or deaf children. Methods: This is a quasi-experimental study with the pretest-posttest design with a control group. The study population comprised all mot­hers of hearing-impaired or deaf children (2−6 years old) in Tabriz City, Iran. Using a purpo­sive sampling method, 32 mothers of hearing-impaired or deaf children were selected and then randomly assigned to control and experimental groups (each group, 16 subjects). The experim­ental group was treated with ACT in 8 sessions of 1.5 hours long in two weeks. The study data were collected by the Acceptance and Action Questionnaire-II (AAQ-II) and Intolerance of Uncertainty Scale (IUS). Results: The results showed that ACT signi­ficantly increased scores on the AAQ-II and IUS in the experimental group compared to the control group (p < 0.001). Conclusion: ACT might be an efficient way to decrease intolerance of uncertainty and avoid­ance of experience in the mothers of hearing-impaired and deaf children. Also, therapists can use this approach for improving the intolerance of uncertainty and experiential avoidance in mothers of hearing-impaired or deaf children in rehabilitation centers.

The mediating role of the metacognition, time perspectives and experiential avoidance on the relationship between childhood trauma and post-traumatic stress disorder symptoms

ABSTRACT Background: The current study was designed to investigate the direct and indirect effects of the childhood trauma, metacognition, time perspectives and experiential avoidance in prediction of post-traumatic stress disorder (PTSD) symptoms. Methods: Participants included 432 adult patients referred for treatment to psychological, psychiatric disorders clinics and medical clinics of Shiraz, Iran. They were exposed to a traumatic event according to criterion A in the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V). Childhood Trauma Questionnaire (CTQ), Post-traumatic Checklist for DSM-5 (PCL-5), Zimbardo Time Perspective Inventory (ZTPI), Acceptance and Action Questionnaire – II (AAQ-II) and metacognitions questionnaire-30 (MCQ-30) all were applied for data collection. Results: The results indicated that childhood trauma has a direct correlation with symptoms of PTSD, metacognition, and time perspectives, while it has an indirect correlation with experiential avoidance as well as symptoms of PTSD. Thus, metacognition and time perspectives play a mediating role between childhood trauma and experiential avoidance. In the same way, all three variables (metacognition, time perspectives, and experiential avoidance) play the same role between childhood trauma and symptoms of PTSD. Conclusions: Altogether, results of this study were consistent with the metacognitive model as well as Time Perspective Theory for PTSD and emphasizes that childhood trauma, metacognition, time perspectives and experiential Avoidance are important in explanation of PTSD symptoms.

Infertility-related stress and depressive symptoms – the role of experiential avoidance: a cross-sectional study

ABSTRACTObjective: The current study aimed to explore the mediating role of experiential avoidance in the relationship between infertility-related stress (impact of infertility in women’s life and representations about the importance of parenthood) and depressive symptoms.Background: Infertility is a stress inducing condition presenting many challenges to individuals facing this diagnosis, particularly to the ones who decide to pursue medical treatment. One of its consequences may be the experience of depressive symptoms which have also been associated with increased infertility-related stress. Moreover, experiential avoidance, conceptualised as an emotion regulation process, has also been connected to psychopathological symptoms, particularly depressive symptoms.Methods: The sample consisted of 124 women presenting an infertility diagnosis who were pursuing medical treatment for fertility problems. Participants were recruited through the national patients’ association website and completed the following self-report instruments: a sociodemographic and clinical questionnaire, the Acceptance and Action Questionnaire–II (AAQ-II), the Fertility Problem Inventory (FPI) and the Depression, Anxiety and Stress Scales 21 (DASS-21).Results: Results showed that representations about the importance of parenthood were associated with depressive symptoms indirectly, throughout the association with the impact of infertility in women’s life and use of experiential avoidance.Conclusions: Experiential avoidance can be considered a relevant emotion regulation process to be targeted in psychological intervention programs for women facing infertility.

RELATIONSHIP OF MODELS OF CONSISTENCY AND PSYCHOLOGICAL FLEXIBILITY WITH PERSECUTORY DELUSIONS

The goal of research is to assess the preference for consistency, cognitive fusion and experiential avoidance levels and their of persons with delusional persecution delusions, and interrelationship of these items. In addition, it was aimed to investigate the attitudes of individuals with persecution delusions towards the inconsistency of the relationship with other cognitions and their discomfort caused by inconsistency. The patient group with delusions consisted of 82 patients was who were diagnosed with schizophrenia, schizophreniform, schizoaffective disorder, delusional disorder, unspecified psychotic For the control group, 86 people who showed similar characteristics were included in the study Participants in both groups fill form for the Sociodemographic Data Form, Preference for Consistency Scale (PFC), Peters Delusion Inventory (PDI, only items for Persecutory Delusion), Cognitive Fusion Scale (CFQ), acceptance and Action questionnaire-II (AAQ-II) themselves. In addition, the Positive and Negative Syndrome Scale (PANSS, only positive symptom subscale) was applied by the researcher in the patient group with delusions. There was a significant difference between the patient group with delusions and the control group for the scores of PFC, AAQ-II and CFQ (p

Tip Fakultesi Ogrencilerinde Tukenmislik Derecesi Psikolojik Esneklik ve Degerler Arasindaki Iliskinin Incelenmesi

Burnout with its increasing prevalence has become a serious risk for medical students who experience challenging education process. Although many variables that affect burnout have been identified, the detection of interventions can provide an empirical basis for studies to reduce or prevent burnout. In this regard, our study aims to analyze burnout in terms of its correlation among values and psychological flexibility levels. The study was carried out with 81 fifth grade students doing internship in Cerrahpasa Medical Faculty during the fall semester of 2018-2019 academic year. In order to determine the socio-demographic characteristics of the research sample such as gender and age socio-demographic data form was used ,to state the levels of burnout in students Maslach Burnout Inventory Student Form was used, to evaluate the levels of psychological flexibility and rigidity, Acceptance and Action Questionnaire-II (AAQ-II) was used, and Values Scale was used to determine value preferences. Research findings show that psychological rigidity levels significantly predicted emotional exhaustion. It is shown that reduction in efficacy , another subscale of burnout, predicted by placing emphasis on intellectual values and the level of psychological rigidity. However there are low level significant relationship among burnouts subscales of cynicism, intellectual values and social values, it was found that these variables did not have a significant predictive power in regression analysis. In conclusion, our study provides preliminary data that attributing higher importance to intellectual values may reduce the burnout of efficacy, also it has shown that as psychological flexibility levels decrease, emotional burnouts increase where as perception of efficacy is decreases. The findings of the research are discussed with the relevant literature.

Association of psychological flexibility with engagement in pulmonary rehabilitation following an acute exacerbation of chronic obstructive pulmonary disease.

This study aimed to investigate (a) the association between psychological flexibility and engagement in pulmonary rehabilitation within 8 weeks following hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and (b) how psychological (in)flexibility presents in this context. A mixed-methods study was conducted. Psychological flexibility during an AECOPD was assessed using The Acceptance and Action Questionnaire-II (AAQ-II) (n = 41) and the Engaged Living Scale (ELS) (n = 40). Engagement in post-AECOPD pulmonary rehabilitation was then recorded. Twenty-three patients also participated in cognitive interviews. Psychological flexibility was associated with a greater chance of accepting a pulmonary rehabilitation referral following an AECOPD. Small numbers prohibited analysis on attendance or completion. An AAQ-II score of 11 translated to a 60 (37–82)% probability of accepting a referral to pulmonary rehabilitation and an ELS score of 73 was associated with a 68 (46–91)% probability of accepting. Four themes were extracted from interviews: (1) family values, (2) self as abnormal, (3) ‘can’t do anything’ versus ‘I do what I can’ and (4) disability, and related emotions, as barriers to action. Randomised clinical trials are needed to evaluate interventions designed to increase psychological flexibility (i.e. acceptance and commitment therapy) to support acceptance of pulmonary rehabilitation post-AECOPD.

The Acceptance and Action Questionnaire-II (AAQ-II) as a measure of experiential avoidance: Concerns over discriminant validity

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.

The Acceptance and Action Questionnaire – II: an Item Response Theory Analysis

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.

The transdiagnostic model of worry: The mediating role of experiential avoidance

The aim of this study was to examine a transdiagnostic risk factor for predicting pathological worry among non-clinical population. The prediction model of worry was examined according to the propositions of the four cognitive models of generalized anxiety disorder; including intolerance of uncertainty model, metacognitive model, model of emotional schemas and acceptance-based model. Participants were 557 students whom were studied at University of Tehran in Iran. Data were gathered by Penn State Worry Questionnaire (PSWQ), Metacognitions Questionnaire-30 (MCQ-30), Leahy Emotional Schema Scale (LESS), Intolerance of Uncertainty Scale (IUS), and Acceptance and Action Questionnaire–II (AAQ-II). Structural equation modeling confirmed the proposed model and indicated that intolerance of uncertainty, metacognitive beliefs and emotional schemas predicted worry both directly and indirectly through experiential avoidance (χ2/df = 1.19, CFI = 0.98, NFI = 0.96, GFI = 0.97, SRMR = 0.03, RMSEA = 0.05). These risk factors had reciprocal relationships and experiential avoidance explained the commonalities between them as a linking mechanism. The variables in the model accounted for 74% of the variance in participants' worry. According to the examined model, individual differences in the ways people use to control their internal experiences and the process of inability to accept these experiences, act like vulnerability and maintenance mechanisms in explaining worry. The findings of this study support the rationale of recent psychotherapies for generalized anxiety disorders that emphasizes both the challenging cognitions and facilitating the acceptance of internal experiences.

Effects of Personality and Psychological Acceptance on Medical Workers' Occupational Stress

Objective: To assess psychological acceptance and occupational stress of medical staff, analyze the relationship among personality, psychological acceptance and occupational stress and discuss the direct or indirect effects of personality to occupational stress. Methods: Eysenck Personality Questionnaire (EPQ-RSC) , Acceptance and Action Questionnaire-II (AAQ-Ⅱ) and Revised Occupational Stress Inventory (OSI-R) were administered to 749 medical staff. Results: The level of occupational stress of medical staff was high, the score of PSY was 26.8±7.13 and the score of PHS was 24.3±6.50. Personality and psychological acceptance can predict occupational stress. Psychological acceptance was a protective factor of occupational stress. Medical staff with personality of introversion, neuroticism and psychoticism suffered higher occupational stress. Personality have both direct and indirect effects on occupational stress. Neuroticism have the strongest effect on occupational stress with effect size of 0.496 (psychological stress) and 0.431 (physical strain) . Conclusion: Medical staff have heavier occupational stress. There is a significant correlation between personality and occupational stress. Measures depending on personality should be taken to deal with this situation.

Psychological inflexibility in overweight and obese people from the perspective of acceptance and commitment therapy (ACT).

To identify the psychological inflexibility (PI) processes (experiential avoidance, cognitive fusion, poor contact with the present moment, unclear personal values and lack of commitment to action) associated with body mass index (BMI), depression, anxiety and stress symptoms and binge eating in overweight and obese people by drawing on the acceptance and commitment therapy (ACT) framework. A cross-sectional study of 243 people with a BMI of at least 25 and aged from 18 to 60years old. The following instruments were used: Acceptance and Action Questionnaire II (AAQ-II), Acceptance and Action Questionnaire-Weight (AAQ-W), Valued Living Questionnaire (VLQ), Cognitive Fusion Questionnaire (CFQ-7), Cognitive Fusion Questionnaire-Body Image (CFQ-BI), Mindful Eating Questionnaire (MEQ), Binge Eating Scale (BES) and Depression, Anxiety and Stress Scale (DASS-21). Data were analyzed using one-way ANOVA and t tests. There were no differences between BMI categories with respect to PI variables, but PI was positively related to the severity of binge eating and to symptoms of depression, anxiety and stress. The development of interventions focused on psychological inflexibility can be useful for the treatment of symptoms associated with overweight and obesity. Level V, cross-sectional descriptive study.

Validation of the Hungarian version of the Acceptance and Action Questionnaire-II (AAQ-II)

The Acceptance and Action Questionnaire-II (AAQ-II) is a broadly used measure of psychological inflexibility, defined as the rigid dominance of psychological reactions over chosen values, in guiding action. This may represent a transdiagnostic process that has been linked to a wide range of mental problems and health issues. The present study aims to validate this instrument for Hungarian and then evaluate its psychometric properties and factor structure. The total sample consisted of 1065 Hungarian-speaking participants, divided into two groups (No treatment history: participants without previous psychiatric/psychological treatment; Treatment history: participants who underwent psychiatric/psychological treatment). The results of this study were similar to the ones obtained in the original version of the AAQ-II and in other language versions. The internal consistency of the instrument was .90 and the hypothesized factor structure showed good fit with the data. Partial measurement invariance was found across gender and sample. The average AAQ-II scores were significantly higher in the Treatment history group than the No treatment history group. On the one hand, psychological flexibility positively correlated with depression, anxiety, stress, general psychological distress and nonadaptative coping styles. On the other, it negatively correlated with psychological wellbeing, life satisfaction, health status and healthy coping style. These findings suggest that the Hungarian version of the AAQ-II is a valid questionnaire which further supports psychological inflexibility as a universal construct across different languages and cultures.

Developing professional caregivers’ empathy and emotional competencies through mindfulness-based stress reduction (MBSR): results of two proof-of-concept studies

ObjectivesTo assess the feasibility and acceptability of a mindfulness-based stress reduction (MBSR)-based intervention and determine if the intervention is associated with a significant signal on empathy and emotional competencies.DesignTwo pre–post...

The role of anxiety and depression on acceptance and action, considering emotional schemas in diabetics of Birjand (Iran).

BackgroundDiabetes is one of the most common noncommunicable diseases around the world that accompanies assorted psychiatric disorders including anxiety and depression due to being chronic.ObjectiveThe aim of this study was to evaluate the effect of anxiety and depression on acceptance and action, considering emotional schemas of diabetics referring to diabetes clinics of health centers in Birjand, Iran.MethodsThis study was conducted in 2016 and was a correlational study with a structural equation modeling approach. The statistical population of this study were all men and women with type 2 diabetes in Birjand, with an active health record in health centers of this county. To collect data, Depression, Anxiety, and Stress Scale (DASS-21), Acceptance and Action Questionnaire-II (AAQ-II) and Leahy Emotional Schema Scale (LESS) were employed. Using SPSS19 and LISREL, data were analyzed via multiple regression and modeling at p≤0.05.ResultsIn general, 350 subjects entered the study, most of whom were between 50 and 60 years of age and of whom, (47.7%) were women. Results show that depression has had a negative contribution in predicting quality of life (p=0.0001). In addition, results demonstrated the negative relation of anxiety and depression in predicting no emotional avoidance (flexibility) (p=0.0001). Anxiety and rumination had a positive effect and emotional unawareness had a negative effect on predicting no emotional avoidance (p=0.0001).ConclusionResults of this study showed that by reducing adaptive emotional schemas, emotions reduce psychological flexibility and increase emotional avoidance. In addition, by increasing non-adaptive emotional schemas, it increases no flexibility and emotional avoidance that finally reduces quality of life as well as acceptance and action.

Experiential Avoidance: An Examination of the Construct Validity of the AAQ-II and MEAQ

Experiential avoidance (also referred to as acceptance or psychological flexibility) is a core construct of third-wave behavior therapies. It is the tendency to avoid uncomfortable thoughts or feelings, even when doing so has negative long-term consequences. In order for developments in experiential avoidance and third-wave behavior therapies to continue, it is imperative to examine the construct validity of the most widely used measures of this construct, the Acceptance and Action Questionnaire–II (AAQ-II) and the Multidimensional Experiential Avoidance Questionnaire (MEAQ). In Amazon’s Mechanical Turk (N = 1,052) and college (N = 364) samples, we evaluated the construct validity of these measures. The AAQ-II demonstrated suboptimal patterns of convergent and discriminant validity with measures of neuroticism/negative affect (Big Five Inventory, Big Five Aspects Scale, Positive and Negative Affect Schedule), the MEAQ, and mindfulness (Five Factor Mindfulness Questionnaire). In contrast, the MEAQ demonstrated optimal convergent and discriminant validity. Factor analyses at the scale, subscale, and item levels demonstrated that the AAQ-II loads with indicators of neuroticism/negative affect and not with other constructs at the core of third-wave behavior therapies. In contrast, the MEAQ loads on factors with mindfulness or forms its own factors. These findings suggest the AAQ-II functions as a measure of neuroticism/negative affect, whereas the MEAQ functions as an indicator of experiential avoidance. These findings have substantial implications for research on experiential avoidance and third-wave behavior therapies. Therefore, in order to improve the theory, research, and practice of third-wave behavior therapies, we recommend using the MEAQ to assess experiential avoidance.

Greek Version of the Avoidance and Fusion Questionnaire for Youth: Psychometric Evaluation and Gender Multigroup Invariance in Adolescents

The Avoidance and Fusion Questionnaire for Youth–Eight-Item Short Version (AFQ-Y8) assesses psychological inflexibility in youth. The present study is the first to examine alternative measurement models for the Greek adaptation of the AFQ-Y8, latent associations with the Acceptance and Action Questionnaire–II (AAQ-II), gender-group invariance, and latent mean comparisons between males and females. In total, 432 students from seven high schools in Cyprus participated in the study. Both a unidimensional and a two-dimensional model had excellent fit, although the one-factor solution was substantively superior. The correlation of the latent AFQ-Y8 factor with AAQ-II was strong and positive, indicating good convergent validity. Finally, the unidimensional AFQ-Y8 model was found to be invariant for gender and no latent means difference was detected between males and females.

Examining the Relationship Between Mindfulness and Multicultural Counseling Competencies in Counselor Trainees

This exploratory study examined the relationship between mindfulness and multicultural counseling competencies (MCC) in counselor trainees. One hundred fifty-seven masters and doctoral students in counseling and therapy-related fields completed a survey containing the Multicultural Counseling Inventory (MCI), Five-Facet Mindfulness Questionnaire (FFMQ), and the Acceptance and Action Questionnaire-II (AAQ-II). Pearson product-moment correlation coefficients were calculated between scales and subscales of the MCC, mindfulness, and acceptance. A hierarchical regression was used to examine the association of mindfulness and mindfulness practices (the total length of mindfulness practice and the duration of weekly mindfulness practice) on MCC along with multicultural training (number of multicultural counseling courses and practica completed) and demographic factors. The results of the study showed that mindfulness and MCC were positively and strongly correlated (r = .48, p < .01). Moreover, all mindfulness facets were positively and significantly correlated with MCC and majority of its subscales. The results suggested that individuals who believed themselves to be more mindful in their daily lives (especially those who reported observing and describing their experiences without automatically reacting) also tended to think of themselves as more multiculturally competent. In addition, mindfulness and mindfulness practices contributed a significant amount of additional variance on MCC and its subscales above and beyond the multicultural training and demographic variables. Study limitations and directions for future research were discussed.

Measuring Experiential Avoidance: Evidence toward Multidimensional Predictors of Trauma Sequelae.

The current study sought to investigate measurement discrepancies in self-report assessment of experiential avoidance (EA). Recent research indicates that EA may be more appropriately conceptualized as a multidimensional construct, operationally defined in terms of specific avoidance strategies. To test this notion, EA was measured using two self-report assessment instruments, the Acceptance and Action Questionnaire-II (AAQ-II) and the Multidimensional Experiential Avoidance Questionnaire (MEAQ) in a convenience sample of university students. Measurement differences across measures and unique contributions to prediction of posttraumatic stress symptoms (PTSS) and engagement in problematic behaviors were evaluated. Both the AAQ-II and MEAQ were found to significantly mediate the effect of childhood trauma exposure on PTSS. However, when levels of PTSS were dummy coded into dichotomies of those with a likely PTSD diagnosis and those without, the MEAQ was a stronger predictor of symptoms for those with a likely PTSD diagnosis than the AAQ-II. These results provide initial support for the discriminant validity of the MEAQ, which appears to be a more specific predictor of trauma-related symptoms.

Turkish Version of Acceptance and Action Questionnaire-II (AAQ-II): A reliability and Validity Analysis in Clinical and Non-Clinical Samples

Objective: Acceptance and Action Questionnaire-II (AAQ-II) is a self-evaluating scale that has been developed for assessing psychological inflexibility levels. The aim of the present study is to ex...

Validation and invariance testing of the Greek adaptation of the Acceptance and Action Questionnaire -II across clinical vs. nonclinical samples and sexes

The Acceptance and Action Questionnaire-II (AAQ-II) is a measure of experiential avoidance (EA), defined as the tendency to escape or avoid private psychological experiences, even when doing so is futile or interferes with valued actions (Hayes et al., 1996). Recent efforts have established the generalizability of this construct across different European cultures and languages and have established it as a deleterious psychopathological process. However, phenomenological differences of this construct between clinical vs. non-clinical samples have not yet been compared. The aim of the present study is to investigate the psychometrics of the Greek adaptation of the AAQ-II and examine measurement equivalence and scale invariance between different groups (sexes, clinical vs. nonclinical), before conclusions about the transdiagnosticity of this measure can be drawn. The total sample consisted of 274 (87 clinical outpatients; 75.8% female) Greek-speaking participants. Results suggest that the AAQ-II Greek translation has good psychometric properties, with high internal consistency, test-retest reliability, high correlations with similar constructs, and a unifactorial structure. Weak measurement invariance between clinical and non-clinical groups was established but scalar invariance failed. Regarding the sexes, invariance was established at all levels suggesting that EA can be considered a deleterious process irrespective of sex.