Action Questionnaire Research Articles

Implementing acceptance and commitment therapy for adherence to antiretroviral therapy: a randomized study

The objective of the research was to evaluate the effectiveness of ACT in optimizing adherence to ART. A quantitative study was conducted with a Solomon experimental design and follow-up. The sample comprised 84 seropositive patients randomly selected and distributed into four groups, two experimental and two controls. Symptoms of anxiety and depression (Hospital Anxiety and Depression Scale), level of treatment adherence (Questionnaire for Adherence to Treatment for HIV / AIDS) and experiential avoidance (Acceptance and Action Questionnaire) were measured. An ACT-based group intervention protocol was applied to the experimental groups, consisting of eight sessions. The results showed negative correlation between adherence and experiential avoidance, anxiety and depression. They also showed positive effects of ACT-based intervention on adherence to ART, with increase in adherence in the experimental groups and statistical difference in adherence in comparison with the control groups, according to the ANOVA test. It is concluded conclude that ACT is effective in optimising adherence to ART, allowing for behavioural changes that promote adaptation to diagnosis and treatment and reducing the presence of avoidance behaviours and emotional involvement.

Adverse childhood experiences and profiles of healthy orthorexia versus orthorexia nervosa: towards an explanatory model of orthorexia as a multidimensional eating style

BackgroundOrthorexia is a complex phenomenon comprising distinct dimensions, including orthorexia nervosa (ON) and healthy orthorexia (HO). However, little is known about the factors influencing these dimensions, their disparities, and the psychological factors underlying orthorexia behaviours.ObjectivesThis study aims to explore ON versus HO dimensions and the predictive role of adverse childhood experiences (ACEs) in a nationally representative sample of Polish individuals. In addition, we aim to investigate the mediating roles of alexithymia, embodiment, and experiential avoidance levels in this association.MethodsA representative sample of Polish adults (n = 3557) participated in this study. Dimensions of orthorexia (HO, ON) were assessed using the Teruel Orthorexia Scale, while ACEs were evaluated using the Adverse Childhood Experiences Questionnaire. Levels of alexithymia were measured using the Toronto Alexithymia Scale, experiential avoidance through the Acceptance and Action Questionnaire, and embodiment intensity via the Experience of Embodiment Scale.ResultsCluster analysis identified two distinctive orthorexia profiles in the whole sample, i.e., HO (n = 469) and ON (n = 1217), alongside three intermediate HO/ON profiles (n = 1871). The number of ACEs predicted ON tendencies as opposed to HO behaviours in participants. The mediating role of alexithymia, experiential avoidance, and embodiment in the association between ACEs and ON was also observed.ConclusionsOur study suggests that orthorexia is a multidimensional eating style shaped by socio-cultural factors. Adverse childhood experiences may be related to ON behaviours by mediating psychological factors such as experiential avoidance, alexithymia, and embodiment. Effective education and collaborative support are necessary for addressing ON tendencies.

A 6-Week Mindfulness-Acceptance-Commitment Intervention to Improve Professional Ballet Dancers' Psychological States Around Performance.

Background: Mindfulness and acceptance-based approaches have been trialled in professional sport. The present pilot study was a randomized controlled trial with professional ballet dancers investigating the effectiveness of the Mindfulness-Acceptance-Commitment (MAC) approach, developed for athletes, compared to an education program which included topics relevant to ballet and performance. Methods: Participants included 16 professional ballet dancers (2 men and 14 women) who were randomly assigned into either the MAC or education group for 1 session per week, for 6 weeks. Participants were assessed pre-and post-intervention using the Mindfulness Inventory for Sport (MIS) and the Acceptance Action Questionnaire (AAQ-II). Within 2 weeks of the final mindfulness session, all participants completed a semi-structured interview. Results: No differences were found when comparing the questionnaire responses between pre- and post- intervention, nor between the MAC group and the control group at post intervention for all subscales. Although dancers reported in the interviews that the sessions were valuable, they advised their ability to dedicate time to mindfulness ongoing would be challenging. Conclusions: Mindfulness interventions, as explored in this study, show promise to promote the well-being of professional ballet dancers. For consistent and ongoing mindfulness practice, future designs should seek to embed mindfulness practice into dancer and company schedules.

Effectiveness of Acceptance and Commitment Therapy on Psychotic Severity Among Inpatients With Primary Psychoses: A Randomized Controlled Trial.

This study investigated the effectiveness of acceptance and commitment therapy (ACT) compared to treatment as usual in managing psychotic symptoms, emotional dysregulation, recovery and psychological flexibility in inpatients with primary psychoses. The Primary outcome assessed the positive and negative syndrome scale, while the secondary outcomes were to assess difficulties in the emotion regulation scale, recovery assessment scale and acceptance and action questionnaire. An open-label, two-arm parallel randomized controlled trial was conducted. Participants diagnosed with primary psychoses were randomly assigned to either the ACT (n = 33) or treatment-as-usual (n = 32) group. The intervention included six structured sessions of ACT. ACT significantly reduced psychotic symptoms from 128 to 104 (Z = 5.01) compared to treatment as usual from 130 to 117 (Z = 4.88). Emotional regulation improved significantly in the ACT group from 73 to 55 (Z = 4.835) compared to treatment as usual from 73 to 70 (Z = 2.406). Recovery increased in the ACT group from 50 to 88 (Z = 5.01) compared to treatment as usual from 51 to 61 (Z = 4.93). Psychological flexibility improved in the ACT group from 33 to 25 (Z = 4.98) compared to treatment as usual from 33 to 31 (Z = 4.75). Between-group differences after intervention were significant for psychotic symptoms, emotional regulation, recovery and psychological flexibility (Z = 2.356, 4.652, 3.881 and 4.453, respectively). Accordingly, the current study demonstrates the effectiveness of ACT in reducing psychotic symptoms and improving emotional regulation, recovery and psychological flexibility in patients with primary psychoses. Integrating ACT into standard care protocols can enhance treatment outcomes, offering a comprehensive approach to managing complex mental health conditions. Trial Registration: ClinicalTrials.gov identifier: NCT06160869.

Resilience in the face of pandemic: exploring the influence of psychological flexibility on turnover intentions and burnout among critical care nurses in COVID-19 hospitals

AimAssess the levels of psychological flexibility, burnout, and turnover intention among critical care nurses and assess the impact of psychological flexibility on burnout, and turnover intention among critical care nurses.BackgroundBurnout and turnover intentions among critical care nurses are rapidly increasing because of the challenges of COVID-19. There is a need for evidence-based interventions like psychological flexibility to be addressed in research to overcome those challenges.MethodsA descriptive correlational research. A convenient sample of 200 critical care nurses working in COVID-19 hospitals from two governorates in Egypt. The sociodemographic and clinical data sheet, the work-related acceptance and action questionnaire, the Copenhagen burnout inventory, and the adopted version of the staff nurses’ intention to leave the nursing profession questionnaire were used.ResultsThe majority of critical care nurses reported a moderate level of psychological flexibility (75.5%, Mean = 31.23), a moderate level of burnout (65.5%, Mean = 59.61), and low to moderate levels of intention to leave (73%, Mean = 5.95). Psychological flexibility has a statistically significant negative correlation with burnout (PC = -0.304, Sig = 0.000) and the intention to leave (PC = -0.258, Sig = 0.000). In addition, psychological flexibility has a predictable effect on decreasing burnout (R2 = 0.232) and intention to leave (R2 = 0.127) among critical care nurses.Conclusioncritical care nurses in COVID-19 hospitals reported varied levels of burnout and an intention to leave that must be considered. The effect of psychological flexibility on burnout and intention to turnover highlighted the importance of improving it among critical care nurses by applying acceptance and commitment therapy as a management intervention.

Intergenerational influence on children's pro-environmental behaviors: Exploring the roles of psychological richness and mindful parenting

Psychological richness, as one of the significant orientations in positive psychology, has received widespread attention. Despite findings indicating that adults' psychological richness significantly predicts pro-environmental behaviors, there is currently no research examining its potential involvement in the intergenerational transmission of environmental attitudes. To fill this gap, this study focuses on the dimension of parents' psychological richness, aiming to explore the positive antecedents of children's pro-environmental behaviors. We proposed and tested a chain mediation model to explore how mindful parenting and children's perceptions of parental behavior mediate the association between parental psychological richness and children's pro-environmental behaviors. This study encompasses 293 families from China, totaling 586 participants, with each family comprising one child and one primary caregiver. Parents and their children completed the Psychological Richness Scale, Mindful Parenting Scale, Perceived Parental Action Questionnaire, and Children's Pro-environmental Behaviors Scale, respectively. The results show that parental psychological richness is positively correlated with children's pro-environmental behaviors, and both mindful parenting and perceptions of parental action mediated this relationship. These findings extend the understanding of the intergenerational influence between parental psychological richness and children's pro-environmental behaviors, highlighting the potential importance of mindful parenting and children's perceptions of parental action in improving children's pro-environmental behaviors.

Relationship between Stigma, Psychological Flexibility, Positive and Negative Affect in Patients with Epilepsy

Background: Epilepsy is a neurological disorder that significantly impacts the daily lives of individuals, leading to psychological, social, and cognitive challenges. Despite advancements in its management, stigma remains a substantial issue for epilepsy patients. Objective: This study aimed to investigate the relationship between stigma, psychological flexibility, and positive and negative affect in patients with epilepsy. Methods: This cross-sectional study included 200 participants, with 100 epilepsy patients and 100 healthy individuals, aged 18 to 45 years, from four major cities in Punjab, Pakistan. Data were collected using convenience sampling. The instruments used were the Internalized Stigma of Mental Illness (ISMI) inventory (epilepsy version), the Cognitive Fusion Questionnaire (CFQ), the Acceptance and Action Questionnaire (AAQ-II), and the Positive and Negative Affect Schedule (PANAS). Data analysis was conducted using SPSS version 25. Descriptive statistics summarized the demographic and clinical characteristics, and independent samples t-tests were used to compare the groups. Results: Epilepsy patients had significantly higher levels of internalized stigma (ISMI total score: 84.05 ± 11.77) compared to healthy individuals (52.79 ± 13.67), t(198) = 17.33, p < 0.01. They also exhibited lower psychological flexibility (AAQ-II score: 39.23 ± 8.92 vs. 26.04 ± 10.07), t(198) = 9.81, p < 0.01, and higher cognitive fusion (CFQ score: 39.62 ± 9.19 vs. 27.56 ± 10.44), t(198) = 8.67, p < 0.01. Positive affect was lower in epilepsy patients (12.58 ± 4.13) compared to healthy individuals (15.30 ± 4.08), t(198) = 4.68, p < 0.01, while negative affect was higher (19.97 ± 4.51 vs. 14.89 ± 4.69), t(198) = -7.81, p < 0.01. Conclusion: The study demonstrated significant relationships between stigma, psychological flexibility, and affect in epilepsy patients. Addressing these factors is crucial for improving the psychological well-being and quality of life for individuals with epilepsy.

The mediating role of meaning in life between experiential avoidance and death anxiety among cancer patients: a cross-sectional study

BackgroundDeath anxiety is thought to cause a range of mental disorders among cancer patients, which may affect their mental health and even quality of life. This study sought to investigate experiential avoidance, meaning in life, and death anxiety among Chinese cancer patients and then explore the relationship between these 3 variables.MethodsA total of 300 cancer patients recruited from a tertiary cancer hospital participated in this study from October to December 2021. A cross-sectional survey was conducted using a demographic and clinical characteristics questionnaire, the Acceptance and Action Questionnaire II, the Meaning in Life Questionnaire, and Templer’s Death Anxiety Scale. Correlation analysis, hierarchical regression analysis, and mediating effect analysis were used to analyze the relationship among experiential avoidance, meaning in life (including 2 dimensions: presence of meaning and search for meaning), and death anxiety.ResultsA total of 315 questionnaires were distributed, and 300 valid questionnaires were returned, resulting in a valid response rate of 95.2%. Experiential avoidance (r = 0.552, p < 0.01) was moderately positively correlated with death anxiety. Presence of meaning (r = − 0.400, p < 0.01) was moderately negatively correlated with death anxiety, while search for meaning (r = − 0.151, p < 0.01) was weakly negatively correlated with death anxiety. Regression analysis showed that experiential avoidance (β = 0.464) and presence of meaning (β = −0.228) were predictors of death anxiety. Mediating effect analysis revealed that presence of meaning either completely or partially mediated the effect of experiential avoidance and death anxiety, and the indirect effect accounted for 14.52% of the total effect.ConclusionOverall, experiential avoidance predicts death anxiety in cancer patients, and meaning in life can mediate this effect. The results of this study provide a new path for studying the mechanism of death anxiety and suggest a more positive and promising strategy for its management.

Turkish Adaptation and Psychometric Properties of Acceptance and Action Questionnaire for Weight-Related Difficulties-Revised

The aim of this study was to adapt the revised Acceptance and Action Questionnaire for Weight-Related Difficulties-Revised (AAQW-R) into Turkish language and examine its psychometric properties in a nonoverweight sample. This cross-sectional study included predominantly female individuals (83.2%), and mean age of the sample was 21.5. Final sample size included 161 university students. AAQW-R was translated into Turkish and translated back into English. Internal consistency levels for the total AAQW-R score and its subscales (i.e., food as control, weight as barrier to living, and weight stigma) were obtained for reliability. Measures of general experiential avoidance (AAQ-II), body anxiety (SPAS), dysfunctional eating attitudes (EAT-26), anxiety symptoms (GAD-7) and subjective happiness (SHS) were examined for convergent and divergent validity. Confirmatory factor analysis was conducted to examine the factor structure of the scale. The three-factor structure model was a good fit to the data (χ2 [N = 161] = 81.27, p &lt; .001, RMSEA = .098, 90% CI [.072, .124]). The Turkish version of AAQW-R and the subscales indicated a good level of internal consistency (α value ranging between .70 and .87). AAQW-R was found positively correlated with general experiential avoidance, dysfunctional eating attitudes and anxiety symptoms, indicating support for convergent validity. No relationship between AAQW-R and subjective happiness demonstrated evidence for divergent validity. Overall, the Turkish version of AAQW-R is valid and reliable tool to measure weight-related experiential avoidance in nonoverweight sample.

Psychometric properties of the chinese version of multidimensional experiential avoidance questionnaire-30

BackgroundExperiential avoidance represents the tendency to avoid negative internal experiences, which is a key concept in Acceptance and Commitment Therapy. However, existing measures of experiential avoidance (i.e., Acceptance and Action Questionnaire–II, AAQ-II) have some limitations. This study aims to assess the psychometric properties of the Chinese version of Multidimensional Experiential Avoidance Questionnaire-30 (MEAQ-30) and provide evidence for the reliability and validity of this new instrument.MethodsTwo questionnaire surveys were conducted. The first sample (N = 546) was analyzed using classical test theory (CTT), and the second sample (N = 511) was analyzed using multidimensional item response theory (MIRT).ResultsCTT supported the six-factor structure of MEAQ-30, indicating good internal consistency and measurement invariance across genders. Furthermore, the Chinese version of MEAQ-30 showed satisfactory convergent and discriminant validity. The incremental validity test showed that after controlling for the effects of neuroticism and AAQ-II, the Chinese version of MEAQ-30 could still significantly predict depression, anxiety, and stress. MIRT indicated that 30 items had good discrimination and difficulty, and the six subscales were sufficiently reliable across the continuum of experiential avoidance.ConclusionThe Chinese version of MEAQ-30 has good reliability and validity and is suitable for assessing experiential avoidance among Chinese populations.

Systematicity of receiving mental health care predicts better subjective well-being of Ukrainians during the second year of the Russian invasion

PurposeThis study aims to develop and test a multivariable psychosocial prediction model of subjective well-being in Ukrainian adults (n = 1,248) 1.5 years after the 2022 Russian invasion of Ukraine.Design/methodology/approachThe research design followed the “Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis” checklist. The online survey combined a questionnaire on sociodemographic characteristics and specifics of living in wartime, as well as validated self-reported inventories: The Modified BBC Subjective Well-being Scale, Acceptance and Action Questionnaire – Version 2 and Connor–Davidson Resilience Scale-10.FindingsThe initially developed model was tested through regression analysis, which revealed nine variables as predictors of the subjective well-being scores within the sample, explaining 49.3% of its variance. Among them, the strongest were living with a friend and receiving mental health care systematically. They were almost twice as influential as forced displacement abroad and trauma exposure, which predicted lower well-being, and living with a spouse, which forecasted higher well-being scores. Two resilience subscales – adjustment and restoring and resistance – as predictors of better well-being and perceived unsuccess in life and age as predictors of lower well-being were relatively weaker but statistically significant.Originality/valueThe obtained results support the previous evidence on the essential role of accessible mental health services and social support in times of war, as well as the deteriorative effect of trauma exposure and forcible taking refuge on subjective well-being.

A pilot study of the effect of group-administered psilocybin on psychological flexibility and outcomes

AbstractPsychological flexibility has been proposed as a core process of change when psychedelics are used for therapeutic purposes, but to date empirical outcomes have only documented changes on the Acceptance and Action Questionnaire (AAQ-II), a very general measure of psychological flexibility. This pilot study measured outcomes from psilocybin administered in a retreat setting across a range of measures assessing aspects of psychological flexibility. Nine participants attended a 7-day psilocybin retreat and completed measures at baseline, 2-, and 6-month follow up. Participants demonstrated significant improvements in cognitive defusion (Cognitive Fusion Questionnaire), valued living (Valuing Questionnaire), and Self-Compassion (Self-Compassion Scale), as well as a trend towards increased overall psychological flexibility (AAQ). Other outcome and process measures included measures related to acute effects of the psilocybin, belief in oneness, social safeness, mental health, burnout and emotion expressivity. These results offer preliminary evidence that therapeutic benefits obtained from psilocybin experiences may be linked to changes in psychological flexibility.

A psychometric evaluation of the parental acceptance and action questionnaire (PAAQ) in parents of children with and without disabilities

Parental psychological inflexibility, particularly characterized by experiential avoidance, represents a significant risk factor for chronic stress and psychological distress. The Parental Acceptance and Action Questionnaire (PAAQ) is a context-specific instrument for the measurement of parental psychological inflexibility. This study aimed to evaluate the psychometric properties of the original composite version of the 19-item PAAQ across the three distinct Swedish samples; a community sample (n = 1018), a clinical sample of treatment-seeking parents of children with disabilities (n = 667), and a test-retest sample (n = 337). The Principal Axis Factoring of the PAAQ in the community sample yielded a 16-item, three-factor solution: 1) action-taking and flexibility in the parenting context, 2) experiential acceptance of internal experiences related to parenting, and 3) experiential acceptance of child's internal experiences. This factor model was supported by the confirmatory factor analysis in the test-retest sample. The associations observed with related constructs (r = between 0.49 and 0.61, p < 0.0001) indicated good discriminant validity. The Receiver Operator Characteristic analysis demonstrated that the PAAQ can effectively classify between the clinical and community sample, achieving 79% sensitivity and 68% specificity. The showed good test-retest reliability (r = 0.82). As anticipated, the parents in the clinical sample showed greater psychological inflexibility compared to parents in the community sample. To conclude, the 16-item Swedish version of the PAAQ demonstrates adequate to good psychometric qualities.

Standardization of the Korean Version of the Acceptance and Action Questionnaire for Obsessions and Compulsions in University Students and Patients With Obsessive-Compulsive Disorder.

The Acceptance and Action Questionnaire for Obsessions and Compulsions (AAQ-OC) is a version of the Acceptance and Action Questionnaire (AAQ) that specifically measures unwanted intrusive thoughts and responses (e.g., experiential avoidance) to them. This study aimed to investigate the reliability and validity of the Korean version of the AAQ-OC in clinical and nonclinical Korean samples. In this study, 561 university students and 121 patients with obsessive-compulsive disorder (OCD) completed the AAQ-OC and several other psychological scales. Descriptive, correlation, and exploratory and confirmatory factor analyses as well as group comparisons were conducted. The results of the exploratory and confirmatory factor analyses indicated a two-factor structure that best fits the data in the university sample: Factors 1 and 2 matched the original Valued Action and Willingness subscales, respectively. The reliability analyses revealed that the AAQ-OC and its factors had excellent internal consistencies. As regards the concurrent validity, the AAQ-OC and its factors had a positive correlation with the AAQ-II and Cognitive Fusion Questionnaire. Compared with the university students, the OCD patients had higher AAQ-OC scores, and their obsessive-compulsive symptoms, particularly the two symptom dimensions of responsibility for harm and mistakes and unacceptable thoughts, were significantly associated with the AAQ-OC and two subscales. The findings of this study confirm the reliability and validity of the Korean version of the AAQ-OC.

Validation of the Spanish version of the body image acceptance and action questionnaire (BI-AAQ-Spanish): Measurement invariance across cultures

The purpose of this study was to assess the psychometric properties of a Spanish version of the Body Image Acceptance and Action Questionnaire (BI-AAQ) and its recently developed 5-item version, the BI-AAQ-5. The BI-AAQ measures psychological flexibility/inflexibility regarding body image. A sample of Spanish adults (n = 938) completed the BI-AAQ and a battery of measures (including body mass index, psychological flexibility, exposure to and internalization of sociocultural body image expectations, body dissatisfaction, and eating disorder symptoms). Measurement invariance was tested against a U.S. American adult sample (n = 866) that completed the English version of the BI-AAQ. The unidimensional factor structure of the BI-AAQ and BI-AAQ-5 was replicated in both samples using confirmatory factor analysis, with model fit indexes ranging from adequate (e.g., CFI = 0.95) to excellent (e.g., CFI = 0.99). Internal consistency was good for both instruments across samples (α = 0.90 to 0.97). Measurement invariance analyses confirmed full configural and metric invariance and scalar partial invariance. The Spanish BI-AAQ and BI-AAQ-5 showed clear evidence of convergent and incremental construct validity. Both instruments’ scores correlated substantively with theoretically related variables. In addition, the results of a conditional process analysis showed that body-image psychological flexibility measured with either instrument moderated the mediated effect of pressure to conform to cultural ideals of body image on disordered eating through internalization of body image ideals and body dissatisfaction. We concluded both instruments are likely suitable for conducting cross-cultural research with Spanish and English-speaking samples.

The mediating role of psychological flexibility in the relationship between psychotic symptom severity and depression in individuals diagnosed with schizophrenia.

INTRODUCTION: Psychological flexibility may help people diagnosed with schizophrenia (PWS) cope with their psychotic symptoms and reduce their depressive symptoms, but the mechanism of this effect is unclear. To investigate whether psychological flexibility mediates the relationship between psychotic symptom severity and depression in PWS. A cross-sectional study was conducted, in which a total of 111 PWS were assessed with DSM-5 Clinician-Rated Dimensions of Psychosis Symptom Severity, Calgary Depression Scale for Schizophrenia and Acceptance and Action Questionnaire. Data analysis was performed using SPSS 25 and PROCESS macro. Significant correlations were found between psychotic symptoms, depression and psychological flexibility. Psychological flexibility partially mediated the relationship between psychotic symptom severity and depression. Psychological flexibility could weaken the impact of psychotic symptom severity on depression in PWS. Higher psychotic symptoms were associated with lower psychological flexibility and higher depression. Interventions to improve psychological flexibility may prevent depressive symptoms in PWS. Psychiatric nurses can use psychological flexibility as a goal for evaluation and intervention.

Modeling the structural relationships between trauma exposure with substance use tendency, depression symptoms, and suicidal thoughts in individuals with earthquake trauma experience: the mediatory role of peritraumatic dissociation and experiential avoidance

BackgroundDespite the fact that studies indicate that earthquake trauma is associated with numerous psychological consequences, the mediating mechanisms leading to these outcomes have not been well-studied. Therefore, this study investigates the relationship between trauma exposure with substance use tendency, depression, and suicidal thoughts, with the mediating role of peritraumatic dissociation and experiential avoidance.MethodsThe descriptive-correlational approach was employed in this study. The participants were people who had experienced the Kermanshah earthquake in 2017. A total of 324 people were selected by convenient sampling method. The Traumatic Exposure Severity Scale, the Peritraumatic Dissociative Experiences Questionnaire, the Acceptance and Action Questionnaire, the Iranian Addiction Potential Scale, Beck’s Depression Inventory [BDI-II], and Beck’s Suicidal Thoughts Scale were used to collect data. The gathered data was analyzed‌ using structural equation modeling in ‌SPSS Ver. 24 and LISREL Ver. 24.ResultsThe study findings indicated that the intensity of the trauma exposure is directly and significantly associated with depression symptoms, peritraumatic dissociation, and experiential avoidance. The severity of exposure to trauma had a significant indirect effect on the tendency to use substances through experiential avoidance. This is while the severity of the trauma experience did not directly correlate with substance use and suicidal thoughts. In addition, peritraumatic dissociation did not act as a mediator in the relationship between the severity of trauma exposure with substance use, depression, and suicidal thoughts.ConclusionsThe severity of exposure to the earthquake was associated with symptoms of depression and these findings indicate the importance of experiential avoidance in predicting the tendency to use drugs. Hence, it is essential to design and implement psychological interventions that target experiential avoidance to prevent drug use tendencies and to establish policies that lower depression symptoms following natural disasters.

Role of family communication patterns as predictors of behavioral health among students of public universities in north of Iran.

Communication is one of the oldest and greatest human achievements and the basis of social life. The aim of this study was to evaluate the role of family communication patterns as predictors of behavioral health among students of public universities in the north of Iran. In this cross-sectional study, a total of 461 students from all the public universities of Babol, Iran, were selected in 2019. A stratified sampling random method was used to select the samples. The demographic characteristics, Depression Anxiety Stress Scale, Acceptance and Action Questionnaire, Rosenberg self-esteem questionnaire, and Communication Skills Interpersonal Test were used to collect data. Simple and multi-variate linear regressions as well as Pearson's correlation coefficient were utilized for data analysis. The mean and standard deviation scores of conversation orientation and conformity orientation were 35.61 ± 0.55 and 19.31 ± 0.41, respectively. Family conversation orientation was a significant predictor of behavioral health scales of students (except for acceptance and action), predicting negatively and significantly depression, anxiety, stress, and positively self-esteem and inter-personal communication skills of students. Family conformity orientation was also a significant predictor of behavioral health scales (except for inter-personal communication skills) of students, which predicted positively and significantly depression, anxiety, stress, and negatively acceptance, action, and students' self-esteem. To prevent behavioral health problems, it is necessary to observe conformity orientation and rely on conversation orientation.

The relationship between postpartum negative life events and postpartum depression: a moderated mediation model of neuroticism and psychological flexibility

BackgroundPostpartum depression (PPD) is a major public health problem worldwide. Previous studies have shown that postpartum negative life events and neuroticism are both important risk factors for PPD. However, few studies have considered the role of protective factors in the influence of postpartum negative life events and neuroticism on PPD. Based on the diathesis–stress model and Acceptance and Commitment Therapy (ACT), a moderated mediating model was established to examine the mediating role of neuroticism between postpartum negative life events and PPD, as well as the moderating role of psychological flexibility in this mediating effect.MethodsA sample of 776 parturients from three different Grade A hospitals in China were assessed using the Edinburgh Postpartum Depression Scale, the Postpartum Negative Life Events Scale, the Neuroticism Subscale of the Big Five Personality Scale, and the Acceptance and Action Questionnaire– II.ResultsPPD, postpartum negative life events, neuroticism, and experiential avoidance were significantly positively correlated with one another. Neuroticism partially mediated the relationship between postpartum negative life events and PPD. In this mediation model, the direct path and the second half of the mediation path were moderated by psychological flexibility. Specifically, the links between postpartum negative life events and PPD, as well as between neuroticism and PPD, were stronger when psychological flexibility was low, but weaker when psychological flexibility was high.ConclusionsThe results show that psychological flexibility plays an important role in buffering the negative effects of postpartum negative life events and neuroticism on PPD. These findings provide implications for the prevention and intervention of PPD using an ACT approach.

The effect of childhood sexual abuse on depressive symptoms in female college students: a serial mediation model.

Childhood sexual abuse (CSA) can have a negative impact on women's psychological, emotional and social functioning. The purpose of this study was to explore the relationship between CSA and depressive symptoms in female college students, as well as the mediating roles of negative core schema and experiential avoidance. 515 female college students responded to the Sexual Abuse subscale of the Childhood Trauma Questionnaire, the Depression subscale of the Depression Anxiety Stress Scale, the Brief Core Schema Scales, and the Acceptance and Action Questionnaire - II. The structural equation modeling was used for the mediation analysis. There was a significant positive correlation between CSA and depressive symptoms in female college students. The theoretical model was well fitted, χ2/df = 3.422, RMSEA = 0.069, CFI = 0.929, TLI = 0.919. The negative core schema played a mediating role between CSA and depressive symptoms. Experiential avoidance played a mediating role between CSA and depressive symptoms. The negative core schema and experiential avoidance played a serial mediating role between CSA and depressive symptoms. These results deepen our understanding of the relationship between CSA and depressive symptoms in female college students, and provide theoretical guidance for the prevention of depression in female college students. Attention should be paid to female college students who have experienced CSA, to eliminate the adverse influence of negative core schema on these students. Meanwhile, we should teach female college students to accept themselves as they are, and thereby reduce their use of experiential avoidance strategies.