Components Of Psychological Flexibility Research Articles

Just as Essential: The Mental Health of Educators During the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic deleteriously impacted physical and mental health. In the summer of 2020, return-to-learn plans were enacted, including virtual, hybrid, and in-person plans, impacting educators and students. We examined (1) how return-to-learn plan was related to depressive and social anxiety symptoms among educators and (2) how psychological flexibility related to symptoms. Educators (N = 853) completed a survey via Qualtrics that assessed internalizing symptoms, psychological flexibility, and occupational characteristics. Two one-way analyses of variance (ANOVAs) examined between-group differences in return-to-learn plans across depression and social anxiety. Two hierarchical linear regressions examined the relation between psychological flexibility components and depressive and social anxiety symptoms. Median T-scores were well above the national normative means for General Depression (median T-score: 81) and Social Anxiety (median T-score: 67). There were no significant differences between reopening plans in general depression nor social anxiety T-scores. Psychological flexibility accounted for 33% of the variance in depressive symptoms and 24% of the variance in social anxiety symptoms. Results indicated high levels of psychiatric symptoms among educators during COVID-19, and psychological flexibility was associated with lower symptoms. Addressing educator mental health is of utmost importance in future research.

Cancer, now what? A cross-sectional study examining physical symptoms, subjective well-being, and psychological flexibility

ABSTRACT Background: The impact of cancer extends beyond treatment and evaluating the adverse psychological effects in survivors is important. We examined: (1) the relationship between diagnosis, relapse, and subjective well-being using a short and a holistic measure of well-being, including comparisons between our sample and established norms; (2) if reported physical symptoms were related to components of subjective well-being; and (3) if increased psychological flexibility predicted overall subjective well-being. Methods: In total, 316 survivors completed online questionnaires to assess cancer, physical health (Edmonton Symptom Assessment Scale-R; ESAS-R), subjective well-being (Comprehensive Inventory of Thriving; CIT; Satisfaction with Life Scale; SWLS) and psychological flexibility (Comprehensive Assessment of Acceptance and Commitment Therapy). Results: Relative to ESAS-R cut-points (Oldenmenger et al., 2013), participants reported only moderate levels of tiredness and slightly elevated drowsiness, depression, and anxiety; participants reported more problems with psychological health. SWLS scores were lower than published norms (M = 18.23, SD = 8.23) and a relapse was associated with the lowest SWLS scores (M = 16.95, SD = 7.72). There were differences in thriving between participants and age-matched norms (Su et al., 2014). Participants reported lower community involvement, respect, engagement with activities, skill mastery, sense of accomplishment, self-worth, self-efficacy, autonomy, purpose, optimism, subjective well-being, and positive emotions coupled with higher loneliness and negative emotions. In regression analysis, two components of psychological flexibility, Openness to Experience, t = 2.50, p < 0.13, β = −0.18, and Valued Action, t = 7.08, p < 0.001, β = −0.47, predicted 28.8% of the variability in total CIT scores, beyond the effects of demographic and disease characteristics and reported physical symptoms. Conclusion: Cancer is an isolating experience, with the adverse psychological effects that impact subjective well-being continuing after the cessation of physical symptoms. Specific components of psychological flexibility may explain some variability in thriving beyond disease characteristics and may inform psychological intervention after diagnosis.

Family functioning and suicidal ideation in college students: a moderated mediation model of depression and acceptance.

To explore the mediating role of depression in the relationship between family functioning and suicidal ideation (SI) in college students, and to explore whether acceptance (It is one of the core components of psychological flexibility) plays a moderating role in this mediating model. In a cross-sectional study, questionnaires were distributed to college students during November and December 2022. The sample of Chinese college students (n = 592, 43.07% male, 56.93% female, mean age 19.40 years, SD = 1.24 years) completed the Family Adaptability and Cohesion Evaluation Scale (FACES III), the Center for Epidemiological Depression Scale (CES-D), the Positive and Negative Suicide Ideation Inventory (PANSI), and the Acceptance and Action Questionnaire-Second Edition (AAQ II). SPSS 25.0 for Windows and PROCESS 2.15 macros were used for data analysis. There was a significant negative correlation between family functioning and SI, and depression played a mediating role in this relationship. Acceptance moderated the indirect effects of depression and SI in college students. In college students with a lower acceptance level (i.e., higher experiential avoidance level), depression had more influence on SI, while the influence of depression on SI was less in college students with a higher acceptance level (i.e., lower experiential avoidance level). Family functioning indirectly influenced SI through the moderation of acceptance. Mental health educators in colleges and universities should pay more attention to identifying and relieving depression in college students, thereby dealing with suicide risk more effectively. At the same time, college students should be discouraged from excessive use of experiential avoidance strategies, and instead taught to master effective emotional regulation strategies such as mindfulness, distress tolerance, and radical acceptance skills to improve their acceptance level and alleviate the influence of depression on SI.

Diagnostics of psychological flexibility and the ability to cope with the inevitable changes among psychology students.

The study concerns the question of how much the emotional competence and the ability to cope with problems in one's own personality increase in the process of professional psychological education, for which students of different years of study were tested. The aim of this study is to deeply diagnose various components of psychological flexibility and the ability to cope with unexpected events among psychology students. The study involved 30 students from 1 to 4 years of university grade level participated into study, divided into 4 equal groups from. Based on testing various aspects of psychological flexibility, emotional intelligence test (EQ test), Emotion Regulation Questionnaire (ERQ) and D.V. Lyusin emotional intelligence instrument (Emin) were used; it was tested using Student's t-test and Kruskal-Wallis H-test to evaluate differences between three or more samples simultaneously. As a result of the study, the significant differences between all groups of participants and between the assessment of individual factors of psychological flexibility in different groups was accepted. Each of the groups demonstrated its specific characteristics of the relationship between emotional competence and coping with stress. Comparison of the results of students from different years of study showed that psychological education does not have a significant effect on emotional intelligence as an indicator of emotional flexibility, but positively affects the development of coping with stress, although in predominantly passive forms. The practical application of the research lies in improving psychology students' learning; the research results can be used as methods for determining psychological flexibility factors that require development in study groups.

The Iranian form of psychometric properties of the Multidimensional Psychological Flexibility Inventory

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.

Exploring the contribution of psychological flexibility processes and self-compassion to depression, anxiety and adjustment in parents of preterm infants

BackgroundThe preterm birth and subsequent hospitalisation of an infant is a challenging time for parents, leaving many parents vulnerable to depression, anxiety and difficulties with adjustment. Psychological flexibility and self-compassion have been theorised to enable effective functioning in such challenging contexts, which may help us understand variation in parental experiences and adjustment. PurposeTo investigate the extent to which psychological flexibility sub-processes (valued action, behavioural awareness, and openness to experience) and self-compassion explain variation in depression and anxiety and individual and relational adjustment among parents of preterm infants. MethodsA sample of 215 parents of preterm infants were recruited via a charity for children born preterm. Data was collected via online survey and analysed using multiple hierarchical regressions. ResultsPsychological flexibility and self-compassion were significant predictors of depression and anxiety in parents of preterm infants. Components of psychological flexibility were significant predictors of individual and relational adjustment while self-compassion was predictive of relational but not individual adjustment. However, the portion of variance accounted for by self-compassion after controlling for psychological flexibility was modest. Components of psychological flexibility but not self-compassion retained their predictive value for individual and relational adjustment when controlling for depression and anxiety. ConclusionsThis study provides preliminary evidence that psychological flexibility and self-compassion are helpful for understanding depression, anxiety and adjustment difficulties in parents of preterm infants and provides support for future development of acceptance-based interventions for this population.

Understanding Fatigue-Related Disability in Rheumatoid Arthritis and Ankylosing Spondylitis: The Importance of Daily Correlates.

Fatigue is common among people with inflammatory arthritis but is hard to manage. The aim of this study was to investigate how daily fluctuations in psychological variables correspond with changes in fatigue-related disability in the daily lives of people with inflammatory arthritis and to identify factors to target in psychological interventions and routine clinical practice. A cohort of 143 patients with rheumatoid arthritis (n = 97) or ankylosing spondylitis (n = 46) participated in a 10-day online diary study. Each evening participants completed a diary questionnaire assessing their fatigue, pain, fatigue-related disability, and 4 components of psychological flexibility (valued activity, mindfulness, cognitive fusion, and fatigue avoidance). On days when participants were more engaged in valued activities or more mindful, they reported less disability due to fatigue, even when controlling for levels of fatigue and pain that day. The daily psychological flexibility variables explained a total of 15.6% of the variance in daily fatigue-related disability. Psychological flexibility variables are directly associated with fatigue-related disability in the daily lives of inflammatory arthritis patients. Further research is needed to investigate whether interventions that target psychological flexibility are effective at reducing fatigue-related disability.

Drexel Ayrışma Ölçeği: Türkçe Versiyonu Geçerlik ve Güvenirlik Çalışması

Cognitive defusion is one of the components of psychological flexibility in Acceptance and Commitment Therapy. The purpose of this study was to translate the Drexel Defusion Scale (DDS) into Turkish and test its psychometric properties. This two-phase study was carried out with two groups of participants. The first phase, Exploratory Factor Analysis (EFA) included 370 university students (218 female, 152 male). The second phase, Confirmatory Factor Analysis (CFA) and divergent validity consisted of 715 university students (351 female, 364 male). The DDS measures the ability to achieve a distance from inner experiences like thoughts and feelings, and it consists of 10 scenarios on a six-point Likert-scale ranging from 0 (Not at all) to 5 (Very much). The DDS has a unidimentional factor structure. The CFA results confirmed the one-factor structure of Turkish DDS (T-DDS). The T-DDS also yielded satisfactory (α &amp;gt; .80) internal consistency and test-retest reliability (α = .81). Thus, findings revealed satisfactory reliability and validity evidence for the T-DDS.

The role of psychological flexibility in the context of COVID-19: Associations with depression, anxiety, and insomnia

Evidence for detrimental impacts of the COVID-19 pandemic on mental health and well-being around the world is now accumulating. As it does a next step is to understand how such effects can be mitigated, such as by studying psychological capacities that may afford people immunity against these impacts. In this study, we explore psychological flexibility (PF) and grit as potential resilience factors in the context of COVID-19. Standardized measures of depression, anxiety, and insomnia as well as measures of PF (committed action and inflexibility) and grit (perseverance of effort and consistency of interest) were administered through a large scale national online survey (N = 1102; mean age 36,9 years; 75% women). As predicted, the results show both PF and grit to be negatively associated with symptoms of depression, anxiety, and insomnia. Further, regression models including relevant background variables and both sets of resilience factors showed that total variance accounted for in symptoms of depression, anxiety, and insomnia was substantial, 50.5%, 49.5%, and 28.8%, respectively, with the PF components accounting for most of the explained variance in mental health. We conclude that PF and to a lesser extent grit may be important psychological resilience factors against mental health problems in the context of COVID-19. Our findings are practically important as they point to malleable public health targets during the ongoing pandemic of COVID-19 and in the event of similar widespread health threats in the future.

Relation between psychological flexibility, emotional intelligence and emotion regulation in adolescence

Abstract The aim of this study is to explore the relationships between components of psychological flexibility and emotional regulation strategies in adolescence. In addition, to find out what emotional dysregulation factors could affect psychological flexibility. The sample was made up of 516 adolescents with an average age of 14 years. Emotional regulation was assessed with emotion intelligence and difficulties in emotion regulation. Psychological flexibility was assessed with experiential avoidance, cognitive fusion and acceptance. Results support the importance of emotion regulation and the psychological flexibility factor in adolescence. We found a clear association between problems regulating emotions and psychological inflexibility. This study point out the importance of psychological flexibility and emotion regulation of youth. In which, behaviors that in the beginning are not dysfunctional or maladaptive can become psychopathological due to psychological inflexibility. These results can be considered for their clinical and educational implications, as they confirm the importance of acceptance and flexible emotion regulation strategies.

Psychological flexibility in the context of COVID-19 adversity: Associations with distress

The COVID-19 pandemic has led to hardship for individuals across the globe, and research to-date has indicated a significant impact of the pandemic on mental health functioning. In order to promote psychological resilience during this time, it is important to understand modifiable targets for clinical intervention. The current study examined demographic characteristics, pandemic-related adversity, and psychological flexibility in relation to general and peritraumatic distress in a sample of United States survey respondents during May of 2020. Participants were recruited from Amazon Mechanical Turk (MTurk), N = 485. Participants completed measures of pandemic-related adversity, psychological flexibility components (openness to experience, behavioral awareness, and valued action), peritraumatic distress, and general distress. Hierarchical regression analyses examined whether demographic characteristics, pandemic-related adversity, and components of psychological flexibility were associated with general and peritraumatic distress. Results indicated that higher pandemic-related adversity, lower openness to experience, and lower behavioral awareness were significantly associated with higher general distress. Greater pandemic-related adversity, lower openness to experience, lower behavioral awareness, and higher valued action were significantly associated with higher peritraumatic distress. Adding the components of psychological flexibility to the model increased the amount of variance accounted for in both measures of distress. The results indicated that psychological flexibility components may be particularly important targets for prevention and intervention efforts in the midst of the COVID-19 pandemic. Transdiagnostic interventions, such as Acceptance and Commitment Therapy, that target psychological flexibility may be useful as the impact of the pandemic continues to unfold.

Experiential avoidance and cognitive fusion mediate the relationship between body evaluation and unhelpful body image coping strategies in individuals with visible differences

Psychological flexibility, the capacity to be open to any internal stimuli and act in accordance with valued ends, has been identified as an explanatory variable in how people cope with body concerns. The role of psychological flexibility is unexplored in adults with an atypical appearance due to a health condition, injury, or medical treatment (collectively visible difference), who often encounter multiple day-to-day body image threats. Testing two core components of psychological flexibility, namely experiential avoidance (a desire to avoid or get rid of unpleasant internal experiences) and cognitive fusion (taking thoughts literally), can also provide a more precise theoretical model, with clearer implications for psychological intervention. This survey study investigated whether each psychological flexibility component mediated the relationship between body evaluation and two unhelpful body image coping strategies (behavioural avoidance and appearance-fixing behaviours) in 220 adults with various causes of visible difference. Controlling for demographic variables and subjective noticeability of visible difference, results suggest that cognitive fusion partially mediated the relationship for both body image coping strategies, and experiential avoidance partially mediated behavioural avoidance but not appearance-fixing behaviours. Cognitive fusion may be a particularly important cognitive process in the mechanisms underpinning unhelpful body image coping strategies in this population.

Evaluating the Open and Engaged Components of Acceptance and Commitment Therapy in an Online Self-Guided Website: Results from a Pilot Trial.

Online acceptance and commitment therapy (ACT) is promising for treating a range of psychological problems. Component research can further clarify which components are needed for optimal outcomes in what contexts. Online platforms provide a highly controlled format for such research. In this pilot trial, 55 adults were randomized to: ACT-Open (i.e., acceptance, defusion components), ACT-Engaged (i.e., values, committed action), or ACT-Combined (i.e., acceptance, defusion, values, committed action). Each condition was 12 sessions over 6 weeks, with assessments at baseline, post-treatment, and 4-week follow-up. ACT-Open, ACT-Engaged, and ACT-Combined all significantly improved from pre- to post-treatment on mental health, psychosocial functioning, and components of psychological flexibility. Compared to ACT-Combined, ACT-Open improved less on psychosocial functioning at post-treatment, and ACT-Engaged worsened on functioning at follow-up. The platform was acceptable with high satisfaction ratings. Results support the feasibility of conducting online ACT component research, which will be tested in a fully powered non-inferiority trial.

Functioning with fibromyalgia: The role of psychological flexibility and general psychological acceptance

ObjectivesFibromyalgia is a chronic condition characterised by widespread musculoskeletal pain, fatigue, mood disturbances, and cognitive difficulties. Psychological flexibility (PF), particularly acceptance of pain, has been associated with the physical and psychological functioning (functional status) of chronic pain patients. Further investigation is required to assess the unique contribution of PF model components to functional status in people with fibromyalgia. This study investigated the role of both pain‐related PF and general acceptance of psychological experiences in a fibromyalgia sample after accounting for self‐efficacy beliefs, the use of traditional pain management strategies, and demographic variables.MethodsParticipants with fibromyalgia (n = 339; 95% female) were recruited primarily from fibromyalgia social media‐based support groups and support services. Participants completed an online questionnaire measuring PF components, self‐efficacy, traditional pain management strategies, and functional status.ResultsPain‐related PF, general psychological acceptance, and self‐efficacy were significantly related to functional status, with higher levels of these variables associated with higher functioning. Use of traditional pain management strategies was not significantly related to functional status. Hierarchical multiple regression analysis demonstrated pain‐related PF explained a statistically significant but small (2%) amount of variance in functional status over and above self‐efficacy, traditional pain management strategies, and demographic variables. General psychological acceptance explained a further significant 2% of unique variance in functional status.ConclusionsPain‐related PF and general psychological acceptance added benefit to functioning of individuals with fibromyalgia. Nevertheless, this additional benefit was small, suggesting other psychological variables such as self‐efficacy may be more clinically relevant to functioning with fibromyalgia.

Psychological flexibility: positive implications for mental health and life satisfaction.

New wave therapies such as Acceptance and Commitment Therapy aim to cultivate people's psychological flexibility in order for them to live a satisfying life. Psychological flexibility has also a role in promoting mental health, which may mediate the relationship with life satisfaction. The aim of this study was to determine whether mental health mediates the effect of psychological flexibility on life satisfaction. A convenience sample of 140 adults (32 males, M = 36.50 years, SD = 12.22; 107 females, M = 38.46 years, SD = 12.81; and a 45-year-old person of unknown gender) completed an online questionnaire assessing psychological flexibility, mental health and life satisfaction. Three of the four hypothesized components of psychological flexibility (experiential acceptance, cognitive alternatives and cognitive control) contributed to the latent construct of psychological flexibility, but cognitive defusion failed to contribute. Psychological flexibility had a direct, positive effect on life satisfaction and the hypothesis that mental health would mediate this relationship was supported. The results suggest that psychological flexibility is important for one's mental health and that both are integral to life satisfaction. The results also support a continued focus on third-wave therapies in cultivating psychological flexibility.

Age, Pain Intensity, Values-Discrepancy, and Mindfulness as Predictors for Mental Health and Cognitive Fusion: Hierarchical Regressions With Mediation Analysis.

Background: Several studies have confirmed that higher levels of psychological flexibility predict better functioning for those suffering with chronic pain. However, few studies have investigated the role of the individual components of psychological flexibility within a chronic pain population in relation to aging specifically and the related indirect mediational processes.Aim: The present study aimed to compare how age, pain intensity, mindfulness, and values-discrepancy predicted mental health and cognitive fusion separately. It also explored the indirect process relations through the use of a mediated analysis.Methods: Two hundred and thirty three participants completed an online survey which included demographical questions as well as the following questionnaires; Short Form McGill Pain Questionnaire (SF-MPQ); General Health Questionnaire 12; Cognitive Fusion 7-Item Questionnaire (CFQ-7); Mindfulness Attention Awareness Scale (MAAS); and the Chronic Pain Values Inventory (CPVI). The relationships from the responses of the questionnaires and demographics were then analyzed through two hierarchical regression models followed by further mediation analysis.Results: In the first model, values-discrepancy, pain intensity, and mindfulness all predicted mental health, but age did not. However, age did account for a significant portion of the variance in the second model when cognitive fusion was used as the dependent measure. It was also found that cognitive fusion mediated the relationship between age and mental health.Conclusion: These results are discussed within the context of using indirect process relations of psychological flexibility and third wave therapies such as acceptance and commitment therapy for a chronic pain population.

Investigation of Psychological Flexibility in Patients with Schizophrenia

The application of psychotherapies in schizophrenia is becoming increasingly common. Although studies showing the effectiveness of Acceptance and Commitment Therapy (ACT) in patients with schizophrenia based on the psychological flexibility model are increased, there is insufficient information on the mechanisms of action. Our study aims to evaluate the validity of psychological flexibility and the relationship between clinical features in patients with schizophrenia. The study included participants between 18-65 years old, consisted of 110 patients who had been diagnosed with schizophrenia and 110 healthy individuals. Participants in both groups filled Sociodemographic Data Form, Cognitive Fusion Questionnaire(CFQ), Valued Living Questionnaire(VLQ), Self-as-Context Scale(SACS), Freibirg Mindfulness Inventory(FMI) and Acceptance and Action Questionnaire(AAQ-II), in addition, Positive and Negative Syndrome Scale(PANNS) was applied to schizophrenia group by clinicians. The patient and control groups were matched in terms of age, gender, and educational level;. The points in the schizophrenia group AAQ-II and CFQ were higher; and the points of SACS, FMI and VLQ were found lower. Furthermore, the PANNS positive subscale points, SACS, AAQ-II points on the schizophrenia group; PANNS negative subscale points with SACS, VLQ, FMI, AAQ-II points were found associated with each other. PANSS general psychopathology was associated with subscale scores of CCQ, VLQ, FMI and AAQ-II points, PANSS total scores were also associated with SACS, VLQ, FMI, AAQ-II. In this study, it was found that schizophrenia patients were more inflexible than healthy individuals. Our results also imply that psychological flexibility components are related to clinical features of patients. The contribution of the psychological flexibility model to the treatment of schizophrenia patients should be investigated with advanced clinical studies.

The role of psychological flexibility in relation to suicidal thinking in chronic pain.

Suicidal thinking (ST) is common in people with chronic pain. It is relevant as it can be associated with suicidal attempts, and typically reflects significant suffering. While little is known about the psychological processes that contribute to ST, current psychological models, such as the Psychological Flexibility (PF) model, could help guide further investigation. This study investigates relations between ST and components of PF in chronic pain. Participants were 424 adults attending treatment for chronic pain in the UK. Included in measures administered before treatment were standardized measures of depression, pain, pain-related interference, and measures of PF, including acceptance, cognitive defusion, committed action, and self-as-context. An item from the measure of depression was used to reflect ST. A large proportion of the sample reported ST, 45.7%. ST was uncorrelated with participant background characteristic, medications taken, or pain intensity. However, it was correlated with the presence of widespread pain, pain-related interference, and depression. Each component of PF was found to be significantly negatively associated with ST, as predicted. General acceptance correlated with ST at a level equal to that achieved by the depression score. In adjusted multivariate logistic regression general acceptance and committed action remained significantly uniquely associated with it. This preliminary study suggests for the first time that components of PF are associated with part of a pattern of suicidal behaviour in people with chronic pain. They may be relevant for reducing avoidance in general and providing more positive behavioural options. This study provides evidence that components of psychological flexibility are associated with a reduced frequency of suicidal thinking in people with chronic pain. Treatments targeting psychological flexibility may help mitigate the impact of chronic pain on suicidal thinking.

Committed Action, Disability and Perceived Health in Individuals with Fibromyalgia

ABSTRACTCommitted action, one of the components of psychological flexibility, has been shown to be related with measures of pain-relevant function domains in patients with chronic pain. However, the associations between measures of committed action and of physical health and function in individuals with fibromyalgia (FM) have not yet been examined. The aim of the present cross-sectional study was to better understand the role that committed action plays in (1) pain-related disability and (2) mental and physical health in individuals with FM. One hundred twenty-nine adult females with a diagnosis of FM from a rheumatologist were administered measures of committed action, disability, physical health, and mental health. After controlling for age and pain intensity, committed action explained an additional 24% of the variance of pain disability, 39% of the variance of physical health, and 41% of the variance of mental health. This study provides important new information on the associations between a measure of committed action and perceived health and function in a sample of women with FM. The findings are also consistent with the psychological flexibility model for understanding pain and its impact in patients with FM.

A Confirmatory Factor Analysis of Facets of Psychological Flexibility in a Sample of People Seeking Treatment for Chronic Pain.

BackgroundEvidence supports the validity of individual components of the psychological flexibility model in the context of chronic pain. However, there is a need to test the inter-relationships amongst measures of individual components of psychological flexibility in a more integrative manner. In particular, research is needed to examine whether a model with discrete facets as proposed is indeed reflected in data from currently used assessment measures in people with chronic pain.PurposeThis cross-sectional study investigated the underlying structure of measures of processes of psychological flexibility amongst individuals with chronic pain and the associations between this measurement model and patient functioning.MethodsFive-hundred and seventy-three adults with chronic pain completed measures of pain, physical and social functioning, mental health, depression and processes of psychological flexibility, including acceptance, cognitive defusion, decentering and committed action. Confirmatory factor analyses tested lower-order, higher-order and bifactor models to examine the structure of psychological flexibility process measures.ResultsA single general factor reflecting openness explained variability in items across all of the psychological flexibility process measures. In addition to this general factor, distinct decentering and committed action group factors emerged in the data. As expected, the general factor was strongly correlated with measures of social functioning, mental health and depression.ConclusionsFuture research is needed to determine the most useful means by which the presence of the general factor can be reflected in the measurement and theory of psychological flexibility.