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Dietz T, Schiewer V, Karbach U, Kusch M. Speechlessness: a Conceptual Framework. Integr Psychol Behav Sci 2024; 58:531-562. [PMID: 37400707 PMCID: PMC11052872 DOI: 10.1007/s12124-023-09789-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2023] [Indexed: 07/05/2023]
Abstract
The phenomenon of speechlessness has hardly been considered in the literature from a psychological point of view. Previous research on speechlessness is limited to the fields of neurology, medicine or psychopathology. The present review aims to consider speechlessness from a psychological perspective distinct from pathology, and to highlight its observability and possible connections to existing research in the context of emotional cognition and processing. Search terms were developed and a comprehensive, systematic literature search was conducted in various databases based on previous scientific work on the understanding of non-speech, silence and speechlessness. Only results that examined the phenomenon of speechlessness from a non-pathological or non-neurological perspective were included. A total of N = 7 publications matching the inclusion criteria were identified. The results were used to develop a procedual model for the phenomenological definition of speechlessness. The developed model differentiates the observable phenomenon of speechlessness into a non-intentional, unconscious form and a intentional, conscious form. The present work suggests that meaningful emotions and their perception and processing is a core element in the emergence of speechlessness and provides a first, psychological, non-pathological explanation of speechlessness.
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Affiliation(s)
- Thilo Dietz
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Kerpener Straße 62, 50937, Köln, Germany.
| | - Vera Schiewer
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Kerpener Straße 62, 50937, Köln, Germany
| | - Ute Karbach
- Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, University of Cologne, Eupener Straße 129, 50933, Köln, Germany
| | - Michael Kusch
- Department of Internal Medicine I, Faculty of Medicine, Cologne University Hospital, University of Cologne, Kerpener Straße 62, 50937, Köln, Germany
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2
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Matthews JA, Matthews S, Faries MD, Wolever RQ. Supporting Sustainable Health Behavior Change: The Whole is Greater Than the Sum of Its Parts. Mayo Clin Proc Innov Qual Outcomes 2024; 8:263-275. [PMID: 38807973 PMCID: PMC11130595 DOI: 10.1016/j.mayocpiqo.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024] Open
Abstract
Behavior change is the foundation for effective lifestyle prescriptions, yet such change is individualized, nonlinear and typically requires ongoing support. Health and wellness coaching (HWC) is a behavior change intervention with rapidly accruing evidence of positive impact on health behaviors such as exercise, nutrition and stress management. Furthermore, HWC enhances prevention and mitigates exacerbation of chronic lifestyle diseases, at least in the short-term (up to 6 months post intervention). Although the impact on long-term stability of behavior change remains unclear, it is evident that effective partnering with patients using key communication strategies, autonomy promotion, and flexible permissiveness can empower patients to develop healthy lifestyles. This partnership can be cultivated by clinicians as well as clinical team members including nationally board-certified coaches. Although much research is needed regarding the ongoing maintenance of lifestyle changes beyond 6 months, this article seeks to equip clinicians with current evidence, theoretical insights and practical strategies from a "coach approach" to foster more intrinsic forms of motivation which, in turn, empowers patients to adopt and maintain health-promoting behaviors.
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Affiliation(s)
- Jessica A. Matthews
- College of Health Sciences, Point Loma Nazarene University, San Diego, CA
- Department of Family Medicine, Centers for Integrative Health, UC San Diego Health, San Diego, CA
| | - Simon Matthews
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, Australia
- Wellcoaches School of Coaching, Wellesley, MA
| | - Mark D. Faries
- Family & Community Health, Texas A&M AgriLife Extension, College Station, TX
- Texas A&M School of Medicine and School of Public Health, College Station, TX
| | - Ruth Q. Wolever
- Department of Physical Medicine and Rehabilitation, Vanderbilt Health Coaching, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt University School of Nursing, Nashville, TN
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3
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Aharon G, Aisenberg-Shafran D, Levi-Belz Y. Adherence to Masculinity Norms and Depression Symptoms Among Israeli Men: The Moderating Role of Psychological Flexibility. Am J Mens Health 2024; 18:15579883241253820. [PMID: 38794957 PMCID: PMC11128175 DOI: 10.1177/15579883241253820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/27/2024] Open
Abstract
Being a man has been recognized as a salient risk factor for suicide. Adopting uncompromised masculine perceptions (i.e., conforming to the masculine gender role norms) may restrict emotional expressiveness in men, which, in turn, may contribute to depression and somatization symptoms. We examined the moderating role of psychological flexibility and alexithymia in the relationship of masculinity with depression and somatization symptoms. A sample of 119 men completed measures of masculinity, alexithymia (difficulty identifying and delivering subjective feelings), psychological flexibility, depression, and somatization symptoms in a cross-sectional design study. Psychological flexibility levels moderated the relationship between masculinity and depression symptoms: Masculinity contributed as positively associated with depression symptoms when psychological flexibility was low, but no such association was found at moderate or high levels of psychological flexibility. As a cognitive factor promoting adaptive emotional regulation, psychological flexibility might reduce depression symptoms among inflexible masculine men. Clinical implications relate to diagnosing at-risk subgroups and their treatment.
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Affiliation(s)
- Gal Aharon
- Ruppin Academic Center, Emek Hefer, Israel
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Wang X, Shao S, Cai Z, Ma C, Jia L, Blain SD, Tan Y. Reciprocal effects between negative affect and emotion regulation in daily life. Behav Res Ther 2024; 176:104518. [PMID: 38492548 DOI: 10.1016/j.brat.2024.104518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024]
Abstract
The extended process model of emotion regulation provides a framework for understanding how emotional experiences and emotion regulation (ER) mutually influence each other over time. To investigate this reciprocal relationship, 202 adults completed a ten-day experience-sampling survey capturing levels of negative affect (NA) experience and use of ten ER strategies in daily life. Residual dynamic structural equation models (DSEMs) were used to examine within-person cross-lagged and autoregressive effects of NA and ER (strategy use and between-strategy variability). Results showed that NA predicted lower between-strategy variability, lower subsequent use of acceptance and problem-solving, but higher subsequent use of rumination and worry. Moreover, reappraisal and between-strategy variability predicted lower subsequent NA levels, while expressive suppression and worry predicted higher subsequent NA levels. Stable autoregressive effects were found for NA and for maladaptive ER strategies (e.g., rumination and worry). Exploratory correlation analyses revealed positive associations between NA inertia and maladaptive ER strategies. Together, these findings provide evidence of a dynamic interplay between NA and ER. This work deepens how we understand the challenges of applying ER strategies in daily life. Future clinical and translational research should consider these dynamic perspectives on ER and affect.
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Affiliation(s)
- Xiaoqin Wang
- Department of Psychology, Zhejiang Normal University, Jinhua, 321004, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, Zhejiang, 321004, China.
| | - Shiyu Shao
- Department of Psychology, Zhejiang Normal University, Jinhua, 321004, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, Zhejiang, 321004, China
| | - Zhouqu Cai
- School of Psychology, Central China Normal University, Wuhan, 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, 430079, China
| | - Chenyue Ma
- School of Psychology, Central China Normal University, Wuhan, 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, 430079, China
| | - Lei Jia
- Department of Psychology, Zhejiang Normal University, Jinhua, 321004, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, Zhejiang, 321004, China
| | - Scott D Blain
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, 43210, United States
| | - Yafei Tan
- School of Psychology, Central China Normal University, Wuhan, 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, 430079, China; Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, 430079, China.
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5
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Giovannetti AM, Rosato R, Galán I, Toscano A, Anglada E, Menendez R, Hoyer J, Confalonieri P, Giordano A, Pakenham KI, Pöttgen J, Solari A. Cross-cultural validity and reliability of the comprehensive assessment of acceptance and commitment therapy processes (CompACT) in people with multiple sclerosis. Qual Life Res 2024; 33:1359-1371. [PMID: 38401014 DOI: 10.1007/s11136-024-03609-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE The Comprehensive assessment of Acceptance and Commitment Therapy (CompACT) is a 23-item questionnaire measuring psychological flexibility, a quality of life protective factor. An 18-item version was recently produced. We assessed validity and reliability of CompACT, and equivalence of paper and electronic (eCompACT) versions in people with multiple sclerosis (PwMS) in Italy, Germany and Spain. METHODS We used confirmatory factor analysis and assessed CompACT-23 and CompACT-18 measurement invariance between the three language versions. We assessed construct validity (Spearman's correlations) and internal consistency (Cronbach's alpha). Test-retest reliability (intraclass correlation coefficient, ICC) and equivalence of paper and eCompACT (ICC and linear regression model for repeated measures) were assessed in subsamples of PwMS. RESULTS A total of 725 PwMS completed the study. The three-factor structure of the CompACT-23 showed poor fit (RMSEA 0.07; CFI 0.82; SRMR 0.08), while the fit of the CompACT-18 was good (RMSEA 0.05; CFI 0.93; SRMR 0.05). Configural and partial metric invariance were confirmed, as well as partial scalar invariance (reached when five items were allowed to vary freely). The CompACT-18 showed good internal consistency (all alpha ≥ 0.78); and test-retest reliability (all ICCs ≥ 0.86). Equivalence between paper and eCompACT was excellent (all ICCs ≥ 0.86), with no mode, order, or interaction effects. CONCLUSION Results support using the refined CompACT-18 as a three-factor measure of psychological flexibility in PwMS. Paper and eCompACT-18 versions are equivalent. CompACT-18 can be used cross-culturally, but sub-optimal scalar invariance suggests that direct comparison between the three language versions should be interpreted with caution.
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Affiliation(s)
- Ambra Mara Giovannetti
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroepidemiology), Via Celoria 11, 20133, Milan, Italy.
- School of Psychology, University of Queensland, Brisbane, QLD, Australia.
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroimmunology and Neuromuscular Diseases), Milan, Italy.
| | - Rosalba Rosato
- Department of Psychology, University of Turin, Turin, Italy
| | - Ingrid Galán
- Centre d'Esclerosi Múltiple de Catalunya-Cemcat, Barcelona, Spain
| | - Anna Toscano
- Department of Psychology, University of Turin, Turin, Italy
| | - Elisenda Anglada
- Centre d'Esclerosi Múltiple de Catalunya-Cemcat, Barcelona, Spain
| | - Rebeca Menendez
- Centre d'Esclerosi Múltiple de Catalunya-Cemcat, Barcelona, Spain
| | - Jürgen Hoyer
- Technische Universitaet Dresden, Dresden, Germany
| | - Paolo Confalonieri
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroimmunology and Neuromuscular Diseases), Milan, Italy
| | - Andrea Giordano
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroepidemiology), Via Celoria 11, 20133, Milan, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Jana Pöttgen
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alessandra Solari
- Fondazione IRCCS Istituto Neurologico Carlo Besta, (Unit of Neuroepidemiology), Via Celoria 11, 20133, Milan, Italy
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Tunç E, Orak OS. The impact of a "clinical adaptation psychoeducation program" grounded in the psychological flexibility model on perceived stress and coping behaviors among nursing students: A randomized controlled experimental study. NURSE EDUCATION TODAY 2024; 139:106230. [PMID: 38703533 DOI: 10.1016/j.nedt.2024.106230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 04/16/2024] [Accepted: 04/28/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The clinical adaptation psychoeducation program grounded psychological flexibility model (PFMCAP) is consisting of six areas, fills a large gap in the literature regarding the effect of nursing students on perceived stress and coping behaviors in the clinical process. OBJECTIVES To determine the effect of PFMCAP on perceived stress and coping behaviors of nursing students. DESIGN This was a simple randomized controlled experimental pre-posttest design. SETTING This study was conducted with 66 first-year students studying in the nursing department of a university in Türkiye. METHODS A simple randomization method (computer-generated random number table) was used. Data were collected with "Sociodemographic Data Form", "Perceived Stress Scale for Nursing Students (PSSNS)" and "Stress-Coping Behaviors Scale for Nursing Students (SCBNS)". PFMCAP was conducted online with first-year nursing students, consisting of a total of six sessions, each lasting 90 min. Data were analyzed using percentiles and frequency distributions, and two-way mixed ANOVA one week after the completion of the PFMCAP. RESULTS There was no significant difference between the groups of descriptive characteristics (p > 0.05). Post-test measurements of students in the experimental group's PSSNS total and sub-dimension scores had a significant decrease compared to the control group (p < 0.001). There was no significant difference between the groups in the post-test SCBNS total scores of the students (p > 0.05). However, there was a significant increase in the post-test SCBNS-Staying Optimistic sub-dimension scores in the experimental group (p < 0.001). CONCLUSION The impact of PFMCAP on nursing students' perceived stress levels was not limited to only reducing stress levels; it also contributed to an increase in the students' levels of optimism. These findings demonstrate the potential of PFMCAP in supporting nursing students during the clinical adaptation process. It is observed that the integration of PFMCAP into nursing education could assist nursing students in better adapting to clinical practices and effectively managing stress.
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Affiliation(s)
- Ercan Tunç
- Ondokuz Mayıs University, Faculty of Health Sciences, Department of Nursing/Psychiatric Nursing, Turkey.
| | - Oya Sevcan Orak
- Ondokuz Mayıs University, Faculty of Health Sciences, Department of Nursing/Psychiatric Nursing, Turkey
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7
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Sloshower J, Zeifman RJ, Guss J, Krause R, Safi-Aghdam H, Pathania S, Pittman B, D'Souza DC. Psychological flexibility as a mechanism of change in psilocybin-assisted therapy for major depression: results from an exploratory placebo-controlled trial. Sci Rep 2024; 14:8833. [PMID: 38632313 PMCID: PMC11024097 DOI: 10.1038/s41598-024-58318-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
Several phase II studies have demonstrated that psilocybin-assisted therapy shows therapeutic potential across a spectrum of neuropsychiatric conditions, including major depressive disorder (MDD). However, the mechanisms underlying its often persisting beneficial effects remain unclear. Observational research suggests that improvements in psychological flexibility may mediate therapeutic effects. However, no psychedelic trials to date have substantiated this finding in a clinical sample. In an exploratory placebo-controlled, within-subject, fixed-order study, individuals with moderate to severe MDD were administered placebo (n = 19) followed by psilocybin (0.3 mg/kg) (n = 15) 4 weeks later. Dosing sessions were embedded within a manualized psychotherapy that incorporated principles of Acceptance and Commitment Therapy. Depression severity, psychological flexibility, mindfulness, and values-congruent living were measured over a 16-weeks study period. Psychological flexibility, several facets of mindfulness, and values-congruent living significantly improved following psilocybin and were maintained through week 16. Additionally, improvements in psychological flexibility and experiential acceptance were strongly associated with reductions in depression severity following psilocybin. These findings support the theoretical premise of integrating psilocybin treatment with psychotherapeutic platforms that target psychological flexibility and add to emerging evidence that increasing psychological flexibility may be an important putative mechanism of change in psilocybin-assisted therapy for MDD and potentially, other mental health conditions.
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Affiliation(s)
- Jordan Sloshower
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA.
- West Rock Wellness PLLC, New Haven, CT, USA.
| | - Richard J Zeifman
- NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Jeffrey Guss
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Robert Krause
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Yale School of Nursing, New Haven, CT, USA
- Centered PLLC, New Haven, CT, USA
| | - Hamideh Safi-Aghdam
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Surbhi Pathania
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
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Cojocaru CM, Popa CO, Schenk A, Jakab Z, Suciu BA, Olah P, Popoviciu H, Szasz S. A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders. Behav Sci (Basel) 2024; 14:327. [PMID: 38667123 PMCID: PMC11047417 DOI: 10.3390/bs14040327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Defined by chronic pain, rheumatic diseases are often co-occurring with anxiety and depression. Among the available psychological interventions, cognitive-behavioral therapies have an already-proven efficiency in these cases. However, the need to adjust their structure became ubiquitous during the post-pandemic period. Hence, the objective of this study was to investigate the impact of a single-session, process-based cognitive-behavioral intervention for patients with rheumatic conditions within an in-patient setting. MATERIALS AND METHODS A total of 31 participants (mean age 58.9 years) completed the single-session intervention. Assessments were conducted prior to the intervention, post-intervention and after one month. RESULTS Pearson's correlations, paired samples T tests and a covariance analysis based on the Linear Mixed Model were performed for exploring the relations between baseline variables and evaluating the impact of the SSI intervention. Immediately after the intervention, a significant reduction in cognitive fusion (p = 0.001, d = 1.78), experiential avoidance (p = 0.001, d = 1.4) and dysfunctional behavioral processes was observed. At the one-month evaluation, participants reported decreased pain (p = 0.001, d = 1.11), anxiety (p = 0.004, d = 0.55) and depression (p = 0.001, d = 0.72). CONCLUSIONS The single-session, process-based approach represents a promising intervention in healthcare contexts, as an integrative part of a multimodal rehabilitation treatment in patients with rheumatic conditions.
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Affiliation(s)
- Cristiana-Manuela Cojocaru
- The Doctoral School of George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.)
| | - Cosmin Octavian Popa
- Department of Ethics and Social Sciences, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania
| | - Alina Schenk
- The Doctoral School of George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.)
| | - Zsolt Jakab
- Department of Counseling, Career Guidance and Informing Students, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania;
| | - Bogdan Andrei Suciu
- Department of Anatomy and Morphological Sciences, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Targu-Mures, Romania;
| | - Peter Olah
- Department of Medical Informatics and Biostatistics, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania;
| | - Horațiu Popoviciu
- Department of Rheumatology, Physical and Rehabilitation Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (H.P.); (S.S.)
| | - Simona Szasz
- Department of Rheumatology, Physical and Rehabilitation Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (H.P.); (S.S.)
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9
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Westhoff M, Heshmati S, Siepe B, Vogelbacher C, Ciarrochi J, Hayes SC, Hofmann SG. Psychological flexibility and cognitive-affective processes in young adults' daily lives. Sci Rep 2024; 14:8182. [PMID: 38589553 PMCID: PMC11001944 DOI: 10.1038/s41598-024-58598-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/01/2024] [Indexed: 04/10/2024] Open
Abstract
Psychological flexibility plays a crucial role in how young adults adapt to their evolving cognitive and emotional landscapes. Our study investigated a core aspect of psychological flexibility in young adults: adaptive variability and maladaptive rigidity in the capacity for behavior change. We examined the interplay of these elements with cognitive-affective processes within a dynamic network, uncovering their manifestation in everyday life. Through an Ecological Momentary Assessment design, we collected intensive longitudinal data over 3 weeks from 114 young adults ages 19 to 32. Using a dynamic network approach, we assessed the temporal dynamics and individual variability in flexibility in relation to cognitive-affective processes in this sample. Rigidity exhibited the strongest directed association with other variables in the temporal network as well as highest strength centrality, demonstrating particularly strong associations to other variables in the contemporaneous network. In conclusion, the results of this study suggest that rigidity in young adults is associated with negative affect and cognitions at the same time point and the immediate future.
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Affiliation(s)
- Marlon Westhoff
- Department of Psychology, Philipps-University of Marburg, Schulstraße 12, 35032, Marburg, Germany
| | - Saida Heshmati
- Department of Psychology, Claremont Graduate University, Claremont, CA, USA
| | - Björn Siepe
- Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Christoph Vogelbacher
- Department of Psychology, Philipps-University of Marburg, Schulstraße 12, 35032, Marburg, Germany
| | - Joseph Ciarrochi
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Steven C Hayes
- Department of Psychology, University of Nevada Reno, Reno, NV, USA
| | - Stefan G Hofmann
- Department of Psychology, Philipps-University of Marburg, Schulstraße 12, 35032, Marburg, Germany.
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10
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Koppert TY, van Hoek R, Geenen R. Dimensions of psychological flexibility and their significance in people with somatic symptoms: The 18-item Flexibility Index Test (FIT-18). J Health Psychol 2024:13591053241239129. [PMID: 38566361 DOI: 10.1177/13591053241239129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Psychological flexibility has been hypothesized to preserve health in bad times. We examined whether psychological flexibility as assessed with an abbreviated questionnaire, was indicated to preserve mental and physical health when having somatic symptoms. Principal axis factoring indicated that two dimensions best represented the 60-item Flexibility Index Test (FIT-60) questionnaire: "mindfulness and acceptance" (M&A) and "commitment and behavior change" (C&BC). We selected 18 items that best denoted these dimensions (FIT-18 questionnaire). Regression analyses in 2060 Dutch people with and without persistent somatic symptoms, indicated that the M&A dimension (β = 0.33, p < 0.001) and C&BC dimension (β = 0.09, p < 0.001) were additively associated with mental well-being, but not with physical functioning. Moreover, the M&A dimension was indicated to protect mental well-being when having more severe somatic symptoms (β = 0.11, p < 0.001). The observed differential associations with health suggest the significance for health of the two dimensions of psychological flexibility as assessed with the FIT-18 questionnaire.
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Affiliation(s)
| | - Renée van Hoek
- Altrecht Psychosomatic Medicine, The Netherlands
- Utrecht University, The Netherlands
| | - Rinie Geenen
- Altrecht Psychosomatic Medicine, The Netherlands
- Utrecht University, The Netherlands
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11
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Villanueva J, Meyer AH, Block VJ, Benoy C, Bader K, Brogli S, Karekla M, Walter M, Haller E, Lang UE, Gloster AT. How mood is affected by environment and upsetting events: The moderating role of psychological flexibility. Psychother Res 2024; 34:490-502. [PMID: 37257198 DOI: 10.1080/10503307.2023.2215392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE Patients suffering from psychological disorders report decreased quality of life and low mood. The relationship of these symptoms to daily upsetting events or environments, and in the context of active coping mechanisms is poorly understood. The present study thus investigates the association between mood, psychological flexibility, upsetting events, and environment in the daily life of outpatients. METHOD We investigated 80 outpatients at the beginning of treatment, using event sampling methodology (ESM). Patients' mood, occurrence of upsetting events, current environment, and psychological flexibility were sampled six times per day during a one-week intensive longitudinal examination. Data were analyzed using linear mixed models (LMMs). RESULTS Participants reported worse mood the more upsetting events they experienced. Further, participants reported better mood when in private environments (e.g., with friends), and worse mood when at the hospital, compared to being at home. Higher levels of psychological flexibility, however, were associated with better mood, irrespective of the occurrence of upsetting events or current environment. CONCLUSION Results suggest that mood is positively associated with psychological flexibility, not despite, but especially during the dynamic and context-specific challenges of daily life. Psychological flexibility may thus potentially act as a buffer against distress-provoking situations as patients go about their daily lives. TRIAL REGISTRATION ISRCTN.org identifier: ISRCTN11209732.
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Affiliation(s)
- Jeanette Villanueva
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Andrea H Meyer
- Department of Psychology, University of Basel, Basel, Switzerland
| | - Victoria J Block
- Department of Psychology, University of Basel, Basel, Switzerland
| | - Charles Benoy
- Rehabilitation Clinic, Neuro-Psychiatric Hospital Center, Ettelbrück, Luxemburg
| | - Klaus Bader
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Sandra Brogli
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Marc Walter
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Elisa Haller
- Department of Psychology, University of Basel, Basel, Switzerland
| | - Undine E Lang
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Andrew T Gloster
- Department of Psychology, University of Basel, Basel, Switzerland
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Gordon TC, Kemp AH, Edwards DJ. Mixed-methods feasibility outcomes for a novel ACT-based video game 'ACTing Minds' to support mental health. BMJ Open 2024; 14:e080972. [PMID: 38553053 PMCID: PMC10982759 DOI: 10.1136/bmjopen-2023-080972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/04/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES To determine the feasibility and acceptability of 'ACTing Minds', a novel single-player adventure video game based on acceptance and commitment therapy (ACT). DESIGN A single-arm, mixed-methods repeated measures feasibility study. SETTING Intervention and questionnaires were completed at home by participants. Semistructured interviews were also conducted at home via the Zoom platform. PARTICIPANTS Thirty-six participants were recruited into the study, 29 completed all phases of the feasibility design. Eligibility criteria required participants to be over the age of 18 and self-reporting experiencing ongoing depression, anxiety or stress. INTERVENTION Participants completed a single session of the 'ACTing Minds' video game, lasting approximately 1 hour, designed to educate users on key principles from ACT. PRIMARY OUTCOME MEASURES Participant recruitment and retention, questionnaire completion, long-term intervention adherence and acceptability of the intervention. Reflexive thematic analysis was conducted on semistructured interviews run immediately postintervention and 3 weeks later. SECONDARY OUTCOME MEASURES Measures of depression, anxiety, stress, psychological flexibility, social connectedness and well-being were assessed at baseline, immediately following intervention completion, and after a 3-week follow-up period. We used a standardised battery of questionnaires. PRIMARY RESULTS Twenty-nine participants completed the study. A reflexive thematic analysis indicated that participants responded positively to the intervention and the study at all stages. Themes reflect participants' desire for an engaging therapeutic experience, use of game for exploring emotions, as well as their perspectives on how they had applied their learning to the real world. SECONDARY RESULTS Quantitative results indicated small to large effect sizes associated with decreases in depression (ηp2 = 0.011), anxiety (ηp2 = 0.096) and stress (ηp2 = 0.108), and increases in psychological flexibility (ηp2 = 0.060), social connectedness (ηp2 = 0.021), well-being (ηp2 = 0.011) and participation in usual activities (ηp2 = .307). CONCLUSIONS Implementation of the 'ACTing Minds' intervention is warranted, based on both qualitative and quantitative outcomes. TRIAL REGISTRATION NUMBER NCT04566042 ClinicalTrials.gov.
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Affiliation(s)
- Tom C Gordon
- School of Psychology, Swansea University, Swansea, UK
- Department of Public Health, Swansea University, Swansea, UK
| | - Andrew H Kemp
- School of Psychology, Swansea University, Swansea, UK
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Dekker J, Doppenberg-Smit E, Braamse A, Lamers F, van Linde M, Verheul HMW, Sprangers M, Beekman ATF. Toward an improved conceptualization of emotions in patients with cancer. Front Psychiatry 2024; 15:1352026. [PMID: 38600981 PMCID: PMC11004313 DOI: 10.3389/fpsyt.2024.1352026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Cancer and its associated treatment is a major stressor, leading to emotions such as anxiety or depressive mood. Human emotions have developed through the course of evolution because they facilitate adaptation to important events, such as cancer and its associated treatment. On the other hand, emotions can be maladaptive and interfere with adaptation to cancer. Emotions are maladaptive if they are disproportionally severe or persistent, and if they interfere with functioning. We aim to expand the conceptualization of adaptive and maladaptive emotions in patients with cancer. We draw on major theories in the field of mental disorder and mental health, and apply these theories to conceptualize adaptive and maladaptive emotions in patients with cancer. (i) Maladaptive emotions have two essential features: mental dysfunction and patient harm. Maladaptive emotions are characterized by a network of strongly associated emotional symptoms, which may include cancer-related somatic symptoms. The dysfunctional symptom network is hypothesized to be the result of disturbance of life goal pursuit caused by cancer. (ii) Adaptive emotions have two essential features: ability to deal with cancer and functioning well. The ability to use emotions in an adaptive way depends on skills to recognize, express, and regulate emotions in a flexible manner. A secure attachment style facilitates adaptive emotional responses to cancer. The present conceptualization of adaptive and maladaptive emotions is expected to contribute to better understanding and management of emotions in patients with cancer.
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Affiliation(s)
- Joost Dekker
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Elise Doppenberg-Smit
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
| | - Annemarie Braamse
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
| | - Myra van Linde
- Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Henk M. W. Verheul
- Department of Medical Oncology, Erasmus University Rotterdam, Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands
| | - Mirjam Sprangers
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Aartjan T. F. Beekman
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, Netherlands
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14
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Guralnik T, Moulder RG, Merom D, Zilcha-Mano S. A multi-modality and multi-dyad approach to measuring flexibility in psychotherapy. Psychother Res 2024:1-17. [PMID: 38252916 DOI: 10.1080/10503307.2023.2292746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Flexibility, the ability of an individual to adapt to environmental changes in ways that facilitate goal attainment, has been proposed as a potential mechanism underlying psychopathology and psychotherapy. In psychotherapy, most findings are based on self-report measures that have important limitations. We propose a multimodal, multi-dyad approach based on a nonlinear dynamical systems framework to capture the complexity of this concept. METHOD A new research paradigm was designed to explore the validity of the proposed conceptual model. The paradigm includes a psychotherapy-like social interaction, during which body movement and facial expressiveness data were collected. We analyzed the data using Hankel Alternative View of Koopmann analysis to reconstruct attractors of the observed behaviors and compare them. RESULTS The patterns of behavior in the two cases differ, and differences in the reconstructed attractors correspond with differences in self-report measures and behavior in the interactions. CONCLUSIONS The case studies show that information provided by a single modality is not enough to provide the full picture, and multiple modalities are needed. These observations can serve as an initial support for our claims that a multi-modal and multi-dyad approach to flexibility can address some of the issues of measurement in the field.
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Affiliation(s)
- Timur Guralnik
- The Department of Psychology, University of Haifa, Haifa, Israel
| | - Robert G Moulder
- Institute of Cognitive Science, University of Colorado, Boulder, CO, USA
| | - Daniel Merom
- The Department of Psychology, University of Haifa, Haifa, Israel
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Ching THW, Amoroso L, Bohner C, D’Amico E, Eilbott J, Entezar T, Fitzpatrick M, Fram G, Grazioplene R, Hokanson J, Jankovsky A, Kichuk SA, Martins B, Patel P, Schaer H, Shnayder S, Witherow C, Pittenger C, Kelmendi B. Safety, feasibility, tolerability, and clinical effects of repeated psilocybin dosing combined with non-directive support in the treatment of obsessive-compulsive disorder: protocol for a randomized, waitlist-controlled trial with blinded ratings. Front Psychiatry 2024; 14:1278823. [PMID: 38264632 PMCID: PMC10803438 DOI: 10.3389/fpsyt.2023.1278823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024] Open
Abstract
Background To date, few randomized controlled trials of psilocybin with non-directive support exist for obsessive-compulsive disorder (OCD). Results and participant feedback from an interim analysis of an ongoing single-dose trial (NCT03356483) converged on the possibility of administering a higher fixed dose and/or more doses of psilocybin in future trials for presumably greater benefits. Objectives This trial aims to evaluate the safety, feasibility, tolerability, and clinical effects of two doses of psilocybin paired with non-directive support in the treatment of OCD. This trial also seeks to examine whether two doses of psilocybin lead to greater OCD symptom reduction than a single dose, and to elucidate psychological mechanisms underlying the effects of psilocybin on OCD. Design A randomized (1:1), waitlist-controlled design with blinded ratings will be used to examine the effects of two doses of oral psilocybin paired with non-directive support vs. waitlist control on OCD symptoms. An adaptive dose selection strategy will be implemented (i.e., first dose: 25 mg; second dose: 25 or 30 mg). Methods and analysis This single-site trial will enroll 30 adult participants with treatment-refractory OCD. Aside from safety, feasibility, and tolerability metrics, primary outcomes include OCD symptoms assessed on the Yale-Brown Obsessive-Compulsive Scale - Second Edition (Y-BOCS-II). A blinded independent rater will assess primary outcomes at baseline and the primary endpoint at the end of the second dosing week. Participants will be followed up to 12 months post-second dosing. Participants randomized to waitlist will be rescreened after 7 weeks post-randomization, and begin their delayed treatment phase thereafter if still eligible. Ethics Written informed consent will be obtained from participants. The institutional review board has approved this trial (protocol v. 1.7; HIC #2000032623). Discussion This study seeks to advance our ability to treat refractory OCD, and catalyze future research seeking to optimize the process of psilocybin treatment for OCD through understanding relevant psychological mechanisms.Clinical trial registration: ClinicalTrials.gov, identifier NCT05370911.
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Affiliation(s)
- Terence H. W. Ching
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Lucia Amoroso
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Calvin Bohner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Elizabeth D’Amico
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jeffrey Eilbott
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Tara Entezar
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Madison Fitzpatrick
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Geena Fram
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jamila Hokanson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Anastasia Jankovsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Stephen A. Kichuk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Bradford Martins
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Prerana Patel
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Henry Schaer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Sarah Shnayder
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Chelsea Witherow
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychology, Yale University, New Haven, CT, United States
- Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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16
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Pakenham KI, Landi G, Grandi S, Tossani E. The mediating role of psychological flexibility in the relationship between resilience and distress and quality of life in people with multiple sclerosis. J Health Psychol 2024; 29:65-80. [PMID: 37387365 DOI: 10.1177/13591053231182364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
The purpose of this study is to investigate the role of psychological flexibility in mediating the beneficial effects of resilience on distress and quality of life (QoL) in people with MS (PwMS). The psychological flexibility framework underpinning acceptance and commitment therapy (ACT) was used to conceptualise psychological flexibility. A total of 56 PwMS completed an online survey that assessed global psychological flexibility and each of its six core sub-processes, resilience, distress, mental and physical health QoL, socio-demographics, and illness variables. Mediation analyses showed that, as hypothesised, higher levels of global psychological flexibility and its sub-processes were associated with increases in the positive impacts of resilience on distress and mental and physical health QoL via a mediational mechanism. These findings suggest that psychological flexibility skills build resilience capacities in PwMS. The psychological flexibility framework offers an ACT-based intervention pathway to build resilience and enhance mental health and QoL in PwMS.
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17
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Gur A, Egozi S, Schweitzer Y. Self-Differentiation, Psychological Flexibility, and Difficulties in Practice in Social Workers and Social Work Students. SOCIAL WORK 2023; 69:43-51. [PMID: 37933592 DOI: 10.1093/sw/swad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/02/2023] [Accepted: 09/12/2023] [Indexed: 11/08/2023]
Abstract
Practicing social work involves unique difficulties, which may vary with seniority. This study aimed to identify these difficulties among social workers and social work students and to examine the associations between psychological flexibility (PF), self-differentiation (SF), and difficulties in practice in both groups. Ninety-one social work students and seventy-five social workers completed the following questionnaires: Difficulties in Practice, the Acceptance and Action Questionnaire-II, and Differentiation of Self Inventory. Results showed higher difficulties among social work students regarding their professional competence. Social workers demonstrated higher levels of PF, while no significant difference was found in SF. SF and PF were positively correlated, and both were negatively correlated with difficulties in practice in both groups. Among social work students, a moderating effect of PF was found for the association between SF and difficulties in practice. The current study emphasizes the importance of developing SF and cultivating PF during social work education to enhance professional competence and reduce difficulties in practice.
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Affiliation(s)
- Ayelet Gur
- PhD, is senior lecturer, Social Work Department, Tel-Hai College, Kiryat Shmona, Upper Galilee, 1220800, Israel
| | - Sharon Egozi
- PhD, are lecturers, Social Work Department, Tel-Hai College, Kiryat Shmona, Upper Galilee, Israel
| | - Yoav Schweitzer
- MA, are lecturers, Social Work Department, Tel-Hai College, Kiryat Shmona, Upper Galilee, Israel
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18
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Carreno DF, Eisenbeck N, Uclés-Juárez R, García-Montes JM. Reappraising personal values in cancer: Meaning-in-life adaptation, meaningfulness, and quality of life. Psychooncology 2023; 32:1905-1917. [PMID: 37930051 DOI: 10.1002/pon.6244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/10/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE This study explores the reappraisal of personal values among people with cancer post-diagnosis and its connections to meaningfulness, encompassing personal meaning and sense of meaning, and various dimensions of quality of life. METHODS A total of 144 patients with diverse cancer types and a control group comprising 158 healthy adults with similar demographic characteristics completed the Valued Living Questionnaire-Perceived Change, the Personal Meaning Profile-Brief, the Portrait Values Questionnaire, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being. RESULTS Cancer patients displayed a substantial values reappraisal compared to healthy adults. They reported an increased significance of social areas and self-transcendental values, including close relationships (family, partner, and friends), spirituality, citizenship, and universalism, as well as an increased importance of self-care and self in general. Conversely, cancer patients assigned less importance to work and self-enhancement values such as stimulation, power, and achievement. Cluster analysis revealed that patients who reappraised their values exhibited higher meaningfulness and better indicators of quality of life, including spiritual and physical well-being, compared to patients who did not modify their value system. CONCLUSIONS These findings underscore the importance of assessing and promoting meaning-in-life adaptability among people with cancer, with potential applications in meaning-centered therapies and interventions aimed at enhancing psychological flexibility.
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Affiliation(s)
- David F Carreno
- Department of Psychology, University of Almería, Almería, Spain
| | - Nikolett Eisenbeck
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Seville, Seville, Spain
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19
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Crump L, LaChapelle D. "Don't need [therapy]! Not necessary, that's what we're for!": Does content from fibromyalgia Facebook peer support groups emulate psychological flexibility principles? PEC INNOVATION 2023; 2:100144. [PMID: 37214520 PMCID: PMC10194218 DOI: 10.1016/j.pecinn.2023.100144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/23/2023] [Accepted: 02/26/2023] [Indexed: 05/24/2023]
Abstract
Objective Many persons with fibromyalgia (FM) use online peer support groups (OPSGs) to address unmet emotional or psychological needs. Some OPSG members have suggested that participation in an OPSG is a viable substitute for professional psychological services, however, no published research exploring this claim was identified. Methods Discussion content collected from three Facebook FM OPSGs was thematically analyzed to explore whether the content posted in FM OPSGs emulated content consistent with the psychological flexibility model underlying Acceptance and Commitment Therapy (ACT) - an evidence-based psychotherapy for chronic pain conditions. Results The content posted in OPSGs did not emulate and often contradicted the core psychological flexibility processes or skills emphasized in ACT programs. Conclusion Participation in an FM OPSG should be approached cautiously. Content from the FM OPSGs should not be considered a substitute for professionally delivered ACT, although participation may provide emotional support to help individuals move towards readiness for active psychotherapy. Innovation This research represents a novel application of the psychological flexibility model underlying ACT to assess the potential therapeutic value of a peer support community. Additionally, it is the first to clarify that content in FM OPSGs is not aligned with psychological flexibility processes.
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20
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McLoughlin S, Roche BT. ACT: A Process-Based Therapy in Search of a Process. Behav Ther 2023; 54:939-955. [PMID: 37863586 DOI: 10.1016/j.beth.2022.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 06/28/2022] [Accepted: 07/28/2022] [Indexed: 11/02/2022]
Abstract
A large array of randomized controlled trials and meta-analyses have determined the efficacy of Acceptance and Commitment Therapy (ACT). However, determining that ACT works does not tell us how it works. This is especially important to understand given the current emphasis on Process-Based Therapy, the promise of which is to identify manipulable causal mediators of change in psychotherapy, and how their effectiveness is moderated by individual contexts. This paper outlines four key areas of concern regarding ACT's status as a Process-Based Therapy. First, the relationship between ACT and Relational Frame Theory has been widely asserted but not yet properly substantiated. Second, most of the studies on ACT's core process of change, psychological flexibility, have used invalid measures. Third, while lots of research indicates means by which individuals can be helped to behave consistently with their values, there is virtually no research on how to help people effectively clarify their values in the first instance, or indeed, on an iterative basis. Finally, the philosophy underlying ACT permits a-moral instrumentalism, presenting several ethical challenges. We end by making several recommendations for coherent methodological, conceptual, and practical progress within ACT research and therapy.
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21
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Chong YY, Kwan JYM, Yau PT, Cheng HY, Chien WT. Roles of Parental Psychological Flexibility, Self-Compassion, and Self-Efficacy in Affecting Mental Health and Quality of Life in Parents of Children with Eczema. Healthcare (Basel) 2023; 11:2708. [PMID: 37893783 PMCID: PMC10606052 DOI: 10.3390/healthcare11202708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/02/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Parents of young children with eczema often experience adverse mental health consequences, including depression, anxiety, stress, and a reduced health-related quality of life (HRQoL), due to the unpredictable nature of flare-ups and exacerbations. This study investigated the roles of psychological flexibility, self-compassion, and self-efficacy in fostering parental mental health outcomes and HRQoL while caring for children diagnosed with eczema. Baseline data from an ongoing clinical trial examining the effects of a family acceptance-and-commitment-therapy-based eczema management program (FACT-EMP) on parent-child dyads affected by eczema (N = 110 dyads, 75.5% mothers; 66.4% boys) were analyzed using adjusted hierarchical regression analyses. The findings indicate that psychological inflexibility was significantly associated with symptoms of anxiety, depression, stress, and HRQoL. Self-compassion was significantly linked to all assessed mental health outcomes, whereas self-efficacy showed a significant association only with symptoms of depression. These results underscore the significance of promoting parental psychological flexibility and self-compassion through acceptance and commitment therapy and compassion-based approaches to enhance mental health and quality of life while managing children's eczema.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (J.Y.M.K.); (P.T.Y.); (H.Y.C.); (W.T.C.)
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Giommi F, Bauer PR, Berkovich-Ohana A, Barendregt H, Brown KW, Gallagher S, Nyklíček I, Ostafin B, Raffone A, Slagter HA, Trautwein FM, Vago DR. The (In)flexible self: Psychopathology, mindfulness, and neuroscience. Int J Clin Health Psychol 2023; 23:100381. [PMID: 36969914 PMCID: PMC10033904 DOI: 10.1016/j.ijchp.2023.100381] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/14/2023] [Indexed: 03/19/2023] Open
Abstract
Clinical and neuroscientific evidence indicates that transdiagnostic processes contribute to the generation and maintenance of psychopathological symptoms and disorders. Rigidity (inflexibility) appears a core feature of most transdiagnostic pathological processes. Decreasing rigidity may prove important to restore and maintain mental health. One of the primary domains in which rigidity and flexibility plays a role concerns the self. We adopt the pattern theory of self (PTS) for a working definition of self. This incorporates the pluralist view on self as constituted by multiple aspects or processes, understood to constitute a self-pattern, i.e. processes organized in non-linear dynamical relations across a number of time scales. The use of mindfulness meditation in the format of Mindfulness Based Interventions (MBIs) has been developed over four decades in Clinical Psychology. MBIs are promising as evidence-based treatments, shown to be equivalent to gold-standard treatments and superior to specific active controls in several randomized controlled trials. Notably, MBIs have been shown to target transdiagnostic symptoms. Given the hypothesized central role of rigid, habitual self-patterns in psychopathology, PTS offers a useful frame to understand how mindfulness may be beneficial in decreasing inflexibility. We discuss the evidence that mindfulness can alter the psychological and behavioral expression of individual aspects of the self-pattern, as well as favour change in the self-pattern as a whole gestalt. We discuss neuroscientific research on how the phenomenology of the self (pattern) is reflected in associated cortical networks and meditation-related alterations in cortical networks. Creating a synergy between these two aspects can increase understanding of psychopathological processes and improve diagnostic and therapeutic options.
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Affiliation(s)
- Fabio Giommi
- NOUS-School of Specialization (PsyD) in Psychotherapy, Milano, Italy
- Insight Dialogue Community [insightdialogue.org/teachers]
| | - Prisca R. Bauer
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Aviva Berkovich-Ohana
- Edmond Safra Brain Research Center, Faculty of Education, University of Haifa, Israel
- Faculty of Education, Department of Learning and Instructional Sciences, University of Haifa, Israel
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Israel
- Faculty of Education, Department of Counseling and Human Development, University of Haifa, Israel
| | - Henk Barendregt
- Faculty of Science, Radboud University, Nijmegen, the Netherlands
| | | | - Shaun Gallagher
- Department of Philosophy, University of Memphis, USA and SOLA, University of Wollongong, Australia
| | - Ivan Nyklíček
- Department of Medical and Clinical Psychology, Tilburg University, the Netherlands
| | - Brian Ostafin
- Department of Clinical Psychology, University of Groningen, the Netherlands
| | - Antonino Raffone
- Department of Psychology, Sapienza University of Rome, Italy
- School of Buddhist Studies, Philosophy and Comparative Religions, Nalanda University, India
| | | | - Fynn-Mathis Trautwein
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - David R. Vago
- Contemplative Sciences Center, University of Virginia
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Pakenham KI, Landi G, Cattivelli R, Grandi S, Tossani E. Identification of psychological flexibility and inflexibility profiles during the COVID-19 pandemic. J Clin Psychol 2023; 79:2225-2250. [PMID: 37192495 DOI: 10.1002/jclp.23536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/31/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND The first coronavirus disease 2019 (COVID-19) wave and lockdown adversely affected the lives of people in diverse ways. AIMS This study used a person-centered approach to identify patterns of engagement in the 12 psychological flexibility (PF) and inflexibility (PI) processes to manage the first COVID-19 wave and lockdown hardships. MATERIALS & METHODS A total of 1035 Italian adults completed an online survey. RESULTS Latent profile analyses conducted on the 12 PI/PF processes measured by the Multidimensional Psychological Flexibility Inventory identified five profiles; three reflected gradations of high to low PF with corresponding inverse levels of PI, while two represented more complex relationships between PI and PF. After controlling for relevant socio-demographic and COVID-19/lockdown factors, the five profiles differed in mental health (depression, anxiety, and COVID-19 distress). Essentially a gradient of progressive decreases in all PI processes (except experiential avoidance) corresponded with increments in mental health across all profiles. Two profiles, which evidenced the highest levels of mental health (highly flexible and moderately flexible profiles), also had the greatest proportion of the sample 56.42% (n = 584), and the highest levels of PF and experiential avoidance. DISCUSSION Findings from this and similar studies suggest intersecting complex relationships among the PI/PF processes that are likely to shift in response to changing contexts. We suggest this network of relationships is better represented by a three-dimensional PF/PI hexaflex than a simplistic two-dimensional depiction of the model. CONCLUSION Distinguishing different PF/PI profiles identified groups most at risk for the adverse mental health impacts of the pandemic and exposed variations in the mental health protective and risk roles of PF and PI processes, respectively, that can inform ACT-based mental health promotion interventions.
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Affiliation(s)
- Kenneth I Pakenham
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Giulia Landi
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Laboratory of Psychosomatics and Clinimetrics (head Prof. Silvana Grandi), University of Bologna, Cesena, Italy
| | - Roberto Cattivelli
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Laboratory of Psychosomatics and Clinimetrics (head Prof. Silvana Grandi), University of Bologna, Cesena, Italy
| | - Silvana Grandi
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Laboratory of Psychosomatics and Clinimetrics (head Prof. Silvana Grandi), University of Bologna, Cesena, Italy
| | - Eliana Tossani
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Laboratory of Psychosomatics and Clinimetrics (head Prof. Silvana Grandi), University of Bologna, Cesena, Italy
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Hughes-Barton D, Skaczkowski G, Fletcher C, Turnbull D, McMahon J, Gunn KM. What consumers, general practitioners and mental health professionals want: the co-design and prototype testing of a transdiagnostic, acceptance and commitment therapy-based online intervention to reduce distress and promote wellbeing among Australian adults. BMC Public Health 2023; 23:1787. [PMID: 37710234 PMCID: PMC10500756 DOI: 10.1186/s12889-023-16688-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Many Australians experience mental health challenges, but only a third access face-to-face psychological services, due to multiple barriers including long waitlists. Additional strategies to prevent or help people de-escalate distress at an early stage are needed. Web-based mental health interventions are becoming increasingly acceptable to consumers and referring General Practitioners (GPs), but most are designed for specific disorders/populations. This study explores consumers' and health professionals' preferences and recommendations for the design of a transdiagnostic, Acceptance and Commitment Therapy (ACT)-based, online intervention for Australian adults. METHODS Thirty-five people (consumers, carers, GPs, mental health professionals) participated in one or more co-design stages. Stage 1: semi-structured interviews to establish what is wanted from such websites (n = 22). Stage 2: feedback emailed on branding options (n = 20). Stage 3: feedback provided via Zoom or an online survey after testing a website prototype (n = 19). Data were analysed using Thematic Framework Analysis and descriptive statistics. RESULTS Stage 1 highlighted nine key design principles (plus 25 subthemes) that participants emphasised as important to ensure the website would have broad appeal and meet their needs: (1) user choice is valued highly; (2) ACT-based content is acceptable as it is focused on helping people be proactive and 'get unstuck'; (3) non-pathologising, direct, empowering, lay language is endorsed; (4) a positive look and feel is appreciated; (5) images and videos are important to break up text and maintain engagement; (6) short text messages to aid engagement are valued; (7) provision of tailored psychoeducation for highly distressed and suicidal users is endorsed; (8) personal and proactive brand name is preferred (icanactnow); (9) diverse marketing and training activities are recommended. In Stage 2, icanactnow branding preferences were elicited (simplicity, colours to represent growth and a call to action). Stage 3 resulted in the inclusion of a safety plan template and a tailored entry portal for people referred to icanactnow by health professionals. High levels of satisfaction with the prototype were reported. CONCLUSIONS These findings informed icanactnow and provide insights for the development of other online mental health interventions, in ways that appeal to both consumers and professionals recommending them.
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Affiliation(s)
- Donna Hughes-Barton
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, City East Campus, North Terrace, Adelaide, South Australia, 5001, Australia
| | - Gemma Skaczkowski
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, City East Campus, North Terrace, Adelaide, South Australia, 5001, Australia
| | - Chloe Fletcher
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, City East Campus, North Terrace, Adelaide, South Australia, 5001, Australia
| | - Deborah Turnbull
- School of Psychology, The University of Adelaide, Adelaide, SA, 5000, Australia
| | - Janne McMahon
- Lived Experience Australia, PO Box 12, Oaklands Park, 5046, Australia
| | - Kate M Gunn
- IIMPACT in Health, Department of Rural Health, Allied Health and Human Performance, University of South Australia, City East Campus, North Terrace, Adelaide, South Australia, 5001, Australia.
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Chong YY, Frey E, Chien WT, Cheng HY, Gloster AT. The role of psychological flexibility in the relationships between burnout, job satisfaction, and mental health among nurses in combatting COVID-19: A two-region survey. J Nurs Scholarsh 2023; 55:1068-1081. [PMID: 36610054 DOI: 10.1111/jnu.12874] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND A growing body of evidence suggests that the COVID-19 pandemic is adversely impacting the mental health and well-being of frontline nurses worldwide. It is therefore important to understand how such impact can be mitigated, including by studying psychological capacities that could help the nurses regulate and minimize the impact. AIM To examine the role of psychological flexibility in mitigating the adverse impacts of burnout and low job satisfaction on mental health problems (i.e., anxiety, depression, and stress) and well-being among the frontline nurses in Hong Kong and Switzerland during the COVID-19 pandemic. DESIGN Cross-sectional, two-region survey study. METHOD Four hundred fifty-two nurses from Hong Kong (n = 158) and Switzerland (n = 294) completed an online survey. An adjusted structured equation model was used to examine the interrelationship of the constructs. RESULTS Psychological flexibility was found to partially mediate the effects of job satisfaction on mental well-being (β = 0.32, 95% CI [0.19, 0.57], p = 0.001) and mental health problems (β = -0.79, 95% CI [-1.57, -0.44], p = 0.001), respectively. Similarly, this partial mediation was found in the effects of burnout on mental well-being (β = -0.35, 95% CI [-0.89, -0.15], p = 0.002) and mental health problems (β = 0.89, 95% CI [0.48, 3.65], p = 0.001). CONCLUSION Psychological flexibility could be a crucial psychological resilience factor against the adverse impact of nurses' burnout on their mental health problems and well-being during COVID-19. CLINICAL RELEVANCE Organizational measures should focus on fostering psychological flexibility in nurses through highly accessible, brief psychotherapeutic interventions, such as Acceptance and Commitment Therapy, to reduce the impact on mental health.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eveline Frey
- Division of Clinical Psychology and Intervention Science, Faculty of Psychology, University of Basel, Switzerland
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Andrew T Gloster
- Division of Clinical Psychology and Intervention Science, Faculty of Psychology, University of Basel, Switzerland
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Zerach G, Ben-Yehuda A, Levi-Belz Y. A prospective investigation of protective factors for moral injury and psychiatric symptomatology among Israeli combatants: A Latent Class Analysis approach. Int J Soc Psychiatry 2023; 69:1134-1144. [PMID: 36734242 DOI: 10.1177/00207640231152211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In this prospective study, we examined pre-enlistment characteristics and pre-deployment protective factors of exposure to potentially morally injurious events (PMIEs) among Israeli active-duty combatants, as well as psychiatric symptomatology outcomes of exposure. METHODS A sample of 335 active-duty Israeli combatants participated in a 2.5-year prospective study with three waves of measurements (T1: 12 months before enlistment, T2: 6 months following enlistment- pre deployment, and T3: 18 months following enlistment- post deployment). Participants' characteristics were assessed via semi-structured interviews (T1) and validated self-report measures (T2-T3) between 2019 and 2021. RESULTS Latent Class Analysis (LCA) was used to identify three classes characterized by unique patterns of exposure to PMIEs (T2): Minimal Exposure (56.6%), Betrayal-Only (25.5%), and High Exposure (17.8%). Higher levels of pre-deployment psychological flexibility (T1) were associated with higher odds for inclusion in the high exposure class (T2). As compared to the minimal exposure class, both high exposure and betrayal-only classes were associated with higher levels of mental health symptoms and MI-related psychological outcomes (T2). CONCLUSIONS This is the first prospective study of antecedents and outcomes of exposure to PMIEs among active-duty combatants. Clinicians treating combatants should be aware of the different types of exposure to PMIEs and their possible psychiatric outcomes.
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Affiliation(s)
- Gadi Zerach
- Department of Psychology, Ariel University, Ariel, Israel
| | - Ariel Ben-Yehuda
- Department of Health and Well-being, Medical Corps, IDF, Tel Aviv, Israel
| | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
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Vagos P, Mateus V, Silva J, Araújo V, Xavier A, Palmeira L. Mother-infant bonding in the first nine months postpartum: the role of mother's attachment style and psychological flexibility. J Reprod Infant Psychol 2023:1-15. [PMID: 37525320 DOI: 10.1080/02646838.2023.2242379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION Mother's bond to the infant in the postpartum period plays an important role in the subsequent mother-infant relationship and the infant's socio-emotional functioning. Several maternal characteristics, such as attachment style and psychological flexibility, may contribute to the quality of mother-infant bonding, though literature examining these variables is still scarce. The present study aimed to examine the impact of mother's attachment on mother-infant bonding in the first month postpartum and the mediating role of psychological flexibility on that association. METHODS Participants were 226 mothers of an infant up to 9 months old, who reported on their own attachment style (in terms of anxiety, comfort with proximity, trust in others), psychological flexibility (in terms of openness to experience, behavioural awareness, valued action) and mother-infant bonding. RESULTS Results showed that mother's attachment anxiety predicted a bond with the infant directly and indirectly via mother's psychological flexibility, specifically through behavioural awareness and valued action. Trust in others had an impact on mother-infant bonding through behavioural awareness, whereas comfort with proximity influenced mother-infant bond indirectly, via valued action. Finally, mothers' civil status, schooling and number of children were relevant to better understand the variance of our mediating and dependent variables. DISCUSSION Our findings highlight the importance of mother's attachment and psychological flexibility in promoting the quality of mother-infant bonding, which can inform future intervention programmes targeting modifiable factors, such as psychological flexibility, to promote early positive parent-infant relationships, particularly for single, first-time mothers, with higher levels of education.
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Affiliation(s)
- Paula Vagos
- Portucalense Institute for Psychology (I2P), Department of Psychology and Education, Universidade Portucalense, Porto, Portugal
- William James Center for Research, Department of Education and Psychology, Universidade de Aveiro, Aveiro, Portugal
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention, (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Vera Mateus
- Portucalense Institute for Psychology (I2P), Department of Psychology and Education, Universidade Portucalense, Porto, Portugal
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention, (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Joana Silva
- Portucalense Institute for Psychology (I2P), Department of Psychology and Education, Universidade Portucalense, Porto, Portugal
| | - Vânia Araújo
- Department of Psychology and Education, Universidade Portucalense, Porto, Portugal
| | - Ana Xavier
- Portucalense Institute for Psychology (I2P), Department of Psychology and Education, Universidade Portucalense, Porto, Portugal
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention, (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Lara Palmeira
- Portucalense Institute for Psychology (I2P), Department of Psychology and Education, Universidade Portucalense, Porto, Portugal
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention, (CINEICC), University of Coimbra, Coimbra, Portugal
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Puolakanaho A, Muotka JS, Lappalainen R, Lappalainen P, Hirvonen R, Kiuru N. Adolescents' stress and depressive symptoms and their associations with psychological flexibility before educational transition. J Adolesc 2023; 95:990-1004. [PMID: 36960576 DOI: 10.1002/jad.12169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION Relatively little is known about individual differences in adolescent psychological flexibility and its associations with symptoms of stress and depression. This study examined different profiles of adolescent stress and depressive symptoms and their associations with developing psychological flexibility before the critical educational transition. METHODS The data were derived from a general sample of 740 Finnish ninth-grade adolescents (Mage = 15.7 years, 57% female) who were assessed twice during the final grade of their basic education. The data were analyzed using growth mixture modeling. RESULTS Four profiles of stress and depressive symptoms were identified during a school year: (1) no stress and no depressive symptoms (None; 69%); (2) mild and decreasing stress and depressive symptoms (Decreasing; 15%); (3) low but increasing stress and depressive symptoms (Increasing; 6%); and (4) high and stable levels of stress and depressive symptoms (High; 10%). The adolescents in these profiles differed from each other in their initial levels and changes of psychological flexibility. The initial level of psychological flexibility was highest in the no-symptom profile group. We observed simultaneous change trends in symptoms and psychological flexibility during a school year. When symptoms decreased, psychological flexibility increased, and when symptoms increased, psychological flexibility decreased. CONCLUSIONS A bidirectional pattern of relationships between psychological flexibility and psychological symptoms was found. Despite initially high level of skills in psychological flexibility, some adolescents, unexpectedly, experienced increased symptoms of stress and depression during the school year. The results call for further studies to explore in-depth the developmental diversity in adolescents' well-being and its antecedents.
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Affiliation(s)
- Anne Puolakanaho
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Joona S Muotka
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Päivi Lappalainen
- Department of Psychology and GeroCenter, University of Jyväskylä, Jyväskylä, Finland
| | - Riikka Hirvonen
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Noona Kiuru
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
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Deng Y, Huang P, Yang Q, Ye B. Perceived Stress, Psychological Flexibility Profiles, and Mental Health During COVID-19: A Latent Profile Analysis. Psychol Res Behav Manag 2023; 16:1861-1871. [PMID: 37228590 PMCID: PMC10204761 DOI: 10.2147/prbm.s409395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
Purpose Although the link between psychological flexibility and healthy functioning has been widely analyzed, the employed measurements often lacked accuracy. The current study introduced a person-centered approach that identified subgroups of college students across the dimensions of the Personalized Psychological Flexibility Index (PPFI) and explored how these subgroups relate to a risk factor (perceived stress) and mental health outcomes (depression, anxiety, negative affect, and positive affect) in the context of COVID-19. Methods A sample of 659 participants (Mage = 19. 99, SD = 1.27; 57.97% females) completed the questionnaires online. Latent profile analysis (LPA) was employed to determine the optimal number of subgroups or profiles. Then, multinomial logistic regression and analyses of variance were used to identify variables associated with profile membership. Results LPA identified three distinct profiles (active strategy, inconsistent strategy, and passive strategy). Furthermore, multinomial logistic regressions indicated that students with high perceived stress were more likely to be in the passive strategy group than the active strategy group (β = -0.104, OR = 0.901, p < 0.001) and the inconsistent strategy group (β = -0.087, OR = 0.917, p < 0.001). Additionally, analyses of variance revealed that the three profiles differed in depression (η2 = 0.062, p < 0.001), anxiety (η2 = 0.059, p < 0.001), negative affect (η2 = 0.047, p < 0.001), and positive affect (η2 = 0.048, p < 0.001). Conclusion The current study employed LPA based on the PPFI to identify and confirm three profiles of psychological flexibility. We found that perceived stress and mental health outcomes were associated with these three profiles. This study offers a new perspective on understanding psychological flexibility through a person-centered approach. Furthermore, interventions aimed at reducing college students' perceived stress during the COVID-19 crisis are critical for preventing the deterioration of psychological flexibility.
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Affiliation(s)
- Yuhong Deng
- School of Psychology, School of Education, Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, People’s Republic of China
| | - Pengfei Huang
- School of Psychology, School of Education, Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, People’s Republic of China
| | - Qiang Yang
- School of Education, Jiangxi Normal University, Nanchang, People’s Republic of China
| | - Baojuan Ye
- School of Psychology, School of Education, Center of Mental Health Education and Research, Jiangxi Normal University, Nanchang, People’s Republic of China
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Gorday JY, Bardeen JR, Rogers TA, Benfer N. A prospective examination of the role of psychological (in)flexibility in posttraumatic stress: A cross-lagged panel design. J Anxiety Disord 2023; 97:102725. [PMID: 37207555 DOI: 10.1016/j.janxdis.2023.102725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 05/03/2023] [Accepted: 05/10/2023] [Indexed: 05/21/2023]
Abstract
Functional contextualist models of psychopathology suggest that psychological inflexibility and psychological flexibility are of central importance for understanding the development and maintenance of posttraumatic stress (PTS) symptomatology. To our knowledge, these two constructs and their domain-specific factors (e.g., cognitive fusion, experiential avoidance) have not been assessed in their entirety and examined in relation to PTS symptoms using a longitudinal study design. As such, the primary aim of the present study was to use cross-lagged panel analysis, an analytic approach that allows stronger causal inferences to be made regarding the nature of temporal relations among study variables, to determine the directional relations among PTS symptoms and psychological flexibility and inflexibility over an eight-month time period. Trauma-exposed adults (N = 810), recruited online via Amazon's Mechanical Turk (MTurk), completed a battery of self-report measures via a secure online platform at three time points, spanning eight months. Results suggest that the relationship between psychological inflexibility and PTS symptoms is bidirectional and mutually reinforcing. In contrast, significant prospective relations were not observed between psychological flexibility and PTS symptoms. Results of a follow-up exploratory path analysis showed that cognitive fusion was the only psychological inflexibility subfactor that partially mediated the relationship between PTS symptoms from baseline to the eight-month follow-up assessment. Taken together, these results suggest that psychological inflexibility, and primarily the domain of cognitive fusion, maintains PTS symptoms following trauma exposure. As such, it may important to integrate cognitive defusion techniques into evidence-based treatments for Posttraumatic Stress Disorder (PTSD).
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Affiliation(s)
- Julia Y Gorday
- Department of Psychological Sciences, Auburn University, Auburn AL, USA
| | - Joseph R Bardeen
- Department of Psychological Sciences, Auburn University, Auburn AL, USA.
| | - Travis A Rogers
- VA Ann Arbor Healthcare System, Mental Health Service, USA; University of Michigan Medical School, Department of Psychiatry, USA
| | - Natasha Benfer
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, USA
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Sarbassova G, Kudaibergenova A, Madaliyeva Z, Kassen G, Sadvakassova Z, Ramazanova S, Ryskulova M. Diagnostics of psychological flexibility and the ability to cope with the inevitable changes among psychology students. CURRENT PSYCHOLOGY 2023:1-13. [PMID: 37359571 PMCID: PMC10172729 DOI: 10.1007/s12144-023-04712-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 06/28/2023]
Abstract
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.
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Affiliation(s)
- Gulzat Sarbassova
- Department of Pedagogy and Psychology, Kazakh Humanitarian and Legal Innovation University in Semipalatinsk, Semey, Kazakhstan
| | - Aliya Kudaibergenova
- Department of Pedagogy and Educational Management, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Zabira Madaliyeva
- Department of General and Applied Psychology, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Gulmira Kassen
- Department of General and Applied Psychology, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Zukhra Sadvakassova
- Department of General and Applied Psychology, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Samal Ramazanova
- Department of Pedagogy and Educational Management, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Madina Ryskulova
- Department of Psychology, Eurasian National University named after L.N. Gumilyov, Nur-Sultan, Kazakhstan
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Erduran Tekin Ö, Şirin A. Rumination Mediates the Relationship Between Childhood Traumas with Cognitive Defusion, Acceptance, and Emotion Regulation: A Qualitative and Quantitative Study. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2023:1-28. [PMID: 37360921 PMCID: PMC10081932 DOI: 10.1007/s10942-023-00503-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 06/28/2023]
Abstract
This study examines the intermediary role of rumination in the relationship between childhood traumas in young adults and cognitive defusion, psychological acceptance, and suppression which is one of the emotion regulation strategies. In the quantitative stage of the study formed according to the explanatory sequential design, the intermediary role of rumination by using a structural equation model while in the qualitative stage, the intermediary role of rumination was analyzed through interviews using the interpretive phenomenology design. Personal Information Form, Childhood Trauma Scale, Short Form Ruminative Response Scale, Acceptance and Action Form II, Drexel Defusion Scale, and Emotion Regulation Scale were used in the research. At the end of the research, it was determined that childhood traumas have a negative effect on cognitive defusion and acceptance, while they have a positive effect on suppression. It was seen that rumination has a partial intermediary role in the relationship of childhood traumas with cognitive defusion, acceptance, and suppression. As a result of the qualitative analysis, twelve themes such as "Constantly thinking about the past, not being able to move away from childhood traumas, not being able to forgive their parents, inability to get rid of negative thoughts, living in the past, moving away from a value-driven life, false expression of emotion, suppression of emotions, emotions reflected in behavior, coping with negative emotions and desired emotion regulation" emerged concerning participants' experiences of cognitive defusion, acceptance, and suppression. Although one of the purposes of using AAQ-II in the study was to support discussions about the scale via qualitative results, this was a limitation for the study. Therefore, although a high rate was obtained, it is not possible to infer that childhood traumas and rumination can explain acceptance behaviors. For this, much more quantitative and qualitative studies are needed. Other qualitative research findings are thought to support quantitative research findings.
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Affiliation(s)
- Özge Erduran Tekin
- Department of Educational Sciences, National Defense University, Air Force Academy, 34149 Yeşilyurt, Istanbul, Turkey
| | - Ahmet Şirin
- Department of Guidance and Psychological Counseling, Marmara University Atatürk Faculty of Education, Istanbul, Turkey
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Faulkner JW, Snell DL, Theadom A, Mahon S, Barker-Collo S. The influence of psychological flexibility on persistent post concussion symptoms and functional status after mild traumatic brain injury. Disabil Rehabil 2023; 45:1192-1201. [PMID: 35382660 DOI: 10.1080/09638288.2022.2055167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE This study investigated the predictive role of psychological flexibility on long-term mTBI outcomes. METHOD Adults with mTBI (N = 147) completed a context specific measure of psychological flexibility, (AAQ-ABI), psychological distress, and mTBI outcomes at less than three months post injury (M = 6.02 weeks after injury) and 6 months later (N = 102). Structural equation modelling examined the mediating effects of psychological flexibility on psychological distress and mTBI outcomes at six months. The direct effect of psychological flexibility at less than three months on mTBI outcomes at six months was entered into the model, plus pre-injury and injury risk factors. RESULTS The theoretically derived model had good overall fit (χ2 = 1.42; p = 0.09; NFI = 0.95; TLI = 0.95; CFI = 0.98 and RMSEA = 0.06). Psychological flexibility at less than 3 months was directly significantly related to psychological distress and post-concussion symptoms at six months. Psychological flexibility at 6 months significantly mediated the relationship between psychological distress and functional disability but not post-concussion symptoms at six months post injury. CONCLUSION The exploratory findings suggest that a context specific measure of psychological flexibility assessed acutely and in the chronic phase of recovery may predict longer-term mTBI outcomes.Implications for RehabilitationPersistent post-concussion symptoms (PPCS) after mild traumatic brain injury (mTBI) can have a significant impact on wellbeing, functional status, and quality of life.In this study, psychological flexibility early in recovery, was associated with higher levels of psychological distress and more severe post-concussion symptoms six months later.Psychological flexibility at six months post-injury also mediated the relationship between psychological distress and functional disability.A context specific measure of psychological flexibility may predict poorer long-term outcomes following mTBI.
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Affiliation(s)
| | - Deborah L Snell
- Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | - Alice Theadom
- TBI Network, Auckland University of Technology, Northcote, Auckland, New Zealand
| | - Susan Mahon
- TBI Network, Auckland University of Technology, Northcote, Auckland, New Zealand
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Cyniak-Cieciura M, Białaszek W, Dudek J, Ostaszewski P. Temperament, Life Satisfaction, and the Role of Psychological Flexibility. JOURNAL OF INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1027/1614-0001/a000396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Abstract: Temperament is related to well-being. Establishing mediators of this relationship, especially mediators which can be influenced through psychological interventions, may contribute to tailoring these interventions to people’s needs determined by temperament. Psychological flexibility may be considered such a mediator. This study aims to examine the relationships between temperament traits and structures, satisfaction with life, and psychological flexibility, with the latter as a possible mediator of the relationship between temperament structures and life satisfaction. 538 participants (18–93 years old) took part in the study. They filled a set of self-reported questionnaires. Psychological flexibility explained a significant part of the variance in life satisfaction above and beyond temperament traits. People with harmonized temperament structures and higher stimulation processing capabilities (sanguine) exhibited higher psychological flexibility and satisfaction with life. Three temperament structures: phlegmatic, choleric, and melancholic in comparison to sanguine were found to be linked to lower satisfaction with life through lower psychological flexibility. The results suggest a meaningful role of stimulation processing capabilities in the development of both psychological flexibility and satisfaction with life.
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Affiliation(s)
- Maria Cyniak-Cieciura
- Advanced Clinical Studies and Therapy Excellence Centre, Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Wojciech Białaszek
- Center for Behavioural Research in Decision Making, Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Joanna Dudek
- Center for Behavioural Research in Decision Making, Faculty of Psychology in Warsaw, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Paweł Ostaszewski
- Center for Behavioural Research in Decision Making, Institute of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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Vylobkova V, Heintz S. A meeting of positive behaviors: The relations of three aspects of flexibility with character strengths. Front Psychol 2023; 13:1078764. [PMID: 36817377 PMCID: PMC9935571 DOI: 10.3389/fpsyg.2022.1078764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/22/2022] [Indexed: 02/05/2023] Open
Abstract
Introduction The adaptation of own plans and behaviors to new circumstances seems to be a desirable personal quality in the modern world. it has been assumed that adaptability cannot be transferred to a single character strength. Methods The present research examines this assumption using typical and daily behaviors of three aspects of flexibility (predictability, adaptability and orderliness) and 24 character strengths across two studies (N1 = 283, N2 = 188). Results Flexibility showed a consistent and large overlap with character strengths. Adaptability was positively related to most of the strengths. Predictability was positively related to humility and prudence, and orderliness to perseverance, prudence, and selfregulation. Discussion These results support our initial assumption and build a strong basis for further examining the relationships and interplay between flexibility and character strengths. They also constitute an important first step toward integrative positive interventions that target relevant aspects of flexibility and character.
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Affiliation(s)
| | - Sonja Heintz
- Department of Psychology, University of Zurich, Zurich, Switzerland
- School of Psychology, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
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Watson DC, Howell AJ. Psychological flexibility, non-attachment, and materialism. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2022.111965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Wang J, Fang S, Yang C, Tang X, Zhu L, Nie Y. The Relationship Between Psychological Flexibility and Depression, Anxiety and Stress: A Latent Profile Analysis. Psychol Res Behav Manag 2023; 16:997-1007. [PMID: 36998741 PMCID: PMC10044140 DOI: 10.2147/prbm.s400757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/14/2023] [Indexed: 04/01/2023] Open
Abstract
Purpose To explore the potential classification of psychological flexibility (PF) among Chinese college students, analyze whether there is group heterogeneity in PF, and discuss the differences in the latent profile of PF in the negative emotions of depression, anxiety, and stress. Methods A total of 1769 college students were investigated using the Psychological Flexibility Questionnaire and Depression-Anxiety-Stress Self-rating Scale, and heterogeneity was tested by latent profile analysis. Results The PF of college students can be divided into three latent profiles: self-contradiction group (19.2%), high PF group (34.1%), and low PF group (46.7%). The scores of depression, anxiety, and stress are significantly different among the groups. Conclusion There is obvious group heterogeneity in the PF of college students, and they can be divided into the self-contradiction group, the high PF group, and the low PF group. The self-contradiction and low PF groups score significantly higher on the negative emotions of depression, anxiety, and stress than the high PF group.
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Affiliation(s)
- Jing Wang
- School of Educational Science, Anhui Normal University, Wuhu, People’s Republic of China
| | - Shuanghu Fang
- School of Educational Science, Anhui Normal University, Wuhu, People’s Republic of China
- Correspondence: Shuanghu Fang, Email
| | - Chunying Yang
- School of Special Education, Zhengzhou Normal University, Zhengzhou, People’s Republic of China
| | - Xiaobin Tang
- School of Marxism, Anhui Normal University, Wuhu, People’s Republic of China
| | - Luosha Zhu
- School of Marxism, Anhui Normal University, Wuhu, People’s Republic of China
| | - Yu Nie
- Office of Student Affairs, Anhui Normal University, Wuhu, People’s Republic of China
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Chiesi F, Marunic G, Tagliaferro C, Lau C. The psychometric properties and gender invariance of the Italian version of the Perceived Vulnerability to Disease Questionnaire (I-PVDQ) during the COVID-19 pandemic. BMC Psychol 2022; 10:321. [PMID: 36581890 PMCID: PMC9797899 DOI: 10.1186/s40359-022-01023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/13/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The Perceived Vulnerability to Disease Questionnaire (PVDQ) measures beliefs associated with personal susceptibility to infectious diseases and behaviors or perceptions in the presence of potential risk of pathogen transmission. Given the onset of the Severe Acute Respiratory Syndrome Coronavirus 2 global pandemic, otherwise known as the COVID-19 pandemic, the construct being measured may function differently based on affective, behavioral, and cognitive changes along with the need to change norms and lifestyles in a global context. The present study aims to test the psychometric properties and the gender invariance of the Italian adaptation of the PVDQ to confirm that the scale can be used with Italian-speaking people, and that it functions effectively during a pandemic. METHODS A total of 509 participants filled out an online questionnaire including the Italian version of the I-PVDQ (I-PVDQ) and several measures of psychological constructs. Reliability and factor analyses (single and multigroup) were conducted. Bayesian correlation tests and Bayesian independent sample t-tests were used to assess the validity of I-PVDQ. RESULTS Exploratory factor analysis supported the two-factor structure of the I-PVDQ, and factor loadings loaded appropriately onto perceived infectability (PI) and germ aversion (GA). In terms of invariance, the scale showed configural, metric, scalar, and strict invariance across genders. Decisive evidence in favor of correlation with the measure of COVID-19 related fears for both PI and GA was found. There was strong evidence for observed correlations with COVID-19 related constructs such as intolerance to uncertainty, psychological inflexibility, resilience, stress, and anxiety. Women showed higher GA than men, while there were no gender differences in PI. CONCLUSIONS Taken together, these results suggest that the I-PVDQ confirms the psychometric properties of the original version and that can be used to detect PVD when it is affected by environmental circumstances since its functioning is preserved during a pandemic.
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Affiliation(s)
- Francesca Chiesi
- grid.8404.80000 0004 1757 2304Department of Neuroscience, Psychology, Drug, and Child’s Health (NEUROFARBA), Section of Psychology, University of Florence, Via San Salvi 12-Padiglione 26, 50135 Florence, Italy
| | - Georgia Marunic
- grid.8404.80000 0004 1757 2304Department of Neuroscience, Psychology, Drug, and Child’s Health (NEUROFARBA), Section of Psychology, University of Florence, Via San Salvi 12-Padiglione 26, 50135 Florence, Italy
| | - Carlotta Tagliaferro
- grid.8404.80000 0004 1757 2304School of Psychology, University of Florence, Florence, Italy
| | - Chloe Lau
- grid.155956.b0000 0000 8793 5925Centre for Addiction and Mental Health, Toronto, ON Canada
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Foote H, Bowen A, Cotterill S, Hill G, Pieri M, Patchwood E. A scoping review to identify process and outcome measures used in acceptance and commitment therapy research, with adults with acquired neurological conditions. Clin Rehabil 2022; 37:808-835. [PMID: 36540937 PMCID: PMC10134096 DOI: 10.1177/02692155221144554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Acceptance and Commitment Therapy interventions are increasing in use in neurological populations. There is a lack of information on the measures available. Purpose To identify and classify the measures used in Acceptance and Commitment Therapy research studies with adults with acquired neurological conditions. Methods PRISMA-ScR guided scoping review. MEDLINE, PsycInfo and CINAHL databases searched (up to date 29/06/2022) with forward and backward searching. All study types included. Extraction of Acceptance and Commitment Therapy process-of-change and health-related outcome measures. Outcomes coded using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy. Results Three hundred and thirty three papers found on searching. Fifty four studies included and 136 measurement tools extracted. Conditions included multiple sclerosis, traumatic brain injury and stroke. Thirty-eight studies measured processes of change, with 32 measures extracted. The process measure most often used was the Acceptance and Action Questionnaire ( n = 21 studies). One hundred and four health-related outcome measures extracted. Measures exploring quality of life, health status, anxiety and depression occurred most frequently, and were used in all included neurological conditions. COMET domains most frequently coded were emotional functioning/well-being ( n = 50), physical functioning ( n = 32), role functioning ( n = 22) and psychiatric ( n = 22). Conclusions This study provides a resource to support future identification of candidate measures. This could aid development of a Core Outcome Set to support both research and clinical practice. Further research to identify the most appropriate and relevant targets and tools for use in these populations should include expert consensus, patient, carer and public involvement and psychometric examination of measures.
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Affiliation(s)
- Hannah Foote
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
- Hannah Foote, Geoffrey Jefferson Brain
Research Centre, The Manchester Academic Health Science Centre, Northern Care
Alliance and University of Manchester, Manchester, UK.
| | - Audrey Bowen
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
| | - Sarah Cotterill
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Geoff Hill
- South Tees Hospitals NHS Foundation
Trust, The James Cook University Hospital, Middlesbrough, UK
| | | | - Emma Patchwood
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
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Zarowsky Z, Rashid T. Resilience and Wellbeing Strategies for Pandemic Fatigue in Times of Covid-19. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2022; 8:1-36. [PMID: 36196257 PMCID: PMC9523176 DOI: 10.1007/s41042-022-00078-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic is truly one of the greatest collective health crises in history which have altered our life and living. For years, people have felt fatigued from following public health directives such as social distancing, wearing masks, washing hands frequently, and working or studying remotely without in-person interactions. In this paper, we explore strategies for resilience and wellbeing which can mitigate pandemic-caused stress and behavioural fatigue. We start with individual level strategies including reworking stress appraisals, the importance of psychological flexibility, reducing loneliness through adaptive online platform use, optimizing familial relationships when living in close quarters for a prolonged period, reducing symptoms of burnout and using adaptive distractions, using specific evidence-based resilience strategies. We discuss specific considerations which tap on our shared identities and shared responsibilities which can enhance a sense of community, especially for individuals from marginalized backgrounds and how suicide risks can be minimized.
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Affiliation(s)
- Zachary Zarowsky
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trial, Toronto, ON M1C 1A4 Canada
| | - Tayyab Rashid
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trial, Toronto, ON M1C 1A4 Canada
- Centre for Wellbeing Science, Melbourne Graduate School of Education, Melbourne, Australia
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Faulkner JW, Snell DL, Theadom A. Psychological flexibility moderates the influence of fear avoidance on outcomes after mild traumatic brain injury. Brain Inj 2022; 36:991-999. [PMID: 35950285 DOI: 10.1080/02699052.2022.2109747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Psychological factors contribute to poorer long-term outcomes following mild traumatic brain injury (mTBI); however, the exact psychological mechanisms that underly this relationship are not well understood. This study examined the relationship between psychological flexibility, fear avoidance, and outcomes over the first 6 months after mTBI. METHOD Adults with mTBI-completed measures of psychological flexibility, fear avoidance, post-concussion symptoms, and functional status at baseline (<3 months post-injury; N = 152), and 3-month (N = 133) and 6-month follow-up (N = 102). A conceptually derived moderation-mediation analysis was used to test the mediating effect of fear avoidance on post-concussion symptoms and functional outcomes, and the moderating effects of psychological flexibility on fear avoidance. RESULTS Fear avoidance had a significant indirect effect on the relationship between post-concussion symptoms and functional status across all three time points. Psychological flexibility was found to significantly moderate these effects. Only low levels of psychological flexibility had a significant influence on the mediating effects of high fear avoidance on functional status at 6-month follow-up. CONCLUSIONS Psychological flexibility may influence mTBI recovery by exerting an influence on fear avoidance. These initial findings provide a potential theoretical explanation of how fear avoidance can become maladaptive with time after mTBI.
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Affiliation(s)
- Josh W Faulkner
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Deborah L Snell
- Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | - Alice Theadom
- TBI Network, Auckland University of Technology, Northcote, Australia
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Spencer SD, Meyer MS, Masuda A. A Case-Series Study Examining Acceptance and Commitment Therapy for Experiential Avoidance-Related Mixed Anxiety and Depression in a Telehealth Platform. Clin Case Stud 2022. [DOI: 10.1177/15346501221115113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Acceptance and commitment therapy (ACT) is a process-based, transdiagnostic approach to treatment that seeks to increase values-based, adaptive functioning (i.e., engaged living [EL]) in part through attenuating the impact of experiential avoidance (EA). The present case-series study examined EL and EA as mechanisms of change within a 10-week course of individual ACT delivered via a telehealth platform. Participants were two adult women with mental health concerns associated with clinically elevated EA. Throughout the study, we collected (a) daily self-monitored clinically relevant behaviors, (b) daily and weekly measures of EL and EA, and (c) pre-, mid-, post-treatment, and 3-month follow-up measures of psychopathology, quality of life, and ACT-related outcome variables. Results showed support for the efficacy of ACT, with both participants demonstrating slight improvements in clinically relevant behaviors, along with expected improvements in EL and EA. These favorable results were most pronounced for Participant 1. Results are discussed in the context of COVID-19-related adaptations (including telehealth), and within the framework of process-based ACT and its transdiagnostic applicability to a range of mental health concerns.
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Spencer SD, Jo D, Hamagami F, Antonio MC, Qinaʻau J, Masuda A, Hishinuma ES. A psychometric validation of contextual cognitive behavioral therapy-informed measures with racially and ethnically diverse adults. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Grove L, Roche AI, Doyle R, Stowe ZN, Thomas EBK. ACT-Informed Treatment of Co-morbid Psychiatric Disorders in the Postpartum Period: A Case Report. Clin Case Stud 2022. [DOI: 10.1177/15346501221091273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The literature describing psychological interventions for co-occurring obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) is limited. Acceptance and Commitment Therapy (ACT) is a transdiagnostic intervention that targets functionally avoidant behavior underlying both OCD and PTSD. The current case report describes how an ACT-informed approach to treatment was implemented over 14 sessions to treat co-occurring OCD and PTSD in a 9-months postpartum adult woman. The patient was initially referred to psychotherapy by her psychiatrist and showed high motivation to engage in treatment. This case presentation outlines how the intervention targeted core ACT processes while also incorporating components from both exposure and response prevention (ERP) and cognitive processing therapy (CPT) to address the patient’s presenting concerns. Measurements of OCD and PTSD symptom severity, as well as of depressive and anxiety symptoms, over the course of treatment are included. Health-related comorbidities, psychiatric medications, and implications are discussed.
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Affiliation(s)
- Lindsey Grove
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine, Madison, WI, USA
| | - Anne I. Roche
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Rena Doyle
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine, Madison, WI, USA
| | - Zachary N. Stowe
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine, Madison, WI, USA
| | - Emily B. K. Thomas
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
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Rauwenhoff JCC, Bol Y, Peeters F, van den Hout AJHC, Geusgens CAV, van Heugten CM. Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases. Neuropsychol Rehabil 2022:1-31. [PMID: 35332849 DOI: 10.1080/09602011.2022.2053169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Patients with acquired brain injury (ABI) often experience symptoms of anxiety and depression. Until now, evidence-based treatment is scarce. This study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) for patients with ABI. To evaluate the effect of ACT for people with ABI, a non-concurrent multiple baseline design across four cases was used. Participants were randomly assigned to a baseline period, followed by treatment and then follow-up phases. Anxiety and depressive symptoms were repeatedly measured. During six measurement moments over a year, participants filled in questionnaires measuring anxiety, depression, stress, participation, quality of life, and ACT-related processes. Randomization tests and NAP scores were used to calculate the level of change across phases. Clinically significant change was defined with the Reliable Change Index. Three out of four participants showed medium to large decreases in anxiety and depressive symptoms (NAP = 0.85 till 0.99). Furthermore, participants showed improvements regarding stress, cognitive fusion, and quality of life. There were no improvements regarding psychological flexibility, value-driven behaviour, or social participation. This study shows that ACT is possibly an effective treatment option for people experiencing ABI-related anxiety and depression symptoms. Replication with single case or large scale group studies is needed to confirm these findings.
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Affiliation(s)
- Johanne C C Rauwenhoff
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Centre, Maastricht, Netherlands
| | - Yvonne Bol
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, Netherlands
| | - Frenk Peeters
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Anja J H C van den Hout
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, Netherlands
| | - Chantal A V Geusgens
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, Netherlands
| | - Caroline M van Heugten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Centre, Maastricht, Netherlands.,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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Giovannetti AM, Pöttgen J, Anglada E, Menéndez R, Hoyer J, Giordano A, Pakenham KI, Galán I, Solari A. Cross-Country Adaptation of a Psychological Flexibility Measure: The Comprehensive Assessment of Acceptance and Commitment Therapy Processes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3150. [PMID: 35328838 PMCID: PMC8953951 DOI: 10.3390/ijerph19063150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/09/2022] [Accepted: 03/04/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE The Comprehensive assessment of Acceptance and Commitment Therapy (ACT) processes (CompACT) is a 23-item self-report questionnaire assessing psychological flexibility, which is the overarching construct underpinning the ACT framework. We conducted a two-phase project to develop validated versions of the CompACT in three languages: phase 1-cross-cultural adaptation; and phase 2-psychometric validation of the questionnaire for use in Italy, Germany and Spain. This article focuses on the first phase. METHODS We translated and culturally adapted the CompACT in the three target languages, following the ISPOR TCA Task Force guidelines. The process was overseen by a translation panel (three translators, at least two multiple sclerosis (MS) researchers and a lay person), ACT experts and clinicians from the research team of each country and the original CompACT developers. We debriefed the new questionnaire versions via face-to-face interviews with a minimum of four adults from the general population (GP) and four adults with MS in each country. RESULTS The translation-adaptation process went smoothly in the three countries, with some items (7 in Italy, 4 in Germany, 6 in Spain) revised after feedback from ACT experts. Cognitive debriefing showed that the CompACT was deemed easy to understand and score in each target country by both GP and MS adults. CONCLUSIONS The Italian, German and Spanish versions of the CompACT have semantic, conceptual and normative equivalence to the original scale and good content validity. Our findings are informative for researchers adapting the CompACT and other self-reported outcome measures into multiple languages and cultures.
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Affiliation(s)
- Ambra Mara Giovannetti
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (A.G.); (A.S.)
| | - Jana Pöttgen
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Elisenda Anglada
- Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (E.A.); (R.M.); (I.G.)
| | - Rebeca Menéndez
- Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (E.A.); (R.M.); (I.G.)
| | - Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany;
| | - Andrea Giordano
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (A.G.); (A.S.)
- Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Kenneth Ian Pakenham
- School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, St. Lucia, QLD 4072, Australia;
| | - Ingrid Galán
- Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (E.A.); (R.M.); (I.G.)
| | - Alessandra Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (A.G.); (A.S.)
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Chen Y, Luo H, Wang S, Bai X, Zhu Z. Preliminary validation of a Chinese version of the comprehensive assessment of acceptance and commitment therapy processes. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02654-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Self-compassion buffers the effects of perfectionistic self-presentation on social media on wellbeing. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2021.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Lackner JM, Gudleski GD, Radziwon CD, Krasner SS, Naliboff BD, Vargovich AM, Borden AB, Mayer EA. Cognitive flexibility improves in cognitive behavior therapy for irritable bowel syndrome but not nonspecific education/support. Behav Res Ther 2022; 154:104033. [DOI: 10.1016/j.brat.2022.104033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 02/06/2023]
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