Validating measures of psychological flexibility in a population with acquired brain injury.

Abstract

This study presents preliminary validation data on both the Acceptance and Action Questionnaire-Acquired Brain Injury (AAQ-ABI) and the Acceptance and Action Questionnaire-II (AAQ-II). Data from 150 participants with ABI was subject to exploratory factor analysis on the AAQ-ABI (15 items). A subset of 75 participants with ABI completed a larger battery of measures to test construct validity for the AAQ-ABI and to undertake a confirmatory factor analysis (CFA) on the AAQ-II (7 items). Three meaningful factors were identified on the AAQ-ABI: Reactive Avoidance, Denial, and Active Acceptance. Reactive Avoidance demonstrated good internal and test-retest consistency (α = .89) and correlated in expected directions with other related measures including the AAQ-II. CFA of the AAQ-II did not provide a good fit but did have similar correlations with measures of psychological distress as found in prior non-ABI samples. The results suggest both measures can be used with individuals following an ABI but they index different facets of psychological flexibility. The AAQ-ABI appears to measure psychological flexibility about the thoughts and feelings relating to the brain injury itself while the AAQ-II measures psychological flexibility around general psychological distress. Future research could explore the additional 2 factors of the AAQ-ABI and use these measures in outcome studies that promote psychological flexibility in individuals with an ABI. AbstractThis study presents preliminary validation data on both the Acceptance and Action

Cognitive and psychological flexibility after a traumatic brain injury and the implications for treatment in acceptance-based therapies: A conceptual review

“…This inverse relationship between self-reported distress and psychological flexibility has also been established in individuals with an acquired brain injury (ABI; Whiting, Deane, Ciarrochi, McLeod, & Simpson, 2015). Acceptance-based therapies such as ACT have a theoretical foundation in Relational Frame Theory (RFT).…”

“…As discussed, there is some research into cognitive flexibility after TBI, but few studies about psychological flexibility, which is still in its preliminary COGNITIVE AND PSYCHOLOGICAL FLEXIBILITY AFTER TBI stages (Sylvester, 2011;Whiting et al, 2015;. ACT treatment trials have a focus on either reducing or increasing a behaviour or emotion within a specific context and such changes are thought to be indicative of psychological flexibility (Levin, Hildebrandt, Lillis, & Hayes, 2012), for example, a reduction in smoking behaviour (Bricker, Wyszynski, Comstock, & Heffner, 2013).…”

“…A measure for people with an ABI, the Acceptance and Action Questionnaire for Acquired Brain Injury (AAQ-ABI; Whiting et al, 2015), has recently been validated. The nine item AAQ-ABI poses questions specifically targeted to address acceptance and experiential avoidance associated with reactions about having an ABI.…”

The “self” in pain: the role of psychological inflexibility in chronic pain adjustment

“…Throughout the process of accepting the post-injury self, psychological flexibility is essential to allow malleability in self-concept structure such that behaviors can be changed or redirected according to personal long-term values (Hayes et al, 1999;Whiting et al, 2015). Similarly, studies have elucidated the importance of adjusting life goals and expectations in patients with chronic pain (Dezutter et al, 2015;Schmitz et al, 1996).…”

“…In clinical contexts, some studies have revealed the therapeutic importance of cultivating psychological flexibility in the face of a self-identity crisis resulted from chronic illnesses (Lundgren et al, 2008;Whiting et al, 2015). Throughout the process of accepting the post-injury self, psychological flexibility is essential to allow malleability in self-concept structure such that behaviors can be changed or redirected according to personal long-term values (Hayes et al, 1999;Whiting et al, 2015).…”