Journal of Contextual Behavioral Science最新文献

Objectives

Psychological flexibility is associated with reduced burnout and improved wellbeing in healthcare professionals. This paper outlines the development and initial validation of the Mindful Healthcare Scale (MHS), a novel measure of psychological flexibility in healthcare professionals.

Methods

This paper comprises of three studies drawing on the following samples. Sample 1 (n = 480) and Sample 2 (n = 196) were cross-sectional samples of healthcare professionals. Sample 3 (n = 162) was the baseline sample of a longitudinal study who were followed up after a six-month interval. Seventy-seven participants of sample 3 provided test-retest data at six months. Classical test theory was used to evaluate the psychometric properties of the Mindful Healthcare Scale. Sample One was used to conduct an exploratory factor analysis. A confirmatory factor analysis was undertaken in sample two. Sample two and three were used to test the convergent validity and concurrent validity of the MHS via corelation with measures of burnout, wellbeing, general psychological flexibility, and self-compassion. Incremental validity of the MHS was assessed in predicting wellbeing and burnout after controlling for general psychological flexibility. The sub sample of Sample 3 was used to assess test-retest reliability.

Results

In study one, exploratory factor analysis led to a three-factor structure that was labelled ‘engaged’, ‘awareness’, and ‘defusion’. In study two, confirmatory factor analyses supported this model. Study 3 supported the convergent validity, construct validity, incremental validity and test-retest reliability of the MHS. Internal reliability was found to be good across all samples.

Conclusions

The MHS is a psychometrically sound measure of psychological flexibility in healthcare contexts. It is hoped that this measure will contribute to research and practice that aims to understand and enhance the wellbeing and training of healthcare professionals.

Background

Acceptance and Commitment Therapy (ACT) is a promising approach in psycho-oncology that has led to an increasing number of studies and reviews. This systematic umbrella review provides a comprehensive overview of the results of existing systematic reviews and meta-analyses to investigate the trans-symptomatic (i.e., psychological and physical symptoms) efficacy of ACT in the context of cancer. The study addresses both physical and psychological outcomes, aiming to identify existing research gaps and delineate potential focal points for future studies exploring the application of ACT in psycho-oncological settings.

Methods

A systematic literature search was conducted in Pubmed, Ebsco Host Academic Search Complete (incl. APA PsycInfo), Web of Science, Cochrane Library, website of the Association of Contextual Behavioral Science (ACBS), and Prospero. To be included, studies had to meet the following criteria: 1) be a systematic review and/or meta-analysis focusing on ACT and its impact on psychological and physical outcomes in cancer patients or survivors; 2) include only patients with oncological conditions; 3) be published in English. The quality of the reviews and meta-analyses was assessed using the AMSTAR 2 criteria.

Results

We included eight systematic reviews and meta-analyses in our synthesis. Results of the reviews and meta-analyses indicate that ACT interventions increase the health-related quality of life (HRQoL) and psychological flexibility, and reduce depression, anxiety, and psychological distress in cancer patients and survivors. The best evidence exists regarding psychological distress and HRQoL. The efficacy of these interventions concerning other psychological outcome measures (e.g., fear of progression/recurrence, hope) and biological parameters has not yet been well investigated. Moderator analyses revealed larger effects for younger patients, individuals from Eastern countries (Iran, China), and after longer intervention durations. Results suggest potential differential effects based on the cancer stage. According to the AMSTAR 2 criteria, the quality of the included reviews was low or critically low.

Conclusion

Recent meta-analyses and reviews suggests that ACT interventions are an effective and evidence-based treatment for increasing HRQoL and reducing psychological distress in patients with cancer. However, the results should be interpreted with caution, as the quality of the included reviews was generally low. Our synthesis highlights the need for more high-quality randomized controlled trials, reviews, meta-analyses, and mediator analyses in this research area.

Experiential avoidance (EA) is a key construct in psychopathology research and practice. Thus, various measures were constructed to assess it, including the Brief Experiential Avoidance Questionnaire (BEAQ). Nevertheless, an Arabic version of the BEAQ has yet to be available, a demand that this study was conducted to fulfill. An Arabic version (BEAQ-A) was developed and tested psychometrically using data from 599 Saudi participants who completed the measures online (Mage = 28.93, ± 8.35, 65.9 % women). Exploratory and confirmatory factor analyses uncovered a 14-item hierarchical structure that comprised one second-order factor and three first-order factors: Perceived Avoidance (PA; 10 items), Procrastination (Proc.; 2 items), and Repression/Denial (RD; 2 items). Utilizing further data from a second sample that completed a paper and pencil (PP) version (N=324, Mage = 22.09, ± 3.92, 56.2 % women), this structure appeared to be partially invariant across modes of administration and gender. The Proc. and R/D loaded significantly, along with psychological distress and negative affectivity items, on the same factor in an EFA, thereby undermining their discriminant validity. All subscales demonstrated good internal consistency reliability. The R/D and BEAQ-A total scores were unique predictors of psychological inflexibility and negative affect. In contrast, depressive and anxiety symptoms, positive affect, and well-being were predicted by Proc. and R/D. In general, findings supported the psychometric suitability of BEAQ-A. However, further research is warranted to replicate findings in larger samples and examine the measure's clinical utility.

Recent research demonstrated that associations between psychological flexibility (PF) and subjective well-being are mediated by psychological need satisfaction, in accordance with conceiving PF as a model of eudaimonic activity. The current studies tested whether such relationships persist even when controlling for alternative operationalizations of eudaimonic activity. In Study 1 (N = 289 undergraduates), need satisfaction mediated associations between Psy-Flex scores and both positive affect and life satisfaction when controlling for scores on the Flourishing Scale or Questionnaire for Eudaimonic Well-Being. Similar findings emerged in Study 2 (N = 283 undergraduates) when controlling for scores on the Multidimensional Existential Meaning Scale; these findings were then replicated using a pre-existing data set. We discuss PF in relation to the Eudaimonic Activity Model and Self-Determination Theory.

The purpose of this study was to validate the Chinese version of the Multidimensional Psychological Flexibility Inventory (C-MPFI-24) for use in China, taking into account cultural differences, using classical test theory and network analysis. Participants were Chinese university students, middle school students, university teachers, and medical professionals, totaling 3568 valid respondents from an initial pool of 3800. A retest was conducted one month later with 350 university students. The inventory was analyzed using confirmatory factor analysis, correlation analysis, linear regression, and network analysis. Results showed that the two higher-order factors of the C-MPFI-24, psychological flexibility and inflexibility, fit well (χ2 = 1726.36, df = 239, CFI = 0.936, RMSEA = 0.067), with a significant negative correlation between them (−0.72). Correlation with related scales confirmed good convergent validity, and network analysis supported the robustness of the model. Linear regression indicated that the subscales of the C-MPFI-24 significantly explained variance in well-being and distress beyond that of the AAQ-II. The inventory demonstrated good reliability, test-retest stability, and measurement invariance across groups and genders, establishing its reliability and applicability for assessing psychological flexibility and inflexibility in a Chinese context. Further research is encouraged to examine its cross-cultural stability and applicability.

Background

Russia's 2022 assault on Ukraine caused widespread destruction and displacement, affecting families. War and displacement heighten the risk of mental health issues, particularly when both parents and children are exposed to trauma. Resilience factors such as parental self-compassion and psychological flexibility might play a crucial role in moderating the symptoms.

Objective

This study aimed to investigate the mental health issues among parent-child refugees and assess their association with parental self-compassion and psychological flexibility.

Method

50 parent-child refugees who arrived in Israel after fleeing the war in Ukraine participated in the study. Parents completed self-report questionnaires assessing mental health issues and resilience factors regarding them and their children.

Results

56% of parents and 2% of children met the PTSD cutoff, while 56% of parents and 50% of children met the criteria for general psychological distress. Associations were found between children's PTSD, general distress, and those of their parents. High levels of parental psychological flexibility, self-kindness, and common humanity eliminated the association between parent and child symptoms. While in low and medium levels of these factors, children's PTSD and distress were linked to their parents.

Conclusions

Refugee parents and children mutually influence each other's mental health difficulties. Parental psychological flexibility and self-compassion may moderate these dynamics, offering potential assistance in managing and alleviating children's symptoms. Targeting these parental resilience factors in treatment can enhance outcomes, improving the overall mental well-being of both children and parents.

Brief Acceptance and Commitment Therapy (ACT) interventions are well-suited to facilitate timely access to effective treatment for patients experiencing common mental health concerns. This study piloted a 4-session virtual ACT group for primary care patients experiencing symptoms of depression and anxiety (n = 21). Changes in symptoms of depression and anxiety, psychological flexibility, and quality of life (QoL) were examined at post-treatment and at 1- and 3-month follow-up. At a group level, there were significant reductions in symptoms of depression for all time points and symptoms of anxiety were significantly reduced at 1- and 3-month follow-up. Measures of psychological flexibility and QoL were significantly improved at 1- and 3-month follow-up. Reliable change index scores revealed high proportions of individual improvement for depression and anxiety symptoms (56–83% across time points). Proportions of reliable change ranged from 25 to 50% for measures of psychological flexibility and QoL at 1- and 3-month follow-up. Overall, these results are comparable with previously reported rates of improvement for empirically supported treatments and provide preliminary evidence for the effectiveness of this brief ACT intervention delivered in a community setting.

State of Surrender (SoS)—the willingness to accept what is to come without resistance—has been conceptualized as a psychological state associated with heightened well-being. Conceptually, SoS bears a resemblance to existing constructs shown to be related to psychological health (e.g., psychological flexibility, mindfulness). As such, the purpose of this paper was to evaluate the psychometric proprieties of the SoS scale, demonstrate its novelty as a correlate of well-being, and experimentally manipulate a surrender state. Study 1 found that the SoS scale consisted of a single factor associated with thriving and flourishing, even while controlling for significant covariates. Study 2 confirmed the single-factor solution and identified social connectedness and self-compassion as statistical mediators of the relationship between SoS and happiness. Finally, Study 3 demonstrated that SoS could be manipulated using a mindfulness exercise; people completing a 10-min mindfulness practice reported higher levels of SoS when compared to a time-matched control. Implications and future directions are discussed.

Contextual Behavioral Science (CBS) and Acceptance and Commitment Therapy or Training (“ACT” in either case) are arguably entering their 5th decade of development. This paper describes features of their early history and divides development into three phases, plus a fourth that is just beginning. In the context of that review, it examines what can be learned by a content analysis of the first ∼1000 randomized controlled trials on ACT-based interventions, from 1986 through 2022. The expansive vision of CBS and the early ACT research base defined their breadth as far wider than psychological intervention targeting traditional psychiatric syndromes, emphasizing instead the principles, processes, and components needed for a more generally applicable approach. After an era of scientific establishment, ACT research has expanded globally and topically. Many RCTs now take place in lower- and middle-income countries with cultural and policy environments that give rise to unique research priorities. Finally, based on the ACBS Task Force Report and new research findings, we suggest that ACT research may be entering a new era of personalized and process-based intervention based on new “idionomic” forms of functional analysis.