The Conceptualization and Measurement of Values: A Review of the Psychometric Properties of Measures Developed to Inform Values Work with Adults

Acceptance and Commitment Therapy Processes and Mediation: Challenges and How to Address Them

Acceptance and commitment therapy (ACT) emphasizes a focus on theory-driven processes and mediating variables, a laudable approach. The implementation of this approach would be advanced by addressing five challenges, including (a) distinguishing ACT processes in measurement contexts, (b) developing and rigorously validating measures of ACT processes, (c) the wide use of psychometrically weaker ACT process measures and the more limited use of stronger measures in earlier work, (d) the inconsistency of past evidence that ACT processes are sensitive or specific to ACT or mediate ACT outcomes specifically, and (e) improving statistical power and transparency. Drawing on the existing literature, we characterize and provide evidence for each of these challenges. We then offer detailed recommendations for how to address each challenge in ongoing and future work. Given ACT's core focus on theorized processes, improving the measurement and evaluation of these processes would significantly advance the field's understanding of ACT.

Using values in cognitive and behavioral therapy: A bridge back to philosophy

Ancient therapeutic practices have influenced the development of cognitive behavioral therapy (CBT) theories such as Albert Ellis's rational emotive behavior therapy and Aaron Beck's cognitive therapy. By drawing inspiration from Socratic questioning, the importance of philosophy in evidence-based practices in human mental health can be acknowledged. Stoicism has also informed CBT, notably its emphasis on establishing psychological distance from emotions. Cognition and emotion are two aspects of mental processes, and irrational demands are processed through rational deliberation. Using mental imaging techniques and acceptance strategies (to accept oneself and the world as imperfect), avoiding catastrophic interpretations and acknowledging emotions are also included among such practices. METHODS: We will explore the use of values across CBT, acceptance and commitment therapy (ACT), and radically open dialectical behavioral therapy (RO DBT) to clarify their use of values. RESULTS: In this framework, values are conceptualized as life-orienting principles and are now widely used across CBTs, such as acceptance and commitment therapy and radically open dialectical behavioral therapy. In recent years, the development of CBT has involved a renewed relationship with philosophy through the use of values, interest in dialectics and development of self-questioning practices reminiscent of classical Socratic principles. This movement from applied clinical psychology toward philosophical skills has also encouraged the recent emergence of philosophical health considerations. The opposition between psychological and philosophical health can be questioned, and the fundamental issue of philosophical skills implemented in psychiatric treatment (and not solely as practices of enhancement for the sane) needs to be considered.

Values engagement as a predictor of eating disorder severity in a residential sample of female adolescents with eating disorders

Values are freely chosen life directions and/or qualities of being that can motivate behavior change. There is nascent support for the utility of values work as a part of the therapeutic process across treatments, particularly in third wave therapy approaches (e.g., acceptance and commitment therapy). However, therapeutic values work is underresearched in clinical samples of youth. The aim of the present study is to examine the role of the two distinct values processes (engagement and obstruction), body image inflexibility, alongside other common comorbid symptoms of eating disorders (anxiety, depression) in a sample of female adolescents with eating disorders attending a residential eating disorder treatment program. Participants (N = 75) were patients at a residential eating disorder treatment facility and completed a battery of measures at time of admission. Correlational analyses and multiple regression were performed. Results found correlations between eating disorder severity, values engagement, values obstruction, body image flexibility, anxiety, and depression in the expected directions. Regression results found body image inflexibility, progression towards values, and anxiety as significant predictors of eating disorder severity (adjusted R² = .54). This study points to the importance of emphasizing values engagement in youth with eating disorders, highlighting a potential treatment target for future research.

Psychometric properties of the Valuing Questionnaire in a Spaniard sample and factorial equivalence with a Colombian sample

BACKGROUND

The Valuing Questionnaire (VQ) is considered as one of the most psychometrically robust instruments to measure valued living according to the acceptance and commitment therapy model. It consists of 10 items that are responded to on a 7-point Likert-type scale and has two factors: Progression and Obstruction. The Spanish version of the VQ showed good psychometric properties in Colombian samples. However, there is no evidence of the psychometric properties of the VQ in Spaniard samples. This study aims to analyze the validity of the VQ in a large Spaniard sample and analyze the measurement invariance with a similar Colombian sample.

METHOD

The VQ was administered to a Spaniard sample of 846 adult participants from general online population. Cronbach's alpha and McDonald's omega were computed to analyze the internal consistency of the VQ. The fit of the VQ's two-factor model was tested through a confirmatory factor analysis with a robust maximum likelihood (MLR) estimation method. Afterward, we analyzed the measurement invariance across countries and gender. Convergent construct validity was analyzed with a package of questionnaires that evaluated experiential avoidance (Acceptance and Action Questionnaire-II, AAQ-II), emotional symptoms (Depression Anxiety and Stress Scale-21, DASS-21), life satisfaction (Satisfaction with Life Scale, SWLS), and cognitive fusion (Cognitive Fusion Questionnaire, CFQ).

RESULTS

The internal consistency across samples was adequate (alphas and omegas were .85 for VQ-Progress and .84 for VQ-Obstruction). The two-factor model obtained a good fit to the data (RMSEA = 0.073, 90% CI [0.063, 0.083], CFI = 0.98, NNFI = 0.97, and SRMR = 0.053). The VQ showed strict invariance across countries and gender and showed theoretically coherent correlations with emotional symptoms, life satisfaction, experiential avoidance, and cognitive fusion. In conclusion, the Spanish version of the VQ demonstrated good psychometric properties in a large Spaniard sample.

Psychometric properties of the spanish version of the Valuing Questionnaire in Colombian clinical and nonclinical samples

OBJECTIVE

To examine the psychometric properties of the Spanish version of the Valuing Questionnaire (VQ) in Colombian clinical and nonclinical samples.

METHOD

The VQ was administered to a total sample of 1820 participants, which included undergraduates (N = 762), general population (N = 724), and a clinical sample (N = 334). The questionnaire packages included measures of experiential avoidance, cognitive fusion, mindfulness, life satisfaction, and psychological difficulties.

RESULTS

Across the different samples, internal consistency was good (global Cronbach's alpha of 0.83 for Progress and 0.82 for obstruction). Measurement invariance was found across samples and gender, and the two-factor model obtained a good fit to the data. The latent means of progress and obstruction of the clinical sample were lower and higher, respectively, than the latent means of the nonclinical samples. Correlations with other variables were in the expected direction.

CONCLUSION

The Spanish version of the VQ showed good psychometric properties.

Post-traumatic growth and value-directed living after acquired brain injury

Traumatic events can be associated with positive change, termed "post-traumatic growth." Existing resesarch suggests some overlap between post-traumatic growth and value-directed living. This study sought to explore the relationship between post-traumatic growth and value-directed living after acquired brain injury. Self-report questionnaires including the Posttraumatic Growth Inventory, Valued Living Questionnaire, Engaged Living Scale, Valuing Questionnaire, Hospital Anxiety and Depression Scale, World Health Organization Well-Being Index, Brief Resilience Scale, Trauma Screening Questionnaire and Glasgow Outcome Scale were posted to 317 individuals who had experienced a head injury, stroke or subarachnoid haemorrhage in the previous 3-13 years, with a hospital admission of minimum 7 days. Questionnaires were completed by 81 participants. Post-traumatic growth was significantly positively associated with two measures of value-directed living (VLQ, r = .269; VQ, r = .215). Higher levels of value-directed living were significantly associated with increased positive outcomes (wellbeing) and reduced negative outcomes (distress, post-traumatic stress symptoms). There was no significant association between post-traumatic growth and any of these outcomes. The association between post-traumatic growth and value-directed living indicates possible common underlying processes. Value-directed living appears to be a more useful concept, as it was associated with clinically relevant outcomes. It is recommended that value-directed living interventions are considered in brain injury rehabilitation.

The relationship between substance use, experiential avoidance, and personally meaningful experiences

Background: High rates of substance use among college students have been associated with a wide range of detrimental consequences. Psychological inflexibility, characterized by both experiential avoidance and a disconnection with personally meaningful values, is proposed to contribute to the development and maintenance of substance misuse. Objectives: This study explored the unique contribution of experiential avoidance and four different values dimensions (i.e., importance, consistency, effort, and intrinsic motivation) on substance use and related problems accounting for the known predictors of gender and drinking motives. Method: Zero-inflated regression was used to analyze predictors of substance use and related problems among 233 college students. Results: Controlling for gender and drinking motives, stronger values importance was predictive of lower rates of alcohol use problems. Less behavioral consistency with values predicted marijuana abstinence, less frequent use of marijuana, and less frequent use of illicit drugs. Although there was little evidence for a unique association between experiential avoidance and substance use or substance-related problems in this sample, coping and enhancement motives predicted alcohol use problems and illicit drug use. Conclusion/Importance: These findings offer preliminary support for prevention and intervention efforts aimed at enhancing engagement in values activities and reducing substance use as a form of affect regulation in this population.