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Li H, Ng MSN, Jin X, Wong CL. Translation and validation of the Chinese version of the acceptance and action questionnaire for cancer in patients with advanced lung cancer. Asia Pac J Oncol Nurs 2023; 10:100262. [PMID: 37497154 PMCID: PMC10365979 DOI: 10.1016/j.apjon.2023.100262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/07/2023] [Indexed: 07/28/2023] Open
Abstract
Objective This study aimed to examine the reliability and validity of the Chinese version of the Acceptance and Action Questionnaire for Cancer (C-AAQ-Cancer) in patients with advanced lung cancer. Methods In Phase I, the AAQ-Cancer was translated from English to Chinese. In Phase II, an expert panel was invited to examine the content validity of the translated instrument, and pilot testing was performed. In Phase III, a total of 200 patients with advanced lung cancer from a university-affiliated hospital in central China were recruited to test the construct validity of the translated AAQ-Cancer using exploratory factor analysis, and reliability was assessed based on internal consistency and test-retest reliability. Results The semantic equivalence and content validity index of the C-AAQ-Cancer were satisfactory. Exploratory factor analysis indicated that the C-AAQ-Cancer contained the following five subscales: cancer concerns, blunting, blame, distancing, and behavioral disengagement. These subscales explain 68.28% of the total variance. The Cronbach's α coefficient of the scale was 0.87, and the test-retest reliability was 0.839. Conclusions This study evaluated the psychometric properties of the C-AAQ-Cancer. The findings support the reliability and validity of this instrument in evaluating experiential avoidance or acceptance levels in patients with advanced lung cancer.
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Affiliation(s)
- Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Marques Shek Nam Ng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaohuan Jin
- The School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Carvalho T, Pinto-Gouveia J, Cunha M, da Motta C. Experiential avoidance, uncompassionate self-responding, and peritraumatic depersonalization/derealization: A novel mediation model for war-related PTSD symptomatology. J Clin Psychol 2022; 78:1074-1092. [PMID: 34993963 DOI: 10.1002/jclp.23303] [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: 10/31/2020] [Revised: 11/29/2021] [Accepted: 12/20/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore a novel model for war-related posttraumatic stress disorder (PTSD) symptomatology including emotion regulation processes, namely experiential avoidance (EA) and uncompassionate self-responding (USR), mediating the impact of childhood threat memories, combat exposure distress, combat and noncombat threats, and peritraumatic depersonalization/derealization (PDD) on PTSD symptomatology. METHOD A sample of 650 male Portuguese Overseas War veterans filled self-report instruments. RESULTS The model explained 59% of the variance of PTSD symptomatology. Both EA and USR mediated the effects of noncombat threats and PDD on PTSD. Additionally, EA mediated combat exposure distress and USR mediated childhood threat memories. Combat exposure distress, combat and noncombat threats, and PDD showed direct effects on PTSD symptomatology. CONCLUSION The findings help to better understand the relationship between predictive factors of war-related PTSD in clinical and research settings, providing novel insights on the effects of combat exposure distress, and the different effects of combat and noncombat-related threats on PTSD.
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Affiliation(s)
- Teresa Carvalho
- Cognitive-Behavioral Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.,Instituto Superior Miguel Torga, Coimbra, Portugal
| | - José Pinto-Gouveia
- Cognitive-Behavioral Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Marina Cunha
- Cognitive-Behavioral Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.,Instituto Superior Miguel Torga, Coimbra, Portugal
| | - Carolina da Motta
- Cognitive-Behavioral Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.,School of Psychology and Life Sciences, Lusófona University, Lisbon, Portugal.,Digital Human-Environment Interaction Lab (HEI-Lab), Lisboa, Portugal
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Cavicchioli M, Scalabrini A, Northoff G, Mucci C, Ogliari A, Maffei C. Dissociation and emotion regulation strategies: A meta-analytic review. J Psychiatr Res 2021; 143:370-387. [PMID: 34592484 DOI: 10.1016/j.jpsychires.2021.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Clinical and neurobiological models posited that dissociative mechanisms might affect processes involved in emotional generation and regulation. However, there is a lack of a comprehensive theoretical framework that systematically includes dissociation within emotional functioning. METHODS The current study aims at conducting a meta-analytic review on the relationship between dissociation and emotion regulation in order to empirically estimate to what extent dissociation is related to emotion regulation processes. The meta-analysis was based on r coefficient as effect size measure, using a random-effect approach. RESULTS The meta-analysis included 57 independent studies for a total of 11596 individuals. Findings showed an overall moderate relationship between dissociation and emotion regulation (rw = .32; p < .05). The association between dissociation and emotion regulation was the same among clinical samples than non-clinical ones. Furthermore, dissociation showed moderate to large relationships with maladaptive domains of emotion regulation, namely disengagement (rw = 0.34; p < .01) (i.e., behavioral avoidance, experiential avoidance, thought and emotional suppression) and aversive cognitive perseveration (rw = 0.38; p < .001) (i.e., rumination, worry and nonacceptance). The analysis did not find significant relationship between dissociation and adaptive domain of emotional regulation (i.e., problem solving, mindfulness). CONCLUSION Dissociation in the context of emotion regulation might be viewed as a basic neuro-mental mechanism that automatically contribute to the over-modulation of emotional states through avoidance reactions from internal and external reality. Future longitudinal studies are needed to clarify the causal relationships between dissociation and emotion regulation.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona 20, 20127, Milano (MI), Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Via Stamira d'Ancona 20, 20127, Milano (MI), Italy.
| | - Andrea Scalabrini
- Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d'Annunzio University of Chieti-Pescara, Via dei Vestini 33, 66100, Chieti (CH), Italy.
| | - Georg Northoff
- Mental Health Centre, Zhejiang University School of Medicine, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China; Centre for Cognition and Brain Disorders, Hangzhou Normal University, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China; The Royal's Institute of Mental Health Research & University of Ottawa. Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, Ontario, K1Z 7K4, Canada
| | - Clara Mucci
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Anna Ogliari
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona 20, 20127, Milano (MI), Italy; Child in Mind Lab, University "Vita-Salute San Raffaele", Via Stamira d'Ancona 20, 20127, Milano (MI), Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona 20, 20127, Milano (MI), Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Via Stamira d'Ancona 20, 20127, Milano (MI), Italy
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Colonial War: When the Years Rekindle the Suffering—A Pilot Study. REPORTS 2021. [DOI: 10.3390/reports4020010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
For more than 150 years, traumatic stress has been a recurrent topic of medical and psychological studies, in which war-related experiences remain to be addressed. Although veterans have been considered a high-risk group for the development of stress-related diseases, the impact of aging on the trauma process is an unexplored field. This study aimed to analyze the aging-related factors that may influence the emergence of traumatic stress symptoms in war veterans. The clinical data of 29 Colonial War Portuguese veterans were verified in order to identify the main diagnoses, and the frequency of health service use. Through thematic analysis of the transcripts of 10 interviews with veterans diagnosed with Post Traumatic Stress Disorder (PTSD), the main symptoms and factors that led them to mental health services were identified. In addition, a literature review on mental health and psychological trauma was conducted to provide an overview of the knowledge on this topic. Aging seems to be an opportunity to face conflicts which have been kept hidden throughout veterans’ lives. Social stigmatization and the non-recognition of traumatic stress as a disease influenced the Portuguese veterans’ silence, which could be broken with the aging process. Retirement, physical illness, death of close friends or family members, and loss of autonomy may contribute to the onset of trauma-related symptoms.
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Majeed R, Faust I, Hüppe M, Hermann C. [Measurement of pain-related experiential avoidance: analysis of the Acceptance and Action Questionnaire-II-Pain in patients with chronic pain]. Schmerz 2021; 35:401-411. [PMID: 33580414 PMCID: PMC8613114 DOI: 10.1007/s00482-021-00537-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 05/05/2020] [Accepted: 12/28/2020] [Indexed: 01/14/2023]
Abstract
Einleitung und Fragestellung Erlebensvermeidung („experiential avoidance“) stellt einen zentralen störungsrelevanten Prozess im Rahmen der Akzeptanz- und Commitment-Therapie (ACT) dar. Zur Erfassung wurde der Acceptance and Action Questionnaire II (AAQ-II) entwickelt und in den Niederlanden für eine Patientengruppe mit chronischem Schmerz adaptiert und validiert (AAQ-II‑P). Hohe Werte im AAQ-II‑P bedeuten hohe schmerzbezogene Erlebensvermeidung. Ziel unserer Untersuchung ist die Erfassung von schmerzbezogener Erlebensvermeidung mit einer deutschen Version des AAQ-II‑P bei chronischen Schmerzpatienten und die Prüfung psychometrischer Merkmale des Messverfahrens. Methodik Der AAQ-II wurde mittels eines Vorwärts-Rückwärts-Verfahrens ins Deutsche übersetzt, für chronischen Schmerz adaptiert (AAQ-II‑P) und von 168 Patienten einer universitären Schmerzambulanz beantwortet. Zusätzlich wurden Daten zu schmerzbedingter Beeinträchtigung (CPG: Schweregrad nach von Korff) und Schmerzkatastrophisieren (PCS) erhoben sowie zu gesundheitsbezogener Lebensqualität (SF-12), Angst und Depressivität (HADS-D). Ebenfalls erfasst wurden allgemeine Persönlichkeitsmerkmale (BFI‑K) und habituelle Achtsamkeit (KIMS-S). Ausgewertet wurden Reliabilität und faktorielle Validität des AAQ-II‑P sowie seine Beziehung zu den anderen psychometrischen Verfahren. Ergebnisse Der AAQ-II‑P erzielte eine hohe interne Konsistenz mit α = 0,89 sowie eine eindimensionale Faktorenstruktur mit 61 % aufgeklärter Varianz. Geringe Korrelationen ergaben sich zu Persönlichkeitsdimensionen (maximal r = 0,44 zu Neurotizismus) und Achtsamkeit (maximal r = −0,43 zu Akzeptanz). Ein hoher Zusammenhang fand sich zu Schmerzkatastrophisieren (r = 0,75), Depression (r = 0,73) und Angst (r = 0,66). Die Beziehung zu Lebensqualität war am stärksten ausgeprägt auf der Psychischen Summenskala (r = −0,58). Diskussion und Schlussfolgerung Die deutsche Version des AAQ-II‑P hat eine gute Reliabilität und weist hinsichtlich Zuverlässigkeit und Faktorenstruktur hohe Vergleichbarkeit mit der Originalversion auf. Die Beziehungen zu den Skalen der psychometrischen Verfahren sind zumeist in erwarteter Richtung und Höhe. Patienten mit chronischem Schmerz und hoher schmerzbezogener Erlebensvermeidung tendieren deutlich zum Schmerzkatastrophisieren und zeichnen sich durch schlechtere psychische Lebensqualität aus. Dies spricht für die Relevanz des Konstrukts hinsichtlich therapeutischer Zielvariablen.
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Affiliation(s)
- Ronja Majeed
- Abteilung Klinische Psychologie und Psychotherapie, Justus-Liebig-Universität Gießen, Otto-Behaghel-Str. 10F, 35394, Gießen, Deutschland.
| | - Ira Faust
- Klinik für Anästhesiologie und Intensivmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Michael Hüppe
- Klinik für Anästhesiologie und Intensivmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - Christiane Hermann
- Abteilung Klinische Psychologie und Psychotherapie, Justus-Liebig-Universität Gießen, Otto-Behaghel-Str. 10F, 35394, Gießen, Deutschland
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A review of AAQ variants and other context-specific measures of psychological flexibility. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.02.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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