Psychological flexibility is not a single dimension: The distinctive flexibility profiles of underweight, overweight, and obese people

Psychological Flexibility Profiles and Mental Health Among University Students with Left-Behind Experience: A Latent Profile Analysis

The left-behind experience as an adverse childhood experience has a negative impact on the mental health of university students. Psychological inflexibility mediated the relationship between adverse childhood experiences and mental disorders, but no similar findings were drawn in psychological flexibility (PF). More research is needed to understand the relationship between PF and mental health of university students with left-behind experience. To investigate the relationship between PF profiles and mental health and sleep quality of university students with left-behind experience based on latent profile analysis. A sample of 1988 Chinese university students with left-behind experience were recruited to complete an online survey. Participants provided demographic information and completed validated measures of PF and mental health. Latent profile analysis was used to identify patterns of PF, and logistic regression analysis was used to examine the relationships among these variables. We found four PF profiles among participants, with the largest number being the moderately flexible profile (n = 808, 40.6%). The level of PF was positively correlated with mental health and sleep quality (all P < 0.001). Females, being left behind at a young age and for a long time, and having little contact with parents were associated with low PF (all P < 0.05). Our study highlights the importance of focusing on the PF of university students with left-behind experience and left-behind children, and the need for interventions to improve their PF and thus their mental health.

The Relationship Between Psychological Inflexibility and Well-Being in Adults: A Meta-Analysis of the Acceptance and Action Questionnaire

Psychological inflexibility is defined as the rigid responding to stimuli (e.g., unpleasant thoughts and feelings) that interferes with well-being and valued actions. It is the treatment target in acceptance and commitment therapy (ACT). Despite the centrality of the link between inflexibility and well-being to ACT theory, an empirical review clarifying the nature of this relationship has not been conducted. As such, the current meta-analysis examined the meta-correlation between psychological inflexibility, measured by the Acceptance and Action Questionnaire (AAQ) and its variants, and well-being. A systematic review yielded 151 studies, including 25 versions of the AAQ and 43 well-being measures. Consistent with ACT theory, higher psychological inflexibility was associated with worse well-being (r = -.47, 95% CI[-.49, -.45]). In addition, sample diagnosis, type of AAQ, and type of well-being measure significantly moderated this relationship. Overall, our findings support the hypothesized link between psychological inflexibility and worse well-being. Limitations include reliance on cross-sectional data, precluding causal interpretation.

Rumination Mediates the Relationship Between Childhood Traumas with Cognitive Defusion, Acceptance, and Emotion Regulation: A Qualitative and Quantitative Study

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.

Measurement invariance in gender and age of the Herth Hope Index to the general spanish population across the lifespan

The Herth Hope Index (HHI) is used to measure hope. Assessing the psychometric properties of HHI in Spanish population, exploring its structural validity, the different functionalities of the items and the invariability of this measure according to the gender and age of the population. Confirmatory factor analysis was conducted to explore the scale's dimensionality and test for strong measurement invariance across sex and age in a cross-sectional, multicenter, prospective study. A new scale was obtained with the structure of one factor with 9 items. Goodness-of-fit indices were excellent. The internal consistency of the one dimension proved high values. The configural invariance on gender shows that both men and women understand the new HHI items, also, this research also shows that there is no scalar invariance across age groups, revealing good levels of adjustment of the item. The Spanish version of the HHI proved to be a valid, reliable instrument to assess the hope in Spanish population.

Association Between Nutrition Literacy and Overweight/Obesity of Adolescents: A Cross–Sectional Study in Chongqing, China

Objective

The burden of overweight and obesity in adolescents is increasing rapidly. This study aimed to assess the association between nutrition literacy and overweight/obesity among adolescents in China.

Methods

This cross–sectional online study involving adolescents aged 10–18 years was conducted in September 2020 in 239 schools in Chongqing China. Overweight and obese adolescents were determined based on the International Obesity Task Force's recommended age–sex specific body mass index cutoff points. Nutrition literacy was measured using the “Nutrition literacy scale for middle school students in Chongqing (CM–NLS).” The CM–NLS included three subdomains (functional nutritional literacy, interactive nutrition literacy, and critical nutrition literacy). Multinomial logistic regression model was used to examine the association.

Results

A total of 18,176 adolescents (49.8% girls) were included. The prevalence of overweight and obesity was 9.6% and 17.0%, respectively. Compared with those having a low nutrition literacy score (below median), those with a high score were less likely to be overweight and obese. The odds ratio (95% CI) for overweight was 0.87 (0.79–0.97) (nutrition literacy) and 0.81 (0.73–0.90) (functional nutritional literacy). The corresponding figures for obesity were 0.84 (0.77–0.91) and 0.73 (0.67–0.80), respectively. Significant interaction existed between grade and nutrition literacy. The inverse association between nutrition literacy and overweight/obesity was significant among those in senior school but not among those in junior high school.

Conclusion

Nutrition literacy was inversely associated with overweight/obesity among adolescents, especially those attending senior high schools.

Defining and measuring "psychological flexibility": A narrative scoping review of diverse flexibility and rigidity constructs and perspectives

Psychological flexibility (PF) is a popular construct in clinical psychology. However, similar constructs have existed since the mid-20th century, resulting in different terms, definitions and measures of flexibility, hindering the advancement of the field. The main measure of PF - the Acceptance and Action Questionnaire (AAQ-II; Bond et al., 2011) - has also been heavily criticized. To move towards definitional consensus and improved measurement, we surveyed the literature to map PF and related-terms, examine definitional overlaps, and assessthe psychometric quality of prominent flexibility measures. A scoping review was conducted in two databases (PsycNET and SCOPUS). Twenty-three flexibility constructs appeared across 220 articles, and twelve measures were included and rated for quality. PF, psychological inflexibility (PI), and cognitive flexibility (CF) were most prominent. Definitional similarities among prominent flexibility constructs emerged, namely handling distress or interference, taking action, and meeting goals or values. The Personalized Psychological Flexibility Index (PPFI; Kashdan, Disabato, Goodman, Doorley, & McKnight, 2020) appears to be the best measure available to assess PF. Problems with the current use of the AAQ-II were apparent, hindering current knowledge of PF. Definitional consensus and measurement development are vital to advance the field. To this end, recommendations and next steps for researchers and practitioners are outlined.

Depressive symptoms, psychological flexibility, and binge eating in individuals seeking behavioral weight loss treatment

Depressive symptoms and binge eating are both prevalent in weight management populations and may be associated with reduced benefit from behavioral weight loss, including higher attrition, more perceived barriers, lower weight loss, and increased weight regain. These two potential risk factors for poor behavioral weight loss outcomes may also be associated with each other as depressive symptoms may trigger binge eating, and binge eating-related distress could increase depressive symptoms. The depressive symptom-binge eating link has not been well studied in weight management samples, and psychological processes involved in this relationship have not yet been elucidated. Psychological flexibility, an individual's ability to be connected with and conscious of the present moment and to engage in values-consistent behavior even in the presence of difficult internal experiences, may be one psychological process that changes the depressive symptom-binge eating relationship. High psychological flexibility may be a protective factor in the association of depressive symptoms with binge eating. This study examined the relationship between depressive symptom and binge eating and a potential interactive role of psychological flexibility. Participants (N = 468, 76% female) completed self-report questionnaires of binge eating, depressive symptoms, and psychological flexibility at baseline prior to initiating behavioral weight loss. Depressive symptoms were positively associated with binge eating (B = 1.00, p < 0.001). Psychological flexibility had an interactive role (B = -0.03, p = 0.005). Among participants with minimal to mild depressive symptoms, those with higher psychological flexibility had less severe binge eating. Findings suggest that psychological flexibility may be a protective factor in the association between depressive symptoms and binge eating in the majority of individuals initiating behavioral weight loss. Psychological flexibility is a psychological process to consider targeting for enhancing efficacy of weight loss treatment, especially among individuals with minimal to mild depressive symptoms and binge eating behavior.

Confirmatory Factor Analysis of the Acceptance and Action Questionnaire for Weight-Related Difficulties-Revised (AAQW-R) in a United States Sample of Adults with Overweight and Obesity

OBJECTIVE

To examine the psychometric properties of the English language version of the 10-item Acceptance and Action Questionnaire for Weight-Related Difficulties-Revised (AAQW-R) in a United States (U.S.) sample of women and men with overweight/obesity (OW/OB).

METHOD

Adults with OW/OB seeking weight loss (N = 283; 59% women) completed the AAQW-R and other weight-related and psychosocial measures. Confirmatory factor analysis was used to examine single-factor, three-factor, and second-order factor structures of the AAQW-R, which were previously examined in a sample of Portuguese women. A chi-square difference test was used to compare the fit of a single-factor structure with three-factor and second-order factor structures. Internal reliability and convergent validity were examined for the total and three-factor subscale scores.

RESULTS

The single-factor structure evidenced poor fit to the data whereas the three-factor structure evidenced acceptable fit. The second-order structure was assessed qualitatively due to limitations to statistical model specification. The internal reliability of the AAQW-R total score and each of the three subscales were in the good and acceptable ranges, respectively. Total and subscale scores demonstrated good convergent validity.

DISCUSSION

Findings suggest that the English language version of the AAQW-R can be used to assess weight-related experiential avoidance in U.S. adult samples with OW/OB as a three-factor construct (food as control, weight as a barrier to living, weight stigma), with or without a total score. Additional research should confirm measurement invariance among various sociodemographic groups.

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.

Using Genetic Algorithms in a Large Nationally Representative American Sample to Abbreviate the Multidimensional Experiential Avoidance Questionnaire

Genetic algorithms (GAs) are robust machine learning approaches for abbreviating a large set of variables into a shorter subset that maximally captures the variance in the original data. We employed a GA-based method to shorten the 62-item Multidimensional Experiential Avoidance Questionnaire (MEAQ) by half without much loss of information. Experiential avoidance or the tendency to avoid negative internal experiences is a key target of many psychological interventions and its measurement is an important issue in psychology. The 62-item MEAQ has been shown to have good psychometric properties, but its length may limit its use in most practical settings. The recently validated 15-item brief version (BEAQ) is one short alternative, but it reduces the multidimensional scale to a single dimension. We sought to shorten the 62-item MEAQ by half while maintaining fidelity to its six dimensions. In a large nationally representative sample of Americans (N = 7884; 52% female; Age: M = 47.9, SD = 16), we employed a GA method of scale abbreviation implemented in the R package, GAabbreviate. The GA-derived short form, MEAQ-30 with five items per subscale, performed virtually identically to the original 62-item MEAQ in terms of inter-subscales correlations, factor structure, factor correlations, and zero-order correlations and unique latent associations of the six subscales with other measures of mental distress, wellbeing and personal strivings. The two measures also showed similar distributions of means across American census regions. The MEAQ-30 provides a multidimensional assessment of experiential avoidance whilst minimizing participant burden. The study adds to the emerging literature on the utility of machine learning methods in psychometrics.