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Greville-Harris M, Withers C, Wezyk A, Thomas K, Bolderston H, Kane A, McDougall S, Turner KJ. Association of resilience and psychological flexibility with surgeons' mental wellbeing. BJS Open 2024; 8:zrae060. [PMID: 39041733 PMCID: PMC11264141 DOI: 10.1093/bjsopen/zrae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/15/2024] [Accepted: 04/25/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Existing research highlights the link between certain personality traits and mental health in surgeons. However, little research has explored the important role of psychological skills and qualities in potentially explaining this link. A cross-sectional survey of UK-based surgeons was used to examine whether two such skills (psychological flexibility and resilience) helped to explain why certain personality traits might be linked to mental health in surgeons. METHOD An online survey comprising measures of personality (neuroticism, extraversion and conscientiousness), psychological skills/qualities (psychological flexibility and resilience) and mental health (depression, anxiety, stress and burnout) was sent to surgeons practising in the UK. Mediation analyses were used to examine the potential mediating role of psychological flexibility and resilience in explaining the relationship between personality factors and mental health. RESULTS A total of 348 surgeons completed the survey. In all 12 mediation models, psychological flexibility and/or resilience played a significant role in explaining the relationship between personality traits (neuroticism, extraversion and conscientiousness) and mental health (depression, anxiety and burnout). CONCLUSION Findings suggest that it is not only a surgeon's personality that is associated with their mental health, but the extent to which a surgeon demonstrates specific psychological qualities and skills (psychological flexibility and resilience). This has important implications for improving surgeons' mental wellbeing, because psychological flexibility and resilience are malleable, and can be successfully targeted with interventions in a way that personality traits cannot.
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Affiliation(s)
| | - Catherine Withers
- Department of Psychology, Poole House, Bournemouth University, Poole, UK
| | - Agata Wezyk
- Department of Psychology, Poole House, Bournemouth University, Poole, UK
| | - Kevin Thomas
- Department of Psychology, Poole House, Bournemouth University, Poole, UK
| | - Helen Bolderston
- Department of Psychology, Poole House, Bournemouth University, Poole, UK
| | - Amy Kane
- Department of Psychology, Poole House, Bournemouth University, Poole, UK
| | - Sine McDougall
- Department of Psychology, Poole House, Bournemouth University, Poole, UK
| | - Kevin J Turner
- Department of Psychology, Poole House, Bournemouth University, Poole, UK
- Department of Urology, University Hospitals Dorset, Bournemouth, UK
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Ong CW, Barthel AL, Hofmann SG. The Relationship Between Psychological Inflexibility and Well-Being in Adults: A Meta-Analysis of the Acceptance and Action Questionnaire. Behav Ther 2024; 55:26-41. [PMID: 38216235 PMCID: PMC10787153 DOI: 10.1016/j.beth.2023.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 01/14/2024]
Abstract
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.
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Gur A, Egozi S, Schweitzer Y. Self-Differentiation, Psychological Flexibility, and Difficulties in Practice in Social Workers and Social Work Students. SOCIAL WORK 2023; 69:43-51. [PMID: 37933592 DOI: 10.1093/sw/swad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/02/2023] [Accepted: 09/12/2023] [Indexed: 11/08/2023]
Abstract
Practicing social work involves unique difficulties, which may vary with seniority. This study aimed to identify these difficulties among social workers and social work students and to examine the associations between psychological flexibility (PF), self-differentiation (SF), and difficulties in practice in both groups. Ninety-one social work students and seventy-five social workers completed the following questionnaires: Difficulties in Practice, the Acceptance and Action Questionnaire-II, and Differentiation of Self Inventory. Results showed higher difficulties among social work students regarding their professional competence. Social workers demonstrated higher levels of PF, while no significant difference was found in SF. SF and PF were positively correlated, and both were negatively correlated with difficulties in practice in both groups. Among social work students, a moderating effect of PF was found for the association between SF and difficulties in practice. The current study emphasizes the importance of developing SF and cultivating PF during social work education to enhance professional competence and reduce difficulties in practice.
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Affiliation(s)
- Ayelet Gur
- PhD, is senior lecturer, Social Work Department, Tel-Hai College, Kiryat Shmona, Upper Galilee, 1220800, Israel
| | - Sharon Egozi
- PhD, are lecturers, Social Work Department, Tel-Hai College, Kiryat Shmona, Upper Galilee, Israel
| | - Yoav Schweitzer
- MA, are lecturers, Social Work Department, Tel-Hai College, Kiryat Shmona, Upper Galilee, Israel
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Unjai S, Forster EM, Mitchell AE, Creedy DK. Predictors of compassion satisfaction among healthcare professionals working in intensive care units: A cross-sectional study. Intensive Crit Care Nurs 2023; 79:103509. [PMID: 37541068 DOI: 10.1016/j.iccn.2023.103509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/16/2023] [Accepted: 07/21/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE To determine the prevalence of compassion satisfaction, related factors, and predictors among healthcare professionals in Thai intensive care units. METHODS A cross-sectional study was conducted in 12 intensive care units at a university hospital in Thailand from August to November 2022. All nurses and doctors were invited to complete an anonymous online survey which included: the Professional Quality of Life Scale version 5, Connor-Davidson Resilience Scale, Passion Scale, Flourishing Scale, and Acceptance and Action Questionnaire. Descriptive statistics, Pearson's correlation coefficients, and hierarchical multiple regressions were used for data analysis in SPSS 28.0. RESULTS A total of 178 nurses and doctors participated (92.13% nurses, 89.89% female, mean 32.10 years). Average compassion satisfaction (assessed using the Professional Quality of Life Scale) was moderate, with a mean score of 37.94 (SD = 5.58). The final regression model predicting compassion satisfaction was significant and explained 65% of the variance in compassion satisfaction, F (11, 154) = 26.00, p < 0.001. Four out of 11 predictor variables made unique statistically significant contributions to the final model: resilience (β = 0.48, p < 0.001), harmonious passion (β = 0.24, p < 0.001), being a nurse (not a doctor; β = 0.17, p < 0.05), and holding a postgraduate qualification (β = 0.10, p < 0.05). CONCLUSION Most healthcare professionals in critical care units have a moderate level of compassion satisfaction, which is correlated with resilience, flourishing, and harmonious passion. Resilience and harmonious passion predict compassion satisfaction. These factors are modifiable through intervention. IMPLICATION FOR CLINICAL PRACTICE Assessment of staff psychological well-being can identify those at risk for stress and impaired professional quality of life. Resilience and harmonious passion predict compassion satisfaction and can be modified through psychological interventions to promote psychological well-being and professional quality of life in healthcare workers in intensive care units.
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Affiliation(s)
- Supan Unjai
- School of Nursing and Midwifery, Griffith University, Australia; Faculty of Nursing, Khon Kaen University, Thailand. https://twitter.com/@SupanUnjai
| | | | - Amy E Mitchell
- School of Nursing, Midwifery and Social Work, The University of Queensland, Australia; Parenting and Family Support Centre, School of Psychology, The University of Queensland, Australia
| | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University, Australia
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Fang S, Ding D, Huang M. Measurement of psychological inflexibility: an examination of the psychometric properties of the AAQ-3 compared to AAQ-II. BMC Psychol 2023; 11:300. [PMID: 37777799 PMCID: PMC10543298 DOI: 10.1186/s40359-023-01318-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/08/2023] [Indexed: 10/02/2023] Open
Abstract
Due to the limitations of the existing measurements of experiential avoidance, we would like to check the validity of the improved version of Acceptance and Action Questionnaire-II (AAQ-II), i.e., Acceptance and Action Questionnaire-3 (AAQ-3), in Chinese content. The present study was aim to examine the construct and validity of the Chinese version of AAQ-3 in college students and provide an initial validation of this instrument to promote future cross-cultural examination of the psychological flexibility. Totally 1,572 college students were invited to complete the Chinese AAQ-3 and the related questionnaires at the same time. After one month, 380 participates were assessed with same questionnaires to examine the test-retest reliability. The results indicated a similar one-factor solution in the Chinese AAQ-3 to the original version by exploratory factor analysis, parallel analysis and confirmatory factor analysis. Internal consistency and test-retest reliability were good. According to the testing of the measurement invariance, the one-factor model was acceptable across gender (Man = 875, Girl = 697). Additionally, Chinese AAQ-3 was significantly negatively correlated with positive mental health (life satisfaction, mindful attention awareness), significantly positively correlated with negative emotions (depression, anxiety, stress), and significantly positively correlated with AAQ-II and Brief Experiential Avoidance Questionnaire (BEAQ). Besides, Chinese AAQ-3 was the strongest predictor of depression, anxiety, stress and life satisfaction compared to the AAQ-II and BEAQ. However, according to the exploratory structural equation model, the Chinese AAQ-3 demonstrated excellent discriminate validity from negative emotions. Overall, the AAQ-3 modified the limitations of the existing measurements of experiential avoidance (i.e., AAQ-II and BEAQ) as it showed better convergent validity with positive mental health indicators, better discriminant validity with negative emotions, and higher incremental validity. Therefore, the Chinese AAQ-3 is a valid measurement tool for assessing the level of experiential avoidance or psychological flexibility in Chinese college students.
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Affiliation(s)
- Shuanghu Fang
- School of Educational Science, Anhui Normal University, Wuhu, China.
| | - Dongyan Ding
- School of Educational Science, Anhui Normal University, Wuhu, China
| | - Mingjie Huang
- School of Educational Science, Anhui Normal University, Wuhu, China
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Rosenblau G, Frolichs K, Korn CW. A neuro-computational social learning framework to facilitate transdiagnostic classification and treatment across psychiatric disorders. Neurosci Biobehav Rev 2023; 149:105181. [PMID: 37062494 PMCID: PMC10236440 DOI: 10.1016/j.neubiorev.2023.105181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/14/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023]
Abstract
Social deficits are among the core and most striking psychiatric symptoms, present in most psychiatric disorders. Here, we introduce a novel social learning framework, which consists of neuro-computational models that combine reinforcement learning with various types of social knowledge structures. We outline how this social learning framework can help specify and quantify social psychopathology across disorders and provide an overview of the brain regions that may be involved in this type of social learning. We highlight how this framework can specify commonalities and differences in the social psychopathology of individuals with autism spectrum disorder (ASD), personality disorders (PD), and major depressive disorder (MDD) and improve treatments on an individual basis. We conjecture that individuals with psychiatric disorders rely on rigid social knowledge representations when learning about others, albeit the nature of their rigidity and the behavioral consequences can greatly differ. While non-clinical cohorts tend to efficiently adapt social knowledge representations to relevant environmental constraints, psychiatric cohorts may rigidly stick to their preconceived notions or overly coarse knowledge representations during learning.
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Affiliation(s)
- Gabriela Rosenblau
- Department of Psychological and Brain Sciences, George Washington University, Washington DC, USA; Autism and Neurodevelopmental Disorders Institute, George Washington University, Washington DC, USA.
| | - Koen Frolichs
- Section Social Neuroscience, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany; Institute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph W Korn
- Section Social Neuroscience, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany; Institute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Tei S, Fujino J. Adverse effects of empathy and cognitive inflexibility on social trauma. Front Psychol 2023; 14:1090297. [PMID: 37303915 PMCID: PMC10250643 DOI: 10.3389/fpsyg.2023.1090297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 05/10/2023] [Indexed: 06/13/2023] Open
Affiliation(s)
- Shisei Tei
- Department of Psychiatry, Kyoto University, Kyoto, Japan
- Institute of Applied Brain Sciences, Waseda University, Saitama, Japan
- School of Human and Social Sciences, Tokyo International University, Saitama, Japan
| | - Junya Fujino
- Department of Psychiatry, Kyoto University, Kyoto, Japan
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Assessing psychological inflexibility in text: An examination of the inflexitext program. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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Garner EV, Golijani-Moghaddam N, Sabin-Farrell R. Psychological flexibility as a predictor of professional quality of life in newly qualified psychological therapy practitioners. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Fang S, Ding D, Zhang R, Huang M. Psychological mechanism of acceptance and commitment therapy and rational emotive behavior therapy for treating hoarding: Evidence from randomized controlled trials. Front Public Health 2023; 11:1084467. [PMID: 36844862 PMCID: PMC9950404 DOI: 10.3389/fpubh.2023.1084467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Hoarding is a common problem behavior worldwide and is detrimental to the physical and mental health of individuals and groups. Currently, effective interventions for hoarding are cognitive-behavioral therapies, but their post-intervention efficacy is questionable, and the available research does not examine the mediating variables of the effects of interventions on clinical outcomes. Moreover, current research on hoarding has focused on Western countries. Therefore, there is a need to investigate the efficacy of other forms of cognitive behavioral therapy on hoarding as well as other psychological outcomes related to hoarding and mediating variables that contribute to its effectiveness in different cultural contexts. One hundred thirty-nine college students with higher hoarding behaviors were randomly divided into three groups: 45 in the Acceptance and Commitment Therapy (ACT) group, 47 in the Rational Emotive Behavior Therapy (REBT) group, and 47 in the control group. They completed the Saving Inventory-Revised (SI-R), Obsessive-Compulsive Symptom Scale (OCSS), Difficulties in Emotion Regulation Scale (DERS), Experiences in Close Relationships Inventory-Attachment Anxiety Subscale (ECR), Depression Anxiety Stress Scales (DASS-21), Acceptance and Action Questionnaire II (AAQ-II), and Cognitive Fusion Questionnaire (CFQ) before and immediately after the intervention. The results showed that ACT and REBT improved individuals' psychological flexibility, cognitive fusion, acquisition-difficulty discarding, clutter, negative affect (anxiety, depression, stress), attachment anxiety, obsessive-compulsive disorder, and difficulty in emotion regulation compared to the control group. In addition, ACT was more effective than REBT in improving psychological flexibility and reducing hoarding, cognitive fusion, depression, stress, and obsessive-compulsive disorder; there were no significant differences between the two in anxiety and emotion regulation difficulties. Furthermore, psychological flexibility is a mediator of the effect of ACT and REBT on some behavioral and psychological outcomes (hoarding, negative affect, attachment anxiety). Limitations were discussed.
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Affiliation(s)
- Shuanghu Fang
- School of Educational Science, Anhui Normal University, Wuhu, China
| | - Dongyan Ding
- School of Educational Science, Anhui Normal University, Wuhu, China
| | - Ru Zhang
- School of Educational Science, Anhui Normal University, Wuhu, China
| | - Mingjie Huang
- School of Educational Science, Anhui Normal University, Wuhu, China
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Fang S, Ding D. Which outcome variables are associated with psychological inflexibility/flexibility for chronic pain patients? A three level meta-analysis. Front Psychol 2022; 13:1069748. [PMID: 36562078 PMCID: PMC9767366 DOI: 10.3389/fpsyg.2022.1069748] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
The psychological flexibility model can be seen as a basis for an integrated and progressive psychological approach to chronic pain management. Some researchers suggest that psychological flexibility and inflexibility represent distinct processes and constructs. This meta-analysis is the first to provide a summary estimate of the overall effect size for the relationship between psychological (in)flexibility and common outcomes among chronic pain patients. The research protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, https://www.crd.york.ac.uk/PROSPERO/), registration number CRD42021285705. Four databases were searched (PsycINFO; PubMed; Web of Science, CINAHL) along with reference lists. Thirty-six cross-sectional studies were included (7,779 participants). Meta-analyses (random effects model) indicated a significant medium negative association between psychological flexibility and pain intensity or functional impairment. The present study also indicated a significant small to medium association between psychological inflexibility and pain intensity, a nearly large association between psychological inflexibility and functional impairment as well as the quality of life, and a large association between psychological inflexibility and anxiety/depression. Due to the limited number of included studies, the relationship between risk behavior and psychological inflexibility may not be significant. Types of countries and instruments measuring psychological inflexibility may explain part of the heterogeneity. These findings may carry significant implications for chronic pain patients regarding the potential relationship between psychological inflexibility or flexibility and these outcomes. It may consequently form the basis for more robust testing of causal and manipulable relationships. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021285705.
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Affiliation(s)
- Shuanghu Fang
- School of Educational Science, Anhui Normal University, Wuhu, China
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The ACT trained physical therapist: Psychologically flexible, resilient, and armed with evidence-based tools. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tee EY, binti Raja Reza Shah RIA. Self‐transcendent emotions and their influence on organizational effectiveness: A literature review and synthesis. ASIAN JOURNAL OF SOCIAL PSYCHOLOGY 2022. [DOI: 10.1111/ajsp.12550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Eugene Y.J. Tee
- Department of Psychology Higher Education Learning Philosophy (HELP) University Kuala Lumpur Malaysia
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Bera S, Kumar P, Bhattacharya S. A study on how to achieve flexibility in healthcare process: a simulation-based approach. INTERNATIONAL JOURNAL OF PRODUCTIVITY AND PERFORMANCE MANAGEMENT 2022. [DOI: 10.1108/ijppm-06-2021-0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe paper aims to investigate the cardiology department’s operational system for improving flexibility by minimizing the patient waiting time and simultaneously maximizing the utilization of service capacity in an uncertain environment. This article also proposes a policy framework that suggests a pool of additional resources and inter-firm collaboration can boost healthcare service delivery excellence.Design/methodology/approachA discrete event simulation (DES) approach is followed for modeling patient flow and determining the service capacity to respond to demand variability and uncertainty. The model's outputs are used to minimize patient waiting time, maximize the utilization of the resources and match the service capacity with the patient demand.FindingsThis research has tested two hypotheses and proved that an increase in waiting time decimates the throughput rate, and additional resources deployment in bottleneck activity positively impacts the throughput rate. The simulated scenarios prescribe an enhanced service capacity with quality care and further contribute to operational performance in reduced waiting time and cost. The results indicate that flexibility reduces the patient waiting time and maximizes the throughput rate.Practical implicationsThe study guides the healthcare policymakers to develop flexible competence and facilitate service mechanisms that are adaptive and robust while operating under a volatile environment. The article contributes to the healthcare literature that conjoins flexibility through simulation and resource utilization.Originality/valueThis research is based on real-life primary data collected from healthcare providers. This study adds value to the healthcare systems to adopt strategic decisions to build flexibility through resource allocation, sharing and coordinated care.
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Akbari M, Disabato D, Seydavi M, Zamani E. The Persian Personalized Psychological Flexibility Index (P-PPFI): Psychometric properties in a general population sample of Iranians. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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