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Background:
Psychological flexibility is considered a fundamental aspect of health. It includes six interrelated facets: 1) cognitive defusion, 2) acceptance, 3) contact with the present moment, 4) self-as-context, 5) values, and 6) committed action. To gain further insight into psychological flexibility and its effects on health, reliable and val...
Context in source publication
Context 1
... a one factor model (all items only measure the construct Committed Action [CA]), second a two factor model (items measure one of two factors depending on how items are keyed) and third a bifactor model (CA factor plus two item class specific factors). Only the bifactor model resulted in an acceptable fit based on RMSEA, SRMR, CFI and TLI (see Table 2). ...Similar publications
This study aims to explore teachers’ perceptions of the importance of culture in teaching German as an international language in secondary schools in Malaysia based on the interrelationship between language and culture which are closely related. The quantitative method through questionnaires was conducted to collect data. A total of 66 Malaysian se...
Citations
... Further refinement of the conceptualization of positive health and the ability to adapt is thus warranted. In the past, various reliable and valid measures have been developed to measure specific skills and competences that promote the ability to adapt such as psychological flexibility (Brown and Ryan, 2003;McCracken and Yang, 2006;Vowles et al., 2008;Wicksell et al., 2010;McCracken et al., 2015;Yu et al., 2016Yu et al., , 2017Terhorst et al., 2020), adaptive coping (Chesney et al., 2006;Greenaway et al., 2015;González-López et al., 2022), and optimism and cognitive styles (Conversano et al., 2010;Schiavon et al., 2017). However, a reliable and valid generic comprehensive measure of perceived ability to adapt more focused on the process than on skills, is still lacking. ...
Introduction
The ability to adapt is a core aspect of daily human life. Recent models and theories emphasize its essential role for health and well-being. It concerns the perceived ability to readjust and actively deal with the psychosocial consequences of challenging events. While many questionnaires measure competences related to adaptability to specific conditions, a scale that measures a generic sense of the ability to adapt is lacking. The aim of the present study is to introduce the Generic Sense of Ability to Adapt Scale (GSAAS) and to examine its psychometric properties.
Methods
The article describes two sub-studies. In the first study the items of the GSAAS were generated and field-tested in a cross-sectional non-clinical sample using item analysis, exploratory factor analysis and Rasch analysis.
Results
This resulted in a 10-item questionnaire measuring a single dimension with good reliability (Cronbach’s α = 0.87). In the second study the 10-item scale was validated using a cross-sectional sample of 496 outpatient adults with mental health problems. Confirmatory factor analysis confirmed the unidimensional structure of the GSAAS and the absence of measurement variance across gender, age and education. Reliability was high (α = 0.89) and moderate to strong correlations between the GSAAS and concurrent validation measures confirmed its convergent validity. Regarding incremental validity, the GSAAS accounted for 7.4% additional explained variance in symptomatic distress above and beyond sense of coherence.
Discussion
In conclusion, the GSAAS appears to be a reliable and valid instrument to assess people’s generic sense of the ability to adapt. It is a practical and quick tool that can be used to measure a vital aspect of health in research and clinical treatment settings.
... In addition, ACT-based measures were applied, including the 20-item Chronic Pain Acceptance Questionnaire (CPAQ), with good reliability of total and subscales of between α = 0.84-0.87 [62]; the 7-item Cognitive Fusion Questionnaire (CFQ), characterized by excellent reliability (α = 0.94) [63]; as well as the 18-item Committed Action Questionnaire (CAQ), with a high reliability of α = 0.91 [64] to assess different aspects of the extent of psychological flexibility in chronic pain management. ...
Musculoskeletal symptoms are increased in farmers, whereas the prevalence of chronified pain is unknown. Online interventions based on acceptance and commitment therapy (ACT) have shown encouraging results in the general population, representing a promising approach for reducing pain interference in green professions (i.e., farmers, foresters, gardeners). We conducted a pragmatic RCT comparing a guided ACT-based online intervention to enhanced treatment-as-usual in entrepreneurs,
contributing spouses, family members and pensioners in green professions with chronic pain (CPG: >=grade II, >=6 months). Recruitment was terminated prematurely after 2.5 years at N = 89
(of planned N = 286). Assessments were conducted at 9 weeks (T1), 6 months (T2) and 12 months (T3) post-randomization. The primary outcome was pain interference (T1). The secondary outcomes
encompassed pain-, health- and intervention-related variables. No treatment effect for reduction of pain interference was found at T1 (b = -0.16, 95%CI: -0.64–0.32, p = 0.256). Improvements in cognitive fusion, pain acceptance, anxiety, perceived stress and quality of life were found only at T3. Intervention satisfaction as well as therapeutic and technological alliances were moderate, and uptake and adherence were low. Results are restricted by low statistical power due to recruitment issues, high study attrition and low intervention adherence, standing in contrast to previous studies. Further research is warranted regarding the use of ACT-based online interventions for chronic pain in this occupational group. Trial registration: German Clinical Trial Registration: DRKS00014619. Registered: 16 April 2018.
... Many studies have shown that psychological flexibility may be a basic aspect of mental health and wellbeing, while psychological inflexibility is a risk factor for psychopathologies, such as chronic pain (Lin et al., 2018;Gentili et al., 2019), psychological distress, somatization, anxiety, or depression (Kashdan and Rottenberg, 2010;Masuda and Tully, 2012). Effective measurements to assess all six constructs are needed to obtain a better understanding of psychological flexibility and further insight into psychotherapeutic processes (Gagnon et al., 2017;Terhorst et al., 2020). Several instruments have been developed to measure aspects of psychological flexibility, including cognitive defusion (Gillanders et al., 2014), acceptance (Bond et al., 2011), presentfocused awareness (Brown and Ryan, 2003), self as context (Yu et al., 2016(Yu et al., , 2017Zettle et al., 2018), and values (McCracken and Yang, 2006). ...
... A shortened version of the CAQ has been developed with eight items, which shows comparably satisfactory reliability and validity (McCracken et al., 2015). The CAQ-8 is psychometrically sound in various languages including Swedish (Åkerblom et al., 2016), French (Gagnon et al., 2017), German (Terhorst et al., 2020), Portuguese (Trindade et al., 2018), and Chinese (Cantonese) (Wong et al., 2016). However, there is no Chinese (Mandarin) version of the CAQ-8, although it is the most common and official language of China. ...
Background: Committed action is one of the core processes of psychological flexibility derived from acceptance and commitment therapy. It has not been widely investigated in mainland China as appropriate measures are lacking. The current study aimed to validate a Chinese (Mandarin) version of the Committed Action Questionnaire (CAQ-8) in a non-clinical college sample and to explore whether committed action would have a mediating effect in the association between experiential avoidance (EA) and life satisfaction.
Methods: We translated the CAQ-8 into Chinese (Mandarin). A total of 913 Chinese undergraduates completed a set of questionnaires measuring committed action, EA, mindful awareness, anxiety, depression, stress, and life satisfaction. For test–retest reliability, 167 respondents completed the CAQ-8 again 4 weeks later.
Results: The entire scale of CAQ-8 (Mandarin) and two subscales showed adequate internal consistency and acceptable test–retest reliability. Confirmatory factor analyses confirmed the two-factor structure and the convergent and criterion validity were acceptable. Committed action was correlated with less EA, more mindful awareness, less depressive symptoms, less anxiety, less stress, and more life satisfaction. In bootstrap mediation analyses, committed action partially mediated the association between EA and life satisfaction.
Conclusion: The results suggest that the CAQ-8 (Mandarin) is a brief, psychometrically sound instrument to investigate committed action in Chinese populations, and the relationship between EA and life satisfaction was partially explained by committed action. This study provides new information about the usefulness of CAQ-8 and supports the assumption that committed action may be considered a promising factors for improving life satisfaction who have involved in EA among an educated non-clinical population.
... The CAQ has been translated from the original English and validated in Swedish (Åkerblom, Perrin, Rivano-Fischer, & McCracken, 2016), French (Gagnon, Dionne, Balbinotti, & Monestès, 2017), Spanish (Galán et al., 2019), and German (Terhorst, Baumeister, McCracken, & Lin, 2020). It has also been demonstrated that the items from the CAQ-8 form separate factors in modeling multiple components of PF/in exibility in con rmatory factor analysis, factors that nonetheless also t within an overall general factor mainly dominated by acceptance (Scott, McCracken, & Norton, 2016). ...
Committed action is a fundamentally important facet of psychological flexibility and acceptance and commitment therapy (ACT). This article introduces committed action, reviews how definitions of it have evolved over time, presents a current definition, and summarizes current evidence. While the term itself has not always garnered great attention either in the clinic or in research, any research in behavioral activation and goal setting will directly relate to processes of committed action. Research explicitly into “committed action” is finally underway, beginning 14 years after publication of the first book on ACT. This was enabled by the appearance of adequate self-report measures of the process. A critical appraisal of the research around committed action shows that not all purported measures of committed action reflect this process with equal fidelity, and some fail to reflect key features. Nonetheless, evidence so far demonstrates that committed action from within the frame of psychological flexibility can be assessed in a theoretically consistent fashion. Measures of it correlate with measures of functioning and change when targeted with appropriate treatment methods; these changes in turn correlate with improvements in key clinical outcomes. These results, taken together with evidence from behavioral activation and goal-setting methods, provide substantial and growing evidence that committed action constitutes an evidence-based process of behavior change. It is recommended that methods to assess and promote this process continue to be developed and that they be included in future treatments.
... The internal consistency is excellent (α=0.94). 89 To measure the facet Committed Actions, the German version of the Committed Action Questionnaire (CAQ-D) 90 will be used. The CAQ-D consists of 18 items: 9 positively keyed items and 9 negatively keyed items. ...
... The internal consistency of the CAQ-D is good (α=0.87). 90 Work capacity Work capacity will be measured with the German version of the Subjective Prognostic Employment Scale (SPE 91 ). The SPE is a validated short self-report scale composed of three items with high internal consistency (Guttman scaling: rep=0.99). ...
Introduction:
Chronic pain is highly prevalent, associated with substantial personal and economic burdens, and increased risk for mental disorders. Individuals in green professions (agriculturists, horticulturists, foresters) show increased prevalence of chronic pain and other risk factors for mental disorders. Available healthcare services in rural areas are limited. Acceptance towards face-to-face therapy is low. Internet and mobile-based interventions (IMIs) based on Acceptance and Commitment Therapy (ACT) might be a promising alternative for this population and may enable effective treatment of chronic pain. The present study aims to evaluate the clinical and cost-effectiveness of an ACT-based IMI for chronic pain in green professions in comparison with enhanced treatment as usual (TAU+).
Methods and analysis:
A two-armed pragmatic randomised controlled trial will be conducted. Two hundred eighty-six participants will be randomised and allocated to either an intervention or TAU+ group. Entrepreneurs in green professions, collaborating spouses, family members and pensioners with chronic pain are eligible for inclusion. The intervention group receives an internet-based intervention based on ACT (7 modules, over 7 weeks) guided by a trained e-coach to support adherence (eg, by positive reinforcement). Primary outcome is pain interference (Multidimensional Pain Interference scale; MPI) at 9 weeks post-randomisation. Secondary outcomes are depression severity (Quick Inventory Depressive Symptomology; QIDS-SR16), incidence of major depressive disorder, quality of life (Assessment of Quality of Life; AQoL-8D) and possible side effects associated with the treatment (Inventory for the Assessment of Negative Effects of Psychotherapy; INEP). Psychological flexibility (Chronic Pain Acceptance Questionnaire, Committed Action Questionnaire, Cognitive Fusion Questionnaire) will be evaluated as a potential mediator of the treatment effect. Furthermore, mediation, moderation and health-economic analyses from a societal perspective will be performed. Outcomes will be measured using online self-report questionnaires at baseline, 9-week, 6-month, 12-month, 24-month and 36-month follow-ups.
Ethics and dissemination:
This study was approved by the Ethics Committee of the University of Ulm, Germany (file no. 453/17-FSt/Sta; 22 February 2018). Results will be submitted for publication in peer-reviewed journals and presented at conferences.
Trial registration number:
German Clinical Trial Registration: DRKS00014619. Registered on 16 April 2018.
The three “waves” of behavioral therapy have each considered chronic pain as a relevant and treatable clinical problem. These treatments have a longstanding and well-established evidence base. As the prime example of a third wave behavioral treatment, acceptance and commitment therapy (ACT) for chronic pain seeks to enhance willingness to have chronic pain in the service of engaging in personally meaningful activity. Several studies have examined willingness to have pain (e.g., pain acceptance) in the service of engagement in meaningful activity (e.g., values-based action) and there is strong support for their relevance in those who are living with chronic pain. Treatments using the ACT model have been successful at improving pain acceptance, values-based action, emotional distress, physical ability, healthcare utilization, and engagement in role functioning up through follow-ups of as long as 3 years. As with the other behavioral treatments from preceding waves, ACT for chronic pain seeks to reduce the deleterious effects of pain on functioning. That being said, ACT is distinctive from the previous two behavioral waves with regard to its view of cognition as an important and relevant, but not uniquely causal, aspect of human behavior and in its specification that increasing engagement in valued activities is the principal goal of intervention.
