In plain language
Psychological flexibility — the ability to stay open to difficult thoughts and feelings while continuing to act on what matters — is a key target of acceptance and commitment therapy (ACT). But most questionnaires measuring it were developed for the general population. People recovering from an acquired brain injury (ABI), such as from a stroke or traumatic accident, face distinctive psychological challenges, and it was unclear whether standard measures work for them. This study provided preliminary validation of two tools: a new injury-specific measure, the Acceptance and Action Questionnaire—Acquired Brain Injury (AAQ-ABI), and the widely used general measure, the AAQ-II.
One hundred and fifty people with an ABI completed the 15-item AAQ-ABI, and their responses were subjected to exploratory factor analysis. A subset of 75 participants completed a larger battery of measures to test construct validity and to run a confirmatory factor analysis of the 7-item AAQ-II. The AAQ-ABI revealed three meaningful factors — Reactive Avoidance, Denial, and Active Acceptance — with the Reactive Avoidance scale showing good reliability and correlating as expected with related measures.
The take-home message is that both questionnaires can be used with people who have an ABI, but they capture different things: the AAQ-ABI taps psychological flexibility around thoughts and feelings about the brain injury itself, while the AAQ-II taps flexibility around general psychological distress. Having validated tools matters because it enables researchers and clinicians to properly evaluate ACT-based interventions designed to help people adjust after brain injury.
Key findings
- Exploratory factor analysis of the 15-item AAQ-ABI in 150 people with acquired brain injury identified three meaningful factors: Reactive Avoidance, Denial, and Active Acceptance.
- The Reactive Avoidance factor demonstrated good internal consistency and test–retest reliability (α = .89) and correlated in expected directions with related measures, including the AAQ-II.
- Confirmatory factor analysis of the 7-item AAQ-II in a subset of 75 participants did not provide a good fit in this population.
- Despite the poor CFA fit, the AAQ-II showed correlations with measures of psychological distress similar to those found in prior non-ABI samples.
- The two measures index different facets of psychological flexibility: the AAQ-ABI captures flexibility around thoughts and feelings about the brain injury itself, whereas the AAQ-II captures flexibility around general psychological distress.
- The authors conclude both measures can be used with individuals after ABI and recommend future research on the AAQ-ABI’s additional factors and on outcome studies promoting psychological flexibility in this population.
How to cite
APA
Whiting, D. L., Deane, F. P., Ciarrochi, J., McLeod, H. J., & Simpson, G. K. (2015). Validating measures of psychological flexibility in a population with acquired brain injury. Psychological Assessment, 27(2), 415–423. https://doi.org/10.1037/pas0000050
BibTeX
@article{whiting2015validating,
title = {Validating measures of psychological flexibility in a population with acquired brain injury},
author = {Whiting, Diane L. and Deane, Frank P. and Ciarrochi, Joseph and McLeod, Hamish J. and Simpson, Grahame K.},
journal = {Psychological Assessment},
year = {2015},
volume = {27},
number = {2},
pages = {415--423},
doi = {10.1037/pas0000050}
}
Related work
- All publications by Joseph Ciarrochi (searchable, with free PDFs)
- Process-Based Therapy & Idionomic Analysis
Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.