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Despite the high prevalence of yips, a psychoneuromuscular impairment affecting fine motor skills in sports performance, the specific aspects of its causality and treatment have not been identified or verified. This cross-sectional study examined psychosocial factors relating to throwing yips in baseball. Amateur baseball players (N = 292) living in Japan completed a self-report questionnaire on their anxiety/fear about throwing the ball, the Acceptance and Action Questionnaire-II, the Cognitive Fusion Questionnaire, the Short Fear of Negative Evaluation Scale, and self-reports evaluating values and social factors relevant to baseball. A hierarchical multiple regression analysis indicated that a low values-based throwing score, a high Cognitive Fusion Questionnaire score, and overreprimanding others' mistakes were positively associated with baseball players' yips symptoms. These results suggest that changing the context of playing baseball, reducing cognitive fusion, and improving coaching methods could reduce the risk of baseball players' throwing yips. [ABSTRACT FROM AUTHOR]

Summary: Psychological flexibility has recently attracted the attention of researchers in the field of sleep disorders; therefore, in the study, psychological flexibility was evaluated as a predictor or factor related to the presence/severity of insomnia. We included 2218 individuals selected from the randomized–control trial for behavioural therapy for insomnia and cross‐sectional studies, including 1797 individuals with insomnia and 421 controls without insomnia. All participants completed the DSM‐5‐based insomnia diagnosis interview, Insomnia Severity Index, Hospital Anxiety and Depression Scale, and Acceptance Action Questionnaire‐II. Linear regression and multinomial logistic regression models were used. Sex, education, occupation, marital status, anxiety, depression and psychological inflexibility were possible predictors or factors associated with the severity of insomnia. Multivariate linear regression analysis demonstrated that sex (훽 = 0.88; t = 2.80; p = 0.005), depression (훽 = 0.41; t = 10.7; p < 0.001), anxiety (훽 = 0.58; t = 14.1; p < 0.001) and psychological inflexibility (훽 = 0.09; t = 5.07; p < 0.001) were predictors of insomnia. The results of the multinomial logistic regression demonstrate that, in comparison to the absence of insomnia, insomnia at all levels (mild, moderate and severe) was associated with sex, anxiety and depression. Psychological inflexibility was only associated with severe insomnia (odds ratio = 1.04). These findings are important from a public health perspective because behavioural strategies designed to treat insomnia with a focus on psychological flexibility are low‐cost and may help improve sleep quality in adults with insomnia, which also influences mental health. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the effect of the Multi-Component Positive Psychology Intervention (MPPI) on adolescents’ risky behaviors and psychological flexibility. The study utilized a convergent parallel design, a mixed-method research design. While the quantitative phase included a 2 × 3 factorial design, the qualitative phase included a descriptive phenomenology approach. The study group consisted of 26 adolescents (experimental group = 13, control group = 13) selected using the simultaneous/nested sampling method (Ranjage=14–17, Mage=15.35, SDage=1.09). While the adolescents in the experimental group received a ten-week MPPI program online, the adolescents in the control group were administered no interventions. Quantitative data were collected through the Risky Behavior Scale and the Multidimensional Psychological Flexibility Inventory-Short Form. Qualitative data were collected through individual interviews conducted with the adolescents after the experimental procedure. The quantitative results showed that MPPI enabled a significant decrease in adolescents’ antisocial behaviors, suicide tendency, risky behaviors total and psychological inflexibility scores and an increase in their psychological flexibility scores. This effect was found to continue in the follow-up measurements taken three months later. On the other hand, MPPI was found to have no significant effects on reducing adolescents’ alcohol use, smoking, nutrition habits, and school dropout scores. Qualitative findings indicated the positive effects of MPPI on decreasing adolescents’ risky behaviors and increasing their psychological flexibility levels. Findings from quantitative and qualitative data assessing the effectiveness of MPPI were found to support each other. [ABSTRACT FROM AUTHOR]

Background: Although depression and anxiety often co-occur, the relationship between their symptoms has not been explored in non-clinical populations. Moreover, the relationship between these affective symptoms and psychological flexibility (PF) requires further investigation to improve intervention sensitivity. This study used a network approach to examine the comorbidities of depression and anxiety, and their relationship with PF. Methods: The study sample included 1,059 Korean community participants. Two separate networks were established using items that assess depression, anxiety, and PF. Bridge strength centrality was calculated to identify the components that acted as bridges between different clusters in the network. Results: The results indicated that the major symptoms related to depression and anxiety symptom clusters were depressed mood, restlessness, and irritability. Additionally, the PF value process was positively associated with combined symptom clusters. Conclusions: These findings provide a nuanced understanding of how symptoms and protective processes interact with and influence each other. Clinical implications and future research directions have been discussed. [ABSTRACT FROM AUTHOR]

Multiple studies have investigated the efficacy of acceptance and commitment therapy (ACT) in improving psychological flexibility among overweight and obese individuals. However, to date, no specific reviews have focused on ACT and weight-related difficulties in this population. This systematic review of the literature aims to identify and assemble all ACT interventions in randomized controlled trials (RCT) that address weight-related difficulties in the treatment of overweight and obese adults. The PRISMA 2020 framework was used for the systematic review, includes manual and computerized database searches. Five databases (Medline, PubMed, Scopus, PsycInfo, and Google) were utilized to gather all articles that: (a) published in English; (b) adopted the RCT design; (c) used ACT as an intervention; (d) included adult participants aged over 18 years with BMI of over 25 kg/m2, and (e) included weight-related difficulties and weight as outcome measures. The review identified seven studies comprising 698 overweight or obese participants of both genders. Improvements were reported in weight-related difficulties and percentage of weight loss in the ACT group and the non-ACT group. The present review supports ACT as an effective intervention that can help adults with weight-related difficulties and excess body weight. Further studies should be conducted in various overweight or obese populations with a more systematic RCT research design to establish the effectiveness of ACT in this area. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Secondary traumatic stress (STS) is the indirect traumatisation of a person through the stress of helping or knowing about other's trauma. Burnout is gradual exhaustion in response to long‐term work‐related stress. Both have negative psychological, physiological and/or organisational consequences; however, the existing research in forensic health care professionals (FHCPs) is limited.One study explored STS in FCHPs and found that lower psychological flexibility (ability to adapt) was a predictor of greater STS. Existing research on burnout in FHCPs suggests that individual differences, such as the ways in which we cope (talking to people vs. using substances), may predict burnout levels. What the paper adds to existing knowledge: Prevalence findings add to the recent evidence base, which also found moderate levels of burnout. However, this study is the first to find high levels of secondary traumatic stress in FHCPs.Similar to existing literature, the study's findings suggest that FHCP's with lower levels of psychological flexibility and more maladaptive coping strategies may experience greater STS and burnout symptoms, while staff who use more adaptive coping strategies may experience less burn‐out.Unexpectedly, staff who reported a more anxious attachment style were burnt‐out; however, there are limitations to this finding. What are the implications for practice: Policies and practices in forensic settings should reflect the risk of STS and burnout.Practices or interventions should enhance adaptive coping strategies and psychological flexibility, such as Resilience Enhancement Programmes or Acceptance and Commitment Therapy (ACT). Introduction: Secondary traumatic stress (STS) and burnout literature in inpatient forensic health care professionals (FHCPs) is limited, despite the psychological, physiological and organisational consequences. Aims: This study aimed to further this limited evidence base, investigating predictors of STS and burnout in FHCPs. Method: 98 healthcare professionals working in two UK forensic inpatient settings completed measures assessing: burnout, STS, psychological flexibility, coping style, attachment style and a demographic questionnaire recording length of service and the sex of staff. Results: Results indicated high STS and moderate burnout levels. The main predictors of STS and burnout were poorer psychological flexibility and greater maladaptive coping styles, whereas lower burnout was predicted by greater adaptive coping styles and an anxious attachment style. Discussion: This study has contributed towards a limited evidence base and indicates poorer psychological flexibility and greater maladaptive coping may be risk factors for STS and burnout in FHCPs, whereas greater maladaptive coping may be a protective factor. Implication for Practice: The findings suggest that interventions such as Acceptance and Commitment Therapy (ACT) and coping skills interventions, may offer protective benefits to inpatient forensic healthcare professionals. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic brought with it significant social, economic and health uncertainties. These were proposed to impact young people more compared to adults, leading adolescents to report more mental health problems during the pandemic. The current study examined whether differences in cognitive risk (tolerance of uncertainty) and protective (psychological flexibility) factors accounted for age-related differences in depression and anxiety. Methods: These associations were investigated in the COVID-19 Risks Across the Lifespan (CORAL) cohort (N = 2280, 11–89 years). Results: The results showed that adolescents experienced greater intolerance of uncertainty and lower psychological flexibility compared to adults and older adults. Tolerance of uncertainty did not account for age-related differences in depression or anxiety. However, psychological flexibility conferred more protective advantage for anxiety in adults compared to adolescents. Conclusion: The observed age-related differences in risk and protective factors advance our understanding of developmental vulnerabilities to depression and anxiety. Implications for mental health interventions in the context of future pandemics are discussed. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the possible mediating role of psychological flexibility in the association between fear of COVID-19, affective symptoms and well-being. 403 subjects were recruited; fear of COVID-19, psychological flexibility, affective symptoms and well-being were assessed via self-report measures. Correlation and mediation analyses were run. Psychological flexibility was found to play a mediating role in the association between fear of COVID-19 and more severe affective symptoms (adjusted R-squared = 52%, p < 0.001), and between fear of COVID-19 and poor well-being (adjusted R-squared = 41%, p < 0.001). Psychological flexibility may mitigate the negative impacts of fear of COVID-19 on affective symptoms and well-being Psychological flexibility could be the potential therapeutic target in clinical interventions aimed at reducing the adverse effects of fear of COVID-19 on mental health. [ABSTRACT FROM AUTHOR]

Extensive research evaluated the protective role of psychological resources (PRs, e.g. optimism, hope, gratitude and wisdom). However, few studies have explored their differential contributions when measured together. This study evaluated the longitudinal relationships between (and among) eight psychological resources, psychological distress (depression and anxiety symptomatology) and well-being (hedonic, eudaimonic, social, and inner well-being), over the first year of the COVID pandemic. Participants (N = 481) reported their levels of PRs, psychological distress, and well-being on two occasions (T0: April 2020; T1: June 2021). Cross-lagged panel analysis of the one-year associations revealed that 1) PRs positively, but differentially, predicted well-being and psychological distress; 2) PRs positively reinforced each other; and 3) well-being and low psychological distress also reinforced PRs, but to a lesser degree. In particular, psychological flexibility appeared to be the most predictive variable in all domains. This study highlights the need to include multiple psychological resources in future research. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionsPostpartum depression is a major public health issue impacting women’s well-being and infant development. Dispositional mindfulness has been linked to lower severity of postpartum depressive symptoms (PDS), but the mechanisms behind this connection remain unclear. This study examines the serial mediation of psychological flexibility and maternal role satisfaction in the relationship between mindfulness facets and PDS.Participants were recruited using convenience sampling and completed an electronic questionnaire assessing sociodemographic background, dispositional mindfulness, psychological flexibility, maternal role satisfaction, and PDS. The study included mothers over 18, who had given birth within ten months and could complete a Hebrew questionnaire. The final sample consisted of 298 women aged 21 to 47 (M = 31.34, SD = 4.34) with babies up to 10 months old.Mediation analyses showed that the mindfulness facets -describing, acting with awareness, and the overall score of dispositional mindfulness – were indirectly linked to lower severity of PDS through psychological flexibility and maternal role satisfaction. A serial mediation occurred, where higher mindfulness increased psychological flexibility, leading to greater role satisfaction and lower PDS. Additionally, nonjudging of inner experiences was directly associated with lower PDS severity and partially mediated by psychological flexibility and role satisfaction.The findings contribute to our understanding of how dispositional mindfulness relates to postpartum mental health through emotional and cognitive pathways. In practice, encouraging mindfulness, particularly nonjudgment, alongside fostering psychological flexibility and maternal role satisfaction, may help alleviate PDS and promote the well-being of postpartum women. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Aim Method Results Discussion Implications for Practice Psychological flexibility is posited to aid individuals with substance use disorder (SUD) in managing stress and tolerating distress. However, the intricacies of this mechanism remain obscure.This study investigates the potential mediating role of psychological flexibility in the relationship between distress tolerance and perceived stress among individuals with SUD.This cross‐sectional study evaluated 187 individuals with SUD, selected through non‐probability convenience sampling, using the Introductory Information Form, the Perceived Stress Scale, the Distress Tolerance Scale and the Acceptance and Action Questionnaire—Substance Abuse. Data analysis was conducted using SPSS 25 and further refined with Jamovi 2.4.14, employing advanced mediation analysis techniques.Significant relationships were found between distress tolerance, perceived stress and psychological flexibility. Mediation model analysis showed that psychological flexibility mediated the relationship between distress tolerance and perceived stress.This study revealed that higher distress tolerance, higher psychological flexibility and lower perceived stress were associated. As individuals adopt a more flexible and accepting attitude towards distressing situations, they perceive stressful events as less threatening and more manageable.The study suggests the need for psychiatric and mental health nursing practice and education to incorporate strategies to increase psychological flexibility. [ABSTRACT FROM AUTHOR]

Objective: Applying mindfulness training across cultures can be challenging because its internal motivation depends on values, but there are differences between Western and Eastern contexts. This meta-analysis examines the comparative impacts of the Western Mindfulness-Acceptance-Commitment (MAC) approach and the culturally-adapted Chinese Mindfulness-Acceptance-Insight-Commitment (MAIC) mindfulness training for athletes, to explore the importance of cultural adaptation in cross-cultural psychology to psychological skills training. Methods: This meta-analysis was registered with Prospero (ID: CRD42023474474) and adhered to the PRISMA principles. The PICO search methodology was employed to identify pertinent Chinese and English literature across six databases (Web of Science, PubMed, Scopus, CNKI, Wanfang, and VIP) from 2003 to 2023. The evidence originated from randomized controlled trials. Effect sizes were evaluated across three primary domains: athletic performance, mindfulness, and psychological flexibility, and heterogeneity and publication bias. Results: Both MAC and MAIC demonstrated positive effects across all outcome categories in 18 studies. MAIC exhibited substantially larger effect sizes compared to MAC. In mindfulness (MAIC: g = 1.273, p < 0.001; MAC: g = 0.521, p = 0.001), sports performance (MAIC: g = 0.945, p = 0.015; MAC: g = 0.550, p < 0.001), MAC did not provide evidence of improved psychological flexibility (g = 0.076, p = 0.747), while MAIC demonstrated significant benefits (g = 0.964, p < 0.001). Discussion: While MAIC is based on MAC, it yields more significant outcomes. This may be the "Insight" component introduced by MAIC, which skillfully integrates Eastern context. The MAIC strategy not only becomes more appropriate for local athletes but also indirectly enhances their mindfulness, athletic performance, and psychological flexibility, resulting from cultural adaptation. The new idea not only solves the culture shock caused by the direct application of Western MAC approach on Chinese athletes, but also provides a new solution to the problem that there is insufficient evidence to support the effect of the MAC approach on "psychological flexibility." Investigating differential effects between MAC and MAIC contributes to understanding the significance of culturally adapting mindfulness training and transnational movement of practices. The findings will assist practitioners in selecting evidence-based protocols tailored to athlete needs and cultural contexts. Systematic review registration: Prospero (ID: CRD42023474474). [ABSTRACT FROM AUTHOR]

Background: The benefits of positive psychology interventions (PPIs) have become increasingly popular. While there is an emerging evidence base on the effectiveness of applying positive psychology in curriculum as preventive, early mental health intervention for higher education students, little is known about the content and pedagogy in these promising courses. Objective: This article describes (a) the rationale for and development of a positive psychology course embedded into the curriculum that aims to foster posttraumatic growth, psychological flexibility, and socio-emotional competencies for higher education students; and (b) a mixed-method non-randomised pre-post study to evaluate the effectiveness of the positive psychology course in achieving positive participant outcomes. Methods: Higher education students from different disciplines will be enrolled to a general education course, "Positive Psychology and Personal Growth", where they will learn progressive topics and complete summative assessments related to key areas in positive psychology. In addition to lectures, participants will engage in constructivist-based experiential activities that are guided by research on PPIs, life-design interventions and constructivist learning principles. The primary outcome is posttraumatic growth, and the secondary outcomes are psychological flexibility, and socio-emotional competencies. Expected results: We hypothesised that after the curriculum-embedded PPI, participants will have significantly higher levels of posttraumatic growth, psychological flexibility, and socio-emotional competencies. Results derived from the questionnaire survey will be supported by corroborating evidence identified from qualitative analysis of participants' summative assessments and follow-up semi-structured interviews on their perceptions of the present course. Discussion: The current study will fill in a gap in existing intervention research and practise in curriculum-embedded PPIs and promote research transparency and pedagogical advancement. The intervention provides guidance and recommendations for educators to consider embedding positive psychology into the formal curriculum as cost-effective, low-intensity, structured, and sustainable educational interventions for higher education students. [ABSTRACT FROM AUTHOR]

Pain is a central feature of inflammatory rheumatic diseases and is associated with psychological distress. Pain is widely recognized not as a mere physical sensation, but as a complex, multidimensional phenomenon with an affective component. A plethora of research has conceptualized adaptation to pain by focusing on minimizing the pain experience. However, pain in autoimmune inflammatory rheumatic diseases is often neither avoidable nor curable. This cross-sectional study aimed to investigate the processes explaining how pain intensity may be associated with low well-being and why some patients may live well despite pain. Drawing upon the psychological (in)flexibility model and the process model of emotion regulation, we propose that cognitive reappraisal moderates the association between pain and euthymia through experiential avoidance. Ninety-seven patients with rheumatoid arthritis, psoriatic arthritis, or axial spondyloarthritis were included for analyses (mean age = 53.4; mean time since diagnosis = 9.2 years). Most patients were women (75%), married/cohabitant (71%), and attended high school (47%). Results indicate that experiential avoidance may explain how severe pain is associated with lowered euthymia. This indirect negative effect of pain intensity on euthymia became non-significant at high levels of cognitive reappraisal, suggesting that cognitive reappraisal may serve as a protective factor for patients with autoimmune inflammatory rheumatic diseases. This study paves the way for future research in this promising context by providing an initial step towards integrating emotion regulation and psychological inflexibility in pain conditions. [ABSTRACT FROM AUTHOR]

Background: Psychological flexibility (PF) is defined as the ability to pursue valuable life goals despite the existence of distress. The Personalized Psychological Flexibility Index (PPFI) is a new measure of psychological flexibility that can address existing deficiencies. This study aimed to translate and validate the psychometric characteristics of the Chinese version of the PPFI among medical college students. Methods: The study was conducted in two phases. Phase 1 involved the translation and cross-cultural adaptation of the PPFI according to guidelines recommended by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Phase 2 was a cross-sectional survey conducted on 945 medical college students in China. The psychometric performances of the scale were assessed using construct validity, divergent validity, criterion validity, incremental validity, internal consistency, and test-rest reliability. Results: The exploratory factor analysis (EFA, n1 = 440) showed that the Chinese version of the PPFI consisted of 3 factors, with a total of 15 items. The confirmatory factor analysis (CFA, n2 = 440) showed that the three-factor structure fit well (χ2/ df =2.469, SRMR = 0.051, RMSEA = 0.058, GFI = 0.94, CFI = 0.985). The total Chinese PPFI score had a moderate positive association with the Comprehensive Assessment of Acceptance and Commitment Therapy (CompACT, r = 0.344) and a negative association with the Acceptance and Action Questionnaire-II (AAQ-II, r = -0.334). Furthermore, the Chinese PPFI demonstrated good internal consistency (Cronbach's α = 0.826) and test–retest reliability (ICC = 0.817, p < 0.001). Conclusion: The 15-item Chinese version of the PPFI is a reliable and valid tool for measuring PF in Chinese medical students. However, additional studies are needed to validate its psychometric properties in more generalizable samples and other contexts. [ABSTRACT FROM AUTHOR]

Stress is a known contributor to psychosocial pathological conditions and reduction of well‐being. The literature has highlighted the role of emotional schemas and psychological flexibility as psychological processes underlying this relationship in the short term. This two‐wave longitudinal study analyses the mediating role of psychological flexibility and emotional schemas in the relationship between stress responses to COVID‐19‐related events and mental health 6 months later. Two hundred and seventy‐six individuals were included in this study, completing measures of stress responses, emotional schemas, psychological flexibility and positive and negative mental health. Negative evaluation of emotions was a significant mediator in the longitudinal relationship between stress responses and negative mental health. Valued action and openness to experience mediate the longitudinal relationship between stress responses and positive mental health. This study underscores the importance of the different dimensions of psychological processes, suggesting that over time, more maladaptive psychological processes play a significant role in elucidating the relationship between stress responses and negative mental health. Similarly, it suggests that more adaptive processes may help explain the relationship between stress responses and positive mental health. This contributes to a better understanding of the stability of these processes, which is important for determining which intervention targets should be prioritised. [ABSTRACT FROM AUTHOR]

Asthma and ADHD represent prevalent pediatric conditions, with the former being a physical disorder and the latter being a neurodevelopmental disorder. This study examined the influence of parental psychological flexibility (PF)—the ability to adapt to evolving situational demands, shift perspectives, and balance competing priorities—alongside parenting competence and asthma management self-efficacy on family functioning and parental psychological adjustment in families with children exhibiting concurrent asthma and ADHD symptoms. Baseline data were analyzed from 130 parents (mean age = 40.3 years, SD = 5.5; 88.9% mothers) of children diagnosed with both asthma and ADHD (mean age = 8.0 years, SD = 2.2; 74.6% boys), who were participating in a randomized controlled trial evaluating an Acceptance and Commitment Therapy (ACT)-based parenting intervention. An adjusted structural equation model revealed that greater parental psychological inflexibility was significantly associated with poorer family functioning (β = −0.61, 95% CI [−0.74, −0.33], p < 0.001) and increased psychological maladjustment (β = 0.48, 95% CI [0.32, 0.63], p < 0.001), accounting for intercorrelations with parenting competence and parental asthma management self-efficacy. Additionally, parental psychological flexibility was found to mediate the relationship between parenting competence and both family functioning and psychological adjustment. These findings underscore the importance of targeting parental psychological inflexibility and enhancing parenting competence in interventions to improve family dynamics and parental mental health and thereby suggest a shift from the traditional focus on self-efficacy in symptom management for pediatric asthma and ADHD. [ABSTRACT FROM AUTHOR]

Objectives: Clinical perfectionism, characterised by stringent standards and persistent striving, correlates with self-criticism and poor wellbeing. In this study we explored the mediating roles of psychological flexibility and inflexibility, and self-compassion, in the relationships of clinical perfectionism with distress, and clinical perfectionism and wellbeing. Methods: We used a cross-sectional correlational study design. A non-clinical sample of 210 Australian residents aged between 18 to 65 years old completed an online survey. Data were analysed using correlational, multiple regression, and parallel mediation analysis. Results: Heightened clinical perfectionism was associated with lower wellbeing and increased distress. Regression models revealed significant mediation by psychological inflexibility processes (self-as-content, experiential avoidance, cognitive fusion) and self-compassion. Cognitive fusion and inaction mediated clinical perfectionism-distress, while self-compassion and inaction mediated clinical perfectionism-psychological wellbeing. Conclusions: These findings support clinical perfectionism as a transdiagnostic predictor of distress and reduced wellbeing. Those with high clinical perfectionism tend to rigidly respond to perfectionistic thoughts, avoid uncomfortable emotions, and engage in value-disconnected inaction. Associations between psychological flexibility and inflexibility processes emphasise their multidimensional nature, distinct yet interrelated. Inaction emerges as a common process in clinical perfectionism-distress and clinical perfectionism-wellbeing, while cognitive fusion specifically influences distress, and limited self-compassion affects wellbeing. Key Points: What is already known about this topic: Clinical perfectionism is linked to psychopathology and transdiagnostic mechanisms, impacting distress and psychological wellbeing. Psychological inflexibility provides a transdiagnostic framework for understanding how rigid and self-limiting responses to feelings and thoughts are maintained despite negative consequences. Clinical perfectionism may be a form of psychological inflexibility, with rigid responses to perfectionistic thoughts, avoidance of uncomfortable emotions, and value-disconnected inaction. What this topic adds: Cognitive fusion and inaction are crucial for understanding clinical perfectionism's impact on distress. Self-compassion and inaction play a key role in understanding the relationship between clinical perfectionism and wellbeing. Understanding the functions of inaction is vital for fostering flexible responses to perfectionistic thoughts. [ABSTRACT FROM AUTHOR]

• There is no established treatment for problematic chemsex. • Problematic chemsex can be comorbid with sexual addiction. • Results of this exploratory study using ACT with MSM engaging in chemsex are promising. • Preliminary results suggest the efficacy of ACT towards associated psychological inflexibility, anxiety, depression, and sexual addiction. • Further research on ACT for chemsex in MSM is needed. Chemsex, a phenomenon involving the use of psychoactive substances in sexual contexts to facilitate or enhance sexual experiences, is substantially increasing among men who have sex with men (MSM), and has been described as a significant risk factor for mental and physical illness. However, no specialized treatment approach has yet been established. Acceptance and commitment therapy (ACT) could potentially be an appropriate psychotherapeutic framework, especially considering the MSM and sexual minority unique challenges and the role of psychological flexibility in this context. The present paper describes the assessment and ACT interventions, reports and discusses the results, of 10 adult MSM who self-referred to an outpatient psychiatry and addiction department in France for self-reported problematic chemsex that interfered with their quality of life. They completed symptom- and process-based measures at three different timepoints. Results were quantitatively analyzed, and the clinician's session notes and patients' experiences/accounts, recorded verbatim, served as a support for evaluating the global effects of ACT interventions. Results on outcome measures showed clinically notable and statistically significative improvements in psychological flexibility, anxiety and depression symptoms, as well as sexual addiction intensity between pre- and posttreatment, which were all persistent at 3- to 4-month follow-up. Process measure results indicated a high and consistent therapeutic alliance throughout therapy. This exploratory study, directly derived from clinical practice, suggests promising preliminary results. It can provide clinicians with a useful resource for using ACT as a potentially effective approach for problematic chemsex and comorbidities, and may guide future investigation to inform treatment development efforts, especially for MSM and sexual minority communities. [ABSTRACT FROM AUTHOR]

Background and Aims: Although resilience has been identified as an important factor for mitigating burnout among health profession students, little is known regarding the modifiable factors that should be emphasized to improve resilience in this population. The purpose of this study was to evaluate psychological flexibility as a modifiable mediator of the relationship between resilience and academic burnout among healthcare students. Methods: This cross‐sectional study was conducted with 369 Doctor of Physical Therapy (DPT) students from universities across the United States. A two‐stage structural equation modeling approach, including confirmatory factor analysis and structural path analysis, was used to investigate psychological flexibility as a mediator of the relationship between resilience and academic burnout. Results: The measurement and structural path models demonstrated a good fit to the data. Resilience had a statistically significant indirect association with less academic burnout through psychological flexibility as the mediator (β = −0.32, 95% confidence interval = [−0.43, −0.08], p < 0.001). The direct relationship between resilience and academic burnout was not statistically significant (β = −0.19, p = 0.10). Conclusion: These results indicate that the positive effects of resilience on academic burnout occur through modifiable psychological flexibility processes only. These results suggest that psychological flexibility is a modifiable mechanism through which resilience impacts academic burnout. Developing interventions focusing on psychological flexibility may help students build resilience and limit academic burnout, positively impacting the students, their future institutions, and their future patients. [ABSTRACT FROM AUTHOR]

ABSTRACT This study aims to explore the differences in psychological flexibility, psychological capital and the perception of marital quality between parents of children with and without autism and to examine whether psychological capital could serve as a moderator of the association between psychological flexibility and the perception of marital quality. One‐hundred fifty parents of children with autism and 192 parents of children without autism completed an online survey. Parents of children with autism had lower psychological flexibility and psychological capital than the comparison group. The levels of psychological flexibility and psychological capital were also found to be significantly and positively correlated with the perception of marital quality of parents in both groups. Amongst parents of children with autism, hope significantly moderated the association between psychological flexibility and the perception of marriage quality. Hope buffers the relationship between psychological flexibility and the perception of marital quality amongst parents of children with autism. Designing unique, specific and tailored therapeutic interventions for parents of children with autism is recommended. [ABSTRACT FROM AUTHOR]

Purpose: Intensive Care Unit (ICU) staff report that a large part of the workrelated distress they experience is related to communication situations with colleagues, patients, and relatives. Based on these findings, the aim of the present study was to preliminary evaluate the effects of a novel Communication Skills Training (CST) program on mental health among ICU staff. Methods: The CST program was delivered to the entire work force of an ICU at a Swedish hospital and was evaluated as an uncontrolled clinical trial with three repeated measures. 100 participants were eligible and included in the analyses. The theoretical framework for the program was learning theory and cognitive behavioral therapy. The program was delivered by two psychologists and included one full-day lecture and three subsequent two-hour supervision sessions. Changes in mental health was evaluated with self-report questionnaires measuring perceived stress, general mental health, work engagement, and psychological flexibility. Results: Analyses of three repeated measures showed significant improvements with 1.3 points lower perceived stress and 2.0 points lower general mental health after the intervention. No differences were seen in measures of work engagement or psychological flexibility. Conclusion: Findings of the study supports the utility of the CST program as an intervention to target perceived stress and general mental health within intensive care. These findings should be further validated in trials with improved design. [ABSTRACT FROM AUTHOR]

Our aim was to assess factors associated with stigmatizing behaviour and beliefs in women who had termination of pregnancy due to fetal anomalies.This was a cross-sectional study of women who had pregnancy termination due to fetal anomalies and age-matched pregnant women as controls, conducted between January - December 2023, at a tertiary fetal medicine center in a metropolitan area. The participitants completed the Turkish-validated version(1) of Stigmatizing Attitudes, Beliefs and Actions Scale (SABAS) (2) and psychological flexibility scale(3, 4) upon admission. Maternal sociodemographic and obstetric history data were collected and analyzed with the questionnaires. Abortion stigma was low in both groups (mean scores 30 vs. 31, out of the maximum score of 90, p=0.65). Psychological flexibility was higher among the control group (132 vs. 109, p<0.001). Higher education and higher economic stat us were inversely related to abortion stigma (26 7 vs. 33 9, p=0.0014 and 26 7 vs. 31 10, p=0.05, respectively). Women who had at least one child had more stigma towards pregnancy termination compared to women who do not have any children (32 9 vs. 27 8, p=0.02). Timing of termination of pregnancy (first vs. second trimester), maternal age, presence or absence of aneuploidy screening test, time from diagnosis to termination were not fac tors associated with abortion stigma and psychological flexibility. We have shown that abortion stigma is quite low among pregnant women who had to terminate their pregnancy due to fetal anomalies and women who had healthy, ongoing pregnancies. Stigmatizing beliefs and behaviours are positively associated with having at least one child, and negatively associated with higher education and higher economic status. Stigma can adversely affect mental health, making it important for healthcare providers to offer compassionate support and counseling. [ABSTRACT FROM AUTHOR]

Objectives Design Methods Results Conclusions Appearance concerns following burn injuries are common. Psychological factors are important in maintaining such concerns. However, there is a lack of longitudinal or prospective research investigating their development. This study investigated whether psychological flexibility and self‐compassion at hospital admission predicted subsequent appearance concerns.A multi‐centre prospective cohort study across six burn services.Adults (n = 175; 67% male) in hospital following burn injuries were recruited. Questionnaires measuring appearance concerns, psychological flexibility, self‐compassion, post‐traumatic stress disorder symptoms and perceived noticeability were completed during hospital admission and two‐ and six‐months later. Demographic and burn injury information was collected.Correlational analyses showed that increased psychological flexibility and self‐compassion at admission were associated with decreased appearance concerns cross‐sectionally and prospectively at two‐ and six‐month follow‐up. These associations remained significant when controlling for key covariates (i.e. gender, age, ethnicity, percentage total body surface area burnt, perceived noticeability, PTSD symptoms). Multiple linear regression analyses revealed that psychological flexibility and self‐compassion predicted appearance concerns during hospital admission. Although psychological flexibility significantly predicted appearance concerns over time, it became non‐significant when controlling for baseline appearance concerns.Psychological flexibility has a protective role against appearance concerns soon after burn injuries, although this protective role is reduced when accounting for baseline appearance concerns. Early interventions targeting psychological flexibility (i.e. acceptance and commitment therapy) may be beneficial after burns if adapted to address appearance‐related concerns. [ABSTRACT FROM AUTHOR]

Background People with cancer who have completed treatment still experience negative effects, such as an increased risk of experiencing cancer-related pain. Psychological factors tend to influence cancer patients' ability to cope with pain in various dimensions. Although personal resources are an important factor in buffering total pain, still little is known about the intervening variables and underlying mechanisms. Purpose The current study examined the relationship between psychological flexibility, self-esteem, and total pain, while considering fear of recurrence, meaning-making, and coping as potential mediating factors. Methods Adults (N = 304) who completed medical treatment (radiotherapy, chemotherapy, and combined therapy) participated in this study. They completed questionnaires measuring the aforementioned variables. Structural equation models were used to examine mediation effects. Results Psychological flexibility, and partly self-esteem, were negatively related to the dimensions of total pain. However, to a large extent, these relationships were serially and parallelly mediated by fear of recurrence, meaning-making, and emotion-oriented coping. Conclusions Consistent with the meaning-making model, cognitive (meaning-making), and affective (fear of recurrence and emotional coping) factors may be potential mechanisms underlying the association between psychological flexibility, self-esteem, and total pain in posttreatment cancer patients. In this study, they tended to interact in the area of physiological and psychosocial experiences of cancer-related pain. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: Psychotic symptoms and depression are common problems in people diagnosed with schizophrenia.Psychological flexibility is a skill that facilitates coping with difficulties.There is limited research on the role of psychological flexibility in the relationship between psychotic symptoms and depression in people diagnosed with schizophrenia. What does the article add to existing knowledge?: This article investigates the role of psychological flexibility in the link between psychotic symptom severity and depression in people diagnosed with schizophrenia.The article shows that psychological flexibility partially mediates the relationship between psychotic symptom severity and depression.The article suggests that interventions aimed at improving psychological flexibility may be beneficial in reducing depressive symptoms in people diagnosed with schizophrenia. What are the implications for practice?: Mental health nurses should consider psychotic symptom severity and psychological flexibility when assessing and intervening for depressive symptoms in people diagnosed with schizophrenia.Mental health nurses should receive training to improve psychological flexibility and pass this skill on to their patients.Mental health nurses should continue to research the effectiveness and outcomes of interventions aimed at improving psychological flexibility. Introduction: Psychological flexibility may help people diagnosed with schizophrenia (PWS) cope with their psychotic symptoms and reduce their depressive symptoms, but the mechanism of this effect is unclear. Aim: To investigate whether psychological flexibility mediates the relationship between psychotic symptom severity and depression in PWS. Method: A cross‐sectional study was conducted, in which a total of 111 PWS were assessed with DSM‐5 Clinician‐Rated Dimensions of Psychosis Symptom Severity, Calgary Depression Scale for Schizophrenia and Acceptance and Action Questionnaire. Data analysis was performed using SPSS 25 and PROCESS macro. Results: Significant correlations were found between psychotic symptoms, depression and psychological flexibility. Psychological flexibility partially mediated the relationship between psychotic symptom severity and depression. Discussion: Psychological flexibility could weaken the impact of psychotic symptom severity on depression in PWS. Higher psychotic symptoms were associated with lower psychological flexibility and higher depression. Implications for Practice: Interventions to improve psychological flexibility may prevent depressive symptoms in PWS. Psychiatric nurses can use psychological flexibility as a goal for evaluation and intervention. [ABSTRACT FROM AUTHOR]

Adverse events have a profound impact on surgeons. This impact extends to physical and mental health, psychological wellbeing, and professional performance. Surgeons are ill prepared for these consequences of adverse events and are under-supported when they inevitably occur. Here we review the data on how adverse events affect surgeons. We explore the efforts made to date to both prepare surgeons before and support them after such events and we make recommendations regarding how this should and could be done better. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to investigate the effectiveness of forgiveness therapy on psychological distress and psychological flexibility in women with marital conflicts. Methods: The research method was quasi-experimental, with a pre-test-post-test design and a control group. The statistical population included all women with marital conflicts who referred to health centers in District 3 of Tehran in 2022. The sample consisted of 30 women who scored lower in psychological flexibility and distress tolerance. They were selected through non-random voluntary sampling and were randomly assigned to experimental and control groups. Data were collected using the Distress Tolerance Scale by Simons and Gaher (2005) and the Psychological Flexibility Questionnaire by Dennis and Vander Wal (2010) in both pre-test and post-test stages. The session content was prepared according to the forgiveness therapy model by Enright and Fitzgibbons (2015). Data were analyzed using descriptive statistics and covariance analysis. Findings: The results of the covariance analysis indicated that the mean scores of psychological distress and psychological flexibility and their components in the experimental group significantly decreased compared to the control group (P = 0.05). Conclusion: Therefore, forgiveness therapy was effective in reducing psychological distress and enhancing psychological flexibility in women with marital conflicts. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic resulted in disruption of competitions and training for most athletes globally. Singapore underwent an unprecedented lockdown that forced cessation of sporting activities, following which, restrictions were lifted. This research aimed to investigate: (a) the impact of COVID-19 across Circuit Breaker (P1; full-lockdown) and Phase 2 (P2; fewer restrictions) on youth male and female athletes' mental health in Singapore through examining psychological distress, (b) the specific challenges faced by athletes, and (c) the moderating effects of psychological resilience and psychological flexibility as protective factors on mental health. A total of 117 national youth athletes (Mage = 16.83 years, SD = 1.75), across 15 sports completed an online survey across both phases including demographic information, validated scales to assess psychological distress (Kessler Psychological Distress Scale), psychological flexibility (Acceptance and Action Questionnaire-II) and psychological resilience (Brief Resilience Scale), as well as questions adapted from an International Olympic Committee survey and an open-ended question on challenges faced. Athletes reported facing significantly higher psychological distress (p <.001), had more difficulties managing sport and studies (p =.011), as well as sleep and recovery (p =.018) in P2 as compared to P1. Psychological flexibility and psychological resilience were significant moderators of poor mental health in P2 (p <.001). Qualitative responses corroborated findings that athletes faced a greater variety of challenges in P2. The findings shed light on how the Covid-19 pandemic impacted youth athletes' mental health, the challenges they faced, and the protective factors that could combat psychological distress. [ABSTRACT FROM AUTHOR]

This clinical trial aims to assess the effectiveness of internet-based Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) during the COVID-19 pandemic in reducing stress, anxiety, and depression, and psychological flexibility. 40 adolescents with subclinical features of emotional disorder randomly divided into two groups of intervention and control. The participants first completed DASS-21 and AAQ-2 questionnare online. Then, the intervention group received 12 sessions of UP-A through video calls on WhatsApp, 2 days per week each for 45 min. UP-A is an emotion-focused, cognitive-behavioral therapy consisting of 5 core modules or components that target temperamental characteristics, particularly neuroticism and resulting emotion dysregulation. Eventually the stress, anxiety, and depression levels decreased in intervention group and their psychological flexibility increased immediately and 3 months after the intervention. Clinical trial registration This study was registered by Iranian Registry of Clinical Trials (Prospective, ID: IRCT20210428051113N1, Registration date: 14/06/2021; https://en.irct.ir/trial/55900). [ABSTRACT FROM AUTHOR]

The present study investigated whether study engagement is predicted by personal resources (i.e., self-efficacy and psychological flexibility) and achievement goals. A total of 223 French first-year humanities and social sciences students were invited to complete an online questionnaire comprising scales measuring the three predictors. The results of regression analyses showed that 43.3% of the variance in study engagement was predicted by self-efficacy, psychological flexibility, and achievement goals, implying that these three factors could be used as levers to promote study engagement. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the predictive roles of psychological flexibility and frustration discomfort on marital adjustment among married women. Specifically, it sought to assess how these psychological constructs influence marital satisfaction and cohesion. Methods and Materials: A cross-sectional design was employed, sampling 350 married women from various counseling centers in Tehran in 2023. Participants completed standardized questionnaires measuring marital adjustment (Dyadic Adjustment Scale), psychological flexibility (Acceptance and Action Questionnaire - II), and frustration discomfort (Frustration Discomfort Scale). Multiple linear regression analyses were conducted using SPSS version 27 to explore the predictive value of psychological flexibility and frustration discomfort on marital adjustment, adjusting for potential confounders such as age and gender. Findings: The results revealed that both psychological flexibility (ß = 0.25, p < 0.01) and frustration discomfort (ß = 0.29, p < 0.01) significantly predicted marital adjustment, accounting for 42% of the variance in marital adjustment scores. These findings indicate that higher levels of psychological flexibility and lower levels of frustration discomfort are associated with better marital satisfaction and cohesion. Conclusion: The study underscores the importance of psychological flexibility and frustration discomfort in influencing marital adjustment. It suggests that interventions aimed at enhancing psychological flexibility and reducing frustration discomfort may contribute to improving marital satisfaction and stability. These findings highlight the need for a holistic approach in marital counseling and therapy that considers these psychological constructs. [ABSTRACT FROM AUTHOR]

Abstract Background Psychological flexibility (PF) is defined as the ability to pursue valuable life goals despite the existence of distress. The Personalized Psychological Flexibility Index (PPFI) is a new measure of psychological flexibility that can address existing deficiencies. This study aimed to translate and validate the psychometric characteristics of the Chinese version of the PPFI among medical college students. Methods The study was conducted in two phases. Phase 1 involved the translation and cross-cultural adaptation of the PPFI according to guidelines recommended by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Phase 2 was a cross-sectional survey conducted on 945 medical college students in China. The psychometric performances of the scale were assessed using construct validity, divergent validity, criterion validity, incremental validity, internal consistency, and test-rest reliability. Results The exploratory factor analysis (EFA, n1 = 440) showed that the Chinese version of the PPFI consisted of 3 factors, with a total of 15 items. The confirmatory factor analysis (CFA, n2 = 440) showed that the three-factor structure fit well (χ2/ $$df$$ df =2.469, SRMR = 0.051, RMSEA = 0.058, GFI = 0.94, CFI = 0.985). The total Chinese PPFI score had a moderate positive association with the Comprehensive Assessment of Acceptance and Commitment Therapy (CompACT, r = 0.344) and a negative association with the Acceptance and Action Questionnaire-II (AAQ-II, r = -0.334). Furthermore, the Chinese PPFI demonstrated good internal consistency (Cronbach's α = 0.826) and test–retest reliability (ICC = 0.817, p

Asthma and ADHD represent prevalent pediatric conditions, with the former being a physical disorder and the latter being a neurodevelopmental disorder. This study examined the influence of parental psychological flexibility (PF)—the ability to adapt to evolving situational demands, shift perspectives, and balance competing priorities—alongside parenting competence and asthma management self-efficacy on family functioning and parental psychological adjustment in families with children exhibiting concurrent asthma and ADHD symptoms. Baseline data were analyzed from 130 parents (mean age = 40.3 years, SD = 5.5; 88.9% mothers) of children diagnosed with both asthma and ADHD (mean age = 8.0 years, SD = 2.2; 74.6% boys), who were participating in a randomized controlled trial evaluating an Acceptance and Commitment Therapy (ACT)-based parenting intervention. An adjusted structural equation model revealed that greater parental psychological inflexibility was significantly associated with poorer family functioning (β = −0.61, 95% CI [−0.74, −0.33], p < 0.001) and increased psychological maladjustment (β = 0.48, 95% CI [0.32, 0.63], p < 0.001), accounting for intercorrelations with parenting competence and parental asthma management self-efficacy. Additionally, parental psychological flexibility was found to mediate the relationship between parenting competence and both family functioning and psychological adjustment. These findings underscore the importance of targeting parental psychological inflexibility and enhancing parenting competence in interventions to improve family dynamics and parental mental health and thereby suggest a shift from the traditional focus on self-efficacy in symptom management for pediatric asthma and ADHD.

Psychological flexibility (PF) has been approached as a mediator between health conditions and outcomes by promoting positive responses and healthier behavior repertoires.

Abstract This clinical trial aims to assess the effectiveness of internet-based Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) during the COVID-19 pandemic in reducing stress, anxiety, and depression, and psychological flexibility. 40 adolescents with subclinical features of emotional disorder randomly divided into two groups of intervention and control. The participants first completed DASS-21 and AAQ-2 questionnare online. Then, the intervention group received 12 sessions of UP-A through video calls on WhatsApp, 2 days per week each for 45 min. UP-A is an emotion-focused, cognitive-behavioral therapy consisting of 5 core modules or components that target temperamental characteristics, particularly neuroticism and resulting emotion dysregulation. Eventually the stress, anxiety, and depression levels decreased in intervention group and their psychological flexibility increased immediately and 3 months after the intervention. Clinical trial registration This study was registered by Iranian Registry of Clinical Trials (Prospective, ID: IRCT20210428051113N1, Registration date: 14/06/2021; https://en.irct.ir/trial/55900 ).

Abstract Aim Assess the levels of psychological flexibility, burnout, and turnover intention among critical care nurses and assess the impact of psychological flexibility on burnout, and turnover intention among critical care nurses. Background Burnout and turnover intentions among critical care nurses are rapidly increasing because of the challenges of COVID-19. There is a need for evidence-based interventions like psychological flexibility to be addressed in research to overcome those challenges. Methods A descriptive correlational research. A convenient sample of 200 critical care nurses working in COVID-19 hospitals from two governorates in Egypt. The sociodemographic and clinical data sheet, the work-related acceptance and action questionnaire, the Copenhagen burnout inventory, and the adopted version of the staff nurses’ intention to leave the nursing profession questionnaire were used. Results The majority of critical care nurses reported a moderate level of psychological flexibility (75.5%, Mean = 31.23), a moderate level of burnout (65.5%, Mean = 59.61), and low to moderate levels of intention to leave (73%, Mean = 5.95). Psychological flexibility has a statistically significant negative correlation with burnout (PC = -0.304, Sig = 0.000) and the intention to leave (PC = -0.258, Sig = 0.000). In addition, psychological flexibility has a predictable effect on decreasing burnout (R2 = 0.232) and intention to leave (R2 = 0.127) among critical care nurses. Conclusion critical care nurses in COVID-19 hospitals reported varied levels of burnout and an intention to leave that must be considered. The effect of psychological flexibility on burnout and intention to turnover highlighted the importance of improving it among critical care nurses by applying acceptance and commitment therapy as a management intervention.

Stigma reduction is a key objective in mental health policies. In the present study, a virtual reality programme, called Virtu-ACT, based on Acceptance and Commitment Therapy was created to promote psychological flexibility and reduce stigma in university students. The research was pretest-posttest randomized controlled experimental trial. A total of 208 students from the Faculty of Education of the University of Almeria participated. The experimental group (N = 143) went through Virtu-ACT and the control group (N = 67) used a virtual reality programme unrelated to mental health. A pre-, post- and one-week follow-up was conducted and two stigma assessment questionnaires, the Attributional Questionnaire Abbreviated Version (AQ-14) and the Acceptance and Action Questionnaire-Stigma (AAQ-S), were used. Results showed that the experimental group significantly increased psychological flexibility and reduced stigma. These results were maintained at follow-up. The significance of these results and the usefulness of using new technologies in this field are discussed. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic held considerable health-related outcomes worldwide, including mental health challenges, with elevated risk of psychiatric sequelae. Methods: This study aimed to test the longitudinal (1 year) predictive role of psychosocial factors on post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms in SARS-CoV-2 survivors (N = 209 at T1; N = 61; attrition rate 70.83%), through Pearson's correlation analyses and longitudinal multiple regression analyses. Participants (age M = 35.4, SD = 10.1) completed online selfreport questionnaires of psychosocial variables, PTSD, anxiety, and depression. Results: Depression and anxiety symptoms were increased, and 42% of survivors presented clinically meaningful PTSD symptoms. PTSD symptoms were longitudinally predicted by having children (β = 0.32, p < 0.01), number of recent major life events (β = 0.34, p < 0.01), and psychological flexibility (β = -0.36, p < 0.01). Number of major life events (β = 0.29, p < 0.05) and psychological flexibility (β = -0.29, p < 0.05) predicted anxiety. Number of recent major life events (β = 0.32, p < 0.01) was the sole predictor of depressive symptoms. Discussion: Psychosocial variables contribute to the long-term harmful effects of the COVID-19 pandemic on psychopathological symptoms. These results suggest that, during the pandemic, mental health was impacted by both sociocontextual factors and individual self-regulatory skills, namely the ability to respond flexibily to contextual cues and guide behavior according to the direct experience. Specifically, results point out the importance of societal incentives to reduce parental burden and socioeconomic losses, as well as to promote adaptive psychological skills such as psychological flexibility. [ABSTRACT FROM AUTHOR]

This paper examines the innovative integration of acceptance and commitment therapy (ACT) principles with biofeedback methodologies, presenting a novel approach to psychophysiological therapy. This paper uses Kevin Polk's structured ACT matrix approach to elucidate how biofeedback can augment ACT processes, including acceptance, cognitive defusion, and present-moment awareness. The paper explicates practical techniques such as the "Hook Words Exercise" and "Verbal Aikido," demonstrating their application within a biofeedback-enhanced therapeutic context. This integrative approach represents a significant advancement in psychophysiological interventions, offering a comprehensive framework for deepening interoceptive awareness and fostering psychological flexibility and value-aligned living while bridging the gap between cognitive processes and physiological responses. By exemplifying assimilative integration in psychotherapy, this approach offers a promising avenue for advancing both clinical practice and research in psychophysiological interventions, potentially improving therapeutic outcomes and client engagement. [ABSTRACT FROM AUTHOR]

Introduction: Public speaking skills are crucial skills for medical students, enabling effective communication in their academic and future professional roles. However, public speaking anxiety (PSA) can hinder their full potential and warrant early intervention. This study aims to determine the prevalence of PSA and associated factors among medical undergraduates at a Malaysian public university. Materials and methods: A cross-sectional study was conducted using a validated and reliable online self-administered questionnaire. The Personal Report of Public Speaking Anxiety (PRPSA) questionnaire was used to assess PSA level and other factors such as sociodemographic, English proficiency level, public speaking training and experience, and the CompACT questionnaire for psychological flexibility. Descriptive, bivariate, and multivariate analyses were performed. Results: The analysis included a total of 362 respondents. The prevalence of moderate and high PSA was 49.3%. There was a significant association between race, psychological flexibility, public speaking experience, public speaking training, and PSA (p<0.05). Multiple logistic regression analysis showed that having high to moderate PSA was significantly linked to being 19-21 years old (AOR: 1.70, 95% CI: 1.081-2.678) and never having had public speaking training (AOR: 1.865, 95% CI: 1.067-3.261). On the other hand, being more psychologically flexible was a protective factor (AOR: 0.944, 95% CI: 0.925-0.964). Conclusion: The high prevalence of PSA among medical students highlights the need for early recognition, screening, and intervention within the education system. Incorporating public speaking training and interventions to enhance psychological flexibility within the curriculum can be beneficial to prevent PSA for better-quality graduates. [ABSTRACT FROM AUTHOR]

Psychological Flexibility is an essential concept in Contextual Behavioural Sciences. The development of instruments is vital for its study, and it is an opportunity to reflect on this concept. Among the measures of this construct, Psy-Flex shows promise due to comprehensiveness in assessing the six facets of psychological flexibility and its pragmatic value. In the present study, we sought to translate Psy-Flex to Portuguese and adapt it transculturally for use in Portugal and Brazil. The translation was done independently by Brazilian and Portuguese researchers, and a consensus procedure was done to identify a synthesis. A total of 873 adults from Portugal and Brazil were involved in this study. The participants completed several questionnaires with ACT-related measures (e.g., cognitive fusion, mindful attention) and instruments measuring conceptually related variables (e.g., positive mental health). The results show good psychometric properties of PsyFlex. The one-factor structure of the original instrument was confirmed in both the Portuguese and Brazilian samples. Confirmatory factor analysis revealed a good fit of the model to the data (CFI = 0.985, RMSEA = 0.055) of both countries. Furthermore, the Psy-Flex showed convergent validity with related measures in a conceptually expected way. As a transcultural instrument, we argue that both the similarities and differences across samples suggest the broad human nature of psychological flexibility while retaining its context sensitivity. [ABSTRACT FROM AUTHOR]

The COVID-19 COVID-19 Pandemic, first seen in China in 2019, has directly affected the daily life practices of individuals, and an understanding that emphasizes isolation rather than socialization has become dominant in the world. With the COVID-19 Pandemic, loneliness among young people has become more visible. This study examined social and emotional loneliness among college students in relation to wellness and psychological flexibility. A total of 498 university students participated in the study (F=395; M=103). One-way ANOVA, MANOVA, and hierarchical regression analysis were used. According to the results of the study, the mean social loneliness scores of men were significantly higher than the mean social loneliness scores of women, and the mean emotional loneliness scores of those whose romantic relationships ended during the COVID-19 Pandemic period were significantly higher than those whose romantic relationships continued. While meaningfulness of life and goal orientation, physical wellness, and social wellness sub-dimensions of wellness, values and behaviors consistent with values, and acceptance sub-dimension of psychological flexibility significantly predicted social loneliness, meaningfulness of life and goal orientation, social wellness sub-dimensions of wellness, and acceptance sub-dimension of psychological flexibility were found to be significant predictors of emotional loneliness. [ABSTRACT FROM AUTHOR]

Meaningful steps have been taken toward using holistic approaches in outpatient rehabilitation for traumatic brain injury (TBI) (i.e., treating the whole individual); however, research and practice continue to disproportionately focus on adapting to physical and cognitive changes. Research suggests treatment focusing on individual values may be important for psychological adjustment after TBI. The current study sought to explore individual values across multiple life domains in those with TBI as well as what values outpatient rehabilitation was helpful for, and to examine discrepancies between these factors (i.e., value-consistent rehabilitation) in relation to important long-term treatment outcomes. 215 adults with a history of TBI who had participated in outpatient rehabilitation completed online surveys assessing how consistent outpatient rehabilitation was with individual values, psychological flexibility, and quality of life. The life domains with the greatest discrepancies between individual importance and rehabilitation helpfulness were spirituality, intimate relations, and family relations. Greater value-consistent rehabilitation was associated with higher levels of psychological flexibility and quality of life beyond demographics and injury characteristics. Our findings provide further support in favour of holistic, client-centred approaches that are facilitated by neurological rehabilitation programs. [ABSTRACT FROM AUTHOR]

Spiritual well-being enhances life quality, acts as a stress reliever, and mitigates unfavorable feelings. It helps individuals find meaning and purpose, increasing inner peace and happiness while improving stress management and overall well-being. This study examined whether positive childhood experiences are linked to spiritual well-being and if psychological flexibility and meaning-based coping serve as mediators. The sample included 1061 participants (Mage = 39.38; SD = 8.82) from various Turkish cities. Structural equation modeling assessed relationships between spiritual well-being, positive childhood experiences, psychological flexibility, and meaning-based coping. Results showed that positive childhood experiences directly enhance spiritual well-being, mediated by psychological flexibility and meaning-based coping. This underscores the significance of fostering positive childhood experiences to promote spiritual well-being and coping mechanisms. [ABSTRACT FROM AUTHOR]

In this article, we offer an exhaustive analysis of academic work on psychological flexibility using bibliometric techniques. We identify emerging trends in a dataset of 3535 scholarly articles from the Web of Science database. We highlight key publications, map out the field's intellectual framework, and anticipate future research avenues through co-citation and co-word analytics. The co-citation assessment revealed five distinct clusters, while the co-word analysis showed three. Although research regarding psychological flexibility has gained recent popularity, there remains a need for more scholarly initiatives to achieve a nuanced understanding of this subject. [ABSTRACT FROM AUTHOR]

The presented study evaluates the evidence base underpinning the use of the Mindfulness–Acceptance–Commitment approach (MAC) in applied sport psychology. To assess the effectiveness of the MAC protocol on improving mindfulness and psychological flexibility, and on enhancing sport performance and well-being among athletes, we used Robust Bayesian Meta-Analysis with Publication Selection Model-Averaging (RoBMAPSMA). In total, there were eleven controlled trials included in the meta-analysis. Results of the RoBMAPSMA show: a moderate model-averaged effect size estimate for developing mindfulness with strong evidence (g = 0.64, 95% CI 0.00–0.91, BFes = 25.35); a small model-averaged effect size estimate for experiential acceptance with anecdotal evidence (g = 0.36, 95% CI 0.00–0.92, BFes = 2.32); and a small model-averaged effect size estimate for improving sport performance with moderate evidence (g = 0.37, 95% CI 0.00–0.79, BFes = 3.27). Only one study assessed the effectiveness of the MAC protocol on well-being and averaged effect sizes ranged from 0.01 to 0.82. Based on the results of the meta-analysis, the Mindfulness–Acceptance–Commitment protocol can be effective in improving mindfulness. In addition, results suggest that the MAC protocol might be effective in improving sport performance. Currently available trials, however, do not provide sufficient evidence supporting the MAC protocol's effectiveness in developing psychological flexibility, experiential acceptance, and promoting well-being among athletes. [ABSTRACT FROM AUTHOR]

Objectives: Increasing psychological flexibility is considered an important mechanism of change in psychotherapy across diagnoses. In particular, Acceptance and Commitment Therapy (ACT) primarily aims at increasing psychological flexibility in order to live a more fulfilling and meaningful life. The purpose of this study is to examine 1) how psychological flexibility changes during an ACT-based treatment in a transdiagnostic day hospital and 2) how this change is related to changes in symptomatology, quality of life, and general level of functioning. Methods: 90 patients of a psychiatric day hospital participated in the study. Psychological flexibility, symptomatology, and quality of life were assessed at three measurement time points (admission, discharge, and 3-month follow-up). The level of functioning was assessed at admission and discharge. Differences in psychological flexibility were tested via two-sided paired samples t-tests. Correlations of residualized change scores were calculated to detect associations between changes in psychological flexibility and other outcomes. Results: Psychological flexibility increased significantly from pre-treatment to posttreatment (d = .43, p <.001) and from pre-treatment to follow-up (d = .54, p <.001). This change was significantly correlated to a decrease in symptomatology (r = .60 --.83, p <.001) and an increase in most dimensions of quality of life (r = -.43 -- -.75, p <.001) and general level of functioning (r =-.34, p = .003). Discussion: This study adds further evidence for psychological flexibility as a transdiagnostic process variable of successful psychotherapy. Limitations are discussed. [ABSTRACT FROM AUTHOR]

Many studies have indicated the negative associations between psychological flexibility (PF) and mental health problems (i.e., depressive, anxiety, and stress symptoms) during the COVID-19 pandemic, however, the associations revealed were inconsistent. This study aimed to summarize the primary literature quantitatively and provide better estimates of these associations. A systematic literature review was performed in six databases (finally yielding twenty-four studies) and three-level meta-analytic models were employed to synthesize effect sizes and to examine potential moderators of the associations between PF and depressive, anxiety, and stress symptoms. Our metaanalyses results revealed a moderate and significant association between PF and depressive (r = − 0.458, 95% CI [− 0.594; − 0.323], p < 0.001), anxiety (r = − 0.452, 95% CI [− 0.581; − 0.323], p < 0.001), and stress symptoms (r = − 0.443, 95% CI [− 0.666; − 0.221], p < 0.01). We found that the association between PF and stress symptoms is larger for males than for females, and that the associations between PF and symptoms of depression, anxiety, and stress differ by the type of measures that are used to assess PF, anxiety and stress symptoms. As a malleable protective factor, PF should be targeted in mitigating individuals' mental health problems during and after the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]