UKRAINIAN ADAPTATION OF THE ACCEPTANCE AND ACTION QUESTIONNAIRE (AAQ-II) IN SUBCLINICAL AND NON-CLINICAL SAMPLES
Abstract
Purpose. The aim of the study is to evaluate the main psychometric properties of the Ukrainian version of the Acceptance and Action Questionnaire-II (AAQ-II). Normative scores, internal consistency, factor structure, test-retest reliability, convergent and discriminant validity, and sensitivity to distinguish between non-clinical and subclinical samples were explored. Methods. Data from six non-clinical (N = 817) and three subclinical samples (N = 142) were collected. A sample of 43 students was used to assess test-retest reliability, over 3 weeks period. Acceptance Scale, CompACT, OQ-45.2, GAD-7, PHQ-9 and TIPI were used to determine convergent and discriminant validity of AAQ‑II. Results. Normative scores of AAQ-II were 19 ± 9 for men and 24 ± 11 for women. There was no significant correlation between psychological inflexibility and age. AAQ-II showed a good internal consistency with Cronbach’s α coefficient in 9 samples between 0.89–0.95. Results of exploratory factor analysis and confirmatory factor analysis indicated that AAQ-II is unidimensional questionnaire with 7 items (RMSEA=0.093, SRMR = 0.028, GFI= 0.966, NFI=0.974, CFI=0.979, N=817). AAQ‑II demonstrated an acceptable level of testretest reliability (r = 0.85) in three weeks period. AAQ-II had good convergent validity with another measure of psychological flexibility (CompACT) (r= - 0.65), as well as with the measures of distress (OQ-45.2) (r= 0.58–0.80), anxiety (GAD-7) (r= 0.52–0.60) and depression (PHQ-9) (r= 0.52–0.60). AAQ‑ІІ highly correlated with distress and didn’t correlate with the ability to accept the negative experiences per se. AAQ‑ІІ had good discriminant validity with measure of personal traits (TIPI), as theoretically predicted. The questionnaire was sensitive to distinguish between non-clinical and subclinical samples, and between people on the different stages of the rehabilitation and progress of the disease. Conclusions. Ukrainian version of Acceptance and Action questionnaire (AAQ‑II) demonstrated acceptable and promising psychometric properties. The results in terms of reliability and validity of AAQ‑II were consistent with previous studies. The questionnaire is recommended to use in research and psychotherapy practice.
References
2. Amble I., Gude T., Stubdal S., Oktedalen T., Skjorten A.M., Andersen B.J., ... & Wampold B.E. Psychometric properties of the Outcome Questionnaire-45.2: The Norwegian version in an international context. Psychotherapy Research. 2014. Vol. 24(4), 504–513.
3. Arlt Mutch V.K., Evans S., & Wyka K. The role of acceptance in mood improvement during Mindfulness‐Based Stress Reduction. Journal of Clinical Psychology. 2021. Vol. 77(1), 7–19.
4. Bartram D., & Hambleton R.K. The ITC guidelines: International standards and guidelines relating to tests and testing. / In F.T.L. Leong, D. Bartram, F.M. Cheung, K.F. Geisinger, & D. Iliescu (Eds.). The ITC international handbook of testing and assessment. 2016. Oxford University Press. P. 35–46.
5. Bond F.W., & Hayes S.C. ACT at work. Handbook of brief cognitive behaviour therapy. 2002. 117–140.
6. Bond F.W., Hayes S.C., Baer R.A., Carpenter K.M., Guenole N., Orcutt H.K., ... & Zettle R.D. Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior therapy. 2011. Vol. 42(4), 676–688.
7. Cattell R.B., & Vogelmann S. A comprehensive trial of the scree and KG criteria for determining the number of factors. Multivariate Behavioral Research. 1977, 12(3), 289–325.
8. Clark D.A. Cognitive restructuring. The Wiley handbook of cognitive behavioral therapy. 2013. 1–22.
9. Correa-Fernández V., McNeel M.M., Sandoval J.R., Tavakoli N., Kahambwe J.K., & Kim H. Acceptance and Action Questionnaire II: Measurement invariance and associations with distress tolerance among an ethnically diverse university sample. Journal of Contextual Behavioral Science. 2020. Vol. 17, 1–9.
10. Edwards K.A., & Vowles K.E. Acceptance and Action Questionnaire–II: Confirmatory factor analysis and measurement invariance between Non-Hispanic White and Hispanic/Latinx undergraduates. Journal of Contextual Behavioral Science. 2020. Vol. 17, 32–38.
11. Francis A.W., Dawson D.L., & Golijani-Moghaddam N. The development and validation of the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT). Journal of Contextual Behavioral Science. 2016. Vol. 5(3), 134–145.
12. Gudmundsson E. Guidelines for translating and adapting psychological instruments. Nordic Psychology. 2009. 61:2. 29–45.
13. Guerrini Usubini A., Varallo G., Granese V., Cattivelli R., Consoli S., Bastoni I., ... & Molinari E. The Impact of Psychological Flexibility on Psychological Well-Being in Adults With Obesity. Frontiers in Psychology. 2021. Vol. 12, 777.
14. Hayes S.C. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior therapy. 2004. Vol. 35(4), 639–665.
15. Hayes S.C., Luoma J.B., Bond F.W., Masuda A., & Lillis J. Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy. 2006. Vol. 44(1), 1–25.
16. Hayes S.C., Strosahl K.D., & Wilson K.G. Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press. 1999.
17. Hayes S. C., Wilson K.G., Gifford E.V., Follette V.M., & Strosahl K. Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of consulting and clinical psychology.1996. Vol. 64(6), 1152. 18. Hyes S., Luoma B., & Bond F. Acceptance and Commitment Therapy: Model, Process and out comes. Behavior research and therapy. 2006. Vol. 44, 1–25.
19. Karekla M., & Michaelides M.P. Validation and invariance testing of the Greek adaptation of the Acceptance and Action Questionnaire-II across clinical vs. nonclinical samples and sexes. Journal of Contextual Behavioral Science. 2017. Vol. 6(1), 119–124.
20. Kashdan T.B., Disabato D.J., Goodman F.R., Doorley J.D., & McKnight, P.E. Understanding psychological flexibility: A multimethod exploration of pursuing valued goals despite the presence of distress. Psychological Assessment. 2020. Vol. 32(9), 829.
21. Kleszcz B., Dudek J.E., Białaszek W., Ostaszewski P., & Bond F.W. Właściwości psychometryczne polskiej wersji kwestionariusza akceptacji i działaniaii (AAQ-II). Studia Psychologiczne. 2018. 56(1), 1–20.
22. Klimanska M., & Haletska I. Українська адаптація короткого п’ятифакторного опитувальника особистості TIPI (TIPI-UKR). Psychological Journal. 2019. 5(9), 57–76.
23. Kuru T., Karadere M.E., Burhan H.S., & Safak Y. Reliability and Validity Study of the Turkish Version of the Acceptance and Action Questionnaire for University Students. Psychiatry and Behavioral Sciences. 2021. 11(1), 18–24.
24. Lappalainen P., Keinonen K., Pakkala I., Lappalainen R., & Nikander R. The role of thought suppression and psychological inflexibility in older family caregivers’ psychological symptoms and quality of life. Journal of Contextual Behavioral Science. 2021. 20, 129–136.
25. Novakov I. Emotional state, fatigue, functional status and quality of life in breast cancer: exploring the moderating role of psychological inflexibility. Psychology, Health & Medicine. 2020. 1–10.
26. Ong C.W., Lee E.B., Levin M.E., & Twohig M.P. A review of AAQ variants and other context-specific measures of psychological flexibility. Journal of Contextual Behavioral Science. 2019. 12, 329–346.
27. Østergaard T., Lundgren T., Zettle R.D., Landrø N.I., & Haaland V.Ø. Norwegian Acceptance and Action Questionnaire (NAAQ): A psychometric evaluation. Journal of Contextual Behavioral Science. 2020. 15, 103–109.
28. Paladines-Costa B., López-Guerra V., Ruisoto P., Vaca-Gallegos S., & Cacho R. Psychometric Properties and Factor Structure of the Spanish Version of the Acceptance and Action Questionnaire-II (AAQ-II) in Ecuador. International Journal of Environmental Research and Public Health. 2021. 18(6), 29–44.
29. Rochefort C., Baldwin A.S., & Chmielewski M. Experiential avoidance: An examination of the construct validity of the AAQ-II and MEAQ. Behavior Therapy. 2018. 49(3), 435–449.
30. Sánchez M.G.M., & Blázquez F.P. Psychometric study of the AAQ-II scale of experiential avoidance in population of Mexico. International journal of psychology and psychological therapy. 2021. 21(1), 81–91.
31. Spitzer R.L., Kroenke K., Williams J.B., & Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine. 2006. 166(10), 1092–1097.
32. Tabachnick B.G., Fidell L.S., & Ullman J.B. Using multivariate statistics. 2007. Vol. 5, pp. 481–498. Boston, MA : Pearson.
33. Tyndall I., Waldeck D., Pancani L., Whelan R., Roche B., & Dawson D.L. The Acceptance and Action Questionnaire-II (AAQ-II) as a measure of experiential avoidance: Concerns over discriminant validity. Journal of Contextual Behavioral Science. 2019. 12, 278–284.
34. Wolgast M. What does the Acceptance and Action Questionnaire (AAQ-II) really measure? Behavior therapy. 2014. 45(6), 831–839.
35. Wooldridge J.S., Herbert M.S., Dochat C., & Afari N. Understanding relationships between posttraumatic stress disorder symptoms, binge-eating symptoms, and obesity-related quality of life: the role of experiential avoidance. Eating Disorders. 2021. 1–16.
36. Yavuz F., Ulusoy S., Iskin M., Esen F.B., Burhan H.S., Karadere M.E., & Yavuz N. Turkish version of Acceptance and Action Questionnaire-II (AAQ-II): A reliability and validity analysis in clinical and non-clinical samples. Klinik Psikofarmakoloji Bülteni – Bulletin of Clinical Psychopharmacology. Vol. 2016, 26(4), 397–408.
