Educational Psychology Commons^™

Discussing Patient Emotions In Audiology: Provider Experiences With The Implementation Process Of Hearing Loss Psychological Inflexibility Screenings, Sydnee Grigsby, Karen Muñoz, Guadalupe G. San Miguel, Michael P. Twohig

Psychology Faculty Publications

Purpose: This study aimed to investigate barriers and facilitators experienced by clinical educators and graduate students when talking with patients about difficult emotions and thoughts related to their hearing.

Method: A longitudinal observational design was used, and an Implementation Research Logic Model guided the process. Five clinical educators and five graduate students participated in the study. Participants completed pre- and post-measures and attended individual debriefing sessions during the eight-month study period.

Results: Four themes emerged from the debriefing sessions: (1) learning process, (2) confidence (3) barriers, and (4) supervision. Participants described that the Acceptance and Action Questionnaire-Managing Child Hearing Loss …

Experiential Avoidance In Depression, Anxiety, Obsessive-Compulsive Related, And Posttraumatic Stress Disorders: A Comprehensive Systematic Review And Meta-Analysis, Mehdi Akbari, Mohammad Seydavi, Zahra S. Hosseini, Jennifer Krafft, Michael E. Levin

Psychology Faculty Publications

Although numerous studies on experiential avoidance and its relationship to psychopathology have been conducted, systematic summaries of this research are lacking. The current systematic review and meta-analysis evaluated the transdiagnostic role of experiential avoidance across depression, anxiety and related disorders (obsessive-compulsive and related disorders [OCRDs] and post-traumatic stress disorder [PTSD]) as well as potential moderators of these relations. A total of 441 eligible studies including 135,347 participants (66.16% female, mean age = 31.53) and 899 effect-sizes were summarized. Results indicated a moderate-to-large association of experiential avoidance with anxiety (r = .506) and depressive symptoms (r = .562), major …

A Randomized Trial Of Acceptance And Commitment Therapy And Traditional Cognitive-Behavioral Therapy Self-Help Books For Social Anxiety, Jennifer Krafft, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

Background: Self-help resources such as books may help meet critical mental health needs in college students, but there is insufficient evidence on whether and how such books work. This randomized trial compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (tCBT) self-help books for social anxiety, a common concern with notable barriers to treatment seeking.

Methods: A sample of college students (n = 102) with social anxiety was randomly assigned to use one of the two self-help books over eight weeks.

Results: Improvements were observed in both conditions across all outcomes (social anxiety, general well-being, and social …

A Psychometric Comparison Of Psychological Inflexibility Measures: Discriminant Validity And Item Performance, Clarissa W. Ong, Benjamin G. Pierce, Julie M. Petersen, Jennifer L. Barney, Jeremiah E. Fruge, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Psychological inflexibility is a rigid behavioral pattern that interferes with engagement in personally meaningful activities; it is the hypothesized root of suffering in acceptance and commitment therapy (ACT). Thus, the quality of its measurement affects the research, theory, and practice of ACT. The current study aimed to evaluate the discriminant validity and item performance of four measures of psychological inflexibility: the Acceptance and Action Questionnaire—II (AAQ-II), a revised version of the AAC-II (AAQ-3), the Brief Experiential Avoidance Questionnaire (BEAQ), and the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT). We analyzed data from community (n = 253), student …

The Role Of Psychological Inflexibility And Self-Compassion In Acceptance And Commitment Therapy For Clinical Perfectionism, Clarissa W. Ong, Jennifer L. Barney, Tyson S. Barrett, Eric B. Lee, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

The current study examined psychological inflexibility and self-compassion as theoretically relevant mediators and moderators of outcomes following acceptance and commitment therapy (ACT) for clinical perfectionism. Fifty-three participants with clinical perfectionism were randomized to either a 10-session ACT condition or a 14-week waitlist control condition (only 39 completed the post treatment assessment). Outcomes tested include concern over mistakes, doubting of actions, personal standards, quality of life, symptom distress and functional impairment, and valued action. Multilevel modeling analyses showed reduced psychological inflexibility mediated the relationship between condition and higher quality of life and increased self-compassion mediated the relationship between condition and decreased …

Measuring Psychological Inflexibility In Adult And Child Hearing Loss., Clarissa W. Ong, John J. Whicker, Karen F. Muñoz, Michael P. Twohig

Psychology Faculty Publications

Objective: Hearing loss is a chronic condition that impacts functioning among individuals with hearing loss and caregivers of children with hearing loss. Even though treatments for hearing loss can alleviate functional impairment, psychological factors like psychological inflexibility may interfere with treatment engagement and adherence, undermining the benefits of treatment. Measuring psychological inflexibility may inform care providers’ case conceptualization, improving the quality and precision of audiological interventions. Thus, the current study aimed to develop and validate measures of psychological inflexibility in hearing loss for adults and caregivers of children with hearing loss.

Design: Participants were invited to complete an online survey. …

A Randomized Controlled Trial Of Acceptance And Commitment Therapy For Clinical Perfectionism, Clarissa W. Ong, Eric B. Lee, Jennifer Krafft, Carina L. Terry, Tyson S. Barrett, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Clinical perfectionism is characterized by imposing excessively high standards on oneself and experiencing severe distress when standards are not met. It has been found to contribute to the development and maintenance of various clinical presentations including anxiety, obsessive-compulsive, and eating disorders. The present study tested the efficacy of ten weekly individual sessions of acceptance and commitment therapy (ACT) relative to a waitlist control on clinical perfectionism and global outcomes among 53 individuals with clinical perfectionism. ACT is a process-based therapy that targets maladaptive underlying processes (e.g., rigid adherence to unrealistic high standards) rather than symptom topography (e.g., anxiety, depression). Participants …

Comparing In-The-Moment Skill Coaching Effects From Tailored Versus Non-Tailored Acceptance And Commitment Therapy Mobile Apps In A Non-Clinical Sample, Michael E. Levin, Cynthia Navarro, Rick A. Cruz, Jack Haegar

Psychology Faculty Publications

Mobile apps are promising for teaching how to practice psychological skills in high-risk and in vivo momentary situations, but there has been minimal research on the immediate effects of app-based skill coaching on mental health in-the-moment. This study analyzed the mobile app data in a non-clinical sample of 39 adults participating in a larger randomized controlled trial, with participants randomized to an acceptance and commitment therapy (ACT) mobile app that tailors skill coaching based on in-the-moment variables (n = 17) or an app that provides randomly selected skill coaching (n = 22). Data was collected before and after each ACT …

Assessing Psychological Inflexibility In Hoarding: The Acceptance And Action Questionnaire For Hoarding (Aaqh), Jennifer Krafft, Clarissa W. Ong, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

Psychological inflexibility is a psychopathological process referring to the tendency for behavior to be overly controlled by internal experiences to an extent that interferes with quality of life. Some studies indicate that psychological inflexibility is linked to hoarding, but findings have been mixed. This inconsistency may be due to reliance on general measures of psychological inflexibility in prior research as there was previously no validated measure to assess psychological inflexibility as it relates to hoarding. The present study developed and validated a measure of hoarding-related psychological inflexibility, the Acceptance and Action Questionnaire for Hoarding (AAQH) in a college student sample …

An Examination Of The Transdiagnostic Role Of Delay Discounting In Psychological Inflexibility And Mental Health Problems, Michael E. Levin, Jack Haegar, Clarissa W. Ong, Michael P. Twohig

Psychology Faculty Publications

Delay discounting is a basic behavioral process that has been found to predict addictive behaviors, and more recently, other mental health problems. Acceptance and Commitment Therapy (ACT), is a transdiagnostic treatment that appears to alter delay discounting, possibly through reducing psychological inflexibility. The current study sought to further bridge research on delay discounting and ACT by examining the relation of delay discounting to a broad range of selfreported mental health problems and measures of psychological inflexibility. A cross sectional online survey was conducted with 389 college students. Small negative correlations ranging between .09 and .15 were statistically significant between delay …

An Examination Of The Role Of Psychological Inflexibility In Hoarding Using Multiple Mediator Models, Clarissa W. Ong, Jennifer Krafft, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Hoarding is associated with functional impairment and impacts quality of life. One process that has been theorized to explain how hoarding develops and leads to impairment is psychological inflexibility, in which behavior is rigidly controlled by a perceived need to regulate internal experiences, at the expense of more effective, valued actions. The present study aimed to test the mediational role of psychological inflexibility in the development of hoarding and its impact on life satisfaction with a sample of 489 college students completing an online survey. Results indicated that multiple measures of psychological inflexibility (overall inflexibility, inattention, and values obstruction) mediated …

Tailoring Acceptance And Commitment Therapy Skill Coaching In-The-Moment Through Smartphones: Results From A Randomized Controlled Trial, Michael E. Levin, Jack Haegar, Rick A. Cruz

Psychology Faculty Publications

There is growing evidence for the efficacy of acceptance and commitment therapy (ACT) interventions delivered through smartphones, but research has not yet focused on how to optimize such interventions. One benefit of mobile interventions is the ability to adapt content based on in-the-moment variables. The current randomized controlled trial evaluated whether an ACT app that tailored skill coaching based on in-the-moment ecological momentary assessments (EMAs) would be more efficacious than the same app where skill coaching was random or an EMA-only condition. A sample of 69 adults interested in using a self-help app were randomized to one of three app …

Examining The Role Of Psychological Inflexibility, Perspective Taking And Empathic Concern In Generalized Prejudice, Michael E. Levin, Jason B. Luoma, Roger Vilardaga, Jason Lillis, Richard Nobles, Steven C. Hayes

Psychology Faculty Publications

Research to-date on generalized prejudice has focused primarily on personality factors. Further work is needed identifying manipulable variables that directly inform anti-prejudice interventions. The current study examined three such variables: empathic concern, perspective taking, and psychological inflexibility/flexibility with prejudiced thoughts, as a test of the flexible connectedness model. A sample of 604 undergraduate students completed online surveys. A model indicated prejudice measures loaded onto a latent variable of generalized prejudice. In a second model, psychological inflexibility, flexibility, empathic concern and perspective taking were all significant, independent predictors of generalized prejudice. Psychological inflexibility also predicted prejudice above and beyond personality and …

Examining The Role Of Implicit Emotional Judgements In Social Anxiety And Experiential Avoidance, Michael E. Levin, Jack Haegar, Gregory S. Smith

Psychology Faculty Publications

This study sought to examine the relationship of implicit emotional judgments with experiential avoidance (EA) and social anxiety. A sample of 61 college students completed the Emotional Judgment – Implicit Relational Assessment Procedure (EJ-IRAP) as well as a public speaking challenge. Implicit judgments were related to greater self-reported EA, anxiety sensitivity, emotional judgments and social anxiety as well as lower performance ratings and willingness in the public speaking challenge. Effects differed by trial type with “Anxiety is bad” biases related to greater EA/anxiety, while “calm is bad” biases related to lower EA/anxiety (“Good” biases were generally unrelated to outcomes). Implicit …

Examining Psychological Inflexibility As A Transdiagnostic Process Across Psychological Disorders, Michael E. Levin, Chelsea Maclane, Susan Daflos, John R. Seeley, Steven C. Hayes, Anthony Biglan, Jacqueline Pistorello

Psychology Faculty Publications

The current cross-sectional study examined psychological inflexibility, a process in which behavior is rigidly guided by psychological reactions rather than direct contingencies or personal values, as a transdiagnostic process relevant to a range of depressive, anxiety, substance use and eating disorders. A sample of 972 first-year college students between 17 and 20 years of age completed self-report measures of psychological inflexibility and psychological distress as well as a structured diagnostic interview. Psychological inflexibility was significantly higher across a range of current and lifetime depressive and anxiety disorders as well as lifetime history of eating disorders, relative to students with no …