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Resumen Objetivo. Analizar las propiedades psicométricas del AAQ-II en población adulta ecuatoriana con tomas presenciales, aumentando la fiabilidad de la muestra. Método. En este estudio se evaluaron las propiedades psicométricas de la Acceptance and Action Questionnaire-II (AAQ-II) en población ecuatoriana. Participaron 450 personas entre 18 y 53 años, de las cuales un 46.7% fueron mujeres y un 53.3% hombres. Resultados. En el análisis factorial confirmatorio se encontró una estructura de tres dimensiones: evitación de recuerdos, evitación emocional y falta de autodominio. Un análisis de invarianza reveló que la escala es invariante entre hombres y mujeres. Se encontró que la escala presenta buena consistencia interna (α = .90). Se discute la validez de la AAQ-II como una herramienta para evaluar la evitación experiencial en población adulta ecuatoriana.

Abstract Objective. To analyze AAQ-II psychometric properties on the Ecuadorian people. Method. In this study, the psychometric properties of the Acceptance and Action Questionnaire-II (AAQ-II) were evaluated in an Ecuadorian population. A total of 450 people between 18 and 53 years of age, 46.7% of whom were women, participated. Results. The confirmatory factor analysis found a three-dimensional structure: memory avoidance, emotional avoidance, and lack of self-control. An analysis of invariance between men and women revealed that the scale is invariant by sex. The scale was found to have good internal consistency (α = .90). The validity of the AAQ-II as a tool to assess experiential avoidance in an Ecuadorian adult population is discussed.

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Insomnia is the most prevalent sleep disorder in women. Sociodemographic, cognitive, and psychological factors may contribute to its severity. This study evaluated factors associated with severe insomnia in women with insomnia complaints. We evaluated 530 women aged 18-59 (mean = 40.5, SD = 10.2), who experienced insomnia complaints, using self-report instruments. Severe insomnia was defined as a score above 21 on the Insomnia Severity Index. Age, marital status, educational level, depression and anxiety, psychological inflexibility, and beliefs about sleep were assessed as potential factors associated with severe insomnia. Simple and multivariate analyses were conducted using binary logistic regression. Low education level (odds ratio; OR = 1.85 [1.27-2.69]), depression (OR = 2.17 [1.27-3.81]), psychological inflexibility (OR = 1.05 [1.02-1.08]), and dysfunctional beliefs about sleep (OR = 1.04 [1.02-1.06]) were factors associated with severe insomnia scores in the multiple logistic regression model. These findings are important from a public health perspective, because behavioral strategies designed to treat insomnia with a focus on cognitive and psychological factors are low-cost treatments and may help improve sleep quality in women, which also influences mental health.

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The Multidimensional Psychological Flexibility Inventory (MPFI) is a new 60-item self-report scale developed to assess the specific components of psychological flexibility and inflexibility proposed in the Hexaflex model of Acceptance and Commitment Therapy (ACT). The present study sought to examine the psychometric properties of the Persian version of the MPFI-60 in a community sample of 307 Iranian adults. The original study supported a 12-factor second-order structure consisting of 6 dimensions for psychological flexibility and 6 dimensions for psychological inflexibility. The Persian MPFI-60 demonstrated acceptable semantic and test content, internal structure, correlations with other variables, and internal consistency. It also evidenced in relation to anxiety, stress, depression, and self-compassion. Overall, the results indicate that the Persian MPFI-60 is a psychometrically sound measure in the Iranian context that enables researchers and clinicians to comprehensively assess the components of psychological flexibility and inflexibility within the Hexaflex model.

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Background/Objective: Depression represents a leading cause of disability and a major contributor to the overall global burden of disease with women systematically reporting a higher prevalence than men. This study aimed to examine the predictive value and relation of three transdiagnostic psychological factors (perceived stress, psychological inflexibility and loneliness) on depression and its sex differences for the general population in a large sample of Ecuador. Method: A non-probabilistic and non-clinical sample of 16.074 people from across Ecuador were online surveyed using a cross-sectional design. The structural equation model was based on scores from standardized questionnaires as measures of depression, psychological perceived stress, psychological inflexibility, and loneliness. Results: Women reported significantly higher levels of depression, mediated by differences in perceived stress, psychological inflexibility and loneliness. Perceived stress was the most important predictor of depression and mediated the effect of loneliness on depression. Complementarily, psychological inflexibility partially mediated the effect of perceived stress and loneliness on depression. The overall model accounted for the 78% of the total variance in depression. Conclusions: Results of this study provide a novel and robust transdiagnostic model of sex differences on depression and insights on how to design effective programs for preventing depression targeting modifiable transdiagnostic risk factors.

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Background: Alcohol use is one of the main risk factors that leads to detrimental health effects and support for a transdiagnostic approach to alcohol use disorders is growing. However, the role of transdiagnostic predictors of problematic alcohol consumption in Ecuador are understudied. Objective: The aim of this study was to examine gender differences in psychological stress and inflexibility as transdiagnostic predictors of problematic alcohol consumption in a large sample of college students in Ecuador. Methods: A total of 7,905 college students (21.49 years, SD = 3.68; 53.75% females) were surveyed using the following standardized scales: Alcohol Use Disorders Identification Test, Perceived Stress Scale-14, and Acceptance and Action Questionnaire (AAQ-7). Macro Process for SPSS (models 4 and 7) was used to analyze mediation and moderation effects. Results: Reported alcohol consumption was significantly higher in men than women students. On the other hand, women reported significantly higher levels of perceived stress and psychological inflexibility than men students. Gender, age, psychological stress, and inflexibility were significant predictors of alcohol consumption. Moreover, psychological inflexibility mediated the impact of stress on alcohol consumption, particularly in women (for men b = 0.065, 95% CI [0.048 to 0.083], for women b = 0.070, 95% CI [0.051 to 0.089]). Discussion: Results of this study support psychological stress and psychological inflexibility as critical transdiagnostic variables related to increased rates of alcohol consumption among Ecuadorian college students. These conclusions contribute to the development of transdiagnostic comprehensive programs, which encompasses promotive, preventive, and treatment services that allow to alleviate the burden of alcohol, as well as to enrich the growing research on alcohol consumption in this population from a gender perspective.

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The Multidimensional Psychological Flexibility Inventory (MPFI) is a new 60-item self-report scale developed to assess the specific components of psychological flexibility and inflexibility proposed in the Hexaflex model of Acceptance and Commitment Therapy (ACT). The present study sought to examine the psychometric properties of the Persian version of the MPFI-60 in a community sample of 307 Iranian adults. The original study supported a 12-factor second-order structure consisting of 6 dimensions for psychological flexibility and 6 dimensions for psychological inflexibility. The Persian MPFI-60 demonstrated acceptable semantic and test content, internal structure, correlations with other variables, and internal consistency. It also evidenced in relation to anxiety, stress, depression, and self-compassion. Overall, the results indicate that the Persian MPFI-60 is a psychometrically sound measure in the Iranian context that enables researchers and clinicians to comprehensively assess the components of psychological flexibility and inflexibility within the Hexaflex model. (AU)

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Background: The current mental health state of healthcare professionals and students during the COVID-19 pandemic in Ecuador remains understudied and how to improve their mental health is a challenge. Objective: This study aimed to explore the anxiety and depressive symptomatology among healthcare students and professionals in Ecuador and to examine the role of psychological inflexibility, loneliness, and psychological stress as predictors of anxiety and depression symptoms. Methods: A total of 191 undergraduate and graduate healthcare students in clinical practice (early-career healthcare professionals) in Ecuador were surveyed between January and March 2021 using standardized measures of psychological stress (PSS), psychological inflexibility (AAQ), loneliness (UCLA), alcohol consumption (AUDIT-C), and anxiety and depressive symptomatology (PHQ). Macro Process for SPSS (models 4 and 7) were used to test mediation effects. Results: Alcohol consumption varied between men and women and anxiety and depression symptomatology was generally low among the sample. Psychological inflexibility and loneliness mediated the impact of stress on anxiety and depressive mood in participants, regardless of gender and previous personal history of COVID-19. Discussion: Implications of psychological inflexibility and the prevention and coping with stress in healthcare professionals during COVID-19 are further discussed.

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Psychological stress, loneliness, and psychological inflexibility are associated with poorer mental health and professional performance in university teachers. However, the relationship between these variables is understudied. The aim of the present study is to analyze the mediating role of psychological (in)flexibility on the effect of loneliness on psychological stress. A total of 902 professors from 11 universities in Ecuador were analyzed using standardized scales: the Perceived Stress Scale (PSS-14) to assess psychological stress, the Loneliness Scale Revised-Short (UCLA-3) for loneliness, and the Avoidance and Action Questionnaire (AAQ-7) and Life Engagement Test as double measures of psychological (in)flexibility. Mediation was tested by using PROCESS macro for SPSS. The results indicated that psychological flexibility mediated the relationship between loneliness and stress in university professors, regardless of sex and the measure of psychological (in)flexibility considered. The practical implications of the results are discussed herein.

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(1) Background: The Acceptance and Action Questionnaire-II (AAQ-II) is the most well-known self-report measure to assess psychological inflexibility, a transdiagnostic pathological process, and targets for interventions. Objective: The aim of this study was to analyze the psychometric properties and factorial structure of the Ecuadorian Spanish version of the AAQ-II in a large sample of college students in Ecuador. (2) Methods: A total of 7905 students, 46.26% male and 53.75% female, from 11 Ecuadorian universities were surveyed. The AAQ-II was tested for factorial structure, reliability, and correlations with other health-related measures. (3) Results: The AAQ-II showed an unidimensional factorial structure, accounting for 66.87% to 70% of the total variance and showing a good fit of the data to the model (comparative adjustment index (CFI) = 0.995; goodness of fit index (GFI) = 0.992; Standardized Root Mean Squared Residual (SRMR) = 0.037; mean square approximation error (RMSEA) = 0.047, CI90% = 0.038-0.056). Reliability was optimal (Cronbach's α = 0.919; ω = 0.928), and AAQ-II scores significantly correlated with multiple health indicators. Psychological inflexibility was significantly higher in women than men. (4) Conclusions: The Spanish version of the AAQ-II showed good psychometric properties, which further supports psychological inflexibility, not just as a transdiagnostic process.

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PURPOSE: To identify the psychological inflexibility (PI) processes (experiential avoidance, cognitive fusion, poor contact with the present moment, unclear personal values and lack of commitment to action) associated with body mass index (BMI), depression, anxiety and stress symptoms and binge eating in overweight and obese people by drawing on the acceptance and commitment therapy (ACT) framework. METHODS: A cross-sectional study of 243 people with a BMI of at least 25 and aged from 18 to 60 years old. The following instruments were used: Acceptance and Action Questionnaire II (AAQ-II), Acceptance and Action Questionnaire-Weight (AAQ-W), Valued Living Questionnaire (VLQ), Cognitive Fusion Questionnaire (CFQ-7), Cognitive Fusion Questionnaire-Body Image (CFQ-BI), Mindful Eating Questionnaire (MEQ), Binge Eating Scale (BES) and Depression, Anxiety and Stress Scale (DASS-21). Data were analyzed using one-way ANOVA and t tests. RESULTS: There were no differences between BMI categories with respect to PI variables, but PI was positively related to the severity of binge eating and to symptoms of depression, anxiety and stress. CONCLUSION: The development of interventions focused on psychological inflexibility can be useful for the treatment of symptoms associated with overweight and obesity. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

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