What Does the Acceptance and Action Questionnaire (AAQ-II) Really Measure?

doi:10.1016/j.beth.2014.07.002

Behavior Therapy

Volume 45, Issue 6, November 2014, Pages 831-839

https://doi.org/10.1016/j.beth.2014.07.002 Get rights and content

Highlights

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Factor analytic examination of the discriminant validity of the AAQ-II
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The AAQ-II seems to a significant extent measure psychological distress
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Using the AAQ-II might lead to confounded measurements.

Abstract

The present study seeks to investigate the extent to which the Acceptance and Action Questionnaire (AAQ-II) is successful in discriminating between experiential avoidance/psychological flexibility on the one hand and the supposed outcomes in terms of psychological well-being of having this trait on the other. This was done using exploratory factor analysis on an item pool containing the AAQ-II items, and items designed for the present study to measure distress and acceptance/non-acceptance, to see what factors are identified and on which factor(s) the AAQ-II items had the highest factor loadings. Interestingly, the analysis found the items of the AAQ-II to be more strongly related to items designed to measure distress than items designed to measure acceptance/nonacceptance with minimal references to functional outcomes. The results of the study are interpreted and discussed in relation to the widespread use of the AAQ in both clinical and scientific contexts and given the centrality of the measure in empirically validating the ACT model of psychopathology and treatment.

Section snippets

The Present Study: Purpose and Hypotheses

As previously stated, the main purpose of the present study was to empirically investigate the extent to which the AAQ-II differentiates between psychological inflexibility/experiential avoidance as a psychological trait and the supposed outcome of having high or low levels of this trait in terms of psychological well-being and functioning.

This was done using exploratory factor analysis (EFA) on an item pool containing the AAQ-II items, and items designed for the present study to measure

Sample 1: ACT Therapists

To validate the items constructed to measure acceptance and distress (see below), the items were presented in an online questionnaire to a sample of therapists working with ACT. Participants were recruited via a group on Facebook for therapists working with ACT and answers were obtained from 30 participants. Of these, 80% were licensed psychologists, 10% were medical doctors, and 10% stated “other” as their profession. Thirty percent of the participants had worked with ACT between 1 and 5

Construct validity of the distress and acceptance scales

The data from the questionnaire administered to ACT therapists were analyzed to investigate the construct validity of the constructed items and scales. Results are presented in Table 2. On scale level, the Acceptance scale was assessed as measuring acceptance to a significantly larger extent than what the Distress scale did, t(29) = 14.37, p < .01, and the Distress scale was assessed as measuring distress to a significantly larger extent than what the Acceptance scale did, t(29) = 6.90, p < .01. In

Discussion

The present study sought to investigate the extent to which the AAQ-II is successful in discriminating between experiential avoidance/psychological flexibility on the one hand and the outcomes in terms of psychological well-being of having this trait or behavioral pattern on the other. Based on a critical examination of the items of the AAQ-II, the assumption was that there exists a problem with regard to the discriminant validity of the AAQ-II in terms of an overlap between the way

Conflict of Interest Statement

The author declares that there are no conflicts of interest.

Acknowledgment

I would like to express my gratitude to professor Lars-Gunnar Lundh for valuable comments on an earlier version of this manuscript.

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View full text

What Does the Acceptance and Action Questionnaire (AAQ-II) Really Measure?

Highlights

Abstract

Section snippets

The Present Study: Purpose and Hypotheses

Sample 1: ACT Therapists

Construct validity of the distress and acceptance scales

Discussion

Conflict of Interest Statement

Acknowledgment

Behavior Therapy

Behaviour Research and Therapy

Behavior Research and Therapy

Clinical Psychology Review

Behavior Therapy

Behaviour Research and Therapy

Emotion-regulation strategies across psychopathology: A meta-analytic review

Clinical Psychology Review

Experiential Avoidance and high risk sexual behavior in survivors of child sexual abuse

Journal of Child Sexual Abuse

Beck Depression Inventory II manual

Emotion Regulation in Acceptance and Commitment Therapy

Journal of Clinical Psychology

Mediators of change in emotion-focused and problem focused worksite stress management interventions

Journal of Occupational Health Psychology

The influence of psychological flexibility on work redesign: Mediated moderation of a work reorganisation intervention

Journal of Applied Psychology

Reliability and validity of the Chinese version of the Acceptance and Action Questionnaire-Second Edition (AAQ-II) in college students

Chinese Mental Health Journal