Vol 6, No 3 (2021)
Review article
Published online: 2021-07-05

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Health in the context of psychological flexibility and acceptance and commitment therapy

Anna Prokopowicz1, Bartłomiej Stańczykiewicz2, Izabella Uchmanowicz3
Medical Research Journal 2021;6(3):249-253.

Abstract

Losing health is associated with an imbalance in one or more areas that are important to an individual. The spectacular achievements of modern medicine have made people believe that the only source of health is the treatment and reduction of symptoms. The ability to function in conditions of unavoidable discomfort can bring back an individual's loss of balance. The aim of this article is to present the model of Psychological Flexibility and its relationship with selected health aspects of an individual. According to the statement of the founders of Acceptance and Commitment Therapy (ACT), suffering in various forms is an integral part of human life. In situations of discomfort that cannot be avoided, and with which an individual must learn to function on a daily basis over a longer period of time, ACT proposes the development of Psychological Flexibility, which strengthens the psyche and body's immune resistance. The COVID-19 pandemic, which has been going on for a year, has disrupted the macro balance. At the micro scale, this balance can be disturbed by chronic disease states such as pain, anxiety and depression. The above conditions reduce the quality of life and health. Psychological Flexibility shapes a set of skills that improve the quality of life, and also affect balance despite perceived discomfort. Psychological Flexibility is a base that has a wide application and significance for the quality of life and health. Its higher resources help an individual live a rich, worthwhile life despite suffering from pain, anxiety or pandemic stress.

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References

  1. Konstańczak S. Zdrowie jako wartość ogólnospołeczna. Studia Ecologiae et Bioethicae. 2012; 10(3): 23–34.
  2. Kowalski M, Gaweł A. Zdrowie – wartość – edukacja. Impuls, Kraków 2007.
  3. Domaradzki JO. O skrytości zdrowia. O problemach z konceptualizacją pojęcia zdrowie. Hygeia Public Health. 2013; 48: 408–19.
  4. Kulik TB, Latalski M. Public health. Czelej, Lublin 2002.
  5. Amit Aharon A, Dubovi I, Ruban A. Differences in mental health and health-related quality of life between the Israeli and Italian population during a COVID-19 quarantine. Qual Life Res. 2021 [Epub ahead of print].
  6. Farley T, Cohen D. Prescription for a healthy nation: A new approach to improving our lives by fixing our everyday world. Boston: Beacon Press. 2005; 113(9): A632.
  7. Smith TW, Orleans CT, Jenkins CD. Prevention and health promotion: decades of progress, new challenges, and an emerging agenda. Health Psychol. 2004; 23(2): 126–131.
  8. Spatola CAM, Manzoni GM, Castelnuovo G, et al. The ACTonHEART study: rationale and design of a randomized controlled clinical trial comparing a brief intervention based on Acceptance and Commitment Therapy to usual secondary prevention care of coronary heart disease. Health Qual Life Outcomes. 2014; 12: 22.
  9. Zhao C, Lai L, Zhang L, et al. The effects of acceptance and commitment therapy on the psychological and physical outcomes among cancer patients: A meta-analysis with trial sequential analysis. J Psychosom Res. 2021; 140: 110304.
  10. González-Fernández S, Fernández-Rodríguez C. Acceptance and commitment therapy in cancer: review of applications and findings. Behav Med. 2019; 45(3): 255–269.
  11. Mirsharifa SM, Mirzaian B, Dousti Y. The efficacy of acceptance and commitment therapy (ACT) matrix on depression and psychological capital of the patients with irritable bowel syndrome. Open Access Maced J Med Sci. 2019; 7(3): 421–427.
  12. Hasheminasab M, Babapour Kheiroddin J, Mahmood Aliloo M, et al. Acceptance and commitment therapy (ACT) for generalized anxiety disorder. Iran J Public Health. 2015; 44(5): 718–719.
  13. Kanter JW, Baruch DE, Gaynor ST. Acceptance and commitment therapy and behavioral activation for the treatment of depression: description and comparison. Behav Anal. 2006; 29(2): 161–185.
  14. Samaan M, Diefenbacher A, Schade C, et al. A clinical effectiveness trial comparing ACT and CBT for inpatients with depressive and mixed mental disorders. Psychother Res. 2021; 31(3): 355–368.
  15. Hayes SC, Strosahl KD, Wilson KG. Terapia akceptacji i zaangażowania: Proces i praktyka uważnej zmiany. Wydawnictwo Uniwersytetu Jagiellońskiego, Kraków 2013.
  16. Harris R. Zrozumieć ACT. Terapia akceptacji i zaangażowania w praktyce. Gdańskie Wydawnictwo Psychologiczne, Sopot 2018.
  17. Kashdan TB, Rottenberg J. Psychological flexibility as a fundamental aspect of health. Clin Psychol Rev. 2010; 30(7): 865–878.
  18. Dougher M, Twohig MP, Madden GJ. Editorial: Basic and translational research on stimulus-stimulus relations. J Exp Anal Behav. 2014; 101(1): 1–9.
  19. Levin M, Twohig M, Smith B. Contextual Behavioral Science. The Wiley Handbook of Contextual Behavioral Science. 2015: 17–36.
  20. Bohlmeijer ET, Lamers SMA, Fledderus M. Flourishing in people with depressive symptomatology increases with Acceptance and Commitment Therapy. Post-hoc analyses of a randomized controlled trial. Behav Res Ther. 2015; 65: 101–106.
  21. Ducasse D, Fond G. Acceptance and commitment therapy. L'Encéphale. 2015; 41(1): 1–9.
  22. Dindo L, Van Liew JR, Arch JJ. Acceptance and commitment therapy: A transdiagnostic behavioral intervention for mental health and medical conditions. Neurotherapeutics. 2017; 14(3): 546–553.
  23. Forman EM, Shaw JA, Goetter EM, et al. Long-term follow-up of a randomized controlled trial comparing acceptance and commitment therapy and standard cognitive behavior therapy for anxiety and depression. Behav Ther. 2012; 43(4): 801–811.
  24. Ruiz F. Acceptance and commitment therapy versus traditional cognitive behavioral therapy: a systematic review and meta-analysis of current empirical evidence. International Journal of Psychology and Psychological Therapy. 2012; 12(3): 333–357.
  25. Steenhaut P, Rossi G, Demeyer I, et al. How is personality related to well-being in older and younger adults? The role of psychological flexibility. Int Psychogeriatr. 2018 [Epub ahead of print]: 1–11.
  26. Pyszkowska A. Personality predictors of self-compassion, ego-resiliency and psychological flexibility in the context of quality of life. Personality and Individual Differences. 2020; 161: 109932.
  27. Guerrini Usubini A, Cattivelli R, Giusti EM, et al. The impact of psychological flexibility on psychological well-being in adults with obesity. Front Psychol. 2021; 12(1): 636933.
  28. Kamody RC, Berlin KS, Rybak TM, et al. Psychological flexibility among youth with type 1 diabetes: relating patterns of acceptance, adherence, and stress to adaptation. Behav Med. 2018; 44(4): 271–279.
  29. Meyer EC, Kotte A, Kimbrel NA, et al. Predictors of lower-than-expected posttraumatic symptom severity in war veterans: The influence of personality, self-reported trait resilience, and psychological flexibility. Behav Res Ther. 2019; 113: 1–8.
  30. GUS. Zdrowie i zachowanie zdrowotne mieszkańców Polski w świetle Europejskiego Ankietowego Badania Zdrowia (EHIS) 2014 r. 2015.
  31. Przybyłko K. Psychological aspects of pain management. Summarium. 2016; 45: 71–88.
  32. Sheng J, Liu S, Wang Y, et al. The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain. Neural Plast. 2017; 2017: 9724371.
  33. Kroenke K, Outcalt S, Krebs E, et al. Association between anxiety, health-related quality of life and functional impairment in primary care patients with chronic pain. Gen Hosp Psychiatry. 2013; 35(4): 359–365.
  34. Kemani MK, Zetterqvist V, Kanstrup M, et al. A validation of the pain interference index in adults with long-standing pain. Acta Anaesthesiol Scand. 2016; 60(2): 250–258.
  35. Leeuw M, Goossens ME, Linton SJ, et al. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007; 30(1): 77–94.
  36. Zale EL, Ditre JW. Pain-Related Fear, Disability, and the Fear-Avoidance Model of Chronic Pain. Curr Opin Psychol. 2015; 5: 24–30.
  37. Gentili C, Rickardsson J, Zetterqvist V, et al. Psychological Flexibility as a Resilience Factor in Individuals With Chronic Pain. Front Psychol. 2019; 10: 2016.
  38. McCracken LM, Vowles KE. Psychological flexibility and traditional pain management strategies in relation to patient functioning with chronic pain: an examination of a revised instrument. J Pain. 2007; 8(9): 700–707.
  39. Rhodes A, Marks D, Block-Lerner J, et al. Psychological flexibility, pain characteristics and risk of opioid misuse in noncancerous chronic pain patients. J Clin Psychol Med Settings. 2020 [Epub ahead of print].
  40. Åkerblom S, Perrin S, Rivano Fischer M, et al. Predictors and mediators of outcome in cognitive behavioral therapy for chronic pain: the contributions of psychological flexibility. J Behav Med. 2021; 44(1): 111–122.
  41. Scott W, Hann KEJ, McCracken LM. A comprehensive examination of changes in psychological flexibility following acceptance and commitment therapy for chronic pain. J Contemp Psychother. 2016; 46: 139–148.
  42. GUS. Zdrowie i ochrona zdrowia w 2019 roku. 2019.
  43. Brenes GA. Anxiety, depression, and quality of life in primary care patients. Prim Care Companion J Clin Psychiatry. 2007; 9(6): 437–443.
  44. Kessler RC, Petukhova M, Sampson NA, et al. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012; 21(3): 169–184.
  45. Jacobson NC, Newman MG. Avoidance mediates the relationship between anxiety and depression over a decade later. J Anxiety Disord. 2014; 28(5): 437–445.
  46. Tirch D, Leahy R, Silberstein L, et al. Emotional schemas, psychological flexibility, and anxiety: the role of flexible response patterns to anxious arousal. International Journal of Cognitive Therapy. 2012; 5(4): 380–391.
  47. Martins A, Canavarro M, Pereira M. The role of psychological flexibility and self-compassion in mental health and quality of life of HIV-infected adults. 2017.
  48. Landstra JMB, Ciarrochi J, Deane FP, et al. Identifying and describing feelings and psychological flexibility predict mental health in men with HIV. Br J Health Psychol. 2013; 18(4): 844–857.
  49. Masuda A, Tully E. The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a Nonclinical College Sample. Journal of Evidence-Based Complementary & Alternative Medicine. 2011; 17(1): 66–71.
  50. Uğur E, Kaya Ç, Tanhan A. Psychological inflexibility mediates the relationship between fear of negative evaluation and psychological vulnerability. Curr Psychol. 2020 [Epub ahead of print]: 1–13.
  51. Gallego A, McHugh L, Villatte M, et al. Examining the relationship between public speaking anxiety, distress tolerance and psychological flexibility. Journal of Contextual Behavioral Science. 2020; 16: 128–133.
  52. GUS. Raport zakażeń koronawirusem (SARS-CoV-2). Raport zakażeń koronawirusem (SARS-CoV-2. 2021.
  53. Sokół-Szawłowska M. Mental health impact of quarantine during the COVID-19 pandemic. Psychiatria. 2021; 18: 57–62.
  54. Özdin S, Bayrak Özdin Ş. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int J Soc Psychiatry. 2020; 66(5): 504–511.
  55. Dawson DL, Golijani-Moghaddam N. COVID-19: Psychological flexibility, coping, mental health, and wellbeing in the UK during the pandemic. J Contextual Behav Sci. 2020; 17: 126–134.
  56. McCracken L, Badinlou F, Buhrman M, et al. The role of psychological flexibility in the context of COVID-19: Associations with depression, anxiety, and insomnia. Journal of Contextual Behavioral Science. 2021; 19: 28–35.
  57. Crasta D, Daks JS, Rogge RD. Modeling suicide risk among parents during the COVID-19 pandemic: Psychological inflexibility exacerbates the impact of COVID-19 stressors on interpersonal risk factors for suicide. J Contextual Behav Sci. 2020; 18: 117–127.
  58. Kroska EB, Roche AI, Adamowicz JL, et al. Psychological flexibility in the context of COVID-19 adversity: Associations with distress. J Contextual Behav Sci. 2020; 18: 28–33.
  59. Landi G, Pakenham KI, Boccolini G, et al. The moderating roles of psychological flexibility and inflexibility on the mental health impacts of COVID-19 pandemic and lockdown in Italy. J Contextual Behav Sci. 2020; 17: 109–118.
  60. Hernández-López M, Cepeda-Benito A, Díaz-Pavón P, et al. Psychological inflexibility and mental health symptoms during the COVID-19 lockdown in Spain: A longitudinal study. J Contextual Behav Sci. 2021; 19: 42–49.
  61. Yu L, Kioskli K, McCracken LM. The psychological functioning in the COVID-19 pandemic and its association with psychological flexibility and broader functioning in people with chronic pain. J Pain. 2021 [Epub ahead of print].
  62. Daks JS, Peltz JS, Rogge RD. Psychological flexibility and inflexibility as sources of resiliency and risk during a pandemic: Modeling the cascade of COVID-19 stress on family systems with a contextual behavioral science lens. J Contextual Behav Sci. 2020; 18: 16–27.
  63. Coyne LW, Gould ER, Grimaldi M, et al. First things first: Parent psychological flexibility and self-compassion during COVID-19. Behav Anal Pract. 2020 [Epub ahead of print]: 1–7.
  64. Gloster A, Meyer A, Lieb R. Psychological flexibility as a malleable public health target: Evidence from a representative sample. Journal of Contextual Behavioral Science. 2017; 6(2): 166–171.
  65. Twohig MP, Levin ME. Acceptance and commitment therapy as a treatment for anxiety and depression: A review. Psychiatr Clin North Am. 2017; 40(4): 751–770.
  66. Kleszcz B, Dudek J, Białaszek W, et al. Właściwości psychometryczne polskiej wersji Kwestionariusza Akceptacji i Działania (AAQ-II). Studia Psychologiczne. 2018; 1: 1–20.
  67. Baran L, Hyla M, Kleszcz B. Psychological flexibility. Polish adaptation of measurement tools for practitioners and researcher. Uniwersytet Śląski, Katowice 2019.