Perceived Discrimination, Experiential Avoidance, and Mental Health among Hispanic Adults in Primary Care

The Hispanic population is the largest minority group in the United States and frequently experiences racial discrimination and mental health difficulties. Prior work suggests that perceived racial discrimination is a significant risk factor for poorer mental health among Hispanic in the United States. However, little work has investigated how perceived racial discrimination relates to anxiety and depression among Hispanic adults. Thus, the current study evaluated the explanatory role of experiential avoidance in the relation between perceived racial discrimination and anxiety/depressive symptoms and disorders among Hispanic adults in primary care. Participants included 202 Spanish-speaking adults ( Mage = 38.99, SD = 12.43, 86.1% female) attending a community-based Federally Qualified Health Center. Results were consistent with the hypothesis that perceived racial discrimination had a significant indirect effect on depression, social anxiety, and anxious arousal symptoms as well as the number of mood and anxiety disorders through experiential avoidance. These findings suggest future work should continue to explore experiential avoidance in the association between perceived racial discrimination and other psychiatric and medical problems among the Hispanic population.

Psychometric properties of the Valuing Questionnaire in a Spaniard sample and factorial equivalence with a Colombian sample

Background The Valuing Questionnaire (VQ) is considered as one of the most psychometrically robust instruments to measure valued living according to the acceptance and commitment therapy model. It consists of 10 items that are responded to on a 7-point Likert-type scale and has two factors: Progression and Obstruction. The Spanish version of the VQ showed good psychometric properties in Colombian samples. However, there is no evidence of the psychometric properties of the VQ in Spaniard samples. This study aims to analyze the validity of the VQ in a large Spaniard sample and analyze the measurement invariance with a similar Colombian sample. Method The VQ was administered to a Spaniard sample of 846 adult participants from general online population. Cronbach’s alpha and McDonald’s omega were computed to analyze the internal consistency of the VQ. The fit of the VQ’s two-factor model was tested through a confirmatory factor analysis with a robust maximum likelihood (MLR) estimation method. Afterward, we analyzed the measurement invariance across countries and gender. Convergent construct validity was analyzed with a package of questionnaires that evaluated experiential avoidance (Acceptance and Action Questionnaire-II, AAQ-II), emotional symptoms (Depression Anxiety and Stress Scale-21, DASS-21), life satisfaction (Satisfaction with Life Scale, SWLS), and cognitive fusion (Cognitive Fusion Questionnaire, CFQ). Results The internal consistency across samples was adequate (alphas and omegas were .85 for VQ-Progress and .84 for VQ-Obstruction). The two-factor model obtained a good fit to the data (RMSEA = 0.073, 90% CI [0.063, 0.083], CFI = 0.98, NNFI = 0.97, and SRMR = 0.053). The VQ showed strict invariance across countries and gender and showed theoretically coherent correlations with emotional symptoms, life satisfaction, experiential avoidance, and cognitive fusion. In conclusion, the Spanish version of the VQ demonstrated good psychometric properties in a large Spaniard sample.

Aversive Reactivity: A Transdiagnostic Functional Bridge Between Neuroticism and Avoidant Behavioral Coping

Aversive reactivity to negative affect has been described as a transdiagnostic mechanism that links distal temperamental vulnerabilities to clinically relevant behaviors. However, the abundance of constructs reflecting aversive reactivity has resulted in a proliferation of models that may ultimately be redundant. We performed a circumscribed review of studies measuring associations between six constructs – anxiety sensitivity, experiential avoidance, distress intolerance, intolerance of uncertainty, thought-action fusion, and negative urgency – and ten relevant coping behaviors. Results suggested that most constructs were measured in relation to a limited number of coping behaviors. Additionally, constructs were most often measured in isolation, rather than with similar constructs. Implications and suggestions for future research and treatment are discussed.

The Effect of Loneliness in Psychological and Behavioral Profile among High School Students in Spain

Loneliness is a distressing feeling that can be a barrier to a student’s development and affect their mental health. This research aimed to analyse the effects of loneliness on psychological and behavioral factors among students aged 12–19 years in Spain. Loneliness, experiential avoidance, psychological inflexibility, physical activity, mobile phone use, and smoke habits were analysed in a sample of 110 men and 122 women assigned into two groups depending on their loneliness levels: higher loneliness group (HLG) and lower loneliness group (LLG). Results showed that experimental avoidance and psychological inflexibility were related with loneliness (r = 0.471; p = 0.000). Experiential avoidance and psychological inflexibility were higher in HLG than LLG. Regarding the use of mobile phones and smoking habits, LLG presented significantly higher values than HLG. Higher age correlated with lower loneliness values (r = −0.155; p = 0.017). The present research found how students with higher loneliness presented higher experiential avoidance and psychological inflexibility and lower age, use of mobile phone, and smoking habits. These findings reveal the importance of considering multiple social behaviours when examining adolescent mental health factors.

Examining depression symptoms within OCD: the role of experiential avoidance

Background: Obsessive compulsive disorder (OCD) and depression commonly co-occur. Past research has evaluated underlying mechanisms of depression in the context of other diagnoses, but few to no studies have done this within OCD. Aims: This study examines the relationships between distress tolerance (DT), experiential avoidance (EA), depression, and OCD symptom severity across intensive/residential treatment (IRT) for OCD. It was hypothesized that all variables would be significantly moderately related and EA would emerge as a potential contributing factor to change in depression and OCD symptoms across IRT for OCD. Method: The sample included 311 participants with a primary diagnosis of OCD seeking IRT. Correlations were performed between all variables at both admission and discharge. A two-step hierarchical regression with change in OCD symptoms and change in DT in the first block and change in EA in the second block examined if change in EA explained change in depression above and beyond change in OCD and DT ability. Results: At both admission and discharge, higher EA, lower DT, and higher OCD symptom severity were significantly associated with more depressive symptoms. Change in EA explained a significant amount of variance in change in depression above and beyond change in OCD symptom severity and change in DT. Conclusions: This study expands past results within an OCD sample, emphasizing EA as an important treatment target in OCD. Future studies could utilize samples from other treatment contexts, use a measure of EA specific to OCD, and utilize a longitudinal model that takes temporal precedence into account.

Ko ngā pūtake o te mātānawe ki tā te rangatahi: An exploration of self-injury in rangatahi Māori

<p>This thesis explores how rangatahi Māori and whānau define and experience self-injury in Aotearoa. The dominance of the current Western knowledge base that contributes to psychology in Aotearoa is questioned, specifically regarding the extent to which current knowledge adequately explains self-injury in rangatahi Māori. To do this, I use a mixed-methods approach that is informed by the principles of kaupapa Māori (G. H. Smith, 1997), Māori-centred (Cunningham, 2000) and interface research (Durie, 2005). Our current understanding of self-injury in rangatahi Māori is informed predominantly by international research and models grounded in worldviews that differ from the unique cultural context in Aotearoa. These definitions, such as that for “non-suicidal self-injury” (Zetterqvist, 2015), and models, such as the Experiential Avoidance Model (Chapman, Gratz, & Brown, 2006), are then applied to the assessment and treatment of rangatahi Māori. In this thesis I highlight why these Western definitions and models become problematic when they are incongruous with the behaviours that rangatahi Māori define as ‘self-injury’ and, as such, fail to consider the unique, complex and diverse experiences of rangatahi Māori who self- injure. The quantitative study involved cross-sectional survey data collected from 343 rangatahi who identified as Māori in the Youth Wellbeing Study. This survey data provided initial insight into the prevalence and correlates of self-injury in rangatahi Māori. In the second study, sequential focus groups were conducted with 25 rangatahi Māori and their whānau. The principles of Interpretative Phenomenological Analysis (J. Smith, 2004) informed the qualitative data analysis. Definitions of behaviours that rangatahi Māori and whānau considered to be self-injury were broad and varied, including harm to wairua (essence, spirit) of the rangatahi and their whānau. Reasons for self-injuring included experiencing intense emotional pain, for example, that which was caused by peers. The most common functions of self-injury endorsed by rangatahi Māori were to express emotional pain, to communicate distress, to maintain a sense of control over their lives, and to manage their suicidal thoughts. It is my intention to produce research that is directly relevant to rangatahi Māori, whānau, the broader community and the clinical profession. In the final chapter of this thesis I answer the question ‘how do we support rangatahi Māori who self-injure?’. I frame these answers by adapting whakataukī (proverb) ‘e kore au e ngaro, he kākano i ruia mai i Rangiātea’ (I will never be lost, for I am a seed sown in Rangiātea). I argue that, while we as Māori should never feel lost when we know who we are and where we come from, many rangatahi feel as though they are lost, and self-injury is one means of coping with this sense of struggle. For rangatahi Māori in this research, self-injury is differentiated from suicide by the concept of hope; suicide is a loss of hope whereas self-injury is a means of holding on to hope. By understanding it in this way, self-injury can form a target for early intervention and prevention of suicide.</p>