Ong, C.W., Barthel, A.L., & Hofmann, S.G. (2023). The Relationship Between Psychological Inflexibility and Well-Being in Adults: A Meta-Analysis of the Acceptance and Action Questionnaire. Behavior Therapy. https://doi.org/10.1016/j.beth.2023.05.007
Measures Reviewed: AAQ and its variants
Abstract
Psychological inflexibility is defined as the rigid responding to stimuli (e.g., unpleasant thoughts and feelings) that interferes with well-being and valued actions. It is the treatment target in acceptance and commitment therapy (ACT). Despite the centrality of the link between inflexibility and well-being to ACT theory, an empirical review clarifying the nature of this relationship has not been conducted. As such, the current meta-analysis examined the meta-correlation between psychological inflexibility, measured by the Acceptance and Action Questionnaire (AAQ) and its variants, and well-being. A systematic review yielded 151 studies, including 25 versions of the AAQ and 43 well-being measures. Consistent with ACT theory, higher psychological inflexibility was associated with worse well-being (r = −.47, 95% CI[−.49, −.45]). In addition, sample diagnosis, type of AAQ, and type of well-being measure significantly moderated this relationship. Overall, our findings support the hypothesized link between psychological inflexibility and worse well-being. Limitations include reliance on cross-sectional data, precluding causal interpretation.
Discussion
The present meta-analysis examined the relationship between psychological inflexibility, measured by the AAQ and its variants, and well-being, variously defined as quality of life, life satisfaction/flourishing, and valued action. Based on 262 correlation coefficients reported from 151 studies across over 35 countries and 22 languages, the overall correlation between psychological inflexibility and well-being was −.47, 95% CI[−.49, −.45]...