A preliminary validation of the Swedish short version of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y8) for children and adolescents with cancer

Psychological inflexibility constitutes a generalized vulnerability for psychopathology. Children and adolescents undergoing cancer treatment are faced with numerous physical and psychological stressors throughout their cancer trajectory. Most of the survivors show resilience but some groups report psychological ill-health and poor quality-of-life long-term. Psychological flexibility has been shown to mediate improvements in psychological health for cancer patients. The Avoidance and Fusion Questionnaire for Youth (AFQ-Y) is the most frequently used measure of psychological inflexibility in children and adolescents. It correlates with a wide range of measures of mental health and long-term functional behavior. The aim of the study was to investigate norm values, psychometric properties and factor structure of the AFQ-Y8 for children and adolescents with cancer. All children and adolescents, aged 7–18 years of age, undergoing cancer treatment in Sweden at the time of the study were invited to participate. Norm values, internal consistency, test-retest reliability and convergent validity were calculated and an exploratory factor analysis was conducted. 62 children participated. The mean of the AFQ-Y8 in the sample was 10.30 (5.75). Internal consistency was acceptable (α = 0.76), test-retest reliability was good (ICC = 0.64) and convergent validity was demonstrated (r = 0.42). Norm values are now available, and the psychometric properties supported, for the AFQ-Y8 for children and adolescents with cancer. This provides implications for the prevention and treatment of psychopathology for this population. However, the one-factor structure of the AFQ-Y8 was not unequivocally supported. The results from the PCA rather suggested a two-factor structure. Due to the small sample of the study, the results should be seen as preliminary and further validation is warranted, specifically with regards to factorial validity and sensitivity to change.

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