Unpaid carers are known to be at heightened risk of poor outcomes (e.g. financially, physically and emotionally). Conversely it is known that carers can have positive experiences through their caring role and continue to experience good well-being even when distress is present. The study proposes that mindfulness, psychological inflexibility and valued living may moderate the relationship between distress and well-being in carers and therefore help ameliorate some of the potentially negative consequences of caring.

The proposed diagnostic criteria for Hypersexual Disorder included "[r]epetitively engaging in sexual fantasies, urges, or behaviors in response to stressful life events" (Kafka, 2010, p.279) as a symptom, although no data demonstrates a causal relationship between stress and hypersexual behavior. We sought to confirm previous findings while furthering the field's understanding of this relationship by being the first study to assess stress and hypersexual behavior across multiple time points. Specifically, we sought to test three hypotheses within a sample of men seeking treatment for hypersexual behavior: 1) hypersexual individuals report higher stress levels than published norm samples; 2) stress predicts sexual thoughts, urges, and behavior at the same time point and across multiple time points; and 3) among various domains of stress, social and personal forms of stress best predict hypersexual behavior. Thirty men seeking treatment for hypersexual behaviors at residential and intensive outpatient treatment centers participated in the study. Various indices of stress (perceived stress, daily hassles, stressful life domains, and salivary cortisol), affect (boredom, psychological distress, depression, anxiety, alexithymia, and loneliness), and process (psychological inflexibility) were assessed, some across two time points. Across multiple analyses, the study did not find sufficient evidence to support a causal relationship between stress and hypersexual behavior. Supporting previous research, the hypersexual sample demonstrated significant elevations on stress, affect, and process measures compared to published norms, strengthening the assertion that hypersexual individuals experience high levels of stress and psychological distress. The implications of these findings, limitations of the methods used, and future directions for research and treatment are discussed.

The relationship between perfectionism and religiosity is clarified when the adaptive and maladaptive dimensions of both constructs are compared. Literature in both areas implicates the idea of a rigid and inflexible personality style as a possible mediator in the relationship. This investigation examined the relationship of perfectionism and religiosity, using adaptive and maladaptive dimensions, as mediated by psychological inflexibility. Measures of perfectionism, religiosity, and psychological inflexibility were given to 376 undergraduate college students in an anonymous online survey. Adaptive perfectionism was found to be significantly correlated with adaptive religiosity. Maladaptive perfectionism was found to be significantly correlated with maladaptive religiosity. Psychological inflexibility was found to be significantly correlated with the maladaptive dimensions of both perfectionism and religiosity. It was also shown to mediate the relationship between maladaptive religiosity and maladaptive perfectionism using the test of mediation proposed by Baron and Kenny. Implications and future directions are discussed.

Sexual trauma is linked to adverse health outcomes (e.g., D’Andre et al., 2011). Given the negative sequelae of sexual trauma, exploration of factors that influence the relation between sexual trauma and health outcomes is crucial. Current literature suggests that psychological flexibility and inflexibility may be factors in promotion of individuals’ health or pathology (e.g., Gloster et al., 2017). The current study sought to explore the variability in psychological flexibility and inflexibility among participants and the potential moderating effects of psychological flexibility and inflexibility on the relation between sexual trauma and both mental and physical health outcomes. Moderation analyses failed to support significant moderation effect of psychological flexibility on either physical or mental health outcomes. However, psychological inflexibility did significantly moderate the relationship between sexual trauma and emotional wellbeing b = 5.50 t(247) = 2.69 p < 0.01 such that sexual trauma significantly predicts worse emotional wellbeing at high levels of psychological inflexibility. Similarly, in the model examining the potential moderating effect of psychological inflexibility on the relationship between sexual trauma and physical functioning, the interaction was significant, b = 7.51 t(248) = 2.13, p < 0.05, suggesting possible moderation. However, after further probing, psychological inflexibility did not significantly moderate the relationship between sexual trauma and physical functioning at any level. Additionally, t-test results suggest that regardless of a sexual trauma history, participants do not significantly differ in their levels of psychological flexibility or inflexibility. However, within moderation models both psychological flexibility and psychological inflexibility predicted physical and mental health outcomes, further supporting the association between resiliency and psychological flexibility and the link between inflexibility and worsened health outcomes. Findings suggest that interventions that promote psychological flexibility and target inflexibility may be important health promotion factors among both survivors of sexual trauma and non-traumatized populations.

Clinical perfectionism is characterized by rigidly pursuing unrealistically high standards on which self-worth is contingent and experiencing distress when these standards are not met. Because clinical perfectionism is associated with many psychological diagnoses, understanding how to treat it may help streamline available treatments. The aim of this dissertation was to test the effect of acceptance and commitment therapy (ACT), a cognitive-behavioral therapy, on 53 individuals with clinical perfectionism. Participants in the ACT group received 10 therapy sessions and those in the control group were on a waitlist for 14 weeks. The first study supported the effectiveness of ACT relative to the waitlist control group with respect to perfectionism severity, quality of life, and general symptom distress. The second study showed changes in psychological inflexibility and self-compassion explained improvements in quality of life and concern over mistakes, respectively. It also found a variable effect of baseline psychological inflexibility on response to treatment depending on the outcome tested. In contrast, average self-compassion was generally associated with better outcomes in ACT. Neurological results from the third study suggest receiving ACT was associated with greater cognitive efficiency while performing error-prone tasks and decreased responsivity to emotionally meaningful stimuli. In addition, changes in brain activation were not linked to changes in self-report outcomes. Collectively, this dissertation examined not only the efficacy of an intervention focused on a maladaptive behavioral pattern like clinical perfectionism but also how and for whom such a therapy works.

Two risk factors for anxiety and depression in adolescence were examined: co-rumination, which occurs when friends excessively talk about problems; and psychological inflexibility, which occurs when one avoids negative feelings and fails to act on values. I hypothesized that psychological inflexibility would exacerbate the effect of co-rumination on adolescent anxiety and depression. Participants were 167 adolescents (Mage = 14.60 years, SD = 1.3; 65.7% cisgender males) who completed standard measures as part of an online survey. Results indicated no moderation effect, but there were main effects of co-rumination and psychological inflexibility on depression symptoms. Co-rumination may relate to higher depression symptoms by reinforcing a focus on stressors. Adolescents exhibiting psychological inflexibility may exacerbate symptoms by avoiding growth opportunities and perseverating on negative emotions. Results call for more research on co-rumination and psychological inflexibility as well as clinical interventions. Limitations include using cross-sectional, self-report methodology.

Mental and emotional health concerns among college students are prevalent and diverse in their symptom presentations. With increasing demands on counseling centers to provide efficient care and to address students with higher acuity or risk for harm, there has been an increased focus on identifying therapeutic targets that underlie a wide breadth of concerns to broaden the scope and impact of mental health services. Psychological inflexibility is one such target and refers to a combination of excessive avoidance of internal experiences coupled with a lack of actions that align with a person’s values. Interventions for psychological inflexibility aim to support people in reducing actions that are mostly about avoiding unwanted thoughts and feelings and actions that involve moving towards chosen values. Such interventions may produce changes in people’s actions in part through helping people notice and label the different roles their actions play in relation to thoughts, feelings, and personal values. However, the skill of noticing and labeling the purposes of one’s actions has not been studied in interventions for psychological inflexibility despite being discussed in theoretical writings. Training this skill may serve as a direct means of reducing psychological inflexibility and as a foundation for other interventions, thus it may be a relevant target in interventions for psychological inflexibility among college students. Given this, the present study developed and tested an intervention focused on noticing and labeling one’s actions as an intervention for psychological inflexibility in a college student sample, as delivered through web and app-based media. The study recruited 106 students with symptoms of depression and anxiety from a medium sized university in the Mountain West of the United States, and then randomly assigned them to either wait for eight weeks or receive a three-week online and app-based training for noticing and labeling avoidant and values-consistent actions. The results of the study indicated short-term effects on symptoms of depression and anxiety for participants who received the online and app-based training as compared with participants who were asked to wait, although both groups showed reductions in symptoms by the end of the study period. Participants did not report changes in the target skill of noticing and labeling their actions although the study did find larger reductions in psychological inflexibility among participants who received the training as compared with those asked to wait. Further, changes in psychological flexibility were related to changes in behavioral activity and life satisfaction, but not life quality. The results raise questions about the necessity of training the ability to notice and label one’s actions as a direct intervention mechanism for psychological inflexibility. The findings also suggest that changing inflexible patterns of behavior may be more important than the capacity to notice such changes. These results are further interpreted in relation to interventions for college student mental and emotional health.

Mindfulness, purposeful attention without judgment or acceptance, and related practices are increasingly popular with a large number of people and have been incorporated into many western psychotherapies (e.g., Mindfulness-Based Stress Reduction, Dialectical Behavior Therapy, Acceptance and Commitment Therapy and Mindfulness Based Cognitive Therapy). There is considerable debate over whether mindfulness is best studied as a state, trait or procedure. Although many studies have found that trait mindfulness is related to physical and mental health outcomes, less is known about the mechanism(s) through which mindfulness enhances clinical outcomes. The current study explored the role of potential mediators of the relationship between trait mindfulness and psychological outcomes, i.e., psychological distress. Specifically, we examined whether the relationship between trait mindfulness and psychological distress is indirect, with mediators such as emotion regulation (i.e., cognitive reappraisal and emotion suppression, experiential avoidance, cognitive flexibility (i.e., alternative), and psychological inflexibility accounting for the relationship. We measured trait mindfulness, psychological distress, emotion regulation, cognitive flexibility, experiential avoidance and acceptance in a large sample of undergraduate students. We hypothesized that the relationship between trait mindfulness and psychological outcomes is indirect and may be due to enhanced acceptance, flexibility, and emotion regulation. We conducted a sequential regression, simple mediational, and multiple mediational analyses to test hypotheses. Results revealed that the proposed mediators explained additional variances in psychological distress above and beyond trait mindfulness. The simple mediational analyses indicated that individually, psychological inflexibility, emotion regulation (only cognitive reappraisal), and experiential avoidance mediated the relationship between trait mindfulness and psychological distress. Finally, the multiple mediational analysis revealed that, when tested simultaneously, only psychological inflexibility mediated the association between trait mindfulness and psychological distress. Implications of results for developing treatment packages that include mindfulness practices are discussed. Limitations of the cross-sectional design, the measurements, and definitional issues of trait mindfulness are discussed as well.

No description available.

As a whole, eating disorders have been characterised as having the following key features: a persistent over concern with body size and shape; and weight control behaviours such as fasting, exercise, and self-induced vomiting. However, there tends to be a blurred line between those that do and do not meet diagnostic thresholds as the level of psychological distress is comparably similar. This study examined whether psychological inflexibility (from an Acceptance and Commitment Therapy perspective) was associated with eating disorders and whether it mediated the relationship between childhood abuse and invalidation and eating disorders. This was considered to be important because high rates of abuse have consistently been found in this population, yet not everyone goes on to develop an eating disorder. In addition, the role of emotional abuse has been largely neglected. A clinical sample of 190 participants with a clinical or subclinical eating disorder were recruited from eating disorder charities and support forums; they completed a range of questionnaires measuring experiences of abuse and maternal/paternal emotional invalidation in childhood, current levels of cognitive fusion and experiential avoidance and current levels of eating pathology. The sample was split into three groups based on their Eating Disorder Risk Composite scores: elevated, typical and low clinical range. It was found that those in the elevated clinical range (most severe eating pathology) had the poorest emotional processing and significantly higher levels of psychological inflexibility, thought-shape-fusion, depression and anxiety than those in the low clinical range (least severe eating pathology). In terms of predicting current levels of eating pathology, three variables emerged as significant predictors: emotional processing, thought-shape fusion and depression. In terms of predicting current levels of psychological inflexibility, five variables emerged as significant predictors: childhood emotional abuse, emotional processing, thought-shape-fusion, depression and anxiety. The results add novel findings to the literature regarding the role of early experiences on the development of psychological inflexibility, and the role of psychological inflexibility in the maintenance of eating pathology and psychological distress. Clinical implications of these findings in relation to assessment, formulation, intervention and prevention are discussed.