Acceptance and Action Questionnaire – version 2 (AAQ-2)

Assessments

Description
The Acceptance and Action Questionnaire – version 2 (AAQ-II), is the most widely used measure of psychological flexibility. It can be used weekly track how individuals are applying flexibility skills to their daily lives and is often used to measure progress in Acceptance and Commitment Therapy (ACT). The AAQ-II defines psychological flexibility is defined as the ability to fully contact the present moment including all negative private events (which is thoughts, feelings, and physiological sensations) it contains, without needless defences and depending on the situation engaging or changing behaviours in line with goals and values (Bond et al., 2011). In contrast to this is psychological inflexibility which is the rigid dominance of psychological reactions over values and goals. This occurs when people fuse with negative thoughts and attempt to avoid experiencing unwanted private experiences. This avoidance has the ironic effect of increasing their distress, reducing their contact with the present moment, and reducing their likelihood of pursuing goals and values (Hayes et al., 2004). Note that different definitions of psychological flexibility are used in the neurocognitive literature. Psychological inflexibility is purported to be determinant of psychological distress and behavioural ineffectiveness (Hayes et al., 2004; Bond et al., 2011). Therefore, greater levels of psychological inflexibility is associated with greater emotional distress (e.g. higher levels of depression and anxiety) and poorer life functioning (e.g. more absence from work). A behaviour therapy that is focused on decreasing psychological inflexibility is Acceptance and Commitment therapy (ACT; Hayes et al., 2006). Studies have shown that ACT is effective in reducing depression and anxiety (e.g., Bohlmeijer, Fledderus, Rokx, & Pieterse, 2011; Forman et al., 2007) and chronic pain (e.g., Vowles & McCracken, 2008) and in increasing positive mental health (Fledderus, Bohlmeijer, Smit, & Westerhof, 2010). Meta-analyses have shown medium to large effect sizes of ACT interventions on different symptoms of psychological distress (Powers, Zum Vörde Sive Vörding, & Emmelkamp, 2009).

Validity and Reliability

Interpretation
Higher total scores on the AAQ-II indicate higher psychological inflexibility, experiential avoidance, and more potential psychological distress. Lower total scores mean more psychological flexibility. A normative percentile is also presented, comparing the respondent’s score against a sample of normative undergraduates and adults (Bond et al., 2011). A percentile of 50 indicates that the client has average (and healthy) levels of psychological flexibility and experiential avoidance. If the client scores 25 or above (percentile of approximately 86) then this is an indication that the client’s psychological inflexibility may impact their overall wellbeing. This ‘cutoff’ is indicated by a dotted line on the graphs.

Developer
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire – II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676–688.

Number Of Questions
7

References
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire – II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676–688.

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