The relationship between psychological inflexibility and well-being in adults: a meta-analysis of the acceptance and action questionnaire
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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.
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Strong associations between experiential avoidance and NNE, along with the negative impact of experiential avoidance on mental health symptoms, have been extensively documented.
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The Association Between Psychological Flexibility and Mindfulness: A Meta-Analytic Review
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- Authors
- Ong, C. W., Barthel, A. L., & Hofmann, S. G.
- Affiliations
- Boston University (US)
- Philipps University of Marburg (DE)
- Corresponding author
- Hofmann, Stefan G.
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 2024-01
- Volume
- 55
- Issue
- 1
- Pages
- 26-41
- ISSN
- 0005-7894 (ISSN-L)
- PMC
- PMC10787153
- OpenAlex
- W4378417731
- Cited by
- 61
- References
- 66
- Citations by year
- 2026: 28 · 2025: 21 · 2024: 10 · 2023: 2
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Behavior Therapy (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Alexander von Humboldt-Stiftung
- National Institute of Mental Health (R01MH128377, U01MH108168)
- Hessisches Ministerium für Wissenschaft und Kunst
- National Institutes of Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- psychological inflexibility, well-being, Acceptance and Action Questionnaire, acceptance and commitment therapy, act theory, psychological flexibility, psychological rigidity
- MeSH terms
- Adult, Cross-Sectional Studies, Emotions, Humans, Surveys and Questionnaires, Acceptance and Commitment Therapy
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