Acceptance and Action Questionnaire-version 2 (AAQ-2) 接纳与行动问卷第二版

简介

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).

接纳与行动问卷--第二版（AAQ-II）是最广泛使用的心理灵活性测量方法。它可用于每周跟踪个人在日常生活中运用灵活性技能的情况，通常用于衡量接纳与承诺疗法（ACT）的进展情况。
AAQ-II 将心理灵活性定义为完全接触当下的能力，包括其所包含的所有负面私人事件（即思想、情感和生理感觉），而不做无谓的防御，并根据情况参与或改变符合目标和价值观的行为（Bond et al., 2011）。与此形成鲜明对比的是心理僵化，即心理反应凌驾于价值观和目标之上。当人们与消极思想融合在一起，试图避免经历不想要的私人体验时，就会出现这种情况。这种逃避具有讽刺意味，会增加他们的痛苦，减少他们与当下的接触，降低他们追求目标和价值观的可能性（Hayes et al.） 请注意，神经认知文献中对心理灵活性使用了不同的定义。
据称，心理不灵活是心理困扰和行为无效的决定因素（Hayes et al., 2004; Bond et al., 2011）。因此，心理不灵活程度越高，情绪困扰越大（如抑郁和焦虑程度越高），生活功能越差（如缺勤越多）。
接受与承诺疗法（ACT；Hayes et al.） 研究表明，接纳与承诺疗法能有效减少抑郁和焦虑（e.g., Bohlmeijer, Fledderus, Rokx, & Pieterse, 2011; Forman et al., 2007）和慢性疼痛（e.g., Vowles & McCracken, 2008），并能增强积极的心理健康（Fledderus, Bohlmeijer, Smit, & Westerhof, 2010）。Meta 分析表明，ACT 干预对不同的心理困扰症状具有中等到较大的效果（Powers, Zum Vörde Sive Vörding, & Emmelkamp, 2009）。

The AAQ-II was developed to address the short comings of the AAQ which had poor internal consistency. The AAQ-II items were generated by a panel of ACT experts from Australia, Europe and the United States. The items reflected either the likely dominance or non-dominance of private events (thoughts, feelings, and physiological sensations) in determining values directed action. The AAQ-II originally started out as a 10-item scale however after final psychometric analysis it was reduced to a 7-item scale (Bond et al., 2011).
Confirmatory factor analysis for the scale was conducted across 3 samples which included 433 undergraduate students from the University of Kentucky, 290 people who were seeking outpatient psychological help for Substance Abuse in New York City and 583 employees of a United Kingdom Bank – with a mean age of 34. Consistent results were seen across all 3 samples. The mean alpha coefficient was .84 (.78 – .88), and the 3- and 12-month test-retest reliability was .81 and .79, respectively.
Higher scores on the AAQ-II were associated with greater depression symptoms on the Beck Depression Inventory and the DASS and anxiety symptoms on the Beck Anxiety Inventory and the DASS. The sample who were seeking treatment for substance abuse were more psychologically inflexible (M = 28.34, SD = 9.92) than the samples that did not have that behavioural status (M = 18.51, SD = 7.05). This difference was statistically significant (F (1,3282) = 362.21, p < .000), with a very large effect size (d = 1.12) suggesting good predictive validity.
From the Bond et al. (2011) study, a normative sample was determined (n = 1,016) from the combination of an undergraduate student sample (n = 433) and an adult employee sample (n = 583). The mean for the total score of the AAQ-II was 18 (sd = 6.4). Given the Bond et al. (2011) findings and the relationship between AAQ-II scores and the BDI-II, GHQ, and GSI, a score of 1 standard deviation above the normative mean (approx. 25 or above) on the AAQ-II indicates psychological distress. These findings have recently been confirmed in a Brazilian normative sample, where a score of 25 or above would classify clients as moderate / severe on measures of anxiety and scores of 27 or above would classify clients as moderate / severe on measures of depression (Berta-Otero et al., 2023).

AAQ-II 是针对 AAQ 内部一致性差的缺点而开发的。AAQ-II 的项目由来自澳大利亚、欧洲和美国的 ACT 专家小组制定。这些项目反映了私人事件（思想、情感和生理感觉）在决定价值观指导行动中可能占主导地位还是不占主导地位。AAQ-II 最初是一个包含 10 个项目的量表，但经过最后的心理测量分析后，它被缩减为一个包含 7 个项目的量表（Bond et al., 2011）。
该量表的确认性因子分析在 3 个样本中进行，包括肯塔基大学的 433 名本科生、纽约市因药物滥用寻求门诊心理帮助的 290 人以及英国一家银行的 583 名员工（平均年龄为 34 岁）。所有 3 个样本的结果一致。平均阿尔法系数为 0.84（0.78 - 0.88），3 个月和 12 个月的重复测试可靠性分别为 0.81 和 0.79。
AAQ-II 分数越高，贝克抑郁量表和 DASS 的抑郁症状越严重，贝克焦虑量表和 DASS 的焦虑症状越严重。因药物滥用而寻求治疗的样本（中位数 = 28.34，标准差 = 9.92）比没有这种行为状况的样本（中位数 = 18.51，标准差 = 7.05）更缺乏心理弹性。这一差异具有统计学意义（F (1,3282) = 362.21, p < .000），其效应大小（d = 1.12）非常大，表明预测效果良好。

根据 Bond 等人（2011 年）的研究，结合本科生样本（n = 433）和成年员工样本（n = 583）确定了常模样本（n = 1,016）。AAQ-II 总分的平均值为 18（sd = 6.4）。鉴于 Bond 等人（2011 年）的研究结果以及 AAQ-II 分数与 BDI-II、GHQ 和 GSI 之间的关系，AAQ-II 分数高于常模平均值 1 个标准差（约 25 分或以上）即表示存在心理困扰。这些发现最近在巴西的一个常模样本中得到了证实，在焦虑测量中，25 分或以上可将受试者划分为中度/重度焦虑，而在抑郁测量中，27 分或以上可将受试者划分为中度/重度抑郁（Berta-Otero et al.） 

评分解释

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.

AAQ-II 的总分越高，表明心理灵活性越差，体验回避越多，潜在的心理困扰越大。总分越低，表示心理灵活性越高。
此外，还提供了一个常模百分位数，将受试者的分数与常模大学生和成年人样本进行比较（Bond 等人，2011 年）。百分位数为 50 表示受试者的心理灵活性和经验回避程度处于平均（健康）水平。如果客户得分在 25 分或以上（百分位数约为 86），则表明客户的心理不灵活可能会影响其整体健康。