Acceptance and Commitment Therapy Processes Differentially Predict Aspects of Mental Health.

Psychological flexibility relates to various aspects of mental health, including psychological distress and adaptive mental health. The CompACT has been developed to assess psychological flexibility by quantifying psychological flexibility as a multidimensional whole, and by three processes of psychological flexibility including, Openness to Experience (OE), Behavioral Awareness (BA), and Valued Action (VA). The current study examined the unique predictive property of each three process of the CompACT with aspects of mental health. Participants (N = 593) were a diverse sample of United States adults. Our results found OE and BA significantly predicted depression, anxiety, and stress. OE and VA significantly predicted satisfaction with life, and all three processes significantly predicted resilience. Our results support multidimensional assessment of psychological flexibility when examining aspects of mental health.

A Confirmatory Factor Analysis of the PROMIS Sleep Disturbance Among Law Enforcement Officers.

Law enforcement officers (LEOs) are at increased risk for sleep disorders relative to the general population. Common LEO occupational stressors, including critical incidents and shift work, predict sleep disturbance, which in turn negatively impacts health, performance, and community safety. The Patient-Reported Outcomes Measurement Information System-Sleep Disturbance 4-item (PROMIS SD4) was developed to assess self-reported sleep quality, satisfaction, and difficulties falling asleep. Previous studies suggest PROMIS-SD short-forms (4-, 6-, and 8-item) have good psychometric properties; however, evaluation of this easily-administered measure in high-stress, frontline populations is limited. The primary goal of this study was to evaluate the validity and reliability of the PROMIS-SD4 in a sample of LEOs (N = 111). A confirmatory factor analysis suggests that the original one-factor solution, with a correlated error-term, provides an excellent fit to the data, SBχ2(2) = 1.62, p = .23, CFI = .99, RMSEA = .12, SRMR = .01. The PROMIS SD4 demonstrated good reliability (α = .85) and evidence of convergent validity correlations in the expected direction with domains of psychological distress, positive health outcomes, reactivity, and body experience (all p's < .05). Results suggest that the PROMIS-SD4 is a valid and reliable measure of sleep disturbance among LEOs.

Adaptive body awareness predicts fewer central sensitization-related symptoms and explains relationship between central sensitization-related symptoms and pain intensity: A cross-sectional study among individuals with chronic pain.

BACKGROUND: Central sensitization (CS), defined as the amplification of neural signaling within the CNS that elicits pain hypersensitivity, is thought be a characteristic of several chronic pain conditions. Maladaptive body awareness is thought to contribute and maintain CS. Less is known about the relationship between CS and adaptive body awareness. PURPOSE: This cross-sectional study investigated relationships among self-reported adaptive body awareness (Multidimensional Interoceptive Awareness Scale-2; MAIA-2), CS-related symptoms (Central Sensitization Inventory; CSI), and pain intensity and further delineate potential direct and indirect links among these constructs. METHODS: Online surveys were administered to 280 individuals with chronic pain reporting elevated CSI scores. Strategic sampling targeted respondents to reflect the 2010 census. Pearson's correlations characterized overall relationship between variables. Multiple regression analyses investigated potential direct links. A path analysis assessed mediational effects of CS-related symptoms on the relationship between adaptive body awareness and pain intensity. RESULTS: CSI demonstrated strong, inverse correlations with some MAIA-2 subscales, but positive correlations with others. Higher CSI scores predicted greater pain intensity (b = 0.049, p ≤ 0.001). Two MAIA-2 subscales, Not-Distracting (b = -0.56, p ≤ 0.001) and Not-Worrying (b = -1.17, p ≤ 0.001) were unique predictors of lower CSI. Not-Distracting (b = -0.05, p = 0.003) and Not-Worrying (b = -0.06, p = 0.007) uniquely predicted lower pain intensity. CSI completely mediated the relationship between adaptive body awareness and pain intensity [point estimate = -0.04; 95% bootstrap confident intervals (CI) = -0.05 to -0.02]. CONCLUSIONS: Findings also support future research to explore causal relationships of variables. Findings suggest that frequency of attention to bodily sensations is distinct from cognitive-affective appraisal of bodily sensation, and the two distinct higher order processes may have divergent influences on perceived pain and CS-related symptoms. Results also support future research to explore causal relationships of variables.

Mindful nonreactivity moderates the relationship between posttraumatic stress disorder and depression.

PTSD and depression represent major individual and societal burdens. Depression is commonly comorbid with PTSD among veterans, although buffers of this relationship are unclear. We evaluated whether facets of mindfulness moderated the relationship between PTSD and depression in veterans with PTSD (N = 70). Three facets - nonjudging, acting with awareness, and nonreactivity - were assessed as moderators. Results indicated nonreactivity significantly attenuated the relationship between PTSD and depression (p=.013), such that veterans with high nonreactivity (+1 SD) showed a nonsignificant relationship between PTSD and depression, whereas veterans with average (Mean; p<.001) and low (-1 SD; p<.001) nonreactivity exhibited a significant relationship.

The Relationships Between Reduced Alcohol Use and Decreased Burnout Following Mindfulness-Based Resilience Training in Law Enforcement Officers.

Objective: This study is a secondary analysis of data collected in an earlier clinical trial of mindfulness-based resilience training (MBRT) (ClinicalTrials.gov registration number 02521454), where the MBRT condition demonstrated a significant reduction in self-reported burnout and trend-level reductions in alcohol use in law enforcement officers (LEOs). Given that MBRT is not designed to be a substance use intervention and does not contain explicit substance-related content, this study sought to clarify these findings by exploring whether improved burnout mediates reduced alcohol use. Method: Participants (n = 61) were sworn LEOs (89% male, 85% White, 8% Hispanic/Latinx) recruited from departments in a large urban metro area of the northwestern United States, and were randomized to either MBRT (n = 31) or no intervention control group (n = 30) during the trial. Results: MBRT group assignment predicted reduced burnout (b = 0.43, standard error [SE] = 0.14, p = 0.004), which subsequently predicted reduced alcohol use (b = 1.69, SE = 0.81, p = 0.045). Results suggest that reduced alcohol use was indirectly related to a reduction in burnout post-MBRT. Conclusion: Given that MBRT does not explicitly address substance use, these findings were interpreted to suggest that officers in the training acquired a new set of coping skills to deal with the operational and organizational stressors of police work.

Mindful Nonreactivity Moderates the Relationship between Chronic Stress and Pain Interference in Law Enforcement Officers.

INTRODUCTION: With high levels of both chronic stress and chronic pain, law enforcement provides a unique population in which to study the potential mitigating impact of cognitive and affective reactivity on the stress-pain link. The primary aim of the present study was to examine the moderating role of mindful nonreactivity in the relationship between chronic stress and pain interference in law enforcement officers (n = 60). METHODS: A regression analysis was conducted to determine if chronic stress predicted pain interference, and subsequently, to compute an estimate of the interaction effect of the chronic stress and mindful nonreactivity on pain interference. RESULTS: Results demonstrated the overall model was significant, F (3,55) = 5.29, p =.003, R2 = .47. When controlling for mindful nonreactivity, chronic stress significantly predicted pain interference, b = .76, t (55) = 3.40, p = .001, such that every one unit increase in chronic stress was associated with a .76 unit increase in pain interference. Results also demonstrated a significant interaction effect of mindful nonreactivity and chronic stress on pain interference, b = -.04, t (55) = -2.86, p = .006. The Johnson-Neyman technique was conducted and revealed among individuals with low levels of mindful nonreactivity, chronic stress significantly predicted pain interference. However, for individuals with greater levels of mindful nonreactivity, chronic stress no longer predicted pain interference. CONCLUSIONS: Findings contribute to a growing understanding of how mindfulness can mitigate harmful effects of stress.

Translation, Cross-Cultural Adaptation, and Psychometric Validation of the English Version of the Postural Awareness Scale.

PURPOSE: The Postural Awareness Scale (PAS) was developed among a sample of German speakers to measure self-reported awareness of body posture. The first aim of this study was to conduct an English translation and cross-cultural adaptation of the PAS. The second aim was to assess psychometric properties of the English version of the PAS. METHODS: Forward and backward translations were conducted. The translated scale was then pretested in a small sample of English-speaking adults (n = 30), followed by cognitive interviews. Finally, consensus of the translated scale was achieved among an expert committee (n = 5), resulting in the Postural Awareness Scale-English Version (PAS-E). Psychometric properties of the PAS-E were investigated among a sample of individuals with chronic pain (n = 301) by evaluating factor structure, reliability, and construct validity. Analyses of variance were conducted to calculate differences in PAS-E scores between specific subgroups (pain conditions, sex, and history of mindfulness practice). Linear regression analyses investigated whether the scores on the PAS-E predicted levels of pain, stress, and mood. RESULTS: The results obtained from an exploratory factor analysis showed a two-factor solution and were supported by a confirmatory factor analysis. The scale demonstrated good internal consistency and satisfactory construct validity. No significant differences related to sex at birth or pain duration were found. CONCLUSION: PAS-E demonstrated good psychometric properties, and therefore, can and should be used both for research and clinical practice.