Development of the Psychological Flexibility in Romantic Relationships Scale (PFRRS): A Validity and Reliability Study

Year 2024, Volume: 8 Issue: 2, 330 - 359

Selva Barkale Şahin , Erdal Hamarta

https://doi.org/10.54535/rep.1557924

Abstract

This research aimed to investigate the psychometric properties of the Psychological Flexibility in Romantic Relationships Scale. Data were collected from two separate study groups in 2024 to assess the validity and reliability of the developed measurement tool. Exploratory and confirmatory factor analyses were conducted to assess the construct validity of the scale. The results supported the single-factor structure of the six-item scale. To provide evidence for the convergent validity of the Psychological Flexibility in Romantic Relationships Scale, its scores were correlated with the Psychological Flexibility Scale and the convergent validity was supported by a significant correlation coefficient of .72 between the scales. Cronbach Alpha coefficients examined for the reliability of the scale are above acceptable limits in both exploratory (.77) and confirmatory (.71) factor analyses and support internal consistency. Item-total correlations indicated that the scale items were highly correlated with the general factor representing the scale. Independent samples t-tests conducted on the top and bottom 27% of the sample revealed significant differences, indicating that the scale could discriminate between individuals with high and low levels of psychological flexibility in romantic relationships. In conclusion, the developed scale was found to be a valid and reliable measurement tool.

Keywords

Psychological flexibility, Romantic relationships, Validity and reliability

References

• Akçabozan Kayabol, N. B. (2022). İlişkilerin başlaması ve gelişimi [Initiation and development of relationships]. In S. B. Özgülük Üçok (Eds.), Yakın ilişkiler [Close relationships] (pp. 125–164). Ankara, Turkey: Nobel Akademik Yayıncılık.
• Alrefi, A. (2019). Psychological flexibility research trends. JOMSIGN: Journal of Multicultural Studies in Guidance and Counseling, 3(1), 64–74. doi:10.17509/jomsign.v3i1.19653
• Amani, A., & Yari, A. (2022). The effect of enrichment training based on acceptance and commitment therapy on communication patterns and cognitive emotion regulation in couples. Journal of Family Counseling and Psychotherapy, 11(2), 101–110. doi:10.22034/FCP.2022.62496
• Avcı, M. (2023). Üniversite öğrencilerinde kendini sabotaj, olumsuz değerlendirilme korkusu, öz-anlayış ve psikolojik esneklik arasındaki ilişkinin incelenmesi [Examining the relationship between self-handicapping, fear of negative evaluation, self-compassion and psychological flexibility] (Master’s thesis, Ufuk University, Ankara, Turkey). Retrieved from https://tez.yok.gov.tr/UlusalTezMerkezi/
• Baumeister, R. F., & Leary, M. R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117(3), 497–529. doi:10.1037/0033-2909.117.3.497
• Bayar, Y. (2022). Yapısal eşitlik modelleri [Structural equation models]. In M. Otrar, B. Dilmaç, & A. Haktanır (Eds.), Psikolojik danışmanlık ve rehberlik, psikoloji ve diğer sosyal bilimlerde ileri istatistik [Advanced statistics in psychological counselling and guidance, psychology and other social sciences] (pp. 235–284). Ankara, Turkey: Nobel Akademik Yayıncılık.
• Beckmeyer, J. J., & Cromwell, S. (2019). Romantic relationship status and emerging adult well-being: Accounting for romantic relationship interest. Emerging Adulthood, 7(4), 304–308. doi:10.1177/2167696818772653
• Begotka, A. M., Woods, D. W., & Wetterneck, C. T. (2004). The relationship between experiential avoidance and the severity of trichotillomania in a nonreferred sample. Journal of Behavior Therapy and Experimental Psychiatry, 35(1), 17–24. doi:10.1016/j.jbtep.2004.02.001
• Bennett, R., & Oliver, J. E. (2023). Kabul ve kararlılık terapisi: 100 anahtar teknik [Acceptance and Commitment Therapy: 100 key points and techniques] (H. T. Karatepe, E. E. Cicerali, & L. K. Cicerali, Trans.) İstanbul, Turkey: Litera Yayıncılık.
• Berger, E., Garcia, Y., Catagnus, R., & Temple, J. (2021). The effect of acceptance and commitment training on improving physical activity during the COVID-19 pandemic. Journal of Contextual Behavioral Science, 20, 70–78. doi:org/10.1016/j.jcbs.2021.02.005
• Bilgen, İ. (2021). Terapide psikolojik esneklik [Psychological flexibility in therapy]. İstanbul, Turkey: Epsilon Yayınevi.
• Bond, Frank, W., Hayes, S. C., & Barnes- Homes, D. (2006). Psychological flexibility, ACT and organizational behavior. Journal of Organizational Behavior Management, 26, 25–54. doi:10.1300/J075v26n01_02
• Boone, M. S., Mundy, B., Morrissey Stahl, K., & Genrich, B. E. (2015). Acceptance and commitment therapy, functional contextualism, and clinical social work. Journal of Human Behavior in the Social Environment, 25(6), 643–656. doi: 10.1080/10911359.2015.1011255
• Braithwaite, S., Delevi, R., & Fincham, F. (2010). Romantic relationships and the physical and mental health of college students. Personal Relationships, 17(1), 1–12. doi: 10.1111/j.1475-6811.2010.01248.x
• Braithwaite, S., & Holt-Lunstad, J. (2017). Romantic relationships and mental health. Current Opinion in Psychology, 13, 120–125. doi: 10.1016/j.copsyc.2016.04.001
• Bucher, A., Neubauer, A. B., Voss, A., & Oetzbach, C. (2019). Together is better: Higher committed relationships increase life satisfaction and reduce loneliness. Journal of Happiness Studies, 20(8), 2445–2469. doi: 10.1007/s10902-018-0057-1
• Burke, K., & Moore, S. (2015). Development of the Parental Psychological Flexibility Questionnaire. Child Psychiatry & Human Development, 46(4), 548–557. doi: 10.1007/s10578-014-0495-x
• Büyüköztürk, Ş. (2019). Sosyal bilimler için veri analizi el kitabı [Handbook of data analysis for social sciences]. Ankara, Turkey: Pegem Akademi.
• Büyüköztürk, Ş., Kılıç Çakmak, E., Akgün, Ö. E., Karadeniz, Ş., & Demirel, F. (2017). Bilimsel araştırma yöntemleri [Scientific research methods]. Ankara, Turkey: Pegem Akademi.
• Can, A. (2016). SPSS ile bilimsel araştırma sürecinde nicel veri analizi [Quantitative data analysis in scientific research process with SPSS]. Ankara, Turkey: Pegem Akademi.
• Çetinkaya, E. (2022). Psikolojik esneklik, öz şefkat, algılanan stres ve evlilik kalitesinin bazı demografik değişkenler ve aralarındaki ilişki açısından incelenmesi [An examination of the relationship among the psychological flexibility, self compassion, perceived stress and marital quality and with some demographic variables] (Master’s thesis, Ufuk University, Ankara, Turkey). Retrieved from https://tez.yok.gov.tr/UlusalTezMerkezi/
• Ciarrochi, J., Bilich, L., & Godsell, C. (2010). Psychological flexibility as a mechanism of change in acceptance and commitment therapy . In R. Baer (Eds.), Assessing mindfulness and acceptance: Illuminating the processes of change (pp. 51–76). Oakland, CA: New Harbinger Publications.
• Cyniak-Cieciura, M. (2021). Psychological flexibility, temperament, and perceived stress. Current Issues in Personality Psychology, 9(4), 306–315. doi:10.5114/cipp.2021.108685
• Dahl, J., Wilson, K. G., & Nilson, A. (2004). Acceptance and commitment therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial. Behavior Therapy, 35, 785–801. doi: 10.1016/S0005-7894(04)80020-0
• Daks, J. S., & Rogge, R. D. (2020). Examining the correlates of psychological flexibility in romantic relationship and family dynamics: A meta-analysis. Journal of Contextual Behavioral Science, 18, 214–238. doi:10.1016/j.jcbs.2020.09.010
• Dallos, R., & Draper, R. (2016). Aile terapisine giriş: Sistemik teori ve uygulama [An introduction to family therapy: Systemic theory and practice] (Ş. Kesici, C. Kiper, & A. Mert, Trans.) Ankara, Turkey: Nobel Akademik Yayıncılık.
• Demirci Seyrek, Ö., & Ersanlı, K. (2017). Üniversite öğrencilerinde yaşamın anlamı ile psikolojik esneklik arasındaki ilişki [The relationship between meaning in life and psychological flexibility of university students] International Periodical for the Languages, Literature and History of Turkish or Turkic, 12(4), 143–162. doi: 10.7827/TurkishStudies.10053
• Diener, E., Gohm, C. L., Suh, E., & Oishi, S. (2000). Similarity of the Relations between Marital Status and Subjective Well-Being Across Cultures. Journal of Cross-Cultural Psychology, 31(4), 419–436. doi:10.1177/0022022100031004001
• Dimidjian, S., Arch, J. J., Schneider, R. L., Desormeau, P., Felder, J. N., & Segal, Z. V. (2016). Considering meta-analysis, meaning, and metaphor: A systematic review and critical examination of “Third Wave” cognitive and behavioral therapies. Behavior Therapy, 47(6), 886–905. doi:10.1016/j.beth.2016.07.002
• Doorley, J. D., Goodman, F. R., Kelso, K. C., & Kashdan, T. B. (2020). Psychological flexibility: What we know, what we do not know, and what we think we know. Social and Personality Psychology Compass, 14(12), 1–11. doi: 10.1111/spc3.12566
• Dush, C. M. K., & Amato, P. R. (2005). Consequences of relationship status and quality for subjective well-being. Journal of Social and Personal Relationships, 22(5), 607–627. doi:10.1177/0265407505056438
• Eifert, G. H., & Heffner, M. (2003). The effects of acceptance versus control contexts on avoidance of panic-related symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 34(3–4), 293–312. doi:10.1016/j.jbtep.2003.11.001
• Eşici, H., & Karaman, M. A. (2022). Doğrulayıcı faktör analizi [Confirmatory factor analysis ]. In M. Ortar, B. Dilmaç, & A. Haktanır (Eds.), Psikolojik danışmanlık ve rehberlik, psikoloji ve diğer sosyal bilimlerde ileri istatistik [Advanced statistics in psychological counselling and guidance, psychology and other social sciences] (pp. 205–233). Ankara, Turkey: Nobel Akademik Yayıncılık.
• Fani Sobhani, F., Ghorban Shiroudi, S., & Khodabakhshi-Koolaee, A. (2021). Effect of two couple therapies, acceptance and commitment therapy and schema therapy, on forgiveness and fear of intimacy in conflicting couples. Practice in Clinical Psychology, 9(4), 271–282. doi: 10.32598/jpcp.9.4.746.3
• Feldner, M. T., Zvolensky, M. J., Eifert, G. H., & Spira, A. P. (2003). Emotional avoidance: an experimental test of individual differences and response suppression using biological challenge. Behaviour Research and Therapy, 41(4), 403–411. doi: 10.1016/S0005-7967(02)00020-7
• Fischer, M. S., Baucom, D. H., & Cohen, M. J. (2016). Cognitive‐behavioral couple therapies: Review of the evidence for the treatment of relationship distress, psychopathology, and chronic health conditions. Family Process, 55(3), 423–442. doi: 10.1111/famp.12227
• Flujas-Contreras, J. M., Recio-Berlanga, Á., Andrés, M. P., Fernández-Torres, M., Sánchez-López, P., & Gómez, I. (2023). The relationship between parental stress and psychological adjustment of the children: The role of parental psychological flexibility as a mediator. Journal of Contextual Behavioral Science, 29, 202–208. doi: 10.1016/j.jcbs.2023.07.006
• Foote, H. W., Hamer, J. D., Roland, M. M., Landy, S. R., & Smitherman, T. A. (2016). Psychological flexibility in migraine: A study of pain acceptance and values-based action. Cephalalgia, 36(4), 317–324. doi: 10.1177/0333102415590238
• Francis, A. W., Dawson, D. L., & Golijani-Moghaddam, N. (2016). The development and validation of the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT). Journal of Contextual Behavioral Science, 5(3), 134–145. doi:10.1016/j.jcbs.2016.05.003
• Fuchs, H. (2022). Psychological flexibility and attitudes towards individuals with disabilities. Kultura-Społeczeństwo-Edukacja, 21(1), 145–159. doi:10.14746/kse.2022.21.9
• Genç, M. (2022). Suça bulaşan ergenlerde kabul ve kararlılık terapisi temelli girişimin psikolojik esneklik, empati ve öfke üzerine etkisi [The effect of acceptance and commitment therapy- based intervention on psychological flexibility, empathy and anger in adolescents involved in crime] (Doctoral dissertation, İstanbul University, İstanbul, Turkey). Retrieved from https:// tez.yok.gov.tr/UlusalTezMerkezi/
• Ghahari, S., Jamil, L., Farrokhi, N., & Davoodi, R. (2021). Comparing the effects of emotion-focused couple therapy and acceptance and commitment therapy on marital conflict and emotion regulation. Practice in Clinical Psychology, 9(2), 121–132. doi: 10.32598/jpcp.9.2.718.1
• Gloster, A. T., Block, V. J., Klotsche, J., Villanueva, J., Rinner, M. T. B., Benoy, C., Walter, M., Karekla, M., & Bader, K. (2021). Psy-Flex: A contextually sensitive measure of psychological flexibility. Journal of Contextual Behavioral Science, 22, 13–23. doi: 10.1016/j.jcbs.2021.09.001
• Godbee, M., & Kangas, M. (2020). The relationship between flexible perspective taking and emotional well-Being: A systematic review of the “Self-as-context” component of acceptance and commitment therapy. Behavior Therapy, 51(6), 917–932. doi: 10.1016/j.beth.2019.12.010
• Gómez-López, M., Viejo, C., & Ortega-Ruiz, R. (2019). Well-being and romantic relationships: A systematic review in adolescence and emerging adulthood. International Journal of Environmental Research and Public Health, 16(13), 2415. doi:10.3390/ijerph16132415
• Greenberg, L. S., & Goldman, R. N. (2008). Emotion focused couples therapy: The dynamics of emotion, love and power. Washington: American Psychological Association.
• Guerrini Usubini, A., Varallo, G., Granese, V., Cattivelli, R., Consoli, S., Bastoni, I., Volpi, C., Castelnuovo, G., & Molinari, E. (2021). The impact of psychological flexibility on psychological well-being in adults with obesity. Frontiers in Psychology, 12. doi:10.3389/fpsyg.2021.636933
• Gur, A., & Reich, A. (2023). Psychological flexibility of parents of children with disabilities: A systematic literature review. Research in Developmental Disabilities, 136, 104490. doi:10.1016/j.ridd.2023.104490
• Harris, R. (2022a). ACT’i kolay öğrenmek [ACT made simple] (F. B. Esen & K. F. Yavuz, Trans.) İstanbul, Turkey: Litera Yayıncılık
• Harris, R. (2022b). Gerçeğin Tokadı [Reality Slap] (K. F. Yavuz, Trans.) İstanbul, Turkey: Litera Yayıncılık
• Harris, R. (2023). Sevgiyle Yürümek [ACT with love] (N. Yavuz & K. F. Yavuz, Trans.) İstanbul, Turkey: Litera Yayıncılık
• Hayes, S. C., Hofmann, S. G., & Ciarrochi, J. (2023). The idionomic future of cognitive behavioral therapy: What stands out from criticisms of ACT development. Behavior Therapy, 54(6), 1036–1063. doi:10.1016/j.beth.2023.07.011
• Hayes, S. C., Levin, M., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior Therapy, 44, 180–198. doi:10.1016/j.beth.2009.08.002
• Hayes, S. C., & Lillis, J. (2021). Kabul ve kararlılık terapisi [Acceptance and commitment therapy] (D. Aksoy, Trans.) İstanbul, Turkey: Okuyanus.
• Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44, 1–25. doi:10.1016/j.brat.2005.06.006
• Hayes, S. C., Masuda, A., Bissett, R., Luoma, J. B., & Guerrero, L. F. (2004). DBT, FAP, and ACT: How empirically oriented are the new behavior therapy technologies? Behavior Therapy , 35(1), 35–54. doi: 10.1016/S0005-7894(04)80003-0
• Hayes, S. C., Pistorello, J., & Biglan, A. (2008). Acceptance and commitment therapy: Model, data and extension to the prevention of suicide. Brazilian Journal of Behavional and Cognitive Therapy, 5(1), 81–102. doi: 10.31505/rbtcc.v10i1.329
• Hayes, S. C., & Smith, S. (2022). Zihninden çık hayatına gir: Kabul ve kararlılık terapisi (ACT) ile kendine yardım kılavuzu [Get out of your mind and into your life] (Ş. İlkay & K. F. Yavuz, Trans.) İstanbul, Turkey: Litera Yayıncılık
• Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168. doi:10.1037/0022-006X.64.6.1152
• Hendrick, S. S. (2016). Yakın ilişkiler psikolojisi [Understanding close relationships] (A. Dönmez & A. Büyükşahin Sunal, Trans.) Ankara, Turkey: Nobel Akademik Yayıncılık.
• Hendrick, S. S., & Hendrick, C. (2006). Measuring respect in close relationships. Journal of Social and Personal Relationships, 23(6), 881–899. doi:10.1177/0265407506070471
• Holman, G., Kanter, J., Tsai, M., & Kohlenberg, R. (2021). FAP’ı kolay öğrenmek [Functional analytic psychotherapy made simple] (M. E. Karadere & F. B. Alptekin, Trans.) İstanbul, Turkey: Litera Yayıncılık.
• Hosseini, N., Poh, L. L., & Baranovich, D.-L. (2019). Enhancing marital satisfaction through acceptance and commitment therapy: A review of marital satisfaction improvement of iranian couples. International Journal of Education, Psychology and Counseling, 4(33), 53–60. doi:10.35631/IJEPC.433005
• Hosseinpanahi, M., Mirghafourvand, M., Farshbaf-Khalili, A., Esmaeilpour, K., Rezaei, M., & Malakouti, J. (2020). The effect of counseling based on acceptance and commitment therapy on mental health and quality of life among infertile couples: A randomized controlled trial. Journal of Education and Health Promotion, 9(1), 251. doi:10.4103/jehp.jehp_512_20
• Hsu, T., Adamowicz, J. L., & Thomas, E. B. K. (2023). The effect of acceptance and commitment therapy on the psychological flexibility and inflexibility of undergraduate students: A systematic review and three-level meta-analysis. Journal of Contextual Behavioral Science, 30, 169–180. doi: 10.1016/j.jcbs.2023.10.006
• Imani, S., Zakeri, M., & Bahadivand, A. (2023). The effectiveness of acceptance and commitment- group therapy on perceived stress and marital distress in women with major depressive disorder seeking divorce. Journal of Research in Psychopathology , 4(11), 33–39. doi: 10.22098/jrp.2022.10517.1081
• Jäger, M., Terry, J., & Rance, J. (2021). ‘A Mindful ACT’- testing the feasibility and acceptability of a brief psychosocial intervention designed to accompany osteopathy treatment for people who live with persistent pain. International Journal of Osteopathic Medicine, 42, 85–91. doi: 10.1016/j.ijosm.2021.12.004
• Kangas, M., & McDonald, S. (2011). Is it time to act? The potential of acceptance and commitment therapy for psychological problems following acquired brain injury. Neuropsychological Rehabilitation, 21(2), 250–276. doi:10.1080/09602011.2010.540920
• Karaaziz, M., Yarar, K., & Keskindağ, B. (2023). Çiftlerde somatizasyon ve psikolojik esnekliğin evlilik çatışması üzerindeki yordayıcı rolü [The predictice of somatization and psychological flxibility on marital conflict among married couples]. Antalya Bilim Üniversitesi Uluslararası Sosyal Bilimler Dergisi [Antalya Bilim University International Journal of Social Sciences], 3(1), 99–108. doi:10.54969/abuijss.1336626
• Karagöz, Y. (2019). SPSS,AMOS,META uygulamalı istatistiksel analizler [SPSS, AMOS, META applied statistical analyses]. Ankara, Turkey: Nobel Akademik Yayıncılık .
• Karakuş, S., & Akbay, S. E. (2020). Psikolojik esneklik ölçeği: Uyarlama, geçerlik ve güvenirlik çalışması [Psychological flexibility scale: Adaptation, validity and reliability study]. Mersin Üniversitesi Eğitim Fakültesi Dergisi çalışması [MersinUniversity Journal of the Faculty of Education], 16(1), 32–43. doi:10.17860/mersinefd.669825
• Karasar, N. (2012). Bilimsel araştırma yöntemi [Scientific research method]. Ankara, Turkey: Nobel Akademik Yayıncılık
• Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30, 865–878. doi: 10.1016/j.cpr.2010.03.001
• Khanjani Veshki, S., Shafiabady, A., Farzad, V., & Fatehizade, M. (2016). A Comparison of the effectiveness of cognitive – behavioral couple therapy and acceptance and commitment couple therapy in the couple’s conflict in the city of Isfahan. Jundishapur Journal of Health Sciences, 9(3). doi:10.5812/jjhs.43085
• Köksal, Burak. (2023). Kabul ve kararlılık terapisine dayalı kendi kendine yardım müdahalesinin üniversite öğrencilerinin depresyon, anksiyete, stres ve psikolojik esneklik düzeylerine etkisi [Effect of self- help intervention based on acceptance and commitment therapy on depression, anxiety, stress and psychological flexibility levels of university students] (Doctoral dissertation, Ondokuz Mayıs University, Samsun, Turkey). Retrieved from https:// tez.yok.gov.tr/UlusalTezMerkezi/
• Konstantinou, P., Ioannou, M., Melanthiou, D., Georgiou, K., Almas, I., Gloster, A. T., Kassianos, A. P., & Karekla, M. (2023). The impact of acceptance and commitment therapy (ACT) on quality of life and symptom improvement among chronic health conditions: A systematic review and meta-analysis. Journal of Contextual Behavioral Science, 29, 240–253. doi: 10.1016/j.jcbs.2023.08.004
• Kroska, E. B., Roche, A. I., & O’Hara, M. W. (2020). How much is enough in brief Acceptance and Commitment Therapy? A randomized trial. Journal of Contextual Behavioral Science, 15, 235–244. doi:10.1016/j.jcbs.2020.01.009
• Kul, A., & Türk, F. (2020). Kabul ve Adanmışlık Terapisi (ACT) üzerine bir derleme çalışması [A review on acceptance and commitment therapy]. Uluslararası Toplum Araştırmaları Dergisi [International Journal of Society Researchers], 16, 3373–3805. doi:10.26466/opus.741907
• Kuşcu, B. (2019). Bireylerin evlilik uyumlarının psikolojik esneklik, affetme ve benlik kurgusu açısından incelenmesi [Investigation of marital adjustment of individuals in terms of psychological flexibility, forgiveness and self-construal] (Master’s thesis, Marmara University, İstnabul, Turkey). Retrieved from https://tez.yok.gov.tr/UlusalTezMerkezi/
• Leahy, R. L., Tirch, D. D., & Melwani, P. S. (2012). Processes underlying depression: Risk aversion, emotional schemas, and psychological flexibility. International Journal of Cognitive Therapy, 5(4), 362–379. doi: 10.1521/ijct.2012.5.4.362
• Lev, A., & McKay, M. (2022). Çiftler için kabul ve kararlılık terapisi [Acceptance and commitment therapy for couples] (D. Dölek, Trans.) İstanbul, Turkey:APAMER Psikoloji Yayınları.
• Li, S., Chen, Z., Yong, Y., Xie, J., & Li, Y. (2023). Effectiveness of acceptance and commitment therapy-based interventions for improving the psychological health of parents of children with special health care needs: A systematic review and meta-analysis. Comprehensive Psychiatry, 127, 152426. doi:10.1016/j.comppsych.2023.152426
• Long, D. M., & Hayes, S. C. (2014). Acceptance, mindfulness, and cognitive reappraisal as longitudinal predictors of depression and quality of life in educators. Journal of Contextual Behavioral Science, 3(1), 38–44. doi:10.1016/j.jcbs.2013.10.004
• Luoma, J. B., Drake, C. E., Kohlenberg, B. S., & Hayes, S. C. (2011). Substance abuse and psychological flexibility: The development of a new measure. Addiction Research & Theory, 19(1), 3–13. doi:10.3109/16066359.2010.524956
• Luoma, J. B., & Platt, M. G. (2015). Shame, self-criticism, self-stigma, and compassion in Acceptance and Commitment Therapy. Current Opinion in Psychology, 2, 97–101. doi:10.1016/j.copsyc.2014.12.016
• Luoma, J. B., Sabucedo, P., Eriksson, J., Gates, N., & Pilecki, B. C. (2019). Toward a contextual psychedelic-assisted therapy: Perspectives from Acceptance and Commitment Therapy and contextual behavioral science. Journal of Contextual Behavioral Science, 14, 136–145. doi:10.1016/j.jcbs.2019.10.003
• Malo, R., Acier, D., & Bulteau, S. (2022). Psychological flexibility: Toward a better understanding of a key concept. Trends in Psychology. doi:10.1007/s43076-022-00188-1
• Manuoğlu, E. (2022). Path analizi [Path analysis] In M. Ortar, B. Dilmaç, & A. Haktanır (Eds.), Psikolojik danışmanlık ve rehberlik, psikoloji ve diğer sosyal bilimlerde ileri istatistik [Advanced statistics in psychological counselling and guidance, psychology and other social sciences] (pp. 173–203). Ankara, Turkey: Nobel Akademik Yayıncılık.
• Maor, M., Ben- Itzhak, S., & Bluvstein, I. (2014). The psychological flexibility questionnaire (PFQ) development, reliability and validity. WebmedCentral PSYCHOLOGY, 5(4), 1–10.
• Masuda, A., Anderson, P. L., Wendell, J. W., Chou, Y.-Y., Price, M., & Feinstein, A. B. (2011). Psychological flexibility mediates the relations between self-concealment and negative psychological outcomes. Personality and Individual Differences, 50(2), 243–247. doi:10.1016/j.paid.2010.09.037
• McCracken, L. M., & Gauntlett-Gilbert, J. (2011). Role of psychological flexibility in parents of adolescents with chronic pain: Development of a measure and preliminary correlation analyses. Pain, 152(4), 780–785. doi:10.1016/j.pain.2010.12.001
• McCracken, L. M., Gutiérrez-Martínez, O., & Smyth, C. (2013). “Decentering” reflects psychological flexibility in people with chronic pain and correlates with their quality of functioning. Health Psychology, 32(7), 820–823. doi:10.1037/a0028093
• McCracken, L. M., & Velleman, S. C. (2010). Psychological flexibility in adults with chronic pain: A study of acceptance, mindfulness, and values-based action in primary care. Pain, 148(1), 141–147. doi:10.1016/j.pain.2009.10.034
• Mills, J., & Clark, M. S. (2001). Viewing close romantic relationships as communal relationships: Implications for maintenance and enhancement. In J. H. Harvey & A. Wenzel (Eds.), Close romantic relationships (pp. 13–26). Mahwah. NJ: Lawrence Erlbaum Associates.
• Mohammadian, S., Asgari, P., Makvandi, B., & Naderi, F. (2021). Effectiveness of Acceptance and Commitment Therapy on Anxiety, Cognitive Avoidance, and Empathy of Couples Visiting Counseling Centers in Ahvaz City, Iran. Journal of Research & Health, 11(6), 393–402. doi:10.32598/JRH.11.6.1889.1
• Moskow, D. M., Barthel, A. L., Hayes, S. C., & Hofmann, S. G. (2022). A Process-based approach to cognitive behavioral therapy. In Comprehensive Clinical Psychology (2nd ed., pp. 16–33). Elsevier. doi: 10.1016/b978-0-12-818697-8.00183-7
• Mousavi Haghighi, S. E., Pooladi Rishehri, A., & Asghar Mousavi, S. (2022). Effectiveness of acceptance and commitment therapy and integrated behavioral couples therapy on intimacy and family functioning in divorce-seeking couples. Journal of Research & Health, 12(3), 167–176. doi:10.32598/JRH.12.3.1972.1
• Mousavi, S. E. (2023). Sosyal kaygı yaşayan öğrencilerde kabul ve kararlılık temelli psikoeğitimin sosyal kaygı belirtileri, yaşantısal kaçınma ve olumsuz değerlendirilme korkusu üzerine etkisi [The effect of acceptance and commitment-based psychoeducation on social anxiety symptoms, experıential avoidance and fear of negative evaluation in students with social anxiety] (Doctoral dissertation, Atatürk University, Erzurum, Turkey). Retrieved from https:// tez.yok.gov.tr/UlusalTezMerkezi/
• Naderi Moghaddam, N., Panah Ali, A., Naghi Aghdasi, A., & Hejaz, M. (2023). The effectiveness of acceptance and commitment therapy on marital conflict and emotional divorce of women facing divorce. Women. Health. Bull., 10(2), 122–132. doi: 10.30476/WHB.2023.97237.1204
• Nalbant, A., & Yavuz, K. (2019). Dil kozasından çıkış: Bilişsel ayrışma [Exit from the language cocoon: Cognitive dissociation]. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi [Journal of Cognitive-Behavioral Psychotherapy and Research] , 8 (1), 58-62. doi:10.5455/JCBPR.33709
• Nemati, M., Dokaneheeifard, F., & Behboodi, M. (2020). Comparing effectiveness of acceptance and commitment therapy (ACT), emotion-focused therapy (EFT) and combining ACT & EFT in the spiritual well-being of couples referring to counseling centers in Sari: An experimental study. Journal of Pizhūhish Dar Dīn va Salāmat , 6(1), 87–99. doi: 10.22037/jrrh.v6i1.21369
• Nikrah, N., Bahari, F., & Shiri, A. (2023). Effectiveness of the acceptance and commitment therapy on resilience and quality of life in patients with post-acute COVID-19 syndrome. Applied Nursing Research, 73, 151723. doi:10.1016/j.apnr.2023.151723
• O’Donohue, W. (2023). The scientific status of acceptance and commitment therapy: An analysis from the philosophy of science. Behavior Therapy, 54(6), 956–970. doi:10.1016/j.beth.2023.07.006
• Omidi, A., & Talighi, E. (2017). The effectiveness of marital therapy based on accerptance and commitmnet on couples marital satisfaction and quality of life. International Journal Of Body, Mind and Culture, 4(1), 46–51. doi:10.22122/ijbmc.v4i1.80
• Ong, C. W., Sheehan, K. G., & Haaga, D. A. F. (2023). Measuring ACT in context: Challenges and future directions. Journal of Contextual Behavioral Science, 28, 235–247. doi:10.1016/j.jcbs.2023.04.005
• Özcan, K., & Karagöz, B. (2023). Evli bireylerde psikolojik esneklik ve sorun çözme becerisi arasındaki ilişkinin incelenmesi [Investigation of the relationhips between psychological flexibility and problem solving skills in married individuals]. Kahramanmaraş İstiklal Üniversitesi Psikoloji Dergisi [Kahramanmaras Istiklal University Journal of Psychology], 1(1), 14–32.
• Pakenham, K. I., Landi, G., Cattivelli, R., Grandi, S., & Tossani, E. (2023). Identification of psychological flexibility and inflexibility profiles during the COVID‐19 pandemic. Journal of Clinical Psychology, 79(10), 2225–2250. doi: 10.1002/jclp.23536
• Pepping, C. A., Belmont, N., & Cronin, T. J. (2024). Romantic relationships buffer minority stress in transgender and non-binary adults: Effects on depressive symptoms and suicidality. Journal of Affective Disorders. doi:10.1016/j.jad.2024.06.062
• Perelli-Harris, B., Hoherz, S., Lappegård, T., & Evans, A. (2019). Mind the “Happiness” gap: The relationship between cohabitation, marriage, and subjective well-being in the United Kingdom, Australia, Germany, and Norway. Demography, 56(4), 1219–1246. doi:10.1007/s13524-019-00792-4
• Petersen, J. M., Zurita Ona, P., & Twohig, M. P. (2022). A Review of Acceptance and Commitment Therapy for Adolescents: Developmental and Contextual Considerations. Cognitive and Behavioral Practice. 31(1), 72-89 doi:10.1016/J.CBPRA.2022.08.002
• Peterson, B. D., Eifert, G. H., Feingold, T., & Davidson, S. (2009). Using acceptance and commitment therapy to treat distressed couples: A case study with two couples. Cognitive and Behavioral Practice, 16(4), 430–442. doi:10.1016/j.cbpra.2008.12.009
• Purol, M. F., Keller, V. N., Oh, J., Chopik, W. J., & Lucas, R. E. (2021). Loved and lost or never loved at all? Lifelong marital histories and their links with subjective well-being. The Journal of Positive Psychology, 16(5), 651–659. doi:10.1080/17439760.2020.1791946
• Rolffs, J. L., Rogge, R. D., & Wilson, K. G. (2018). Disentangling components of flexibility via the hexaflex model: Development and validation of the multidimensional psychological flexibility inventory (MPFI). Assessment, 25(4), 458–482. doi:10.1177/1073191116645905
• Ross, C. E., Mirowsky, J., & Goldsteen, K. (1990). The impact of the family on health: The decade in review. Journal of Marriage and the Family, 52(4), 1059. doi:10.2307/353319
• Ruan, J., Chen, S., Liang, J., Mak, Y. W., Yee Ho, F. Y., Chung, K. F., Kwun Tong, A. K., Zhang, X. L., & Yeung, W. F. (2022). Acceptance and commitment therapy for insomnia and sleep quality: A systematic review and meta-analysis. Journal of Contextual Behavioral Science, 26, 139–155. doi:10.1016/j.jcbs.2022.09.002
• Sabouri, H., Zarei, E., Samavi, A., & Fakhraei, A. A. (2020). Comparison the effectiveness of acceptance and commitment therapy and compassion focused therapy on the quality of life and tendency to betray in married students with tendency to infidelity. Iranian Evolutionary and Educational Psychology Journal, 2(3), 184–199. doi:10.29252/ieepj.2.3.184
• Sağar, M. E. (2022). Yetişkinlerde sosyal medya bağımlılığının yordayıcısı olarak psikolojik esneklik ve problem çözme becerileri [Psychological flexibility and problem solving skills as predictors of social media addiction in adults]. Mehmet Akif Ersoy Üniversitesi Sosyal Bilimler Enstitüsü Dergisi [Mehmet Akif Ersoy University Journal of Institute of Social Sciences], 35, 179–192. doi:10.20875/makusobed.1080674
• Savruk, G. (2023). Genç yetişkinlik dönemindeki bireylerin psikolojik esneklik ve mizah tarzları ile duygu düzenleme becerileri arasındaki ilişki [The relationship between psychological flexibility and humor styles and emotion regulation skills of young adults] (Master’s thesis, İstanbul Aydın University, İstanbul, Turkey). Retrieved from https://tez.yok.gov.tr/UlusalTezMerkezi/
• Schone, B. S., & Weinick, R. M. (1998). Health-related behaviors and the benefits of marriage for elderly persons. The Gerontologist, 38(5), 618–627. doi:10.1093/geront/38.5.618
• Scott, W., & McCracken, L. M. (2015). Psychological flexibility, acceptance and commitment therapy, and chronic pain. Current Opinion in Psychology, 2, 91–96. doi:10.1016/j.copsyc.2014.12.013
• Seçer, İ. (2021). Psikolojik test geliştirme ve uyarlama süreci [Psychological test development and adaptation process]. Ankara, Turkey: Anı Yayıncılık .
• Şencan, H. (2005). Sosyal ve davranışsal ölçümlerde güvenilirlik ve geçerlilik [Reliability and validity in social and behavioural measurement]. Ankara, Turkey: Seçkin Yayıncılık.
• Shahbazfar, R., Zarei, E., Haji Alizadeh, K., & Dortaj, F. (2021). Comparing the effectiveness of cognitive-behavioral couple therapy and couple therapy based on acceptance and commitment therapy in improving marital quality of non- clinical couples. Quarterly Journal of Psychological Methods and Models, 12(43), 100–113. doi:10.30495/JPMM.2021.4726
• Siegel, J. A., Mendoza, R. R., Tesselaar, J. M., DeJesus, J., Elbe, C. I., Caravelli, N. S., Troy, L., Fenton, M., Victoria, B., Herrera, J., & Blashill, A. J. (2024). “I felt so powerful to have this love in me”: A grounded theory analysis of the experiences of people living with and recovering from eating disorders while in diverse romantic relationships. Body Image, 49, 1001709. doi: 10.1016/j.bodyim.2024.101709
• Stoddrad, J. A., & Afari, N. (2023). ACT metaforları: Kabul ve adanmışlık terapisinde deneyime dayalı alıştırmalar, uygulamalı metaforlar rehberi [The big book of act metaphors] (G.Tekin & B. Ergin, Trans.) İstanbul, Turkey: Epsilon.
• Strosahl, K. (2002). Acceptance and commitment therapy. In Encyclopedia of Psychotherapy (pp. 1–8). Elsevier. doi:10.1016/B0-12-343010-0/00001-5
• Strosahl, K. D., Bergan, J., & Romano, P. (1998). Assessing the field effectiveness of acceptance and commitment therapy: An example of the manipulated training research method. Behavior Therapy , 29(1), 35–64. doi: 10.1016/S0005-7894(98)80017-8
• Strosahl, K., Robinson, P. A., & Gustavsson, T. (2017). Radikal değişimler için kısa müdahaleler [Brief interventions for radical change] (Y. S. Altındal, Trans.) İstanbul, Turkey: Litera Yayıncılık.
• Tabachnick, B. G., & Fidell, L. S. (2020). Çok değişkenli istatistiklerin kullanımı [Using multivariate statistics] (M. Baloğlu, Trans.) Ankara, Turkey: Nobel Akademik Yayıncılık.
• Thompson, B. L., Twohig, M. P., & Luoma, J. B. (2021). Psychological flexibility as shared process of change in acceptance and commitment therapy and exposure and response prevention for obsessive-compulsive disorder: A single case design study. Behavior Therapy, 52(2), 286–297. doi:10.1016/j.beth.2020.04.011
• Tinsley, H. E. A., & Tinsley, D. J. (1987). Uses of factor analysis in counseling psychology research. Journal of Counseling Psychology, 34(4), 414–424. doi:10.1037/0022-0167.34.4.414
• Toprak, T. B., Arıcak, O. T., & Yavuz, K. F. (2020). Tıp fakültesi öğrencilerinde tükenmişlik derecesi psikolojik esneklik ve değerler arasındaki ilişkinin incelenmesi. [Investigation of the relationship between burnout degree, psychological flexibility and values in medical faculty students] Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi [Journal of Cognitive Behavioural Psychotherapy and Research], 9(1), 16–27. doi:10.5455/JCBPR.26978
• Towey-Swift, K. D., Lauvrud, C., & Whittington, R. (2023). Acceptance and commitment therapy (ACT) for professional staff burnout: a systematic review and narrative synthesis of controlled trials. Journal of Mental Health, 32(2), 452–464. doi: 10.1080/09638237.2021.2022628
• Trindade, I. A., Vagos, P., Moreira, H., Fernandes, D. V., & Tyndall, I. (2022). Further validation of the 18-item Portuguese CompACT scale using a multi-sample design: Confirmatory factor analysis and correlates of psychological flexibility. Journal of Contextual Behavioral Science, 25, 1–9. doi:10.1016/j.jcbs.2022.06.003
• Türküler Aka, B. (2022). İlişkilerin doğası ve tarihi [The nature and history of relationships] In B. Özgülük Üçok (Eds.), Yakın İlişkiler [Close relationships] (pp. 1–31). Ankara, Turkey: Nobel Yayıncılık.
• Twiselton, K. (2021). How we ripple: The interplay of psychological flexibility, wellbeing and relationship quality (Doctoral dissertation, The University of Edinburgh, Edinburgh, Scotland). Retrieved from https://era.ed.ac.uk/handle/1842/38351
• Twiselton, K., Stanton, S. C. E., Gillanders, D., & Bottomley, E. (2020). Exploring the links between psychological flexibility, individual well‐being, and relationship quality. Personal Relationships, 27(4), 880–906. doi:10.1111/pere.12344
• Twohig, M. P., Vilardaga, J. C. P., Levin, M. E., & Hayes, S. C. (2015). Changes in psychological flexibility during acceptance and commitment therapy for obsessive compulsive disorder. Journal of Contextual Behavioral Science, 4(3), 196–202. doi:10.1016/j.jcbs.2015.07.001
• Ulubay, G., & Güven, M. (2022). Kabul ve kararlılık terapisi ve psikolojik esneklik ile ilgili araştırmaların incelenmesi [Acceptance and commitment therapy and psychological flexibility: A review study]. The Journal of International Lingual Social and Educational Sciences, 8(2), 92–101. doi:10.34137/jilses.1109608
• Villatte, J. L., Vilardaga, R., Villatte, M., Plumb Vilardaga, J. C., Atkins, D. C., & Hayes, S. C. (2016). Acceptance and commitment therapy modules: Differential impact on treatment processes and outcomes. Behaviour Research and Therapy, 77, 52–61. doi:10.1016/j.brat.2015.12.001
• Waite, L. J., & Gallagher, M. (2000). The case for marriage. New York, NY: Broadway Books.
• Wang, J., Fang, S., Yang, C., Tang, X., Zhu, L., & Nie, Y. (2023). The relationship between psychological flexibility and depression, anxiety and stress: A latent profile analysis. Psychology Research and Behavior Management, 16, 997–1007. doi:10.2147/PRBM.S400757
• Whisman, M. A., & Baucom, D. H. (2012). Intimate relationships and psychopathology. Clinical Child and Family Psychology Review, 15(1), 4–13. doi:10.1007/s10567-011-0107-2
• Williams, B., Onsman, A., & Brown, T. (2010). Exploratory factor analysis: A five-step guide for novices. Australasian Journal of Paramedicine, 8, 1–13. doi:10.33151/ajp.8.3.93
• Yadavaia, J. E., Hayes, S. C., & Vilardaga, R. (2014). Using acceptance and commitment therapy to increase self-compassion: A randomized controlled trial. Journal of Contextual Behavioral Science, 3(4), 248–257. doi:10.1016/j.jcbs.2014.09.002
• Yaghoobi, H., Toozandehjani, H., & Zendedel, A. (2020). Comparison of emotionally-focused couple therapy and acceptance and commitment therapy regarding quality of interpersonal relationships in couples with marital conflicts. Avicenna Journal of Neuro Psycho Physiology, 7(2), 116–125. doi:10.32592/ajnpp.2020.7.2.106
• Yazar, R., & Tolan, Ö. (2021). Evlilik Terapilerinde Bilişsel Davranışçı Yaklaşım [Cognitive-behavioral approach in marital therapy] Psikiyatride Güncel Yaklaşımlar [Current Approaches in Psychiatry], 13(1), 1–22. doi:10.18863/pgy.708061
• Yu, L., Norton, S., & McCracken, L. M. (2017). Change in “Self-as-context” (“Perspective-taking”) occurs in acceptance and commitment therapy for people with chronic pain and is associated with improved functioning. The Journal of Pain, 18(6), 664–672. doi:10.1016/j.jpain.2017.01.005
• Ziapour, A., Mahmoodi, F., Dehghan, F., Abadi, S. M. H. M., Azami, E., & Rezaei, M. (2017). Effectiveness of group counseling with acceptance and commitment therapy approach on couples’ marital adjustment. World Family Medicine, 15(8), 230–236. doi: 10.5742/MEWFM.2017.93082