DOI: https://doi.org/10.34069/AI/2024.83.11.8
Volume 13 - Issue 83: 100-111 / November, 2024
How to Cite:
Fedoryshyn, H., Chepurna, H., Lunchenko, N., Pichurin, V., & Nyzovets, O. (2024). The role of psychological flexibility in post-traumatic adaptation. Amazonia Investiga, 13(83), 100-111. https://doi.org/10.34069/AI/2024.83.11.8
The role of psychological flexibility in post-traumatic adaptation
Роль психологічної гнучкості у посттравматичній адаптації
Received: October 1, 2024 Accepted: November 29, 2024
Written by:
Halyna Fedoryshyn
https://orcid.org/0000-0002-8905-0906
Сandidate of Psychological Sciences, Associate Professor Department of Social Psychology, Vasyl Stefanyk Precarpathian National University, Ukraine. WoS Researcher ID: KMA-3559-2024
Email: galmf1975@gmail.com
Hanna Chepurna
https://orcid.org/0000-0003-4486-5447
Сandidate of Psychological Sciences Department of Psychology and Creative Industries, Chernihiv Polytechnic National University,
Ukraine. WoS Researcher ID: ABR-9254-2022 - Email: chepyrna74@gmail.com
Nadiia Lunchenko
https://orcid.org/0000-0002-4926-7115
Сandidate of Psychological Sciences Laboratory of Applied Psychology of Education, Ukrainian Scientific and Methodological Center of Applied Psychology and Social Work, Ukraine.
WoS Researcher ID: T-9743-2017 - Email: lnvpsi@ukr.net
Valerii Pichurin
https://orcid.org/0000-0002-3893-375X
Candidate of Psychological Sciences, Associate Professor Department of Physical Education, Ukrainian State University of Science and Technology, Ukraine. WoS Researcher ID: F-1651-2016
Email: valeriypichurin@gmail.com
Olena Nyzovets
https://orcid.org/0000-0002-2601-7869
Candidate of Psychological Sciences Psychologist at the Charitable Organization “Positive Women”, Ukraine. WoS Researcher ID: LEL-7584-2024 - Email: lena-nik75@ukr.net
Abstract
According to the World Health Organization, 70% of the population reports experiencing traumatic incidents. Psychological flexibility, which consists of acceptance, cognitive defusing, mindfulness, value orientation, and behavioral flexibility, is important for adaptation after traumatic situations. Therefore, the purpose of the study is to determine the role of psychological flexibility in the process of recovery from traumatic events. This paper uses the methods of literature analysis and observation. In particular, the PRISMA approach was used to collect relevant scientific materials. To include the literature, 5 criteria were developed that related to the content, methodology, and time of writing (from 2014–2024). A total of 40 items were included. The results showed that psychological flexibility is characterized by such factors as perception, cognitive defusing, mindfulness, value orientation, and behavioral flexibility. The study found that individuals with a high level of psychological flexibility cope better with traumatic events, have fewer PTSD symptoms, and recover faster. The conclusions note that well-developed psychological flexibility contributes to effective emotional management, adaptation to change, and finding constructive solutions in stressful situations. Thus, it is proved that developed psychological flexibility promotes recovery from trauma and reduces the negative impact of stress on health.
Keywords: PTSD, Psychological Flexibility, Assistance, Recovery.
Анотація
За даними Всесвітньої організації охорони здоров’я 70% населення повідомляють про переживання травматичних подій. Психологічна гнучкість, яка складається з прийняття, когнітивного дефузіювання, майндфулнесу, орієнтації на цінності та поведінкової гнучкості, є важливою для адаптації після травматичних ситуацій. Отже, метою дослідження є визначення ролі психологічної гнучкості у процесі відновлення після травматичних подій. У роботі використані методи аналізу літератури та спостереження. Зокрема, для збору релевантних наукових матеріалів використовувалися рекомендації PRISMA. Для включення літератури було розроблено 5 критеріїв, які стосувалися змісту, методології та часу написання (з 2014 до 2024 року). Загалом до вибірки потрапило 40 джерел. Результати показали, що психологічна гнучкість характеризується такими факторами, як сприйняття, когнітивне дефузіювання, майндфулнес, орієнтація на цінності та поведінкова гнучкість. Дослідження виявило, що особи з високим рівнем психологічної гнучкості краще справляються з травматичними подіями, мають менше симптомів ПТСР і швидше відновлюються. У висновках зазначено, що добре розвинута психологічна гнучкість сприяє ефективному управлінню емоціями, адаптації до змін і знаходженню конструктивних рішень у стресових ситуаціях. Таким чином, доведено, що розвинена психологічна гнучкість сприяє відновленню після травм і знижує негативний вплив стресу на здоров’я.
Ключові слова: ПТСР, психологічна гнучкість, допомога, відновлення після травми, психологічна адаптація.
Introduction
Background
The post-traumatic period is a time when a person is faced with the consequences of complex life events that may have left a deep emotional imprint on a person's mentality. At such a time, it is important to maintain internal balance and the ability to adapt even in a difficult period. One of the important factors that influence the process of recovery and order is psychological flexibility, which means the ability of an individual to remain stable and balanced even under conditions of stress or uncertainty. In some modern works, it is determined that it helps to avoid fixation on negative experiences and enables a better perception of reality and to find constructive ways of solving difficult situations.
Thus, the relevance of the topic of psychological flexibility in the post-traumatic period is becoming more and more noticeable in the environment of modern scientific discourse. This relevance can also be determined by the fact that in the modern world the number of stressful and traumatic events is increasing: military conflicts, natural disasters, pandemics or complex personal losses leave a deep impact on the psyche. Modern studies emphasize that in such conditions, the search for effective methods of mental health support becomes a necessity.
Problem Statement
Some facets of the concerns mentioned were partially taken into consideration by the scientists. First and foremost, it discusses the significance of psychological adaptability for mental health, the connection between social roles and different facets of contemporary interaction, and the investigation of many psychological and social elements in conjunction with the effects of the global environment on personality. The research environment is actively discussing the problem of creating universal questionnaires to measure psychological flexibility, which will also enable the establishment of links between psychological flexibility, individual temperament, and the measured level of stress.
The main problem of the study is that modern scientists have only partially paid attention to all components of the formation of adaptive flexibility in the process of overcoming PTSD processes. Therefore, this study will be aimed at analyzing a comprehensive consideration of the role of instruments for the formation of adaptive flexibility and determining their effectiveness against the background of comparing data obtained through observation and literature analysis. Thus, the research challenge is to determine the role of psychological flexibility as an important factor that contributes to adaptation in the post-traumatic period. At the same time, it is worth recognizing that psychological flexibility helps people better cope with the consequences of traumatic events and adapt to new living conditions.
Research Objectives
Therefore, the purpose of the study is to characterize the role of psychological flexibility in the process of recovery after traumatic events. The range of research questions is as follows:
By implementing this research, it will have potential not only in terms of scientific novelty, but also in terms of practical value. Therefore, this study can serve as a valuable basis for the formation of effective strategies for supporting people who have experienced traumatic events.
Literature review
Psychological Flexibility and Mental Well-being
The scientists partially considered certain aspects of the indicated problems. First of all, it is about the importance of psychological flexibility for mental health, the relationship between social roles and various aspects of modern interaction, the study of various psychological and social factors in combination with global environmental influences on individuality. In particular, the issue of developing universal questionnaires for measuring the level of psychological flexibility is being actively discussed in the research environment, which will also make it possible to establish connections between psychological flexibility, individual temperament and the obtained level of stress (Benoy et al., 2019; Cyniak-Cieciura, 2021; Fedoryshyn et al., 2024). In the future, such developments can be an important tool for understanding the phenomenon of psychological flexibility as a whole (Benoy et al., 2019). At the same time, other scientists are quite skeptical about the possibility of measuring psychological flexibility. Pointing out the difficulties of such a process, generally considering it an individual characteristic of each person (Doorley et al., 2020).
The importance of psychological flexibility as an element of recovery of the psychological state was immediately noted by several scientific teams: to increase the effectiveness of this indicator, a series of special trainings are offered that can improve this component, make it more effective during the recovery of certain social games, in particular, military personnel (Evans et al., 2023).
Psychological flexibility in coping with PTSD symptoms
Instead, other researchers also draw attention to the use of psychological flexibility in counteracting the symptoms of PTSD, investigating the specifics of the influence of this aspect on the consequences of receiving bodily injuries (mild brain injuries) (Faulkner et al., 2022), depression caused by postpartum depression (psychological flexibility in general is able to overcome this negative phenomenon) (Hu et al., 2024). It is important to note the social dimensions of the functioning of psychological flexibility as a tool for overcoming crisis phenomena of personality development.
First of all, attention is drawn to vulnerable categories of the population and the need to protect their health (Bhandari, 2024). Separately, it is worth pointing out the relationship between depressive syndromes and alcohol addiction, one of the mechanisms for counteracting which is psychological flexibility: the mechanism of its action is believed to be similar to overcoming the symptoms of PTSD (Napryeyenko et al., 2020). The social significance of this phenomenon is also noted in studies (Iastremska et al., 2023). An important aspect of this is the relationship between parents and adolescents, in which psychological flexibility enables both parties to better cope with conflicts and stressful situations (Moyer & Sandoz, 2015). The outlined research trends point to the importance of psychological flexibility as a factor influencing various aspects of mental health and social interaction.
Therefore, modern scientists have characterized various aspects of psychological flexibility for mental health, the relationship between social roles and various aspects of modern interaction. However, the establishment of a clear role for overcoming post-traumatic syndrome is poorly studied. This study will solve this problem and demonstrate important areas of development of psychological flexibility for mental health of people who have experienced PTSD.
Methodology
Research Design: Methods of observation and literature analysis will be used to realize the goal of researching the peculiarities of the formation of psychological flexibility as a factor of orderliness in the post-traumatic period. Thus, this study will belong to the mixed type.
Data collection: The PRISMA approach was chosen to search for relevant scientific literature. Various types of scientific sources have been chosen to include literature, including scientific articles, books, chapters from collective monographs, conference materials, etc. The following databases will be used for this: Scopus, PubMed and Google Scholar. Keywords such as psychological stability, post-traumatic period, recovery strategies after injuries, orderliness, stability are entered into the search databases.
The process of searching for sources took place from September to October 2024. The authors of the article paid attention to publications from such locations as Ukraine, the EU, the USA, and countries affected by military conflicts.
Previously, the authors were aware of 8 publications related to the topic of the study. 1789 results were initially found in the specified databases: Scopus, PubMed and Google Scholar. At the first stage of sampling, all duplicates were rejected - 321 results. After a short screening, which was based on the analysis of the found results, in particular, on the superficial analysis of titles, abstracts and keywords, 956 papers were obtained. The literature inclusion criteria were as follows:
Data Analysis: The method of systematization and coding was used for data analysis. In particular, the found sources are divided according to key topics: psychological flexibility, recovery strategies after trauma, post-traumatic events. This was done in order to later systematize the results. After that, the results were synthesized. The data obtained from the literature analysis will be used to confirm or refute theses, which are formed on the basis of observations.
Observation: An important part of this research was also the observation that was conducted among participants who experienced traumatic events, in particular, military actions. The sample of individuals was purposive. The authors included in the study individuals who had a clear diagnosis of PTSD, underwent rehabilitation and gave consent to follow-up on their condition. Thus, the authors of the article observed 23 individuals who had an officially confirmed diagnosis of PTSD. All participants underwent rehabilitation in Ukrainian mental and physical health support centers. All study participants gave consent to the processing of their data under conditions of anonymity.
Direct observation of participants in their natural environment or during specially organized meetings played an important role. This made it possible to obtain objective data on the behavior of persons who suffered from injuries in real situations. However, structured observation was not carried out in the work, therefore, the results will only record the experience of the authors and some important opinions regarding the peculiarities of the formation of psychological flexibility.
Data analysis of observation: The analysis of observation data included several stages in order to provide additional information about the behavior of individuals with PTSD. In particular, observation data were collected in naturalistic settings, where individuals with PTSD were engaged in structured and unstructured activities that were aimed at supporting their psychological and emotional well-being. Qualitative analysis tools (coding) were applied, based on the fact that information was systematically coded in special notebooks about each participant for recurring themes. In particular, the following recurring themes were identified: the use of psychological flexibility in practical settings, indicators of orderliness, behavioral signs of adaptation (development of new coping mechanisms). After that, the coded observations were compared with the main scientific findings contained in the sources. This was done in order to verify and contextualize new themes. In particular, behaviors that indicated psychological flexibility of the participants were compared with theoretical frameworks and empirical studies.
Synthesis and Interpretation
In this way, the main findings were synthesized into broader conclusions about the role of psychological flexibility in supporting recovery from trauma. The interpretation of the data focused on how these real-world observations align with or differ from existing models in the literature. The combination of observational studies and literature analysis provides a holistic approach to understanding the needs of children with posttraumatic stress disorder and the effectiveness of pedagogical interventions. So, as a result of combining the method of observation and analysis of the literature, an understanding of the importance of psychological flexibility in orderliness and adaptation after traumatic events was obtained.
Results and Discussion
Results: In their lives, the majority of people will go through at least one traumatic event (Bardeen & Fergus, 2016). For instance, the World Health Organization (WHO) evaluated trauma exposure in 24 countries (n = 68,894) in a series of epidemiological surveys. 70% of the participants said they had experienced one or more traumatic incidents. Estimates of lifetime trauma exposure in the United States may reach 90% based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (Jeffords et al., 2020), which includes Criterion A for Posttraumatic Stress Disorder (PTSD). A significant proportion of trauma survivors will have post-traumatic stress disorder (PTSD), although the majority of people who endure a traumatic event will recover naturally. Finding the causes and aggravating variables of posttraumatic stress disorder (PTS) symptoms is crucial because of the high levels of anguish and functional impairment linked to PTSD.
The dominance of psychological reactions over selected values and circumstances in directing actions is known as psychological inflexibility, and it is one of the factors that may support and exacerbate trauma (Bruno et al., 2024; Puolakanaho et al., 2020). Thus, developed psychological flexibility allows you to freely respond to life's challenges and not get stuck on negative thoughts or emotions. In addition, it also helps to find constructive ways of adapting to new situations. Therefore, psychological flexibility is important in stressful situations or in conditions of uncertainty. Its main components are formed from acceptance, which means the ability to consciously perceive one's thoughts and emotions, cognitive defusion, that is, the ability to distance oneself from one's thoughts and perceive them as temporary phenomena, contact with the current moment (mindfulness), value orientation, the ability to act in accordance with one's own principles and values, flexibility of behavior (ability to take responsibility for one's actions) (See Figure 3).
According to the findings of a latent profile analysis, psychological inflexibility and psychological inflexibility can actually change over time apart and are significantly different from one another (Lysetskyi et al, 2024). Cross-sectional study results show that elements of psychological rigidity are linked to different types of psychopathology, including eating disorders, mood disorders, anxiety disorders, drug use disorders, and particularly post-traumatic stress disorder (PTS) (Wersebe et al., 2018). Observation of 23 individuals in Ukraine showed that most individuals had problems with emotional regulation, which consisted of sudden emotional outbursts or a prolonged state of anxiety (70%). Only 10% of individuals had stable emotional stability. In 65% of individuals, there was a noticeable desire to avoid certain activities that could remind them of the traumatic experience. At the same time, 40% showed increased irritability in social situations. In the vast majority of individuals, hyperactivity or inattention during task performance was noticeable. Table 1 shows the main indicators for the observed individuals
Table 1.
Indicators of individuals subject to observation
Experiential avoidance and cognitive fusion have been repeatedly shown to be significantly positively linked with PTS symptoms in a number of cross-sectional studies. Studies have shown varying degrees of connection between PTS symptoms and experience avoidance as well as between PTS symptoms and cognitive fusion.
Figure 4 illustrates the relationships between psychological inflexibility, its components, and various psychopathologies, with a particular focus on PTSD. In this figure, the central block expresses the psychological inflexibility from which two key components derive: experiential avoidance and cognitive fixation. These components have notable connections with PTSD and other psychopathologies (mood disorders, anxiety disorders, eating disorders, etc.).
The other four areas of psychological inflexibility - loss of engagement with the present moment, self as content, inaction, and lack of contact with values - and PTS symptoms have been the subject of relatively few published studies (Benfer et al., 2021; Daneshvar et al., 2022). Nevertheless, in certain research, it was discovered that PTS symptoms in adult veterans or active military personnel were substantially positively correlated with each category of psychological inflexibility. The magnitude of these effects varied from medium to considerable (rs = 0.44 – 66). Furthermore, a stepwise regression analysis showed that, when all six psychological inflexibility categories were included in the analysis, cognitive fusion, experiential avoidance, inaction, and lack of engagement with the present moment were all substantially linked with PTS symptoms (Daneshvar et al., 2022).
During the development of psychological flexibility skills, 60% of individuals had difficulty adapting to structured learning tasks. Only 30% were able to complete the tasks correctly, but with the support of specialists. Only 10% of the observed individuals demonstrated high adaptability. Also, only 25% (6 individuals) were able to effectively express the basic signs of psychological flexibility in a changing environment. At the same time, 75% (17 individuals) expressed the need for additional measures to develop this quality. Progress was also noticeable during the observation. For example, after observation in structured conditions with the support of teachers, 40% expressed improvements in emotional regulation and social interaction skills. At the same time, 25% expressed a greater desire to participate in group activities. 15% of individuals demonstrated progress in performing individual adaptive tasks. So, there is a connection between the level of psychological flexibility and adaptation after traumatic situations. Psychological flexibility plays a prominent role in the recovery process after trauma (Bennett & Oliver, 2019; Hu et al., 2024). In particular, individuals with a high level of psychological flexibility are better able to cope with traumatic events, because they are able to respond flexibly to stressful conditions and avoid excessive emotional reactions. In addition, developed psychological flexibility makes it possible to manage emotions, find new ways to solve problems and not be in negative experiences. In turn, this helps to reduce the impact of stress on the individual's mental health and thus contributes to its recovery.
Table 1.
Impact of psychological flexibility on health
So, these examples record the impact of psychological flexibility on the process of adaptation and recovery after difficult and traumatic events in a person's life.
Discussion: The proposed article is devoted to the characteristics of the role of psychological flexibility during recovery after traumatic events. In particular, the theoretical foundations of psychological flexibility and its components were analyzed, the connection between the level of psychological flexibility and adaptation after traumatic situations was determined, and the peculiarities of the influence of psychological flexibility on the recovery process after traumatic events were characterized.
First of all, it was established that psychological flexibility makes it possible to find constructive ways of adapting to modern situations, which makes it an important element of stability in stressful situations and conditions of uncertainty. This confirms the scientists' conclusions that its absence poses a threat to the psychological health of individuals even in the absence of aggravating circumstances, including PTSD (Daneshvar et al., 2022; Fonseca et al., 2020; Pyszkowska, 2020). It also proves the validity of the results of those researchers who consider psychological flexibility one of the mandatory components for recovery after suffering complex psychological traumas (Bardeen & Fergus, 2016; Filonenko et al. (2022); Gloster et al., 2021; Kroska et al., 2020). На основі спостеререження визначено, що більшість осіб мали проблеми із емоційною регуляцією, що полягало у раптових емоційних спалахах або тривалому стані тривоги, водночас, у деяких осібах помітним було бажання уникннути певних видів діяльності, які могли нагадати їм про травматичний досвід. Це корелюється із результатами інших вчених, у яких вказано на основні проблеми із емоційною адаптацією осіб із ПТСР (Fonseca et al., 2020; Pyszkowska, 2020). Under such circumstances, understanding the importance of its components is quite relevant in the recovery process. It was established that such components are acceptance (the ability to consciously perceive one's thoughts and emotions), cognitive defusion (the ability to distance oneself from thoughts and perceive them as temporary phenomena), value orientation (the ability to act in accordance with one's own principles and values), flexibility in behavior (the ability take responsibility for one's actions). Researchers also point to a communicative skill, which also involves the ability to communicate and at the same time distance yourself from the opinions of other people (Pyszkowska, 2020; Stepanova et al., 2023). However, such conclusions are ambiguous. Some scientists point out that such conclusions have not yet received a proper empirical basis (Bruno et al., 2024; Marshall & Brockman, 2016; McCracken & Morley, 2014). It is worth agreeing with such cautious assessments, because after studying the scientific literature, no proper evidence of the existence of such an element was found.
During the observation, it was found that during the development of psychological flexibility skills, 60% of people had difficulties adapting to structured learning tasks, while 30% were able to complete the tasks correctly, but with the support of specialists. 25% were able to effectively express the main signs of psychological flexibility in a changing environment. The study also identified progress that was noticeable during the observation. In conditions of support, 40% expressed improvements in emotional regulation and social interaction skills. At the same time, 25% expressed a greater desire to participate in group activities. 15% of people demonstrated progress in completing individual adaptation tasks. Therefore, there is a connection between the level of psychological flexibility and adaptation after traumatic situations. Similar conclusions were obtained in other studies, where it was also emphasized that in the field of combating PTSD, the presence of high psychological flexibility is an indisputable advantage (Bruno et al., 2024; Daneshvar et al., 2022; Plys et al., 2023). In addition, it is worth agreeing with the opinion of scientists that the development of psychological flexibility makes it possible to manage one's own experiences and emotions, not to fall into dependence on them, and to maintain mental health (Wersebe et al., 2018). In view of this, further searches for opportunities for the integration of special trainings on the development of psychological flexibility for persons suffering from PTSD look promising.
The results also demonstrate the specifics of the impact of psychological flexibility on the recovery process after traumatic events. It is primarily about adaptation to normal life after serious illnesses, overcoming the consequences of traumatic events, rehabilitation after injuries. The obtained results confirm the scientists' conclusions that individuals with a high degree of psychological flexibility are much better able to overcome the consequences of traumatic events (Lysetskyi et al., 2024; McCracken et al., 2021; Reiff & Feldman, 2014; Whiting et al., 2017). Thanks to this, effective recovery is possible, which, moreover, takes place in shorter chronological intervals.
Therefore, the results of this study, which identified the importance of psychological flexibility in promoting disorder and adaptation in individuals with PTSD, have significant implications for clinical practice. Also, they constitute an important theoretical basis for the development of interventions with trauma outcomes. Thus, it is proven that psychological flexibility can be a basis in the system of planning therapeutic and pedagogical interventions. An important value is that approaches based on importance can be adapted for the younger population as well. In the future, this will give you the opportunity to improve your ability to adapt to change and effectively cope with stress. The proposed study is based on the use of a methodology that has certain limitations. First of all, it is about using a limited number of scientific works, the selection of which is determined by applied criteria. Instead, the emphasis was placed on English-language articles, while other studies written in other languages may have had relevant ideas that were not properly taken into account. Overall, this limitation does not affect the relevance of the study, as the studies analyzed focus largely on the study of coping with the consequences of PTSD, with relevant references to important non-English-language works. Accordingly, this aspect has been indirectly taken into account, although in general the problem of studying psychological flexibility based on a more thorough study of individual national experiences will still need further updating.
Conclusions
Hence, the paper shows that most people experience at least one traumatic event in their lifetime, with up to 70% of people in some countries reporting having experienced one or more such incidents, and in the US this figure can be as high as 90%. Although a significant number of trauma survivors may develop PTSD, most people recover naturally from trauma. Therefore, it is important to investigate the causes and factors that worsen PTSD symptoms. One of them is psychological inflexibility, which consists in the dominance of psychological reactions over values and circumstances, which can contribute to and exacerbate trauma. Instead, psychological flexibility is essential for successful adaptation to stressful situations and conditions of uncertainty. It includes acceptance, cognitive diffusion, contact with the present moment (mindfulness), value orientation and behavioral flexibility. It has been established that psychological inflexibility and psychological flexibility can change separately from each other over time and are significantly different from each other. Cross-sectional studies have shown that elements of psychological inflexibility are associated with different types of psychopathology, for example, eating disorders, mood disorders and anxiety disorders.
Moreover, the findings contribute to a deeper understanding of the role of psychological flexibility and inflexibility as distinct constructs in trauma recovery. The differentiation between these constructs underscores the need for refined theoretical models that explore their independent trajectories and interplay in psychopathology development and resolution.
This article also makes a significant contribution to trauma psychology by:
Bibliographic references
Bardeen, J. R., & Fergus, T. A. (2016). The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms. Journal of Contextual Behavioral Science, 5(1), 1–6. https://doi.org/10.1016/j.jcbs.2016.02.002
Benfer, N., Spitzer, E. G., & Bardeen, J. R. (2021). Efficacy of third wave cognitive behavioral therapies in the treatment of posttraumatic stress: A meta-analytic study. Journal of Anxiety Disorders, 78, 102360. https://doi.org/10.1016/j.janxdis.2021.102360
Bennett, R., & Oliver, J. E. (2019). Psychological flexibility. In R. Bennett & J. E. Oliver (Eds.), Acceptance and Commitment Therapy (1st ed., pp. 57–58). Routledge. https://doi.org/10.4324/9781351056144-24
Benoy, C., Knitter, B., Knellwolf, L., Doering, S., Klotsche, J., & Gloster, A. T. (2019). Assessing psychological flexibility: Validation of the Open and Engaged State Questionnaire. Journal of Contextual Behavioral Science, 12, 253–260. https://doi.org/10.1016/j.jcbs.2018.08.005
Bhandari, M. P. (2024). Past and Present of Social Inequality: Analysing Structure and Future Trends. Futurity of Social Sciences, 1(3), 47–60. https://doi.org/10.57125/FS.2023.09.20.04
Bruno, F., Vozzo, F., Arcuri, D., Maressa, R., La Cava, E., Malvaso, A., Lau, C., & Chiesi, F. (2024). The longitudinal association between Perceived Stress, PTSD Symptoms, and Post-Traumatic Growth during the COVID-19 Pandemic: The role of coping strategies and psychological inflexibility. Current Psychology, 43(15), 13871–13886. https://doi.org/10.1007/s12144-022-03502-3
Cheng, Z. H., Lozier, C. C., Lewis, M. M., O’Neil, M. E., Luoma, J. B., & Morasco, B. J. (2021). Investigating the role of psychological inflexibility, mindfulness, and self-compassion in PTSD. Journal of Contextual Behavioral Science, 22, 102–107. https://doi.org/10.1016/j.jcbs.2021.10.004
Cherry, K. M., Hoeven, E. V., Patterson, T. S., & Lumley, M. N. (2021). Defining and measuring “psychological flexibility”: A narrative scoping review of diverse flexibility and rigidity constructs and perspectives. Clinical Psychology Review, 84, Article 101973. https://doi.org/10.1016/j.cpr.2021.101973
Choi, H., & Lee, S. (2023). The Structural Relationships between Interpersonal Stress, Cognitive Flexibility, Self-Compassion, and Psychological Well-Being of College Students. Future Oriented Youth Society, 20(4), 155–177. https://doi.org/10.34244/JFOYS.2023.20.4.7
Cyniak-Cieciura, M. (2021). Psychological flexibility, temperament, and perceived stress. Current Issues in Personality Psychology, 9(4), 306–315. https://doi.org/10.5114/cipp.2021.108685
Daneshvar, S., Basharpoor, S., & Shafiei, M. (2022). Self-compassion and cognitive flexibility in trauma-exposed individuals with and without PTSD. Current Psychology, 41(4), 2045–2052. https://doi.org/10.1007/s12144-020-00732-1
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. https://doi.org/10.1111/spc3.12566
Evans, W. R., Meyer, E. C., Moore, B. A., & Peterson, A. L. (2023). Psychological flexibility training to enhance resilience in military personnel. Military Behavioral Health, 1–13. https://doi.org/10.1080/21635781.2023.2246900
Faulkner, J. W., Snell, D. L., & Theadom, A. (2022). Psychological flexibility moderates the influence of fear avoidance on outcomes after mild traumatic brain injury. Brain Injury, 36(8), 991–999. https://doi.org/10.1080/02699052.2022.2109747
Fedoryshyn, H., Lukіianchuk A., Zelenin, V., Lunchenko, N., & Ivashchenko, A. (2024). The role of psychology in the formation of emotional intelligence in Ukrainian education. Amazonia Investiga, 13(76), 297–307. https://doi.org/10.34069/AI/2024.76.04.24
Filonenko, L., Demchenko, I., Shakhina, I., Klochok, O., Borozentseva, Т., & Bieloliptsev, V. (2022). Developing a Values-Based Attitude towards People in Adolescent Rehabilitation Centres: Neurophysiological Patterns. BRAIN. Broad Research in Artificial Intelligence and Neuroscience, 13(2), 76–96. https://doi.org/10.18662/brain/13.2/333
Fonseca, S., Trindade, I. A., Mendes, A. L., & Ferreira, C. (2020). The buffer role of psychological flexibility against the impact of major life events on depression symptoms. Clinical Psychologist, 24(1), 82–90. https://doi.org/10.1111/cp.12194
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. https://doi.org/10.1016/j.jcbs.2021.09.001
Gorday, J. Y., Bardeen, J. R., Rogers, T. A., & Benfer, N. (2023). A prospective examination of the role of psychological (in)flexibility in posttraumatic stress: A cross-lagged panel design. Journal of Anxiety Disorders, 97, Article 102725. https://doi.org/10.1016/j.janxdis.2023.102725
Hu, N., Luo, J., Xiang, W., Yang, G., Huang, T., Guan, L., Xu, J., & Peng, B. (2024). The relationship between postpartum negative life events and postpartum depression: A moderated mediation model of neuroticism and psychological flexibility. BMC Psychiatry, 24(1), Article 147. https://doi.org/10.1186/s12888-024-05594-6
Iastremska, O., Tryfonova, O., Mantaliuk, O., & Baranets, H. (2023). The impact of strategic decisions on the future development of organisations and economic dynamics. Futurity Economics & Law, 3(4), 117–134. https://doi.org/10.57125/FEL.2023.12.25.08
Jeffords, J. R., Bayly, B. L., Bumpus, M. F., & Hill, L. G. (2020). Investigating the Relationship Between University Students’ Psychological Flexibility and College Self-Efficacy. Journal of College Student Retention: Research, Theory & Practice, 22(2), 351–372. https://doi.org/10.1177/1521025117751071
Kashdan, T. B., Disabato, D. J., Goodman, F. R., Doorley, J. D., & McKnight, P. E. (2020). Understanding psychological flexibility: A multimethod exploration of pursuing valued goals despite the presence of distress. Psychological Assessment, 32(9), 829–850. https://doi.org/10.1037/pas0000834
Kroska, E. B., Roche, A. I., Adamowicz, J. L., & Stegall, M. S. (2020). Psychological flexibility in the context of COVID-19 adversity: Associations with distress. Journal of Contextual Behavioral Science, 18, 28–33. https://doi.org/10.1016/j.jcbs.2020.07.011
Landi, G., Pakenham, K. I., Mattioli, E., Crocetti, E., Agostini, A., Grandi, S., & Tossani, E. (2022). Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility. Journal of Contextual Behavioral Science, 26, 44–55. https://doi.org/10.1016/j.jcbs.2022.08.008
Lysetskyi, B., Vesova, O., Kindras, I., Kryvosheieva, A., Kaminskyy, V. (2024). Theoretical medicine: The foundation of the future of medicine. Futurity Medicine, 3(2), 45–56. https://doi.org/10.57125/FEM.2024.06.30.05
Marshall, E.-J., & Brockman, R. N. (2016). The Relationships Between Psychological Flexibility, Self-Compassion, and Emotional Well-Being. Journal of Cognitive Psychotherapy, 30(1), 60–72. https://doi.org/10.1891/0889-8391.30.1.60
McCracken, L. M., & Morley, S. (2014). The Psychological Flexibility Model: A Basis for Integration and Progress in Psychological Approaches to Chronic Pain Management. The Journal of Pain, 15(3), 221–234. https://doi.org/10.1016/j.jpain.2013.10.014
McCracken, L. M., Badinlou, F., Buhrman, M., & Brocki, K. C. (2021). The role of psychological flexibility in the context of COVID-19: Associations with depression, anxiety, and insomnia. Journal of Contextual Behavioral Science, 19, 28–35. https://doi.org/10.1016/j.jcbs.2020.11.003
Moyer, D. N., & Sandoz, E. K. (2015). The Role of Psychological Flexibility in the Relationship Between Parent and Adolescent Distress. Journal of Child and Family Studies, 24(5), 1406–1418. https://doi.org/10.1007/s10826-014-9947-y
Napryeyenko, O., Marazziti, D., Napryeyenko, N., Loganovsky, K., Mucci, F., Loganovskaja, T., & Tsekhmister, Y. (2020). Depressive syndromes associated with alcohol dependence. Clinical Neuropsychiatry, 16(5-6), 206–212. https://doi.org/10.36131/clinicalnpsych2019050603
Plys, E., Jacobs, M. L., Allen, R. S., & Arch, J. J. (2023). Psychological flexibility in older adulthood: A scoping review. Aging & Mental Health, 27(3), 453–465. https://doi.org/10.1080/13607863.2022.2036948
Pryzvanska, R., Borysova, O., Mozgova, G., & Fedorenko, A. (2024). Clinical cases and recommendations for post-traumatic rehabilitation based on EI. Amazonia Investiga, 13(74), 227–238. https://doi.org/10.34069/AI/2024.74.02.19
Puolakanaho, A., Tolvanen, A., Kinnunen, S. M., & Lappalainen, R. (2020). A psychological flexibility -based intervention for Burnout:A randomized controlled trial. Journal of Contextual Behavioral Science, 15, 52–67. https://doi.org/10.1016/j.jcbs.2019.11.007
Pyszkowska, A. (2020). Personality predictors of self-compassion, ego-resiliency and psychological flexibility in the context of quality of life. Personality and Individual Differences, 161, Article 109932. https://doi.org/10.1016/j.paid.2020.109932
Reiff, M. I., & Feldman, H. M. (2014). Diagnostic and Statistical Manual of Mental Disorders: The Solution or the Problem?. Journal of Developmental & Behavioral Pediatrics, 35(1), 68–70. https://doi.org/10.1097/DBP.0000000000000017
Rysbayeva, Z. I., & Tormanova, A. N. (2023). The Philosophy of Medicine: On the Ethical Discussion about the Life and the Death. Futurity Philosophy, 2(4), 61–74. https://doi.org/10.57125/FP.2023.12.30.04
Stepanova, N., Pletenytska, L., & Zakharina, T. (2023). The role of communication between parents and teachers in the implementation of electronic learning elements in secondary school. E-Learning Innovations Journal, 1(2), 21–38. https://doi.org/10.57125/ELIJ.2023.09.25.02
Watts, R., & Luoma, J. B. (2020). The use of the psychological flexibility model to support psychedelic assisted therapy. Journal of Contextual Behavioral Science, 15, 92–102. https://doi.org/10.1016/j.jcbs.2019.12.004
Wersebe, H., Lieb, R., Meyer, A. H., Hofer, P., & Gloster, A. T. (2018). The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention. International Journal of Clinical and Health Psychology, 18(1), 60–68. https://doi.org/10.1016/j.ijchp.2017.09.002
Whiting, D. L., Deane, F. P., Simpson, G. K., McLeod, H. J., & Ciarrochi, J. (2017). Cognitive and psychological flexibility after a traumatic brain injury and the implications for treatment in acceptance-based therapies: A conceptual review. Neuropsychological Rehabilitation, 27(2), 263–299. https://doi.org/10.1080/09602011.2015.1062115
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