Abstract. Experiential avoidance, the tendency to rigidly escape or avoid private psychological experiences, represents one of the most prominent transdiagnostic psychological processes with a known role in a wide variety of psychological disorders and practical contexts. Experiential avoidance is argued to be based on a fundamental verbal/cognitive process: an overextension of verbal problem solving into the world within. Although cultures apparently differ in their patterns of emotional expression, to the extent that experiential avoidance is based on a fundamental verbal/cognitive process, measures of this process should be comparable across countries, with similar relationships to health outcomes regardless of the language community. This research tests this view in European countries. The psychometric properties of the Acceptance and Action Questionnaire-II, a measure of experiential avoidance, are compared across six languages and seven European countries, for a total of 2,170 nonclinical participants. Multiple group analysis showed that the instrument can be considered invariant across the language samples. The questionnaire constitutes a unidimensional instrument with similar relationships to psychopathology, and has good and very similar psychometric properties in each assessed country. Experiential avoidance reveals not just as transdiagnostic, but also as a transcultural process independent of a specific language community.

In the literature on bereavement, claims are made that homicidal loss is associated with posttraumatic stress reactions, depression, and other severe mental health problems. It is surprising that only a few studies have investigated the nature and prevalence of emotional symptoms following homicidal bereavement and a reference to systematic, empirical research is seldom provided. This article reviews the available literature to investigate whether these claims have empirical evidence. Three databases were searched to identify relevant studies. This approach was supplemented with a bibliography search. Eligible studies included English-language peer-reviewed articles that assessed psychopathology in the homicidally bereaved, as defined in the Diagnostic and Statistical Manual of Mental Disorders. Of the 360 potentially relevant articles, 8 studies (13 references) met predefined inclusion criteria. Homicide-related psychopathology among the bereaved assessed in these studies includes posttraumatic stress disorder (PTSD), depression, complicated grief, and substance abuse. Prevalence of lifetime homicide-related PTSD varied from 19.1% to 71% across studies. Current PTSD varied between 5.2% and 6%. The reviewed literature was inconclusive regarding the course of symptoms over time and the severity of psychopathology among the homicidally bereaved, compared to individuals bereaved by other causes of death. A comparison of the nature and prevalence of psychopathology between studies was complicated by unequal sample sizes and type, recruitment strategy, study design, and time since loss. Limitations of the included studies are discussed, as well as implications for clinical practice, policy, and future research.

Introduction: Pain related fear and pain intensity have been identified as factors negatively influencing Functional Capacity Evaluation (FCE) performances in patients with CLBP. Conflicting results have been reported in the literature. The objective of this study was to analyze the relationships between pain intensity and pain-related fear on the one hand, and performances during an FCE on the other hand in two samples of patients with chronic low back pain (CLBP). Methods: Two cross sectional observation studies were performed with two samples of patients with CLBP (study 1: n = 79; study 2: n = 58). Pain related fears were operationally defined as the score on the Tampa Scale of Kinesiophobia in study 1, and the Fear Avoidance Beliefs Questionnaire (FABQ) in study 2. Pain intensity was measured with a Numeric Rating Scale in both studies. Avoidance behavior observed during FCE was in both studies operationally defined as the unwillingness to engage in high intensity performance levels of three different functional activities: high intensity lifting, prolonged standing in a forward bend position, and fast repetitive bending at the waist. Results: A total of 25 correlations between pain and pain related fear, and performance variables were calculated, out of which 7 were significant (p < 0.05). The strength of these significant correlations ranged from r = − 0.23 to r = − 0.50. Multivariate linear regression analyses revealed non-significant relationships in most instances. Pain and pain related fear contributed little if any to these models. Conclusions: [247][248][249][250][251][252][253][254][255][256][257][258] The relation between pain and pain related fear and FCE performance is weak or non-existent in patients with CLBP.

Psychological flexibility receives increasing attention as the overarching process in Acceptance and Commitment Therapy (ACT). This study investigates the psychometric properties of the Psychological Inflexibility in Pain Scale (PIPS), measuring “avoidance” and “cognitive fusion” with pain, in a heterogeneous clinical sample of 428 chronic pain patients from four rehabilitation centers. Furthermore, the relationship between the PIPS and mindfulness (Five Facet Mindfulness Questionnaire, FFMQ) as a theoretically related measure within ACT is explored. Confirmatory factor analyses replicated acceptable/good model fit and internal consistencies. In a subsample from two rehabilitation centers (n = 237), the PIPS showed moderate to high relationships with aspects of mindfulness, pain interference in daily life, pain disability and mental health, and small relationships with pain intensity and physical functioning. The avoidance subscale explained additional variance in outcome variables beyond the FFMQ, ranging from 4.5 to 15.8%. Outcomes support the psychometric properties of the PIPS in a heterogeneous chronic pain sample. The PIPS and FFMQ measure slightly overlapping, but distinct constructs, and can be used complementary to assess a broad range of processes within ACT. Potential problems with the cognitive fusion subscale are acknowledged for future research.