Substance abuse and psychological flexibility: The development of a new measure

Psychological flexibility is a relatively new clinical construct targeted by Acceptance and Commitment Therapy, a behavior analytic treatment incorporating mindfulness and values interventions, among other processes. Poor psychological flexibility has been shown to relate to clinical problems as well as normative life challenges, and efforts to increase psychological flexibility have correlated with improvements for a variety of psychological difficulties, including substance abuse. The Acceptance and Action Questionnaire (AAQ) is currently the standard measure of psychological flexibility, but in substance misusing samples, has not shown adequate psychometric properties. Content-specific variants of the AAQ have been effective in other treatment domains, suggesting that a substance abuse focused version of the AAQ may be useful. This article details the construction and initial validation of such a measure, the AAQ-SA, which demonstrated good internal consistency, factor structure, and construct validity. In addition, the AAQ-SA appeared to be empirically distinguishable from the AAQ. Future researchers are advised to address limitations of this study and encouraged to expand the empirical database on substance abuse treatment with this new measure.