Child Psychiatry Hum Dev DOI 10.1007/s10578-014-0495-x
ORIGINAL ARTICLE
Development of the Parental Psychological Flexibility Questionnaire Kylie Burke • Susan Moore
Ó Springer Science+Business Media New York 2014
Abstract This paper describes development and validation of the Parental Psychological Flexibility (PPF) Questionnaire, a parent-report measure designed to assess psychological flexibility among parents of pre-adolescents and adolescents (aged 10–18 years). Psychological flexibility within parenting refers to parents’ accepting negative thoughts, emotions and urges about one’s child and still acting in ways that are consistent with effective parenting. Exploratory factor analysis (n = 178 parents) of a 43-item draft measure, resulted in a 30-item, 3-factor structure. Three subscales were created, consistent with the psychological flexibility literature: acceptance, cognitive defusion and committed action. A second sample of parents (n = 192) was then used to confirm the factor structure and reliability and validity of the PPF. Results supported the 3-factor structure, reduced the number of items to 19 and demonstrated that the PPF subscales have adequate reliability and validity and are thus suitable for researching psychological flexibility among parents of pre-adolescents and adolescents. Keywords Parenting Psychological flexibility Questionnaire development Adolescents
K. Burke S. Moore Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, VIC, Australia K. Burke (&) Parenting and Family Support Centre, School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia e-mail:
[email protected]
Introduction For parents, raising children results in what Jon Kabat-Zinn describes as the ‘‘full catastrophe’’ of human emotions [1], from joy to despair, pride to anger. Most parents would understandably prefer to experience only the positive thoughts and emotions without ever having to experience the more negative and difficult ones. Hayes and colleagues [2] suggest that rather than deny or avoid negative internal experiences, such as emotions, thoughts and physical sensations, it is important to learn that these negative private events are as much a part of life as the positive experiences and that there are ways to accept and live with them while still acting effectively. Further, they suggest that one of the primary causes of psychological difficulty is an individual’s unwillingness to remain in contact with particular private experiences (e.g., bodily sensations, thoughts, emotions, memories, urges). This unwillingness then results in ‘experiential avoidance’, in which the individual engages in actions that try to change the frequency and content of those events and the contexts where they occur, even though doing so is accompanied by a behavioral cost [3]. The notion of ‘psychological flexibility’ underpins these processes. Defined as ‘‘to fully contact the present moment and the thoughts and feelings it contains without needless defense, and, depending upon what the situation affords, persisting in or changing behavior in the pursuit of goals and values,’’ [4] psychological flexibility refers to a process of making appropriate choices and taking considered action even when those choices/actions are accompanied by difficult/painful thoughts, memories, emotions or sensations. A person who is psychologically flexible will have a broad array of strategies (both physical and cognitive) they can implement according to the demands of a situation and
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their own values [4]. In parenting, this means accepting negative thoughts, emotions and urges (such as anger, selfdoubt or desire to yell) in relation to one’s child as they arise, while also managing to act in ways that maintain the parent–child relationship and are consistent with good parenting practices, such as expressing warmth and providing boundaries. For example, rather than engage in an angry exchange with an adolescent who is late home and under the influence of alcohol, the psychologically flexible parent is more likely to express their concern and disappointment briefly, help the child to bed and indicate the intention to discuss the issue on the following day, at which point a more productive discussion of expectations, sanctions and options may be possible. Six overlapping and interrelated processes underpin psychological flexibility: (a) acceptance (the willingness to experience private events without attempting to change their frequency or form); (b) cognitive defusion (the ability to separate thoughts, emotions, physical sensations and urges from the assessment of actual events and to choose behaviours that are likely to be effective for their context, thus meaning the individual recognises that their private events do not control their actions); (c) mindfulness (being psychologically present in each moment, bringing full awareness to one’s actions); (d) self-as-context (recognition that an individual is more than the sum total of their private events or any single conceptualisation of who they are, rather there is self is who experiences the events of their life but that is also continuous and distinct from those events); (e) values (the personally chosen guiding principles that set the direction for a person’s life and provide them with a sense of purpose); and (f) committed action (responses that are chosen flexibly, dependent on the individual’s specific context and in line with their values) [1, 2, 5]. Research on the role of psychological flexibility in parenting is in its infancy with limited evidence relating to whether interventions promoting this approach in parents are beneficial for parents and their children [6]. Published, larger scale experimental design studies are still needed. However, several studies have linked aspects of psychological inflexibility, such as experiential avoidance, in parents with mental health problems in mothers [7, 8]. For example, Shea and Coyne [7] in their study of the relationship between experiential avoidance, depression, parenting style and child behavior in a high-risk sample of 144 parents of preschool aged children found that parents who attempted to manage their symptoms of depression by avoiding their difficult thoughts and emotions were at risk for high levels of stress relating to their parenting and were likely to use more ineffective parenting practices, such as over-reaction to mild child behavior problems, harsh or inconsistent discipline
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practices or laxness in regard to more serious child behavior difficulties. A critical step in assessing psychological flexibility as it applies to parenting is to be able to define the construct within the parenting context. One way to define a construct is to attempt to operationalise and measure it via a scale. This can have the effect of both narrowing down the theoretical concept under consideration and broadening the elaboration of it, due to the necessity of generating items that exemplify the concept. As research on the impact of psychological inflexibility/flexibility has progressed, a number of scales have been developed to measure its associated processes, although not within the general parenting field [9–11]. The Acceptance and Action Questionnaire [AAQ; 12] is perhaps the most well-known and is a general measure of psychological flexibility/inflexibility The original version of the scale was reported to have only moderate internal consistency and an unstable factor structure [12], however, a recent revision of the measure has demonstrated good psychometric properties with the AAQ predicting outcomes such as job satisfaction, depression and anxiety [4, 13]. Concerns that general measures of psychological flexibility/inflexibility are less useful than measures targeted to specific developmental, social or individual situations have led to the development of context or population-specific scales such as the Chronic Pain Acceptance Questionnaire [CPAQ; 11]; and the Acceptance and Action Diabetes Questionnaire [AADQ; 10]. One measure, the 15-item Parental Acceptance and Action Questionnaire [PAAQ; 14] targets psychological flexibility in parents of children with anxiety disorders. Specifically, the scale measures parental unwillingness to witness a child’s negative emotions (Unwillingness) and parental ability to manage their own responses to their child’s emotions (Inaction). To date no measure has been published that measures psychological flexibility within a general parenting context. Yet parenting primarily occurs outside a clinical setting and involves parents managing responses to their own private experiences (thoughts, feelings, physical sensations, urges) about their child’s emotions, beliefs and behaviors while also dealing with private experiences relating to the myriad of other responsibilities, relationships and activities associated with everyday living. This paper describes the development and validation of the Parental Psychological Flexibility Questionnaire (PPF), a parent report measure designed to assess psychological flexibility in the general context of parenting children aged 10–18 years, that is, pre-adolescents and adolescents. The paper is divided into two parts. Part 1 describes the development of items and establishment of scale properties using Exploratory Factor Analysis. Part 2, with a new sample, describes the re-analysis of the factor structure of
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the measure via Confirmatory Factor Analysis, to provide further reliability and to assess the validity of the scale. The aim of the studies was to develop a measure of psychological flexibility in parents that has a stable structure with adequate construct and content validity.
Method Participants Characteristics of participants and their children in Parts 1 and 2 of the study are provided in Table 1. Part 1 participants were 178 parents of preadolescents and adolescents aged between 10 and 18 years (M = 14 years; SD = 2.1 years). The Part 1 sample comprised 158 (89 %) mothers and 20 (11 %) fathers. Part 2 participants were 192 parents of preadolescents and adolescents aged between 10 and 18 years (M = 14 years; SD = 2.2 years). The Part 2 sample comprised 172 (90 %) mothers and 20 (10 %) fathers. Procedure Each study received ethics approval from Swinburne University’s Human Research Ethics Committee. Parents Table 1 Participant characteristics Part 1 (n = 178) %
Part 2 (n = 192) %
Australian born
83
86
Parent age (M: SD)
48.77 (7.91)
44 (6.5)
Family structure Original 2 parent
168 (67 %)
127 (66 %)
Sole
44 (18 %)
35 (18 %)
Step
28 (11 %)
27 (14 %)
Other
10 (4 %)
2 (2 %)
Home duties
37 (15 %)
39 (20 %)
Part time employed
96 (38 %)
84 (44 %)
Full time employed
117 (47 %)
69 (36 %)
53 (21 %)
46 (25 %)
22 (9 %)
37 (19 %)
Employment status
Highest education Year 12 or less Trade/TAFE
a
Tertiary
82 (33 %)
45 (23 %)
Post graduate
93 (37 %)
64 (33 %)
54 %
50 %
Child gender Male a
Trade/TAFE refers to completion of an apprenticeship and/or training in vocational and industry related courses (e.g., Building and Construction, Hospitality, Hairdressing and beauty) at a Technical and Further Education Institute (TAFE)
for both parts of the study were recruited using a range of promotional activities, including advertising the survey on parenting websites, media releases to local newspapers within Melbourne, Australia and flyers and emails sent to parenting professionals and contacts of the researcher, asking them to complete the survey themselves and/or send it on to others who may be eligible. An online survey package was prepared for each of the two parts. For Part 1 only, hard copies of the survey and postage-paid mail back envelopes were available for those who preferred to complete the study off-line. In this part of the study, 11 parents completed the hardcopy and 167 completed the online survey. For Part 2, all participants were online. Participation was anonymous with consent inferred by completion of the survey package. Participants were instructed to think about one of their children currently aged 10–18 years and answer the items accordingly. This child was referred to as the ‘focus child’. Measures The survey in Part 1 included items on demographics (parent age, gender, age and gender of ‘focus’ child, etc.), the draft parental psychological flexibility scale and, for purposes of assessing construct validity, the Acceptance and Action Questionnaire Version 2 [13], described below. The Part 2 survey included demographic items, the draft parental psychological flexibility scale (PPF), adapted as a result of the findings in Part 1 of the study, plus further measures (described below) for assessing construct validity of the PPF (Mindfulness Attention Awareness Scale [15]; Parenting Scale [16]; Alabama Parenting Questionnaire [17]; Parents’ Sense of Competence Scale [18]). Acceptance and Action Questionnaire Version 2 [13] The Acceptance and Action Questionnaire—Revised [13] is a 10-item questionnaire assessing psychological flexibility/inflexibility in adults. Example items include ‘‘I worry about not being able to control my worries and feelings’’ and ‘‘My painful memories prevent me from having a fulfilling life.’’ Participants rate each item on a 7-point Likert from 1 (never true) to 7 (always true), with higher total scores indicating greater inflexibility. In this study, the items in the scale were reversed and the measure used to assess psychological flexibility. The revised version– the 10-item AAQ-2—has a single factor structure and demonstrates adequate construct, concurrent and predictive validity and good reliability, both internal (a = .84) and test–retest (.79–.81) [13]. In the current study, a = .85. It was expected that the AAQ-2 would be positively correlated with psychological flexibility.
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Mindfulness Attention Awareness Scale [15] The MAAS is a 15 item instrument that measures the tendency to be mindful of moment-to-moment experiences. A sample (reversed) item is ‘‘I rush through activities without being really attentive to them’’. Respondents rate each item on a Likert scale from 1 (almost always) through 6 (almost never). Higher scores reflect higher levels of mindfulness. The MAAS has been validated with college, community, and cancer patient samples and shows good test–retest and internal reliability [15, 19]. For this study, a = .91. It was expected that the MAAS would correlate positively with psychological flexibility. Parenting Scale [16] The 10-item Parenting Scale (PS) is designed to measure dysfunctional parenting practices. This version of the PS has two subscales, Laxness and Over-reactivity, plus a total score [16]. The 5-item Laxness scale purports to measure the extent to which parents notice but do not discipline misbehavior, for example ‘‘If saying no doesn’t work I offer my child something nice so he/she will behave’’. The 5-item Over-reactivity scale measures emotional reactivity in the context of discipline encounters, for example ‘‘When there’s a problem with my child things build up and I do things I don’t mean to’’. This version of the PS [16] demonstrates acceptable validity (construct, concurrent and discriminant) and reliability (Total Scale a = .71; Laxness, a = .70; Over-reactivity, a = .74). In the current study, Total Scale a = .78, Laxness, a = .79; Over-reactivity, a = .74. It was included in as a measure of construct validity for the PPF, with the expectation that psychological flexibility would be negatively correlated with measures of poor parenting practice. Alabama Parenting Questionnaire: Short Form [17] The adapted 9-item Australian short form version of the Alabama Parenting Questionnaire has three, 3-item subscales: Positive Parenting, Poor Supervision and Inconsistent Discipline. The measure has been validated for 4–19 year olds and has shown alphas between a = .57 and a = .79 in samples of children from 5 to 18 years [17]. Each item on the scale refers to a parenting practice. Respondents indicate how often they typically use each of these practices on a 5 item scale ranging from Never (1) to Always (5). Example items include ‘‘You let your child know when he/she is doing a good job with something’’ (Positive Parenting); ‘‘You threaten to punish your child and then do not actually punish him/her’’ Inconsistent Discipline); ‘‘Your child fails to leave a note or to let you know where he/she is going’’ (Poor Supervision). It was
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expected that psychological flexibility would be positively related to positive parenting and negatively related to inconsistent discipline and poor supervision. In the current study, Positive Parenting a = .86, Inconsistent Discipline, a = .71; and Poor Supervision, a = .81. Parents’ Sense of Competence Scale [18] This 16-item questionnaire assesses parents’ views of their competence as parents on two dimensions: satisfaction with their parenting role (Satisfaction), and self-efficacy as a parent (Self-Efficacy). Respondents indicate how true each statement is for them on a 5 item scale ranging from Never True (1) to Always True (7). Example items include ‘‘My parents were better prepared to be a good parent than I am’’ (Efficacy); ‘‘My talents and interests are in other areas, not in being a parent’’ (Satisfaction); The PSOC has demonstrated good reliability in past research [18] and in the current study, a = .78 (Efficacy), a = .83 (Satisfaction) and a = .86 (Total Score). The PSOC was included to test construct validity of the PPF, with the expectation of moderate positive correlations between parental psychological flexibility and PSOC subscales. Data Analysis Part 1 Exploratory factor analysis was undertaken using Principal Components Analysis (PCA) with Oblimin rotation, in order to reduce the number of items in the 43 item version of the PPF. Suitability of the data for factor analysis was determined via inspection of the correlation matrix for values greater than .3 (termed the Factorability of R), along with inspection of the Kaiser–Meyer–Olkin (KMO) Measure of Sampling Adequacy for a value greater than .5 and a significant (p \ .05) Bartlett’s Test of Sphericity [20, 21]. Factor extraction used the principal components procedure, rotating factors on the basis of eigenvalues, the Scree test and results of a parallel analysis [20, 21]. Factors were refined by removing cross loading or non-loading items. Subscales were constructed by summing ratings on factor items. Part 2 AMOS version 16 was used to conduct a Confirmatory Factor Analysis on the version of the PPF that was revised in Part 1. First, the factor structure of the PPF was validated and confirmed by running one factor congeneric models (in which the relationship between indicators and the latent variable are direct) on each of the three subscales in Part 1: Cognitive Defusion, Acceptance and Committed Action.
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Secondly, the measurement models for the three PPF subscales were combined in a three factor model to test for discriminant validity. The results from a CFA include estimates of factor variances and covariances, the loadings of the items (indicators) on their respective factors, and the amount of measurement error for each item [22]. A good model will generally have relatively high standardised factor loadings for all items relating to a particular factor ([.70); and discriminant validity between the latent factors (e.g., only small to moderate correlations between the factors) [22]. Five statistical criteria [20, 23] were used to assess model fit: 1) non-significant Chi square statistic (p [ .05); Standardised Root Mean Square Residual (SRMR; p \ .08); Comparative Fit Index (CFI C .95); Tucker-Lewis Index (TLI C .90); and the Root Mean Square Error of Approximation (RMSEA; p \ .06). All three subscales violated the assumptions of multivariate normality and hence the Bollen-Stine bootstrap p was completed as a post hoc adjustment to allow for the non-normality of the data In addition the ‘‘Bollen-Stine bootstrap p’’ bootstrapping procedure was used to account for non-normality [24, 25]. A non-significant Bollen-Stine p is indicative of good fit. Discriminant validity refers to the extent to which a latent variable discriminates from other latent variables. To demonstrate discriminant validity a latent variable is able to account for more variance in the observed variables associated with it than is accounted for by measurement error or other constructs within the conceptual framework. To assess discriminant validity of the PPF, a three factor CFA was conducted. First, the correlations between the three latent factors were inspected to ensure correlations were not close to one. Secondly, a Chi square test of independence was performed, in which the correlation between the two highest correlating latent factors was fixed to 1. The constrained model’s v2 was then compared to the original model’s v2 where the correlation between the constructs is estimated freely. If there is a significant deterioration in model fit when the correlation is assumed to be 1, evidence of discriminant validity is obtained.
Results Part 1: Initial Scale Development Item Development A pool of 56 items relating to psychological flexibility in parenting was developed from a review of the literature on both psychological flexibility and parenting. Item content and wording was modelled on previously developed
Table 2 Parallel analysis: Eigenvalue comparison [28] Component number
Actual Eigenvalue from part 1 PCA
Random order from parallel analysis
Decision
1
8.26
1.86
Accept
2
2.72
1.73
Accept
3
2.28
1.64
Accept
4
1.42
1.56
Reject
measures, primarily the Acceptance and Action Questionnaire [13] and versions of this questionnaire adapted for specific populations [9, 11]. Items on the scale were designed to reflect the processes of psychological flexibility noted earlier: mindfulness, acceptance, cognitive defusion, self-as-context and committed action. Valued-living was not included in this scale as this process can be considered the desired outcome from applying the other five processes to one’s life. Positively and negatively worded items were generated. This pool of items was initially disseminated for review to five parents and five professionals with expertise in contextual behavioral psychology, parenting research and/ or parenting practice. The professionals provided feedback on face validity, theoretical coherence, wording and item clarity, while parents provided feedback on item relevance, clarity, repetition and difficulty. Items which received negative feedback, were judged as unclear or overly complex, or assessed as not reflecting any of the processes of psychological flexibility were removed, resulting in a 43 item draft measure, the Parental Psychological Flexibility Questionnaire (PPF). The 43 item PPF became part of the survey questionnaire completed by parents in Part 1 of this study. They were asked to rate each statement on the PPF as it applied to their parenting on a 7-point Likert scale ranging from 1 (never true) to 7 (always true). Exploratory Factor Analysis Inspection of the correlation matrix, KMO and Bartlett’s Test of Sphericity indicated that the data was suitable for Factor Analysis as shown by a large number of correlations over .3, an initial KMO of .7 and a significant (p \ .000) Bartlett’s Test of Sphericity [20, 21]. The 43 items of PPF were subjected to exploratory factor analysis (EFA) using principal components analysis (PCA), which revealed 11 components with eigenvalues above 1. However, inspection of the Scree plot showed a clear break after the third component and a smaller break after the fourth component. Using the Scree plot and results from Parallel Analysis (see Table 2), it was decided to retain three components for further investigation.
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The three factor solution explained 39.36 % of the variance thus: Component 1: 26.47 %; Component 2: 6.94 %; Component 3: 6.06 %. Oblimin rotation revealed a number of items that either did not load or crossloaded between components. Removal of these items resulted, in a 30-item, three factor solution which explained 44.20 % of the variance (Component 1: 27.52 %; Component 2: 9.08 %; Component 3: 7.61 %). Component 1 had twelve items of which the highest loading was for ‘‘My emotions get in the way of my being the type of parent I would ideally like to be’’. The theme for the items (when reversed) was that private events do not control actions so it was labeled Cognitive Defusion and as such represented one of the processes underpinning psychological flexibility. Component 2 had eight items and was labelled Committed Action since items appeared to tap behavioral responses to emotions. The highest loading was for, ‘‘It is very stressful for me when I am not in control of my child’s activities’’. Component 3 consisted of ten items with the theme for items relating to parental willingness to experience difficult emotions and thoughts and still take positive action with the highest loading item ‘‘I can still take care of my parenting responsibilities even when I don’t feel like it.’’ Thus, this component appeared to tap into the acceptance processes of psychological flexibility and so was named Acceptance. Aspects of mindfulness and self-as-context values appeared to be represented across the three factors. For example, the Cognitive Defusion item ‘‘My painful memories prevent me from parenting the way that I would like’’ contains aspects of cognitive fusion and self-ascontext, with memories being viewed as representing who the parent is and this self-representation limiting their capacity to act. Similarly, with the Acceptance subscale, items such as ‘‘I can get angry with my child and still be a good parent’’ reflects mindful parenting. Overall, the rotated solution revealed the presence of a clear structure with all three components showing a number of strong loadings. This 30 item solution was used to construct subscales for the Parental Psychological Flexibility questionnaire (PPF). The Factor Loadings for the 30 item solution are provided in Table 3. Parental Psychological Flexibility Scale Characteristics Subscales representing each of the factors of the Parental Psychological Flexibility Scale were developed by summing the ratings on items comprising each subscale (with appropriate reversals for all Cognitive Defusion and Committed Action subscale items so that all subscales were in the positive (flexible) direction). Each of the subscales had good internal consistency: Cognitive Defusion (M = 5.64: SD = .77; a = .90); Acceptance (M = 5.30; SD = .75; a = .79); and Committed Action (M = 5.36;
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SD = .76; a = .78) and low levels of skewness and kurtosis (scores \1). Correlations with the AAQ-2 were all significant and positive as expected (Cognitive Defusion .60; Committed Action: .47; Acceptance: .38; p \ .01 in each case). Part 2: Confirming the PPF Factor Structure In order to confirm the factor structure of the PPF and further verify the scale’s psychometric properties the PPF was disseminated to a second sample of parents in Part 2. Their responses were analysed using Confirmatory Factor Analysis. One Factor Congeneric Models One factor congeneric modelling was conducted for each of the three subscales to confirm the content validity of each latent factor (Cognitive Defusion, Committed Action, and Acceptance) and to ascertain if the items specified on each latent factor represented a uni-dimensional measure of the theorised construct. Each model was re-specified via the removal of items that demonstrated high levels of shared variance on the standardised residuals or modification indices. The items retained were those with greater theoretical consistency. Cognitive Defusion The one-factor congeneric model of Cognitive Defusion revealed that the 12 items were not a good fit for the hypothesised factor (v2 = 167.472, df = 54, p \ .001; TLI = .84; CFI = .91; RMSEA = .11; SRMR = .06). The factor loadings were all significant at the p \ .001 level, with standardized factor loadings ranging from .54 to .87. Respecification led to the removal of 4 items and resulted in the data being a good fit for the model (v2 = 25.037, df = 20, p = .20; TLI = .99; CFI = .99; RMSEA = .04; SRMR = .03). The BollenStine p was also non-significant (p = .89). The 8 item model was therefore retained as the final model of Cognitive Defusion. Committed Action As for the Cognitive Defusion subscale, the one-factor congeneric model of Committed Action also revealed that the items were not a good fit for the hypothesised factor (v2 = 60.269, df = 20, p \ .001; TLI = .84; CFI = .89; RMSEA = .10; SRMR = .06). The factor loadings were all significant at the p \ .001 level, with standardized factor loadings ranging from .40 to .67. Two items were removed during respecification resulting in the data being a good fit for the model (v2 = 14.557, df = 9, p = .10; TLI = .96; CFI = .97; RMSEA = .06; SRMR = .04). The Bollen-Stine p was also non-significant (p = .59) suggesting that the data fit
Child Psychiatry Hum Dev Table 3 Factor loadings for the 19 (N = 192) and 30 (N = 178) item versions of the Parental Psychological Flexibility Questionnaire Items
Part 1
Part 2
Factor loading
Factor loading
Bootstrap confidence intervals (95 %)*
Cognitive defusion 1
My emotions get in the way of the being the type of parent I would ideally like to be
.88
.89
.79–.94
2 3
My worries get in the way of me being successful as a parent My emotions cause problems in my relationship with my child
.86 .79
.87 .76
.81–.91 .67–.84
4
It seems to me that most people are better parents than I am
.68
.71
.56–.80
5
My painful memories prevent me from parenting the way that I would like
.63
.57
.43–.70
6
My feelings stop me from doing what I know is best for my children
.59
.72
.59–.82
7
I worry about not being able to control the feelings I have about my children
.55
.68
.52–.78 .39–.66
8
I have to feel in the mood before I can give my child affection or attention
.49
.53
My past makes it difficult for me to parent in a way that I would really like to
.64
–
–
The disciplinary strategies I use with my child are controlled by my emotions rather than by me
.60
–
–
It seems to me that most people manage their children better than I do
.59
–
–
I’m afraid of the feelings I have about my children
.48
–
–
Committed action 9 I could not cope with the guilt if my child did something wrong
.61
.59
.41–.72
10
I don’t let my child do many things with their friends because I don’t think I could cope if something bad happened to him/her
.56
.66
.56–.79
11
I have refused to let my child do things that were important to them because I would worry too much (e.g., spend time with friends, walk to school by themselves)
.56
.73
.61–.82
12
I don’t let my child do things that I’ll worry about
.55
.65
.52–.77
13
I am responsible for my child’s behavior
.54
.37
.16–.51
It is very stressful for me when I am not in control of my child’s activities
.72
Worrying about my child’s wellbeing gets in the way of my doing things that are really important to me
.52
If my child does something wrong I feel it is my fault
.54
Acceptance 14
I can still take care of my parenting responsibilities even when I feel tired, stressed, sad or angry
.57
.65
.51–.76
15
I can get angry with my children and still be a good parent
.55
.39
.19–56
16
I can have a good relationship with my children no matter what I am thinking and feeling
.47
.52
.41–.71
17
Watching my child deal with new experiences as he/she grows up (e.g., starting high school, first kiss, puberty) is interesting and exciting
.45
.52
.32–.66
18
I am able to separate how I respond to my children from how I am feeling
.44
.76
.62–.84
19
The unpredictability of being a parent is one of the things that makes parenting fun and rewarding
.34
.46
.25–.59
I can still take care of my parenting responsibilities even when I am doubting my abilities to parent
.73
I am able to take care of my parenting responsibilities even when I don’t feel like it I can worry about my children and still be a good parent
.72 .61
If I am worried about an activity my child wants to do it must be for a good reason
.52
Items without numbers in the first column were omitted during the CFA in Part 2
the model well when allowance is made for non-normality. The 6 item model was therefore retained as the final model of Committed Action.
Acceptance The Acceptance one-factor congeneric model items were not a good fit for the hypothesised factor (v2 = 73.928, df = 35, p \ .001) although the comparative
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Child Psychiatry Hum Dev Table 4 Correlations between the PPF and the MAAS, parenting and adolescent variables MAAS
OR
Lax
PosPar
ID
PSup
TPSOC
Satis
Eff
Cognitive defusion
.57**
-.60**
-.38**
.24**
-.40**
-.30**
.66**
.64**
.49**
Acceptance
.38**
-.43**
-.29**
.43**
-.21**
-.15*
.51**
.44**
.46**
Committed action
.42**
-.22**
-.19**
-.43**
-.16*
.26**
.28**
.15*
-.09
MAAS Mindfulness Attention Awareness Scale, OR Over-reactivity, Parenting Scale, Lax Laxness, Parenting Scale, PosPar Positive Parenting, Alabama Parenting Questionnaire, ID Inconsistent Discipline, Alabama Parenting Questionnaire, PSup Poor Supervision, Alabama Parenting Questionnaire, Total PSOC Total Parents’ Sense of Competence Scale, Satis Satisfaction, Parents’ Sense of Competence Scale, Eff Efficacy, Parents’ Sense of Competence Scale * p \ 0.05 level (2-tailed); ** p \ 0.01 level (2-tailed)
fit indices provided some support for the model (TLI = .90; CFI = .92; RMSEA = .08; SRMR = .06). The factor loadings were all significant at the p \ .001 level, with standardized factor loadings ranging from -.25 to .90. Three items were removed during respecification resulting in the data being a good fit for the model (v2 = 13.032, df = 14, p = .52; TLI = 1.0; CFI = 1.0; RMSEA = .00; SRMR = .03). The Bollen-Stine p was also non-significant (p = .98) suggesting that the data fit the model well when allowance is made for non-normality. The 7 item model was therefore retained as the final model of Committed Action. Discriminant Validity of the PPF Subscales Discriminant validity testing involved assessment of whether the three revised factors had adequate discriminant validity in relation to one another, with each of the factors measuring a unique element of psychological flexibility in parenting. To investigate this, the CFA was rerun as a three factor model. Inspection of the resulting model of psychological flexibility using Maximum Likelihood (ML) estimation did not reveal a good fit for the hypothesised model, v2 = 273.286, df = 186, p \ .001. The standardised factor loadings were all significant, ranging from .35 to .89. Inspection of modification indices: regression weights revealed problems with crossloading between two items on different subscales. Consideration of similarities between items in the same subscale led to the removal of two items. This resulted in improved support for the hypothesised model. Inspection of the approximate fit indices showed some support for the model (TLI = .96; CFI = .96; RMSEA = .04; SRMR = .06) even though the Chi square remained significant (v2 = 195.387, df = 149, p \ .01). The standardised factor loadings were all significant, ranging from .35 to .89. To further check discriminant validity, a Chi square test of independence was performed to check if the observed Chi square would differ significantly if the correlation between the factors was forced to be 1. The Chi square test was performed on the
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largest correlation between the three factors, Cognitive Defusion to Acceptance (r = .61). Results from the Chi square test of independence increased the Chi square by 4.5 points with 1 associated degree of freedom to v2 = 199.90, df = 150, p = .03. These results demonstrate that there was a significant deterioration in the model fit when the correlation was assumed to be 1 and therefore provided confirmation of discriminant validity. The 19-items reflecting the three factors, their respective factor loadings and confidence intervals are listed in Table 3. Overall, the analysis supported a 19 item scale consisting of three conceptually separate subscales Cognitive Defusion (8 items; M = 5.6, SD = .96; a = .88), Committed Action (6 items; M = 5.1, SD = .98, a = .75), Acceptance (7 items; M = 5.4, SD = .8 3, a = .74). All correlations between subscales were significant and in the expected positive direction (Cognitive Defusion and Committed Action .42; Cognitive Defusion and Acceptance .61; Committed Action and Acceptance: .25; p \ .01 in each case). The correlations small to moderate, providing further support for discriminant validity, however were not sufficiently large to allow the formation of a secondorder construct (Total Scale) for the PPF [25]. The Factor Loadings for the 19-item solution are provided in Table 3. Validity Table 4 shows intercorrelations between PPF subscales and other measured variables. Support for construct validity of the PPF comes from its significant correlations with the mindfulness measure, the MAAS. Further support for construct validity was indicated by the significant correlations of the PPF subscales in the expected directions (in 26 of 27 instances) with measures of theoretically related but distinct constructs—parenting practices (positive parenting, inconsistent discipline, poor supervision, over-reactivity and laxness) and parents’ sense of competence (satisfaction, efficacy and total scale). The lack of correlation between the Committed Action subscale and the
Child Psychiatry Hum Dev
Positive Parenting subscale was the exception to these significant findings.
Discussion This paper describes the development and initial validation of the Parental Psychological Flexibility Questionnaire (PPF), a parent-report measure designed to assess psychological flexibility as it applies to a general parenting context and specifically to parenting pre-adolescents and adolescents aged 10–18 years. The paper is among the first to describe and validate a measure of psychological flexibility as it relates to the general parenting context and specifically to parenting of adolescents. Overall, results indicate that the PPF may be useful for assessing parental psychological flexibility. Exploratory Factor Analysis and Confirmatory Factor Analysis with two separate samples resulted in a 19-item measure consisting of three stable factors measuring distinct but overlapping aspects of the construct of psychological flexibility within a general parenting context. The three factors appear to be measuring processes associated with psychological flexibility: Acceptance, Cognitive Defusion and Committed Action. The Acceptance subscale of the PPF seems to measure the degree to which parents accept that difficult emotions and thoughts are part of their parenting and that they do not need to change them or avoid them to be effective as a parent. The Cognitive Defusion subscale (in its reversed form) appears to measure parents’ recognition that their emotions and thoughts are not literally in control of their actions or decisions relating to their parenting and are thus separate from their capacity to act. The Committed Action subscale (in its reversed form) seemed to be measuring parents’ ability to step back from their adolescent’s choices and actions, allowing them to assert their independence in appropriate ways, even when these raise the parent’s anxiety levels, thus tapping into the process of committed action. Criteria for judging internal consistency has been variously defined in the literature, with Cronbach’s alpha’s a C 0.9 considered ‘Excellent’ and Cronbach’s alpha’s a C 0.7 and \0.9 considered Good [26, 27]. The PPF subscales displayed adequate reliability with the Cognitive Defusion subscale’s internal consistency within the excellent range for Part 1 and approaching the excellent range for Part 2. The Acceptance and Committed Action subscales also showed good internal consistency across both Parts 1 and 2 of the study. Given that there were no other measures of psychological flexibility in parenting available, the small to moderate correlations found between the PPF subscales and measures of similar (but not identical) theoretically related constructs (the AAQ-2 [13], MAAS [15], PSOC [18], Alabama [17] and the
Parenting Scale [16]) were to be expected and provide some evidence of adequate construct validity. However, additional research on the scale with separate samples is clearly required to more thoroughly establish validity. Additionally, the Committed Action subscale did not relate well to positive parenting subscale of the Alabama and some items on the scale were not as clearly identifiable as being related to the committed action process of psychological flexibility (e.g., ‘‘I could not cope with the guilt if my child did something wrong’’). This factor warrants further investigation. A number of limitations must be acknowledged. Both studies comprised samples of convenience and may therefore not be representative of a general sample of parents of adolescents. Both samples were predominantly Australian born with a high proportion employed and holding university qualifications. Additionally fathers were underrepresented, making up approximately 11 per cent in Part 1 and 10 per cent in Part 2. Given that post hoc adjustments were made to the PPF constructs in Part 2 and to better understand the influence of psychological flexibility in parenting, future research specifically targeting fathers, diverse cultural groups, parents of younger children and clinical samples is needed. In addition, in order to ascertain the utility of the measure for clinical practice, studies focusing on assessing test–retest reliability (to establish the stability of responses over time), and on postintervention clinical change are important, as is further research on the validity of the scale.
Summary The Parental Psychological Flexibility Questionnaire (PPF) is a new measure that demonstrates promise as a research and clinical tool in both the parenting and contextual behavioral fields. The PPF, consisting of 19 items divided across three factors, Cognitive Defusion (8 items), Acceptance (6 items) and Committed Action (5 items), provides a broad assessment of the processes of psychological flexibility The measure demonstrated a stable factor structure with adequate reliability and validity and items relevant to the general context of parenting. The measure shows promise as a tool for better understanding the ways in which psychological flexibility influences parenting and adolescent outcomes in both a research and practice context.
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