Psychological flexibility in mild traumatic brain injury: an evaluation of measures

ABSTRACT

Primary objective

In this study, we examined the psychometric properties of measures of psychological flexibility in a mild traumatic brain injury (mTBI) sample.

Method and Procedures

Adults who sustained a mTBI (n = 112) completed the Acceptance and Action Questionnaire – Acquired Brain Injury reactive avoidance subscale (AAQ-ABI (RA). Exploratory factor analysis and Rasch analysis were conducted to evaluate the facture structure, dimensionality, and differential item functioning. Construct validity was determined by correlating the AAQ-ABI (RA) with the Acceptance and Action Questionnaire-Revised (AAQ-II) and Fear Avoidance after Traumatic Brain Injury (FAB-TBI).

Main outcome and Results

The AAQ-ABI (RA) was found to have strong internal consistency (Cronbach’s α = 0.87). Consistent with previous findings, the AAQ-ABI (RA) had one distinct factor. Fit to the unidimensional Rasch model was adequate ($\chi$² (18) = 22.5, p = .21) with no evidence of differential item functioning across person factors examined. The AAQ-ABI (RA) also had expected relationships with theoretically relevant constructs.

Conclusions

The AAQ-ABI (RA) appears to be a psychometrically sound measure of psychological flexibility in mTBI.

KEYWORDS:

• Mild traumatic brain injury
• psychological flexibility
• psychometrics
• post-concussion symptoms

Acknowledgments

We thank Proactive Rehabilitation for their support and collaboration with this research.

Disclosure of interest

The authors have no disclosures and no competing financial interests exist.

Additional information

Funding

The study was funded by a Health Research Council of New Zealand Foxley Clinical Fellowship (20/041)