Willingness and Acceptance of Delusions Scale: early findings on a new instrument for psychological flexibility

ABSTRACT

Acceptance and Commitment Therapy and related constructs (experiential avoidance, cognitive defusion and committed action) have recently been applied to psychosis. However, with a few exceptions, this application has not resulted in symptom-specific assessment instruments. The current work intends to develop a measure for assessing experiential acceptance regarding delusions (the Willingness and Acceptance for Delusions Scale) and to conduct a preliminary study of its psychometric properties in a sample of 91 patients with a psychotic disorder, mostly male (87%), single (86%), unemployed (44%), presenting with a schizophrenia diagnosis (71%), and currently with delusions (last week – 52%). Exploratory factor analysis yielded a three-factor structure (Acceptance and Action, Non-entanglement and Non-struggling), which adequately fitted the data and reflected the intended constructs within an Acceptance and Commitment Therapy framework. Scores from all factors achieved adequate reliability and were associated with mindfulness and satisfaction with life. These early findings point to the internal and construct validity and reliability of the scores of the WADS. Although further research into the scale’s psychometric properties, particularly construct validity, is needed, its use in research and clinical practice with psychosis populations seems substantiated.

KEYWORDS:

• Acceptance and Commitment Therapy
• delusions
• psychosis
• willingness

Acknowledgments

The authors would like to acknowledge the collaboration of the patients and clinicians from the Psychiatry and Mental Health Departments of the Baixo Vouga Hospital Centre (Aveiro, Portugal), Coimbra University and Hospital Centre (Coimbra, Portugal), Leiria-Pombal Hospital Centre (Leiria, Portugal), Magalhães Lemos Hospital (Oporto, Portugal) and Tondela-Viseu Hospital Centre (Viseu, Portugal) for which we are very grateful.

Compliance with ethical standards

The present study meets the ethical standards for conducting research with human subjects (Portuguese Data Protection Authority).

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research has been supported by the first author Ph.D. Grant (SFRH/BD/96092/2013), sponsored by FCT (Portuguese Foundation for Science and Technology)