The buffering role of psychological flexibility in the association between symptom severity and mental health in individuals with persistent physical symptoms

Abstract

Individuals with persistent physical symptoms (PPS) often report a poor quality life and are known to have high comorbidity rates with mental disorders. Occasional evidence suggests psychological flexibility can protect individuals with PPS from the mental burden of their symptoms. However, to inform treatment, there is a need to replicate this finding as well as to identify which components of psychological flexibility buffer the relation between symptom severity and mental health. This study made use of the Flexibility Index Test (FIT-60) to measure psychological flexibility. The aim was to examine (1) the underlying components of psychological flexibility by performing a series of factor analyses on the data of a large sample (N = 1529), and (2) which factor-analytically derived components of psychological flexibility buffered the association between symptom severity and mental health in individuals with PPS (N = 429). Results suggested a two-factor solution, consisting of a mindfulness and acceptance factor and a commitment and behavior change factor. The first factor was found to buffer the association between symptom severity and mental health in individuals with PPS. The study provided insight into the role psychological flexibility components play in the mental health of individuals with PPS and the therapeutic approaches that might be most suitable to preserve mental health. The suggestion that mindfulness and acceptance processes mitigate the consequences of symptom severity on mental health more clearly than commitment and behavior processes, indicates that mindfulness and acceptance based management may be more fruitful than value and action based interventions for individuals with PPS. This should be examined in clinical experimental studies.