Targeting Psychological Flexibility in Youth to Enhance Health-Related Behaviors

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Samuel Andrew Faulkner (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: Background: Adolescents are uniquely vulnerable to a wide range of psychological issues and often , concerns inadequately addressed. When addressed , mental health concerns are commonly handled in schools , which are uniquely positioned to prevent social and emotional difficulties. Universal , social and emotional learning curricula have demonstrated efficacy within a framework providing multi-tiered systems of support and represent promising methods for addressing youth mental health with a broad scope. Unfortunately , implementation of social emotional learning curricula presents multiple barriers to implementation and limited understanding of the processes of change , necessary procedures , relevant contextual variables , and differential impact of curricula on positive student functioning with high school students. Traditional models used to address mental health in adolescents often take a deficit-oriented approach. An emerging developmental model of behavior change incorporates principles of Acceptance and Commitment Therapy , Positive Psychology , Behaviorism , Relational Frame Theory , and Evolution Science to target functional classes of behavior and facilitate health-promoting behaviors in youth. Purpose: The present study is a preliminary investigation examining the feasibility , acceptability , efficacy , participant characteristics (e.g. , trait mindfulness) , and processes of change (e.g. , psychological inflexibility) associated with a universal preventive intervention based on a process-oriented , developmental model of behavior change targeting health-promoting behaviors. Method: Students (n = 118) were recruited from 6 Health/PE classes in a rural , underserved high school. The participant sample consisted of 48% African-American/Black , 27% Hispanic/Latino , 22% Caucasian/White , and 3% American Indian/Native American. Almost all (i.e. , 96%) of participants reported receiving free or reduced lunch. Participants were assigned to an enhanced Health/PE condition or a comparison condition. Participants in the enhanced Health/PE condition received 6 weeks of a universal preventive intervention targeting social and emotional learning skills , sleep , and physical activity. Results: The enhanced Health/PE curriculum was feasibly implemented with satisfaction from students and teachers. Participants in the enhanced curriculum did not exhibit significant changes in psychological inflexibility , sleep hygiene , or physical activity from baseline to post-intervention; however , changes in amount of time engaging in physical activity were present at one-year follow-up relative to the comparison condition. Trait mindfulness did not moderate the relationship between condition assignment and treatment outcomes. Psychological inflexibility did not mediate the relationship between condition assignment and health-related outcomes. Post-hoc analyses indicated no significant differences between pre- and post-test psychological inflexibility scores for students with clinically significant ratings. Due to a relatively small number of participants (n = 14) meeting the clinically significant cutoff on the AFQY-8 (total score of at least 15) , post hoc analyses of these participants were conducted to determine potential differential impact from programming. Nine participants in the DNA-v-PE condition and four in the comparison condition exhibited clinically significant ratings of psychological inflexibility at baseline. Independent samples t-tests were conducted to compare pre- and post-scores of psychological inflexibility for both groups. Participant pre-test scores (M = 17.79 , SD = 2.99) did not differ significantly from post-test scores (M = 13.15 , SD = 8.55) , t(25) = 1.91 , p = .07 , d = .73 , 95% CI [-.05 , 1.51). Pre and post scores were also compared within conditions. DNA-v-PE participants pre-test scores (M = 17.56 , SD = .82) did not differ significantly from post-test scores (M = 14.44 , SD = 9.29) , t(16) = .97 , p = .35 , d = .46 , 95% CI [-.49 , 1.39]. Comparison condition participants pre-test scores (M = 18.2 , SD = 1.83) did not differ significantly from post-test scores (M = 10.25 , SD = 6.8) , t(7) = 2.19 , p = .07 , d = 1.47 , 95% CI [-.09 , 2.94). Results indicate both conditions exhibited non-significant reductions in psychological inflexibility from baseline to post-intervention. Notably , although there were non-significant changes in scores for participants in the either condition , changes were associated with a large effect (i.e. , Cohen's d > .8) in the comparison condition and a small to medium effect in the DNA-v-PE condition. Discussion: Findings were reviewed in the context of research and clinical implications of process-oriented , social and emotional learning curricula and the importance of evaluating contextual variables , and moderators and mediators of treatment. Practical implications of conducting universal preventive interventions in schools and limitations of the current study are discussed.

Additional Information

Publication

Dissertation

Language: English

Date: 2019

Keywords

Psychological Flexibility

Subjects

Email this document to