Test-retest reliability and further validity of the cognitive fusion questionnaire

Abstract

Introduction Acceptance and Commitment Therapy (ACT) has developed from traditional behavioural theory and seeks to reduce experiential avoidance and increase psychological flexibility. It is argued to be distinct from cognitive therapy and has been used to treat a variety of mental health problems in addition to chronic pain. ACT is linked to Relational Frame Theory and the research developments associated with this. One central process of ACT is termed ‘cognitive defusion’ and this process is used to encourage individuals to become less identified with the content of their cognitions. It is important to measure the extent to which individuals become ‘fused’ with their cognitions and a Cognitive Fusion Questionnaire (CFQ) has been developed to do this. The current studies build upon earlier research by subjecting the CFQ to further reliability and validity testing and assessment of its factor structure. Method A community sample was used throughout. The majority of participants took part online, however, some participants completed paper copies of the questionnaires. Study one had a sample of 47 and focused on construct validity of the CFQ where participants completed this measure and also measures of similar and distinct constructs. The other measures included a mindfulness questionnaire, a measure of experiential avoidance and a social desirability questionnaire. Study two concerned the test-retest reliability of the CFQ. There were 82 participants in this study who completed the CFQ on two occasions, one month apart. In this study, participants also completed a measure of anxiety and depression symptoms. Study three had 144 participants and assessed the factor structure of the CFQ. Results Results from study one indicate that the CFQ negatively correlates with a measure of mindfulness and positively correlates with a measure of experiential avoidance. This study also found that the CFQ has no relationship with a measure of conscious attempts to appear more desirable. Results from study two show that there is a strong positive correlation between scores on the CFQ at testing time one and testing time two. The CFQ was also found to correlate positively with a measure of anxiety and depression symptoms and to mediate the relationship between anxiety scores at testing time one and testing time two. Confirmatory factor analysis was used in study three to assess the factor structure of the CFQ and found a two factor model was the best fit for the data. Discussion The results are considered in relation to relevant research. Limitations of the current studies are assessed and possibilities for future research discussed. In particular, cognitive fusion is discussed in relation to anxiety and depression symptoms. The similarities between the CFQ and a measure of experiential avoidance are discussed and the different aspects of measurement are reflected upon.