Cross-cultural adaptation and validation of the core psychometric instruments used in acceptance and commitment therapy (ACT): assessing the validity and reliability of ACT measures in the Chinese populations

Abstract

Aims: This research was aimed to cross-culturally validate seven reliable measures that frequently used in Acceptance and Commitment Therapy (ACT) for the Chinese populations. The Acceptance and Action Questionnaire-II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), Engaged Living Scale (ELS), Bref Experiential Avoidance Questionnaire (BEAQ), Self-Compassion Scale (SCS), and Five Facet Mindfulness Questionnaire (FFMQ), and Valued Living Questionnaire (VLQ) were selected to be validated. Design and Methods: The ACT measures for Chinese people were adapted based upon the results of 800 non-clinical participants and 154 clinical participants in China. Various psychometric properties had been investigated in four studies, including content validity, factorial validity, reliability, measurement invariance, convergent validity, incremental validity and potential criterion validity. Results: After the validation, the Chinese version of AAQ-II, CFQ, and VLQ (C-AAQ-II, C-CFQ, and C-VLQ) had retained all the items and a one-factor model. The other validated measures, including the Chinese version of ELS, BEAQ, SCS, and FFMQ (C-ELS, C-BEAQ, C-SCS, and C-FFMQ) had all eliminated some items or changed in the factorial model. The adapted Chinese version of all the above measures showed good factorial validity and reliability in both non-clinical and clinical samples. The C-AAQ-II, C-CFQ, C-ELS, C-SCS, and C FFMQ also demonstrated good convergent validity and might be able to predict the overall psychological distress and quality of life, whereas C-BEAQ showed relatively poor convergent validity and insufficient ability to predict psychological symptoms. The C-VLQ revealed acceptable convergent validity in both samples, whereas it weakly correlated with other ACT constructs, psychological symptoms and quality of life when applied to the non-clinical participants. Moreover, except C-BEAQ, it had been shown that all the other adapted measures might be able to distinguish the clinical participants from the non-clinical participants. Conclusion: The psychometric properties of validated ACT measures might suggest that C-AAQ-II, C-CFQ, C-ELS, C-SCS, C-FFMQ, and C-VLQ have overall good validity and reliability. However, the C-BEAQ retained a less valid construct in the Chinese context. The discussions were also made on cross-cultural validation issues, cross-cultural perception of ACT concepts, implementation of Chinese ACT measures in research and clinical practice, strengths, limitations and proposing future research directions.