title: Development and initial validation of the Cardiovascular Disease Acceptance and Action Questionnaire (CVD-AAQ) in an Italian sample of cardiac patients.
abstract: Psychological inflexibility refers to the attempt to decrease internal distress even when doing so is inconsistent with life values, and has been identified as a potential barrier to making and maintaining health behavior changes that are consistent with a heart-healthy lifestyle. Disease- and behavior-specific measures of psychological inflexibility have been developed and utilized in treatment research. However, no specific measure has been created for patients with heart disease. Thus, the CardioVascular Disease Acceptance and Action Questionnaire (CVD-AAQ) was developed. The present study is aimed to evaluate the psychometric properties of the CVD-AAQ and to explore its association with measures of psychological adjustment and cardiovascular risk factors in an Italian sample of 275 cardiac patients. Exploratory factor analysis showed a structural one-factor solution with satisfactory internal consistency and test-retest reliability. The relation with other measures was in the expected direction with stronger correlations for the theoretically consistent variables, supporting convergent and divergent validity. CVD-AAQ scores were associated with general psychological inflexibility, anxiety and depression and inversely correlated with psychological well-being. Moreover, the results showed that CVD-AAQ scores are associated with two relevant risk factors for cardiac patients, namely low adherence to medication and being overweight. In sum, results suggest that the CVD-AAQ is a reliable and valid measure of heart disease-specific psychological inflexibility with interesting clinical applications for secondary prevention care.
authors.affiliation: Psychology Research Laboratory, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico Milan, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy.
authors.forename: Chiara A M
authors.initials: CA
authors.lastname: Spatola
authors.affiliation: Psychology Research Laboratory, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico Milan, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy.
authors.forename: Emanuele A M
authors.initials: EA
authors.lastname: Cappella
authors.affiliation: The Ohio State University Columbus, OH, USA.
authors.forename: Christina L
authors.initials: CL
authors.lastname: Goodwin
authors.affiliation: Psychology Research Laboratory, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico Milan, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Baruffi
authors.affiliation: Cardiology Division, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico Milan, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Malfatto
authors.affiliation: Cardiology Division, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico Milan, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Facchini
authors.affiliation: Psychology Research Laboratory, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico Milan, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Castelnuovo
authors.affiliation: Psychology Research Laboratory, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico Milan, Italy ; Faculty of Psychology, eCampus University Novedrate, Como, Italy.
authors.forename: Gian Mauro
authors.initials: GM
authors.lastname: Manzoni
authors.affiliation: Psychology Research Laboratory, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico Milan, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Molinari
keywords: Cardiovascular Disease Acceptance and Action Questionnaire; acceptance; adherence to treatment; cardiovascular disease; experiential avoidance; psychological inflexibility